Alcohol and Drug Studies: Prevention and Determinants

Pharmacology

• Pharmacokinetics: Study of how drugs move through the body, including absorption, distribution, metabolism, and excretion.
• Pharmacodynamics: Study of how drugs affect the body, focusing on mechanisms of action and drug-receptor interactions.

Take-Home Naloxone

• Prenoxad®: 400ug doses in 0.4 ml (2mg/2ml syringe) for intramuscular use.
• Nyxoid®: 1.8 mg in 0.1 ml for intranasal administration.
• Availability: Over the counter and on prescription (S3 and S4), supplied through Needle Syringe Program.

Determinants

Risk and Protective Factors

• Analogy: Snowball Effect - Early onset of drug use increases long-term risk.
• Analogy: Snowstorm Effect - Multiple concurrent risks heighten likelihood of harmful drug use.
• Quote: "The more risk factors that persist over longer periods of time, the greater the subsequent impact" (Loxley, p 72).

Risk Factors

• Prior to Birth:
  • Social disadvantage
  • Family breakdown
  • Genetic influences
  • Maternal smoking and alcohol use
  • Birth outside Australia
• Social Disadvantage / Low SES:
  • Higher drug use and problems in low SES areas
  • Economic discrepancies lead to personal and interpersonal insecurities, tensions, and conflicts impacting health and well-being (Bonomo, 2004)
• Recent Use by Socioeconomic Area (2022-23):
  • Most advantaged areas have higher recent use of hallucinogens, cocaine, inhalants, pharmaceutical stimulants
  • Lowest SES areas see higher use of pain-relievers and opioids
• Illicit Drug Use Trends:
  • Decrease in risky alcohol consumption among 14–17-year-olds from 9.5% to 5.5%
  • Higher illicit drug use among young females than young males for the first time
• Genetic/Biological Factors:
  • Variations in substance metabolism
  • Temperament
  • Behavioral problems
  • Personality factors
  • Quote: "Genes load the gun and environment pulls the trigger" (George Bray)

Protective Factors

• Ethnicity:
  • Being born outside Australia can be both protective and a risk factor depending on various elements
  • Indigenous risk factors are related to poverty, disadvantage, cultural dispossession, and exclusion rather than biological or genetic predispositions
• Developmental Stages and Risk/Protective Factors:
  • Infancy/Pre-school:
    • Risk: Parental neglect and abuse
    • Protective: Easy temperament
  • Primary School (5-11 years):
    • Risk: Early school failure, conduct disorder, aggression
    • Protective: Social and emotional competence, shy and cautious temperament
  • Secondary School (12-17 years):
    • Risk: Low involvement in activities with adults, perceived high level of community drug use, community disadvantage, availability of drugs, parental attitudes
    • Protective: Attachment to family, low parental conflict, parental communication and monitoring, religious involvement
  • Adulthood (18-64 years):
    • Risk: Frequent drug use in late adolescence, unemployment, mental health problems
    • Protective: Well-managed environment for alcohol use, early marriage
  • Retirement/Old Age (65+ years):
    • Risk: Losing a spouse, retirement, loneliness, poor health
    • Protective: Good health, social support

Prevention

• Definition: Measures to prevent or delay the onset of drug use and protect against risk and reduce harm associated with drug supply and use (Loxley et al., 2004)
• Objectives:
  • Delay initiation of drug use
  • Reduce harm associated with drug use
  • Increase resilience and other protective factors