Module 5 - Department of Health | Welcome to the …File/module5blw.pdf5 Topic 2 Values and attitudes to AOD use 2.1 Significance of values and attitudes Values are beliefs about what

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Contents

Topic 1 Introduction .....................................................................3

Topic 2 Values and attitudes to AOD use ....................................5

Topic 3 Understanding AOD use in society................................15

Topic 4 AOD use by young people ............................................28

Topic 5 Factors influencing AOD use by young people ............54

Topic 6 Harm minimisation in AOD work....................................63

Topic 7 Current policies and legislation guiding AOD work........69

Topic 8 Understanding the issues that have shaped theAOD industry .................................................................82

Topic 9 Summary and conclusion ..............................................92

References ...................................................................................95

Key terms ...................................................................................99

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Topic 1

Introduction

Overview

This module explores some of the reasons whyyoung people may use drugs and focuses on thesocial and economic factors that influence drug use.It also contains information about drug use patternsand legislation and policy relevant to young peopleand drug use.

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1.2 Learning outcomes

When you have completed this module you will be able to:

Identify your own personal values and attitudes regardingAOD issues and their implications for working with youngpeople on AOD issues

Describe current models used to understand drug-usebehaviour

Describe patterns and prevalence of drug use by youngpeople

Discuss a broad range of factors that can impact on AODuse by young people

Outline harm minimisation and other current policies andframeworks that underpin AOD work with young people.

It is suggested you remind yourself of these learning outcomesas you work through the module. At different stages ask yourselfwhether you think you have achieved each of the learningoutcomes. This will help you keep track of your progress andwhat you still need to learn to successfully complete the module.

1.3 Assessment events

Your facilitator will provide you with information on anyassessment activities you might be required to undertake. If youare not provided with assessment information when youcommence this module, make sure you ask your facilitator ifthere are any assessment requirements for module completion.

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Topic 2

Values and

attitudes

to AOD use

2.1 Significance of

values and attitudes

Values are beliefs about what is good and desirable.This includes what we consider good and desirable forourselves, for others and for the wider community.

Each worker has a unique perspective on the worldand has their own set of values. These can often betraced back to our experiences as children and themessages that we get from our parents, friends andsociety as we grow into adults. As we mature wedevelop our own attitudes towards life. We discardsome parts of our value system and adopt newvalues.

We bring to the workplace a whole range of lifeexperiences that define who we are. It is neitherpossible nor desirable to separate ourselves into a‘work’ self and another ‘social’ or ‘family’ self. We maymodify our behaviour to fit work or social situations,but it is not psychologically healthy to alter our wholepersonality or to split our psyches into separate selves.

Significance of

values and

attitudes

Values and

attitudes to

AOD use

Values and

working with

young people

Personal values in

the workplace

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Our identity is not fixed but is constantly evolving as a result ofour interactions with friends, family, co-workers and clients. Weare also influenced by our interactions with employers and withsocial institutions. For example, people who work in a healthenvironment might absorb ideas about harm minimisation.These ideas are gradually absorbed into our value system andbecome part of who we are.

The significance of values and attitudes

Note: If you are completing this by distance learning ask twoother people for their responses to these questions andcompare them to your own. Write your first response andencourage those who assist you to do the same.

Write down three words that describe what youthink about young people today.

In one or two sentences describe the role ofparents in today’s society.

Write down three words that describe what youthink of young people who use AOD.

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Being aware of our values and attitudes is important because ithelps us to:

• identify why we are doing what we are doing

• identify what the consequences of our actions will be forourselves or for the young person or colleague

• consider other or better options

• be more aware of the reasons for our responses tosituations.

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2.2 Values and

attitudes to AOD use

Alcohol and drug use in our society is not a neutral issue. It isstrongly influenced by the attitudes and values common insociety. It is not unusual to pick up a newspaper or turn on thetelevision on almost any given day and hear about or see astory relating to the ‘dangers’ of drug use.

Our beliefs and attitudes have been influenced to at least someextent by the messages portrayed by the media and societymore generally. It is important then, that we are aware of ourown values and attitudes and the impact that they may havewhen working with young people.

Some drugs might be more socially acceptable in Westernsociety than others (e.g. coffee or alcohol versus heroin orcocaine), but all of these substances are drugs nevertheless. Itis important to realise how pervasive our attitudes are in relationto drugs and drug use.

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Rate these statements on a scale of 1 to 10, 10 being themost disturbing to you, 1 being the least disturbing. Useeach number once only.

� A man with his family at the beach, drinking from a beercan

� A 14-year-old smoking a joint at a party

� A woman shooting up heroin in a flat with her childrenplaying in another room

� A well-dressed businessman staggering blind drunk outof a major international hotel

� A 13-year-old girl chain smoking

� A young man shooting up heroin in a public toilet

� A 15-year-old girl staggering blind drunk in a local parkabout to throw up

� A 16-year-old male prostitute soliciting for gay men to getmoney for drugs

� A senior youth worker taking a dose of Valium during thelunch break

� A drunk young man getting in a car to drive home.

Can you identify any themes coming through? What arethey? Can you draw any conclusions about your attitudes?(You may like to compare your responses with those of yourfriends or colleagues.)

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2.3 Values and working

with young people

Our values can impact in positive and negative ways when weinteract with young people with AOD issues. For example, wemay attempt to influence the choices and decisions of youngpeople on the basis of our own experiences, rather than lookingat the individual situation of each young person.

Consider your beliefs and values

The aim of this exercise is to consider some of your beliefs andvalues about young people, which may impact on the way youinteract with them.

Read the following statements. Each of the statements willask you to think about how you perceive the behaviour ofyoung people. Consider whether you strongly agree, agree,are neutral, disagree or strongly disagree with eachstatement. Draw an ‘x’ on the line to indicate your feelings.

1. Life was easier for young people when you were an adolescent

Strongly Disagree Disagree Neutral Agree Strongly Agree

2. Young people only want to spend time with their mates


3. Young people have too many options today


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4. Young people can’t make good decisions for themselves


5. There is no safe level of drug use for young people


6. It is preferable for a young person to use some substances overothers


7. Young people who are voluntary clients are easier to work withthan those who are involuntary.


8. The family is a safe environment for young people


9. Young people only think about themselves


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Can you identify any emerging themes? Forexample, do you have strong views on anyparticular topics or issues? Can you draw anyconclusions about your attitudes?

Discuss (with a colleague or learning group) howyour values and attitudes might impact on yourwork with young people. Write down any areas orissues which are problematic.

Write down some strategies you could develop toavoid these issues impacting on the young peopleyou work with.

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2.4 Personal values

in the workplace

Not only can our values impact on the young people with whomwe work, but they can also impact on our relationships withother workers.

Read the following scenario and answer the questionsbelow.

You are working in a government-run youth health centre. Yoursupervisor has a strong belief in religion and has definite ideasabout right and wrong, sin and guilt. She believes thatabstinence from using AOD is the only way to be ‘free’ of AODproblems and that this should be the goal of all interventionswith young people.

Would you be able to have an effective relationshipwith this person?

What values does this example bring up for you?

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How might your boss’s attitude impact on youngpeople?

• We all have personal values and attitudes that canimpact significantly on the way we work with youngpeople

• The nature of work with young AOD users can evokeemotional and personal responses

• Reflecting upon our values and attitudes can assistus develop strategies to manage work with youngpeople

• Developing strategies for managing those responsesis critical both for yourself as a worker and for thequality and effectiveness of your work with youngpeople.

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Topic 3

Understanding

AOD use in society

3.1 Reasons why

people use drugs

For most people, using drugs is just another way ofaltering consciousness that is not so different frommany other recreational activities. However, for therelatively small number of people who develop morecompulsive drug-using patterns, drug use is not justabout having fun, relaxing or for ‘partying’. It usuallyserves a deeper purpose (such as helping enhanceidentity, acceptance, and reducing psychologicaldistress or a sense of alienation).

Human beings have a long history of usingsubstances to alter their consciousness. Ancienttribes made their own mind-altering substances,some of which are still used today.

When working with young people, it is important tounderstand that for many, drug use is a fairly normalpart of growing up, and that the reasons why manyyoung people use drugs is not too different from thereasons why adults might enjoy drinking alcohol orengaging in other non-drug activities.

Reasons why people

use drugs

Types of AOD use –

Schaeffer’s model

Dependence

Models that help us

understand AOD

use in society

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It is important to understand why young people might choose touse alcohol and other drugs and to consider this in the contextof youth and youth culture. Life can be difficult for many youngpeople as they work to define their identities and deal with manyof the pressures of adolescence. While adolescence is a periodof discovery, fun and achievement, it can sometimes be aconfusing time for some young people. Frustration, anger andtrauma can result from environmental and individualcircumstances. It is therefore, important to consider that AODuse may be due to certain aspects of a young person’ssituation, and may be used as a mechanism for coping withsuch pressures.

Adolescence is also a time of happiness, experimentation,celebration and fun and just as adults derive pleasure fromusing drugs, so can young people. Sharing an intoxicated timewith friends can be a bonding experience. It can heighten asense of group membership and belonging. Risk-taking is also anormal part of development and experimenting with psycho-active drugs is just one of the many risks that some youngpeople will take during this time of great change.

Comparing adults and young people

Consider the reasons why adults use psycho-active drugs(including caffeine, alcohol, and tobacco) and why youngpeople use psycho-active drugs. Write down the reasons inthe table below.

Adults Young people

Consider your responses. Are they very different?

Now consider the reasons given by a sample of drug users fortheir use of a particular drug (Zinberg).

• To enjoy the effect 85 percent

• To use for recreation 57 percent

• To use for relaxation 54 percent

• To socialise 46 percent

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3.2 Types of AOD use

– Schaeffer’s model

Schaeffer outlined five distinct patterns of AOD use:

• experimental

• recreational/social

• situational

• intensive

• compulsive

Schaeffer has developed a model to describe patterns of druguse. In this model (see below) he acknowledges that mostpeople use drugs in an experimental or recreational manner.This is particularly true for young people who often experimentwith various substances as part of their growing up.

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Drug use by recreational users serves different purposes thandrug use by intensive and particularly compulsive users. Inother words, recreational users and intensive or compulsiveusers use drugs for different reasons (Spooner, 1999; Shedler &Block, 1990; Stein, Newcomb & Bentler, 1987).

