thesis on drug use

Drug Use Normalization: A Systematic and Critical Mixed-Methods Review

Affiliation.

• 1 School of Public Health, University of Haifa, Mt. Carmel, Haifa, Israel.
• PMID: 27588528
• DOI: 10.15288/jsad.2016.77.700

Objective: Drug use normalization, which is a process whereby drug use becomes less stigmatized and more accepted as normative behavior, provides a conceptual framework for understanding contemporary drug issues and changes in drug use trends. Through a mixed-methods systematic review of the normalization literature, this article seeks to (a) critically examine how the normalization framework has been applied in empirical research and (b) make recommendations for future research in this area.

Method: Twenty quantitative, 26 qualitative, and 4 mixed-methods studies were identified through five electronic databases and reference lists of published studies. Studies were assessed for relevance, study characteristics, quality, and aspects of normalization examined.

Results: None of the studies applied the most rigorous research design (experiments) or examined all of the originally proposed normalization dimensions. The most commonly assessed dimension of drug use normalization was "experimentation." In addition to the original dimensions, the review identified the following new normalization dimensions in the literature: (a) breakdown of demographic boundaries and other risk factors in relation to drug use; (b) de-normalization; (c) drug use as a means to achieve normal goals; and (d) two broad forms of micro-politics associated with managing the stigma of illicit drug use: assimilative and transformational normalization.

Conclusions: Further development in normalization theory and methodology promises to provide researchers with a novel framework for improving our understanding of drug use in contemporary society. Specifically, quasi-experimental designs that are currently being made feasible by swift changes in cannabis policy provide researchers with new and improved opportunities to examine normalization processes.

Publication types

• Systematic Review
• Behavior, Addictive / diagnosis
• Behavior, Addictive / epidemiology*
• Behavior, Addictive / psychology*
• Databases, Factual / trends
• Forecasting
• Substance-Related Disorders / diagnosis
• Substance-Related Disorders / epidemiology*
• Substance-Related Disorders / psychology*

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Thesis Paper on Drug Addiction

Drug addiction has long been and still is a topical issue around the world. There are different reasons why people get addicted and various levels to which people become dependent on drugs. Some people start taking them because of pure curiosity, others so as to improve their athletic performance or reduce stress and get rid of depression. It doesn't matter why people start, the main thing here is to get help at the right time and not to ruin their life and health. When people start taking drugs, with time the way their brain functions and looks is altered. First of all, drug taking causes elevation of dopamine level in brain, which results in the feeling of pleasure. Brain remembers this event and wants it repeated. So, the drug a person takes eventually reaches the significance that other physiological needs have. As a result, the person's abilities to think clearly, control behavior, exercise good judgment and feel well without drugs intake becomes affected. This, in its turn, causes problems in relations with family, friends, at work or in university. It is extremely important to recognize drug addiction at the right moment, preferably in the beginning, so as not to spoil social relationships and health. It is necessary to understand that the sooner the problem will be attended, the better it is for the treatment progress. There are certain symptoms of drug abuse: when drug is getting people into legal trouble, if because of it people start neglecting their responsibilities, when they use drugs under dangerous conditions, and when they cause problems in relationships.

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Life throws up innumerable situations, which we greet with both negative and positive emotions such as excitement, frustration, fear, happiness, anger, sadness, joy etc. All human beings are not equipped to take on changes or difficult situations in life, naturally. Out of them, many don’t adapt to those situations. The result normally is— those situations and accompanying stress overwhelm people. The mind-boggling changes in every sphere of life—culture, profession, modes of transportation and rapid lifestyle changes put pressure on men to adjust with equal speed. Stress begins to wear them out and there is a loss of resiliency against adverse situations of life. Consequently, they begin to pull away from others and give in to depression. It is said that life acts and you react. Our attitude is our reaction to what life hands out to us. A significant amount of stress symptoms can be avoided or aroused by the way we relate to stressors. Stress is created by what we think rather than by what has actually happened. For instance, handling adopted children, adolescents, academic failures, retirements or sudden loss of money needs a relaxed attitude, focused will and preparedness to face the quirks of life positively. Otherwise one tends to feel stressed and reacts in anger and frustration. Children of stressed out parents are more likely to be ill equipped to handle stressors positively. They may suffer from emotional disturbances, depression, aggressive behaviour or confusion besides chances of weak physical constitutions, which again can be a source of anxiety. With a better control of attention one can feel that the world is a more congenial place to live in. A right attitude can make a resilient person out of us in the face of stressful situations. We can choose to stand aside; or to take weak and ineffective measures; or to implement robust and enduring measures to protect the health and wealth of populations.

Philosophy, Psychology and Psychiatry

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Philosophers and psychologists have been attracted to two differing accounts of addictive motivation. In this paper, we investigate these two accounts and challenge their mutual claim that addictions compromise a person’s self-control. First, we identify some incompatibilities between this claim of reduced self-control and the available evidence from various disciplines. A critical assessment of the evidence weakens the empirical argument for reduced autonomy. Second, we identify sources of unwarranted normative bias in the popular theories of addiction that introduce systematic errors in interpreting the evidence. By eliminating these errors, we are able to generate a minimal, but correct account, of addiction that presumes addicts to be autonomous in their addictive behavior, absent further evidence to the contrary. Finally, we explore some of the implications of this minimal, correct view.

Adrian Carter , Ruud ter Meulen , David J Dm Frcp Frcpsych Fmedsci Nutt , W. Hall

The potential developments mentioned in this report raise issues that are likely to become important for policymakers within Member States and will require careful consideration at European level in regard to the EU's role. They raise important questions for both drug policy and human rights and may have implications for the future regional role of the EU in developing policies, monitoring the activities of Member States and taking appropriate action with regard to Member States' policies.

