Substance Abuse Prevention Program
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Substance abuse is a serious problem. It can cause a lot of problems in people's day to day functioning. Problems of substance abuse can be correlated to family problems, health problems, school problems and also occupational problems. Bigger problems lay within adolescents that have substance abuse problems. Substance abuse of adolescents between the ages of 12 to 17 has increased to 11.4%. This data was collected in 1997 from the Substance Abuse and Mental Health Service Administration. Their data also presented an increase from 2.2% to 3.8% between the ages of 12 to 13 years old (Substance Abuse and Mental Health Service Administration, 1999). Therefore it is to be said that substance abuse is becoming more relevant at younger ages as time progresses. According to the National Institution of Health, the abuse of Ecstasy has increased in 12th graders from 3.0% to 4.5% and has also increased in 10th grades from 2.4% to 3.5% between the years of 2005 to 2007. Hansen and Ponton indicated that adolescent risk behavior of the use of alcohol, tobacco, and other drugs will only get worse in the future. Adolescents that continue to abuse substances often experience a number of problems. Another substance that adolescents are increasingly abusing is alcohol in which 40.9% of 10th graders reported they had been drunk in the past year. According to the DSM-IV a substance abuse can be diagnosed if there is a continual pattern of substance use resulting in either failing to complete task such as school, work, or home, risking the harm of others by operating heavy machinery while under the influence. If the recurrent substance also creates legal problems by getting arrested or creates social or interpersonal problems within a 12 month period is to be considered a substance abuse. Because of these dangerous affects this paper will focus on the prevention of substance abuse rather than treating it.
Adolescents are taking more risk than ever before. The consequences of these risks can encounter problems that affect their health, their lives, and their futures (Danish, 1997). Because of this early age of substance abuse more and more adolescents who are being treated are found to have more social and emotional problems (Fisher & Harrison, 2000). One major consequence of a substance abuse is that it can negatively affect user's health. Adolescents that are abusing illicit drugs increase their risk of death by suicide, homicide, accidents and illness (McCaig, 1995). The results of the drug abuse warning network study revealed that drug related emergencies increased by 17 % (McCaig, 1995). Not only is the physical health perceived as a negative consequence but also the user's mental health. Adolescent illegal drug use causes problems involving healthy psychological growth and functioning for a healthy lifestyle (Brook et al., 1998a).
Substance abusers frequently leads to depression, developmental lags, apathy, withdrawal and psychosocial dysfunctions (Bureau of Justice Statistics, 1992).Substance abusers can also develop a wide cluster of personality disorders. One personality disorder that is associated with adolescent substance abuse is conduct disorder (Stratton, 1998). Conduct disorder consist of behavior and emotional problems in adolescents. Adolescents with this disorder are viewed as bad or delinquents. They have a difficult time following the basic social and cultural norms and rules in which they behave in ways that are considered socially unacceptable. (Bureau of Justice Statistics, 1992)
Another consequence that is related to adolescent substance abuse has to do with the performance in academics. Hawkins, Catalano, and Miller (1998) cited research revealing that low levels of commitment to education and high truancy rates are related to an adolescent substance abuse. Truancies rates are also know as inexcusable absences. Low commitment to school and inexcusable absents set up bigger problems for education in the future. These bigger problems include users producing low standings compared to their class and even dropping out of school. The school consequences are very important to consider in the development of adolescents. Education is one aspect that dictates ones present and future quality of life. School dropout rates are highly correlated with adolescents that have substance abuse problems (Crowe, 1998). It is important to understand the different causes of the negative effects from a substance abuse. The more knowledge we know the better chance we have to prevent it.
One cause that can make an adolescent vulnerable to start abusing substances at an early age could be due to social influences. Instead of only looking at the individual for explanations of the cause/origin of adolescent substance abuse it is also important to consider the social influences in which adolescents are surrounded by as an important causal contribution. Chau-Kiu Cheung and John Wing-Ling (2008) had conducted a study concerning the impact of social influences of adolescent substance abuse. Their study was directed to demonstrate how social influences, such as social encouragement and support are relevant to a cause of a substance abuse (Cheung and Ling, 2003). An adolescent is more likely or at greater risk of substance abuse when the adolescent is helpless due to "contextual unhappiness" (Patterson, 1999). From the results of Cheung and Ling's study (2003), found a main interaction between social influences and "contextual unhappiness. When external social influences engage in an adolescent while they are unhappy, can create a vulnerability to abuse a substance (Cheung and Ling, 2003). Adolescents being stressed combined with an external social influence (encouragement & support) also creates a vulnerability to cause a substance abuse (Cheung and Ling, 2003). The overall findings from Chau-Kiu Cheung and John Wing-Ling's study (2008) shows that external forces play an important role in an adolescent substance abuse. These external forces lay in lines of our environment (peers, family members, and others) and are a huge contributor to the cause of a substance abuse.
