Substance Abuse and Public Health Quiz

Substance Abuse Prevention

• Substance abuse is defined as the excessive use of a substance to modify or control mood or state of mind in a manner that is illegal or harmful.
• A substance is any chemical, drug, or compound (natural or synthetic) that can alter a person's physical, mental, or emotional state when consumed. These can be legal (alcohol, prescription medications) or illegal (cocaine, heroin).

Learning Outcomes

• Define substance abuse
• Describe symptoms and signs of substance abuse.
• Understand the initiation of substance use.
• Identify reasons why individuals use alcohol and drugs.
• Recognize risk and protective factors of substance abuse.
• Understand the consequences of substance abuse.
• Identify methods of substance abuse prevention.

Symptoms and Signs of Substance Abuse

• Emotional: aggression, burnout, anxiety, depression, paranoia, denial.
• Behavioral: slow reaction time, impaired coordination, slowed/slurred speech, irritability, excessive talking, inability to sit still, limited attention span, poor motivation/lack of energy.
• Physical: weight loss, sweating, chills, smell of alcohol.

Tolerance

• Tolerance is a change in how the individual reacts to a substance. They will need increasing higher doses of a substance to obtain the similar effect.
• This means a drug's effect diminishes with repeated use unless dosage increases

Substance Dependence

• Neuro-adaptation signifies a physiological state produced through repeated substance use requiring continued use to prevent withdrawal.
• Dependence is a characteristic of addiction, and alcoholism is a form of alcohol dependence

Substance Dependence: Additional Problems

• Withdrawal: psychological and physiological reactions to abrupt cessation of substance use.
• Rebound: exaggerated expression of the original condition after treatment.
• Inability to stop use.
• Preoccupied with "getting" and using.
• Develop tolerance (needs more to get the same effect).
• Give up important things to use.
• Compulsions or cravings to keep using.

Substance Dependence: Additional Characteristics

• Chronic: Requires lifelong abstinence (avoiding substance use) and active participation in recovery programs after addiction has been developed.
• Progressive: Symptoms worsen over time affecting every aspect of life (physical, mental, emotional, spiritual). The issue can worsen rapidly or gradually depending on the substance.
• Primary: The main problem that must be treated and is not a secondary symptom.

Disease Characterized by Denial

• Denial is a common psychological response to substance abuse. This means individuals refuse to acknowledge issues relating to their substance usage regarding severity and consequences.

Initiation of Substance Use

• Smoking is a significant initiating factor for substance abuse.
• The risk of moving onto marijuana use is 65 times higher in smokers or drinkers.
• The risk of moving on to cocaine is 104 times higher for those who frequently use marijuana.
• The more risk factors, the greater likelihood for using substances.

Ways of Substance Use

• Smoking/Inhaling
• Snorting/Insufflation
• Oral ingestion
• Injection

Reasons for Substance Use

• Stress relief/coping mechanism
• Social influence/peer pressure
• Recreational/pleasure-seeking
• Curiosity/experimentation
• Dependence/addiction

Consequences of Substance Abuse

• Individual: aggressiveness, injuries, risky driving, infections, life revolves around substance use, smoking leads to lung cancer.
• Family: money leads to conflicts, destructive conflicts (emotionally and/or physically), money for substance use replacing other family needs, money on treatment drains family resources.
• Community: stealing, violence, engaging in crime, drug syndicates engaging in violent crimes, recruitment youth for illegal activities, violence and illegal activity harm/create mistrust.

Risk Factors for Substance Abuse

• Chaotic home environment
• Ineffective parenting
• Little mutual attachment and nurturing
• Parental/sibling substance abuse or mental illness
• Academic failure
• Inappropriate/shy classroom behavior
• Poor social coping skills
• Perceived external approval of drug use
• Associations with deviant people

Protective Factors for Substance Abuse

• Strong family bonds
• Parental engagement
• Clear parental expectations and consequences
• Academic success
• Conventional norms about drugs and alcohol
• Strong bonds with pro-social institutions (school, community, mosque)

Prevention of Substance Abuse

• Primary prevention: aims to delay the beginning of substance use by reducing supply and demand.
  • Reduce supply through various approaches.
  • Minimize risk factors and support protective factors.
• Secondary prevention: focuses on early detection and intervention within early stages of psychoactive substance use.
• Tertiary prevention: focuses on addressing dependence and minimizing problems resulting from use or abuse. This is sometimes called rehabilitation and relapse prevention. This aims to improve functioning and health.