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Neuroscience research is uncovering the neurochemical mechanisms that produce the behavioural and cognitive problems observed in those with an addiction. This includes: the pharmacological sites at which drugs act (eg receptors); the neurochemicals involved in the metabolism (eg enzymes) and trafficking of drugs (eg transporters) that regulate their activity within the brain; and the molecular changes that occur in the brain as a result of continuous use of addictive drugs over long periods of time (see Chapter 2).

Addiction and drug abuse exact an enormous toll upon European society, largely as a result of premature death, physical harm and increased health care costs, violence and crime. A significant proportion of the European population will become addicted to licit or illicit drugs during their lifetime. Given the health and social burden of addiction, there is strong public interest in preventing addiction and improving the chances that addicts will stop using drugs.

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A Review of the Prevention of Drug Addiction: Specific Interventions, Effectiveness, and Important Topics

Background:.

This study was a narrative review on prevention of addictive behaviors with an effort to clarify the major concepts of prevention and its dimensions.

The PsycInfo and MedInfo databases were used to identify prevention. Α total of 65 articles were found 46 of which were included in the review. Τhe data were analyzed using content analysis.

For a better understanding of the results, it was deemed advisable to categorize them into: (a) the types of major interventions and the theoretical approaches on which they were based, (b) the results of the review articles according to (1) variables and factors concerning the prevention proved important through the review and (2) a number of more general important topics which arose in the prevention of addictive behaviors.

Conclusion:

The results highlighted the greater effectiveness of community-based programs, applied primarily in broader contexts but also secondarily in high-risk groups. Τhe results were discussed based on the combination of the emerged factors with each other and prevention experience.

Introduction

One of the most important questions in the field of psychotropic substances addiction, including alcohol abuse, is which ways, methods, techniques, or interventions are effective in substance use prevention. Given the fact that there are various kinds of prevention strategies, this question becomes even more complicated as it is hard to find and systematize these factors. It is essential to continue research in this direction since the question why young people resort to substances and get addicted to them has not been fully answered yet. Furthermore, it is generally accepted that prevention is better than treatment.

Psychotropic substances addiction refers to the substance-related disorders as described by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). Although the psychological mechanism of addictive substance use is considered to be common with or at least similar to that of addiction to illegal substances and alcohol, in this study, the surveys that focus exclusively on alcohol were not included. The reason for this decision was that articles on alcohol prevention are numerous and could be investigated –as already done- in a separate study. Besides, alcohol use displays certain peculiarities; for example, it is a legal and easily accessible substance.

Traditionally, prevention strategies have been categorised into primary, secondary, and tertiary preventions. Primary prevention refers to the prevention of substance use and abuse. Secondary prevention refers to the early identification and treatment of individuals already using substances, while tertiary prevention refers to the treatment and reduction of harm in people who have already used substances and have consequences from their use. We can literally talk about prevention only in primary and partially in secondary types. Tertiary prevention is essentially not prevention but treatment and reduction of harm.

Another distinction that has been made in recent decades (e.g., National Advisory Mental Health Council Workgroup on Mental Disorders Prevention Research 1 ) classifies prevention strategies into universal, selective, and indicated preventions. The universal strategies apply to the general population (e.g., students) in order to inform and raise awareness about the issue of drugs. 2 Selective strategies target individuals at increased risk of substance use and abuse (e.g., children of addicts, children growing up in high-risk environments or neighborhoods). Indicated strategies are for people who may not already be addicted to drugs but have had a contact with them (e.g., young people experimenting with substances).

Preventive interventions in the three categories described above may have different goals, including the following: (a) increasing the knowledge about drugs in adolescents; (b) reducing the use of drugs; (c) delaying the onset of first use; (d) reducing abuse of drugs; and (e) minimising the harm caused by the use of drugs. 3 Additionally, regarding the context of implementation of prevention interventions, it is evident that these interventions can aim at different settings such as schools, families, the wider community, the media, 4 or even in places of gathering of young people e.g., cultural centres, parks, cafes, and so on.

The field of prevention is in general very broad as it includes prevention policies, designs, methods, techniques, and interventions. The design of interventions requires the appropriate theoretical background and the deployment of previous knowledge and results. Furthermore, it potentially includes various intervention implementation frameworks, a different extent of involvement, and participation of the individuals e.g., children, parents, and teachers.

There are a lot of important dimensions to be investigated in what is broadly defined as prevention. The effectiveness of the interventions is an important parameter. Effectiveness is usually defined as a reduction in substance use or a reduction in the positive attitude towards substances, after the implementation of a prevention program. The sustainment, however, of positive results on a long-term basis is an even more important dimension. The active participation of the involved members and the retention of the therapeutic results are other necessary components for the implementation of effective interventions.

As far as the evaluation of interventions is concerned, reliability should be tested as youth substance use programs are often of limited generalizability due to methodological restrictions and the absence of consistency in evaluation of interventions. 5

Furthermore, it should be mentioned that the concepts usually studied (e.g., self-efficacy, motivation for change, coping skills) are complex and hard to be assessed in self-report measures. In addition, these psychological processes may not be part of conscious awareness and thus may not be possible to be evaluated using self-report measures. Additionally, it is doubtful whether they are indeed related to the underlying pathology of addiction. 6

The main objective of this narrative review was to investigate the key modern trends in the prevention of psychotropic addiction and to identify which interventions are most effective and where and how they are performed.

A specific review of factors important for the prevention of drugs was conducted in PsycInfo and MedInfo databases, entering as search items for the factors the words “prevention”, “addiction”, “drug addiction”, “drugs”, “drug prevention strategies”, “substance use” and “dependence” or the combination of the above words. The data were collected from 2018 to 2021. The search included articles published from 2000 onwards. A total of 65 articles were found among which 46 articles were included in the review. Articles that clearly referred to the prevention of substance use (interventions, strategies, or prevention systems) were included in this study. Articles that indirectly referred to prevention or were restricted to medication or genetic aspects of prevention were excluded. Regarding the type of articles, 26 of them were research articles and 20 were review articles. Among the research articles, 11 were correlational quantitative studies, 9 were quasi-experimental studies, and 6 used qualitative designs. Concerning the participants, 34 of the studies were conducted on school-based programs and 9 on community-based prevention programs. The remaining ones did not refer to specific intervention programs and focused on theoretical elements or prevention and health policies systems.

