Continuing education online courses on Prevention Values.

D18. Prevention Values, 3 CE-hours

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D18   Prevention Values, 3 CE hours

DrugFree Living

Most of us seem to have a great capacity for denial of the unpleasant. Drug misuse is one such unpleasant thing. Denial often seems the easiest way of shutting it out. From this comes this classic denial statement: “Not My Jim.”

“Never Say Never” has been advice frequently given. In this case It is very appropriate. There is no way of knowing what an individual will do at some future time. Besides, drugs are all around us. In a different way, coffee, caffeine drinks, teas, alcohol, aspirins, and sleeping pills are drugs of common misuse. Thus the stage for drug misuse is set in nearly every restaurant, office, home, and place of recreation. The core of the problem is not only the individual drug users, but our whole system of pleasure seeking and rewarding by use of mind-altering drugs.

This course is intended to present the basics of drug prevention for health care professionals, teachers, drug-prevention educators and parents. It can serve both as a self-learning guide or as an aid for drug prevention education.

The reader may benefit from reviewing some sections a number of times in order to get thoroughly acquainted with the topic. But the real learning will take place as the reader gets acquainted in depth with individual children and youth and patiently works through the problems of growing up and drug use.

The number of helps in drug prevention education is growing rapidly. The contribution of this course to the field is to present the more practical application of prevention from a comprehensive of values, life styles and health-promotion and to avoid a concentration on theory and un-integrated facts.

“Should I try using drugs like the other kids do?” Jim wonders. He knows how easy it is to get drugs from the kids at school. His teachers wouldn’t know if he tried a joint. Mom and Dad probably wouldn’t know about it either. “Why are drugs such a big deal ?”

Jim’s problems at school bother him. His grades are dropping and he’s been losing Interest in his schoolwork. He didn’t make the basketball team and that hurt. His father seems too busy to spend time with him. “Life is such a hassle,” Jim sighs.

*Some of my friends drink beer and smoke pot, and they’re O.K. Maybe I’ll try it, too,” he thinks.

Jim’s pressures are getting to him. He isn’t sure how to handle his stresses. Can he make the right decisions? If he uses drugs, how will he feel and act? Will he get “hooked” on drugs?

Jim daydreams about his future. “What’s the matter with me, anyway? Why can ‘t I get better grades?”

He thinks about the groups he belongs to his family, friends, and classmates “Do they care about me? Do they want to help me?”

Once again Jim thinks about all the drug information he hears and reads about. “Who’s right and who’s wrong? How do I know what to believe?”

Besides, there is the easy access to drugs. Jim wouldn’t even have to leave the school grounds. And the TV commercials make it seem 0.K. to drink beer. “Almost anybody can get alcohol or other drugs,” he says to himself.

Jim Is also very aware of his parents’ spiritual values and how they feel about drugs. “I don’t believe it’s right to use drugs,” notes Jim’s dad.
“Drugs would destroy Jim’s life. I want him to feel stable with himself,” adds Mrs. Allen.

Jim is a typical, 12-year old boy who is struggling with growing up. He isn’t sure about his direction In life. Jim needs some help. What will he do? “I want people to care about me. I want people to like me.”

Jim’s conflicts in life relate to five aspects of drug-free living. These aspects make up the Prevention Pentagon model. Each aspect is linked together to provide the inner support against outside pressures. Therefore, the model is used to strengthen an individual against misuse of drugs. The five components consist of: (1) personal concerns; (2) group/social concerns; (3) information; (4) access-control; and (5) Personal values and spiritual resolve.

1. Self	Risk Factors
2. Group	Peer Pressure
3. Information	Drug Ignorance
4. Access Control	Manipulation Prevention
5. Personal Values	Disintegration Prevention

Each Inner-strength component is matched against an outside pressure: (1) risk factors; (2) social pressure; (3) Ignorance; (4) manipulation; and (5) disintegration. Thus, the stronger the outside pressure, the stronger the inner support must be. Otherwise, there is a greater likelihood of problem behavior and drug use. The goal in prevention is to promote healthy choices for drug-free living.

The first approach to prevention concerns oneself. Jim’s thoughts deal with his total self, his background, his values, decision making, and behaviors. His family life will have a strong influence on the development of his self-concept. Some of the risks Jim might take because he is not well-developed may contribute to drug misuse.

