At risk young people and drug abuse in WA

At risk young people
and drug use in
Australia
ADDICTIONS AND PRACTICE
SWK2108 Addictions and Practice - Assessment 1. 1

“As young Australians overdose on novel
psychoactive substances and teenagers
in the UK on ecstasy, there can be only
one certainty: drugs are here to stay.”
(Stevens, 2017)

This presentation is designed to assist those working in the Youth
Work and AOD sector in identifying and assessing at risk young
people within Australia. Whilst exploring contemporary theories
relating to drug use, prevention and harm reduction, drug use
types and drugs in a cultural and social construct within Australia.

History of Drug Use
• Recorded use of Alcohol was first used in the form of mead
and was highly popular in the Paleolithic age – 8000 B.C
• Opium use is reported in the Sumerian tablets – 4000 B.C
• Marijuana use has been documented in China – 2737 B.C
(Brick & Erickson, 1999, p. 3)

Patterns of Drug Use
Experimental
Social or
Recreational
Response to
Stimuli
Intensively Compulsively
(Ryder D., 2006)

Stages of Adolescent Drug Use
•No use of drugsAbstinence
•Infrequent use of tobacco, alcohol or other drugs
Experimental
Use
•Use of AOD on an occasional but regular basisRegular Use
•Adolescent has experienced adverse consequences associated
with use
Problem Use
•Engages in ongoing use of AOD, loss of control over useSubstance Abuse
•Development tolerance or withdrawal symptoms,
preoccupied with use
Substance Dependency
•Idealistically users become non usersSecondary Abstinence
(BrightFutures, 2017)

Models of Drug Use
• Moral Model – Those who do drugs are morally reprehensible, intervention results in sanctioning or
punishment for drug use.
• The Temperance Model – Substance orientate, intervention would suggest lifelong abstinence or
moderating use.
• Disease Model – Individual orientated, obtains a disease and unable to control their use, intervention
would suggest lifelong abstinence and social support.
• Learning Model – Developed learning into an ability to take drugs, intervention is learning the ability
to stop taking drugs.
• Sociocultural and Family Systems Model – Environmental and family related influence for drug use,
intervention family based interventions and social policy.
• Public Health Model – Considers drug use to consist of 3 sectors the agent, the host, and the
environment. Therefore intervention would require review and implementation of strategies to deal
with all three aspects to obtain the best outcome.
(Ryder D., 2006, p. 31-32)

Influences of Young Peoples Drug Use
• Individual
The state of mind, the reason for use, stress levels, paranoia, mental health, low self esteem,
exposure to abuse, desire for experimentation and pushing limitations
• Family and friends
Parental or family drug abuse, peer pressure, parental moral and ethics
• Society
Mixed messages and exposure through peers, parents, school and employment
• Environment
Government laws and legislation which regulate supple and availability, advertising and
promotional aspects, sports and other event sponsorships
(Issues in Society - Young People and Substance Abuse, 2000, p.13)

Reasoning Behind Young People’s Drug
Use
To, Sek-yum Ngai, Ngai, & Cheung, 2007 categorizes YP’s reasoning for
drug use into four sectors these being;
YP think drugs are a solution to achieving their desires. However,
eventually drugs become the problem and YP are then left searching for
a solution again ("The Truth About Drugs," 2015)

Theories relating to Adolescent Drug Use
• Sociological Theory
• Anomie
• Differential Association
• Social Control Theory
• Subcultures and Cultural Deviance Theory
• Symbolic Interactionism/ Labeling
• Psychoanalytic Theory
• Cognitive Learning Theory
(Abadinsky, 2008, p.183-222)

How do you define abuse?
Well, as the term abuse is constructed by an individual experience, everyone will
have a different understanding. Therefore Ryder D., (2006) refers to the World
Health Organisation in the use of the following terminology in replacement of
the word abuse;
• Unsanctioned Use – Disapproved by society
• Hazardous Drug – Likely to lead to harmful consequences
• Harmful Use – Caused harm to tissue damage or mental health problems
• Dysfunctional Use – leads to psychological or social problems
(p. 84)
Finding it hard to all agree on a definition?