Recreational drug use is more about:

• curiosity

• rebellion

• being social

• having fun

• relaxing

• confidence

• the physical sensations of the drug

Intensive and particularly compulsive drug use on the otherhand, is more about:

• reducing a sense of alienation

• identity formation

• self-medication

• relieving emotional distress

• improved self-regulation (soothing your emotions)

Recreational users tend to use more to have fun or party whilecompulsive users are motivated more by deeper psychologicalprocesses such as self-medication and providing relief fromnegative emotions.

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ROBERTO AND JULIAN

Roberto and Julian are two 16-year-olds who spend most of theirtime together. On weekends, they like to party hard and theyconsume large amounts of alcohol (mainly spirits) every Saturdaynight. When there are no parties, they usually go to the beach todrink together. Julian usually drinks a lot more alcohol thanRoberto, but for both of them, Sundays are spent recovering.

Roberto also uses a variety of substances to get him through theweek. He claims that this helps him to cope with his parents andlife in general. He does not see his drug or alcohol use as aproblem and believes his life is under control.

What are the differences in Roberto and Julian’sAOD use? Which seems to have more of aproblem? Why?

Can Julian’s alcohol use be described as purelyrecreational?

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3.3 Dependence

Being dependent on drugs is not very different to beingdependent on many other everyday activities such as thetelevision, work or your car. Dependence exists on a continuum,and a useful way to think about the process of dependence isto relate it to your own relationships.

Dependence

The word dependence means different things to differentpeople.

Most of us will admit that we are dependent on our cars,computers, money, partners or friends.

One definition of dependence is: ‘A state of relying on or beingsustained by something’.

When it comes to drug dependence, however, society tends toview it as something quite different from these everydaybehaviours. Despite this, a number of authors have arguedstrongly for it to be considered in the same light.

Dependence is a relatively normal human experience. Most ofus are dependent to a greater or lesser extent on something.

Understanding the normality of dependence is important interms of developing relationships with young people with AODissues, as well as being able to dispel some of the mythssurrounding dependence with your client group, parents and thewider population.

In the absence of the thing that we are very dependent on weoften experience negative feelings and become quiteuncomfortable. We think about the thing/object/person a lot, andwe often orient our behaviour towards getting it back.

Experiencing negative feelings in the absence of drugs isconsidered one of the hallmark features of drug dependence.

This understanding is important in terms of developing anempathic relationship with a young person, and also for helpingparents and other key stakeholders understand what it is like tobe strongly attached to, or dependent on a substance.

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Assessing your own dependence

Write down a list of five things or people you depend on.Remember to include things like technology (e.g. T.V., radio,mobile phone) and food/favourite items/pets.

1.

2.

3.

4.

5.

Using a scale of 1-5, rate each item according to how muchyou think you depend on it. If you think you depend onsomething a lot, or feel that it is a big part of your life itshould be rated at 5.

1. 1 - 2 - 3 - 4 - 5

2. 1 - 2 - 3 - 4 - 5

3. 1 - 2 - 3 - 4 - 5

4. 1 - 2 - 3 - 4 - 5

5. 1 - 2 - 3 - 4 - 5

Think about how you would react if this item orperson were unavailable to you. How would youfeel? How would you cope? Take the time to writedown some of your thoughts in the space below.

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3.4 Models that help

us understand

AOD use in society

Models of drug use

Throughout history people have tried to understand the conceptof drug use and why some people become dependent oraddicted to certain drugs and why some don’t. Many theorieshave been developed over time that provide us withexplanations of drug use. Some of these theories have beendeveloped into models which is a way of defining a problem orsituation so that it can be more easily understood.

The following models have been most influential in developingdrug policies and drug treatment historically and are still used inAustralia. These models influence the way people work withyoung people and other individuals who have drug problems.You may be able to relate to some models better than othersand identify models that underpin your agency’s approach todrug use.

Moral model

During the eighteenth and early nineteenth centuries addictionwas viewed as a sin. Drug-dependent people were consideredmorally weak, and addiction was seen as a fault of one’scharacter. Under the influence of this model, users werepunished with whippings, public beatings, stocks, fines, andpublic ridicule being relatively common. (In some British townspeople were made to walk around wearing nothing but beerbarrels.) Spiritual direction was also a common treatment. Jailsentences were another form of punishment and at the turn ofthe century many more drug users were put in mental hospitalsas the jails became full.

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Disease model

The disease model assumes that the origins of addiction liewithin the individual him/herself. This model adopts a medicalviewpoint and suggests that addiction is a disease or an illnessthat a person has. It believes that:

• Addiction does not exist on a continuum – it is either presentor it isn’t.

• Addicted people cannot control their intake of a givensubstance. Once they consume some of the substance(such as one drink of alcohol) they are powerless to stopthemselves having any more and are overtaken by almostirresistible cravings when they cannot have it.

• The disease of addiction is irreversible. It cannot be curedand can only be treated by lifelong abstinence.

Alcoholics Anonymous (AA) is based on the disease model.Given the popularity of disease models, it is worth examiningtheir advantages and disadvantages in greater detail.

Advantages of disease models include:

• drug use becomes a health issue and not just a legal issue

• allows ‘addicted’ people to understand their behaviour.

• offers a treatment approach (abstinence) that works forsome people

• removes some of the shame often felt by people affected byaddiction.

Disadvantages of disease models include:

• removes responsibility from the user

• offers only one course of treatment (abstinence) which is notsuitable for all people, particularly young people

• not supported by a large amount of evidence.

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Psycho-dynamic model

This theory originated with Sigmund Freud and is still usedtoday as a way of treating people with drug problems. Thebasic philosophy behind the psycho-dynamic model is that wecan link problems to our childhood and how we cope (or don’tcope) as adults. In other words, drug use or misuse may be anunconscious response to some of the difficulties individuals mayhave experienced in childhood. This philosophy forms the basisof many counselling approaches which aim to gain insight intoan individual’s unconscious motivations and try to enhance theirself-image.

Social learning model

Prior to the 1970s, substance dependence was understoodpurely in terms of a physical reliance on a substance and theexperiencing of withdrawal symptoms in its absence. Russell(1976) introduced the idea that dependence is not only chemicalbut also behavioural and social in nature. It is based more onthe user’s thoughts about the substance, and what it is like to be‘under the influence’ of the drug itself.

The key points of the social learning model can be summarisedin the following way:

• Anyone who engages in an activity that they find pleasurableis at risk of developing dependence on that activity.

• Dependence is a learned behaviour that results fromconditioning, modelling and thinking about the substance.

• Dependence on an activity/drug or person exists in degrees.The greater the dependence then the greater the negativefeelings experienced in the absence of the activity.

• Dependence is a normal facet of human behaviour. It onlybecomes a problem when the individual experiences anumber of negative consequences as a result of theirbehaviour, but continues to do it anyway.

• A sense of compulsion, of wanting to engage in a behaviour(such as drug use), but knowing that one really shouldn’t, isthe hallmark of addictive behaviour. People talk about asense of having handed over control to thedrug/person/object.

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• In wanting to do something very much but knowing that oneshouldn’t, behaviour becomes erratic. ‘Bingeing’,ambivalence, secrecy, unreliability, rationalisations and vowsof abstention are common.

• Addictive behaviours are only terminated when the individualmakes the decision that the costs of continued use are vastlygreater than the benefits.

Socio-cultural model

This model has become popular in the last 15 years. Unlikeother models it focuses on society as whole and not just onindividuals. This model is based on the idea that the type ofsociety in which people live has an impact on their drug use. Inparticular, this model makes links between inequality and druguse. It suggests that people who belong to groups who areculturally and socially disadvantaged are more likely toexperience substance abuse problems. It also recognises thatsociety labels users of certain substances as deviant, therebycreating further problems.

Because this model links substance abuse to the conditions ofthe wider society, the solution to ‘drug problems’ revolvesaround changing the social environment, rather than treatingindividuals. This involves developing ways to address poverty,poor housing and discrimination.

Public health model

In Australia this approach was launched at the National DrugSummit of 1985. The summit resulted in the National CampaignAgainst Drug Abuse and later the National Drug Strategy 1992–1997 and 1998–2003. This model continues to guide treatmentand prevention programs in Australia. It is an integratedapproach and identifies three key factors and the relationshipsbetween them.

1. The agent – characteristics and effects of the drug itself

2. The host – characteristics of the individual or group ofusers

3. The environment – the context of the drug use.

This approach is reflected in the Interaction model.

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This model is based on the philosophy of harm minimisation.This means that we accept that drug use is a reality within oursociety and that trying to stamp it out is an unreachable goal.The goal therefore is to reduce the harms brought about bycertain types of drug use through the following range ofintervention approaches.

Models of drug use

A group of around 12 young people (mainly boys) aged between14 and 17, meet each Saturday night in an isolated section ofthe local park and get drunk.

There have been a lot of complaints from neighbouringresidents and some of the young people involved drive cars toand from the park.

You are a local Youth worker and have been requested tohandle this complaint. Using the following tables,summarise how you would deal with this situationaccording to the assumptions of the models of drug usepresented in this topic.

• Primary prevention - The aim is to ensure the problemdoes not occur in the first place. This may be achievedthrough:

- community development- drug education- media-based strategies

• Secondary prevention - The problem is identified in itsearly stages and intervention is applied to stop furtherprogress of possible problematic drug use.

• Tertiary prevention - This is when the problem isconsidered serious and may be affecting the individual’shealth, finances, relationships and/or legally. Treatmentmay include counselling, hospitalisation etc.

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Model Response

Moral Model

Psychodynamic Model

Disease Model

Social Learning Model

Public Health Model

Socio-cultural Model

Throughout history various models of drug use have beendeveloped:

Model Central Theme

Moral Model Views addiction as a sin or a moral weakness

PsychodynamicModel

Asserts childhood traumas are associated withhow we cope or do not cope as adults

Disease Model Argues that the origins of addiction lie in theindividual him/herself

Social LearningModel

Suggests that dependence behaviours arelearned, exist on a continuum and consist of anumber of behavioural and cognitive (thought)processes

Public HealthModel

Drug use seen as the interaction between thedrug, the individual and the environment

Socio-culturalModel

Argues that substance abuse should beexamined in a wider social context and can belinked to inequality

Distance learners should take time now to reflect on theirlearning, check in with their facilitator and determine theirprogress.

