Drug Education Programs Research Articles

Developmental trajectories of adolescent risky drinking: predictors from the Drug Education in Victoria Schools (DEVS) study

ABSTRACTWith alcohol misuse one of the leading causes of disability among young Australians, determination of potential predictors of risky drinking trajectories of young people is crucial. This study aimed to identify risky drinking trajectories from early to mid-adolescence and to determine if membership of a harm minimization intervention, alcohol knowledge, attitudes towards alcohol and prevalence of alcohol harms would predict trajectory group membership. Longitudinal data from 1746 students were used to identify alcohol consumption trajectory groups for both intervention and control students. Higher baseline knowledge predicted a higher, increasing, consumption trajectory for controls, whereas, safer attitudes at baseline were not associated with a higher, increasing trajectory. All other alcohol harms at baseline were strongly associated with higher consumption trajectories. The intervention group had fewer increasing trajectories and a lower level of consumption at the end of the programme, suggesting the drug education programme reduced the number of students who substantially increased their consumption over time, while at the same time reducing their level of consumption in relative terms. The consistency of better intervention student outcomes across all trajectories provides evidence that the drug education programme was influential with all types of student drinkers and is suitable for universal delivery.

War on Drugs: The Church’s Resilient Mission of Resistance

The war on drugs has become contentious in the public and private spaces in this nation. What is contested is the defensibility of an immoral means that legitimizes killing and collateral damage in the guise of upholding the public safety at the expense of the human security of the poor and the dispensable drug-pushers and addicts from the poorer neighborhoods. In light of the teachings of the Catholic Bishops’ Conference of the Philippines (CBCP), Association of Major Religious Superiors of the Philippines (AMRSP), the Manila Episcopal Area of the United Methodist Church and the evaluative framework of the just war theory, the use of EJK as a legitimate means and use of the term ‘war’ are debunked as indefensible. The truth-telling of two former death squad members is a strong indictment of EJK and the militaristic connotation of the term ‘war on drugs’ with the subsequent violation of the dignity and security of the weak. The more sustainable means of safeguarding the public safety of the weak in particular is the recourse to viable strategies related to the Drug Education & Harm Reduction Policies and Programs implemented by the Church and civil society in response to their official pronouncements.

The relationship between Australian harm minimisation alcohol education and student uptake, consumption and harm

BackgroundAlcohol use by young people is a public health concern in Australia because of the disproportionate harm they experience. Accordingly, governments have sought to protect young people, with school identified as an appropriate site for drug, including alcohol, prevention through education. School-based drug education programmes, however, have not been particularly effective, and even when individual programs report prevention benefits they can be criticised for being developed and evaluated by the same group. MethodsThis study involved secondary analysis of alcohol data from the 2011 and 2014 Australian Secondary Students Alcohol and Drug (ASSAD) surveys, to examine the relationship between the amount of alcohol education students reported receiving and their patterns of use and harm. Associations between the amount of alcohol education remembered and alcohol uptake, consumption, risky consumption and alcohol-related harm were measured using Logistic and Tobit regression techniques. As most alcohol education in Australia reflects harm minimisation aims, this research provides an independent, proxy assessment of the effect of harm minimisation education. ResultsIn the 12- to 17-year-old student group, as a whole, there was a significant positive association between having tried alcohol and the level of alcohol education recalled. There were significant negative associations between the amount of alcohol consumed and the level of alcohol education recalled for drinkers and risky drinkers. There were no significant associations between alcohol-related harm and the level of alcohol education recalled for drinkers and risky drinkers. ConclusionProviding more harm minimisation alcohol education did not persuade students to abstain from alcohol, but rather the reverse. Providing more harm minimisation education was influential in reducing consumption by students, particularly those drinking at risky levels. This should be considered indirectly beneficial in terms of minimising harm. However, the alcohol education provided to Australian students has not directly influenced their alcohol-related harm.

Drug education: A deceptively simple answer to a complex question

This paper describes a quantitative and qualitative evaluation of a drug education programme in schools. This description leads to discussion of the many influences beyond the classroom that severely challenge drug education.A case is then advanced for drug education to be seen as a primary preventative measure in a framework of graduated responses that are related to students' needs and circumstances.

