TINGIM LAIP ALCOHOL HARM REDUCTION DISCUSSION GUIDE

Transcription

1 TINGIM LAIP ALCOHOL HARM REDUCTION DISCUSSION GUIDE ALCOHOL DISCUSSION GUIDE.indd 1

2 Tingim Laip PO Bx 1402 Madang Papua New Guinea (P) (F) TLinf@tl2.rg.pg ALCOHOL DISCUSSION GUIDE.indd 2

3 CONTENTS ABOUT THIS DISCUSSION GUIDE... 2 DISCUSSION ONE: ALCOHOL USE IN PNG... 3 DISCUSSION TWO: ALCOHOL RELATED HARM... 7 DISCUSSION THREE: ALCOHOL MAP AND DIARY - WHERE AND WHEN DO WE DRINK?...13 DISCUSSION FOUR: REDUCING PROBLEMS CAUSED BY DRINKING...17 DISCUSSION FIVE: PEER SELF-ASSESSMENT...27 DISCUSSION SIX: MAKING PLANS TO REDUCE ALCOHOL HARM...31 WORKS CITED...34 ACKNOWLEDGEMENTS ALCOHOL DISCUSSION GUIDE.indd 1

4 ABOUT THIS DISCUSSION GUIDE This discussin guide has been develped fr use by Tingim Laip (TL) wrkfrce: vlunteers, field wrkers and prject fficers. The Guide was develped based n a series f cnsultatins cnducted by Tingim Laip t explre the availability f alchl harm reductin services and prgrams in PNG and the Pacific t assist peple t manage alchl and its impacts. As part f these cnsultatins, discussins were held with TL vlunteers and staff wh expressed the need fr resurces that will help vlunteers t lead discussins with their peers t explre hw they use alchl in their wn lives and think abut hw they can manage alchl mre effectively. This discussin guide presents a series f discussins that vlunteers can have with their peers. They can be presented thrugh peer educatin r small grup discussin sessins. Discussins include: Useful facts abut alchl and the harms it can cause Infrmatin abut hw alchl use can increase risk fr HIV Strategies t reflect n alchl use: their wn and their peers in their cmmunity Strategies that can be used t reduce alchl related harm Planning exercises t prmte respnsible alchl use Building n their wn persnal achievements in managing alchl, vlunteers will als be able t use this discussin guide t help their peers and cmmunities think abut alchl related harm, t better manage alchl use and t build strnger, safer envirnments. The discussin guide includes exercises that vlunteers and field fficers can d tgether with their peers. Discussin 1 asks vlunteers and peers t think abut hw alchl is used in their cmmunities and intrduces the idea f alchl related harm Discussin 2 asks vlunteers and peers t talk abut why peple drink and the effects f drinking. This helps vlunteers and peers t develp an understanding f why alchl is used in their cmmunity. Discussin 3 asks vlunteers and peers t draw a map f where peple drink and a timetable fr when peple drink in their cmmunities. This helps vlunteers and peers develp an understanding f hw alchl is used in the cmmunity. Discussin 4 asks vlunteers and peers t identify different prblems (harm) that happen as a result f drinking alchl in their cmmunities and discuss ways f reducing these prblems. Discussin 5 asks vlunteers and peers t d a cmmunity assessment, identifying hw the cmmunity is respnding t alchl-related harm. Discussin 6 asks vlunteers and peers t develp a plan fr respnding t the harms caused by alchl in their cmmunity. 2 ALCOHOL DISCUSSION GUIDE.indd 2