Epidemiology

• Definition: The study of the distribution and determinants of health-related states or events in specified populations and its application to controlling health problems. It's a fundamental science focused on health and illness within a population. It's a discipline combining elements of biology, social sciences, statistics, and medicine.

• Core functions: Identifying frequency, patterns, and causes of disease in a population; planning and evaluating strategies to prevent illness or managing disease when developed.

• Key concepts: Distribution, Determinants, Control of health problem.

• Methodology: Various study designs (cross-sectional, cohort, case-control) are employed, along with statistical analysis to interpret data and make informed conclusions. There's also impact on public health through policies and healthcare practices.

• Morbidity Rates:

  • Incidence Rate: Number of new cases per population. Calculated by (No. of new cases x 100,000) / population at risk.
  • Attack Rate: Specific incidence rate for a disease within a time point.
  • Prevalence Rate: Total number of individuals with an attribute or disease at a particular time, divided by the population at risk. Calculated as (Total number of cases with attribute or disease x 100,000) / Total Population at risk.
  • Relationship between Incidence and Prevalence: In a steady-state situation, where the rate is not changing and the population is stable, prevalence = incidence x duration of disease.

• Study Designs:

  • Observational Studies: Researcher observes events naturally, without outside intervention.
  • Case Reports/Case Series: Detailed records of single or multiple patients with similar diagnoses.
  • Cross-Sectional Studies: Assess prevalence of health outcomes.
  • Case-Control Studies: Compare individuals with a disease to those without, retrospectively, to identify risk factors.
  • Cohort Studies: Follow a group of people over time to observe how exposures affect outcomes.
  • Experimental Studies: Involves intervention by the researcher.
    • Randomized Controlled Trials (RCTs): Random assignment to intervention or control groups.
    • Community Trials: Randomization occurs at the community level.
  • Ecological Studies: Examines exposure-disease relationship at the group level.
  • Meta-Analyses: Combines data from multiple studies for stronger statistical power.

• Importance of study designs: Strengths, weaknesses, ethical concerns, and research questions driving strategy.

• Determinants of disease:

  • Biological: genetics, age, sex.
  • Environmental: living conditions, climate, pollution.
  • Behavioral: lifestyle choices, dietary habits.
  • Social: socioeconomic status, community support networks.

• Risk Factors: characteristics increasing the likelihood of disease. Can be environmental, biological, behavioral, or social.

  • Modifying Risk Factors: factors that can be changed (e.g., lifestyle habits, exercise, diet).
  • Non-Modifying Risk Factors: factors that cannot be changed (e.g., age, gender, genetics).

• Measuring Risk: Epidemiologists use incidence and prevalence rates, proportions, to quantify risk.

• Causality: refers to the contributing factors of a disease. Establishment requires more research and evidence since a risk factor does not always result in disease development.

• Interactions: multiple risk factors interact in complex ways.

• Challenges in epidemiology: Data quality, bias, confounding variables, sample size.

Road Traffic Safety Principles

• Road safety requires a multidisciplinary approach involving collaboration, education, enforcement, vehicle safety, speed management, infrastructure & engineering, and vulnerable road user considerations. Road traffic injuries don't have a single cause, so a holistic approach is needed to tackle the issue.

Workplace Safety

• Steps to reduce workplace injuries:
  • Establish and implement workplace safety policies.
  • Offer regular safety training.
  • Identify and manage potential workplace hazards.
  • Implement procedures for reporting and investigating incidents.
  • Implement ergonomic practices within work settings.
  • Ensure appropriate maintenance and use of equipment.
  • Foster a safety-oriented culture within the workplace.
  • Equip employees with proper personal protective equipment (PPE).
  • Manage and address any issues relating to on-site stress.
  • Regularly review and update workplace safety measures.
• Shared responsibility for safe work environments between employers and employees. Establishing safety cultures prevents injuries and supports worker well-being..

Levels of Prevention

• Primary prevention: Aims to prevent disease occurrence before it occurs (e.g., education, vaccination). This is focused on preventing disease before it begins.
• Secondary prevention: Aims to detect and treat illnesses while they are still in early stages to minimize the impact of disease development (e.g., regular screenings, early interventions).
• Tertiary prevention: Aims to reduce long-term complications from diseases (e.g., rehabilitation programs). This aims to address the consequences of existing diseases.

Test your knowledge on substance abuse, its symptoms, dependence, and the role of public health professionals, particularly in the context of the COVID-19 pandemic. This quiz covers key concepts and definitions related to substance use and the responsibilities of epidemiologists. Challenge yourself and learn more about these critical health topics!