School-based drug education and prevention: the impact of inspection and curriculum provision

Purpose – The purpose of this paper is to examine the links between school inspection requirements as represented by Ofsted and the provision of drug education programmes in schools. Design/methodology/approach – An examination of relevant guidance from the Department of Education and the school inspection agency Ofsted; and reference to the research literature and evidence base around drug education. Findings – The provision of drug education programmes in schools is influenced by the requirements of the national curriculum; and the frameworks used by Ofsted in its inspections. Recent reduction in emphasis on drug education in both sources has reduced the extent and quality of drug education in schools. Research limitations/implications – The paper looks at national documentation and conclusions. It is not a quantitative study of school provision – some indication of this is provided by Ofsted reports. Practical implications – The paper indicates that reports and conclusions from Ofsted and other bodies, e.g. House of Commons select committees and the ACMD, have in the recent past reported on rather than informed governmental action. Social implications – The paper concludes that central government support and professional training and development are essential ingredients in the provision of universal drug education in schools. Originality/value – The paper illustrates some of the factors involved in the provision of drug education; the contribution this can make to drug prevention, including harm reduction; and the seeming lack of understanding of education and prevention in the wider professional and political discussions about drugs and their use.

Smoking Prevention for Students: Findings From a Three-Year Program of Integrated Harm Minimization School Drug Education

ABSTRACTBackground: This study investigated the impact of the Drug Education in Victorian Schools (DEVS) program on tobacco smoking. The program taught about licit and illicit drugs in an integrated manner over 2 years, with follow up in the third year. It focused on minimizing harm, rather than achieving abstinence, and employed participatory, critical-thinking and skill-based teaching methods. Methods: A cluster-randomized, controlled trial of the program was conducted with a student cohort during years 8 (13 years), 9 (14 years), and 10 (15 years). Twenty-one schools were randomly allocated to the DEVS program (14 schools, n = 1163), or their usual drug education program (7 schools, n = 589). One intervention school withdrew in year two. Results: There was a greater increase in the intervention students' knowledge about drugs, including tobacco, in all 3 years. Intervention students talked more with their parents about smoking at the end of the 3-year program. They recalled receiving more education on smoking in all 3 years. Their consumption of cigarettes had not increased to the same extent as controls at the end of the program. Their change in smoking harms, relative to controls, was positive in all 3 years. There was no difference between groups in the proportionate increase of smokers, or in attitudes towards smoking, at any time. Conclusions: These findings indicate that a school program that teaches about all drugs in an integrated fashion, and focuses on minimizing harm, does not increase initiation into smoking, while providing strategies for reducing consumption and harm to those who choose to smoke.

Development, validation, and implementation of a medication adherence survey to seek a better understanding of the hemodialysis patient

Factors contributing to non-adherence have become a priority for clinicians, healthcare policy makers, and healthcare payers alike. Patients who are non-adherent to their medication regimen appear to have poor health outcomes, with evidence of both high mortality rates and high morbidity in the form of more frequent emergency room admissions, recurrent exacerbations of disease, and poor overall well-being. The primary objective of this study was to identify and describe patient-identified factors associated with non-adherence in patients maintained on chronic hemodialysis. A 23-item questionnaire was developed and validated for use in the hemodialysis population. This questionnaire was administered to patients undergoing chronic hemodialysis in a single center during the period of October to December 2013. A total of 156/183 eligible patients consented. Of these 156 patients, 36 (23%) patients reported being non-adherent. The most common non-adherent behaviors were changing the frequency of taking medications and skipping doses. Patients identified information gaps around medication interactions, the flexibility around drug timings, and how best to manage medications that needed to be taken apart from, with, or without food. Our study shows that, despite an intensive drug education program, almost one quarter of patients continue to have problems with taking medication and that traditional education around medications is insufficient. We propose that clinicians customize education to the patient-driven gaps in knowledge, in particular focusing on the education needed to empower patients to recognize which aspects of their care they can and should modify and which aspects require further clinician input.

What Are Youth Asking About Drugs? A Report of NIDA Drug Facts Chat Day.

The current study analyzes a sample of questions about drugs asked online by youth who participated in the National Institute on Drug Abuse's (NIDA) "Drug Facts Chat Day." The types of drugs youth asked about were coded into 17 substance categories, and the topics they raised were coded into seven thematic categories. The top five queried drugs were marijuana (16.4%), alcohol (8.5%), tobacco (6%), cocaine (5.7), and pharmaceutical drugs (4.5%). The effects of drug use, experience of being high, the addictiveness of drugs, pharmacology, and drug sales were among the more common types of questions to emerge but varied depending on the substance. These findings show the types of information young people are seeking about drugs and have clear implications to inform youth drug education programs.

Alcohol Prevention and School Students: Findings From an Australian 2-Year Trial of Integrated Harm Minimization School Drug Education.