5 DISCUSSION 1 ALCOHOL USE IN PNG 1 3 ALCOHOL DISCUSSION GUIDE.indd 3

6 1: ALCOHOL USE IN PNG 1 HOUR BUTCHER PAPER, PENS, BLUE TACK/TAPE 1 Welcme everyne t the sessin. Explain: The main fcus f this discussin is t talk abut the use f alchl in PNG. The purpse is nt t judge ther peple r t get peple in truble. We just want t think abut alchl use and hw it affects peple wh drink alchl, as well as their friends and family. TL wrks with peple frm Key Affected Ppulatins (KAPs) t prevent HIV transmissin. Alchl use has been identified by many f ur stakehlders as a factr that cntributes t unprtected sex, sexual vilence and dmestic vilence. The sale f alchl, t peple ver 18 years, and drinking alchl are legal activities in PNG. Drinking alchl in mderatin can lessen alchl-related harm. Unfrtunately in PNG, many peple drink a lt f alchl at a time this is smetimes called binge drinking. Alchl, including Steam, is widely available in PNG. The prductin and sale f alchl is als a significant cntributr t PNG s ecnmy. It prvides surces f incme fr many families in PNG. 2 When alchl is misused, the related harm can be cnsiderable and cstly t peple s health and ecnmy, their friends and family, the sciety and cuntry in general. In PNG, it is estimated that ver 80% f injury-related admissins t hspital emergency wards are related t the harmful use f alchl (Alchl Abuse Wrking Cmmittee, 2012). The effects can be very serius and can have negative impacts n family members and the wider cmmunity, particularly where the drinker is likely t becme vilent r be invlved in criminal behaviur when drunk. What des drinking in mderatin mean? Respnsibly Nt t excess Nt extreme amunts Having nly a cuple f drinks nt a cartn 4 ALCOHOL DISCUSSION GUIDE.indd 4

7 1: ALCOHOL USE IN PNG Ask yur peers: D peple in yur cmmunities drink alchl? 3 What kind f alchl d peple nrmally drink? D bth men and wmen drink? D men drink mre than wmen? D wmen drink mre than men? Ask yur peers: Why d peple drink? 4 D men and wmen drink fr the same reasns? Why d men drink? Why d wmen drink? 1. Give the grup 10 minutes t discuss. 2. Write their answers n a butcher paper where everyne can see. 3. Discuss each f the answers that the grup presents Say: 5 6 What are the gd aspects f drinking? 1. Give the grup 10 minutes t discuss. 2. Write their answers n a butcher paper where everyne can see. 3. Discuss each f the answers that the grup presents Say: What are the prblems caused by drinking? 1. Give the grup 10 minutes t discuss 2. Write their answers n a butcher paper where everyne can see 3. Discuss each f the answers that the grup presents 5 ALCOHOL DISCUSSION GUIDE.indd 5

8 1: ALCOHOL USE IN PNG Nte fr the facilitatr: 7 This table is designed t start the discussin abut alchl: the reasns that we drink (the benefits ) and the prblems that drinking can cause. Use this table t capture the grup s answers. Encurage peple t use their wn life experiences and what they have seen in their cmmunity t identify the gd aspects f drinking and the prblems that drinking can cause. Remember that sme f the issues raised will be very unique t a particular grup s the respnses DON T have t be the same! What are benefits/ gd aspects f drinking? Example: Drinking helps me scialise. It s fun! What are the prblems caused by drinking? Example: I spent mney n bze that I culd have spent n smething else 6 ALCOHOL DISCUSSION GUIDE.indd 6

9 DISCUSSION 2 ALCOHOL RELATED HARM 2 7 ALCOHOL DISCUSSION GUIDE.indd 7

10 2: ALCOHOL RELATED HARM 1 HOUR BUTCHER PAPER, PENS, BLUE TACK/TAPE 1 Welcme everyne t the sessin. 2 Explain that the main fcus f this discussin is t talk abut alchl related harm. Say: What is alchl related harm? (Yu may have t discuss each wrd in this phrase separately first: alchl, related, harm. Then discuss what the wrds mean tgether.) 1. Give the grup 10 minutes t discuss 2. Write their answers n a butcher paper where everyne can see 3. Discuss each f the answers that the grup presents 3 Cntinued... 8 ALCOHOL DISCUSSION GUIDE.indd 8

11 2: ALCOHOL RELATED HARM Cntinued... What are sme examples f alchl related harm? (Make sure the fllwing pints are cvered) Physical health prblems: hangver, headache, vmiting, alchl pisning, liver disease, heart disease, cancer Alchl dependence and addictin Mental health prblems Effects n unbrn children Drink driving related deaths and injuries fr persn drinking, passengers and peple walking n the street Drwning Death Vilence: dmestic vilence and utside the hme, resulting in injuries and death Wrkplace injuries, lst prductivity and terminatin frm emplyment Pr rle mdels within the hme/ with peers/ acrss the cmmunity Resrting t alchl use in deal with stressful lifestyles r situatins 3 1. Give the grup 10 minutes t discuss 2. Write their answers n a butcher paper where everyne can see 3. Discuss each f the answers that the grup presents Is alchl related harm the same fr men and wmen? What kinds f alchl related harm d men face? What kinds f alchl related harm d wmen face? 1. Give the grup 10 minutes t discuss 2. Write their answers n a butcher paper where everyne can see 3. Discuss each f the answers that the grup presents What are sme things that cntribute t high levels f alchl use and alchl related harm? (Make sure the fllwing pints are cvered) Acceptance f heavy/ binge drinking and alchl use Easy accessibility and availability f alchl, particularly fr yunger drinkers Underemplyment resulting in peple having the time t drink Lack f stable hme envirnment Lack f apprpriate rle mdels Acceptance f peple s behaviur when they are drunk n cnsequences fr fighting, vilence and ther behaviurs 9 ALCOHOL DISCUSSION GUIDE.indd 9