Taking into consideration the above mentioned as well as the theoretical concerns and the steady need to improve the problematic parts, a search of relevant findings from research and review articles was conducted. Given the dissimilarity of the research studies found, the data were analyzed using content analysis and systematized in different categories according to the point on which each research focused. For a better understanding and categorization of the research results, it was deemed expedient to mention a) the major interventions and techniques used in the studies and b) the results categorized through the above-mentioned analysis.

(A) With regard to the type and the theoretical approach of the interventions applied in the studies found in this review, a wide range of theoretical approaches and techniques were identified that illustrate the preferred trends in prevention over the past years. Characteristically, there is a great heterogeneity among the programs and methods. 7 , 8 Before reviewing the results in the following section, these interventions are elaborated. The following categorization of interventions was chosen because it contributes to a systematic and comprehensive display ( Table 1 ).

a) A lot of studies used interventions that could be characterized as environmental interventions 9 - 11 which highlight mainly the implementation of interventions in a more natural, social, and cultural environment where the individuals act and behave. The aim of these interventions was to increase the cultural belonging to achieve which, a lot of interventions used culturally-based techniques. 12

b) A second category of studies, possibly the one encompassing the majority of them, includes the studies that used more cognitive-based techniques, namely interventions whose broader theoretical framework relies on the cognitive-behavioral approach. Thus, it specifically includes social skills interventions, strengthening families programs and life skills trainings, 13 enhancing communication channels interventions, CHAT- a solution focused strategies program, increasing self-efficacy methods, 14 - 16 McGuires’s persuasion, 17 CHOICE program, Cherokee self-reliance program, 18 Project ALERT program, Persuasion Communication Model, SMART program, random student drug testing, 19 development and monitoring of career goals, and internet-based prevention programs. 20

c) A third research category includes methods that could be characterized in a broader sense as humanistic. These methods are based on the restricted results of the mainly informative (based on providing information) and more cognitive approaches and illustrate the experiential character of prevention. Thus, a lot of prevention strategies deal with the promotion of youth development, 21 peer-to-peer mentoring, 22 motivational interviewing 23 , 24 (a method with a cognitive background as well), narrative therapy, educational and career counseling, and positive youth development strategies with the active participation of teachers and parents. 21 , 25 Obtaining insight and expertise from program personnel and school staff and administrators can bring the program to a point where these strategies can still be achieved and theoretical linkages made after a program has been implemented. This is a necessary foundation for measuring the success of an intervention. 21 A common characteristic of these methods is the intent of active participation of all the community members such as local media and teen networks. Some of them, when implemented in a school-based environment, are delivered by teachers, 26 not by specialized scientists alien to the school environment.

(B) In the second and main part of this section, the results of the reviewed articles are presented as categorized based on (a) variables and factors concerning the effectiveness proved important through the review and (b) a number of important topics highlighted for the prevention of addictive behaviors ( Table 2 ).

a) Concerning the variables and/or the factors that proved more or less important to the implementation of prevention programs, the self-efficacy variable is the most frequently mentioned one. Self-efficacy is the optimistic self-belief in one’s competence or chances of successfully accomplishing a task and producing a favorable outcome. 27 , 28 The building of self-efficacy seems to be a characteristic of addiction-proof children. 14 Apart from self-efficacy, other variables from the cognitive approach associated with successful efforts of prevention are motivational enhancement, life coping skills, decision-making, 20 enhanced drug resistance skills, increased knowledge, and behavior determinants (attitudes, subjective norms, self-efficacy, intention) more negative towards drugs. 13

The variables that derive from the humanitarian tradition and positive psychology have very positive results when included in prevention programs. Thus, the promotion of positive youth development and the cultivation of an optimistic future orientation, 21 the development of hopefulness, 29 harmony among family members, 30 and the strengths and the enforcement of a healthy lifestyle have been repeatedly associated with a reduction in use of addictive substances. The positive role of self-reliance which is defined as being true to one’s self and being connected, responsible, disciplined, and confident 18 can be included in the same context.

Other studies investigated the social support and generally the effect of the social environment on addiction prevention. The results are usually controversial. Therefore, the influence of friends and peer pressure 31 may be associated with high-risk behaviors, but friends are preferred in seeking help. 26 , 30 Self-evidently, having family members who use drugs and adverse life events are associated with high risk. 31 , 32 On the other hand, peer networks and dynamic group leaders can also help to motivate the students. 33 The role of the teachers in prevention is estimated to be positive, as their involvement in prevention programs is associated with lower risk. A positive impact seems to be attributed to parenting monitoring and strict parenting as well as religiosity. 26 Especially in the school context, it seems that belonging to the public school network, development of activities targeting sexuality, development of “Health at School Program” activities, offering extracurricular activities, and having an administrator that participated in training courses on drugs are associated with program implementation. 34

b) With regard to the more general important topics highlighted in substance addiction prevention, a first point is that a lot of researches were based on an informative approach about prevention (e.g., decision), 31 namely the provision of information to the target group (youths or students) about the negative effects of addiction that is expected to lead to a logical refusal of substance use. The major conclusion drawn is that prevention strategies based mainly or exclusively on information have poor results, 17 , 35 which is confirmed by a study according to which most youths were aware of the adverse health effects of substance use. 31 However, other studies based on internet-based interventions supported that intervention groups have more knowledge and are less likely to use cannabis. 20 It is recommended to adopt a broader approach which embraces other directly or indirectly involved individual groups (parents, teachers) and control the quantity and quality of the information provided. 35 , 36 Relevant to the provision of appropriately purposeful information about substance use was the finding about the inadequate awareness and messages in workplace, 37 an example of the expansion of prevention in environments outside the school.

