Treatment and prevention of substance abuse

Risk groups
1. Drummond - invited people from A&E with alcohol problems to a clinic. Half attended the clinic
Health promotion - helps people to live a healthy lifestyle
1. Fear aroual
  1. Scare people about SA
  2. TV etc.
  3. INSKO - investigated different levels of fear aroual appeals
    1. Low fear - no impact as little fear
    2. High fear - no impact as too scary to watch
    3. Medium fear - maximum fear as scary enough to watch
  4. criticism
    1. Are they actually scared ?
      1. Teens think they'll change before that
    2. Unethical to put scary things on TV with children there
    3. Attitudes don't reflect behaviour - may agree but do it due to peer pressure
    4. Doesnt target risk groups
    5. Paul Armentano - Marijuana FA cause pro drug attitude
2. Social inoculation
  1. Schools etc
  2. Role play
  3. FLAY - should inform, develop peer pressure resistence and discuss roles of peers.
  4. Most 10 year olds are against smoking but grow up to smoke.
  5. Perry - children with social inoculation were half as likely to smoke
  6. Sussman - only works if group gets involved
  7. Criticism
    1. Donaldson - only works for people who already don't want to do SA
      1. Need to challenge social norms instead
    2. Most effective when a role model delivers it
    3. Most research only targets teens
    4. Irrational causes can't be solved rationally
    5. May arouse curiosity
Aversion therapy
1. Based on classical conditioning
  1. Given an emetic drug
    1. They associate the substance with being sick
      1. Stop taking substance
2. Evaluation
  1. Takes only 3 weeks
  2. Unpleasant - must be motivated to change
  3. Unethical - causes stress
  4. Most evidence is on alcohol
  5. Reductionist
Self management.
1. Alcoholics Anonymous
  1. Abuser for life.
    1. One drink relapse
      1. Must stop all together
  2. Religious
    1. Follow a series of steps to heal.
  3. Evaluation
    1. MOOS and MOOS
      1. Continued attendance = more likely to stop abusing
    2. Tonigan
      1. Unlikely to go back if you are not religious
    3. Don't release efficacy
2. Cognitive Behavioural Therapy
  1. Changes thoughts and so behaviour
  2. Monitor use
    1. Can stop or reduce
  3. Teaches coping strategies
  4. Evaluation
    1. Carrol - effective for cannabis and cocaine
    2. Effective before physical dependence.
3. Evaluation
  1. Needs motivation
    1. HIgh relapse
    2. Teach peer pressure resistence
  2. Craving may outweigh the want for change
Prochaska Model
1. 6 stages
  1. pre contemplation - no action - no problem
  2. contemplation - have a problem - no action
  3. Preparation - have a problem - plan to change - reduced abuse
  4. Action - have a problem - have stopped for a day
  5. Maintenance - have stopped for at least 6 months
  6. Termination - new behaviour is normal
2. Evaluation
  1. High completion rates
  2. Stages - less overwhelming
  3. Unlikely to stop if try to stop in early stages

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Treatment and prevention of substance abuse

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