12 2: ALCOHOL RELATED HARM Say: Harmful use f alchl is assciated with mre than 60 types f diseases and ther health cnditins: Immediate Health Risks: High alchl use has immediate effects that can increase the risk f many harmful health cnditins. These immediate effects are ften the result f binge drinking and include: 4 Injuries: falls, drwning, burns, traffic injuries and unintentinal injuries frm guns and knives Vilence, including vilence against partners and children Risky sexual behaviurs, including unprtected sex, sex with multiple partners and increased risk f sexual vilence. These can lead t unintended pregnancy r STIs and HIV. Miscarriage and stillbirth amng pregnant wmen and mix f physical and mental birth defects amng children that last thrughut their life. Alchl pisning that can affect the brain and can cause lss f cnsciusness, lw bld pressure and bdy temperature, cma, respiratry depressin r death. Lng-Term Health Risks: Regular high alchl use ver time can lead t chrnic diseases, brain damage and scial prblems that include: Brain prblems, including dementia, strke Circulatin prblems, including heart disease, heart attack and high bld pressure Psychiatric prblems, including depressin, anxiety and suicide. Scial prblems, including prblems with family, cmmunity, peers and unemplyment Cancers, including muth, thrat, esphagus, liver, cln and breast Liver diseases Other prblems with digestive system 10 ALCOHOL DISCUSSION GUIDE.indd 10

13 2: ALCOHOL RELATED HARM Read Jhnny s stry t yur peers: Jhnny lives in a village clse t twn. He is 26 years ld and wrks at a Mining Cmpany. As part f his wrk, Jhnny wrks full time fr 6 weeks and takes 2 weeks ff. Like any ther yung man, Jhnny enjys ging ut, having a few drinks and getting int a bit f fun. It is nrmal fr Jhnny and his friends t drink late int the night and smetimes, until the next day. On ne such uting, Jhnny made plans with a few ther friends fr a night ut. After much drinking and dancing, they all decided that they will g and drink sme mre at a friend s place. Jhnny s friend Paul, decided t drive them all t his huse. They were pretty drunk by the time they left the club. 5 The next day, the cmmunity learned that there was a car accident in twn. It went n t say that the driver and 2 ther passengers died instantly. Only ne persn survived (Jhnny) and is in critical cnditin at the hspital. Ask yur peers t think abut and discuss the fllwing questins: 1. What was the cause f the accident? 2. Is alchl the prblem r is it the amunt f alchl that peple drink? 3. What ther things culd have happened after drinking this much alchl? 4. What are pssible ripple effects t this incident? Summarise the discussin by saying: There can be gd things abut drinking alchl and negative things abut drinking alchl. The amunt f alchl cnsumed is the prblem. In PNG, it is very cmmn fr peple t binge drink and find it hard t stp nce they start drinking. Drinking t much alchl stre-bught, hmebrew r Steam, is a big prblem in PNG. 11 ALCOHOL DISCUSSION GUIDE.indd 11

14 NOTES 12 ALCOHOL DISCUSSION GUIDE.indd 12

15 DISCUSSION 3 ALCOHOL MAP AND DIARY: WHERE AND WHEN DO WE DRINK? 3 13 ALCOHOL DISCUSSION GUIDE.indd 13

16 3: WHERE AND WHEN DO WE DRINK? 1 HOUR BUTCHER PAPER, OUTLINE OF MAP OF AREA DRAWN ON BUTCHER PAPER, CALENDAR (1 MONTH) DRAWN ON BUTCHER PAPER, PENS 1 Welcme everyne t the sessin. 2 Explain that the purpse f the discussin is t get peple t think abut their wn alchl use and hw this affects their lives Say: Where d peple drink in this area? 3 Where can peple buy alchl in this area (Stre-bught and Steam)? - (Places might include: hmes; bars; markets; wrkplaces; guest huses...) 1. Give the grup 10 minutes t discuss 2. Mark the lcatins n the map 3. Discuss each f the answers that the grup presents 4 Say: When d peple drink in this area? Which days f the week? Is it mre n sme days than n thers? Des it change during pay frtnights? What abut when peple are n break frm mining r ther wrk? D sme peple drink n certain days and sme peple drink n ther days? Wh? When? Are there sme days that are mre likely fr binge drinking? 1. Give the grup 10 minutes t discuss 2. Mark each f the drinking days n the calendar wh drinks n what days (Lk at the sample calendar belw t guide yu) 3. Circle the days when there is likely t be binge drinking 4. Discuss each f the answers that the grup presents 14 ALCOHOL DISCUSSION GUIDE.indd 14