The importance of development stages and the transition from one development stage to the next was another topic highlighted in the review. 38 Studies focused on the understanding and recognition of possible genetic risks and protective factors at the crucial age of children and teenagers. 39 , 40 Some data seem to be confirmed, such as the fact that the onset of substance use at a later stage reduces the problematic use. 12

A lot of studies 18 , 41 - 43 mentioned the effectiveness of culturally grounded interventions. These interventions are culturally sensitive, which means that they primarily take into consideration the cultural characteristics of the population on which the intervention is implemented. Quite often sub-techniques are used that deploy special cultural characteristics of a place (e.g. canoe). 41 The positive results of these efforts reinforce the poorer results of interventions, where a prevention program is transferred and implemented invariably from one country to another, mainly from a developed country to a so-called developing country. 42 Therefore, the integration of appropriate theory and cultural elements seems to be necessary. However, there are also findings that consider that risk and protective factors concerning majority-based research may also be predictors for minorities. 43

Similar to the above is the finding that a lot of preventive interventions followed the ground-up methodology, namely the configuration of interventions after relevant research in population members, where the intervention was implemented later on. 16 , 20 Therefore, in case the aim is to apply an intervention in the school-based environment, the prevention strategies are configurated and chosen after some preliminary work (e.g., focus groups) with the affected populations (e.g., teachers, students), which illustrates the needs of these particular individuals at a specific time. This is in contrast with the most common method (up-ground) where already tested interventions are applied to various populations. 40

As mentioned in the methods section, the greatest part of interventions took place in school-based environments that seem to be probably the most suitable ones for the implementation of interventions, as indicated by findings about effectiveness. 19 However, the findings are not always consistent, as there are also findings that suggest minor to insignificant positive results. 17 Furthermore, certain findings indicated a lower effectiveness in boys compared with girls and better results in children of a low socio-economic level compared with children of a higher socio-economic level. 42 With regard to the frequent implementation of prevention programs in school-based environments, a question of generalization is raised, as expected, namely to what extent the whatsoever results achieved in this environment can be sustained outside this environment. 20

A classic study indicated small- to medium- sized differences in behavioral problems between students who participate for the longest period of time and those who participate for the shortest time 19 which highlighted the importance of the sustainment of the results as well as the retention of students both in the school-based environment and the prevention programs. As noted, the impact of education and persuasion programs tended to be small, at best. When positive effects were found, they did not persist. 17 Furthermore, in terms of effectiveness, the flexibility in delivering the program, such as offering the program in different days and times, seems quite important. 22 However, low effectiveness, indicated even by large-scale studies, is probably attributed to issues of methodology, such as selection strategies. 43

A matter of greater importance with various social aspects that was highlighted was social responsibility with regard to addiction prevention. 44 The importance of the involvement of all the community members leads to the conclusion that prevention concerns potentially every member of the society and not just the populations included in the so-called high-risk groups. Thus, the involvement of school, neighborhood, family, and various associations and religious bodies 45 - 48 seems to be important as it enhances the conscientiousness and responsible behavior of the citizens towards such a vitally important matter. In the same context, the importance of a broader collaboration and consistency between policy design and implementation of educational interventions 17 is also highlighted; however, this is a very complex issue which faces various obstacles during its implementation such as the cost of the interventions. 4

The policy issue comes to the forefront when addiction prevention issues are dealt with. Roumeliotis 49 showed drug addiction is presented as a problem to be handled by experts rather than politics. This shows an important shift in the role of policies in prevention and treatment. Certainly, there is an increasing trend towards harm reduction and even educational approaches and other more traditional forms of prevention including harm reduction. 48 These matters are underlined by the necessity for transdisciplinary scientific collaborations that have the potential to strengthen substance use and abuse research and prevention. 49 Transdisciplinarity is distinguished from other forms of cross-disciplinary collaboration, such as multidisciplinarity and interdisciplinarity. Transdisciplinarity is the process whereby researchers work jointly using a shared conceptual framework that draws together discipline-specific theories, concepts, and approaches to address a common problem. 49

As indicated in the first part of the results, there is great heterogeneity in the interventions and techniques of addiction prevention. This might imply a great variety of available methods and strategies that can be used. The selection of the suitable methods in each case should be based on the needs of the population to which the respective program is applied and on the study of the effectiveness of the available interventions. Any combination of methods and techniques is legitimate as long as it is based on a justified theoretical background and previous experience from prevention programs. The reported trend of environmental interventions 8 - 10 is a positive step, as it takes into account people’s needs in the natural and social environment in which they act. Given the prevalence of cognitive-behavioral methods on a large scale in the treatment of mental disorders, it is absolutely natural for similar interventions to be used in prevention as well. 15 , 16 These interventions, which require a rational data processing, have a proven effectiveness; however, quite often they seem to be inadequate for the prevention of rather complex psychosocial problems, such as addiction. For this reason, there is a prevalence of more experiential interventions (either in combination with cognitive-behavioral techniques or not), which attempt to include not only the directly affected people (e.g., the students) but also parents, teachers, and other community members or bodies. 34 , 35 Apart from the above mentioned, other factors should be taken into account including ‘Who is training the trainers?’, ‘How can quality delivery be ensured on a large scale?’, ‘How can a universal program become part of a chain of prevention?’ and ‘How do we handle the needs of practitioners?’ 50 - 52

With regard to the factors/variables that play an important role in addiction prevention, as expected, the findings highlighted already known variables, such as self-efficacy 14 - 16 and the development of positive characteristics like hopefulness 29 and social support. 31 It could be assumed that based on the repeated findings, an effective prevention program could include the development of cognitive and social skills in line with the development of a positive lifestyle, way of thinking, feeling, and behaving. The introduction of complementary concepts and interventions from the field of positive psychology would be a suggested step at the therapeutic level. Such interventions could be the emergence and strengthening of strengths as well as mental resilience and positive emotions, such as hope and gratitude. According to Peele, 53 addiction-proof children have skills to gain real rewards in life, values that sustain moderation, and reject addiction in favor of pursuing positive goals, and confidence that they can achieve these goals. This is in contrast with addiction-prone children, who are more likely to come from backgrounds that deny them any opportunity, are plagued by bad feelings (depression, anxiety, lack of purpose), and have history of dependence. The reinforcement of these characteristics seems to be even more effective when teachers, parents, and the broader community are involved in the program. Therefore, prevention should concern a bigger part of society and should not be implemented fragmentarily only to the population at risk.