The findings from the previous study suggested that our environment is a causal factor to substance abuse. To better understand why our environment possess causality to substance abuse, we need to determine what aspects, domains, or settings put adolescents at risk for becoming substances abusers. Settings that include risk factor can include families, peer groups, schools, and your community. The more risk factors that adolescents are exposed to, the more likely the child will abuse a substances. (Hawkins and Spoth, 2001)
Risk factors that appear in a family setting converse around the parents. Furthermore the risk factors revolve around parental active roles of supervision and appear in family situation (Kumpfer, Olds, Zucker,1998). For example, if there is a lack of attachment or nurturing between the parent/caregiver while that adolescent is developing. A number of investigators have shown that a close and mutually warm bond between the parent and the child is associated with less adolescent abusing drugs (Brook et al., 1993;Schmidt et al., 1996). Also drug use by a parent or sibling has been found to cause a substance abuse (Conger and Rueter, 1996; Duncan et al., 1995; Kandel, 1990; Kazdin, 1987; Loeber and Dishion, 1983; Patterson et al., 1989). If a family member is or has abused a substance and if there is a poor relationship between the child and the parent will put adolescents at risk of a substance abuser (Brook et al., 1990, 1998b). Children that have used drugs were compared to kids that have not and were found to be three times more likely to have a family member who is or has abused a substance (Brooks, La Rosa,Whiteman, Johnson, Montoya, 2000).
In a study done by Brooks, La Rosa,Whieman, Johnson and Montoya (2000) did research examining family drug use, parent and child relationship, and environmental factors that contribute to a cause of a substance abuse. Strong parent and child relationships were found to decrease the chances of a substance abuse. In this study, parent-child relationship were described by support, identification, and non-conflict relationships. Results from the study (200) about parental identification suggest for a better internal representation of the father will decrease the chances of a substance abuse. This means not only the mother but the father has to spend more time with the child engaging in his or her life. This creates a close mutual relationship that will allow the child to admire his or her parental figure as a role model according to Brooks, La Rosa,Whieman, Johnson and Montoya (2002). Another aspect of the parent-child relationship was found to decreased a substance abuse was the amount of time the parent spends with his or her child. Furthermore by parents not having a close mutual relationship and not engaging with the child will create a risk factors for a substance abuse. Overall this research presented by Brooks, La Rosa,Whieman, Johnson and Montoya (2000) demonstrated that parental drug use and poor parent child relationships are key risk components to developing a substance abuse. (Brooks, La Rosa,Whieman, Johnson and Montoya, 2002)
Environmental causes outside of the family home setting can decrease the chances of a substance abuse (Brooks, La Rosa,Whieman, Johnson and Montoya, 2002). For instance, by having children attend to church regularly. Church can teach morals, values, and give guidance about life. Brooks, La Rosa,Whieman, Johnson and Montoya (2000) also hit on the importance of neighborhoods being a component of an environmental cause. Neighborhoods that are found to have violence, drug availability, low familism and non regular attendance to church will increase the chance of causality of a substance abuse.
Like I mentioned previously there is more than one domain or setting that can cause an adolescent being involved in substance abuse. Not only can the family play apart in the causality of developing a substance abuse but also schools. Instead of blaming the victim we can put blame on our school systems. For example, the classrooms adolescents are attending to might not be conducting good classroom behavior or good social skills. These skills play a big role in the developmental process of an adolescent. This leaves kids very vulnerable to external forces from the classroom. Not only can the classroom be the problem but the school itself. Schools offer a lot of social activity and interactions. While being at school adolescent are at risk of associate and becoming involved with adolescent that have a substance abuse problem. This also opens up new doors for the availability of getting a hold of drugs; quantity and variety. (NIDA, 2001)
Although there are a variety of types of treatments that show positive effects for a substance abuse. I want to focus on preventing a substance abuse and not blame the victim. Some adolescent substance abuse programs have attempted school based approaches, community approaches, and family based approaches.