17 3: WHERE AND WHEN DO WE DRINK? MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY Example: Men drink sme beer at wrk during the day. In the evening men and wmen drink beer and spirits Example: We drink less during the week than at weekends because we have t g t wrk in the mrning Example: Peple drink less n Wednesday because we haven t gt much cash befre pay day Example: We buy mst f the alchl n Thursday because that s when we get paid Example: We drink the mst n Friday night because we dn t have t g t wrk n Saturday Example: Mst peple g t the bar at night because that s the nly place allwed t sell alchl at the weekend Example: During the day we sit with friends drinking watching sprt n TV 15 ALCOHOL DISCUSSION GUIDE.indd 15

18 NOTES 16 ALCOHOL DISCUSSION GUIDE.indd 16

19 DISCUSSION 4 REDUCING PROBLEMS CAUSED BY DRINKING ALCOHOL 4 17 ALCOHOL DISCUSSION GUIDE.indd 17

20 4: REDUCING PROBLEMS CAUSED BY DRINKING ALCOHOL 1 HOUR BUTCHER PAPER, MARKER, BLUE TACK/ TAPE, APPLYING ACTION POSTERS 1 Welcme everyne t the sessin. 2 Explain that the purpse f this discussin is t explre different actins peple can take t change their drinking behaviurs and reduce harm caused by alchl. Say: There are a number f different actins peple can take t change their drinking behaviurs and reduce harm caused by alchl. 3 These include: 1. Actin 1: Setting alchl-free times 2. Actin 2: Creating alchl-free znes 3. Actin 3: Drinking less 4. Actin 4: Drink safer 5. Actin 5: Drink less and drink safe 18 ALCOHOL DISCUSSION GUIDE.indd 18

21 4: REDUCING PROBLEMS CAUSED BY DRINKING ALCOHOL In the next sectin, ask the grup t think abut each f the different actins. Befre shwing peple the Actin psters, ask them t think abut each f the actins. Use the fllwing questins t help them think abut the actins. What des the actin mean? What can peple d under each actin? (These shuld lk like items in the left clumn What t d ) What are sme examples f what peple can d? (These shuld lk like the right clumn Examples and explanatins ) Next, shw the grup the Actin Psters, ne at a time. After each Actin Pster, have the fllwing discussin: 4 Review each f the items in the left clumn Review each f the examples and explanatins in the right clumn Ask the grup if they think these actins might help them t change their alchl drinking behaviur. Can they think f any ther actins that might help them t change their alchl drinking behaviur? Ask the grup if they can see themselves trying sme f these actins? What wuld the actin lk like in their envirnment? Wuld it be easy r hard? Hw culd they make it easy t try sme f these actins? 19 ALCOHOL DISCUSSION GUIDE.indd 19

22 4: REDUCING PROBLEMS CAUSED BY DRINKING ALCOHOL ACTION POSTERS ACTION POSTER 1: HOW CAN I HAVE ALCOHOL-FREE TIME OR QUIT DRINKING? WHAT TO DO Decide which days yu will and wn t drink EXAMPLES AND EXPLANATIONS Yu might chse nt t drink n certain days Yu might start by chsing nt t drink every secnd day Yu can adjust yur plans t increase the number f nn-drinking days as yu get used t drinking less Dn t give in t cravings Have a plan in case smene ffers yu a drink Remember yur gal t reduce the amunt that yu drink Cravings ften nly last 5 minutes: watch yur craving - let it cme and g rather than give in t it An empty stmach and can cntribute t cravings: have smething t eat instead f a drink Prepare sme things t say in case smene ffers yu a drink r asks why yu re nt drinking: I m taking a vacatin frm bze My liver is n vacatin this mnth I can t drink n my new medicatins My stmach desn t feel well -I better give it a pass I dn t feel like it I dn t want t g ff my diet Nt fr nw maybe in a little while. 20 ALCOHOL DISCUSSION GUIDE.indd 20

