Models Of Drug Intervention

The Consumption Distribution Model

Some of the measures that have been proposed from this perspective to limit consumption are the increase in prices, the control of advertising, the increase in the ages of legal consumption, restrictions on the opening hours of establishments linked to consumption, fines and penalties for establishments that serve minors, penalties for consumption in unauthorized places, or criminal penalties for drunk drivers (Elzo, Elorza, and Laespada, 1994).

Even though the availability factor is essential to understand the massive consumption of alcohol and tobacco in our society, the mere mention of the extensive commercial distribution of these products, without mentioning other psychological and social factors, is an incomplete explanation for understanding consumption. Abusive or addictive in certain individuals or groups (Giró, 2007).

However, this approach differs from the legal model’s greater interest in non-institutionalized substances. The consumption distribution model would reduce the negative effects of standardized substances by regulating their supply. In short, a set of legislative measures tending to restrict the supply and availability of drugs in the social environment is advocated. In a broader sense, they reduce the uncritical acceptability contributing to certain substances’ massive consumption.

The Traditional Medical Model

The traditional medical model is not a sufficient interpretation to explain the complex problem of drug use, not only because of the previous critical reflection on the stigmatization of the addict as sick but also because of other shortcomings:

 The emphasis on biologist and individualist interpretations ignores aspects important for understanding consumer behavior, such as social factors. It is a monadic and biologist model, according to which the addiction problem can only be understood and addressed from within the affected subject. Although it is not explicitly recognized, it is considered that drug addiction has an idiopathic etiology. This unknown or unclear origin can only be understood by itself, assuming only the possible influence of genetic factors (Schuckit, 1986).

 It barely contemplates non-addictive abusive consumption; that is, it focuses on drug dependence. He is interested in studying drug use as a pathological category, not behavior.

 It is a model more oriented to illness than health (Friedman, 2002). It does not focus on health as the final object of study, but this is the disease. However, the contemporary conception of health, defined by the WHO, understands that the study and treatment of the disease must be a part –very important, in any case– of a whole that is the full and global achievement of health.

Proposes that the prevention of any disease or illness should be based on the dissemination among the population of the knowledge accumulated by science about what factors cause health problems. Scientific research itself in the field of social sciences and health sciences has proven that information does not reduce unhealthy behaviors (Kramer and Cameron, 1975; Salleras, 1985; Heaven, 1996; Sánchez-Vidal, 1998). The traditional medical model assumes that, depending on people’s appreciation for their health, knowing what can harm it will discourage them from carrying out certain behaviors. However, it is a proven fact that not all people give their health a high priority within their scale of values. There will be those who put other values ​​of more immediate verification before health, such as fun, group acceptance, image, and a taste for risk. This will also depend on the life cycle stage in which each individual is.…

Read More

The Legal Model

The legal model is not oriented toward a detailed analysis of drug addiction and much less of its causal factors. His interest, on the contrary, is to underline personal responsibility in the criminal act and the responsibility of coercive Intervention of the judicial system, which must respond through legal sanction to guarantee, as far as possible, public health and collective security. From this model, drugs are perceived as dangerous and capable –in certain circumstances and at the hands of certain people– of creating risky situations that endanger the physical integrity of individuals and collective health.

According to this model, all non-institutionalized drug-related activity becomes at least antisocial behavior, if not explicitly illegal. The individual involved will respond to the judicial system, which is prepared for this purpose, and will do so based on the seriousness of his offense and the consequences derived from it. The social context may play a modulating role in the crime or anti-regulatory act, mitigating or aggravating its consequences and responsibility. However, the legal model only affects the detailed analysis of the interactions and influences between the person and the drug or between the person, the drug, and the environment.

The Model Of Social Deprivation

The transgressive social meaning and the anxiolytic and liberating psychoactive experience of bodily and psychological gratifications can explain the drug-deprivation relationship.

The living conditions of individuals involve economic, labor, and material aspects, as well as value priorities, group norms, and relational properties of the environment. But they also involve the opportunities to obtain gratification in social life and the possibility of satisfying basic rights. For all these reasons, opportunities are socially conditioned by the objective social structure (Cockerham, Abel, and Lüschen, 1993).

From this interpretative perspective, measures are proposed to reduce or eliminate environmental factors that may favor the abusive consumption of substances or drug addiction. This would imply the reduction of social and economic tensions, the conditions that cause frustration and lack of opportunities for individuals and groups, and the promotion of conditions that facilitate equality and social well-being for all social sectors.

This model reduces the problem of drugs to an essentially economic causality, and the same economic perspective restricts it to a poverty-drug relationship while stigmatizing the most depressed classes as drug users (Ramírez, 1991). On the contrary, it has been verified in Spain that the consumption of substances does not have a higher incidence in neighboring communities with more economic problems (Pons, Pinazo and Carreras, 2002), as well as that among adolescents, the consumption of alcoholic beverages increases in groups with a high purchasing power (Pons and Berjano, 1999). Using Mexican samples of the urban population, it has recently been found that alcohol consumption and extra-medical consumption of anxiolytic drugs are lower in people with a low socio-educational level.

The Health Education Model

From this perspective, drug use is seen as a problem that affects people’s physical, mental, and relational health, and that can be reduced through educational procedures. Green (1984) explains that health education is the discipline responsible for transmitting knowledge about specific behaviors that pose a health risk and about others that, on the contrary, promote and protect health.

This approach coincides with the traditional medical model in the trust placed on transmitting information to society to reduce the incidence of substance use. However, it emphasizes the educational and communicative aspects of this information transmission process and does not propose a simple disclosure of information. It is also a more interventional approach than descriptive or conceptualizing and more oriented towards comprehensive health than pathology.

