This report discusses the issue of drug and alcohol abuse among Aboriginal youths aged 13 to 24 years, including the trends, impact, and interventions. It provides recommendations for public health workers to prevent and alleviate the health condition.
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Running head: PUBLIC HEALTH PUBLIC HEALTH Name of the student Name of the university Author note
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1 PUBLIC HEALTH Introduction Adolescents or young adulthood is the main developmental period, which is typically characterized by a sequence of life transitions, like going through and leaving the compulsory education system, making new peers, entering employment. Younger people experience greater freedom and less control than they normally experience during the childhood (Snijder et al., 2018). This appears to be one of the particular issue related to drug and alcohol abuse among the aboriginal male aged between 13 to 24 years. The consumption of alcohol and drugs is one of the main cause of preventable disease and illness in Australia. , including the main trends in the availability, harm, consumption and treatment for the vulnerable population (Snijder et al., 2018). The report aims to discuss about a current health issue like drug and alcohol abuse among the aboriginal youths aged 13 to 14 years. In order to do so, the report will critically interpret the methods for the building up of the community constituencies and collaborations directed to an advancing youth health within the local primary health care settings. Furthermore, this report will also provide with some sets of recommendations of how the public health care workers can support this groups of population to prevent, minimize and alleviate the health condition. Impact of alcoholism and illicit drug use Indigenous people have the oldest culture in the world. One of the common experience among the indigenous people is the lasting impact of colonization that continues to impact the health and the wellbeing of many indigenous people nowadays. Additionally with the lower outcomes in many social determinants of health like education, poor access to the health care services, racism, housing and unemployment increases the susceptibility of the drug and alcohol
2 PUBLIC HEALTH abuse. Hence, the prevention of the substance use among the adolescents has been identified as one of the key areas to improve the health of the indigenous people. Substance use and alcoholism has been evident in the lower age. In Australia, the substance use among the aboriginals is reported to be 2-6 years earlier than the national average (Snijder et al., 2018). The Aboriginal and the Torres Strait Islanders are 4 times more likely to report about injecting drugs. In Australia, the indigenous adolescents aged between 14-15 years are five times more likely to report about the use of the cannabis and are more than twice to report about excessive use of the alcohol when compared to the non0indegenius counterparts (Snijder et al., 2018). The early onset of the substance abuse has been found to be identified as one of the risk factors for the problematic substance abuse later in the life. Alcoholism and drug abuse have well documented effect on the substance users. The prolonged use of the drugs and the alcohol not only deteriorates the health of a person, but also impairs the mental health and also damages the spirit of the person (Doyle et al., 2018). Alcoholism and drug abuse impacts both the users and the society, from the health risk of the users to the increased risk of early pregnancy, financial cost, accidents and the productivity cost. The three main causes of death due to alcoholism and drug abuse has been found to be motor vehicle accidents, suicide and homicide (Geia, Broadfield, Grainger, Day & Watkin‐Lui, 2018). Adolescent people have stated that in the last two weeks they have either driven under the influence of alcohol or drugs. Recent data has shown that the aboriginal adolescents who indulge in binge drinking are more likely to engage in risky behavior, such as keeping a large number of sexual partners and inconsistent use of sexual protection. 25% of the females who had been treated for substance abuse have reported pregnancies (Wand et al., 2016). A significant amount of hospitalizations and do tor’s visits are attributable to illicit use of drugs and alcohol. As per
3 PUBLIC HEALTH the report in 2018, 78666, emergency rooms visits by the adolescents in Australia have been found due to the illicit use of drugs and alcohol. Some of the most common drugs used in Australia are Cocaine, marijuana, methamphetamine (Wand et al., 2016). Higher rates of marijuana has been associated with increasing number of school dropouts. As per the findings, adolescents are more susceptible to the chronic effects of marijuana on the cognition of the adolescent population. Some of the common psychiatric disorders associated with the use of alcohol are depression, anxiety disorder, bipolar disorder. More cases of suicide attempt has also found to be associated with the illicit use of drugs (Kennedy et al., 2015). ADHD among the adolescents has been found to be associated with substance abuse. As it has been already stated, that adolescents aboriginals who consume alcohol or drugs are often associated with antisocial behavior and risky behavior such as unprotected sex, increasing the transmittance of sexually transmitted disease. An elevated risk of HIV has been found among the Aboriginal and the Torres Strait Islander adolescents, this is due to the illicit use of injectable drug use among the adolescent population. Again according to the study byWebster (2012) there had been an elevated rate of prescription drug use among the Australian aboriginal adolescent Individuals. The reason behind the current pattern of substance abuse among the aboriginal and the Torres Strait Islanders are complex. Many scientist are of the opinion that alcohol and drug abuse are consequences of the effects of dispossession and colonization and the separation from the cultural practices (Bryant et al., 2016). However, most of the literary sources have focused on the impact of the contemporary realities of poor living standards, unemployment, family conflict and welfare dependence, lack of boredom. Racism and discrimination in the field of health care, education and unemployment have also been identified as some of the factors for alcoholism and