23 4: REDUCING PROBLEMS CAUSED BY DRINKING ALCOHOL ACTION POSTER 2: HOW TO CREATE ALCOHOL FREE ZONES OR PLACES WHAT TO DO Decide which places r areas shuld be alchl free and when EXAMPLES AND EXPLANATIONS Yu might need t get agreement frm peple wh share the spaces that yu want t be alchl free. Fr example, if yu want yur hme t be alchl free yu might need t negtiate with ther husehld members Yu might start by negtiating fr yur hme t be alchl free n certain days f the week Yu might agree with thers that events r shared spaces becme alchl free znes, fr example in a Village r Cmmunity. 21 ALCOHOL DISCUSSION GUIDE.indd 21

24 4: REDUCING PROBLEMS CAUSED BY DRINKING ALCOHOL ACTION POSTER 3: HOW TO DRINK LESS WHAT TO DO Think abut hw and when yu drink EXAMPLES AND EXPLANATIONS Think abut hw much alchl yu drink (including steam) and when yu drink. Thinking abut hw and when yu drink is ne f the mst useful ways t start changing yur behaviur. One step at a time Yur gal might be t drink nly ne day a week but it might be mre realistic t slwly build up t yur gal It might be mre realistic if yu start with ne alchl free day each week in the first mnth, then tw alchl free days in the secnd mnth and keep increasing the number f alchl free days each week until yu reach yur target. Set limits Sme peple find that specific limits t the number f drinks they will have in a day r evening is a gd way t change their behaviur Try and stick t the limit yu set but dn t be t hard n yurself if yu g ver yur limit every nw and then. The mst imprtant thing is t remind yurself f the limit yu set fr yurself and stick t it the next time If yu find that yu drink simply because alchl is available in yur huse, dn t keep bttles f it in the hme limit the temptatins! Limit cash If yu plan t g ut drinking take a set amunt f cash with yu s that yu can stp drinking when yu run ut f mney Avid dinau if yu dn t have cash Remember t make arrangements fr yur transprt hme and keep enugh cash fr PMV r taxi if yu need it Switch between alchlic and nn-alchlic drinks Try switching yur drinks s that after every alchlic drink, yu have a nn-alchlic drink like a sft drink r water. Try starting t drink at a later time than yu usually wuld. This may als help t reduce yur alchl intake, but nly if yu stp drinking at the usual time. If yu find that starting t drink later nly leads t yu drinking later int the night, then this strategy might nt wrk fr yu. Stp sner Just like yu might put a limit n the number f drinks yu have, yu can als set a time when yu want t stp drinking alchl. After this time yu can switch t sft drinks r water. Find an alternative t alchl t help yu get t sleep Sme peple drink t help them get t sleep. Find a different slutin r intrduce smething new int yur daily rutine, such as exercising, t help yu sleep withut alchl Add ice Adding ice r sme water t yur drinks can help slw dwn hw much yu drink Dance If yu are in a night club, ne way t limit yur alchl intake is t dance thrughut the night. It als helps burn the alchl. Use the law Sme peple find that the lcal laws which disallw the sale f alchl n certain days f the week help them reduce their cnsumptin (Eg. In Madang, alchl is nly sld in shps frm Mnday t Thursday) They nly buy alchl n the days that sales are legal, and nly buy as much as they intend t drink that day This means they dn t have any leftver alchl n nn-sale days and they can t buy any either Get the right amunt If yu plan t buy nly the amunt f alchl that yu will drink, chse the amunt carefully It might be cheaper t buy the 750ml bttle but if yu nly want t drink 500ml in ne evening it will be better t buy the mre expensive smaller bttle. If yu buy the 750ml bttle yu may be tempted t drink the whle thing, and will need t buy mre anyways. Buying the mre expensive smaller bttle, will save yu grief in the lng run! 22 ALCOHOL DISCUSSION GUIDE.indd 22

