SOC 204 Goldberg Ch 16 Week 9
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Drugs Across the Spectrum by Goldberg Chapter 16 Drug Prevention and Education
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SOC 204 Goldberg Ch 16 Week 9
- 1. SOC 204 Drugs & Society Goldberg Chapter 16 Drug Prevention and Education http://digital.films.com/PortalViewVideo.aspx?xtid=7683 http://ezproxy.wwcc.edu:2048/login?url=http:// digital.films.com/PortalPlaylists.aspx?aid=7539&xtid=7683
- 2. How is your group doing? A. Awesome. We are the best! B. Okay. C. Scrambling, but getting by. D. Sinking fast. Aw esom e.W eare the best! Okay. Scram bling,butgettingby. Sinkingfast. 25% 25%25%25% Response
- 3. Approaches to Prevent Drug Abuse What should be the goals of drug education and prevention? When should drug education and prevention efforts be initiated? What education and prevention efforts are effective? Who should be responsible for drug education and prevention?
- 4. Funding Drug Prevention In the US, most funds for drug prevention come from the federal government 2012 National Drug Control Budget: $1.7 billion was allocated to drug prevention out of a budget of $26.2 billion Most community leaders favor spending a larger portion on reducing demand rather than supply of drugs
- 5. Agencies Substance Abuse and Mental Health Services Administration (SAMHSA) is responsible for: Center for Substance Abuse Prevention (CSAP) National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Drug Abuse (NIDA) Office of Treatment Improvement National Institute of Mental Health (NIMH)
- 6. Drug Prevention in Retrospect 1970s: Primary focus was to reduce the supply of drugs by stopping their importation, sale, and manufacture Interdiction remains a popular strategy but now is complemented by other measures 1980s: Some drug experts began to contend that prevention should be directed toward the underlying factors that contribute to drug abuse
- 7. Drug Prevention in Retrospect Society was concerned primarily with hard drugs such as heroin, LSD, cocaine, crack, and PCP Soft drugs such as alcohol, tobacco, and marijuana are known as gateway drugs The primary strategy of CSAP is to keep young people from experimenting with drugs at all
- 8. Effectiveness of Prevention Programs Problems in assessing effectiveness of programs: Absence of control groups Poor data collection Groups that are too small Inappropriate statistics Lack of follow-up to determine how long any change in drug use persisted
- 9. School-Based Programs Five essential criteria: 1. Adequate hours of curricula, over at least three years 2. Peer involvement 3. Emphasis on social influences, life skills, and peer resistance 4. Change in perceived norms 5. Involvement of parents, peers, and the community in changing norms
- 10. Did you get drug prevention or education in school? A. Yes B. No C. Not sure Yes No Notsure 33% 33%33% Response
- 11. Goals of Drug Prevention To prevent the individual from beginning drug use To minimize the risks of drugs to the user To reduce the risks of drug use to society To prevent drug dependency To teach responsible drug use To stop drug use after patterns have been established To delay the onset of drug use
- 12. How effective was the program in your school? A. Great, I think it worked B. It worked for me. C. Horrible, people still used drugs, it made no impact. Great,Ithinkitw orked Itw orked form e. Horrible,people stilluse... 33% 33%33% Response
- 13. Levels of Drug Prevention Primary prevention: Strives to reach people before they start using alcohol, tobacco, or other drugs Should be initiated at a young age because most children already have tried drugs, especially alcohol, by the time they get to high school Includes drug education, mass media campaigns, community-oriented programs, drug testing, and legislation
- 14. Levels of Drug Prevention Secondary prevention: Attempts to minimize potential damage resulting from drug use by targeting people who have experience with drugs. Considered an early intervention stage Tertiary prevention: Geared to heavy drug users and those whose patterns of drug use are well established Basically refers to drug treatment
- 15. A teacher develops a small group for children who have anger problems. This prevention model is: Response 33% 33% 33% A. Primary B. Secondary C. Tertiary
- 17. Identifying High Risk Youth High risk behaviors include: Delinquent behavior, self-destructive behaviors, and dropping out of school Risk factors include: Individual behavioral factors Individual attitudinal factors Individual psychosocial factors Family factors Community environmental factors
- 18. Drugs and Delinquent Behavior