As indicated by the findings, in the review of substance addiction prevention, certain repeated matters raised which were evaluated in order to improve future choices and practices. Therefore, the restricted effectiveness of strategies based exclusively on information 17 , 35 has been confirmed, as aptly pointed out by Zafeiridis. 54 As we live in an era in which information constitutes a basic part of our lives, information is recommended to be provided at an initial stage of prevention, whereas later on it should become more experiential. As indicated, it is important to control the quantity and quality of the information 35 , 36 to be essentially helpful to parents, teachers, and children.

Prevention programs should also take into account the importance of development stages. 38 A reasonable conclusion drawn by the findings is that prevention should be applied at a young age (even at pre-school age), because the beginning of substance use later on reduces the possibility of problematic use. This is probably due to the fact that young people, from an age onwards, have already managed to develop important cognitive and emotional mechanisms of dealing with situations. The recognition of protective factors, as well as risk factors at a crucial age is also helpful in designing an effective intervention.

An issue dealt with in numerous researches was the importance of culturally-based interventions. 17 , 41 The programs implemented in developed countries can form a good knowledge and practice basis, but it is obvious that they should not be applied invariably in different cultural environments. A good suggestion in this regard would be the development of programs through the ground-up methodology, which initially illustrates the population needs, followed by the design of prevention interventions. To this end, the theoretical knowledge should be deployed and there should also be an integration of the appropriate theory and cultural elements.

With regard to the usual choice of implementing prevention programs in school-based environments, 19 it seems that school-based environment remains the most suitable one for these interventions as it combines the daily involvement of the child in a series of activities in the community environment where potentially significant others, such as teachers and parents, are also involved. The utilization of research findings is important in order to increase the so far minor positive results and generalize them in different conditions outside school.

On a broader level, it is commonplace that substance addiction prevention should be dealt with not only by the directly affected populations but by various bodies, such as associations, communities, religious bodies, as well as every individual member of the society. It is a reasonable assumption that the increase in social responsibility brings about an increase in individual responsibility and that the social well-being is interrelated with the individual one.

Finally, on a policy level, drug prevention is not something only experts should deal with, but requires an active political will and active involvement of the citizens. Accordingly, not only transdisciplinarity, but also the consistency of policy design and implementation of educational interventions is required and vital. To overcome possible obstacles, the cost of prevention should be calculated and compared to that of interventions. Effective prevention can, therefore, have multiple benefits on both personal and social levels.

The results of this study concerning the prevention of drug use showed the most effective interventions are those implemented in community contexts, such as schools, at a young age, and based on experiential methods tailored to the needs of each population. Humanitarian approaches are effective and can be applied in parallel with cognitive and behavioral approaches. In this context, methods from positive psychology could be used. It is important for clinicians working in the community to implement or recommend prevention programs with the above characteristics. Nevertheless, even for those clinicians who do not work in the community, it is important to know what really prevents substance use to make the right referrals and give the right directions. At the level of health services, it is important that prevention programs are implemented primarily universally in a broad context such as schools but also secondarily selectively in high-risk groups. Finally, it is important to emphasize that substance abuse prevention is not just for mental health professionals but also for the whole community, teachers, parents, and every individual citizen.

The present narrative review highlighted some important issues for addiction prevention. However, this was not a systematic review or meta-analysis. Further studies are recommended to conduct a more systematic review.

Acknowledgments

I thank the colleagues in the Department of Psychology at the University of Western Macedonia and the students in the course of psychopathology for their support.

Citation: Flora K. A review of the prevention of drug addiction: specific interventions, effectiveness, and important topics. Addict Health . 2022;14(4):288-295. doi:10.34172/ahj.2022.1348

Conflict of Interests

Author declares no conflict of interests.

Ethics Approval

Not applicable.

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Dissertations / Theses on the topic 'Substance and drug abuse'

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Chan, Kin-yi Ivy. "A study of determinants of relapse in psychotropic substance abuse /." Hong Kong : University of Hong Kong, 1995. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19470757.

Carr, Christopher M. "Substance abuse education with elite athletes." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/833473.

Williams, Patricia Joanne. "Factors affecting Hispanic adolescent substance abuse." CSUSB ScholarWorks, 1996. https://scholarworks.lib.csusb.edu/etd-project/1137.

Williams, Hector Chandra-shekar. "The desire of the spirit theological reflections on substance use and misuse /." Thesis, Available from the University of Aberdeen Library and Historic Collections Digital Resources. Restricted: no access until Oct. 5, 2011, 2009. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?application=DIGITOOL-3&owner=resourcediscovery&custom_att_2=simple_viewer&pid=53336.

Fuller, Joyce Julianne. "Differential Effectiveness of Substance Abuse Treatment For Drug Traffickers vs. Substance Users." Thesis, Kaplan University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1546521.