25 4: REDUCING PROBLEMS CAUSED BY DRINKING ALCOHOL ACTION POSTER 4: HOW TO DRINK SAFER These are sme ways t help increase yur safety frm harm caused by alchl. WHAT TO DO Keep track f yur behaviurs EXAMPLES AND EXPLANATIONS Knwing when and hw much yu drink is the first step t reducing alchl related harm fr yurself, yur peers, yur family and yur cmmunity G with a friend If yu are ging away frm yur hme t drink, it is a gd idea t g with a friend s yu can lk ut fr each ther Peple lking fr truble ften target peple wh have drunk t much alchl and take advantage f them Being with a friend wn t cmpletely stp this risk, but it may help t reduce it. Watch yur glass r bttle Drink nly at hme Plan yur transprtatin Sleep n a friend s flr Always carry cndms Avid hmebrew that may be unsafe t drink Be careful abut mixing medicines with alchl Dn t let strangers pur yur drinks fr yu. Sme peple add drugs t drinks ( spike drinks). Let the bartender pen and pur yur drink when yu are at a bar, r d it yurself. Watch drinks that yu leave n tables r carry them with yu Fr sme peple it s easier t drink nly when they are at hme and never drink when they are ut and abut The benefits f drinking nly at hme are: that yu dn t have t wrry abut getting hme after a night f drinking; yu can plan yur alchl cnsumptin better; yu can make sure yur drinks are safe; yu can reduce yur chances f ther peple causing yu harm It s a gd idea t never drive t a drinking event. It s nt a gd idea t drink if yu have driven smewhere. Drunk driving is ne f the majr high risk behaviurs assciated with alchl use and can have serius and deadly impacts If yu plan t get a PMV r taxi hme, make sure yu knw when and where t g, that yu have enugh mney t pay fr the transprt, and if pssible, g with a friend If yur friend is the designated driver but has als been drinking, think carefully abut the risks f getting in the car with them. Yu are risking yur life if the vehicle crashes Make an agreement with yur friends, that yu can sleep n each ther s flr if ne f yu gets t drunk t get hme safely Unplanned pregnancy r HIV and ther STIs are nt wrth the risk! Whether yu re male r female remember t carry a cndm with yu because alchl can weaken yur decisin making and yu might find yurself in need f a cndm Hmebrew (steam, yawa, kpi kandi, etc) desn t have the same quality cntrl as legally prduced alchl. This means that the alchl cntent in hmebrew can be higher, and tests fr cntaminatin (particularly frm pisnus heavy metals) are nt dne. There is n way yu can really knw what yu are drinking. Aspirin with alchl can be dangerus because it affects the chemical in the bdy that breaks dwn alchl. This can lead t blackuts and ther serius effects such as bleeding inside the stmach Many prescriptin and nn-prescriptin drugs can have serius effects if taken with alchl. Avid taking drugs r medicines when yu are drinking, and avid drinking when yu are n any medicatin 23 ALCOHOL DISCUSSION GUIDE.indd 23

26 4: REDUCING PROBLEMS CAUSED BY DRINKING ALCOHOL ACTION POSTER 5: HOW TO DRINK LESS AND DRINK SAFER This table have sme ways t help yu drink less and safely. WHAT TO DO Eat first and drink water These are sme ways t help increase yur safety frm harm caused by alchl. EXAMPLES AND EXPLANATIONS Eating befre drinking alchl helps in several ways: 1. With a full stmach yu are mre likely t drink mre slwly and it can avid serius situatins such as black uts. 2. After eating, yur digestive system is busy while it digests the fd, s less alchl gets int yur bldstream Chse yur drink Be cautius f drinking games Plan and schedule Drinking plenty f water will help t stp yu feeling thirsty s yu are less likely t drink larger amunts f alchl Yur chice f drink can affect the amunt f alchl that yu drink and help yu avid blackuts and alchl pisning Yu can chse drinks that have a lwer alchl cntent Yu can buy mre expensive drinks that yu will drink slwly r nly n special ccasins rather than large quantities f cheap liqur Artificial sweeteners can speed up the rate at which alchl is absrbed int yur bldstream (cmpared t natural sugar) s avid drinking diet sft drinks when yu drink alchl Chse a drink with a strng taste, if yu find yu drink mre tasteless drinks at a quicker rate The purpse f drinking games is t increase the amunt yu drink! If yu avid drinking games yu can help avid blackuts, and serius alchl pisning D yur wn thing and dn t be afraid t say NO t peer pressure Always pace yurself when drinking Drinking withut planning ahead can smetimes lead us t drink far mre than we realise If yu plan yur drinking and nn-drinking days yu ll have mre cntrl ver the amunt f alchl yu drink 24 ALCOHOL DISCUSSION GUIDE.indd 24

