Patan Academy of Health Sciences

School of Nursing and Midwifery

Lalitpur Nursing Campus
Sanepa, Lalitpur

Presentation on
PREVENTION OF SUBSTANCE ABUSE

Submitted to: Submitted by:

Respected Madam, Isha Bhusal
Associate professor MN 1st year
Shova Laxmi Bajracharya
 Unit:14 Mental and Behavioral problems due to Substance Abuse

Prevention Intervention
The best approach to prevention is to begin early to reduce emerging behavioral and emotional
problems in youth. Longer-lasting results can be obtained from changing school, community,
and family environments that promote and maintain drug problems in youth. Communities need
nurses and other health care providers who are knowledgeable about substance abuse prevention
and who can advocate for the implementation of prevention programs with proven effectiveness.
Many communities across the United States have taken positive steps to combat the problem of
substance abuse. Raising the minimum drinking age to 21 years was found to decrease alcohol
use by 25% in those 18 to 20 years old, along with a reduction in related accidents and problems.
[Stuart GW,2013]

PREVENTION OF SUBSTANCE USE

Primary Prevention
Attempts to avoid substance use or abuse before it has a chance to occur.
 Reduction of over prescribing by doctors (especially with benzodiazepines and other
anxiolytic drugs).
 Identification and treatment of family members who may be contributing to the drug abuse.
 School nurses can be involved in education efforts in the schools.
 Nurses also can support legislation designed to reduce the incidence of use and abuse and
serve as public speakers in the community on drug abuse issues.
 Introduction of social changes is likely to affect drinking patterns in the population as a
whole. This is made possible by:
o Putting up the price of alcohol and alcoholic beverages
o Controlling or abolishing the advertising of alcoholic drinks
o Controls on sales (by limiting hours or banning sales in supermarkets)
o Restricting availability and lessening social deprivation (Governmental measures)
 Other approaches are to strengthen the individual's personal and social skills to increase self-
esteem and resistance to peer pressure.
 Health education to college students and the youth about the dangers of drug abuse through
the curriculum and mass media.
 Health education should also include certain specific groups where a substance like alcohol
may be culturally accepted.
 For instance, in certain tribal communities, alcohol intake is considered normal.
 Some communities use it in the postnatal period, as alcohol is believed to strengthen the
pelvic muscles and also speed up retroversion of the uterus. Such attitudes should be
addressed and corrected.
 An overall improvement in the socioeconomic condition of the population.

B. Secondary Prevention
 Interventions designed to prevent substance-use problems just as the early signs of abuse
begin to appear.
 Secondary prevention efforts are aimed at people with mild to moderate substance abuse
problems.
 Several brief therapies have evolved to address their special needs.
 They range from simple advice to stop drinking to more elaborate programs involving:

 Early identification of drug/alcohol problems.

o Examples are legal responses of alcohol education courses for DUI (Driver Under Influence)
offenders.
 Presentation of assessment findings
o A full assessment including an appraisal of current medical, psychological and social
problems.
o Assessment also includes ascertaining whether substance abuse is the primary or secondary
problem.
o For example, a patient with diabetic neuropathy may be using alcohol & drugs to numb
pain.
o Alcohol is also used by some to relieve asthmatic symptoms.
o In such instances, treatment of the medical problem can help to control substance abuse.

 Detoxification with benzodiazepines (diazepam, chlordiazepoxide).

 Education advice regarding the need to reduce drinking with an emphasis on personal
responsibility,
 Counselling
 Motivational interviewing which involves providing feedback to the patient on the personal
risks that substance poses, together with a number of options for change.
 Self-help manuals / education leaflet
 Periodic follow-up.

C. Tertiary Prevention
 Tertiary prevention can decrease the complications of addiction.
 The goals are to terminate use of the substance and thus avoid further deterioration in the
person’s functioning.
 It includes efforts to reduce the effects of drunkenness & abuse, such as automobile
accidents, drowning, and family disputes, on the user and others.
 Specific measures include:
 Alcohol deterrent therapy (Disulfiram or Antabuse).
 Other therapies include assertiveness training (to prevent yielding to peer pressure), teaching
coping skills (some take drugs to combat stress), behavior counseling, supportive
psychotherapy and individual psychotherapy.
 Some practical issues under relapse prevention include:
o Motivation enhancement, including education about health consequences of alcohol use
o Identifying high-risk situations and developing strategies to deal with them (craving
management)
o Drink refusal skills (assertiveness training)
o Dealing with faulty cognitions
o Handling negative mood states
o Time management
o Anger control
o Financial management
o Developing the work habit
o Stress management
o Sleep hygiene
o Recreation and spirituality
o Family counseling, to reduce interpersonal conflicts, which may otherwise trigger relapse

D. REHABILITATION
The aim of rehabilitation of an individual addicted from the effects of alcohol/ drugs, is to enable
him to leave the drug sub-culture and to develop new social contacts.
In this, clients first engage in work and social activities in sheltered surroundings and then take
greater responsibilities for themselves in conditions increasingly like those of everyday life.
Continuing social support is usually required when the person makes the transition to normal
work and living.

Patient and Family Teaching

 Teach the patient/family about the physical, psychological and social complications of drug
and alcohol use.
 Inform the patient/family that psychoactive substances may alter a patient’s mood,
perceptions, consciousness or behavior.
 Explain to the family that the patient may use lies, denial or manipulation to continue drug or
alcohol use and avoid treatment.
 Teach the patient/family that drug overdose or withdrawal can result in a medical emergency
and even death, give the family emergency resources for help.
 Caution the patient that sharing dirty or used needles can result in a life-threatening disease
such as AIDS, Hepatitis B.
 Teach the family to establish trust with the patient and to use firm limit setting, when
necessary to help the patient confront drug abuse issues.
 Teach the patient/family how to recognize psychosocial stressors that may exacerbate
substance abuse problem and how to avoid or prevent them.
 Emphasize to the patient the importance of changing of lifestyle, friendships, and habits that
promote drug use to remain sober.
References
 Townsend MC. Psychiatric mental health nursing- concepts of care in evidence-based
practice. 8th ed. Philadelphia: F.A. Davis Company, 2015. 641-44pp.
 Reddemma S. A guide to mental health and psychiatric nursing. 4 th ed. New Delhi: Jaypee
Brothers: Medical Publishers (P) Ltd, 2018. 192-213pp.
 Ahuja N. A short textbook of psychiatry.7th ed. India: Jaypee Brothers Medical Publishers (P)
Ltd, 2011. 52p.
 Stuart GW. Principles and practice of psychiatric nursing. 10 th ed. Missouri: Elsevier Mosby
Publishers, 2013. 293-95pp.
 Lloyd C. Risk factors for problem drug use: identifying vulnerable groups. Drugs: Education,
Prevention and Policy.2009; 5(3):217-32. [DOI]
 Nepal Law Commission. Drug Abuse Prevention. 2021. [Weblink]
 https://drugfree.org/article/risk-factors-problem-use-addiction/