Causes and Correlates of Adolescent Drug

Experimentation with illicit drugs and substance use is common among youth population. This is the most common reason for early onset of drugs which exposes youth to developmental harm and risk of developing mental health problems. Early onset of drug is also associated with depression, anxiety, psychosis and educational under achievement among youth population. Due to such harm and health risk to youth population, it is necessary to evaluate how far policies and programs implemented for preventing early drug onset among youths have mitigated different   risk factors of drug abuse (Modesto-Lowe et al. 2008). The essay particularly evaluates the effectives of this program and preventive strategies to identify strength and weakness in approach. Based on this evaluation, it recommends possible steps to improve current strategies to delay the onset of drugs. As there is emphasis on early intervention to reduce the cost and harm associated with early drug onset among youths, it is necessary to evaluate education programs implemented for youths in Australia. The review of such school based educational programs for preventing alcohol and other drugs revealed that the school-based program has harm minimization goal and it mainly employed the principle of social influence approach or cognitive behaviour therapy (CBT). By this approach, youth were taught to resist external pressure and strengthen their coping skills. CBT helped to analyse and modify the negative thinking pattern and behavior of school children. The CLIMATE program for alcohol and cannabis and other programs like SHAHRP, Life Education, Greenhouse project and Resilient Family Intervention gave mixed results. While CLIMATE, SHAHRP and greenhouse projects have significant effect in reducing risk, the other two programs gave no significant results. The main strength of these inter ventions was that the program was implemented by means of a computer-delivery method. This minimized the cost involved in recruiting and training the staffs for education and guaranteed flexible and consistent delivery of information. However, minimum efficacy was found for those schools which had minimum resource for internet based delivery of prevention and where teachers failed to adapt the program according to the needs of particular school (Teesson et al. 2012). Hence, in the future, it is necessary that resource of the school is developed to deliver internet-based educational program to promote efficacy. The key teachings of the educational program should also be supported by evidence (Bonomo and Bowes 2001). As the above evaluation suggested lack of resource regarding computer based program behind the reason for poor outcome of the program, this section particularly evaluates the effectiveness of the universal computer-based Climate School psycho-stimulants and cannabis module. In the randomized controlled study with secondary school children in Australia, students were randomized to computer-based Climate schools program and the usual health classes group. The Climate program was based on social influence approach to harm minimisation. The impact of the Climate Schools program on school children was that they decreased pro-drug attitude due to better awareness about the ill-effects of cannabis and psychostimulants. The frequency of experimentation use of drugs among children significantly reduced which resulted in subdued uptake. In comparison with children who received usual drug education, climate school group children had better used cannabis less often. The advantaged of computer-ba sed delivery was that use of cartoon story raised interest among children and they could recall the information very well. However, one limitation of the Climate School program is that although it reduced children’s intention to use meth/amphetamine among youths, it could not sustain these intention for longer time (Vogl et al. 2014). Hence, to sustain the long-term knowledge and preventive behavior related to early drug onset, it is necessary to continue ongoing intervention in a sequential and regular pattern. The feasibility of the program can be further increased by encouraging children to bring their own laptop to schools. Among all the alcohol education programs implemented in schools, the Climate Schools, All Stars and Project ALERT   was most effective in yielding positive results for children. Many other programs lacked efficacy because of poor quality of research and inconsistency in approach. The programs which gave evidence of good effect included revealed use of multiple peer-reviewed publications as the reason for good outcome in such programs (Roche et al. 2014). Similarly, the study regarding primary school drug education in UK indicated that impact cannot be measure as understanding of true effects requires long timescale. Therefore, the study suggested that those programs are successful that are long-term and intensive on their goals and employ interacting teaching styles and wider community to mitigate the early drug use (Lloyd et al. 2000). Hence, the review suggest that most effective alcohol education program is dependent on availability of effective resource such as managing accessi bility issues and training staffs in efficiently adapting the program in school setting. Furthermore, extension of supportive network is also essential to guarantee the success of the program such as collaboration with families and local community to bring a cultural change and reinforce preventive message not just in schools but at family and community level too. The National Drug Strategy (NDS) is one of the policies regarding the prevention of substance use, risk and harm in Australia. This was a supply reduction and harm reduction strategy to disrupt supply of illicit drugs, prevent uptake of harmful drugs and reduce drug related to harm to people. The National Drug Strategic Framework was implemented in Australia in 2004 which provided a balanced approach to reducing the supply and demand of drugs. Apart from training, monitoring and evaluation, the policy also focussed on research and other measures to prevent the harm associated with drug use (National Drug Strategy - National Drug Strategic Framework 2017). The goal of the national policy was to set an evidence based prevention agenda by means of strategic mapping of system and pathways that are interconnected with risk factors and outcome.   