Pervious school based drug prevention programs have focused on protective factors of social influences on drug abuse. Some have been successful by delaying the use of tobacco, alcohol and illicit drugs for adolescents in middle school. Programs that have been targeted toward middle school have been found to miss the importance of the transition phase from middle school to high school. It is important to set prevention programs to gear in to adolescents that are making this transition phase. (Lynskeyet al., 2003)
Another problem with previous prevention programs (ALERT) found that their programs affect boys more that girls. The cause of this problem still remains unknown (Longshore, Ellickson, McCaffrey, Clair, 2007).
The Project ALERT program was focused on middle school students. This programmed aimed its principles to motivate youth against using drugs and develop skills for resistance behavior. Project ALERT used small group activities and used techniques to examine questions and answers. These are important components to an effective program (Tobler, 1992). Pervious trials of the ALERT program have produced positive results, but they found room for improvement. Their new program called "ALERT PLUS" is based off the same fundamental principles of their old program; however, they have made changes to address problems. The ALERT PLUS added changes to focus on developmental changes during the transition phase of middle school to high school. Developmental changes can affect opportunities and motivation to drug use (Longshore, Ellickson, McCaffrey, Clair, 2007). These developmental changes include friendship networks and dating opportunities. Overall, the new program goals were to strengthen norms against drug use, help students cope with drug situation, and learn ways to quit. Furthermore they wanted to have a better educational system for teaching students consequences of drug and cope with emotional stress. (Longshore, Ellickson, McCaffrey, Clair, 2007)
Pervious results from their old program were able to prevent and reduce marijuana and tobacco in 8th grade students. However the program was not able to help students how have already smoked cigarettes. Also the old program only affected alcohol use in the short-run and not long-run. Therefore the PLUS program strengthened their lessons to improve education on alcohol use and was designed to help those who have already smoked more than one cigarette. (Longshore, Ellickson, McCaffrey, Clair, 2007)
The results of the ALERT PLUS program showed significant improvements. Girls in the PLUS program reported lower rates of weekly alcohol use. Girls in the plus program were compared to girls in the original program showing a reduction of alcohol by 32%. Reductions were also found in marijuana use by 49%. Another important finding that contributed to the new program was the scores of alcohol consequences and high risk alcohol use all showing improvements. (Longshore, Ellickson, McCaffrey, Clair, 2007).
Other programs mostly rely on school teachers and police officers to educate the youth during school time. In my opinion they never left enough time that adolescents need to be well educated/rounded on substance abuse.
This next prevention program created by Abbey, Pilgrim, Hendrickson, Buresh, (2002) set its principles on family based substance abuse prevention. This program offers skills that are directed toward parents. These skills are designed to increase family communication and bonding. Skills in this direction will decrease the chances of an adolescent substance abuse. The "families in Action" (FIA), includes techniques for a stronger parent-child communication, positive behavior management, ways of interacting among the family, factors for school achievements, and education on substance abuse. These were designed to create a better overall relationship. (Abbey, Pilgrim, Hendrickson, Buresh, 2002)
The FIA programs goal was to increase resiliency and protective factors within the family. The program was aimed toward children who are entering middle school. This prevention took place between 1994 to1995. It involved 37 children and 38 parents. The program involved once a week sessions for six consecutive weeks. The session went no longer than 2.5hrs. (Abbey, Pilgrim, Hendrickson, Buresh, 2002)
Families were measured on three different accounts for pre and post data. They were measured on family cohesion, family communication, and family fights. Cohesion was measured by the family environment scale on a nine point rating. Family communication was also measured on a nine point scale by participants indications the number of times they had different behavioral patterns. (Abbey, Pilgrim, Hendrickson, Buresh, 2002)
There were no significant finding presented between children in the FIA program when compared to a baseline group. However, the parents produced an important finding when compared to the comparison group. Parents in the FIA program had lower scores on attitudes toward tobacco, an appropriate age to drink at, and family cohesion. (Abbey, Pilgrim, Hendrickson, Buresh, 2002)
Because substance abuse is becoming active at earlier and earlier ages as the time goes on, it is important to start prevention early in a child's life. What is needed is more consistent and long term adolescent substance abuse prevention that stays associated and involved with children during their courses of development. The program needs to be consistent by reaching out to where adolescent spend most of their time. This adolescent substance abuse program includes educations and developmental skills across the family and school settings.