Study considered the differential effectiveness of standard substance abuse treatment for persons with actual histories of drug use vs. those who have been arrested for drug trafficking, possession, dealing, delivery, manufacture, or sale. Dataset contained 1,348 subjects who had completed drug and alcohol treatment. Mean age was 33; 2/3 of subjects were male, 1/3 female; ethnic mix was well rounded. The researcher identified 77 outcome variables within 12 outcome categories. Of the 77, 64 trended as predicted, suggesting poorer outcomes for drug traffickers vs. substance users. A Chi Square was computed on trend data and was highly statistically significant. A MANOVA was then computed, considering each of the 64 outcome variables, with two covariates: 1) number of days during the three months post treatment that the individual was in a controlled environment; and 2) severity of alcohol and drug abuse at time of treatment commencement. The overall MANOVA was highly statistically significant, indicating that drug trafficking has a pure effect on poorer treatment outcomes. ANOVAs were computer to contrast drug traffickers vs. substance users on each of the 64 individual outcome variables, using a Bonferroni corrected alpha level. In five of 12 outcome categories, one or more outcome measures differed significantly between traffickers and users. The five categories with significantly different outcomes were Continued Alcohol/Drug Use, Reinstitutionalization, Environmental Issues, High Risk Sexual Behaviors, and Relationship Issues. Why drug traffickers are receiving treatment designed for substance users, and treatment alternatives for drug traffickers along with costs and policy implications are considered. Keywords: substance use, drug trafficking, treatment, outcomes, substance abuse

Britt, Carolyn Sue. "Increased Risk Factors for Substance Abuse and Attitudes Regarding Substance Use Among Nursing and Non-Nursing Students." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2523.

Weil, Jennifer Mindy Goldstein Naomi E. Sevin. "Developing a substance use screening instrument: the juvenile offender substance abuse screen /." Philadelphia, Pa. : Drexel University, 2006. http://hdl.handle.net/1860/1230.

Lee, Pui-chun Dinah. "An evaluation of the Social Welfare Department's policy to control or limit substance abuse." Hong Kong : University of Hong Kong, 1997. http://sunzi.lib.hku.hk/hkuto/record.jsp?B18596666.

Chan, Kin-yi Ivy, and 陳健儀. "A study of determinants of relapse in psychotropic substance abuse." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1995. http://hub.hku.hk/bib/B31250038.

Rungani, Judith. "Drug abuse in selected Grahamstown schools." Thesis, University of Fort Hare, 2012. http://hdl.handle.net/10353/d1004784.

Zorland, Jennifer L. "The association between social context and phase of recovery among drug court clients a gender comparison /." unrestricted, 2008. http://etd.gsu.edu/theses/available/etd-05272008-141600/.

Makhura, Machaba James. "An investigation of the causes of substance abuse by learners in the Waterberg District of Limpopo Province : a case study." Thesis, University of Limpopo (Turfloop Campus), 2011. http://hdl.handle.net/10386/551.

Held, Jonathan Robert. "Substance abuse and anxiety: Implications for drug use among parolees." CSUSB ScholarWorks, 1993. https://scholarworks.lib.csusb.edu/etd-project/639.

Garvis, Pamela J. "Assessing methamphetamine withdrawal symptoms in the residential substance abuse treatment patient." Laramie, Wyo. : University of Wyoming, 2008. http://proquest.umi.com/pqdweb?did=1605148101&sid=1&Fmt=2&clientId=18949&RQT=309&VName=PQD.

Erlank, Elizabeth Cathrine. "Die substansafhanklinke geneesheer 'n maatskaplikewerkperspektief /." Pretoria : [s.n.], 2002. http://upetd.up.ac.za/thesis/available/etd-07252005-153955.

McAloon, Thomas John Psychology Faculty of Science UNSW. "Developmental trajectories into substance use in adolescence." Awarded by:University of New South Wales. School of Psychology, 2006. http://handle.unsw.edu.au/1959.4/30391.

Boys, Annabel Frances. "Young substance users : modelling consumption patterns, problems and expectations." Thesis, King's College London (University of London), 2001. https://kclpure.kcl.ac.uk/portal/en/theses/young-substance-users--modelling-consumption-patterns-problems-and-expectations(350a7ff3-f70f-4d4a-9acb-814c5ded88d5).html.

Simmons, Travis G. ""Because they made me come" : motivation and outcome in adolescent substance abuse treatment /." Electronic version (PDF), 2005. http://dl.uncw.edu/etd/2005/simmonst/travissimmons.html.

Lynch, Wesley W. "Adolescent Substance Abuse Screening." ScholarWorks, 2020. https://scholarworks.waldenu.edu/dissertations/7880.

Johnson, Mirta Escobedo. "Social workers' knowledge of substance abuse." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3205.

Coetzee, Lezanie. "Modelling Drug Abuse and Drug-related Crime: A Systems Approach." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97863.

Kimball, Bree A. Blackburn Ashley Gail. "Getting sober while incarcerated an exploratory analysis of correctional substance abuse treatment programs /." [Denton, Tex.] : University of North Texas, 2007. http://digital.library.unt.edu/permalink/meta-dc-5156.

Gaus, Joseph Stelmach. "Adolescent substance use as mediated by self reporting of motivation and associated circumstances." Diss., The University of Arizona, 1988. http://hdl.handle.net/10150/184588.

Casey, Kevin Francis. "Vulnerability to substance abuse: The striatal dopamine response to drug challenge." Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=121145.

Langsam, Adam H. "Juvenile Substance Abuse and Criminal Career Continuity." Thesis, University of North Texas, 2000. https://digital.library.unt.edu/ark:/67531/metadc2631/.

Carrano, Jennifer L. "Cumulative Genetic and Environmental Predictors of Youth Substance Use." Thesis, Boston College, 2012. http://hdl.handle.net/2345/2910.

Smith, Courtney E. "Influence of Parental Substance Abuse on Substance Use and Psychiatric Severity in Drug-Dependent Pregnant Women." VCU Scholars Compass, 2009. http://hdl.handle.net/10156/2393.