The Drug Education in Victorian Schools program provided integrated education about licit and illicit drugs, employed a harm minimization approach that incorporated participatory, critical thinking and skill-based teaching methods, and engaged parental influence through home activities. A cluster-randomized, controlled trial of the program was conducted with a student cohort during Year 8 (13 years) and Year 9 (14 years). Twenty-one secondary schools in Victoria, Australia, were randomly allocated to the Drug Education in Victorian Schools program (14 schools, n = 1,163) or their usual drug education program (7 schools, n = 589). This study reports program effects for alcohol. There was a greater increase in the intervention students' knowledge about drugs, including alcohol; there was a greater increase in communication with parents about alcohol; they recalled receiving more alcohol education; their alcohol consumption increased less; and they experienced a lesser increase in alcohol-related harms. Among intervention group risky drinkers, consumption and harm increased less. There were no differences between study groups in attitudes toward alcohol or in the proportion of drinkers or risky drinkers. While the program did not stop students taking up drinking, it did reduce their consumption and harm.

Sophie and Pierre take part in a drug education programme in Costa Rica.

Sophie and Pierre take part in a drug education programme in Costa Rica.

School-based drug education: the shaping of subjectivities

Purpose – The purpose of this paper is to explore how school-based drug education programmes in Australia have sought to reduce adolescent drug use. Design/methodology/approach – Drawing on insights from Foucault's later works and writers on governmentality, the paper considers how, through the use of various technologies, techniques and strategies, students have been encouraged to problematise their understanding of self by way of a series of choices they are required to make in relation to recreational drug use. Findings – Drugs are positioned as a key factor in the psychic and social well-being of youths insofar as their health and personal happiness is said to depend on the decisions they make concerning their use of drugs. In the process, moral and political objectives are met as students internalise norms, values and objectives consonant with a self-disciplined, self-governing society. Practical implications – By bringing into question school-based drug education, a space is created for further discussions around this historically controversial strategy. Social implications – What is common to all school-based drug education programmes is that the problem is conceptualised in terms of individual and interpersonal deficiencies or inadequacies. Conceptualised thus, both the problem and the solution lay with the individual; it is the individual who must change. Originality/value – The focus of this paper has not been on why school-based drug education is needed or how to improve it (the focus of most research on the subject), but rather on the methods employed to influence student use of recreational drugs. By identifying how school-based drug education has sought to shape student subjectivities, this paper has exposed specific moral and political dimensions of the project.

Response Inhibition Moderates the Association between Drug Use and Risky Sexual Behavior

Background: HIV infection is problematic among all drug users, not only injection drug users. Drug users are at risk for contracting HIV by engaging in risky sexual behaviors. Objective: The present study sought to determine whether inhibitory processes moderate the relationship between problematic drug use and HIV-risk behaviors (unprotected sex and multiple sex partners). Methods: One hundred ninety-six drug offenders enrolled in drug education programs were administered a battery of computer-based assessments. Measures included a cued go/no-go assessment of inhibitory processes, the Drug Abuse Screening Test (DAST) assessment of problematic drug use, and self-report assessment of condom use and multiple sex partners. Results: Findings revealed that response inhibition assessed by the proportion of false alarms on the cued go/no-go moderated the relationship between problematic drug use and an important measure of HIV risk (condom nonuse) among drug offenders. However, response inhibition did not moderate the relationship between problematic drug use and another measure of HIV risk: multiple sex partners. Conclusions: Among this sample of drug offenders, we have found a relationship between problematic drug use and condom nonuse, which is exacerbated by poor control of inhibition. These findings have implications for the development of HIV intervention components among high-risk populations.

Cannabis and Harm Minimisation Drug Education: Findings from the Drug Education in Victorian Schools Study

Aims: To evaluate the effectiveness of an integrated harm minimisation focused school drug education programme in terms of reducing cannabis use and harm. Design and Methods: A cluster randomised controlled trial of the 18 lesson Drug Education in Victorian Schools (DEVS) drug education programme was undertaken with students during years eight and nine (13 and 14 years of age respectively), with follow up in year ten (15 years of age). The programme covered all drugs, employed a harm minimisation approach that used participatory, critical thinking and skills based teaching methods, and engaged parental influence through home activities. Twenty-one secondary schools in Victoria, Australia, were randomly allocated to receive the DEVS programme (14 schools) or the drug education usually provided by their schools (7 schools). In relation to cannabis, communication with parents, lessons remembered, responsible attitudes, whether used, frequency of use and associated harms were measured. Results: In comparison to controls, there was a significantly greater increase in the intervention students’ communication with parents about cannabis recall of cannabis lessons received, and responsible attitudes towards cannabis. While there were no significant differences between the two study groups in relation to the proportion of cannabis users, the increase in level of use by intervention students was significantly less and they experienced a lesser increase in associated harms. Conclusion: A harm minimisation focused school drug education programme reduced the level of cannabis use and associated harm. This supports harm minimisation education as an effective prevention strategy for school students.