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Topic 4

AOD use

by young people

4.1 Legal drug use

by young people

Substantial community and political concern aboutillicit drug use among young people has resulted ingovernment actions such as drug summits andfunding to address these issues. However alcohol

and tobacco − two legal drugs − are also verypopular. Young people are using alcohol andtobacco at high rates even before they reach 18when they are legally able to buy and consumethem.

www.wa.gov.au/drugwestaus/core.htmlwww.health.nsw.gov.au/public-health/dpb/images/index.html

Perspectives on Working with Young People

Legal drug use by

young people

Comparing AOD use

patterns of young

people and adults

Tobacco and alcohol

use among young people

Marketing of alcohol

and tobacco to young

people

Drug-related deaths

and harm among

young people

Information sources on

AOD use

Crime and AOD use

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Alcohol and tobacco use among young people

What might be some of the reasons that manyyoung people tend to use legal drugs such asalcohol and tobacco as their drugs of choice?

(Write your answer here, then check the possible answerson the next page.)

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Possible answers include:

• relative low cost

• easy availability

• modelling by parents and peers

• marketing

• fear of illicit drugs

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4.2 Comparing AOD use

patterns of young

people and adults

The three most popular recreational drugs in Australia arealcohol, tobacco and cannabis, generally in that order. This istrue for both young people and adults.

Look at these statistics comparing lifetime AOD use amongyoung people and the general population from National DrugStrategy Household Survey, 2001.

Table 1: Lifetime use of the drug

0

10

20

30

40

50

60

70

80

90

100

Alcoh

ol

Tobac

co

Can

nabis

per

cen

t

14 - 19 years

All ages

NDSH, 1998

This table suggests that if young people start to use alcohol andtobacco before they are 20 they are likely to keep using thesedrugs when they become adults. The table also suggests thatcannabis use is slightly higher among young people than in thegeneral population.

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Factors associated with smoking

The level of tobacco smoking among young people remains amajor problem in Australia despite a generation of effort andfunding from state and national governments to prevent themfrom taking up smoking. While there was a reduction in youthsmoking rates in the 1980s, smoking rates have risen againsince the early 1990s. Smoking is the largest cause ofpreventable illness and death in Australia. People who startsmoking in their teens smoke at a heavier level and are lesslikely to quit in adulthood. Children of smoking adults are morelikely to smoke.

Smoking is strongly associated with social factors, and peoplefrom the following groups more likely to smoke:

• lower socio-economic regions

• unemployed

• blue collar workers

• residents of rural areas

Tobacco use and socio-economic status

What might be some of the reasons that peoplefrom certain groups are more likely to smoke?

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4.3 Tobacco and alcohol

use among young people

Tobacco use

Males and females of all ages have similar patterns of tobaccouse.

Table 2: Tobacco use, 14−29-year-olds 2001 (percent)

Males Females

0

10

20

30

40

50

60

70

80

Nev

ersm

oked

afu

llci

gare

tteEx

smok

ers

Wee

kly

Dai

ly

Nev

ersm

oked

afu

llci

gare

tteEx

smok

ers

Wee

kly

Dai

ly

pe

r c

en

t

14-19

20-29

(Source: National Drug Strategy Household Survey, 2001.)

a) Never smoked more than 100 cigarettes or the equivalent amount oftobacco.

b) Ex-smoker: smoked at least 100 cigarettes (manufactured and/or rollyour own) or the equivalent tobacco in their life, but reported no longersmoking.

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Alcohol use

Significant numbers of young people consume alcohol on aregular basis, with females consuming less than males.

Table 3: Alcohol use, 14−29-year-olds, 2001 (percent)

Males Females

0

10

20

30

40

50

60

Never consumed a full glass

Occasional, less than weekly

Never consumed a full glass

Occasional, less than weekly

per

cen

t 14-19

20-29


Men of all ages drink more alcohol than women. However,young people drink significantly more than the generalpopulation.

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Table 4: Amount of alcohol usually consumed:proportion of recent drinkers aged 14-29 years,

by age and sex, compared to all ages.

Drinks per week

0

10

20

30

40

50

Low risk High riskRisky

pe

r ce

nt

Males

Females

Table 5: Consumption by age and sex

14-19 years 20-29 years

0

10

20

30

40

50

60

70

80

90

Absta

inee

Low

Risky

Hig

hris

k

Absta

inee Lo

w

Risky

Hig

hRisk

per

cent

Males

Females


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Where do young people drink?

What are the most likely places for young people toconsume alcohol?


37

The top five places where young people consume alcoholare:

1. at parties

2. at a friend’s house

3. at home

4. at licensed premises (e.g. clubs and bars)

5. in cafes and restaurants.

• Young women (14−18-year-olds) are more likely to drink atparties, at clubs, at work and in educational institutions (e.g.universities), than are young males. This suggests a moresocial aspect to their drinking.

• Young men of the same age are more likely to drink athome, in cars and at friend’s houses. However, the mostcommon place for both males and females to drink is atparties.

• Adults are more likely to consume alcohol at home.

What do young people drink?

Young men (14−18-year-olds) drink mainly beer and spirits,whilst young women drink a high proportion of pre-mixed drinkssuch as UDL, coolers and spirits. Young people tend not todrink wine.

Reflection

Do the facts and figures presented in the tables andgraphs in this section fit with your experience ofworking with young people in your area? Whatsimilarities exist? What differences can you identifyand why might these differences exist?

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Many of the statistics indicate that young womenare catching up with young men in their use ofcigarettes and alcohol. Is this reflected in your workwith young people? Can you suggest some reasonswhy this might be happening?

Over the past 10 years the level of advertising foralcohol and cigarettes has been greatly reduced.Does advertising still have a significant effect onyoung people? Why?

Once you have written down your responses discuss themwith your colleagues or in a group.

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4.4 Marketing of

alcohol and tobacco

to young people

Alcohol

Advertising for alcohol products remains legal in all forms ofmedia although there are some restrictions. Clearly themanufacturers of alcoholic drinks are trying to make theirproducts appear attractive to young people. People who drink

are usually beautiful, sophisticated, sexy and popular −attributes considered very important to young people.

Identify some commercials that target a youngermarket.

(Write your answer here, than check they possible answerson the next page.)

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• Archers

• Bacardi Breezees

• Midori Illusions

• Stolleys

Tobacco

Young people are particularly vulnerable to advertising andmarketing. They want to look and act cool. Advertising fortobacco products has virtually ceased in Australia. Sponsorshipof sport is one of the remaining ways for tobacco companies toopenly market their products. Promotions where attractiveyoung women offer free cigarettes also occur, although this isusually limited to licensed venues.

Tobacco companies now take advantage of one of their lastrefuges: the retailer selling the tobacco. Called ‘point of sale’advertising, retailers such as corner shops and service stationsoften display advertising as well as a large wall of cigarettepackets which become de-facto advertising. It seems thattobacco companies are also paying for ‘product placement’ oftheir brands in films and television to get around the laws and tomarket their products to young people, who are big filmgoers.

Advertising restrictions vary across Australian states andterritories. Some do not allow any ‘point of sale’ advertising andcigarettes are kept under the counter.

Look at cigarette retailers in your area. Whatrestrictions apply?

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4.5 Drug-related deaths

and harm among

young people

Deaths

Nearly one in five deaths in Australia is drug-related. In 1998, itwas estimated that 17,671 Australians died as a result ofharmful drug use and over 18,500 Australians would behospitalised for conditions resulting from harmful drug use.

Tobacco and alcohol were responsible for over 93 percent ofdeath-related mortality and morbidity. Tobacco and opiatesfigure significantly in the death rates (as the primary cause ofdeath) for adults, while alcohol features much more strongly inthe death rates for young people.

Table 6 outlines drug-related deaths among 15−34-year-oldswith a comparison of deaths among those over 35.

Table 6: Drug-related deaths 1998(not including suicide/accidental poisoning)

0

10

20

30

40

50

60

70

80

Alcohol

Tobacco

Opia

tes

Cannabis

Oth

er illicit

drugs

15 - 34 years

Over 35 years*

*1992 data

42

Harm consequences

Alcohol and other drug use results in health problems in a verylarge number of young people in Australia (Alcohol in Australia2001; National Action Plan on Illicit Drugs, 2001).

Some of the AOD-related health consequences for youngpeople are summarised below:

• road traffic injuries

• assault

• depression and self-harm

• cognitive impairment (brain damage)

• overdose (especially with heroin use)

• blood-borne disease such as Hepatitis C and HIV.

Note: Young males have much higher rates of alcohol-relatedhealth problems compared to females.

43

4.6 Information sources

on AOD use

Young people arrested for crime have high rates of AOD use.There is a particularly strong link between alcohol and crime.A significant proportion of the following crimes are committed byoffenders affected by alcohol at the time of the offence(Williams, 1989):

• murder

• assault − including domestic violence against women

• sexual assault of adults

• theft

• drink driving

Both the perpetrators and victims of alcohol-related violencetend to be young men, with most offences taking place late onFriday and Saturday nights, in or near licensed venues. Alcohol-related violence is also more common in rural communities.

Building a profile of your community

In the following series of exercises you will build a comprehensivepicture of the young people and drug issues in your local area.You will need to find out about which drugs are used, where theyare used and by whom.

Sources of community information

Think about the sort of information you need tofind. Make a list of organisations and services inyour local area that might gather relevant statistics.


44

Possible sources of relevant data include:

• police data on the extent of drug use and drug-relatedcrime

• hospital and other health services data on drugoverdose and other drug-related health problems

• Coroner’s Court data on drug-related mortality

• Ambulance Service data on non-fatal overdose

• alcohol and other drug agency data, such as treatmentand referral statistics

• needle and syringe program data

• local court data on drug offences

• school information on student drug use, truancy andso on

• local media stories on drug-related issues in thecommunity.

Community location

Where is your community located?

Research shows that young people from outside capital cities inAustralia are more likely to drink alcohol heavily than their citybased peers (Williams, 1999). This is probably related to a wellentrenched heavy drinking culture in the bush, especially amongyoung men. Rates of tobacco use are also higher in rural areas(National Action Plan on Illicit Drugs, 2001).