Jarman, Lennon. "Parental management of adolescent substance abuse." Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/17625.

McCarthy, Sara-Amanda, and Jennifer Ann Palmersheim. "Uncovering the methadone counseling process among recovering and non recovering chemical dependency counselors." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3129.

Gilson, Brian P. "Surveying the views of alcohol and drug treatment providers on family involvement in treatment." Online version, 2001. http://www.uwstout.edu/lib/thesis/2001/2001gilsonb.pdf.

McLachlan, Andre David. "Addiction Phenomenology In Substance Use And Non-Substance Use Disorders." The University of Waikato, 2008. http://hdl.handle.net/10289/2314.

Hammes, Shelley. "Differences in developmental assets and alcohol and drug use of Siren students in grades 7-12 after one year." Online version, 2002. http://www.uwstout.edu/lib/thesis/2002/2002hammess.pdf.

Hagaman, Angela M., and Stephanie M. Mathis. "Interprofessional Working Group Addresses Prescription Drug Abuse." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/3198.

Jones-Castillo, Jennifer Lynn. "Characteristics and service needs of the pregnant substance abusing population." CSUSB ScholarWorks, 1994. https://scholarworks.lib.csusb.edu/etd-project/930.

Groebner, Jeffrey Michael. "Pathological gambling and substance abuse in the Las Vegas arrestee population." access full-text online access from Digital Dissertation Consortium, 2005. http://libweb.cityu.edu.hk/cgi-bin/er/db/ddcdiss.pl?1428559.

Garrod, Harriet. "How does the wounded healer phenomenon manifest in ex-drink/drug addict counselling psychologists working in addiction?" Thesis, Regent's University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.646048.

Vassilev, Philip. "Arc and homer 1a expression following intravenous administration of heroin and cocaine : a novel application of the catFISH technique." Thesis, University of Sussex, 2018. http://sro.sussex.ac.uk/id/eprint/79700/.

Harder, Jennifer Pam. "A comprehensive study on the impact of asset building and value education among alcoholic and other drug abuse prevention in adolescents." Online version, 2003. http://www.uwstout.edu/lib/thesis/2003/2003harderj.pdf.

Turner, Paul. "The Relationship Between Risk for Drug Abuse and Meaning in Life." TopSCHOLAR®, 1995. http://digitalcommons.wku.edu/theses/891.

Mintz, Lora B. "Substance Abuse Education for Newly Licensed Registered Nurses." Mount St. Joseph University Dept. of Nursing / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=msjdn1588325931844645.

Watkins, Philip A. ""Waltzing with the monster" interventions with the substance-abusing adolescent for pastors, treatment providers, and family /." Lynchburg, Va. : Liberty University, 2006. http://digitalcommons.liberty.edu.

Hagemeier, Nicholas E. "Prescription Drug Abuse: Reflections and Visioning." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/1433.

Weeks, Kristie Graham 1952. "BIRTH ORDER AND PSYCHOLOGICAL POSITION OF ACADEMIC AND SUBSTANCE ABUSING WOMEN." Thesis, The University of Arizona, 1986. http://hdl.handle.net/10150/275557.

De, Pirro Silvana. "Substance-specific modulation of the affective and neurobiological effects of heroin and cocaine in human addicts." Thesis, University of Sussex, 2017. http://sro.sussex.ac.uk/id/eprint/71904/.

Redl, Donnie. "Factors in older adults' resistance to substance abuse treatment." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2342.

Tetrault, David E. "Select Counselors' perspectives on alcohol and substance abuse among Hispanic adolescents." Lynchburg, Va. : Liberty University, 2006. http://digitalcommons.liberty.edu.

Pack, Robert P., and Stephanie M. Mathis. "An Evidence-Based Response to Prescription Drug Abuse." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/3201.

Faulkner, Briar Lee. "Chemical dependency treatment: An examination of following continuing care recommendations." CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2145.

Smith, Donna Carroll. "Substance use attitudes and behaviors of students with learning disabilities." Connect to this title online, 2004. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1092148415.

Hagemeier, Nicholas E. "Prescribing Practices and Prescription Drug Abuse." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1431.

Allosteric Modulation at the Delta Opioid Receptor for the Treatment of Gastrointestinal Motility Disorders

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Drug Addiction and Thesis Statement

Drugs addiction is a problem faced by many people of the world, it is a topic that interests many writers, and they wish to write an essay on drugs for this topic. Drugs are very harmful and keep the capability of dragging an individual towards death and destruction. People all over the world want to eradicate the adverse situation of drug addiction from this world and this is the reason why they are busy in writing essays on drugs.

Essays on drugs are of many types such as war on drugs essay, essay on performance enhancing drugs in sports, essay on drug abuse, essay on illegal drugs, essay on drug addiction, essay on drug use, essay on drugs and alcohol and essay on drug testing, etc. The essays on drugs should be initiated by bringing in the information related to the topic of the essay on drug. You should know what drugs are.

In an essay on drugs, you will have to write about drugs, their affects and the reasons due to which people use them, you have to include the information about why the drugs are so famous and how harmful are they. A persuasive essay on drugs will be one, which will be according to the topic of the essay on drugs. It should have a full-fledged introduction, which should introduce the topic completely. The introduction should also have a thesis statement that should be the main idea of the essay on drugs.

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A thesis statement should be based on the essay question to which your essay on drugs is an answer. A thesis statement of an essay on drugs can be one sentence or more than one sentence but it is suggested that it should be only one sentence. Essays on drug abuse or essays on drug addiction should be written by arranging the ideas in a format that should be understandable. You should divide your ideas in different paragraphs for an essay on drug abuse or for war on drugs essay.

One paragraph should contain one idea and should not go towards a second idea, as it will reduce the comprehensiveness of the paragraph of essay about drugs. The essays on drugs should be written by researching the topic of drugs thoroughly so that the writer can depict information knowledgably. If you feel disturbed by an exercise of writing an essay on drugs, you can also get plagiarism free essays on drugs from custom writing websites, which are there for your assistance and support in terms of writing essays on drugs.