27 4: REDUCING PROBLEMS CAUSED BY DRINKING ALCOHOL 25 ALCOHOL DISCUSSION GUIDE.indd 25

28 NOTES 26 ALCOHOL DISCUSSION GUIDE.indd 26

29 DISCUSSION 5 PEER SELF-ASSESSMENT 5 27 ALCOHOL DISCUSSION GUIDE.indd 27

30 5: PEER SELF-ASSESSMENT 1 HOUR BUTCHER PAPER, MARKERS, SELF-ASSESSMENT POSTER 1 Welcme everyne t the sessin. 2 Explain that the purpse f this discussin is t help vlunteers and their peers lk at their wn alchl behaviurs, their risk fr alchl related and harm and hw they can reduce their risk. Say: Fr this exercise, we are ging t use the Self-Assessment Tl This is nt a test and there are n right r wrng answers Fr this exercise, the grup will assess themselves and their envirnment against five tpics: 3 1. Identificatin and Recgnitin 2. Wrking tgether 3. Access t alchl related harm reductin strategies and services 4. Identify and address vulnerability 5. Gender The grup will cnsider each tpic and decide which Level they are at: Cntinued Level 1: We are aware the grup recgnises prblems and the impact they have, but desn t d anything abut them 2. Level 2: We react the grup recgnises prblems and thinks that smething shuld be dne t change the situatin, but n actin is taken 3. Level 3: We act the grup takes actin persnal r as a grup this might be a shrt term actin (meeting, discussin, campaign) 4. Level 4: We take regular actin the grup takes regular actin persnal r as a grup plans t change behaviur, plans t wrk with stakehlders, etc. 5. Level 5: The bevhaviur is part f ur regular life-style the grup has successfully made changes in their behaviur and envirnment t reduce harmful effects f alchl 28 ALCOHOL DISCUSSION GUIDE.indd 28

31 5: PEER SELF-ASSESSMENT Cntinued... Fr each tpic, lead the grup thrugh a discussin and analysis: 2 1. Discuss the tpic, (A, B, C, D, E ne at a time) make sure the grup understands what we are assessing 2. Discuss the statements prvided in each level what d each f these mean? 3. Help the grup decide which level they feel they r their envirnment is at 4. Is the grup happy with that? Wuld they like t change this? 5. What are sme actins peple culd take t change this? (Recrd these n a piece f butcher paper save it fr the next discussin) 6. Remind peple that it may take many mnths r even year t mve alng all f the levels. 7. Once the grup has cmpleted their assessment, encurage them t pst their assessment n a wall where they will see it regularly. This will remind them f what was discussed and the things they wanted t achieve. 29 ALCOHOL DISCUSSION GUIDE.indd 29

32 5: PEER SELF-ASSESSMENT Level 1 We are aware Level 2 We react A. Identificatin and Recgnitin We knw that alchl misuse can cause harm in ur cmmunity. We knw enugh abut alchl related harm reductin t respnd when smething happens. B. Wrking tgether We are aware f the imprtance f invlving thers wh are affected by alchl related harm We c-perate with sme peple t reslve cmmn issues. C. Access t alchl related harm reductin strategies and services We have basic infrmatin hw t reduce alchl related harm We apply ur knwledge f alchl related harm reductin strategies in ur lives D. Identify and address vulnerability We knw wh is mst vulnerable within ur cmmunity. We help thse mre vulnerable t alchl related harm than urselves. E. Gender We are aware f gender issues and hw they are related t alchl related harm. We ntice gender issues in ur alchl related harm reductin wrk and respnd t them. Level 3 We act We publicly recgnise that alchl related harm is affecting us as a grup/cmmunity and take ccasinal actin We meet in ur separate grups t reslve cmmn issues (e.g. yuth, wmen, men, PLHIV). We access services that prvide supprt fr r prevent alchl related harm (e.g. addictin supprt, health clinics, legal r plice services). Our respnse includes sme specific actins t address ur wn vulnerability t alchl related harm. We have started t address gender issues in sme f ur alchl related harm reductin wrk. Level 4 Regular actin We regularly discuss alchl related harm, and have a cmmn prgram f actin t respnd. Varius grups share cmmn gals and define each member s cntributin. Sme f us are using services regularly that prvide supprt fr r prevent alchl related harm reductin. We systematically address ur wn factrs f vulnerability. We regularly cnsider gender in ur alchl related harm preventin, care and supprt Level 5 The behaviur is part f ur nrmal life-style Our respnse t alchl related harm is part f ur daily life. We knw ur wn risks t alchl harm and act frm strength. Because we wrk tgether n alchl related harm reductin we can address and reslve ther challenges facing us. All thse in need f services that prvide supprt fr r prevent alchl related harm reductin are using them effectively. Our actins t address vulnerability t alchl related harm strengthens us in addressing ther challenges. We have mainstreamed gender issues in all ur alchl related harm reductin wrk. 30 ALCOHOL DISCUSSION GUIDE.indd 30