Educational And Informational Interventions Are Directed At Four Areas:

  • The educational environment itself. In educational centers for children and adolescents, the teachers are responsible for educating students about health protection.
  • The media field. It refers to campaigns in the mass media aimed at highlighting the risks associated with substance use.
  • The community sphere. It includes actions in social and community services, information points, and programs with street workers or youth centers, among others.
  • The health field. Health centers’ responsibility for transmitting knowledge on this subject corresponds to the doctor.

As noted above, special interest is placed in the persuasive capacity of the educational or communicative message, in the communicative and pedagogical methodology used, and, in general, in the quality of the information transmission process aimed at modifying people’s behavioral intentions.…

Read More

Brief Intervention For Adolescents Abusing Alcohol 

The effectiveness of alcohol interventions is measured by reducing the use of alcohol with risk patterns in individuals with low levels of dependence ( Ayala et al., 1998 ). The PIBA has been empirically shown to be cost-efficient through the implementation of randomized clinical trials in adolescents with legal and illegal drug use problems, in urban and rural populations of our country and for periods longer than six months ( Martínez, 2003; Martínez et al . al., 2008 )

Among the limitations of this study, the sample was not randomized, and the results obtained were not contrasted with a control group. Future research is proposed to investigate variables such as adherence to treatment, new technological modalities of brief Intervention, and effective components in brief interventions.

Although not all adolescents managed to complete the brief Intervention, many of them managed to maintain positive results, probably because they all participated in the following stages of the PIBA: admission, evaluation, induction, and the first session of the intervention phase, decisional balance. The decisional balance seeks to consider the pros and cons of substance use; it can reduce ambivalence and lead young people to reduce or stop using substances. Given the above, it would be plausible to think that the pre-treatment phases, added to a PIBA treatment session, help young people decide to change without completing the entire program.

Procedure

The PIBA Is Designed To Be Applied In Four Stages:

  • Admission, in which it is determined whether adolescents are candidates to receive the Intervention.
  • The evaluation, with which an assessment of the history of consumption and its pattern in the last six months is made; It also serves to identify the main risk situations that lead the user to consume, as well as their level of perceived self-efficacy and their idea of ​​the severity of consumption.
  • Induction to treatment, with which the adolescent is motivated to change their consumption behavior to remain and adhere to the treatment; Motivational interviewing techniques are used at this stage.
  • The Intervention is divided into several sessions. First, a balance is made between the advantages and disadvantages of consuming psychoactive substances, the reasons the participant has to change are listed, and a treatment goal is established. In the second, risk situations are identified, and strategies for change or action plans are developed with the participant. In the third, the goals the participant wants to achieve in the short and long term are identified, and how consumption influences them is analyzed. In the fourth, the participant is given feedback on the changes achieved, a second consumption goal is established, and it is planned how it will be maintained once the treatment is finished. These sessions are held once a week in an individual format and the follow-ups

Users who came to CPAHAV for the first time underwent an initial assessment; Those who met the PIBA entry requirements began the Intervention. Those who were not candidates were channeled to other institutions.

With those adolescents who were included in the PIBA between 2010 and 2014, a follow-up and an interview with collateral were carried out. In total, 60 complete follow-ups were carried out on adolescents together with their respective collateral; five were done in person and 55 over the phone.

Thirty adolescents completed the brief Intervention and were discharged; the other 30 failed to complete the Intervention but completed the initial assessment and attended at least the first session (decisional balance and goal setting). Once the users attended their scheduled appointment or agreed to conduct the follow-up interview, they signed the informed consent, which they read over the telephone. Each participant was informed that the follow-up data is confidential and would be used for research purposes; They were also told that the purpose of follow-up is to support users in the change process after treatment.…

Read More

Family Intervention

Health as an individual and social category is the product of promotion, prevention, recovery, and rehabilitation strategies and actions carried out by individuals, families, social groups, and society to maintain and develop integrity.

In communities and social groups, various health problems can be the object of Intervention and susceptible to modification due to their seriousness and importance. The Intervention is a set of actions to modify a certain reality and achieve the desired objectives.

Interventions in the field of psychology can be classified according to the type of objective or goal, the intervention unit or addressee, and the method used. Thus we can refer to psychosocial Intervention, whose objectives are to seek to change social systems to promote community or social well-being, and psychological Intervention, whose objectives are to provide changes in people (individuals, couples, and families] to help in the solution of various psychological problems using different procedures that provide personal and group improvement.

One of the fundamental groups to intervene is the family, given its importance in developing the personality of its members.

The family has the task of developing certain functions, such as biological, economic, and educational, in forming its members, contributing to the formation of values, the socialization of its members, education, reproduction, and the satisfaction of economic needs, among others. It also has the task of preparing individuals to face changes produced both from the outside and the inside, which can lead to structural and functional modifications.

These changes or crises may be related to the transition from the stages of the life cycle, which are derived from the confrontation with life events, and crises that derive from the occurrence of accidental events and usually have a very unfavorable impact on family dynamics. In most of these cases, the family requires psychological care.

Faced with these situations, some families assume adjusted coping styles and are capable of using stabilizing mechanisms that provide health, and others cannot face crises, lose control, manifest imbalances, imbalances, and violence that unfavorably conditions the health-disease process and, in especially family functioning.

Family functioning is considered the interactive and systemic dynamic among family members and is evaluated through harmony, cohesion, communication role, affection, permeability, and adaptability.

Family dysfunction may be at the root of health problems, and health problems may contribute to or exacerbate inadequate family functioning.

The considerations mentioned earlier make us reflect on the importance of planning psychological intervention strategies to promote adequate family functioning, so in this study, we propose the following objectives.

…

Read More