Substance Abuse
Prevention
Across the Lifespan
Let’s Get
Acquainted
Prevention
What is your definition
of prevention?
Prevention
The role of prevention is to create
healthy communities in which
people have a quality of life:
Healthy environments at work and in school
Supportive communities and neighborhoods
Connections with families and friends
Drug and crime-free
Source: SAMHSA/CSAP
Prevention Definition
Prevention is a proactive process that
empowers individuals and systems
to meet the challenges of life
events and transitions by creating
and reinforcing conditions that
promote healthy behaviors and
lifestyles
Source: SAMHSA/CSAP
Prevention Definition (cont.)
The goal of substance abuse prevention is the
fostering of a climate in which (a) alcohol use is
acceptable only for those of legal age and only
when the risk of adverse consequences is
minimal; (b) prescription and over-the-counter
drugs are used only for the purposes for which
they were intended; (c) other abusable
substances, e.g. aerosols, are used only for their
intended purposes; and (d) illegal drugs and
tobacco are not used at all
Source: SAMHSA/CSAP
SAMHSA’s SPF
Source: SAMHSA/CSAP
SAMHSA’s Strategic Prevention
Framework (SPF)
The Strategic Prevention Framework
(SPF) outlines a five-step planning
process designed to draw resources
from multiple sources to create a
community-based approach to
substance abuse prevention that cuts
across existing programs and systems.
Source: SAMHSA/CSAP
SAMHSA’s Strategic Prevention
Framework (SPF)
Assessment
Profile population needs, resources, and
readiness to address needs and gaps
Capacity
Mobilize and/or build capacity to
address needs
Planning
Develop a Comprehensive Strategic
Plan
Implementation
Implement evidence-based prevention
programs and activities
Evaluation
Monitor, evaluate, sustain, and
improve or replace those that fail
Source: SAMHSA/CSAP
Key Principles of the SPF
1.
2.
3.
Adheres to a public health model
Utilizes data-driven decision
making
Emphasizes outcomes-based
prevention
Source: SAMHSA/CSAP
Public Health: Focus for Strategic
Planning in Prevention


A public health approach focuses on
change for entire populations and/or
communities – the goal is sustainable
community level change
Population-based public health
focuses efforts across the lifespan
Why Be Concerned About
Health Across the Lifespan?
We need to understand the influence
of social health determinants as
predictors of population and individual
health
Social determinants of health will
influence health from early life
Contributed by Tania Garcia, CSAP’s Northeast CAPT March 06
It is commonly accepted that
individuals are at highest risk for
substance use & abuse at “transition”
points in their life and at “key”
stages across the lifespan cycle
The Lifespan Cycle
Elderly
Adult
Young Adult
Adolescent
Early Childhood/
School Age
Prenatal
Brain Development
and the
Impact of ATOD
on the Brain
Olny srmat poelpe can raed this.
i cdnuolt blveiee taht I cluod aulaclty uesdnatnrd
waht I was rdanieg.
The phaonmneal pweor of the hmuan mnid,
aoccdrnig to a rscheearch at Cmabrigde
Uinervtisy, it dseno't mtaetr in waht oerdr the
ltteres in a wrod are, the olny iproamtnt tihng is
taht the frsit and lsat ltteer be in the rghit pclae.
The rset can be a taotl mses and you can sitll raed
it whotuit a pboerlm. Tihs is bcuseae the huamn
mnid deos not raed ervey lteter by istlef, but the
wrod as a wlohe. Azanmig huh? yaeh and I awlyas
tghuhot slpeling was ipmorantt!
The Human Brain
Limbic
System
Brain Stem
Cortex
Introducing the Human Brain



The brain stem – controls basic
functions critical to life
The limbic system – contains the brain’s
reward system; in addition, it is
responsible for our perception of other
emotions, both positive and negative
The cerebral cortex – divided into areas
that control specific functions
Source: Drugs, Brains and Behavior: The Science of Addiction, NIDA
Construction Ahead
judgment
emotion
motivation
physical
coordination;
sensory
processing;
Pruning occurs in stages, from back
of the brain to the front
Source: National CAPT Substance Abuse Prevention Specialist
Training Manual, June 2006
Brain Development
Adolescence is a period of profound
brain maturation
We thought brain development was
complete by adolescence
We now know… maturation is not
complete until about age 24-25!!!
Source: National CAPT Substance Abuse Prevention Specialist
Training Manual, June 2006
Age 24-25
judgment
emotion
motivation
physical
coordination
; sensory
processing;
Risk Factors
Biology/Genes
•Genetics
•Gender
•Mental Disorders
Environment
DRUG
Brain Mechanisms
•Early use
•Availability
•Cost
•Route of
administration
•Effect of drug itself
•Chaotic home
•Parent’s use &
attitudes
•Peer influence
•Community
Attitudes
•Poor school
achievement
Addiction
Source: Drugs, Brains and Behavior: The Science of Addiction, NIDA
Alcohol and the
Adolescent Brain
 Stimulates release of dopamine and interferes
with body’s own release of dopamine
 Adolescents are LESS sensitive to the
negative effects of acute alcohol intoxication
 Adolescents can drink significantly more than
adults before they experience the sedative
effects of alcohol.
 Impairs memory and learning at lower doses
than adults who consume equal amounts
Source: National CAPT Substance Abuse Prevention Specialist
Training Manual, June 2006
Tobacco and the
Adolescent Brain
 Nicotine increases production of dopamine, so
smokers feel good
 Adolescents more likely to get addicted than
adults, and get addicted quicker
 If someone reaches 18 without using, odds are
1 to 5 of never using
 Tobacco Settlement acknowledged that
companies targeted adolescents; “Hook them
early or risk losing lifelong customer”
 Need 3000 new smokers every day to replace
the ones who die or quit
What Are We Preventing?
Use
Misuse
Abuse
Addiction
Source: National CAPT Substance Abuse Prevention Specialist
Training Manual, June 2006
Institute of Medicine
Continuum of Care
Prevention Classification
The Institute of Medicine (IOM1994) classified prevention
interventions into three
categories:



Universal preventive interventions
Selective preventive interventions
Indicated prevention interventions
Types of Prevention
Interventions
Universal: Activities designed to
reach the entire population,
without regard to individual risk
factors and intended to reach a
large audience.
Source: National CAPT Substance Abuse Prevention Specialist
Training Manual, June 2006
Types of Prevention
Interventions
Selective: Strategies designed
to target subgroups of the
general population that are
determined to be at risk for
substance abuse.
Source: National CAPT Substance Abuse Prevention Specialist
Training Manual, June 2006
Types of Prevention
Interventions
Indicated:
Designed to identify
individuals who are experiencing early
signs of substance abuse and other related
problem behaviors and target them with
special programs. The individuals have not
reached the point where clinical diagnosis
of substance abuse can be made.
Source: National CAPT Substance Abuse Prevention Specialist
Training Manual, June 2006
Activity:
Universal, Selective or
Indicated???
The Six CSAP Prevention
Strategies
1.
2.
3.
4.
5.
6.
Information dissemination
Prevention education skills training
Alternative activities
Community-based process
Environmental/social policy
Problem identification and referral
Source: National CAPT Substance Abuse Prevention Specialist
Training Manual, June 2006
Information
Dissemination
Providing
info about nature & extent of
drug use, abuse, addiction and the
effects on individuals, families &
communities
Providing info on available prevention
programs & services
Characterized by one-way
communication
Source: Substance Abuse Prevention: The Intersection of
Science and Practice, Julie Hogan, 2003
Prevention Education
Skills Training
Involves two way communication
and is based on interaction between
the educator and the participants
Activities aim to affect critical life &
social skills

Source: Substance Abuse Prevention: The Intersection of
Science and Practice, Julie Hogan, 2003
Alternative Activities
Goal is to have target populations
participate in activities that are ATOD
free;
Assumption is that “constructive &
healthy activities offset the attraction to
drugs, or otherwise meet the needs
usually filled by drugs” then the target
population would avoid using drugs

Source: Substance Abuse Prevention: The Intersection of
Science and Practice, Julie Hogan, 2003
Community-Based Process
Aims to enhance the ability of the
community to provide more effective
prevention through interagency
collaboration, coalition building &
networking

Source: Substance Abuse Prevention: The Intersection of
Science and Practice, Julie Hogan, 2003
Environmental Approaches
Seeks to establish or change
community standards, codes, &
attitudes thereby influencing the
incidence and prevalence of
substance abuse in the general
population;

Source: Substance Abuse Prevention: The Intersection of
Science and Practice, Julie Hogan, 2003
Problem Identification
& Referral
Aims to identify those who have
indulged in the illegal use of drugs in
order to determine whether their
behavior can be reversed through
education or whether they need a
referral for a chemical dependency
assessment

Source: Substance Abuse Prevention: The Intersection of
Science and Practice, Julie Hogan, 2003
The Six CSAP Prevention
Strategies
Research has shown that the
most effective prevention
programs present a
comprehensive approach that
includes all or many of the
CSAP strategies
Source: Substance Abuse Prevention: The Intersection of
Science and Practice, Julie Hogan, 2003
Prevention Across the
Lifespan
Group Activity
1. Divide participants into four lifespan
workgroups: pre-natal, young adult, adult
and elderly
2. Groups will brainstorm and record
appropriate prevention strategies for their
assigned age population.
3. Share with larger group.
Prevention Across the Lifespan:
Strategies at Various Stages of Life
Prenatal
Young Adult
Adult
Elderly
NOTE: Early Childhood/School Age and Adolescent are the
age populations traditionally served by prevention programs,
therefore our activity will focus on the traditionally underserved populations
Prevention Across the Lifespan
QUESTIONS
???
Rainbow Days, Inc.
Training Services
www.rdikids.org
1.214.887.0726
Janet Mitchell
janetm@rdikids.org