- 19. Resilient Children Many children from impoverished backgrounds display resiliency despite the presence of major life stressors Characteristics of resilient children: Flexible, responsive, adaptable, and active Have positive relationships Empathetic, caring, persistent, competent problem- solvers, success oriented, and educationally motivated Able to disengage from dysfunctional family environments
- 20. At-Risk Factors Hereditary and Familial Factors: Sons of men with alcohol problems are more likely to have alcohol problems Rates of dependence are greater if siblings are dependent Family history of antisocial behavior or criminality increases the risk of drug problems Lack of supervision of children after school is related to drug use
- 21. At-Risk Factors Psychosocial Factors: Peer pressure Low self-esteem Low self-efficacy Sensation seeking Lack of social skills Rebelliousness against authority Lack of commitment to school Attraction to deviance Unfavorable attitudes toward adult behavior
- 22. At-Risk Factors Biological Factors: Different amounts of pleasure derived from drugs Different amounts of self-control Community Factors: Communities where people move often Extreme poverty and deprivation Communities that lack social support and controls regulating behaviors, including drug use
- 23. Preventing High-Risk Behavior Education: Poor school performance and low expectations for school are strong predictors of drug use School alternative programs focusing on community and recreational activities, physical activities, and job training help youths at risk to stay off drugs Teachers may be role models for helping children to develop resilience
- 24. Head Start Preschool programs such as Head Start help at-risk children
- 25. Preventing High-Risk Behavior Role of parents: Parental drug use greatly increases the likelihood of children’s drug use Parents who have high expectations for their children foster academic success and resilience Community efforts: Drug use is prevalent in impoverished, urban neighborhoods Jobs have been shown to help curb drug use
- 26. Preventing High-Risk Behavior Barriers to community prevention efforts: Leaders’ lack of perceived empowerment to continue prevention work Insufficient preparation for adopting successful programs Public resistance to spending more money on drug prevention programs after ineffective programs Idea that programs that are effective in one community will not necessarily work in other communities
- 27. Drug Education Evolution in Drug Education: 1970s: Information about the dangers of drugs Mid 1970s: Values clarification focused on the underlying values contributing to drug use Alternatives approach substitutes a positive addiction for the negative addiction More emphasis on health in general and less emphasis on the pharmacology of drugs Current education emphasizes developing resilience skills, learning peer-refusal techniques, and gaining life skills
- 28. Limitations of Drug Education Problems with Drug Education: Teachers often do not keep up with latest information Students sometimes know more about drugs than teachers do Some teachers are judgmental or moralistic Goals of drug education are often unclear Goals of drug education are often unrealistic
- 29. Goals of Drug Education Possible goals: To impart knowledge Reducing drug abuse or dependency Preventing or delaying first-time drug use Curtailing students’ drug use Teaching responsible drug use
- 30. One-Size-Fits-All Drug Education What Works: Schools Without Drugs Objectives 1. Valuing and maintaining sound personal health and understanding the effects of drugs on health 2. Respecting laws and rules that prohibit drug use 3. Recognizing and resisting pressure to engage in drug-taking behavior 4. Promoting activities that reinforce a positive, drug-free lifestyle
- 31. Current Approaches to Drug Education Personal and Social Skills Training: Young people who rate high in self-efficacy are more likely to avoid harmful patterns of drug use Skills training: A drug prevention program in which one learns skills to prevent drug use ○ Includes skills for resisting media and interpersonal influences, problem-solving and decision-making, relieving stress and anxiety, relaxation, self-control, self-esteem, interpersonal relations, and assertiveness
- 32. Current Approaches to Drug Education Social Norms Approach: Goal is to correct misperceptions of students and reduce alcohol use Resistance Skills Training: Involves recognizing, managing, and avoiding situations that may encourage drug use