It is important to note that while these differences in alcohol andtobacco use are significant, the differences in the rates of usebetween city and country based young people are not large.

When you are examining the statistics for your area, try to keepa look out for differences with the general population. If you livein a regional or isolated area, try to compare your findings withthose of a major city.

45

Community cultural make-up

What is the cultural makeup of your community?(You can usually get this information from your localcouncil, library or the Australian Bureau of Statistics)

Does your community include many IndigenousAustralians? How does the proportion of Indigenouspeople in your local community compare to thefigures for Australia generally? What are theimplications (e.g. agency staffing) for your work?

The cultural make-up of your community is obviously veryimportant and will impact on the drug choice of young people inyour community.

For example, there is considerable evidence that there arehigher rates of smoking tobacco and harmful use of alcoholamong Indigenous Australians, compared to other Australians.There are also higher numbers of non-drinkers among theIndigenous population than the broader population.(Drug Statistics, 2000)

While there is a reasonable amount of information available onAOD use among indigenous Australians overall, there is muchless information regarding the use of AOD among youngIndigenous people. This is partly due to the relatively smallnumbers of young Indigenous people, as compared to non-Indigenous young people.

While there is a lack of scientific data collected on a large scale,petrol sniffing has been acknowledged as a major problem for

some Indigenous communities − especially in rural areas − forover 20 years.

46

Culturally and linguistically diverse (CALD) groups

Does your community include young people fromculturally and linguistically diverse groups?

As with indigenous populations, there is little data available onAOD use among young people from CALD groups. Researchconducted in the 1990’s by the Drug and Alcohol MulticulturalEducation Centre in NSW found that there are some distinctdifferences in AOD use among people (including young people)from cultures where the first language is not English.

Alcohol

• Overuse of alcohol in Australia is much less commonamong people from CALD groups compared toAustralian-born and English-speaking migrants (Alcoholin Australia, 2001).

• CALD communities which do tend to drink alcoholregularly (e.g. Italian and Spanish) are more likely todrink in a less harmful pattern (wine daily with meals),compared to the Australian and English tradition of bingedrinking in order to get drunk.

• Alcohol overuse is not common among Arabic, Chineseand Vietnamese speaking communities.

Tobacco use

Research by the Drug and Alcohol Multicultural EducationCentre in New South Wales found:

• smoking is highest among Arabic speakers (at a higherrate than the general community)

• males in this group are much more likely to smoke thanfemales, but this gender difference reduces with youngerpeople.

• smoking was lowest among Chinese speakingcommunities, again with women smoking at much lowerlevels than men.

47

Young people with psychological disorders

The results from the Australian Survey of Mental Health andWell Being (1997) Australian Bureau of Statistics indicate thatpeople (including young people) with psychological disordersare more likely to abuse alcohol and other drugs. Among youngpeople in treatment for drug and alcohol abuse, there is a highprevalence of psychological disorders including:

• depression

• anxiety

• conduct disorder

• personality disorders

• attention deficit hyperactivity disorder (ADHD)

• schizophrenia

• post-traumatic stress disorder (PTSD)

It must be noted that many homeless young people have notbeen diagnosed and use AOD to self-medicate.

Information sources

From your local Area Health Service, find out how manyyoung people in your local area suffer from the disorderslisted above.

Drug information sources

What sort of drugs are used by young people inyour area?There are a large number of resources available foraccessing information about patterns and prevalence ofAOD use in the general community. Survey reportsare a good source of information about drug use.Surveys are conducted by a variety of organisations ona regular basis.

48

Obtaining survey reports

Most survey reports can be downloaded from the Internet.For example, the Australian Drug Foundation(www.adf.org.au/drughit/stats/) has a comprehensive list of linksto sites where surveys can be viewed and printed. Likewise,most state health departments supply data on AOD use whichcan often be accessed on their websites

The librarian at your local library or at your workplace will assistyou in obtaining paper copies if you do not have access to theInternet.

Other sources of information

In addition to survey reports, there are many other sources ofinformation about drug use which including:

• Australian Bureau of Statistics (ABS) which conducts andpublishes numerous studies relating to patterns andprevalence of AOD use

• mortality and morbidity (death and sickness) data from stateand federal health departments

• Australian Institute of Criminology

• police arrest data

• ambulance data

• methadone client urine testing data

• the National Drug and Alcohol Research Centre (NDARC)publishes regular reports on the use, availability and price ofillicit drugs

• Australian Institute of Health and Welfare publishes reportson the health of Australians

• Australian customs reports on illicit drug seizures

• Australian Intravenous League (Ivy League) www.aivl.org.au

49

4.7 Crime and AOD use

Illicit drug use among the general population

The following table has been included as an example of theinformation that is available.

Table 7: Summary of drug use in the preceding 12 months:proportion of the population aged 14 years and over,

Australia wide, 1998

0

10

20

30

40

50

60

70

80

90

Mar

ijuan

a/ca

nnab

is

Pain-

kille

rs/a

nalg

esics

Tranq

uilis

ers/

slee

ping

pills

(a)

Stero

ids

Barbi

tura

tes(

a)

Inha

lant

s

Her

oin

Met

hado

ne(a

)

Amph

etam

ines

(a)

Coc

aine

/cra

ck

LSD/syn

thet

icha

llucino

gens

Ecsta

sy/d

esigne

r drug

s

Inje

cted

illega

l dru

gs

Ever us

edan

yilli

cit d

rug

Non

eof

the

abov

e

(Source: National Drug Strategy Household Survey 1998.)

(a) For non-medical purposes.

50

Patterns of cannabis use

Like adults, the most popular illicit drug among young people iscannabis. Cannabis is used much more widely than other drugsby young people (except at ages of under 14, where inhalantuse is more popular) probably because of its easy availabilityand low cost factors which have a strong impact on drug use.

Cannabis use and young people in Australia

Young people:

• are more likely to smoke hydro cannabis with a bong (waterpipe), while older Australians tend to use joints

• tend to smoke stronger potency cannabis (hydro or head),while older adults tend to smoke leaf, which is less potent.

• report that they obtain cannabis from friends or acquaintances,as opposed to a street dealer (85-90 percent).

Note:The level of cannabis use declines in people over 25.

Where are young people most likely to smokecannabis?

(Write your answer here, then check the possible answers onthe next page.)

51


In order of popularity:

• friend’s house

• parties

• own home

• public places − e.g. park, beach

• car

Other illicit drug use

When young people use drugs, they tend not to inject − they aremore likely to smoke, swallow, snort or inhale. Injecting drugsappears to be a barrier for many young people.

Next to cannabis, the most popular illicit drugs for youngAustralians are:

• inhalants − especially among those under 16

• benzodiazepines (prescribed sedatives)

• amphetamines − which are usually snorted

• ecstasy − taken as a tablet

• hallucinogens (aka trips) − LSD is usually dissolved on atiny piece of paper which is swallowed.

Injecting drug use

Injecting drug use has increased significantly in recent years,but remains relatively rare among the general population of

under 20’s in Australia. Less than 1.4 percent of 14−19-year-olds injected illicit drugs in 2001.

Lifetime injecting rises to almost 7 percent for Australians 20-29years, still well below rates of cannabis use. While the rates ofinjecting drug use remains relatively low in mainstream youthculture, injecting drugs can result in serous harms, includingoverdose, Hepatitis C and criminal activity (to finance the cost ofdrugs).

52

Heroin

In recent years there has been much community concern aboutthe level of heroin use and overdose. This concern has beenreflected and/or fuelled by attention by the media and bypoliticians. Drug Summits have been held in NSW and WesternAustralia in the late 1990s and early 2000s.

With the level of concern that has been shown, one wouldexpect that the use of heroin among young people would be

very high. This is not true. Use of heroin among 14−19-year-olds, that is used at least once in a lifetime is 0.7 percent formales and 1.1 percent for females. A slightly higher incidence is

prevalent for 20−29-year-olds showing males use at 5.2 percentand females at 2.0 percent in the year 2001.

Comparing your workplace experience

Does the information contained in this module fitwith your experiences with young people? Whatsubstances are commonly used by the youngpeople you know or work with? (Discuss someideas with your colleagues or in groups.)

Complete profile of your community by bringing togetherall the information you have collected and putting it in afolder. It will give you a clear picture of your localcommunity and it will be useful in supporting yourarguments for new or more appropriate services.

53

• Legal drug use such as alcohol and tobaccoconsumption among young people is very commonand remains a major problem in Australia

• The media portrays alcoholic beverages as beingsexy and sophisticated and aims to target a youngpopulation, contrary to tobacco advertising which hasceased throughout Australia

• Nearly one in five deaths in Australia are drug-related. Some AOD-related health consequences foryoung people include road traffic injuries, assault,depression, overdose and infectious diseases

• Statistics claim there is a strong link between alcoholuse and crime in young people

• Statistics indicate that young people withpsychological disorders are more likely to misusealcohol and other drugs and have a higherprevalence of psychological disorders.

54

Topic 5

Factors influencing

AOD use

by young people

5.1 Systems model

Young people do not grow and develop in isolation.Experiences, families, their peers and even thegeneration they grow up in impacts upon theirgrowth and development.

A useful way of understanding how young people’sexperiences and environment effects them is to lookat them through a systems approach.

A systems approach assumes that no aspect ofbehaviour occurs in isolation without the widercontext in which it occurs. In other words, when wetry to understand young people, we must considerthe individual, their family, the wider community andsociety as a whole as well as how they interact witheach other. Even subtle changes in one part of thesystem impacts on other parts and can also affectrelationships between various systems.

Introducing the

systems model

The systems

approach and

young people

The systems

approach and AOD

use

Perspectives on Working with Young People

55

Your adolescence

Think about your own adolescence. What kinds ofsystems impacted on the way that you experiencedlife? Think about another adolescent that you knew.What kinds of systems impacted on their life?

Systemic youth-focused framework

In applying a systems approach to working with young peoplewe need to acknowledge the following assumptions.

• Young people are normal and deal with challenges in wayssimilar to other people in society (e.g. some well and othersnot so well).

• Young people develop their coping strategies and skills bylearning from others around them, through their ownpersonalities and through trial and error.

