Category: Addiction

Introduction

Background

Substance use disorder is a severe chronic disease that adversely affects the lives, health, and well-being of individuals when neglected or unaddressed in a proper and timely manner. Alcohol use disorder is one of the most prevalent conditions affecting people of various ages and resulting in severe comorbidities related to physical and mental health. Indeed, multiple research studies recognize liver cirrhosis, hepatocarcinoma, depression, and other mental and physical impairments, as well as negative social consequences, are correlated and dependent on alcoholism (Jain et al.; Jones et al. 721-722).

Alcohol intake in excessive amounts or for continuous periods of time increases the “risk of high blood pressure, high triglycerides, increased abdominal girth, and elevated blood glucose” (Jain et al. par. 8). Moreover, excessive alcohol consumption is a frequent cause of death.

The statistics on alcohol use consequences in relation to health and mortality demonstrate that it is a significant issue both nationally and globally. Indeed, according to the data provided by the Centers for Disease Control and Prevention (CDC), “alcohol use contributes to approximately 88,000 deaths annually in the United States” (Tawa et al. 507). Furthermore, on an annual global scale, more than one million individuals aged 15 and older have been diagnosed with alcohol addiction (Zaso et al. 216).

Such a high level of identified cases of alcohol use disorders is reflected by the statistical data on worldwide mortality rates induced by uncontrolled drinking. Indeed, as stated by Zaso et al., “139 million disability-adjusted life years and 3.3 million global deaths were attributed to alcohol in 2012” (2016). Such a high level of severe consequences of this disorder encourages scholars, health care professionals, and counselors work collaboratively to find answers to the questions and solutions to the problems of alcoholism.

As a clinical diagnosis, alcohol addiction is a well-documented condition that is characterized by particular characteristics. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition contains “11 criteria pertaining to excessive alcohol use, alcohol abuse, and alcohol dependence” (Tawa et al. 507). These criteria include but are not limited to continuous drinking and inability to stop in spite of health complications or mental health impairments. Given the clinical diagnoses, the wide-spread nature of the problem, and the severe consequences impacting the life and health of millions of people, the in-depth investigation of the causes of the disorder is of critical importance.

The topic of the hereditary nature of alcohol abuse has long been at the center of scholarly debate in biology. Much has been investigated in terms of the inherited likelihood of the consecutive generations to develop a dependence on alcohol if their family members have been impacted by the issue. The extensive research findings in this field indicate that there are multiple genes in a human organism that contribute to the likelihood of developing alcohol use disorder (Edenberg and McClintick 2281; Jain et al.; Tawa et al. 507-508; Wall et al. 59). However, there is a specific group of genes that have been identified to account for alcohol intake in particular.

Moreover, specific combinations of such genes are most contributive within the context of alcohol use disorder. As a result, studies demonstrate that “approximately 50% of the risk for developing alcohol use disorder is due to genetics, while the remaining percent may be due to either environmental factors, or gene-environment interactions” (Tawa et al. 507). The reverse mechanism is also observed; as discussed by Jain et al., alcoholism not only has a destructive effect on health but also causes genetic changes that provoke continuous biological processes harmful to the organism. Thus, the genetic factor is a particular cause in the development of alcohol use disorder.

In a similar manner, environmental drivers also significantly contribute to the etiology of alcoholism. They are related to lifestyle choices, behavior, and the variety of stressors a person is exposed to throughout life (Tawa et al. 507). Nonetheless, the addictive particularities of alcohol are perceived to be more influential at younger age. Indeed, as identified by scholars, early exposure to alcohol consumption, especially in adolescence, significantly increases the risks of mental, physical health, and social problems in adulthood (Byrnes et al. 152; Yuen et al. 1-2).

An individual’s pattern in alcohol drinking that might vary from regular to binge consumption “may be an important predictor of later alcohol problems, such as alcohol dependence symptoms and neglecting responsibilities because of drinking” (Yuen et al. 2). Moreover, alcohol intake is recognized to be “the leading global risk factor for burden of disease among people aged 10–24 years” (Yuen et al. 2). Thus, it is imperative to maximize efforts to study the biological underpinnings of the problem to enhance the options for finding more effective solutions.

Hypothesis

While both environment and genes play a role in predetermining the likelihood of a person’s alcohol addiction, the spectrum of the determinants that trigger the abusive behavior is wide. Different combinations of genes have been found to induce excessive and uncontrolled alcoholic beverage consumption. Environmental factors include the social surroundings influencing an individual, behavioral patterns in family and peers, employment characteristics, stress, educational, and other determinants.

From a logical perspective, one might assume that the environment representative of the combination of changeable factors is possible to be adjusted or altered in order to minimize the potential of the disease development (Enoch and Albaugh 461-462). Therefore, it is important to clarify whether this assumption means that the environmental factors dominate the genetic predisposition toward alcohol addiction. Since the manipulations with the environment are capable (in theory) of reducing the likelihood of the development of alcohol dependence, then genetics might not necessarily dominate.