- 33. Current Approaches to Drug Education Drug Prevention Programs: Project ALERT has been shown to reduce weekly alcohol and marijuana use, at-risk drinking, and alcohol use resulting in negative consequences, as well as attitudes and perceptions conducive to drug use Life Skills Training (LST): students are taught how to avoid being persuaded by others, to manage anxiety, to communicate more accurately, to be assertive, and to enhance their self-esteem
- 34. Current Approaches to Drug Education Drug Abuse Resistance Education (DARE): Police officers go to classrooms and teach elementary students about drugs and personal safety Had little impact on drug use Just Say No! Adequate for some students, but not for others Some students do not recognize peer pressure or have the skills to refuse drugs
- 35. DARE improves relationships between police, children, and schools
- 36. Effectiveness of Drug Education Components of Effective Programs: Based on an understanding of theory and research Information is developmentally appropriate; short- term, negative social consequences are emphasized Emphasize social resistance skills training Includes normative education Teachers use interactive teaching techniques Teachers receive training and support Time devoted is sufficient and continued Programs are culturally sensitive. School programs include family, community, and media Evaluation is necessary to determine effectiveness
- 37. Health Education Drug education at the secondary level typically is taught in health education classes Sequential health education from K through 12th grade had a positive effect on knowledge, attitudes, and behaviors Administrative support and teacher training are important to the success of health education
- 38. Peer Programs In some, older students teach younger students about drugs In other programs, peers facilitate discussions about drugs with others of the same age, or peers counsel peers Besides acting as role models, peer leaders have to be able to communicate effectively Peer programs were most effective with the average student; for at-risk students, alternative programs were most effective
Editor's Notes
- Society’s Attempts to Limit Drug Availability Key facts As long as there is a market for drugs, there will be people to supply them To attack the source of the problem, the demand for drugs must be eliminated Drugs will never disappear, so people need to learn to live in a world that includes them Our society has accepted the continued existence of tobacco and alcohol despite the harm they cause Is it possible to teach people to coexist with legal and illegal substances that can impair their health? Defining Goals and Evaluating Outcomes Goal of presenting negative information about drugs in schools = prevention of use Programs should be evaluated according to how many students in the program later tried drugs Until the early 1970s, most drug prevention programs were not evaluated TYPES OF PREVENTION Public health model: primary, secondary, and tertiary prevention Primary prevention Aimed at young people who have not yet tried the substances in question May encourage abstinence and help teach people how to view the potential influence of drugs on their lives, emotions, and social relationships Must avoid giving information in ways that arouses children’s curiosity and encourages them to try the substances in question Goals Prevention of use of other, more dangerous substances Prevention of more dangerous forms of use Example = college programs encouraging responsible use of alcohol Tertiary prevention Aimed at people have been through substance abuse treatment or who stopped using a drug on their own Goal is relapse prevention Institute of Medicine’s “continuum of care” Prevention Treatment Maintenance Classification scheme for prevention efforts Universal prevention Selective prevention Indicated prevention Universal prevention = for an entire population Example: community, school Selective prevention = for high-risk groups within a population Example: students doing poorly in school Indicated prevention = for individuals who show signs of developing problems Example: adult arrested for a first offense of driving under the influence of alcohol Don’t be a Patsy Advertisement Campaign The ads showed an over-protective mother “patting down” her daughter before she left the house. The ad ended with “Don’t be a Patsy. Learn a better way at drugfree.org.” The advertisements are a shift from the 1980s “This is your brain on drugs ads, which overstated the harmful effects of drugs on young people. These types of embellishments decrease the credibility of drug educators and lead young people to reject all drug-related information from so-call informed sources.