• The term ‘youth’ is a social construction. Societal values,beliefs and myths about young people can often determinethe way in which they are treated by adults. For example,young people are viewed differently in different cultures.

• Young people are not a homogenous group. Althoughyoung people experience some common developmentalissues, their backgrounds, experiences and cultures are asdiverse as the rest of the population.

• Young people make choices and actively participate in oursociety. They are not victims of a dysfunctional society,family or peer group.

56

Other factors that influence young people are:

• developmental stages (differences between a 13-year-old and a 19-year-old, individual differences in reachingdevelopmental milestones)

• socio-economic status (where they are placed in thestructure of society),

• culture (the culture they identify with, and their culturalpractices)

• gender (biological and social experiences related to thatgender)

• sexuality (their sexual identity)

• educational background (type of education, the schoolthey attended and educational experiences)

• family background (foster care, state wards, blendedfamily, single-parent family, traditional family, extendedfamily etc)

• physical attributes (disability or impairment, tall, short,dark-skinned, light-haired etc)

• peer culture (values and beliefs of friends and peers)

• cohort (people who were born in the roughly the sameera. Values, beliefs and behaviours of one cohort canbe vastly different from those of another).

• interests (hobbies, passion).

57

5.2 Applying a youth-related

systems approach

to young people

Approaching young people from a systemic model requirestreating each young person as an individual. The aim of theworker is to remain curious about that young person and to findout as much as possible about their background, influences,values, attitudes, passions, interests, goals and abilities.

A systems approach assists workers to be non-judgemental intheir approach, seeing each young person as unique rather thanpart of a group of people with a label while at the same timeunderstanding the influences in that young person’s life.

This approach encourages workers to ask open questions andexplore all the facets of the young person’s life. It helps themdevelop an understanding and respect for each individual youngperson’s experiences.

Using a systemic approach means engaging with young peoplein a positive and respectful way being aware of power issueswithin the helping relationship.

SAM

A young man (Sam) attends your centre. He has dreadlocks,make-up and feral attire. He looks like he has been using asubstance.

What are your assumptions about Sam?

58

What would you like to find out about Sam?

What are some ways that you think you mayengage with this young man?

59

5.3 The systems approach

and AOD use

The youth-focused systems approach provides a framework forunderstanding a range of adolescent behaviours. It helps us tounderstand the context of young people’s AOD use by indicatingthe broad range of factors that affect their lives.

The following diagram illustrates the factors that can influence ayoung person. Each of the factors involves a complex array ofinfluences and situations which can serve as ‘protective’ or ‘risk’factors in a young person’s life. The kinds of risk or protectivefactors present in a young person’s life can influence the healthand wellbeing outcomes for that individual.

60

SAM

Remember Sam? He is 18 years old and is living in a refuge inthe city for young people who identify as same-sex attracted.He left home when he was 15 due to domestic violence in thefamily. His mother was born in Vietnam and his father is ofAnglo-Australian background. Sam has one younger brother.His family of origin are from a working class background.

Sam attended the local state school until year 10. He has limitedcontact with his family but has a rich network of friends of allages in the gay community. He was sexually assaulted at theage of 10 by a family friend. He told his father who physicallyassaulted him for making up stories. He has experiencedanxiety, depression and suicidal feelings since the assault. Hehas not sought counselling about his experiences and has beenusing alcohol and other drugs since the age of 14 mainly as away of self-medicating.

Consider the following questions:

What are your assumptions about Sam now?

What would you like to find out about Sam? (Usethe diagram on the following page to think about thefactors that influence Sam.)

How do you think you could help Sam?

61

YO

UT

H-F

OC

US

ED

SY

ST

EM

S A

PP

RO

AC

H

•Law

s o

f socie

ty

•S

ocio

-econom

ic c

limate

•A

vaila

bili

ty o

f serv

ices

•S

ocia

l valu

es a

nd n

orm

s

•S

ocia

l/cultura

l pra

ctices a

nd t

raditio

ns

•P

opula

r culture

(e.g

. m

ovie

s a

nd m

usic

)

•G

overn

ment

ideolo

gy a

nd p

olic

ies

•R

ole

of

media

and a

dvert

isin

g

• F

am

ily h

arm

on

y

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buse a

nd n

egle

ct

•F

am

ily d

ysfu

nction

•P

att

ern

s o

f com

munic

ation

•F

am

ily incom

e/e

mplo

ym

ent

•P

are

nts

’ m

enta

l and p

hysic

al health

•C

onsis

tency o

f connection

•F

am

ily v

alu

es,

belie

fs a

nd r

ole

models

•F

am

ily d

iscip

line a

nd s

tructu

re

•E

xte

nded/n

ucle

ar

fam

ily

•F

am

ily s

ize

•P

opula

tion d

ensity

•H

ousin

g c

onditio

ns

•U

rban/r

ura

l are

a

•N

eig

hb

ourh

ood v

iole

nce a

nd c

rim

e

•C

ultura

l norm

s,

identity

and e

thnic

pride

•O

pport

unitie

s f

or

socia

l develo

pm

ent

•R

ecre

ational an

d s

upport

serv

ices

•D

em

ogra

phic

and e

con

om

ic f

acto

rs

•C

onn

ecte

dness o

r is

ola

tion

•N

atu

re o

f re

lati

on

sh

ips

•H

ealt

h a

nd

we

llb

ein

g

•L

ife o

pp

ort

un

itie

s(e

.g. ed

ucati

on

an

d w

ork

)

•C

rim

inal

an

d l

eg

al

co

nseq

uen

ces

•A

OD

use a

nd

rela

ted

harm

•S

ocia

l in

clu

sio

n o

r

marg

inalisati

on

• P

eer

connecte

dness

• S

chool clim

ate

and c

ulture

• S

chool att

end

ance

• O

pport

unitie

s f

or

socia

l connection

• N

orm

s a

nd v

alu

es o

f pe

ers

and s

chool

• F

riendship

s a

nd inte

rests

• E

ducational a

ppro

ach/m

eth

ods

•S

chool dis

cip

line a

nd s

tructu

re•

Pe

rso

na

lity a

nd

in

telli

ge

nce

• G

end

er

• C

ultura

l backgro

und

• P

hysic

al and m

enta

l he

alth

• S

ocia

l skill

s a

nd s

elf e

ste

em

• S

exu

al beh

avio

ur/

sexualit

y

• A

lcohol and d

rug u

se

• C

rim

inal in

volv

em

ent

• Liv

ing s

ituation/h

om

ele

ssness

• V

alu

es a

nd b

elie

fs

62


• A systems approach is a useful way ofunderstanding how a young person’s experienceand environment affects them.

• Factors that influence young people includedevelopmental stages, socio-economic status,culture, gender, sexuality, educational, family,physical, peer culture, cohorts and interests.

• A frontline worker should find out as much aspossible about a young person’s background. Thiscan be achieved by applying a youth-focusedsystems approach framework.

• Once a worker obtains some backgroundinformation from the young person it is necessaryto establish which influences are protective or riskfactors.

63

Topic 6

Harm minimisation

in AOD work

6.1 What is harm

minimisation?

Harm minimisation aims to address alcohol andother drug issues by reducing the harmful effects ofalcohol and other drugs on individuals and society.Harm minimisation considers the health, social andeconomic consequences of AOD use on both theindividual and the community as a whole. It hasbeen a key policy of Australian state and federalgovernments since the 1985 launch of the NationalCampaign against Drug Abuse and the subsequentNational Drug Strategy.

Earlier in this module you looked at values andattitudes to AOD use and patterns of AOD use bothby young people and society in general. As with allwork on AOD issues, certain values and beliefsunderpin the harm minimisation approach.

What is harm

minimisation?

Harm

minimisation in

the workplace

64

The harm minimisation approach

The harm minimisation approach is based on the following:

• Drug use, both licit and illicit, is an inevitable part of society

• Drug use occurs across a continuum, ranging fromoccasional use to dependent use

• A range of harms are associated to different types andpatterns of AOD use

• A range of approaches can be used to respond to theseharms.

You have already explored a range of models that are used tohelp understand drug use. Harm minimisation is based on thepublic health model. According to this approach, AOD use isviewed as the result of the interaction between the followingthree components: the individual; the social, economic, culturaland physical environment; and the drug itself. Strategies toreduce harm related to AOD use are therefore focused on thesethree interacting components.

65

We can also link the harm minimisation approach to the youth-focused systems approach discussed in Topic 5. The systemsapproach expands on the public health model by providing agreater emphasis and depth to the environmental factorsinvolved. It increases our awareness of the broader societaland cultural factors, the interactions between different parts ofthe system and the impact these have on young people andtheir behaviours. It helps us to see that interventions to reduceharm can be directed at different parts of the system.

Goals and strategies for harm minimisation are wide ranging.The approach is broad enough so that the goals of safer druguse, controlled use and abstinence can all be accommodated.

Does your agency have a policy on harmminimisation? If so, briefly outline the policy.Reflect on any harm minimisation strategies thatyou currently use in your work with young people.Do you think these strategies work well for theyoung people that you work with? Consider thereasons for your response.


66

Harm minimisation strategies can be categorised into threeareas:

• Harm reduction − strategies that aim to reduce the harmfrom drugs for both individuals and communities. Thesestrategies do not necessarily aim to stop drug use. Examplesinclude needle syringe services, methadone maintenance,brief interventions and peer education.

• Supply reduction − strategies aimed at reducing theproduction and supply of illicit drugs. Examples includelegislation and law enforcement.

• Demand reduction − strategies aimed at preventing theuptake of harmful drug use. Examples include communitydevelopment projects and media campaigns.

Suppose that a new illicit drug called Mafu hasbecome a problem in your community. It is a type ofamphetamine with a range of negative side effectsand has been the cause of sudden death in numberof new users. You have been appointed to lead thetaskforce in tackling the Mafu issue. What factorswould you consider in attempting to reduce theharm associated with using Mafu?


67

Possible factors to be considered include:

• the different patterns of use discussed in Schaeffer’smodel (i.e. experimental, recreational, social, regularand dependent)

• who is your target group and what you want to achieve

• types of strategies you could use – harm reduction,demand reduction, supply reduction

• different parts of the system that you could target.