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4 PUBLIC HEALTH drug abuse (Gutierrez & Sher, 2015).The effect of familial environment is another factors influencing substance abuse and abstinence, particularly for the Indigenous Australians, where association to the immediate and the extended family are strong and are expected culturally. In communities where illicit use of drugs or alcoholism in common or for the individuals who are regular users, family instability is found to be one of the common predisposing factor (Gutierrez & Sher, 2015).Some of the other issues that has been noticed related to alcohol or drug use are, parental absenteeism, drug use, home based use of alcohol and drug use. Peer groups can be greatly influential as acknowledged by young Aboriginal Australians involved in the sniffing of petrol and intravenous use of drugs. Role of the public health workers and services and interventions Efforts for preventing alcoholism and reducing the use of drugs includes a wide range of interventional approaches that target primary interventions, addressing the needs of the users and the community. A number of services can be provided by health care workers with the aim of delaying the use of adolescent substance abuse and prevention of the associated adverse effects. In order to benefit the mainstream population, health care workers can collaborate with the educators and can conduct school based prevention programs for reducing the onset and the escalation of the substance use.Calabria, Clifford, Rose and Shakeshaft,(2014) have stated that family based and community based strategies can be helpful.Gutierrez and Sher, (2015)have argued, mass media campaigns had not been very effective in reducing drug abuse and alcoholism. In fact theCalabria, Clifford, Rose and Shakeshaft, (2014) have argued that mass media campaigns can to some extent contribute to this practice. This can be explained by the fact that younger generation might consider it to be cool enough to try out some thin that is banned or is related to something risky.
5 PUBLIC HEALTH Recognizing the community threat of alcohol and drugs an interdisciplinary team model can be used to prevent the use of drugs in the communities (Broyles, Conley, Harding& Gordon, 2013).Themodelcombinestheparticipationofthecommunities,students,healthcare professionals and the teachers. It is necessary to develop the workforce. In order to make that possible it necessary to provide sufficient training to the health care workers and the social workers for enhancing the educational competencies for providing the basic services like alcohol screening, brief intervention and referral to treatment, prevention programs for children of the parents with substance abuse disorder, implementationof the evidence based community programs(Cunningham&Paradies,2012).Stakeholderslikethepharmacist,physicians, assistants, nurse practitioners, social workers, dentists, psychologists and occupational therapists can be involved in the community based programs. According toBroyles, Conley, Harding Jr and Gordon,(2013), community Reinforcement Approach (CRA) is an evidence bases cognitive behavioral intervention for the adolescent population suffering from alcohol and drug abuse. CRA reduces the consumption of alcohol and drug abuse by the use of a social, recreational , family and the vocational reinforces for motivating people towards making their non-drinkingand non-drug using life style more rewarding than alcoholism or the consumption of drugs (Broyles, Conley, Harding Jr and Gordon, 2013). Community Reinforcement and Family Training (CRAFT) is a cognitive behavioral intervention in collaboration with targeted aboriginal and the Torres Strait Islander community for the delivery of health care in an aboriginal-specific health care setting. The interventions would provide systematic and personalized training and support to the family members of a problem drinker (Broyles, Conley, Harding Jr and Gordon, 2013). It would also take in to account, the social and the emotional wellbeing of the family members.
6 PUBLIC HEALTH Substance abuse and alcoholism is a public threat and hence the nurses and health care professionals play an important role in patient advocacy. They can provide referrals to important services like special helpline number, rehabilitation centers for drug abuse. Nurses can teach or counsel the patients to develop resilience in order to cope up with both the positive and negative emotions and disruptive behavior related to drinking and drug abuse (Alim et al., 2012). Resilience allows an individual to adapt themselves to stressful or traumatic events associated with substance abuse (Calabria, Clifford, Rose & Shakeshaft, 2014). Conclusions and recommendations Although, the government had introduced several reforms in order to control the rampant alcoholism and drug abuse among the aboriginal adolescent, but one of the flaw is the common assumption of Aboriginal to be a homogenous population with the some common interventions. Better approaches are required to address the diversity of the population as well as facilitating cultural appropriateness, encouraging the training of the staffs for offering a broader range of the intervention approaches that even include support for the families. It is recommended to find out the protective factors that can prevent the indiscriminate use of drugs and alcohol among the adolescent youth. These are- strong bonding with the families, experience of parental surveillance with transparent rules of conduct within the family unit and the involvement of the parents in the lives of the children, bond with prosocial institutions like school , family or religious organizations can also have positive impact on the adolescents. The government should increase the funding to set up more community based programs for abstaining the adolescents from alcohol. Some of the other recommendations includes, increasing the tax over alcohol. No alcohol outlets should be present within the close proximity of schools and universities.
