NSTP Common Module Topic 8: Drug Education |

Francis Grace Duka-Pante

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Hi NSTT students, I'm so happy to be sharing with you the basics of drug education. I am
Professor Francis Grace H. Luca-Pande from the UP College of Education, Health Education
Area, and I'm also serving as a Director of the Ashland Training Center for Preventive Drug
Education. For today, I'm going to share with you the basics or the essentials of drug
education, but before we do that, I would like to do a feelings check.

So as you can see from this slide, I have the animal moods. So A stands for sadness, okay B is
for happiness, and C is for being grumpy. And I know that many of you can relate with this
emotion.

And well, the point of this slide is to make you realize that whatever you are feeling right
now, you're in the midst of a pandemic, whatever you're feeling is exactly normal and value.
So I guess we're now ready to start. So we are going to cover four sub topics for this
presentation.

We're going to start with drug-related terms and concepts. Next, we're going to move on to
the effects of drug use, then the legal aspect of drug use, and lastly, which is the most
important part of the presentation, is the skills for a drug-free lifestyle. So the objectives of
this presentation include to discuss basic terms and concepts related to drug use, a second
is to describe the general effects of drug use and its legal implications, and a third is to
recommend ways to develop life skills for a healthy and drug-free life.

So first, we're going to review some important concepts. Let us differentiate drugs from
medicine. So a drug is any chemical agent that alters the biochemical or physiological
processes of patients of organ missus.

So it means that when you ingest drugs, it alters the function or the structure of any part of
your body. If it's a psychoactive substance, it alters the function and structure of your brain.
While medicine is actually a kind of drug with curative properties.

So you need to remember that medicines are drugs, but not all drugs are medicines. So I
hope you understand that clearly. So now let's proceed to the difference between medicine
misuse and abuse.

So when we say misuse, this is the use of a medicine for a purpose that is not consistent
with medical guidelines, so you don't follow the doctor's prescription. So for instance, when
you take too much of a medicine, when you take it for reasons other than the reason they
were prescribed for, or when you stop a medication, or you accept a prescription
medication from a friend, those are examples of medicine misuse. While for medicine
abuse, you're using a particular medicine to feel high or because you'd like to experience
the euphoric feeling.
So you take those medicines, okay, because there is a compulsion for you to use it despite
negative consequences. So when you do that, you're experiencing medical or medicine
abuse. Now I'm going to introduce to you a general term and it's called substance use.

It's actually the use of psychoactive substances that includes tobacco, alcohol, of course the
illegal drugs of abuse like marijuana and shampoo, inhalants, and other non-medical use of
prescription medication. So you need to remember that in the global context now,
substance use is the term being used to describe the use of tobacco, alcohol, illegal drugs of
abuse, inhalants, and other non-medical use of prescription medications. What is substance
use disorder? Well, this is a chronic relapsing brain disease that is characterized by
compulsive substance seeking and use despite harmful consequences.

So now instead of using the term drug abuse or substance abuse, we use the term
substance use disorder. Well, we will now proceed to an activity called knowledge check.
Okay, so I'm going to ask you to get a piece of paper and then write your answers to these
statements whether they are true or false.

So you just need to write the word true and false. So number one is all drugs are bad. Is this
a true or a false statement? Second, legal drugs are generally safe.

Third, drug users are not morally weak. And lastly, majority of people are non-users. Okay,
so I'm going to give you 10 seconds to write your answers.

10, 9, 8, 7, 6, 5, 4, 3, 2, 1, time is up. Okay, so now let's check your answers. Is the first
statement a true or a false statement? All drugs are bad.

This is actually a false statement. You are correct. Because we said that medicines are
actually drugs or curative properties.

So this is a false statement. The second one, legal drugs are generally safe. This is another
false statement, because we all know that tobacco and alcohol are legal drugs, but they
have dangerous effects on the body.

So they are unsafe for use. Number three, drug users are not morally weak. Is this a true or
a false statement? This is a true statement.

Okay, they are not morally weak. You need to remember that behavior is a very complex
thing. And explaining drug use is actually complicated because it is multifactorial.

So we are going to talk about that later on. And then the last one, majority of people are
non-users. This is definitely a true statement.

So congratulations if you were able to get all four items correctly. So again, one and two are
both false statements, T and four are true statements. So give yourself a pat on the back if
you were able to get four out of four.