In terms of the workplace, what additional harmminimisation strategies could be used with theyoung people that you work with?

What factors in your workplace could assist you inapplying some of these new harm minimisationstrategies? How could you make use of these tohelp you to implement harm minimisationstrategies?

68

What factors in your workplace may be obstacles toyou applying harm minimisation strategies with theyoung people that you work with? How can you tryand overcome some of those obstacles?

• Harm minimisation aims to address alcohol and other drugissues by reducing their harmful effects on individuals andsociety

• Harm minimisation is based on the public health model, inwhich AOD use is seen as an interaction between thedrug, the individual and the environment

• Harm minimisation can be categorised into three areas:- harm reduction- supply reduction- demand reduction.

69

Topic 7

Current policies

and legislation

guiding AOD work

7.1 Overview of

current national drug

policies and programs

Australia has a range of drug policies and programsthat have been developed over the years. Thedevelopment of legislation and policies should beviewed as an ongoing process that has been influencedby various factors such as changes in government andchanges in community values and attitudes. Changesin staff at policy making levels can also influence thedirection and purpose of policies and programs.

The National Drug Strategy, launched in 1985 was thestarting point for a range of policies based on a harmminimisation approach. These policies have had asignificant impact on the everyday work of frontlineworkers, especially in the way they interact andintervene with young people.

Overview of current

national drug policies

and programs

State policies and

initiatives

Key stakeholders in

the AOD sector

Legislation that

impacts on work with

young people

Young People and Drugs – Issues for Workers

www.nationaldrugstrategy.gov.auwww.drugs.health.gov.auwww.adin.com.auwww.adca.org.au/www.nationaldrugstrategy.gov.au/nidswww.ceida.net.au

70

The development of national alcohol and drug policies inAustralia featured the following key initiatives:

1985 Launch of the National Campaign Against DrugAbuse

1991 Development of the National Drug Strategic Plan1993 Launch of the National Drug Strategy1996 Launch of the National Public Health Partnership1998 Development of the National Drug Strategic

Framework 1998-99 to 2002-03

National Drug Strategic Framework

The National Drug Strategic Framework provides a nationalpolicy framework to reduce the harm caused by drugs. Itidentifies eight priority areas for action:

1. Increasing the community’s understanding ofdrug-related harm

2. Building partnerships

3. Links with other strategies

4. Supply reduction

5. Preventing use and harm

6. Access to treatment

7. Professional education and training

8. Research data and development

The National Drug Strategy Household Survey series is the datasource used to monitor trends and evaluate the progress of theNational Drug Strategy. These surveys provide data onbehaviour, knowledge and attitudes relating to drug use amongyoung people aged 14 years and over.

71

Diversity of approaches to drug issues in Australia

As well as the National Drug Strategic Framework, Australia hasdeveloped a range of policies and programs that aim to improvethe health, social and economic outcomes for both thecommunity and the individual. These include:

• Prevention efforts which employ the use of social marketingcampaigns and the distribution of information products

• Community development projects

• Peer education programs and school-based drug education

• Efforts to help people cease their use and/or help preventthe most harmful consequences of using drugs

• Efforts aimed at disrupting both the supply of illicit drugsentering Australia and the production and distribution of illicitdrugs within Australia.

72

7.2 State policies

and initiatives

Policies and programs are developed at a national level andprovide a nationwide approach to drug issues in Australia.However, each state government has its own programs andpolicies and these also reflect the political aims and aspirationsof the government in power. For example, the NSWGovernment spent considerable time trialling the use of safeinjecting rooms. Policies and programs relating to drug use varywidely from state to state.

Collecting information about your state

Using some of the information sources you collected inbuilding your community profile, locate and describe someof the policies and initiatives of your state government overthe past 20 years? (A great deal of information is available onthe web. You should try looking at the site for your stategovernment.)

Do these policies impact on your day-to-day work?In what ways?

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7.3 Key stakeholders

in the AOD sector

Changes in policy usually result in new or different programsbeing introduced at a local level. For example, if yourorganisation adopts a harm minimisation approach, this mayresult in a whole range of interventions, such as the provision ofcondom machines or the provision of information about the safeuse of illicit substances. Changes in policy therefore have aflow-on effect to many people in the community.

Can you think of some key stakeholders in yourlocal community?


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Some examples of stakeholders include:

• alcohol and other drug workers

• police

• residents

• drug users or their representatives

• lawyers

• local government officers

• youth workers and the young people they work with

• hotel licensees

• pharmacists

• school teachers

• general practitioners

• traders

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7.4 Legislation that

impacts on work

with young people

Areas covered by legislation

Many laws impact on our work with young people. Theseinclude laws regulating:

• drugs – legal or illegal status

• mandatory reporting – if you suspect that a child is beingphysically, emotionally or sexually abused

• confidentiality and privacy legislation – to protect theconfidentiality of young people

• duty of care – to reduce or limit the amount of harm or injuryto your clients

• OH&S – ensures workers operate in a safe environment toprevent injuries or hazards in the workplace.

Laws regulating drugs

All drugs are regulated to some extent by laws, which can haveparticular ramifications for young people.

Drug-related laws act as a form of control of drug use andcomprise an important part of the harm minimisation approach(in terms of demand reduction and supply control). Psycho-active drugs have legal, illegal or restricted status. In someinstances, however, certain substances are illegal for certainpeople (alcohol for anyone under the age of 18), or in certainplaces.

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Cannabis as a case study

The laws relating to cannabis vary from state orstate. Find out about the cannabis laws in yourstate, and summarise the key points. (The internet isuseful for finding current information. Log on to:www.druginfo.nsw.gov.au/druginfo/Legislation.html)

Mandatory reporting

In NSW the Children and Young Persons (Care and Protection)Act 1998 requires all community services and health workers tocontact their Community Services Department if they haveconcerns for the safety, welfare or well being of a child. The Actdifferentiates between children (under 16) and young people(16-17 years). This is an important distinction to make, as itrecognises that older adolescents may be physically andemotionally mature and heading towards financial and socialindependence.

In most states, you must let your community servicesdepartment know if you suspect that a child is being physically,emotionally or sexually abused. Mandatory reporting means thatyou don't have a choice. The law says you must make a report.

Some states (e.g. New South Wales) requires that criminalrecord checks are undertaken on people who wish to work withchildren and young people.

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Confidentiality and Privacy Legislation

The law generally requires workers to protect the confidentialinformation of their clients. There are certain laws thatstrengthen clients’ protection. For example, the CommonwealthPrivacy Act 1988 and the Privacy and Personal Information Act1998 (NSW) state that an individual’s personal and familyhistory cannot be divulged to other organisations without theirconsent and that these records must be kept in a secure place.

The Freedom Of Information Act 1982 states that young peoplehave the right to request access to their personal records.Workers should be careful to be accurate and concise in theirclient records and avoid recording their assumptions aboutclients or opinions that are not based on evidence.

Duty of care

As a worker, you have a legal and moral responsibility to keepyour clients safe from harm while they are using a service. Thisresponsibility is known as ‘duty of care’.

Workers’ responsibility to reduce or limit any harm or injurycan sometimes seem overwhelming. For example, yourresponsibility to one party (for example, your employer) mightconflict deeply with your responsibility to your clients. It helps toremember that duty of care is a balancing act.

Sources of harm

Suggest some ways in which a young person mightcome to harm in your organisation?


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• Physical injury (from an unsafe environment)

• Physical injury (as a result of violence from other youngpeople or workers)

• Sexual abuse (by another person or a worker)

• Infectious disease

• Misinformation

There are several aspects to duty of care:

Legal - What does the law require you todo?

Professional/ethical - What do other workers expect us todo?

Organisational - What does your organisation, and itsfunding body, say you should do?

Community - What do the parents of our clientsand other community membersexpect you to do?

Personal - What do your own beliefs and valuessuggest you do?

You need to balance the safety of the young person againstother concerns such as:

• safety of other people/your personal safety

• other rights that young people have (e.g. the right to privacy)

• aims of the service (e.g. to empower young people)

• limits of your organisation (e.g. money and other resources).

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SULA

Sula visits your centre on a regular basis for counselling. Oneday she arrives and is clearly very unwell. You think she needsmedical attention but she says that she does not want to see adoctor. Are you carrying out your duty of care if you call thedoctor yourself?

What do you think is the right course of action?

What would you consider to reach your decision?

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Occupational health and safety (OH&S)

OH&S legislation exists to ensure that workers can operate in asafe environment. Organisations have an obligation to maintainequipment and to put into place strategies to prevent injuriesand control hazards in the workplace. This includes adequateprovision for the disposal of hazardous waste materials. OH&Slegislation also requires organisations to make arrangements forworker’s compensation and obliges them to have detailedemergency plans in the event of a fire or security breach.

Agencies are required by law to develop their own policies todeal with these issues. These policies should also relate to themental health and wellbeing of workers as stress and burnoutare an important consideration for people working in thecommunity services and health fields.

Check the policy and procedure manual at yourworkplace. Does it contain specific policies relatingto preventing and managing stress at yourworkplace? If not, why not?

What steps could you take to make sure thesepolicies are developed and/or put into action?

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• Historical development of national alcohol and drugpolicies have led to the current National DrugStrategic Framework that aims to reduce the harmcaused by drugs.

• Australia has a range of policies and programs thataim to improve health, social and economic outcomesfor community and individuals.

• Each state government has their own programs andpolices in relation to alcohol and other drugs.

• Changes in policy have a flow-on effect to manypeople in the community

• Many laws impact on our young people.

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Topic 8

Issues that

have shaped the

AOD field

8.1 AOD issues

The AOD field is dynamic and fluid and is constantlybeing shaped by a variety of forces. It is importantto be aware of these in order to understand whycertain changes have, or have not, happened and tokeep abreast with key issues.

In this topic you will examine the key factors thathave shaped the sector and focus on a major AODissue that affects young people in your area and theresponse to it.

AOD issues

Investigating a local

issue in your area

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Key factors

Key factors affecting the AOD sector include politics, funding,philosophies, factional battles, research findings, personalities,changes in drug availability and changes in the demographics ofpeople who use. Importantly, all of these factors are interrelatedand impact on each other.