The Association between Non-Medical Prescription Drug Use and Suicidal Behavior among United States Adolescents.

Adolescence represents a vulnerable time for the development of both drug use/abuse and mental illness. Although previous research has substantiated a relationship between drug use and suicidal behavior, little research has examined this relationship with non-medical prescription drug use. Given the growing prevalence of non-medical prescription drug use (NMPDU) among adolescents, this study explored the association between NMPDU and suicidal behavior. Nationally representative data were derived from 16, 410 adolescents who completed the 2009 National Youth Risk Behavior Survey. Approximately 19.8% of participants reported lifetime NMPDU. NMPDU was associated with significantly increased odds of suicidal behavior (P < 0.01), with seriously considering attempting suicide and making a plan about attempting suicide representing the strongest correlates for males and females. Results suggest the importance of 1) continued reinforcement of drug education programs in high school begun at earlier ages and 2) mental health care and screenings among adolescents.

Preventing alcohol harm: Early results from a cluster randomised, controlled trial in Victoria, Australia of comprehensive harm minimisation school drug education

BackgroundIn Australia, the burden of alcohol-attributable harm falls most heavily on young people. Prevention is important, and schools have long been seen as appropriate settings for pre-emptive interventions with this high risk group. This paper evaluates the effectiveness, in relation to alcohol harm prevention, of the Drug Education in Victorian Schools (DEVS) programme, nine months after implementation. This intervention dealt with both licit and illicit drugs, employed a harm minimisation approach that incorporated interactive, skill based, teaching methods and capitalised on parental influence through home activities. MethodsA cluster randomised, controlled trial of the first ten lessons of the DEVS drug education programme was conducted with year eight students, aged 13–14 years. Twenty-one secondary schools in Victoria, Australia were randomly allocated to receive the DEVS programme (14 schools, n=1163) or the drug education usually provided by their schools (7 schools, n=589). Self-reported changes were measured in relation to: knowledge and attitudes, communication with parents, drug education lessons remembered, proportion of drinkers, alcohol consumption (quantity multiplied by frequency), proportion of student drinkers engaging in risky consumption, and the number of harms experienced as a result of alcohol consumption. ResultsIn comparison to the controls, there was a significantly greater increase in the intervention students’ knowledge about drugs, including alcohol (p≤0.001); there was a significant change in their level of communication with parents about alcohol (p=0.037); they recalled receiving significantly more alcohol education (p<0.001); their alcohol consumption increased significantly less (p=0.011); and they experienced a lesser increase in harms associated with their drinking (p≤0.001). There were no significant differences between the two study groups in relation to changes in attitudes towards alcohol or in the proportion of drinkers or risky drinkers. There was, however, a notable trend of less consumption by risky drinkers in the intervention group. ConclusionsA comprehensive, harm minimisation focused school drug education programme is effective in increasing general drug knowledge, and reducing alcohol consumption and harm.

A national study of substance use behaviors among NCAA male athletes who use banned performance enhancing substances

BackgroundReports of illicit substance use by college athletes have become commonplace in recent years, yet comparatively little effort has been put forth by the research community to understand these behaviors. MethodsData for this study came from a large, national dataset collected by the National Collegiate Athletic Association (NCAA). This study compared substance use behaviors of male undergraduate student athletes who reported using ergogenic performance enhancing substances (e.g., anabolic steroids and peptide hormones) during college (PES users) to those who did not (PES non-users). ResultsA consistent pattern of higher substance use rates was observed among PES users compared to non-users, including heavier drinking, higher prevalence rates of cigarettes, marijuana, amphetamines, narcotics, and a variety of permissible and impermissible dietary supplements. An unexpected finding was that there were large discrepancies in reported prevalence rates between similar or overlapping survey items (e.g., past year use of “narcotics” versus “I have taken Vicodin, Oxycontin or Percocet with/without a prescription”). ConclusionsThese findings suggest that male college athletes who use PES while in college demonstrate a general tendency to engage in alcohol and drug use behaviors, regardless of whether these behaviors improve or impede athletic performance. The results further suggest that college athletes may not fully appreciate drug categorizations that are commonly employed to gauge substance use behaviors. Changes to drug education and prevention programs may be needed to enhance understanding of drug properties and actions.