Now I'm going to share with you a model, and it's called the risk and protective factors for
substance use or drug use. And it's going to be quite surprising for many of you. Because
when I've learned about this, I was surprised myself.
Yeah, the first one is that, by the way, before I start with this factors, I would like to make
you realize that risk factors are factors that increase your susceptibility or vulnerability to
drug use. So the number, the first one is genetic predisposition. So it's really a surprise that
about 40 to 60% of substance, vulnerability to substance use is actually genetic, genetically,
so there is a genetic predisposition.

The second one is that there are certain personality traits that increase our vulnerability. So
this includes risk taking, sensation seeking and impulsive behavior. And the last one is that
when you have overall health conditions, okay, so if you have co-existing health issues, like if
you have mental health issues, then that predispose you to risk to substance use and other
unhealthy behaviors.

So in general, these are the risk factors. But if we're going to look at risk factors in the school
setting, it includes school failure. So if you are academically having problems, okay, if you
have low commitment to school, so you have very low motivation, especially now that we're
going to do remote learning.

So if you have difficulty of committing to school work, then that is actually a risk factor. So
for those who are socialized or those who are being rejected, there's rejection by peers,
there's association with deviant and substance using peers. In general, these are risk factors
in the school setting.

Now let's move on to the protecting factors. These are the factors that decrease your
susceptibility or vulnerability to substance use. So the first one is very important.

If you're self-controlled, if you have this behavior regulation and you're academically
competent, so I guess because you're in UP, you have this protective factor, so
congratulations. And then if you have a school-based drug education, in UP, we have
actually courses that deals with drug education. So for instance, in the College of Education,
we have EDH 130 for undergraduate students.

It's consumer health education and drug education. We also have that in the graduate level.
It's called EDH 209, drug education.

And I'm so happy that the NSTP is integrating this in the curriculum because it's really very
important for us to know the skills, the competencies that we need so that we'll be able to
live a healthy and a drug-free lifestyle. Another protective factor is strong neighborhood
attachments and of course parental influence. If your parents are loving, you have a very
supportive home environment, that's a very good protecting factor.

And then if you have a rich environment and at home and school, there is enforcement of
limits from discipline with you, they monitor, okay, the adults monitor your activities. That is
an important protective factor. Let's look at the global context of substance use or drug use.

So currently, this is actually the latest data from the United Nations Office on Drugs and
Crime. This is the World Drug Report 2020, okay. They just released this last June 26 and it
says that in 2018, there were actually 269 million drug users.
And this is 5.3 percent of the global population. I'd like you to remember that 5.3 percent.
Why? Because I'd like to emphasize that majority of people are non-users.

Majority of young people like you are non-users. Why is this important? Because there is a
notion that among young people that they tend to smoke or drink alcohol or worse use
illegal drugs because they have this misconception that most or majority are using
substances. When in fact, it's not true.

Okay, so remember that majority are non-users. So according to the DSM-5, this is the
diagnostic and statistical manual of mental disorders fifth edition. Okay, this was actually
published by the American Psychiatric Association.

We no longer use the term drug addiction or dependence, but rather it refers to
problematic use of drugs as substance use disorder or as a substance-induced disorder. So
again, let me remind you that we are no longer using the term drug addiction. So please do
not refer to a person who is using drugs or substances as a drug addict because that is
actually demoralizing.

Okay, it's stigmatizing. So instead, we refer to a person with a problematic use of drugs as a
person with substance use disorder. So how do we know? Okay, you also need to remember
that the term being uses substance use and not substance abuse.

So substance use is a neutral term because we need to look at substance use as a continued
use, so from mild to severe. And so according to the DSM-5, there are 11 criteria that we
need to watch out for so that we will be able to assess whether the person has mild,
moderate, or severe case. So how do we know? So let's look at the 11 criteria for substance
use disorder.

Number one is hazardous use. The second is social or interpersonal problems related to use
on the name. You have problems dealing with maybe your friends, your family members,
and you are not neglecting your major role.

So you can no longer study if you're working. You tend to actually do things other than
working. So you actually experience withdrawal.

So withdrawal are the unpleasant symptoms that you feel whenever you stop using the drug
or the psychoactive substance. You also experience tolerance. Tolerance is the need to
increase the dosage of the drug so that you will be able to experience the same effect.

Okay, number six is use larger amounts for a longer duration. Seven, repeat attempts to
with or control use and then as much time is spent using. The person experiences physical
or psychological problems related to use, and there are activities being given up to use the
substance.

