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Psychoactive substances and

new technologies abuse in


children and adolescents
Lenka Chudomelova
Department of Child and Youth Health
3rd Faculty of Medicine

Definition

Psychoactive drugs are chemical substances


that affect the brain functioning, causing
changes in behavior, mood and consciousness.

Commonly abused drugs


Cannabinoids: hashish, marijuana
Depressants: barbiturates, BZD
Dissociative anesthetics: ketamine, phencyclidine
Hallucinogens: LSD, mescaline, psilocybin
Opioids: codeine, fentanyl, heroin, morphine, opium
Stimulants: amphetamine, methamphetamine,

cocaine, nicotine

Other compounds: anabolic steroids

Why do people take drugs?

To feel good

drugs produce intense feelings of pleasure


euphoria is followed by other effects, which
differ with the type of drug used
stimulants (cocaine): the high is followed by
feelings of power, self-confidence, and
increased energy
opiates (heroin): feelings of relaxation and
satisfaction

Why do people take drugs?

To feel better

To do better

social anxiety
stress-related disorders
depression
improve their athletic or cognitive performance

Curiosity and because others are doing it

strong influence of peer pressure

Early signs of risk in the family


lack of mutual attachment and nurturing by
parents or caregivers
ineffective parenting
a chaotic home environment
lack of a significant relationship with a caring
adult
a caregiver who abuses substances, suffers
from mental illness, or engages in criminal
behavior

Risk factors outside the family


inappropriate classroom behavior, such as
aggression and impulsivity
academic failure
poor social coping skills
association with peers with problem behaviors,
including drug abuse
misperceptions of the extent and acceptability of
drug-abusing behaviors in school, peer, and
community environments

Drug abuse/substance abuse

compulsive, excessive, and self-damaging


use of habit forming drugs or substances,
leading to:

addiction or dependence
serious health damage (kidneys, liver, heart)
psychological harm (such as dysfunctional
behavior patterns, hallucinations, memory
loss)
death

Drug addiction/drug dependence

compulsive craving for a drug which offers

short-term intense relief/pleasure


rapid induction of emotional state individuals
normally are not able to experience

Development of addiction

1st stage = FIRST CONTACT


mostly in a group as a unique episode
experience of belonging to a particular
group or culture

2nd stage = EXPERIMENTATION


a positive experience from the first contact
often motivates uncertain and anxious
children to continue

Development of addiction

3rd stage = USAGE, restful phase

trigger point (conflict, trauma)


because of the positive effect the child often regularly
returns
drug becomes part of their social life - perceived as
the best period of his/her life ever
evolves into compulsive patterns of substance-seeking
and substance-taking behavior that take place at the
expense of most other activities
somatic complaints begin to appear, breaking promises,
increasing need for money, occasional absence
following weekend trips, late arrivals home,
deterioration of relations in the family and at school,
loss of friends

Development of addiction

3rd stage = USAGE, problematic/advanced


usage
develops after a few months rather years of usage
cumulating problems

loss of control over drug use, desire to confide


loss of hobbies, lack of interest in school, work, family
conflicts and theft
serious health problems

young person perceives problems and tries to prove he's


got a control
5 10 days sober establish him falsely in his view
within next years the head currently runs two programs
program of a drug and program of abstinence

Development of addiction

4th stage = ADDICTION


unconditional loss of control over life
drug brings nothing positive
loss of dignity
destruction of the closest relations
delusion and inability to perceive reality
loss of lust for life
difference between problematic usage and
addiction?
doses of the drug
ability to admit the addiction

Development of addiction

5th stage = QUITTING

never ending stage


life will never be as friendly as with the drug
experiencing pain
high motivation
great social support

ESPAD 2011 - Alcohol


ESPAD = The Europian School Survey Project on
Alcohol and Other Drugs

1,6 %
60,0 %

strict nondrinkers
regular consumers

! Risk alcohol consumption rising !

Example: drunkennes during last month admitted


37% of 16 year old:

1/5 three times during the past month


5% ten times

ESPAD 2011 - Illegal drugs

experience with:

cannabis .......................... 42%


ecstasy ............................ 8,3%
hallucinogens .................. 5,6%

first experience in younger age


girls prefer to experiment with amphetamines
and sedatives

Consumption of tobacco, alcohol and


drugs in CR

one of the leading positions in Europe


reasons

high tolerance to consumption


physical and financial accessibility even for children and
youth
influence of media (celebrities)
commercial interests
role models in the family
lack of control mechanisms and sanctions

Gambling
slot machines
terminals
electro roulette
common cause

lack of money (allowance)


lack of hobbies
peer influence

Virtual reality
internet addiction
computer games
completely identical problems as in drug
addiction

Prevention principles

prevention programes should enhance protective


factors and reduce risk factors (Hawkins et al.
2002)
prevention programes should address all forms of
drug abuse (legal, illegal drugs, inappropriate use
of legally obtained substances (Johnston et al.
2002)
prevention programes should address the type of
drug abuse problem in the local community
(Hawkins et al. 2002)
prevention programes should be tailored to
address risks specific to population characteristics
like age, gender, ethnicity (Oetting et al. 1997)

Risk factors x protective factors


Protective
factors

Risk facto rs

Domain

Earl y Ag g ress iv e
Behavior

Individ u al

Lack of P a rent a l
Supervi s ion

Fa m ily

Parent a l
Monitoring

Peer

Acad e mi c
Competence

Substance Abuse

Drug Av a ilab ili t y

Poverty

Impuls e Contr o l

School

Antidrug Us
Polic ies

Communi t y

Strong
Neighborhood
Attachment

Examples of preventive interventions

Prior to birth

preventing/delaying pregnancy in young and vulnerable


mothers
antenatal health service
antenatal educational courses/home visitation

Examples of preventive interventions

Early childhood

school preparation programes


school-based drug education
parent education
family therapy

Examples of preventive interventions

Adolescents

school-based drug education


peer intervention, peer eduaction
youth sport and recreation programs
mentorship
employment and training

Examples of preventive interventions

Community based prevention

education campaignes
homelessness strategies
crime prevention
regulation and law enforcement
judicial procedures
harm-reduction strategies (I.e. low threshold centers)

How to say NO

assertiveness

an important communication skill


learn to reject things that are not right for him based on his
conviction,
ability to say no can save the child from the very first contact
with the drug

self-confidence/self-esteem

child should perceive that he is a unique human being


child with an adequate self-esteem would not use drugs to
confirm his confidence in relation to peers

Literature

http://www.who.int/substance_abuse/publications/global_a
lcohol_report/en/
http://www.espad.org/
http://www.unodc.org/unodc/en/data-and-analysis/WDR2012.html
http://www.who.int/substance_abuse/links/othersites/en/
NIDA: Preventing drug use among children and
adolescents. (A research-based guide for parents,
educators and community leaders. Second edition.)