However, the failure of some individuals to respond adequately to environment alterations or treatment indicates that genetic inclination and the supposed hereditary alcohol dependence becomes a driving force in the occurrence of the disorder (Enoch and Albaugh 461). Many currently available research studies indicate that alcohol use disorder is a moderately heritable condition, implying that both environmental and genetic indicators play a partial role in the development of the disease (Zaso et al. 216). Nonetheless, most research studies involve participants of all ages concentrating more on the socioeconomic or ethnic characteristics of individuals with alcohol use disorder (Chartier et al., Environmental Influences on Alcohol Use 446; Chartier et al., Interactions between Alcohol Metabolism Genes and Religious Involvement 393; Enoch and Albaugh 461; Zaso et al. 216; Zheng et al. 79).

Such a vulnerable age population as adolescents have not been adequately investigated from the perspective of the interplay of environmental and genetic factors in alcohol consumption patterns. Therefore, it is vital to conduct research and identify whether the genetic predisposition to alcoholism prevails over environmental characteristics in teenage alcohol abuse behavior.

In essence, the present research paper is aimed at testing the validity of the hypothesis addressing the correlation between environment and genetics. It is assumed that if teenagers with alcohol metabolism genes are not exposed to environmental factors that reinforcing continuous alcohol intake, they will not develop alcohol use disorder. Therefore, the variables that are of critical importance to the study are alcohol metabolism genes (independent variable), environmental factors (independent variable), and alcohol use disorder occurrence (dependent variable).

Hypothesis: The presence of genes of alcohol metabolism outweigh the influence of environmental factors in the development of alcohol dependence in teenagers.

The developed hypothesis will be tested upon the addressing of four specifically designed objectives for the present research study.

Objectives

Taking into consideration the multifaceted and complicated nature of the research topic and the compound hypothesis that involves two independent variables, the objectives are aimed at collecting separate sets of data. Findings contributing to the theoretical investigation of both genetic processes and environmental contributors and their impact on the development of addiction to alcohol will be included. The four objectives are as follows.

• Objective 1: To identify the epigenetics of alcohol metabolism, as presented in the current scholarly literature.
• Objective 2: To identify the influence of alcohol metabolism genes on alcohol use disorder in teenagers.
• Objective 3: To identify the environmental factors that influence more frequent and continuous alcohol consumption leading to dependence on a general scale.
• Objective 4: To identify the influence of environmental factors on adolescent alcohol use disorder development.

Methods

The choice of methodology predetermines the outcomes of research and outlines the scope of possible findings in accordance with the objectives. The present research study design is a qualitative integrative literature review. Given the interdisciplinary nature of the research problem that incorporates the field of biology, genetics, and sociology, the literature review is a design that allows for fulfilling the requirements of collecting interdisciplinary qualitative data. The method of a literature review is “an excellent way of synthesizing research findings to show evidence on a meta-level and to uncover areas in which more research is needed” (Snyder 334). In particular, an integrative or critical literature review is aimed at assessing the content of studies in order to synthesize findings.

Since the ultimate goal of the present research study is to test the hypothesis, the choice of the integrative literature review method will allow for providing an adequate set of data accordingly. The data analysis method that is used is content analysis. According to Snyder, the purpose of an integrative literature review is “to critically analyze and examine the literature and the main ideas and relationships of an issue” (334-335). Therefore, the selection of methods is validated by the nature of the research, intended goals, and the particularities of the topic.

Discussion

Data for Objective 1: The Epigenetics of Alcohol Metabolism as Presented in the Current Scholarly Literature

The genetic predisposition of individuals to alcohol addiction is derived from the alterations in genes. Multiple research studies have been designed to identify particular alcohol-related risk alleles. The genetic influence of ethanol metabolism is proven to be consistent over time. A study conducted by Vadigepalli and Hoek was devoted to investigating the persistence of genetic memory of alcohol intake across time (845-848). The findings demonstrated that “ethanol-induced epigenetic changes account for altered regulation of cell function that persists well after ethanol or its metabolites have disappeared” (Vadigepalli and Hoek 848).

The effect of the substance on the genes, regardless of the enzyme particularities, is preserved for minutes or even decades and leads to the intergenerational transmission of the memory. As the authors state, such a mechanism on a genetic level has a “potential to drive persistent gene regulatory changes underlying fetal alcohol syndrome, cancer, and metabolic disorders” (Vadigepalli and Hoek 848). Therefore, it is evident that alcohol has a direct influence on the genetic codes of individuals inducing predictable responses in consecutive generations. However, it is important to understand how alcohol addiction correlates with particular genetic composition.

The process of alcohol metabolism is commonly considered as a primary framework for understanding the molecular and neurobiological processes that take place following alcohol consumption. In particular, two enzymes play a key role in alcohol metabolism in the human liver, representing two stages of ethanol metabolism. They include alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) (Chartier et al., Interactions between Alcohol Metabolism Genes and Religious Involvement 395; Tawa et al. 508; Wall et al. 61). The first enzyme, ADH, catalyzes ethanol contained in alcoholic drinks by breaking it into acetaldehyde, which is then transferred to the second stage of alcohol metabolism. This second stage involves the second enzyme, ALDH, which produces acetate out of acetaldehyde.