Politics

Politics plays a major role in the AOD field. This factor ischangeable, however, as it is subject to the philosophical ideasof the government. For example, while the Labor governmentin Western Australia recently stated that they supportconsideration of a heroin trial on principle, the Liberal party isopposed to the idea. Because drug issues do not win votes,government policies tend to follow perceived public opinionrather than shape it (Saunders & Marsh, 1999). Consequently,there are numerous instances where governments have failedto follow the recommendations of research in favour of doingwhat the general public wants. For example, harsher drug-related penalties have been introduced in response to publicdemand, despite the fact that research shows that the threat oflegal consequences fails to deter many users of illegal drugs.

Funding

Heavily impacted by the political agenda, public concern andvisibility of the issues, funding exerts a significant influence inthe AOD field. For example, given the recent concern raised byfamilies and parents of drug users, more funding has beendirected into initiatives targeting this population. As a result,there has been a swing towards increased service provision andresearch relating to parent and family-based interventions.

Personalities

The personalities of key players in the field have a significantinfluence on directions taken, funding and community attitudes.If a very vocal and visible but conservative key figure in the fieldtalks about the dangers of harm reduction and pushes forstronger zero tolerance, there may be a corresponding changein policy direction in terms of education, community-basedprograms, as well as in community attitudes.

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Factional battles

For many years, the AOD field has been characterised byfactional battles. Perhaps one of the most well known relates toharm reduction versus zero tolerance or ‘abstinence only’ basedapproaches. While the harm reduction model has becomewidely accepted, in the early 1990’s there was an uproar when itwas suggested that perhaps the community should accept druguse as a fact, and seek to reduce the harm associated with it(Single, 1995) rather than focusing all of our efforts on stoppingdrug use altogether. A number of people suggested that such apolicy was both unethical and untenable and that the only ‘right’way to approach drug use was to advocate abstinence andsupport the ‘war on drugs’.

Another famous (or perhaps infamous) factional battle is stillgoing on between proponents of the disease model of addictionand social learning theorists. Such battles influence the AODfield through the manipulation of research topics, communityattitudes (through political and media agendas), treatmentregimes and even education and training programs.

Drug availability

Drug availability changes according to time and place, not onlyinfluencing what people use, but determining research, treatmentand professional education and training. For example, recentlythere was a noticeable reduction in the availability of heroin anda corresponding increase in the availability of methamphetamineand cocaine. Not only has this temporarily altered the nature ofdrug use and drug-related problems most commonly experiencedby drug users (for example, a decrease in overdose and increasein drug-related psychosis) but it has also had wider ramificationsfor the field as a whole.

The nature of some treatment programs has changed, and inparticular the role of pharmacotherapies has been reduced.There has been a decrease in requests for methadone andnaltrexone, and an increase in psycho-social treatments andalternative medical responses for stimulant-related problems(Towers, 2002). In line with this trend, there has been a changein the focus of some professional education and trainingprograms, as well as funding for new research programs.

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To demonstrate the interaction between the various factors thatinfluence the AOD field, it is interesting to note some of thesources of this change in drug availability. Increasingly, theworld is becoming a global village, with the llicit drug trade beingone of the largest global industries. World events such as wars,natural disasters, and even changes in weather patterns cansignificantly alter drug use around the world. For example,when the Taliban came to power in Afghanistan, growing theopium poppy was banned. As a result, the quantity of heroinavailable in Australia was reduced significantly. At the sametime, the manufacture of methamphetamine in Burma increasedresulting in an increase in amphetamine availability in Australia.Following the defeat of the Taliban in Afghanistan, changes inheroin availability are thought to be imminent.

Philosophies

Current popular perceptions of drug users and the nature ofaddiction are important in terms of responding to drug-relatedissues. For example, in the eighteenth and nineteenth centuriesdrug users and excessive drinkers were perceived to be moraldeviants who lacked willpower and were making a consciouschoice to ‘behave badly’. The most appropriate treatment waspunishment and most appropriate prevention program was thethreat of punishment and the strengthening of moral fibre and‘good moral values’.

In contrast, the pharmacological model demanded a differentresponse. Both prevention and treatment involved theeradication of the ‘demon drink’ (or other substances). Thedisease model advocated a more humanistic approach that putaddiction into the health realm, whereas the social learningmodel advocates a multidisciplinary, systemic approach to bothtreatment and prevention.

Research

The AOD sector is influenced to a large extent by researchfindings and the strong links between research, practice andeducation. Australia, in particular, emphasises evidence-basedpractice, which involves the integration of research and clinicalwisdom into education, prevention and treatment. This programfollows the evidence-based model in that both research and theexperiences of other key stakeholders such as clinicians andclients support its teachings.

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For example, until quite recently it was believed that abstinencewas the only treatment option for people with addiction-relatedproblems. Research by the Rand corporation and Sobell,Sobell and Davies suggested that controlled drinking (asopposed to abstinence) was an option for some people. Whilethis caused an uproar in the field at the time (and a significantfactional battle in which the Sobells were wrongly accused offalsifying data - Heather & Robertson 1989), such treatmentoutcomes are now well accepted for some populations (such asyoung people).

Demographics of drug users

Who is actually using what also plays a big role in terms ofresearch directions, community attitudes and treatmentresponses. For example, the National Drug Household Survey(1998) shows that increasing numbers of young people areusing drugs at a younger age. This means that greateremphasis is being put into treatment and prevention andeducation designed specifically for working with young people(such as this training program). Research also shows that,contrary to popular opinion, there are a large number of youngprofessionals who use illegal drugs on a recreational (andsometimes not so recreational) basis (Dale, 2002). As aconsequence, some harm reduction and community-basedinterventions have been developed to target this population.

Community attitudes

Largely shaped by the media, community attitudes influencepolitical agendas and funding bodies. In turn, this impacts onthe directions in the AOD field. In addition, the more subtle andinsidious influences of community attitudes are directly felt bydrug users themselves, families and workers in the field. Thiscan shape people’s drug-using patterns (in terms of increasingsecrecy of use etc), and also their approach to and experienceof treatment. Since alcohol and drug use is so much in thepublic eye, it is natural that community attitudes are among themost influential of the factors that shape the context of the AODsector.

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Media

The role of the media in terms of shaping community attitudesand political agendas has been mentioned many times in thismodule. Since we live in such a media-driven society, themedia has the power to shape attitudes and responses to AODissues positively (highlighting the need for funding, givingpeople good information on AOD use) and negatively(sensationalizing and demonizing drug users and failing topresent accurate information and balanced points of view).

Investigating a local AOD issue

Identify a specific issue that you consider is importantrelating to AOD use by young people in your localcommunity. Select an issue that has generated someinterest in the local press.

Examples include:

• the introduction of an alcohol free zone in your main street orat the local beach

• the closure or opening of a needle exchange facility

• the opening of a youth drop-in centre in an area known fordrug trading

• fears of the local community about the use of a particulardrug (e.g. amphetamines, heroin)

• perceived links between local crime and drug use by youngpeople

What is your issue?

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Who are the key stakeholders in this issue? (Who isaffected by the issue? Who will have something to sayabout the issue? Describe their role or their interest inthe issue.)

What do your local newspapers have to say aboutthe issue? Can you identify any themes?(Remember to read the letters to the editor as well asthe editorials.)

What do your work mates think about the issue?Are they of one opinion or are there a variety ofviews?

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What do you think about this issue? Have youalways felt this way or have your views beeninfluenced by the young people with whom youwork or your co-workers?

What social, cultural or economic factors impact onthis issue? Does the issue relate to a particulargroup of young people? How does this groupcompare socially, culturally and economically withthe rest of the community?

What research findings exist about this issue? (Useyour library or the Internet to find out what is knownabout the issue or how it has been dealt with in othercommunities.)

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How have the key stakeholders in your communityresponded to this issue? Does the response of yourlocal community fit with a harm minimisationapproach, an abstinence model, or some othermodel? Can you identify why?

Does this issue impact on your organisation? Has itresponded in any particular way?

In your opinion, how should this issue be dealtwith? Can you identify any possible blocks to yoursolution? (Consider local politics, funding limitationsand the impact on young people)

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Can you think of any strategies for overcomingthese obstacles?

The AOD sector is a dynamic and fluid area that isconstantly changing as a result of:

• politics

• funding

• philosophies

• factional battles

• research findings

• personalities in the field

• changes in drug availability

• changes in the demographics of peoplewho use

All these factors are interrelated and impact oneach other in the AOD sector.

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Topic 9

Summary and

conclusion

9.1

At this point you should speak with your facilitatorand together assess whether you can:

• Identify your own personal values and attitudesregarding AOD issues and their implications forworking with young people on AOD issues

• Describe current models used to understanddrug-use behaviour

• Describe patterns and prevalence of drug use byyoung people

• Discuss a broad range of factors that can impacton AOD use by young people

• Outline harm minimisation and other currentpolicies and frameworks that underpin AOD workwith young people.

If you have any concerns about meeting theselearning outcomes you should speak further withyour facilitator.

Before you contact your facilitator, complete theReflection Activity in this topic.

Remember that if you want to know more about anyof the topics covered in this module, a range ofreferences are provided at the end of this module.

You could also contact your local health service oryouth service for further information.

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9.2 Summary of contents

As you can see, the AOD sector is constantly being shaped by avariety of influences. Topic 8 gives you an idea of the breadthof issues important to the AOD sector.

This module has highlighted the important role of economic,political and social factors in determining AOD use as well asour responses to it. Models for understanding AOD use havebeen presented and explored as well as patterns of use andlegislative and policy responses to AOD issues. Our ownpersonal responses to AOD issues have also been examined.

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9.3 Self-reflection activity

Take some time to reflect on what you have gained from yourlearning. You may wish to share your insights with otherlearners or colleagues, if possible.

What aspect of this module do you feel is mostrelevant and useful in your work practice?

What kinds of issues has this module raised for youin your work?

Have you identified any further learning needs as aresult of completing this module?

If so, what are some ways you can achieve theselearning needs?

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References

Adhikari, P. & Summerill, A. (1998). National Drug StrategyHousehold Survey: Detailed findings. AIHW Canberra 2000.

Australian Bureau of Statistics (1998). 1997 Australian Surveyof Mental Health and Well Being, Canberra.