Drug Types
Major Drug Types as defined by Goeders, 2001, in the 2nd Edition of the
Encyclopedia of Drugs, Alcohol & Addictive Behavior are as follows;
• Ethanol – Alcohol
• Nicotine – Tobacco
• Caffeine – Coffee, Cola
• Cannabinoids – Marijuana
• Central Nervous System
– Benzodiazepines
• Central Nervous System stimulant
Amphetamines
• Psychedelics – LSD
• Inhalants – Nitrous Oxide, Glue
• Arylcyclohexylamines – PCP
• Designer Drugs – MDMA
• Opioids – Morphine
• Miscellaneous – Betel Nut,
Ayahuasca
Important to note is many users will combine drug types which will have an impact when
analysing the situation and circumstances. (2001, p. 517)

Neurological Effect of Mixing Drugs
• Addictive – 2 Similar drugs and the effects are doubled
1+1=2
• Synergistic – 2 Similar drugs, joined together can result in
a cumulative 1+1=3
• Potentiating – 2 Different drugs used together enhances
the effect of the other 1+1=4
• Antagonistic – Two or more drugs taken together and
results in counteraction of one another 1+1=0
(Abadinsky, 2008, p.78-79)

Drug Use from Societies Perception
• As mentioned by Ryder, Walker and Salmon (2006) from a lawful
perspective individuals are governed by formal and informal laws,
legislation and regulations, this in turn influences others thoughts and
opinions, resulting in a negative stigma toward drug addicts. (p.64)
• Publics opinion and perception of drug abuse is in fact particularly negative
(Lang & Rosenberg, 2017, p. 79)
• How do we change publics perception you ask? Well Brick and Erikson
(1999) suggest;
“When people stop blaming the drug-induced afflicted for their
disease by shifting the emphasis of blame from the drug to a brain
chemistry dysfunction leading to an inability to stop, perhaps public
sympathy will produce a realistic movement to help those afflicted
and suffering individuals with these diseases. But it will take time.”
(p.164)

Pharamacology
• Brick and Erikson (1999) hypothesis addictions are a result of
Neurochemical dysfunctions and it would seem the mesolimbic
system of the brain is the contributing factor to drug addiction.
(p.162)
• Drug addiction is referred to as a disease just like Parkinson's
(which is due to lack of dopamine) or Diabetes where the
pancreas lacks the ability to produce enough insulin.
• Addiction is a result of chemicals which are deficient including
dopamine, serotonin, endorphins and gamma-aminobutyric
acid. (p.164)

Drug Dependence Syndrome
To be diagnosed with a DDS, the individual will need to have experienced any three of
the following within a 12 month period. As outlined by the DSM IV;
• Established a tolerance
• Experienced withdrawals
• Taking larger amounts or taken for longer than intended
• Persistent desire, unable to control substance use or unable to cut down
• Time is spent with activities necessary to obtain the substance or recovering from
the effects
• Important social, occupational or recreation activities are affected due to use
• Continued substance use despite knowledge or reoccurring problems associated
with use or is exacerbated by use.
(Ryder D., 2006, p. 91)

Effective Treatment Approaches
• Medication
• Withdrawal
• Treatment
• Buprenorphine
• Behavioural Treatments
• Outpatient Behavioural Treatment
• Cognitive Behaviour Therapy
• Multidimensional Family Therapy
• Motivational Interviewing
• Motivation Incentives
• Residential Treatment Programs
(Van Wormer & Thyer, 2010, p.225-228)
“Studies show that treatment does not need
to be voluntary to be effective.” (Van Wormer
& Thyer, 2010, p.228)

