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This article explores the connection between substance use, behavior, and community. It delves into the impact of substance use disorders, the correlation between psychoactive substances and violence, and the prevalence of amphetamine use in New Zealand. It also discusses the adverse outcomes of uncontrolled use and the importance of brief interventions and helplines in addressing substance abuse.
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Substance use, behaviour, and community Blair Bishop September 2018 Nurse Practitioner Candidate CCDHB
Tūtiramaingā iwi • If more of us showed compassion then there would be less people to worry about. • With less people to worry about then more of us could show compassion
Better or Worse? A Subjective Clarification IMHO I am here for primarily three reasons • To have fun • To ‘make better’ for those around me • Dealing with the hard stuff is part of aroha
Risk, security, and de-escalation CCDHB patient and visitor behaviour charter
Substance use disorder A substance use disorder is primarily a disorder of behaviour whereby an individual continues to use a substance despite that individuals best efforts to not use
Location, location, location Alcohol More personal injurys related to alcohol than any other drug
Location, location, location Alcohol More physical assaults related to alcohol than any other drug
Location, location, location Alcohol More sexual assaults related to alcohol than any other drug
Psychoactive substances and violence Toxicology studies indicate that both the perpetrators of, and victims of murder have significantly higher levels of psychoactive substances in their systems than found in the general population Alcohol is both the most common psychoactive substance in these toxicology studies and its availability is evidenced to directly correlate to the availability of crack-cocaine, in that as markets for alcohol increase so does the availability of crack-cocaine in that geographical area
Amphetamine Use 2015/16:New Zealand Health Survey In the past year, 1 percent of adults used amphetamines In 2015/16, 1.1 percent of adults (95% confidence interval, CI: 0.9–1.5) used amphetamines in the past year. This equates to about 34,000 New Zealanders.
Amphetamine Use 2015/16:New Zealand Health Survey Amphetamine use has been stable since 2011/12 There was no difference between the 2015/16 past-year prevalence of amphetamine use (1.1%;0.9–1.5) and that of the previous year (2014/15 = 0.9%; 0.7–1.1). In fact, no significant difference in prevalence of amphetamine use has been found since 2011/12.
Amphetamine Use 2015/16:New Zealand Health Survey Young men aged 24-35 and Māori adults aged 24-35 were significantly more likely to use methamphetamine than other groups
Why does the coal-face feel the problem is growing? Are our most vulnerable users using more? The only correlation noted internationally is that if you deal crack-cocaine you are significantly more likely to use Vulnerable populations also attend hospital more frequently
Methamphetamine primarily stimulates the release of dopamine Dopamine critically mediates motivation not pleasure When dopamine is released naturally it reinforces our motivation to eat, create, and have sex. Psychostimulants exert their effects by increasing dopamine levels in the brain
Intoxication: Man why did I do that?! Dopamine plays a role in executive function, and psychostimulant use impacts on memory, attention, decision making, interactional behaviours, and problem-solving tasks. Johnny, why on Earth did you do that? You’ve turned into a forgetful, innattentive, short-fused, and reactive d***head?
Adverse outcomes of uncontrolled use: • Loss of employment • Debt • Increased exposure to/or participation in criminal or harmful behaviours • Social dislocation • Poor self cares • Marked physical deterioration
If treatment is about behavioural modification, then our response to intoxication is about addressing the behaviours’ ‘in the moment’. Brief intervention Your boundaried response to inappropriate, threatening, or aggressive behaviour is a brief intervention.
Helplines Get help now • Confidential helplines provides free support for any person concerned about their own or someone else’s drug use. • Helplines available 10am-10pm, 7 days a week, free from landline or mobile. Alcohol Drug Helpline • 0800 787 797 • www.alcoholdrughelp.org.nz Pasifika Helpline • 0800 787 799 Whaka-tu-tangata Helpline • 0800 787 798