Australian Institute of Health and Welfare 2002. (2001). NationalDrug Strategy Household Survey: First results. AIHW Cat No.PHE 35. Canberra: AIHW (Drug Statistics Series No 9).

Commonwealth Department of Health and Aged Care,Canberra, (2001). Alcohol in Australia: Issues and Strategies.

Commonwealth Government of Australia (1998). National DrugStrategic Framework 1998-99 to 2002-03: Building partnerships.Canberra: Commonwealth of Australia.

National Drug Strategy Household survey (1994). UrbanAboriginal and Torres Strait Islander Peoples Supplement,Canberra.(www.health.gov.au/pubhlth/publicat/document/ndsatsi.pdf)

Gossop, M. (1996) Living with drugs (4th ed). England: AshgatePub.

Hamilton, M., Kellehear, A. & Rumbold, G. (1998). Drug Use inAustralia: A harm minimisation approach. Australia: Oxford UniPress.

Hando J., Howard J. & Zibrert, E. (1997). Risky drug practicesand treatment needs of youth detained in NSW Juvenile Justicecentres. Drug and Alcohol Review, 16, 137-145.

Heather, N. & Robertson, I. (1989) Problem Drinking (2nd Ed.)New York, Oxford Uni Press.

Helfgot, S. & Allsop, S. (1997). Models of addiction behaviour.In S. Helfgot (Ed). Helping Change: The addiction counsellorstraining program. Perth: Alcohol and Drug Authority, WesternAustralia.

Makkai, T., Johnson, D & Loxley, W (2000). Patterns of DrugUse Amongst Police Detainees: 1999-2000. Australian Instituteof Criminology December.

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Ministerial Council on Drug Strategy (1998). National DrugStrategic Framework 1998-99 to 2002-3. Canberra:Commonwealth of Australia.

Moon L. Meyer P. & Grau J. (1999). Australia’s Young People:their health and wellbeing. Canberra: AIHW.

National Drug Trends 2000 (2001). National Drug and AlcoholResearch Centre, NDARC Monograph No 47.

Patterson, I. & Pegg, S. (1999). Nothing to do: the relationshipbetween 'leisure boredom' and alcohol and drug addiction: isthere a link to youth suicide in rural Australia? Youth StudiesAustralia, 18 (2), 24-29.

Ryder, D., Salmon, A. & Walker, N. (2001). Drug Use andDrug-related Harm: A delicate balance. Melbourne: IPCommunications Pty Ltd.

Saunders, B., & Marsh, A. (1999). Harm reduction and the useof currently illegal drugs: Some assumptions and dilemmas.International Journal of Substance Use, 4(1):3-9.

Saunders, B., O’Connor, J., Dale, A. & Marsh, A. (1999).Certificate in Addiction Studies: Foundation; Intervention andPrevention Study Manuals. Unpublished: Perth, WesternAustralia.

Single, E. (1995). Defining harm reduction. Drug and AlcoholReview, 14, 287-290.

Spooner, C., Hall, W. & Lynsky, M. (2001). Structuraldeterminants of youth drug use. Canberra: Australian NationalCouncil on Drugs.

Spooner, C. (1999). Causes and correlates of adolescent druguse, Drug and Alcohol Review, 18, 453-475.

Spooner, C., Mattick, R. & Howard, J. (1996). The nature andtreatment of adolescent substance abuse. NDARC MonographNo.26. Sydney: National Drug and Alcohol Research Centre.

Stewart, T. (1987). The Heroin Users. London: Pandora Press.

Stockwell, T., Heale, P., Chikritzhs, T., Dietze, P. & Catalano, P.(2002). How much alcohol is drunk in Australia in excess of thenew Australian alcohol guidelines, Medical Journal of Australia,176, 91-92

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Thorley, A. (1980). Medical responses to problem drinking.Medicine (3rd series), 35, 1816-1822.

Toumbourou, J.W. Drug Prevention Strategies: a developmentalsetting approach. Prevention Research.

Evaluation No 2, Sept 2002. (available from Drug InfoClearinghouse – druginfo.adf.org.au)

Wallack, L., & Holder, H. (1987). The prevention of alcohol-related problems: A systems approach. In H. Holder (Ed.),Advances in Substance Abuse: Behavioural and BiologicalResearch (p.65-82), Connecticut: JAI Press.

Weil, A. & Rosen, T. (1984). From Chocolate to Morphine.Boston: Houghton Mifflin.

Weil, A. (1973). The Natural Mind. Boston: Houghton Mifflin.

Williams, P. (2000). Alcohol-related Social Disorder and RuralYouth: Perpetrators. Canberra: Australian Institute ofCriminology.

Zinberg, N. (1984) Drug, Set and Setting: The basis forcontrolled intoxicant use. New Haven: Yale University Press.

Websites

An excellent website, with details descriptions of majordisorders and links to many high quality mental health andAOD-related siteswww.mentalhealth.com

Australian Institute of Criminologywww.aic.gov.au/publications/tandi/tandi18.html

Australian Institute of Health and Welfarewww.aihw.gov.au

Commonwealth Department of Health and Ageingwww.health.gov.au/

Drug and Alcohol Multicultural Education Centrewww.damec.org.au

Drug Arm (This site is particularly focused on youth issues):www.drugarm.org.au

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Drug Info Clearinghouse – The drug prevention networkdruginfo.adf.org.au

National Drug Strategywww.nationaldrugstrategy.gov.au

National Drugs Campaignwww.drugs.health.gov.au

National Illicit Drug Strategy (NIDS)www.nationaldrugstrategy.gov.au/nids

The Alcohol and Other Drug Council of Australia (ADCA)www.adca.org.au/

The Australian Drug Foundation (ADF)www.adf.org.au/index.htm

The Australian Drug Information Networkwww.adin.com.au

The Centre for Education and Information on Drugs and Alcohol(CEIDA):www.ceida.net.au/

The National Drug and Alcohol Research Centre (NDARC):www.med.unsw.edu.au /ndarc/

The Network of Alcohol and Drug Agencies (NADA):www.nada.org.au

Useful summaries of youth AOD use in WA and nationallywww.wa.gov.au/drugwestaus/html/contents/publications/prevalence/summaries/wa-summary-youth.pdf

The Centre for Youth Drug Studies is within the ADF:www.adf.org.au/cyds/index.html

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Key terms

Abstinence Refraining from drug use.

Binge A lengthy episode of very heavy drinking that produces extremeintoxication.

Cognitive A person’s thought processes.

Community A broad group of people (who may live close together, but do notnecessarily live in the same area), who share common socialstructures and goals and engage in a wide range of activities in aninterdependent, mutually advantageous, and empowering manner.

Compulsivedrug use

Frequent daily doses and experiencing withdrawal symptoms.

Depressants Drugs that slow down the brain and central nervous system.

Drug Within the context of this course, a drug is a substance thatproduces a psycho-active effect which involves changes in mood orbehaviour due to alterations in brain function.

Drugdependence

Anyone who relies on and regularly seeks out effects of a drug canbe considered to be dependent on that drug to some degree. Drugdependence occurs when a drug becomes central to a person’sthoughts, emotions and activities. A dependent person finds itdifficult to stop using the drug or even to cut down on the amountused. Dependence has physiological and psychological elements.

Experimentaldrug use

Single or short-term use of a drug.

Hallucinogens Drugs that act on the brain to distort perception, i.e. sight, taste,touch, sound, smell.

Harmminimisation

Harm minimisation is the primary principle underpinning theNational Drug Strategy and refers to policies and programs aimedat reducing drug-related harm. It encompasses a wide range ofapproaches including abstinence-oriented strategies. Both legaland illegal drugs are the focus of Australia’s harm minimisationstrategy. Harm minimisation includes preventing anticipated harmand reducing actual harm.

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Key terms (continued)

Harm-reduction Harm reduction aims to reduce the impact of drug-related harm onindividuals and communities. It includes those strategies designedto reduce the harm associated with drug use without necessarilyreducing or stopping use.

Healthpromotion

The process of enabling people to improve their health

Intensive druguse

High doses – binge.

Intersectoralcollaboration

Coordination of interventions by agencies from different sectors orindustries

Intervention A purposeful activity designed to prevent, reduce or eliminate AODuse at an individual, family or community level.

Intoxication Any alteration whatsoever in our perception, mood, thinkingprocesses and motor skills as a result of the impact of a drug(s) onour central nervous system.

Overdose The use of a drug in an amount that causes acute adverse physicalor mental effects. Overdose may produce transient or lasting effectsand can sometimes be fatal.

Poly-drug use The use of more than one psycho-active drug, simultaneously or atdifferent times. The term ‘poly-drug user’ is often used to distinguisha person with a varied pattern of drug use from someone who usesone kind of drug exclusively.

Preventionstrategies

Interventions which aim to prevent people from taking up drugs(e.g. reducing tobacco sales to minors) and to prevent those usingAOD from using AOD in a harmful way (e.g. promoting safe levelsof drinking).

Protectivefactors

Those factors that enhance the coping abilities of a young personthus increasing active participation in community activities anddecreasing susceptibility to adverse consequences.

Psychotherapy Non-pharmacological treatment of psychiatric disorders utilising awide range of strategies, from simple education and supportivecounselling to insight-oriented, dynamically based therapy.

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Key terms (continued)

Recreational druguse

Controlled use in a social setting.

Resilience This is the ability of an individual to face particular difficulties (suchas abusive situations, living in poor conditions and having a nonsupportive family), yet not necessarily go on to develop problem/riskbehaviours. It describes the capacity of a person to respond in apositive way to the risks, stresses, and adversities of life.

Risk taking Refers to risks that could be associated with AOD use, apart fromthe drug use itself. In an assessment, involves identifying factorssuch as sharing injecting equipment, being intoxicated indangerous places (e.g. near a railway track, having unprotectedsex while intoxicated).

Stakeholders An individual or group who holds an interest or stake in the issueunder investigation.

Stimulants Drugs that speed up the brain and nervous system.

Withdrawalsymptoms

Symptoms that can occur when a person using a drug over aprolonged period reduces or ceases use.

Documents

Module 5 - Department of Health | Welcome to the …File/module5blw.pdf5 Topic 2 Values and attitudes to AOD use 2.1 Significance of values and attitudes Values are beliefs about what