Kenneth B. Hilliard
Risk Factors and Prevention Measures
This final section discusses the risk and prevention measures that can be taken to reduce substance abuse. In general nutrition, substance abuse, and other adolescent problems can be summed up with one word “avoidance.” But when avoidance is not successful, then prevention must take place. Prevention is the best cure. First let’s identify some of the risks associated with substance abuse.
In general males are more likely to be users than females. The greatest risks seem to be with beginning drug use early versus later in life. It is agreed that both are equally dangerous to the user. Adolescents become involved because they perceive that their peers are involved (one of their greatest influences).
Prevention, which should involve the community, must be done on a large scale. There are three basic types of prevention;
Primary Prevention
; before use begins,
Secondary Prevention
; stopping the progression of drug dependency once it begins,
Tertiary Prevention
; stopping the worst sequence use.
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Initial prevention (media, anti drug messages) began in the late 60’s to early 70’s. Later school based education programs began. The belief was the more that was known the more effective it would be at reducing the drug rate. In reality it had no real effect on reducing the drug rate. Other programs were geared to enhance self esteem and provide alternatives to these activities. The best programs seem to be those that teach resistance to peer pressure, avoidance and social competence skills.
Other factors to be considered in the establishing of an effective prevention program would be;
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general problem solving skills, brainstorming, and decision making techniques. These activities could include group discussions where students are assigned specific roles or duties to complete within the group. Teacher directed activities can also be used.
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skills in resisting media influences, our students need to see and hear the facts about the world of advertising. Students should be given knowledge about what is fact and how to separate it from fiction.
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skills in building self control and self esteem, students need pride and confidence to succeed in today’s world. They must feel that they belong in our society and that they can be productive in our society. Students need to learn to relax and gain control of their own destiny.
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strategies for relieving stress and anxiety, students must be shown though deep breathing, walking, reading, exercise, or other ways that they have an outlet for all the stress and anxiety that they encounter in day to day life.
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interpersonal skills in initiating social interactions, students must be taught good communication skills that will allow them to speak to their peers on a variety of different subject matters other than matters related to substance abuse. Positive social activities such as school dances and other school organizations will also allow students to develop strong social ties to one another.
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skills in expressing feelings, opinions, and “saying no,” students need to be taught that they can say no to people (adults included) and not be forced into many situations. Through group interactions they should also learn that they can express their feelings and that it is O.K. to be sad at times.
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All skills should be taught and practiced in class, at home, and modeled. The use of role play should also be included for students to act out and express their feelings to one another.
In most years the programs have focused on grades six and seven. The sessions usually run from seven to twenty weeks and have been shown to reduce smoking up to 75%.
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Summary
To really see effective change however, a long term program needs to be in place. These programs could not only enhance school based programs but also lend support to community based programs that use schools, mass media, parents, community organizations, and health policy programs that prevent a gateway to drug use by adolescents.
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In school systems where this type of intervention has been in place (New York) there has been a significant reduction in those students admitting substance abuse.
It has been concluded that drug use perceived by the social environment might be most modified through community based programs that emphasize resistance skills and non drug use. In general any type of program that is in place must be visible, and should involve large numbers of people and many diverse organizations.