And lastly, there is craving. So based on this 11 criteria, if the person exhibits two to three,
then the person is considered a person with mild substance use disorder. If you have four to
five criteria, then you are a moderate case.
Six or more, then you are a severe case that necessitates treatment and rehabilitation. So
now let's proceed to the general health consequences of substance use. So, well, this can be
cut back or rising to two.

So we have the short term and the long term in general, when you take substances,
especially illegal drugs, then it depends actually if it's a stimulant, a depressant or a
psychedelic. But generally in the short term, you will experience changes in appetite,
wakefulness or drowsiness. There is also a change in respiratory and heart rate.

So if you took a stimulant, for example, then it will increase your respiration and your heart
rate. There would be change in mood. So if you, for instance, took a stimulant, then you will
be an energetic, you will be happy.

And then if it's a depressant, there will be a slow reaction time or reflexes. There would be
nausea and vomiting. And for psychedelics, people may experience hallucination.

And then for depressants, they will experience decreased motor coagulation. So in the long
term, many of these psychoactive substances can produce adverse effects. So negative
consequences on our health.

So this includes having heart or lung disease, cancer, different kinds of cancer, mental
issues, HIV and AIDS, especially for those who inject psychoactive substances, hepatitis,
okay, and then there could be physical or psychological dependence, memory loss or brain
damage and malnutrition. So generally in the long term, the use of psychoactive substances
can lead to substances. So it depends on a lot of factors, but you need to remember that
factors can include the type of substance being used, the duration, and the frequency of
use.

Again, in general, let's look at the cost of substance use. So for the person using the
psychoactive substance, he or she can be predisposed to accidents, different diseases, then
mental issues, depression, and the worst is death. For interpersonal, for the interpersonal
aspect, okay, so relationships can be damaged.

There can be marital conflict for couples, okay, for married people. There can be disruption
in friendships and possible child abuse. So if the parents are using substances, there is a high
probability that there would be violent behavior, okay.

For social functioning, this includes dangerous behavior, okay, especially for those who are
actually using psychoactive substances, and then they can commit crimes, okay. There might
be financial problem, employment difficulty, and legal problems. So now at this point, I'd
like you to do an alertness check.

So very easy. You just need to follow the instruction as shown in the slide. You just need to
grab your left ear with your right hand, okay, left ear with your right hand, and now grab
your nose with your left hand, then you reverse, okay.

So now it's time to grab your right ear with your left hand, and now grab your nose with
your right hand. So you can do this alternately. I just would like to be sure that you are still
with me.
So very quickly, let us just review why are adolescents like you more vulnerable to risky
behavior? Why are you have higher susceptibility to risky behavior such as drug use? Well,
basically because your brain is still developing. So you need to remember that the brain
development starts from the back, or was the front, and the back part, okay, this is actually
in charge of emotional regulation, okay, and the prefrontal cortex is in charge of reasoning,
organizing, prioritizing information, control of impulses, the session making, and judgment.
And this is not fully mature until age 25.

This is the reason why usually you make the sessions because of your emotions, okay. So the
main responsibility of adults like us, okay, is to guide you in making right choices in life. So
what are the hands-risk periods among young people like you? So you need to remember
that during major transitions you are particularly vulnerable.

So this includes the transition from elementary to high school, junior to senior high school,
and of course from senior high school to college or work. So these particular transitions in
your life make you particularly vulnerable to mistaken behaviors. So better watch out when
you are transitioning.

Now we will proceed to implications of drug use. So we have a law, okay, this is the
Comprehensive Dangerous Drugs Act of 2002. It's Republic of 9165.

When you watch the news, and there is a news about a drug-related incident, you always
hear this law being cited, so RA 9160. So basically we're just going to look at a very
important provision in that law, and that is section 15, the use of dangerous drugs. So
according to the law, first offense, the penalty is minimum six-ment rehabilitation in a
government center, okay.

So and then if it's the second offense, there would be six years and one day to 12-year
imprisonment and a fine of 50,000 to 200,000. So you need to remember the legal
implication of using dangerous drugs. So dangerous drugs pertain to illegal drugs, such as
the use of marijuana and chamois.

Lastly, we are now going to proceed to the most important part of this presentation. This is
the skills for a substance-free life. So how are we going to safeguard our health and well-
being and ensure that we are living a drug-free life? There are three very important skills
that we need to enhance, especially among young people like you.

So the first one is assertiveness. The second is the session-making skill. Remember your
prefrontal cortex is still developing, so we need to re-enhance your decision-making skills.

And the last very important life skill is on resistance or refusal skills. So how to say no, how
to refuse an offer of a psychoactive substance. So let's start off with the assertiveness skill.