Smoking prevention: what benefits are indicated by a pilot school drug education programme that focuses on minimising harm?

Background: This pilot study investigated the smoking prevention benefits of a secondary school drug education programme for all-licit and illicit drugs. The programme took a harm minimisation approach and incorporated abstinence as one of a range of prevention strategies. Method: The study population comprised a cohort of 318 Victorian junior secondary school students (intervention N = 225 in three schools, control N = 93 in one school). During Years 8 (13–14-year-olds) and 9 (14–15-year-olds), the intervention students received a 22-lesson programme derived from evidence of effective practice and aimed at minimising the harm associated with drug use. Control students received the drug education programme normally provided by their school. Results: Students who received the intervention remembered receiving more lessons about smoking and were more knowledgeable about drug use issues overall. They were no less likely to take up smoking, but those who did smoke, reported smoking fewer cigarettes and experiencing fewer harms associated with their smoking. Conclusions: This pilot study suggests that a harm minimisation approach to smoking can complement, rather than threaten, the abstinence message for adolescents. A school drug education programme with a harm reduction focus does not increase initiation into smoking and can equip smokers with the understanding and skills to make better decisions regarding use.

Drug taking beliefs of Australian adolescents: a pilot study.

In this study adolescents offered their insights and perspectives of factors associated with adolescent illicit drug taking intentions. The factors explored were identified using a cross-disciplinary approach involving the Theory of Planned Behavior (TPB) and criminological theories, and these formed the framework for data analysis. Interviews with 24 students aged 15-17 found that adolescents' beliefs to drug taking attitudes, subjective norms, perceived behavioral control, moral norms, negative affect, and reputation enhancement involved a number a sub-themes that provided an in-depth understanding of the association of these components to intended drug use. The incorporation of these elements in drug education programs could be an effective approach in prevention interventions for adolescent drug use.

Effectiveness of a Multiple Intelligences Teaching Approach Drug Education Programme on Pupils’ Attitude to Drug Abuse

The researcher developed a drug education programme based on Multiple Intelligences Teaching Approach (MITA) and evaluated the effectiveness of same on the attitude of pupils (11 - 13 year old) towards drug. The differential effect of the programme on pupils of different sex and school location were explored. The study, a quasi experimental study involved 91 pupils who were grouped into experimental (taught with the MITA) and control (taught with the usual Traditional Lecture Method) groups. The result revealed that the experimental group had a mean attitude score that was significantly higher than that of the control group. While the MITA had no significant differential effect on pupils' attitude due to sex, its positive impact on healthy attitudinal development was more manifest with urban based pupils. It was concluded that the MITA was more effective than the usual Traditional Lecture Method in helping pupils to develop healthy attitude towards drugs.

혈액투석환자의 이행에 관한 체계적인 문헌고찰

본 연구는 국내 혈액투석환자의 이행 관련 선행연구들을 체계적으로 고찰하여 이행 측정도구와 관련변인을 파악하고, 중재의 효과크기를 분석하여 혈액투석 환자를 위한 근거중심의 실무프로그램 개발 및 향후 연구 방향을 제시하기 위하여 시도되었다. 10개의 데이터베이스에서 검색한 437편의 연구 중 37편의 연구를 최종 선택하였으며, 5편의 중재연구를 메타 분석하였다. 연구결과, 사용된 이행 측정도구는 11개의 원 도구로부터 도출된 것으로 나타났으며, 관련변인은 총 20개 변인이 검색되었다. 중재방법은 개별교육프로그램, SMS, 이메일 및 전화 상담을 이용한 자가간호프로그램, 지지간호프로그램, 약물교육프로그램 등으로 분류되었고, 임의효과모형(random effect model)을 이용하여 분석한 중재의 효과크기는 1.04(95% CI: 0.60, 1.49, p<.00001)로 중재프로그램의 효과가 큰 것으로 나타났다. The purpose of this study was to analysis instruments, identify relevant factors and analyze the effect size of intervention studies in reference to adherence among hemodialysis patients. Electronic literature searches were conducted for PubMed, CINAH, RISS, Naver academic, KISS, NDSL, Nanet, Kci, DBpia and KoreaMed. Of 437 studies identified, 37 met inclusion criteria, and 5 were used to estimate effect size. As a results, total of 11 original instruments were found, 61 factors were considered as relevant factors for adherence. Types of intervention were individual education program, self-care program using SMS, E-mail, or telephone counseling, supportive care program and drug education program. The effect size using random model effect was high (d=1.04, 95% CI: 0.60, 1.49, p<.00001).