- Figure 16.1 Drug Prevention Continuum
- Hereditary and Familial Factors: Sons of men with alcohol problems are more likely to have alcohol problems Rates of dependence are greater if siblings are dependent Family history of antisocial behavior or criminality increases the risk of drug problems Lack of supervision of children after school is related to drug use Psychosocial Factors: Peer pressure Low self-esteem Low self-efficacy Sensation seeking Lack of social skills Rebelliousness against authority Lack of commitment to school Attraction to deviance Unfavorable attitudes toward adult behavior Biological Factors: Different amounts of pleasure derived from drugs Different amounts of self-control Community Factors: Communities where people move often Extreme poverty and deprivation Communities that lack social support and controls regulating behaviors, including drug use
- Figure 16.2 Past Month Illicit Drug Use among Youths (12–17) by Participation in Fighting and Delinquent Behavior
- Knowledge-Attitudes-Behavior Model Programs typically involve presentations by police and former users Often include traditional scare tactics and/or pharmacological information Approach assumes that increasing student knowledge about drugs will change their attitudes and that these changed attitudes will be reflected in decreased drug-using behavior Model questioned by research findings Students with more knowledge about drugs tend to have more positive attitudes about drug use All early prevention approaches Effective in increasing knowledge about drugs Ineffective in altering attitudes or behavior Concerns raised that drug education programs were actually teaching students about drugs that they otherwise wouldn’t have been exposed to Evaluation of effectiveness depends on program goals Possible goals No experimentation with drugs by students Rational decisions about drugs by students Research on early drug prevention education efforts Students more likely to experiment with drugs Students less likely to develop abuse problems Does society view this as an appropriate goal? Teaching students to make rational decision about their own drug use with the goal of reducing the overall harm produced by misuse and abuse Affective Education Affective domain focuses on emotions and attitudes, which may underlie some drug use Students may use drugs for excitement or relaxation, for feelings of power or control, or in response to peer pressure Drug use may be reduced by helping children To know and express their feelings To achieve altered emotional states without drugs To feel valued and accepted Values clarification: Teach students to recognize and express their own feelings and beliefs Assumes students have factual information about drugs What they lack is the ability to make appropriate decisions based on that information Programs that teach generic decision-making skills may be appropriate in this approach Students are taught to analyze and clarify their own values Parents may not understand this approach as it may run contrary to the particular set of values that parents want their children to learn Alternatives to drugs Assumes that one reason young people take drugs is for the experience of altered states of consciousness Teaches students other ways of obtaining a “high” such as relaxation exercises, meditation, vigorous exercise, or sports Alternatives need to be realistic and tailored to particular audiences Level of experience Motives Possible Alternatives Physical Relaxation Relaxation exercises Increased energy Athletics, dancing Sensory Stimulation Skydiving Magnify senses Sensory awareness training Interpersonal Gain acceptance Learn about social norms, find a group that “fits” Spiritual/mystical Develop spiritual insight Meditation Personal and social skills Assumes that personal and social problems are causes of drug use Based on the known association of drug use with poor academic performance and lack of involvement in school activities Teaches students communication skills and provides opportunities for successful interpersonal interaction Examples A group of students operates a school store Older students tutor younger students Anti-Drug Norms 1984 review of drug prevention programs Most programs don’t contain an appropriate evaluation component Few studies have demonstrated any success in terms of actual substance abuse prevention Increased knowledge about drugs has virtually no impact on substance abuse Affective education approaches appear too experiential and place too little emphasis on skills necessary to resist pressure to use drugs Anti-drug norms programs were developed in part in response to these findings Refusal skills and pressure resistance strategies Focus on teaching students to recognize and respond to peer pressure to use drugs Presented within the broader context of self-assertion and social skills training Typical program Film that demonstrates effective ways of responding Follow-up student discussion Practice with techniques presented in the film Approach shown to be effective in reducing cigarette smoking among adolescents Adapted for other drugs and behaviors Drug-free schools 1986: Government began providing direct aid to local school districts for drug-prevention activities DOE recommended school policies designed to demonstrate that the school and community do not condone drug use or underage alcohol use Examples of school policies Locker searches Ban on tobacco use on school grounds Part of trend of teaching generally accepted values rather than the more “value-free” approach taken in the 1970s Social Influence Model Advantages of education research on smoking prevention programs directed at adolescents Large enough proportion of adolescents smoke so that measurable behavior change is more easily detectable Health consequences of smoking are so clear that there is a good community consensus that preventing smoking is an appropriate goal Easy to verify self-reported use of tobacco through saliva tests Many approaches to drug-abuse prevention have been tried with smoking behavior Key lessons can be learned from research findings about these approaches It is possible to design effective smoking prevention programs Presenting information about the delayed consequences of smoking (e.g., lung cancer) is relatively ineffective Presenting information on immediate effects (e.g., shortness of breath) is more effective Five key elements of the social influence model Training in refusal skills through films, discussion, and practice Students taught ways to refuse without being negative as well as ways to be assertive and insist on the right to refuse Public commitment such as making a public pledge Countering advertising by inoculating children against it Students taught to analyze and discover the hidden messages in ads and how these messages differ from the actual effects of smoking Example: advertisements associating cigarette use with healthy young athletes Normative education to teach students that they may overestimate the number of their peers who smoke Countering the “everybody is doing it” attitude Use of teen leaders to talk to younger students about cigarettes Older students can explain that neither they nor their friends smoke and how they have dealt with others’ attempts to get them to smoke Possible improvements by applying the cognitive development approach to smoking behavior Don’t automatically assume that all students need training in social skills or refusal skills Students make active, conscious decisions in preparation for trying smoking and becoming an occasional or regular user Prevention programs might be different at each stage of cognitive development Risk and protective factors reviewed in Chapter 1 have more influence on drug behavior than any information or education program devised Drug Abuse Resistance Education (DARE) Developed in 1983 in Los Angeles; spread to all states by the early 1990s Widely accepted initially despite lack of studies supporting its effectiveness Contains many components of earlier prevention models Delivered by trained, uniformed police officers Includes elements of social influence model Refusal skills, teen leaders, and public commitment Includes elements of affective education Self-esteem building, alternatives to drug use, decision making Studies on effectiveness of DARE 1994: Program shown to affect self-esteem but no evidence for long-term reduction in drug use 1994: Program shown to increase knowledge about drugs and knowledge about social skills, but the effects on drug use were marginal 2004: Review of earlier studies showed program effect is small and not statistically significant Despite failure to demonstrate a significant impact of the DARE program on drug use, it continues to be widely used
- Head Start is a successful program of preschool education. Health screening and nutrition education are provided for at-risk children in this government-sponsored program.