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8 PUBLIC HEALTH References Alim, T. N., Lawson, W. B., Feder, A., Iacoviello, B. M., Saxena, S., Bailey, C. R., … Neumeister, A. (2012). Resilience to meet the challenge of addiction: psychobiology and clinicalconsiderations.Alcoholresearch:currentreviews,34(4),506–515. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860393/ Australian Institute of Health and Welfare, (2017).Alcohol, tobacco & other drugs in Australia. Accessdate:12.3.2019.Retrievedfrom: https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/ contents/priority-populations/aboriginal-and-torres-strait-islander-people Broyles, L. M., Conley, J. W., Harding Jr, J. D., & Gordon, A. J. (2013). A scoping review of interdisciplinary collaboration in addictions education and training.Journal of addictions nursing,24(1), 29-36.DOI: 10.1097/JAN.0b013e318282751e Bryant, J., Ward, J., Wand, H., Byron, K., Bamblett, A., Waples‐Crowe, P., ... & Kaldor, J. (2016). Illicit and injecting drug use among I ndigenous young people in urban, regional and remote A ustralia.Drug and alcohol review,35(4), 447-455.doi: 10.1111/dar.12320 Calabria, B., Clifford, A., Rose, M., & Shakeshaft, A. P. (2014). Tailoring a family-based alcohol intervention for Aboriginal Australians, and the experiences and perceptions of healthcareproviderstrainedinitsdelivery.BMCPublicHealth,14(1),322. https://doi.org/10.1186/1471-2458-14-322
9 PUBLIC HEALTH Calabria, B., Clifford, A., Rose, M., & Shakeshaft, A. P. (2014). Aboriginal Australians, and the experiences and perceptions of health care providers trained in its delivery.BMC Public Health,14(1). Cunningham, J., & Paradies, Y. C. (2012). Socio-demographic factors and psychological distress in Indigenous and non-Indigenous Australian adults aged 18-64 years: analysis of national survey data.BMC public health,12(1), 95.https://doi.org/10.1186/1471-2458- 12-95 Doyle, M. F., Butler, T. G., Shakeshaft, A., Guthrie, J., Reekie, J., & Schofield, P. W. (2015). Alcohol and other drug use among Aboriginal and Torres Strait Islander and non- Aboriginal and Torres Strait Islander men entering prison in New South Wales.Health & Justice,3, 15. doi:10.1186/s40352-015-0027-1 Geia, L., Broadfield, K., Grainger, D., Day, A., & Watkin‐Lui, F. (2018). Adolescent and young adult substance use in Australian Indigenous communities: a systematic review of demand control program outcomes.Australian and New Zealand journal of public health,42(3), 254-261.https://doi.org/10.1111/1753-6405.12789 Gutierrez, A., & Sher, L. (2015). Alcohol and drug use among adolescents: an educational overview.International journal of adolescent medicine and health,27(2), 207-212.DOI 10.1515/ijamh-2015-5013 Kennedy, M. C., Marshall, B. D., Hayashi, K., Nguyen, P., Wood, E., & Kerr, T. (2015). Heavy alcoholuseandsuicidalbehavioramongpeoplewhouseillicitdrugs:Acohort study.Drugandalcoholdependence,151,272-277. https://doi.org/10.1016/j.drugalcdep.2015.03.006
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10 PUBLIC HEALTH Snijder, M., Stapinski, L., Lees, B., Newton, N., Champion, K., Chapman, C., … Teesson, M. (2018). Substance Use Prevention Programs for Indigenous Adolescents in the United States of America, Canada, Australia and New Zealand: Protocol for a Systematic Review.JMIR research protocols,7(2), e38. doi:10.2196/resprot.9012 Wand, H., Ward, J., Bryant, J., Delaney-Thiele, D., Worth, H., Pitts, M., & Kaldor, J. M. (2016). Individual and population level impacts of illicit drug use, sexual risk behaviours on sexually transmitted infections among young Aboriginal and Torres Strait Islander people:resultsfromtheGOANNAsurvey.BMCpublichealth,16(1),600. https://doi.org/10.1186/s12889-016-3195-6 Webster P. C. (2012). Prescription drug abuse rising among Aboriginal youths.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 184(12), E647–E648. doi:10.1503/cmaj.109-4258