The second approach-concerns the group. Jim shares his world with those around him. He is part of many groups-his family, his circle of friends, his athletic team, his classes, his neighborhood. Groups can provide positive or negative support-strengthen or pressure Jim into drug misuse. Healthy communication and a sense of family pride can foster positive relationships that are supportive of drug-free living. Jim’s healthy outlets for his pent-up energy are basketball and other sports activities. These are alternative activities for destructive behaviors. Sports and work activities are often positive influences for drug-free living. Thus, despite his social pressure, Jim has the ability to say “No.”

The third approach concerns the information about drugs. Jim gets a lot of information about drugs. But it doesn’t fit together. In the school’s health courses Jim learns about drugs in a factual manner and how drugs affect his health. From his parents he hears horror stories. And from his friends he hears how “neat the stuff is.” In spite of the confusion, he can learn to make healthy choices to stay fit, eat right, manage stress and live drug-free.

The fourth approach used in the Prevention Pentagon is access-control. For Jim, alcohol and other drugs are so readily available that their access is difficult to control. Jim often sees how easily drugs and liquor are shared among his friends. But his home, school and community groups can work together, helping Jim to avoid the drug habit. Influential support groups, such as Mothers Against Drunk Driving (MADD),  work to ban or restrict advertising. The greater availability of drugs, the more drug misuse will exist.

The fifth approach to prevention deals with personal values and spiritual resolve. In his sane and quiet moments, Jim asks himself some big questions: “Why was I born?” “How does all this fit together anyway?”

A person is more than the sum of his or her parts. The values/spiritual approach to drug prevention helps to integrate the mind, body, and spirit of a person into a stable, complete whole. It concerns itself with the place of that person in the universe — through time. It gives meaning to life, perspective to events, and depth to relationships. A healthy spiritual life strengthens youth against inner distress and ego problems, so common in our society. It can fortify youth against the human tendencies of “doing their own thing” for now, while ignoring the long-range consequences.

The Prevention Pentagon model provides a framework for understanding life in terms of healthy living. The following principles reinforce the model’s structure:

*Life is developmental. Drug dependence is a dangerous risk which inhibits one’s development

*Life has purpose. Drug dependence thwarts or arrests the effective movement toward a life purpose.

*Life needs discipline. Drug dependence erodes the desire to fulfill goals. However, strong emotional support helps the person to become a healthier individual.

Jim is influenced through many learning experiences in his home, in school, through friendships, and the community as a whole. The mass media exerts a particularly strong influence on his choices.

While watching television, he sees and listens to how alcohol drinking is popularized as a normal and everyday event. Alcohol is usually advertised as a “social” drug that makes people feel good-  like the add that portrays a beautiful, smiling young lady and her friend, both drinking. As a result, misleading information is presented which distorts the realities of alcohol drinking. The impression is given that alcohol makes for a happy and healthy life. The same is true with regular advertisements of various drugs.

Therefore, the core of the problem is not only with the individual drug user, but with our whole social system of promoting a good time and quick relief of pain through the use of drugs.

There is no “safe drug.” Every drug, prescriptive or non-prescriptive, can be harmful. Alcohol, nicotine, and caffeine, although legal, are very potent drugs.

Recent trends in increasingly early alcohol and drug use are frightening. Young people have begun to experiment with many kinds of drugs at a progressively younger age. Americans are confronted with more and more cases of drug dependency. Teenagers are the “new” alcoholics. “I just don’t know what to do. I can’t handle this,” says many a health professional and parent.

Drug-free living is based on the effective use of concepts presented In the Prevention Pentagon model. The health promotion approach can be used among such helping groups as PTA’s, schools, and community agencies.

Establishing an atmospheres conducive to positive communication is vital for success. Honesty and non-biased attitudes are important qualities. Bullying, “preaching,” bribing, and “scare tactics” are seldom effective means of communication. Prevention efforts that work focus on individual growth, emphasizing the positive self-worth of the individual.

This course is designed to provide basic information on the prevention of drug misuse to promote healthier living among young people. The Prevention Pentagon model can be applied in various educational settings. Following is a sequence of five narrative cases dealing with the five aspects outlined in the Prevention Pentagon.

1. Jim Tries To Understand Himself

Jim, when alone, thinks about himself. He isn’t sure about his feelings or what he wants in life. He’s also unclear about how to make decisions and how to act with others. His need to understand himself is very important. How can Jim help himself?

Jim’s self-concept propels everything he does. In many ways, he is becoming what he pictures himself to be. His self -concept affects his feelings and what he wants to be. It also affects his actions and how he takes care of himself.