So I have here the OFNR script. So this is an acronym that stands for observation, feelings,
need, and request. So as you can see from this slide, there are several steps to assertive
action.
The first one is to state your observation. So the script here is that, of course, you need to
describe the situation. So for instance, you can tell a friend when you offered me a stick of
cigarette, tell the person how it made you feel without blaming me.

I was actually disappointed because I thought that you were my friend. And then after that,
express your need. So in that situation, I need to know that you value my health.

And lastly, you need to state your request. So please offer a healthy alternative. So that's it.

And this is very much applicable to different areas of our life. So whenever you are faced
with a situation that compromises your health, you can make use of the OFNR script. So this
is the steps to assertive action and the script that you can use to be assertive.

It is actually many of us, many Philippines have difficulty being assertive. So it's very easy for
us to be passive if we just don't do anything, or the opposite is that we become aggressive.
So the middle ground is really to be assertive.

When you are assertive, you respect the right of the other person. And at the same time,
you respect yourself. And now let's proceed to the decision making skill.

And I'm going to make use of the side model. Again, just like the OFNR acronym, we have an
acronym. Now it's the side model.

So the acronym here is the side. So it's very easy to remember. So the side here stands for D
is to determine the problem or the issue.

So what is the issue at hand? Is it am I going to drink alcohol? And then you explore the
alternatives. There you have two options, right? And then letter C is to consider the
consequences. If you drink alcohol, what's going to happen? If you don't drink, what's going
to happen? And then I used to identify your values.

What is the most important thing for you? Is it to satisfy your need for belongingness for
your friends? Is it your value about health and wellness? Can you value your parents'
advice? What is it that is most important to you? And then after weighing all of these things
and identifying your values, now it's time to decide. And don't forget the last step. This is
very important to evaluate your decision.

Were you able to come up with the right decision? If not, then there is a great lesson
learned, right? So the basic rule really is to stay away from situations where you can be
thankful. So stay away from situations. So for instance, if it's very hard for you to say no,
okay, don't go to parties, okay? Don't go to social activities or you know that there will be
alcohol.

So stay away from situations where you can beat them. This is the general rule for the
refusal or the resistance case. There are also other strategies that you can use to say no.

These are strategies that you can try, okay? So maybe you can try this out with a partner.
Maybe you're self-made right now. You can choose any of the strategies to use.
So imagine that one of you is offering a bottle of alcohol to another and the other person,
your partner needs to say no. So which of the following are you going to use? The first one is
very simple. You just need to maintain eye contact, eye contact, and say no feeling.

So eye contact, you just say no, okay? The second one is you can match your verbal with
nonverbal signals in refusing the offer. So when you say no, you do this. You don't do this,
okay? So your verbal and nonverbal signals should be consistent, okay? Remember that
action speaks louder than words.

So better it should be consistent. And then you can use the broken regular technique. So
this one is you say no as many times as needed.

So when the other person keeps on offering, okay, this is just one state, no, okay? Don't
worry, this is going to be free, no. Oh, I'm not going to tell your parents no. So you say no as
many times as needed.

That's the broken regular technique. And then you can also use the cold shoulder approach.
Or you can give reasons or excuses.

I don't like to smoke because I have a long problem. So make up excuses and then give
helpful alternatives. So instead of drinking alcohol, why not drink water? Water is still the
healthiest drink, right? So this is the last part.

So helpful alternatives. Many young people say that they smoke, they drink alcohol, or
worse, they use illegal drugs because for them it's a lifestyle. And so we need to offer
helpful alternatives to drug use.

So what can you do? There are actually a lot of things that you can do instead of engaging in
substance use. So I have here several recommendations. These are just examples.

You can do spiritual activities. You can do something that will not ensure minds. You can do
volunteer work.

You can join organizations. Maybe they're available online, okay? Because now we are in a
new normal. So volunteer work.

And then I have here, this is actually a peer-based approach to substance use prevention.
This is a program of the Dangerous Drugs Board and the Department of Education. To
encourage young people to form clubs and develop their lives close together, so that they
will be able to live a healthy and drug-free lives.

By the way, the Yup'ik College of Education, through the health education area, made this
infographic class April, okay? So we came up with an alphabet guide. So these are the many
things that you can do to stay sane while we are in the midst of the pandemic. So feel free
to have a copy of this.

You can get this from the Yup'ik College of Education website. The Ashland Training Center
for Preventive Drug Education, based in the College of Education, also produced this
infographic, Healthy Lifestyle for the New Normal.
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