The strategy was effective as it dependent on extensive review of scientific literature to implement corrective actions for the community. Exte nsive research was done in all areas related to efficacy of different risk and protection model, cost-effectiveness of alcohol and drug interventions, legal status of drugs, patterns of use in early years and impact on individual and families (Butler 2005). There is strong implication of the efficacy of this policy. The developments and actions mentioned in this policy can guide public level action reducing the harm of drug use among youths. In future, there is a need to invest in early childhood development and maximize human potential to take full advantage of the protection and risk reduction approach to prevention of drugs. Cannabis is one of the drugs highly used by adolescent children and young adults. They intermittently use this drug till the age of 20 for experimentation purpose and very few of them proceed to long-term regular use. Considering the high prevalence of lifetime use among females in between 1995 to 2000, a vigorous campaign was launched to take action against this practice. To distinguish harm reduction as a policy goal, the main criteria was to include harm reduction as a primary goal and to plan strategies that can bring net-reduction in drug-related harm. Some of the issues found in the strategy of harm reduction is that lack of longitudinal research on adverse health effects delayed making causal inferences. Secondly, the irrational policy and drug law reform acted as an obstacle in evaluation of action for explicit harm reduction. This issue is widely found in raising awareness regarding harm reduction for cannabis. The most probable chronic harm of regular use include cannabis d ependence syndrome, cognitive impairment, respiratory distress and the harm related to acute use include psychological impact such as dysphoria, panic attacks and paranoia. As adolescents particularly belong to high-risk group for adverse effect of cannabis, there is a need to consider legal harm of preventive cannabis use among youths (Swift et al. 2000). There is a need to develop a balance between harm reduction approach and acceptable public message so that other issues are not exacerbated. A realistic and flexible approach will help to yield positive results. Recent research findings should also be included in the strategy to reduce the harm related to enhance health and well-being of society. There is great argument regarding the implementation of the harm reduction approach into an adolescent context. This debate exists due to the views on zero tolerance and legalization of certain drugs. Zero tolerance approach is also not ethically correct because abrupt ban or disruption may also harm addicted individual or youths. Zero tolerance promotes complete prohibition of any form of drug use. On the other hand, legalization and decriminalization of drugs involves removing criminal sanction for possession and sale of drugs. Many oppose these two steps as by this means drug use will further increase among youths (Bonomo and Bowes 2001). Harm reduction approach can balance these two extreme issues by means of implementing two forms of strategies. The first may focus on reducing harms among drug users and other may focus on those vulnerable to initiating drug use. For example, educational campaigns related to safely injecting drugs can reduce blood borne infection and educational strategies on social context can educate young children about the risk of this drugs in their development stage. This would be a rational and relevant approach to achieve better response and prevent drug-related harm. The review and evaluation of current program and strategies to delay the age of drug onset presents weakness in approach resulting in poor response or wide issues at public level. Although some programs were found to be highly effective in integrating right resource to reduce the use of drugs, other programs failed due to lack of adequate infrastructure and training in staff regarding implementing the program. This problem was mainly seen in educational program implemented at school level. For instance, Climate school program was highly efficacious in reducing drug related in harm in school children, however poor outcome was seen due to limitations in infrastructure and design of the program. To improve the performance of school-based educational program in reducing risk of drug use, there is a need to specifically target high-risk group adolescents. The advantage of focusing on high-risk group is that it will maximize preventive outcome for high-risk students as well as lead to positive health behaviour in other youths (Teesson et al. 2012). Secondly limitation found from the evaluation of approach was that educational programs and modules were prepared without integration of peer-reviewed intervention strategies to prevent drug use. This resulted in poor quality of prevention programs resulting in poor or moderate outcome. Hence, extensive research is required while preparing educational modules so that evidence based public intervention is delivered and the program has the potential to improve health behaviour in long-term too (Jenson and Fraser 2015). Improvement in primary prevention strategies for drug prevention is also necessary so and it should be based on theoretical foundation for prevention. For example, while designing educational programs, social determinants, risk and protective factors of health should be adequately covered (Munro and Ramsden, 2017). There are various public health system model available and selecting of these models should depend on the setting, context and severity of drug use issue in target group. Community based approach is necessary so that not just youths, but teachers, parents and local community groups are involved in curbing the menace of high drug use among children. To promote success of intervention, infrastructure and program should be tailored to the needs of the local community and keys actions should be consistent with overall program objectives (Spooner 2009). The essay focused on the public health issue of high prevalence and early onset of drug use among youths. Youths engage in this practice to experiment or gain the ecstasy of drugs. As many of them shift to lifetime consumption of drugs, it leads to many health related consequences such as drug dependency, psychological problem and paranoia. Hence, the evaluation of current educational program and policies was necessary to analyse the extent to which they are effective in delaying in early onset of drugs. This evaluation helped in the identification of limitations in the approach and proposed possible recommendation to yield better results and sustain them for long-term too. Bonomo, Y.A. and Bowes, G., 2001. Putting harm reduction into an adolescent context.  Journal of Paediatrics and Child Health,  37(1), pp.5-8. Butler, S., 2005. The prevention of substance use, risk and harm in Australia: a review of the evidence.  Drugs: education, prevention and policy,  12(3), pp.247-248. Jenson, J.M. and Fraser, M.W. eds., 2015.  Social policy for children and families: A risk and resilience perspective. Sage Publications. 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