EPIDEMIOLOGY
Define Epidemiology
The study of the causes, patterns, and effects of health and disease conditions in defined populations.
What are the 3 main methods for drug control?
Regulation
Prevention
Treament
Primary: Populations that had had little to no exposure to substances (DARE)
Secondary: Populations who had likely exposed to substances but haven't shown problems
Tertiary: Populations that are in treatment and recieve relapse prevention education
What are barriers people face when seeking treatment?
Unrealistic expecations
Low Income
No healthcare
Lack of room in treatment centers
What is 12-step facilitation?
Difference between that and 12-step meetings? Peer led, no physician present
What are the challenges to research substance use trends?
Underreporting, lack of data in other regions of the world (Africa and Asia), black markets (difficulties in measuring), and emergence of new drugs.
Who declared the War on Drugs?
Nixon
Problems with past prevention efforts?
Scared tactics discredit efforts
People don't take it seriously
Abstinence only's unreasonable
Makes people more curious about substances
Just Say No too simple
Define continuum of care
Patients are initially placed in the type and intensity of care that's approprate, given the current siverity of ther SUD and co-occuring prblems.
Behavioral Couples Therapy?
Uses a sobriety/abstinece contract and behavioral principles in the context of couples-therapy.
2 main epidemiological research studies on SU patterns.
1. Monotoring the Future Project - Data from students 8-12 grade, annually for 30 yrs.
2. National Survey on Drug Use and Health (NSDUH)- gathers data from U.S. households, face to face interviews, ages 12 +, also conducted annually
*Both look at frequency and prevelance
Differrence between legalization, prohibition, and decriminalization?
Legalization: Drug distribution is regulated by gov., drug possession is legal.
Decriminalization: Drug possession of a certain amount's not a criminal offense, drug distribution's illegal
What do contemporary prevention efforts focus on to be more effective?
Building resiliency
Teaching how to say no
Having a plan when using
Open communication with adults
Increasing protective factors
What are the levels of treatment?
As their condiction improves or deterriorates they eaither ________ or _______.
Outpatient
Intensive oupatient/partial hospitalization
Residential/ Inpatient
Medically Managed Intensive Inpatient
Step down or Step up
Describe the Finland Model
Doctor Sinclair in Finland began telling partients to take naltrexone or nalmefene an hour before driniking, 78 % reported reduced drinking patterns after completing the 6-month long treamtent.
Cost only $2500, which is much cheaper in comparison to prices in the U.S.
Wht are barriers in providing intergrated treatment in individuals who suffer comorbidity?
Chemical Dependency counselors aren't allowed to target the comorbid illness, only the SUD by law
Not enough evidence for integrated treatment
Not enough awareness within recovery communities on importance of integrated treatment
What are the unintended consequences of the War on Drugs?
Criminalization of poor communites (racial bias)
Mass incarceration
Implicit racism (New Jim Crow)
Over policing, disproportionate sentencing of drugs (crack cocaine 1:100 ratio)
A lecture to college students about substance use is what type of prevention effort?
Secondary
Challenges for treament?
Not all practitioners apply scientific finding
Little info is available about standards of practice
U.S. treatment is very expensive
Somewhat difficult to implement EBP (evidence based practice) effectively
Organization of care have barriers to EBP
Less well known treamtents but ones that are at the forefront of research.
Electric stim devices: magnetic stimulation, non-invasive, help peoplle with cocaine addiction in their cravings.
Opiod alternatives: PZM21 to be used for opiod dependence as it is synthetic and aliviates pain.
What factors impact drug seizures?
Changes in trafficking patterns
Changes in patterns in use
Drug policy changes
Conflict between federal and state policy
Shifts in law enforcement priorities
International human rights violations related to drug charges?
China publicly executed 7 people charged with drug trafficking (Condoned by President Trump)
Which medications are FDA approved for alcohol and opiate use disorders?
Alcohol: Naltrexon, Antibuse, Campral
Opiates: Methadone, Buprenorphine, Naltrexon