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Domain I: Planning and Evaluation
Published in Nicole M. Augustine, Prevention Specialist Exam Study Guide, 2023
This strategy aims to enhance the ability of the community to more effectively provide prevention and treatment services for drug misuse disorders. Activities in this strategy include organizing, planning, enhancing the efficiency and effectiveness of service implementation, building coalitions, and networking. Examples include running a coalition.
General healthcare of drug users
Published in Berry Beaumont, David Haslam, Care of Drug Users in General Practice, 2021
Drug users may not immediately declare their illicit drug use to the GP. Some fear judgemental attitudes or breach of their confidentiality or are ashamed of their habit. Consequently the diagnosis of drug misuse may not be considered until physical examination is undertaken. Intoxication with drugs or alcohol, poor levels of general education, lack of awareness of the possible causes of their ill health and reticence born of mistrust can conspire to make some drug abusers poor historians whose symptomatology is at best vague and not uncommonly masked by the substances they are abusing. Clinical examination of any substance misuser (suspected or declared) is therefore of paramount importance and is often more illuminating than the history. In addition to those observations which a doctor routinely notes during examination of any patient, it may be helpful to consider the following points when examining a known or suspected drug abuser.
School-Based Drug Use Prevention Programs in the Ex-Drug Users’ Perspective
Published in Teuku Tahlil, Hajjul Kamil, Asniar, Marthoenis, Challenges in Nursing Education and Research, 2020
To develop an effective drug misuse prevention program in this current study, interviews were carried out with some relevant stakeholders, one of whom used to consume drugs. To prevent drug misuse in adolescents, the respondents concerned about two interventions, including drug misuse socialization and drug misuse rehabilitation. For drug misuse socialization, the respondents focused on five sub-themes (media for socialization, target groups, models, materials, and dissemination of information).
Prescription Pain Reliever Use and Misuse among Cannabis Users Aged 50+ Years
Published in Clinical Gerontologist, 2021
Namkee G. Choi, Diana M. DiNitto, Bryan Y. Choi
Given the potential harms of polysubstance use/misuse, including PPNR overdose death, dual cannabis/PPNR users/misusers may need professional help to address substance use problems. Socioeconomically disadvantaged older individuals, including those who are not yet eligible for Medicare and do not have other health insurance coverage, need improved access to healthcare professionals who can systematically review the co-use of cannabis, PPNR, and other psychotherapeutics. Although opioid pain reliever prescribing has been curbed in recent years, some older adults who misuse PPNR still appear to have access to PPNR through physician prescribing. Physicians should carefully examine these older adults’ use patterns and identify ways to treat pain that will help patients avoid misusing PPNR and offer alternative pain care. Those who have PPNR use disorder may need medication-assisted therapy (Oesterle, Thusius, Rummans, & Gold, 2019) as well as other evidence-based non-pharmacological treatments for their physical and mental health problems. Healthcare providers should also evaluate other drug misuse problems and make referrals to substance use and mental health treatment programs. Physicians may need additional education and encouragement to feel confident in undertaking these tasks. Prescription drug monitoring programs can also help physicians in identifying patients who may need assistance with appropriate PPNR use.
Common substance use disorders in older adults
Published in Hospital Practice, 2020
Lynsey Seim, Priyanka Vijapura, Sandeep Pagali, M Caroline Burton
Prescription drug misuse is the taking of a medication in a manner other than as directed or indicated [28]. The most common medications associated with prescription drug misuse in older adults are opioids and benzodiazepines [29]. Older adults experiencing emotional, social, and medical problems like chronic pain, anxiety, insomnia, depression, disability, and dementia are noted to be at higher risk for prescription drug misuse disorder [2]. Opioid misuse is associated with activities of daily living (ADLs) disability (ex: difficulty with feeding, bathing, grooming, dressing, and homemaking), while instrumental activities of daily living (IADLs) disability (ex: difficulty with preparing meals, grocery shopping, managing finances, doing laundry, and using telephone) is associated with benzodiazepine misuse and combined opioid and benzodiazepine misuse [30]. Risk factors for prescription opioid misuse include advanced age, females, Caucasian race, concomitant benzodiazepine use, prescribed and illicit polysubstance abuse, cognitive impairment, changes in life circumstances and poor pain control [31,32]. Risk factors for benzodiazepine misuse in older adults are predominantly environmental risk factors such as work stressors, retirement, and loss of other family members [33]. Older adults are at an increased risk of receiving opioid or benzodiazepine prescription when symptoms of pain, anxiety, or insomnia are addressed as part of primary care visits or hospitalization [29,34].
Friends and relatives as sources of prescription opioids for misuse among young adults: The significance of physician source and race/ethnic differences
Published in Substance Abuse, 2020
Jason A. Ford, Corey Pomykacz, Alec Szalewski, Sean Esteban McCabe, Ty S. Schepis
Second, sources of prescription drugs for misuse are linked to patterns of misuse and outcomes associated with prescription drug misuse. A number of studies have shown that certain sources are significantly associated with increased risk for substance use and other risky behaviors. Individuals who report buying prescription drugs from dealers or strangers are at increased risk for other types of substance use and substance use disorders, whereas obtaining prescription drugs from physicians or free from friends and family members reduces risk.16,20,23,27–29 Although the current research suggests that fewer negative outcomes are associated with prescription drug misuse when the source is a friend/relative, there is likely important variation in this relationship based on how friends/relatives obtain the prescription drugs they freely share.