2 Why People Use Drugs

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Prepared byJ. Mabbutt & C. MaynardNaMO

September 2008

2: Why people

use drugs?


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1. During the session nurses and midwives will explore why people

use drugs and alcohol and what the models of drug use are

2. Nurses and midwives will undertake an exercise to challenge andexplore attitudes and opinions regarding drug & alcohol use

3. By the end of the session nurses and midwives will have a broaderunderstanding of why people use drugs and alcohol, which willincrease their ability to work with this patient group

2: Why people use drugs:

Objectives


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Handout Repugnancy Scale and ask participants to complete without

discussion (or ask them to score them within this presentation)

Once everyone is finished discuss selections

You may find it useful to do a tally of responses on the whiteboard

Allow 10 minutes minimum

RPA Education Unit CSAHSPowell, Keen & Brown 1994

2: Why people use drugs

Activity 1Repugnancy Scale (1)


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Please rate the following From 1 to 10

1Being the Mostrepugnant and 10Being the Least

Use each number from 1 to 10 only once




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An overweight man with his family at the beach, sucking on a beer can

A 14 year old smoking a joint with friends at a party

A woman shooting up heroin in the flat with her children

A businessman staggering drunk out of a hotel

A pregnant woman chain smoking




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A young man shooting up heroin in a public toilet

A woman staggering drunk out of a bar

A middle aged school teacher taking a dose of serepax

(oxazepam) during the lunch break

A 60 year old man with a history of heavy alcohol intake

A 60 year old woman with a history of benzodiazepine use

From Attitudes Module 3A Teaching Kit for NursesRPA Education Unit CSAHS

Powell, Keen & Brown 1994 RPA Education Unit CSAHSPowell, Keen & Brown 1994




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Handout the attitude measure scale as an optional activity

See Training Activities section in the CD-Rom for further information


Activity 2/Attitude Measurement Scales


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dependent

intensive

purposive

experimental

From Commonwealth Government /NCETA 2004GP Trainers Illicit Drug Issues CD Rom

2: Patterns of drug use


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People use drug for many reasons

Experimentation as a young person is a normal learning process, this can

include the use of alcohol and drugs

Some people take more risks than others, they may like the appeal of taking

drugs, being in a sub culture, breaking the rules

Peer pressure can play a part, people can use to fit in, to be part of the group

and end up using regularly or suffered major consequences from even one

episode of alcohol or drug use

2: Why people use drugs (1)


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Initially the drugs or alcohol can deliver a high to the users or make

them just feel normal

In time they may become tolerant as the drugs stop working as well andthey may need to use more to stay feeling normal and to not experience

withdrawal

The Australian movie Candy had three parts to it: heaven, earth and

hellthis is an example of this progression

As the drugs or alcohol stop working, people may change to another

drug to get an effect, this is colloquially known as a drug geographical



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The use of drugs can numb the emotional pain people are feeling

Trauma and related PTSD from many causes may be a reason to

commence and continue to use drugs e.g.

childhood sexual/physical abuse

rape

domestic violence

other life traumas, assault, accidents, losses, relationship

breakup, poverty, unemployment etc.



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Drugs and alcohol are also used for self medicating physical pain

People may move to another town, state, country hoping to leave the problem

behind, often the problem follows themthis is called a geographical

Drugs and alcohol are also used by many people with mental health or other

issues as a form of self medication



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Moral:people use because they are bad/immoral

Pharmacological:due to the drug/half life/effects etc

The Dopamine Theory of drug reward:due to dopamine rewards effects

via the receptors in the brain

Disease/Biological: having apredisposition/genetic to being an alcoholic

or drug user

Cognitive: due a persons thoughts & beliefs about their drug and alcohol use


Some Models/Theories of Drug use (1)


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Gateway theory:If you use a drug with less powerful effects you are

more at risk to use a drug with more effects

Transtheoretical model (TTM):Stages of change model. People can

move backwards & forwards through the stages

Social learning: the learnt behaviour from others/groups

Public health:due to the individual, the drug, the availability/temptationto use the drug and the environment

Adapted from Commonwealth Government /NCETA 2004

GP Trainers Illicit Drug Issues CD Rom & West, R.Theory of Addiction. 2006.


Some Models/Theories of Drug use (2)


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Dependence Success rate %

Alcohol 50 (40

70)

Opioid 60 (5080)

Cocaine 55 (5060)

Nicotine 30 (2040)

OBrien, C. & McLellan, A. (1996)

From Commonwealth Government /NCETA 2004

GP Trainers Illicit Drug Issues CD Rom

2: Treatment success in dependence


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Disorder Compliance & Relapse

IDDM Medication regimen < 50%

Diet & foot care < 30%

Relapse 3050%

Hypertension Medication regimen < 30%

Diet < 30%

Relapse 50

60%

Asthma Medication regimen < 30%

Relapse 6080%

OBrien, C. & McLellan, A. (1996) From Commonwealth

Government/NCETA 2004GP Trainers Illicit Drug Issues CD Rom

2: Some medical conditionsCompliance and relapse (


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Fear of professional judgment

Poor access to care

Money problems

Services not always designed to meet the needs of culturally

and linguistically diverse people and their families

Fear of being labeled a junkie, addict or alcoholic

2: Why people dont seek help (1)


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Fear of lack of confidentiality

Agemost drug and alcohol services are unable to address the needs

of people under 16 or people over 60

Genderfew services can meet the needs of women and children of

parents who are seeking treatment

Fear of professional consequencesprofessionals with drug and alcohol

problems often fear being recognised and judged

2: Why people dont seek help (2)


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It is someone elses problem

Nurses and midwives are in ideal settings to address D&A problems

People who have drug and alcohol problems are hopeless people

most people have jobs, manage households and raise their children


Myths of drug and alcohol use (1)


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Addicts are beyond help

Many people modify their use or move away from D&A dependence

All substance misusers are dependent on drugs

Many people use recreationally, only a small proportion become dependant


Myths of drug and alcohol use (2)

Documents

2 Why People Use Drugs