33 DISCUSSION 6 MAKING PLANS TO REDUCE ALCOHOL HARM 6 ALCOHOL FREE ZONE 31 ALCOHOL DISCUSSION GUIDE.indd 31

34 6: MAKING PLANS TO REDUCE ALCOHOL HARM 1 HOUR BUTCHER PAPER, MARKERS, APPLYING ACTION POSTERS (DISCUSSION 4), SELF ASSESSMENT AND IDEAS FOR ACTION (DISCUSSION 5), BLANK PLAN TEMPLATE ON BUTCHER PAPER 1 Welcme everyne t the sessin. 2 Explain that the purpse f this discussin is t discuss specific plans and actins the grup can take t reduce alchl amngst their peers and in their envirnment Review the Applying Actin psters with the grup: 3 1. Actin 1: Setting alchl-free times 2. Actin 2: Creating alchl-free znes 3. Actin 3: Drinking less 4. Actin 4: Drink safer 5. Actin 5: Drink less and drink safe 4 Review the Self Assessment they cnducted in Discussin 5, as well as the list f pssible actins that peple discussed. 5 Fr each Self Assessment tpic help the grup list pssible actins they can take. Ask them t think abut what actins can be dne immediately (shrt term) and what actins might take lnger t d (lng term) every gd plan needs bth shrt term and lng term actins! A: Identify and Recgnitin B: Wrking tgether C: Access t alchl related harm reductin strategies and services D: Identify and address vulnerability E: Gender 32 ALCOHOL DISCUSSION GUIDE.indd 32

35 6: MAKING PLANS TO REDUCE ALCOHOL HARM Using this infrmatin ask them t write dwn what they can d using the plan template belw. (This is just a sample t give yu an idea f what a cmpleted plan might lk like) Mnth 1 WHAT WE WILL DO Examples: Each f the vlunteers will make a persnal plan t drink less and/r drink safer We will hld a cmmunity meeting t discuss the challenges and prblems that alchl causes, and share the strategies in this tlkit with everyne 6 Mnth 2 We will arrange fr a health wrker t cme t a vlunteer meeting t tell us mre abut the health risks f alchl (we need t ask the Prject Officer fr help t find a suitable health wrker t invite) We will agree sme areas and times when ur village will be alchlfree Mnth 3 We will review ur persnal plans t drink less and/r drink safer and encurage each ther t meet ur gals We will review whether ur agreement t have alchl-free areas/ times is wrking, and decide if we need t make changes t ur plans After they have cmpleted the exercise, ask them t present their ACTION Plan t everyne. Cngratulate the grup fr allwing themselves t challenge ne f the mst difficult prblems in PNG. Remind them that addressing alchl is nt easy and that they have t give themselves time t be able t fllw thrugh n their actin plans. Say that they can get supprt frm TL as well as frm ther prgrams if they need mre infrmatin n Alchl Harm Reductin. 33 ALCOHOL DISCUSSION GUIDE.indd 33

36 WORKS CITED WHO. (2007). Reginal Strategy t Reduce Alchl Related Harm. WHO Western Pacific Regin. Alchl Abuse Wrking Cmmittee.(2012). Reprt n Alchl Abuse in PNG- Outcmes f Research & Cnsultatin. Department f Health, PNG.(2010). Natinal Plicy n Reduce Alchl Harm. Tingim Laip. (2011). Literature Review f Alchl, High Risk Sex and HIV in PNG. 34 ALCOHOL DISCUSSION GUIDE.indd 34

37 ACKNOWLEDGEMENTS Discussins 2, 3 and 5 are adapted frm New Yrk-based HAMS Harm Reductin Netwrk ( hamsnetwrk.rg) fr the cntext f cmmunities wrking tgether in Papua New Guinea. HAMS prvides a cmprehensive set f tls and supprt mechanism t help individuals reduce alchl related harm. Discussin 4 is adapted frm a HIV vulnerability and respnse analysis tl develped by The Cnstellatin ( The Cnstellatin is an rganisatin f facilitatrs and cllective f cmmunities aiming t build the capacity f cmmunities t becme life cmpetent. 35 ALCOHOL DISCUSSION GUIDE.indd 35

38 Tingim Laip PO Bx 1402 Madang Papua New Guinea (P) (F) TLinf@tl2.rg.pg ALCOHOL DISCUSSION GUIDE.indd 36