Vulnerability and drug prevention

Transcription

1 Vulnerability and drug prevention Margareta Nilson Gregor Burkhart, Gilberto Gerra Mental Health of children and adolescents Luxembourg, September 2004

2 Vulnerability and drug prevention Prevention strategies Vulnerable groups Selective prevention Individuals at risk Indicated prevention

3 Overview prevention strategies Universal prevention Prêt à porter Risk Selective prevention Haute couture Target Population size Indicated prevention

4 Vulnerable groups

5 Vulnerability factors - groups Homeless, runaways from home Excluded from school or truanted Young offenders Family/siblings involved in drug use Family conflict or disruption Deprived neighbourhood Ethnic minority

6 % Comparison of lifetime any drug use by groups aged (Source: UK Youth Lifestyles Survey 1998/1999) Young people with older sibling who used any drug last year School excludees and truants General population

7 Use of drugs during past month by 'vulnerable' groups in the Netherlands cannabis ecstasy % 60 cocaine 40 amphetamine 20 heroin year old school students Current Cannabis users* homeless youth** at special schools*** In truancy projects***

8 Selective prevention Strategies which target specific groups at greater risk of developing drug-related problems than others. The purpose of selective prevention is to prevent drug abuse.

9 Why selective prevention? Addresses risk factor models more specifically Takes specific needs of the target groups into account Drug problems, not drugs in focus Risk factors for drug problems drug use Focuses resources More time- and cost intensive Results more visible

10 Selective prevention Some activities in Tallinn Municipality Early identification and localisation of problem development and young people s risk behaviour High importance, high activity level (good practice examples available) Importance recognised, some or recent activities No or vague references, no relevant activities available No information Several targeted intervention for Roma youth

11 Individuals at risk

12 Individual risk factors Early onset of substance abuse Petty crime Aggressive behaviour Conduct problems Impulsivity Cognitive difficulties Social anxiety Gerra 2003; Wills et al., ; Moffit, 1993; Poikolainen, 2002

13 Psychiatric disorders Internalising disorders depression anxiety Externalising disorders ODD (Oppositional Defiant Disorder) Antisocial personality disorder ADD (Attention Deficit Disorder ADHD (Attention Deficit Hyperactivity Disorder)

14 Psychiatric symptoms Symptoms 12 months before substance abuse diagnosis in adolescents Anxiety 60% Mood disorders 51% ADHD 47% Conduct disorder 19% Gerra, 2003; Shrier et al., 2003

15 EARLY ADOLESCENCE TEMPERAMENT RELATED ATTRIBUTES MIDDLE ADOLESCENCE DEVIANT PEER AFFILIATION Gerra, 2004; Wills and Cleary, 1999 EARLY SUBSTANCE USE

16 Indicated prevention Indicated prevention seeks to identify individuals at risk early and tackle their specific vulnerability

17 Indicated prevention Early interventions, e.g. Commissão de Dissuação, FreD Life-skills training Contingency training Cognitive-behaviouristic interventions Psychatric diagnosis Medication

18 EU Council Recommendation on the prevention and reduction of healthrelated harm associated with drug dependence 1. Member States should... set as a public health objective the prevention of drug dependence and the reduction of related risks, and develop and implement comprehensive strategies accordingly. 6. provide, in accordance with the individual needs of the drug abuser... adequate psychosocial care... taking into account the fact that a wide variety of different treatment options should be provided for the drug-abuser; 12. promote appropriate integration between health, including mental health, and social care, and specialised approaches in risk reduction;

19 Thank you!

20 This paper was produced for a meeting organized by Health & Consumer Protection DG and represents the views of its author on the subject. These views have not been adopted or in any way approved by the Commission and should not be relied upon as a statement of the Commission's or Health & Consumer Protection DG's views. The European Commission does not guarantee the accuracy of the data included in this paper, nor does it accept responsibility for any use made thereof.