Harm Minimisation
• It is quoted by Lightbourne, R., Nolan, G., & Ball, Dr A. (1989, p. 12) that “it is not the
chemical property of the drug which causes the harm, but the situation where usage
takes place or the way in which the drug is used.”
• In 1985 the Australian Government adopted the Harm Minimisation approach as the
national framework for addressing problems associated with AOD use.
(Intergovernmental Committee on Drugs, 2015)
• One method of Harm Minimisation which was implemented apart of the national
framework was the supply of clean equipment to reduce the infection of blood borne
virus. Therefore an initiative was established to enable drug users access to clean injection
equipment via local pharmacies. In total 86% of metropolitan and 90% of country
pharmacists were supplying users with safe injecting equipment however 89% of
pharmacists where experiencing disruption whilst supporting this policy and 78%
experienced threating incidents, influencing changes in the supply methods. (Newbey,
1995, p.67-68)
• 77% of pharmacies had implemented policies relating to the supply of needles and
syringes to injecting drug users (Newbey, 1995, p.69)
• According to Newbey, 1995, only 9% of pharmacies believed this to relate to an important
commercial decision, displaying the strong support of assistance and intervention for the
benefits of injecting drug user. (p. 72)

Harm Reduction
• “Harm reduction refers to policies and programmes that aim to
reduce the harms associated with the use of drugs. A defining
feature is their focus on the prevention of drug-related harm rather
than the prevention of drug use per se. One widely-cited conception
of harm reduction distinguishes harm at different levels - individual,
community and societal - and of different types - health, social and
economic” (Hunt, 2010).
• “Harm reduction refers to those strategies that aim to minimise harm
arising from drug use while people are still choosing to use drugs”
(Ryder D., 2006, p. 130).
• Strategies can cater to the drug it self and or the environment in
which the drug use takes place (p. 136).
• It is quoted by Lightbourne, R., Nolan, G., & Ball, Dr A. (1989, p. 12)
that “it is not the chemical property of the drug which causes the
harm, but the situation where usage takes place or the way in which
the drug is used.”

Drug Use in Schools.. What about Drug Testing in Schools?
One interesting perception as reviewed in Issues in Society - Young People and Substance Abuse, 2000 is the concept
of bringing drug testing into schools. An issue relevant to young people is the risk of becoming a drop out and
engaged in problematic drug use. So rather then ignoring the problem with suspensions, whereby this only
intensifies the risks of problematic and excessive drug use. However attempting to intervene and support drug users
to achieve socially acceptable goals, however there seems to be a complex amount of social, legal, technical and
ethical barriers.
• Intrusive and infringement of privacy
• Conflicting and unreliable results
• Possibility the school will expel in return of a positive result
• May lead young people to use exotic drugs to bypass systems
• Expensive and time consuming legal action in result of a false result
• Emotional turmoil for students, parents, staff should legal action occur (p.30-31)
Perhaps this intervention could work with obtaining authorization from the parent or care giver with justification of
the young persons best interests. After all drug testing does happens in the workforce, according to the Australian
Government in 1981, Australian Schools are preparing young people for the workforce, it would only seem rational to
implement strategies to prepare each individual for life after school which may include referral to youth and health
services to explore problematic drug use and development of life skills. What do you think?

Drug Related Reporting Systems in Australia
NDARC and University of New South Wales have established four programs to monitor and
remain up to date with current drug use through the participation of regular drug users
located within the capital cities of each Australian state and territory. This is to conduct
developmental research in identifying the existence of illicit drugs and the harm relevant to
users within Australia.
• Ecstasy and Related Drugs Reporting System (EDRS)
• Illicit Drug Reporting System (IDRS)
• National Illicit Drug Indicators Project (NIDIP)
• Drugs and New Technologies Project (DNeT)
System is based on this methodology utilizes 3 consist components
• Interviews with regular ecstasy and psychostimulant users (REU/RPU)
• Interviews with key experts (KEs)
• Execute analysis and examination of recorded indicators and data sources
("Drug Trends," 2015)

How Serious Is Drug Use In Young People?
• 1in5 Western Australians over 14 years of age are drinking at
risk of lifetime harm
• 1in5 recently used illicit drugs
• In Western Australia, over 50% of domestic and more 1/3 of
non-domestic assaults are alcohol related
(Western Australian Mental Health Commission, 2015)
Now lets take a look at the deaths as a result of drugs….
How many deaths do you think occurred in 1999 as a result of
drugs?