For instance, negative feelings such as anger, fear, resentment, and insecurity, are influenced by his self-concept. His inability to cope with these feelings contributes to a more inadequate self-concept. This poor self-esteem breaks down his resistance to harmful behaviors, such as using drugs.

If Jim’s self-concept could talk, it would sound something like this:

“My visible me” is the impression I give about myself that can be seen. My face, my body, and my clothing all tell who I am. If I care about myself, I will show it by my outward appearance to others.

“My pluses” describe my personality, my strengths and wants. They mirror my mind. They may be balanced, exaggerated, or even exchanged. If I don’t like myself, I won’t have any pluses for others to know.

“My inner me” is the picture I take with my inner yes, full of emotion and moods. It is the real me with whom I have to live.

I have found “My niche” (my place in I Ife), or I am on my way of finding it, or I’m just lost with myself. Somewhere, there is just the right niche for the right me — in a family, in a job, in a church, in a community of people. Life is all about finding my niche and knowing that I have found it, at least for today.

To put it another way, self-concept means self-awareness, self-esteem and self-image. As with every growing child, Jim’s self-concept has many windows to his inner self.

Jim’s uncertain feelings toward himself and others are influenced by his surrounding environment. His high and low feelings are different every day. “Why is it so difficult for me to understand myself?” He keeps wondering. “I get confused.”  Explore www.acde.org

2. Jim’s Self-Concept Is Influenced by Others

Adolescence is a difficult time of growth and development. Young people are experiencing powerful feelings and pressures which they can’t always understand. Teenagers fight for independence yet fear too much freedom; they resent overprotection but need and want parental attention.

Jim is very dependent on his parents. He has strong needs for their understanding and love. Their emotional support -guidance and direction- are vital to him. For Jim, it is frequently a time of confused feelings about his relationship with his parents.

If Jim’s human needs are not met, he could turn to drugs. Drug use often serves some psychological, social, or physical function for youth. Otherwise, they would not use drugs. Positive communication and family unity can help most Jim’s needs in healthier ways. His parents exert a strong influence on his developing self-concept.

Jim’s peers also influence his self-concept. As Jim is starting to feel independent, his peers are beginning to have a powerful influence on how he feels. He needs their acceptance of him. But, will Jim get pressured into doing the wrong things? How Jim’s friends feel toward him will also affect his decisions about using drugs. In many ways, their influence is stronger than that of his parents. Peer pressure at this stage of life can be irresistible.

In addition, Jim’s feelings toward himself are affected by the society as a whole. All that he sees and hears outside of his family and friends also influence his feelings.

Jim gets a lot of different information from TV, magazines, his teachers, and others. He can’t always be sure what to believe. He is getting mixed messages about drugs, and Jim isn’t sure how to deal with his feelings.

Jim struggles with his feelings about drugs. “I want to feel good even when things bother me. Why do I have to feel down when I can feel up?” Jim thinks. “Drugs aren’t such a big deal.”

People try drugs because they are curious about their effects and how they will feel afterwards. If you ask a child why he uses drugs, he will tell you that it makes him feel good. He may also say that it helps him forget his problems, that all his friends use drugs, or simply because he Iikes to get high. Often, children do not see drug use as a harmful experience but rather as a pleasurable one.

Drugs do help meet some of our basic human needs, at least for a while. They may help us escape our problems, reduce pain, and gain acceptance among others. But young people are often naive and unaware of the consequences. They just end up feeling worse.

Taking drugs never solves problems. It can create problems afterward. To Jim, later irrelevant. He is more concerned with how he feels now and what his problems are. He thinks that drugs will help him feel better.  Consultwww.cadca.org

3. Information for Prevention

Abused drugs usually include alcohol, nicotine, depressants, stimulants, marijuana, opiates, and inhalants. Extensive information on these drugs can be found via www.health.org and cecourses.org/drug-abuse/

4. Access Control: Jim Needs Guidance for His Choices and Behaviors

A child who is neglected for long periods of time and who does not have a stimulating environment may harm himself. He will often identify with the wrong crowd and find destructive ways of filling time.

As Jim grows, he will develop a life-style that is appropriate to his needs. It is easy at this developmental stage to form unhealthy habits and life-style behaviors, such as drug use. The purpose of prevention is to help individuals like Jim choose constructive, not destructive, outlets to frustration.