- Some programs have been demonstrated to have beneficial effects on actual drug use ALERT: Based on social influence model Cigarette experimenters were more likely to quit or to maintain low rates of smoking Initiation of marijuana smoking among nonusers was reduced Level of marijuana smoking among users was reduced Life Skills Training: Based on social influence model Teaches resistance skills, normative education, media influences, and general self-management and social skills Peer influence approaches Based on open discussion among a group of children or adolescents Underlying assumption is that the opinions of an adolescent’s peers are significant influences on behavior Peer participation programs Emphasize becoming participating members of society Often focus on youth in high-risk areas May involve activities such as paid community service Data on effectiveness are not yet available or are inconclusive Informational programs for parents Provide basic information about alcohol and drugs and their use and effects Also may aim to make parents aware of their own alcohol and drug use Rationale for these programs is that well-informed parents Can teach appropriate attitudes Can recognize potential problems Parenting skills programs Focus on communication, decision-making, setting goals and limits, and when and how to say no to a child Parent support groups Key adjuncts to skills training or in planning community efforts Family interaction approaches Families work as a unit to examine, discuss, and confront issues relating to drug use Programs can improve family communication and strengthen knowledge and skills Example: Strengthening Families program Targets children of substance abusers Goals are improving parenting skills and family relationships and increasing children’s skills Evaluations indicate it reduces tobacco and alcohol use in children and reduces substance abuse and other problems in parents Reasons for organizing prevention programs on the community level Coordinated approach at different levels can have a greater impact Drug education and prevention can be controversial, and programs that involve many groups can receive more widespread community support Community-based programs can involve other resources, including local businesses and the public media Communities Mobilizing for Change on Alcohol is one of SAMHSA’s model prevention programs Works for community policy changes and encourages participation of many community organizations and businesses Most consistent feature of workplace programs is random urine screening All companies and organizations that obtain grants or contracts from the federal government have to adopt a “drug-free workplace” plan Ultimate goal is to prevent drug use by making it clear through policies and actions that it is not condoned What needs to be done in a particular situation depends on the motivations for doing it Example 1: State requirement for drug education as part of health curriculum, in the absence of a particular drug problem Most appropriate approach might be a balanced combination of factual information and social skills training Important to avoid inadvertent demonstration of things you don’t want students to do Example 2: Widespread concern and fervor about a local “epidemic” of drug and alcohol use Goal would be to use energy to organize a community planning effort Best approach would combine efforts on many levels Need to avoid scary, preachy, negative approaches than have been shown to be ineffective Information and training available from the SAMHSA Center for Substance Abuse Prevention SAMHSA Center for Substance Abuse Prevention: Model Programs Across Ages Athletes Training and Learning to Avoid Steroids (ATLAS) Child Development Project Communities Mobilizing for Change on Alcohol Creating Lasting Family Connections Dare to Be You Families and Schools Together Keep a Clear Mind Life Skills Training Project ALERT Project Northland Project Towards No Tobacco Use Reconnecting Youth Residential Student Assistance Program Safe Dates SMART Team Strengthening Families Program Too Good for Drugs