Review of Drug Induced Deaths
0
50
100
150
200
250
300
350
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Males 95 114 97 135 145 160 162 220 228 200 101
Females 50 50 46 44 68 47 75 74 87 70 43
Both 145 164 143 179 213 207 237 294 315 270 144
Drug induced deaths - 15-24 years of age from 1991 - 2001
Males Females Both
(Australian Bureau of Statistics, 2003)

Deaths of 15 - 24 Year Olds
Within Australia as a Result of Drug Use
(1991 – 2001)
0
100
200
300
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
81 97 99
134 152 152
182
248
281
250
118
51 49 38 38 40 34 35 30 22 19 23
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001
Accidental 81 97 99 134 152 152 182 248 281 250 118
Suicide 51 49 38 38 40 34 35 30 22 19 23
Accidental vs. Suicidal Deaths Involving Drug Use
Accidental Suicide
(Australian Bureau of Statistics, 2003)

This article released only 5 hours ago, displays the
outcome of a methamphetamine addiction.
(Wildie, 2017)
As a society are we dealing
with addiction effectively? It
would seem from this article,
as a nation Australia does not
have the facilities or abilities
to deal with addiction
effectively.
According to the National
Institute on Drug Abuse in
2006, 23.6 million people aged
12 years or older required
assistance for the treatment of
illicit substance abuse. (Van
Wormer & Thyer, 2010)

Identifying Young People At Risk Of Harm
As cited in the Substance Use and Young People Framework by NSW Health the key
concepts, to take into consideration when identifying potential young person at risk
of harm include;
• Past professional experience
• The age, development, functioning and vulnerability of the young person
• Identifying behaviours that have desensitization young people to abusive related
behaviours
• External factors including other relationships which expose toxicity and negativity
to the development stages of the young person especially the family and
friendship circle
• Physical signs of abuse or neglect
(Branch, 2014, p. 81)

Activity 1. Four L’s – Identifying Risk Factors
Liver: Person's
health – physical,
psychological or
emotional health
problems
Lover: Problems
associated with a
person's
relationships,
family, friends,
children, lovers etc.
Livelihood: Issues
which relate to
accommodation,
work, finances,
education etc.
Legal: Any
problems
associated with the
law.
(National Youth Commission, 2008, p. 163)

Activity 1. Four L’s – Identifying Risk Factors
Liver: Person's
health – physical,
psychological or
emotional health
problems
Lover: Problems
associated with a
person's
relationships,
family, friends,
children, lovers etc.
Livelihood: Issues
which relate to
accommodation,
work, finances,
education etc.
Legal: Any
problems
associated with the
law.
(National Youth Commission, 2008, p. 163)
Liver = Medical / Health
related issues damage to
lungs, chemical and
neurological abuse, broken
bone from poor bone
destiny, asthma, scabs,
infection from needles
Lover = Relationships
Problems relating to
breakdown with parents,
friends, children, family,
relationship within the
community

Did You Know!
• If a YP has not used a drug at 21, they are likely to never use a drug
• 48% of YP have used Marijuana
• At least 246 million people worldwide have consume some form of illicit drug
("The Truth About Drugs - Program Guide," 2016)
• Substance abuse generally begins throughout mid to late adolescence
• Young people with mental health barriers report a higher rate of smoking,
drinking and illicit drug use
(Branch, 2014, p. 46)
• Homelessness has been closely networked with mental health problems and
substance use
(Commission, 2008)

References

At risk young people and drug abuse in WA

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