Someone like Jim needs positive guidance from parents, teachers and role models. He needs help in forming a creative program for himself that includes exercise, recreation, work, study and religious activities will help develop a healthy, positive lifestyle.

The following suggestions can be explained to your child so that he can learn to make rational decisions:

*A person has control over his senses. He can choose what to look at, what to hear, what to touch, what to smell, what to taste.

*How he chooses to use his senses influences his thinking. He will think about the things he sees, hears, touches, smells, and tastes.

*His thinking will influence his behavior. He will act on things he sees, hears, touches, smells, and tastes.

*He can choose to use his senses to stimulate his emotions and cravings that lead to irrational thinking and self-destructive behaviors.

*He can learn to think logically, reasonably, and responsibly. He can do this by writing out his thoughts and critiquing them either by himself or In a small support group.

*People often make excuses and blame others for their wrongdoings. This Is negative thinking. A person must be responsible and take the blame, and face the facts and consequences of his actions.  Review  www.ncadd.org

5. Jim Needs to Develop Sound Values for Decision Making

As Jim is struggling for independence, he often makes decisions based on feelings, rather than sound reason. Consequently, many of his decisions turn out to be wrong ones.

Jim admits he would often do things with his buddies because it felt good at the time. But, sometimes he got into trouble. He never thought things through, to look at what happens afterward. Jim just wanted to go where his feelings led him.

That’s a risky way to do things. It can be dangerous. He wants to be popular with his friends at school and “fit-in,” but taking drugs is risky business. How can Jim understand how to be more rational and less emotional with his decisions?

As a start, Jim can be taught the importance of developing sound values. That is, understanding the things that are important to him. This will help Jim make decisions that lead to drug-free, healthy behaviors.

For example, Jim can learn the value of good health. If he wants to make the basketball team next year, he may understand that drugs will diminish his athletic abilities. Therefore, he will I have a good reason not to take drugs. That would be a sound decision based on facts. Thus, his knowledge will strengthen his will when he comes to the place where he has to say “No.”

Jim can also learn to develop other important values In life. He does want to feel love and care by his family, and friendship and work are also important to him. These are all life-long values, basic wants or needs-to be cherished. By developing these and other strong values, Jim will have a greater sense of direction in his life.

Jim needs to think about taking risks. To take a risk is to expose himself to danger, or failure, or rejection. Taking a risk can also expose him to a new experience, a new friend, a new skill, a new idea, and a new achievement.

It is important for Jim to know that there are reasonable and unreasonable risks. This is true for everyone.

A reasonable risk is putting yourself in a situation where you stand to gain something positive if you take a chance and succeed. Here are some reasonable risks (Cook and Newman, 1978): *risk buying an album by a musician you’ve never heard before, *risk exploring a new part of your city, town or county, *risk asking someone what he or she likes (dislikes) about you, *risk taking part in a new sport at school, *risk not going to college if you’re a good student, *risk going to college if you’re not a good student.

An unreasonable risk is putting yourself in a situation where you stand to gain nothing positive; lose something of value which can’t be replaced; cause serious physical or mental harm to yourself or to another person. Here are some unreasonable risks: *risk taking alcohol, cigarettes, or other drugs and developing a dependence, *risk not going to see the doctor when you’re really sick, *risk stealing *risk driving a car while drunk, or riding with a drunk driver, *risk using hostility to get what you want. If Jim is aware of his values, he’ll probably be aware of the risks involved before making any decision. He’ll think about the possible results of his decision-the benefits or consequences that may occur.

Young people often lack the experience and maturity in making the right choices. Therefore, Jim needs the understanding and support from those who care about him, especially his parents. This will produce feelings of trust, acceptance, and respect for himself. Jim will also have greater confidence and will develop healthy behaviors in Iife.

But, If Jim’s self-concept is damaged by criticism, defeat, and distrust, he may develop weak values and make poor choices. This could lead to drug use and erode his health.  See www.cadca.org

The Twelve Step Program may be used not only for treatment, but also prevention. Knowing the danger may help prevent the problem. The Steps are:

“1. We admitted we were powerless over alcohol–that our lives had become unmanageable.

2. We came to believe that a power greater than ourselves could restore us to sanity.

3. We made a decision to turn our will and our lives over to the care of God as we understand him.

4. We made a searching and fearless moral inventory of ourselves.

5. We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

6. We’re entirely ready to have God remove all these defects of character.

7. We humbly asked Him to remove our shortcomings.

8. We made a list of all persons we had harmed and became willing to make amends to all of them.

9. We made direct amends to such people as much as possible except when to do so would Injure them or others.

10. We continued to take personal Inventory and when we were wrong promptly admitted It.

11. We sought through prayer and meditation to improve our conscious contract with God as we understood Him, praying only for knowledge.