A Conversation with My Father by Grace Paley

Grace Paley combined several elements and devices in her short story “A Conversation with My Father”. The most striking themes in this short story are abandonment and family relationships.

In this new story, the daughter is describing facts, whereas the father wants a more complete description, full of details. Following this, we see that the daughter prefers to be optimistic, while the father prefers reality.

This is illustrated by the following quotes: “No, Pa, it could really happen that way, it’s a funny world nowadays”, and to this, the father replies “No… Truth first. She will slide back.” Her story describes the life of a mother and her son, and how she becomes a junkie to remain close to her son, who has become a junkie. In the end, the son quits the drugs world, but the mother cannot.

Her son leaves her, introducing the element of abandonment in the story. This theme is pursued further, but in between lines. For example, the son left his mother at a critical time, when she needed him most, whereas the narrator stayed with her dad, even in his dying days.

The father does not believe that the woman in his daughter’s story is strong enough and that even though she manages to quit doing drugs, she will fall back. I would tend to agree with him, because a lot of substance abusers, who quit, eventually, fall back. Her story is too optimistic, with a sense of denial for the tragedy.

As the story ends, the father says “Tragedy! You too. When will you look it in the face?” Again, here we wonder whether the tragedy refers to the mother/son situation, or the fact that he will be dying soon. Earlier on, the father had said “what a tragedy. The end of a person.”

And again, here the daughter refuses to accept that this is the end…whether it is the end of the mother or her father. This all relates to hope. When she started her story, she was determined to have hope in her story, to demonstrate that “everyone…deserves the open destiny of life.” I find it ironical, as she tries her best to present the story with an open end, with plenty of hope. However, when she read the story, her father says that it does not communicate hope.

It’s the “end”. On a lighter tone, there is another obvious pair of ironical sentence. The father says “Doesn’t anyone have the time to run down to City Hall before they jump into bed” and to this his daughter replies “In real life, yes. But in my stories, no.” I find this ironical, as nowadays the opposite is true.

Today, in real life, people jump to bed and then get married, or never get married. This is a contrast between then and now, and how the people, as well as literature, have changed.

Dont Do Drugs

Hi I'm Alma and this my opinion on why you shouldn't use drugs. I believe that drugs ruin your body, mind , and life. Drugs affect your body in many different ways such as brain damage , heart problems, kidney failure, liver problems and the list goes on and on. First of all Drugs are against the law and until the law is changed, anything to do with growing, transporting and selling of drugs is illegal. So unless you want to spend some time behind bars i suggest you think twice before trying any drug.

The most common drug that is used is marijuana. A lot of people say its not bad and that it helps with pain blah blah blah but when really marijuana can be the cause for people to go to stronger more addictive drugs such as heroine, cocaine, and crystal meth. These drugs are known for basically taking over peoples lives. All it takes is to try it once and then bam your hooked on it. They'll do anything just to get that high feeling they first got.

Which means they have to use more and more of the drug each time just to get that high feeling once again. Drug addicts often think and act differently when using drugs. They will often steal from their family, and there's more of a chance that they'll abuse them physically and mentally. The hardest thing for drug users is trying to quit. People get withdrawals where they can become depressed , have anxiety, become restless and many other hard side affects to deal with. So why go through all that struggle when you can simply just say no?

Another reason to stay away from drugs is because they can hold you back from getting your dream job or even a job period and from being able to be around family and friends. Many drug users tend to lose all their friends and family because they either don't trust them, they're a bad influence or they're violent. I for one wouldn't risk loosing my family or friends because of drugs its just not worth it and why worry about if their going to make you take a drug test to get that job you really want.

When you can be worry free if your drug free and then you can get any job you want. The last reasons to stay away from drugs is that they can have irreversible damage not only to your body but to your mental health. Many people have been known to loose touch with reality and in most of those cases its hard for them to return to normal mental capacity. There are people who are often in denial that they have a drug problem that can ultimately lead to overdose and death. In my opinion you should stay away from all drugs, because of these three main reasons.

The First one being Drugs are illegal and using them can lead to the lost of your freedom for many years. The second reason is There's a high probability of getting addicted and you can end up loosing everything and everyone you love. The final reason is that drugs can cause you to lose your sanity and eventually your life. This is why i chose not to use drugs because i don't want to risk loosing my loved ones and my life. Hopefully this will convince you not to ever try drugs either.

Different Types of Drug Abuse

Robert Cain Cocaine, Marijuana, Meet, Crack Cocaine, Heroin, and Prescription Pills are all illegal drugs. All of these types of drugs can be found on any corner of America these days. It seems that a lot of Americans are doing them. Many Americans are tempted by the excitement or possibly the escape these drugs seem to offer. Learning about the facts of these drugs can help you see the potential risk of chasing the excitement and escape. No one knows exactly why so many Americans are using drugs.

Some use drugs as a way to escape reality and some may use them just to fit in. While others use them to be rebellious and get attention. Many people use drugs because they feel It will help them cope with whatever feelings they are trying to mask. The sad truth Is after using the drugs many of the users have a feeling of regret and feel worse than they did to begin with. Drugs can ruin every aspect of a person's life. That Is why It Is very Important to spread the word of how damaging drugs can be. In conclusion with drug use in America.

No matter what type of drug you try you are that much closer to becoming addicted to it. All it takes is one time try it and like it. Drugs can ruin everything you have worked so hard for. Help me spread the word on how not to become a drug user. COW use drugs as a way to escape reality and some may use them Just to fit in. While they feel it will help them cope with whatever feelings they are trying to mask. The sad truth is after using the drugs many of the users have a feeling of regret and feel is why it is very important to spread the word of how damaging drugs can be.

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