Explaining public health model of Addiction and harm-reduction strategies

Active/Lethal Dose Ratio and Dependence Potent...

Active/Lethal Dose Ratio and Dependence Potential of Psychoactive Drugs. Data source is Gable, R. S. (2006). Acute toxicity of drugs versus regulatory status. In J. M. Fish (Ed.),Drugs and Society: U.S. Public Policy, pp.149-162, Lanham, MD: Rowman & Littlefield Publishers. This is simply a rescaled version of the file listed in “other versions”. (Photo credit: Wikipedia)

In Australia, the  Public Health Model  recognizes that  three variables – agent, host and environment, must be included in any theory of drug use. It is equally important to understand the interplay of these variables and the effect of the subjective experience for drug users when considering Alcohol and Drug Policy.  It is necessary to understand in every case how the specific characteristics of the drug and the personality of the user interact and are modified by the social setting and its controls in order to maximize treatment success.   Progress has been achieved in implementing public health approaches although a significant paradigm shift has been necessary in order to frame substance abuse as a complex health issue. Current prevention programs and health promotion strategies have been positively based on the understanding that problematic substance use is not solely an outcome of illicit drugs but the result of many social, psychological and physical variables that require equally complex approaches.

So here is a break-down of  The public health model of Addiction and the associated harm-reduction strategies. This model attempt to reduce the impacts of drug-related harm on individuals and communities by identifying all potentials in the drug use dynamic and the aspect of subjective experience is recognized as an important factor.   From a public health perspective, the three factors involved in addiction are identified as agents – the psychoactive drugs, hosts – the individual, and  environment – the availability and accessibility and use of the agent.  A public health model in relation to drugs and alcohol aims to reduce harmful use of substances, minimize negative health effects to the individual, and limit secondary drug-related harms to society.  This moves illicit drug use in particular from being a criminal issue to a health issue and afford greater opportunities for education and treatment interventions.  All of these three factors have an impact on the subjective, or personal, experience of the user.  Individuals have different biochemical reactions to psychoactive drugs.  Some of these reactions create resistance to drug related damage while others have biochemical reactions that make them more sensitive to damage and hence more vulnerable. To complicate these reactions further the individual also reacts to external factors experienced within the environment.  The exposure to psychoactive drugs is a catalyst for the development of problems in a susceptible host and these environmental factors increase or decrease the results of exposure or reaction to the toxic agents.  Both the positive and negative aspects of an individual can affect their substance use and the consequences affect their general health and nutrition, reactions to other substances used by the person, increase or decrease in levels of support and the persons expectations.  Some aspects of the substance that can affect the use and consequences of substance use can include the type of substance or substances used, pharmacological properties, social influences around the individual, immediate and longer term effects and even the strength and purity of the substances being used.  There are also many interplaying environmental aspects that can affect the consequences of substance use such as the mood of the occasion, the physical environment, expectations of the group as well as the individual, the social climate and location or the presence or absence of others.

The more a culture reinforces the use of drugs the greater the likelihood of  exposure  and with  individuals differing in these genetic, physiological, behavioral, and socio-cultural susceptibilities to various forms of chemicals psychoactive drugs and certain activities will correlate highly with shifting subjective states. These activities reliably influence and change the individual’s emotional experiences and the subjective affects of alcohol and psychoactive drugs affecting mood, behaviour and cognition are significantly influenced by the number of thee interacting factors such as mood and external environment.

The causes of addiction are multi-factorial and addiction is the description of a relationship between host and agent within  the environment.                                 Specific personality characteristics and participants previous drug experiences have also been found to have significant effects on subjective psychological responses. The personality trait of openness to internal experiences in particular was significantly related to a wide variety of drug responses and a history of drug use also appeared to intensify some of the subjective effects of drugs.  As you can see the subject of substance abuse and addiction generally is an extremely complex interplay and one that needs the attention of researchers and practitioners who hold degrees in psychology, counselling and addiction.  As always, take care of your recovery.  Cheers, Aly

Aly Birmingham Geats  BA Psych, Cert AOD (Dist).



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Posted in Alcohol and drugs Australia

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