Because substance abuse can affect ones academics, physical and mental health and ones future, it is important to start prevention as early as 8 years old. For prevention to start this early prevention needs to be focused on families and more so on parents. One leading cause to a substance abuse is having a family history or a parent who was chemically dependent. Family members who were chemically dependent put their child to be genetically vulnerable to a substance abuse (Kumpfer, 1999). The first step of prevention is to get the parents to be well rounded and educated on drugs and substance abuse. Parents need to become aware of the origins of substance abuse. Meaning they need to know the causes and effects of a substance abuse. A great way for parents to become educated is to take part in neighborhood leader groups. Leader groups offer a great opportunity for getting and giving input and output. This also leads to another important prevention aspect in the family setting. Getting involved and paying attention to the child is important. Parents need to become very active when it comes to supervising. Staying involved with your child will heighten protective factors to outweigh the risk factors. Parental involvement is a crucial ingredient to preventing a substances abuse. Involvement doesn't just mean being around the kid when he/she is at home. Parents need to reach out past the home setting. A great skill for prevention is to get involved with your children's interest. This can include friends, activities and their fantasies like a hero/role model. This is why it is important to take part in neighborhood leader groups. It gives the chance to know your child's friends and their families. Becoming aware of who their friends are, where they come from, and getting to know the parents makes for a very strong and effective way for staying involved and having a tight relationship. Getting to know your child's interest can really make a positive impact on the child and is a great skill for prevention. For example, take your child's favorite superhero/role model and exemplify a new anti drug message once a week that has consequence toward that hero or role model. Parents being educated, staying involved with the child's interest and having good supervising skills offers a big part in keeping this prevention program consistent and long-term.
Because it is important to keep the program consistent and long term in the development of the child, education and skills need to be implemented at school settings. At this point schools offer more risk factors than protective factors for substance abuse. Because of this window of risk factors and because schools take part in a big section of development of children; prevention needs to be enforced. Most school systems do not seem to be aware of the severity of negative effects of a substance abuse. This is apparent because of how high dropout rates are correlated to substance abuse in which rates are only going up. Instead of school systems only setting aside 15-20 minutes for drug awareness assemblies, school need to set aside more time for children just as their parents. In doing so the school systems have to change their academic system. They need to implement a full education class three days a week. Instead of the children just sitting in the class room and listening to the teacher, the class is going to involve a lot of participation. This participation will not only involve inside the classroom but will also take part as an extracurricular active outside of the school. By giving children extra actives to do outside and inside of school, will lessen the chance of them becoming involved with children that already have a substance abuse problem and take away from the availability of drugs. Inside the classroom teachers will be instructed to keep kids well rounded on types of drugs, health effects, academic affect, behavior affects and what a substance abuse can lead you to, like in the juvenile system. Activities inside the class room will be meant for participation toward learning coping skills, emotional control skills and social skills. Because this program is constructed to be long term and consistent, inside school classes and the extracurricular activities need to be practiced and implemented into school academic circular systems and not just as a brief assembly or an announcement.
The extracurricular actives outside of school are going to involve children reaching out into their communities beyond the school and family settings. This component to the program will stay active throughout the whole year and the summer so transition phases are not in effect. These activities will involve children from schools giving educational seminars in public place around their community. They will take what they have learned from inside the classroom and propose anti drug messages consistently across their community. Seminars will include places such as libraries, parks, beaches, neighborhoods, churches and shopping centers. Unlike other program this program needs to stay consistent and long-term through the stage of development. That is why this program is implemented into the family, school and beyond.
In summary, this educational and skills substance abuse prevention program will strengthen the protective factors and weaken the risk factors of a substance abuse. For this program to be affective it has to take place in our families and school staying consistent and long term. All the aspects of family and school settings combine to create a chance of involvement of socializing creating strong relationship in a positive manner for being substance free. By having the protective factors outweigh the risk factors we can stop this continual pattern of adolescent substance abuse.
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