12. Having undergone a spiritual experience as a result of these steps, we tried to carry the message to other alcoholics and to practice these principles in all our affairs.” Source: AA

6. Definitions of Terms

The following terms are defined to clarify their usage and to assist the reader In understanding the concepts used throughout the guide.

Drug — Any medical or non-medical chemical substance (licit or illicit) which exerts a pharmacological effect on the mind, regardless of the relative .benefit or harm which results from its effect.

Drug-free— Avoidance of using non-medical drugs.

Drug use— Use of non-medical drugs. (There are four categories of drug users: experimental, casual, regular, and heavy–psychological or physical dependence.)

Drug Misuse — The use of any medical or non-medical drugs to the extent that It causes apparent harm to oneself or others.

Prevention — Strategies which focus on helping young people strengthen their values and decision-making abilities to reduce the likelihood that they harm themselves or others through the misuse of drugs. The goal of these efforts is health promotion–promoting healthy choices and behaviors–for drug-free living.

The Prevention Pentagon— The conceptual framework (structure) which consists of five integrating health promotion factors as the basis for developing or enhancing healthy choices and behaviors for drug-free living.

The Prevention Model/The Model — The Prevention Pentagon.

Alternative Drug-free Choices/Alternatives — Optional, available drug-free choices–for promoting healthier living–which serve as a practical prevention strategy.

Physical Dependence (Addiction) — A physiological state of adaptation to a drug normally following the development of “tolerance” and resulting in a characteristic “withdrawal syndrome” when use of the drug is stopped. The extent to which physical dependence occurs in the use of certain drugs and its causes is a matter of considerable controversy.

Psychological Dependence (Habituation) — A broad term generally referring to a craving for or compulsion to continue the use of a drug that gives satisfaction or a feeling of well-being. Psychological dependence may vary in intensity from a mild preference to a strong craving or compulsion to use the drug. In severe cases, unpleasant psychological symptoms may develop If continued administration of the drug is stopped.

7. Worksheets

The following suggested activities will help the reader to understand and use prevention skills and the health promotion programs.

1. The purpose of this exercise is to help a person consider what he has chosen, what he prizes, and/or what he is doing. It stimulates him/her to clarify his/her thinking and behavior, and thus to clarify values. The person asking the questions also benefits by getting to know the participants better.

2. Procedure. Write about your feelings on one of these subjects for two minutes: Money,  Friendship,  Family,  Religion/Morals, Love/Sex,  Work,  Maturity,  Physical Fitness, Leisure,  School.

3. Dear Abby, my older brother is sixteen and smokes. He sometimes drinks beer and wine with the older boys in the neighborhood. When my parents get home from work he is over at one of the boy’s houses, and he stays there until he feels better. Should I tell my parents what he’s doing? He just started doing these things about two weeks ago. Signed, Worried Sick.  How Will You Respond?

4. Dear Abby, My eight-year-old brother takes cigarette butts from out of the ash trays and smokes them. One day, he almost set the sofa in the basement on fire. We put it out, and didn’t tell Morn and Dad. I am scared that one day he will set the house on fire. How can I stop my brother from doing this? Signed,  Afraid. How Will You Respond?

5. Dear Abby, My parents drink and smoke a lot. They give a lot of parties on the weekends. I am ten, and they sometimes give me a sip of beer. How can I tell them that I don’t like the taste of beer and that I don’t want to act like they act when they drink alcohol ? I don’t like the smell of cigarettes either.  Signed, Confused. How Will You Respond?

6. Valuing Human Needs. Rank each of the following human needs according to its importance to you. Afterwards, discuss how these needs can be applied to spiritual resolve in overcoming a drug-related problem: Trust, Friendship, Love, Pleasure, Self-respect, Social Recognition,
Family Security, Honesty, Independence, Responsibility, Self-Control, Inner Harmony, A Sense of Accomplishment, Happiness, A Comfortable Life.

Resources and Links

DrugFree USA supports the Partnership for a Drug-Free America as a patron, the American Council for Drug Education as a partner, the Community Anti-Drug Coalition of America as a contributor, and DrugFree Kids as a developer. If someone has a problem, check out NCADI: http://www.health.org/govpubs/ph317/ 

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