The particularities of these two processes predetermine how a person’s body will respond to alcohol. According to Wall et al., the importance of the quality of these stages of alcohol metabolism is explained by the fact that “accumulation of acetaldehyde can lead to heightened responses as well as unpleasant reactions” (61). Importantly, each individuals’ alcohol metabolism enzymes have variants or alleles depending on the genetic code inherited from parents. As a result, the individuals who have genetically designed isoenzymes of ADH that catalyze ethanol faster and isoenzymes of ALDH that catalyze acetaldehyde more slowly are characterized by reduced risk of alcohol use disorder (Tawa et al. 508).

Indeed, the examples of such isomorphs are ADH1B*2 single-nucleotide polymorphism (SNP) rs1229984 (Arg48His), ADH1C*2 SNP rs698 (Ile350Val), and ALDH2*2 SNP rs671, which trigger particular ethanol oxidation, thus performing a protective role in alcohol use disorder development (Tawa et al. 508; Wall et al. 61). Moreover, additional neurobiological processes of a genetic level are associated with alcohol addiction. They include D2 dopamine receptor (DRD2), dopamine transporter (SLC6A3), serotonin transporter (SLC6A4), tryptophan hydroxylase 1 (TPH1), and others (Tawa et al. 509).

As a demonstration of hereditary implications of an alcohol use disorder, the similarities in isomorphs responsible for ethanol metabolism have been found. For example, studies with multiethnic participants found that “the ADH1C*2 allele … was associated with an increased risk for alcohol dependence compared with the ADH1C*1 or A allele (Chartier et al., Interactions between Alcohol Metabolism Genes and Religious Involvement 395). Overall, the extensive investigation of the patterns in isomorphs of enzymes across different populations demonstrates a particular rate of consistency, implying genetic predisposition to alcoholism in individuals with particular enzyme variants.

Data for Objective 2: The Influence of Alcohol Metabolism Genes on Alcohol Use Disorder in Teenagers

Given the age-specific and developmental particularities of adolescents, their predisposition to alcohol intake is increased. The differences in teenagers’ responses to alcohol addiction treatment have been studied by several scholars to identify the particularities of individual perception of alcohol-related behaviors. While the influence of peers and the environment is more researched, the occurrence of gene variations in teenagers is particularly important to discuss.

The combinations of ADH and ALDH isomorphs are consistently observed across different age groups, implying their relevance to teenage individuals (Chartier et al., Interactions between Alcohol Metabolism Genes and Religious Involvement 395; Wall et al. 61). Nonetheless, the particularities of alcohol use disorder manifestations and underlying processes related to adolescents, in particular, have not been sufficiently addressed in scientific literature.

Considering the scope of problematic consequences associated with teenage alcoholism, including antisocial behavior, mental and physical health impairments, and alcoholism risks in adulthood, teenage alcohol dependence is approached from the perspective of treatment effectiveness. Since genetically designed particularities of ethanol oxidation are reliant on the enzyme combinations that have demonstrated reduced risks in alcohol use disorder development, the scientists expect that individuals with such phenotypes would respond to treatment better.

Indeed, as demonstrated by the study conducted by Zheng et al., the qualities of the glucocorticoid receptor (NR3C1) gene predetermine the perceptivity of alcoholism treatment interventions in teenagers (79). The individual differences between participants’ genotypes indicate adolescents’ different rates of predisposition to alcohol intake initiation and continuous binge drinking. The findings of the study strengthen the implications of biological data for the development of effective treatment approaches and interventions aimed at reducing the risks or consequences of alcohol addiction in adolescents.

Data for Objective 3: The Environmental Factors that Influence more Frequent and Continuous Alcohol Consumption Leading to Dependence on a General Scale

Unlike genetic predisposition, environmental factors’ contribution to the development of various substance use disorders, including alcohol abuse, has been broadly investigated. However, the heterogeneity of influencing factors triggering addictive behaviors implies the complexity of study findings and probable inconsistency of results across different populations. Indeed, since environments vary depending on social, economic, and cultural particularities, it is difficult to estimate the definite way in which an individual is impacted by the environment. Nonetheless, the studies that have investigated this issue have provided an extensive domain of data illustrating the dependence of alcohol use disorder development on external determinants.

There are several spheres that constitute an environment for an individual. The spectrum of influences these environmental factors may have on an individual varies from enforcing to reducing risks. Indeed, they have been categorized into the social trigger and social control mechanisms (Chartier et al., Environmental Influences on Alcohol Use 448). Social control mechanisms, such as alcohol laws, policies, cohort effects; community work including advertising, religious affiliation; and social networks, such as marriage, family, and friends, might become either constraints or opportunities for excessive alcohol consumption.

Similarly, such social trigger mechanisms as economic opportunities or poverty; neighborhood safety, discrimination; childhood maltreatment or family drinking history might become either nurturing or adverse contributors to alcohol addiction (Chartier et al., Environmental Influences on Alcohol Use 448). Therefore, the exposure to a combination of such factors is found to be most influential in triggering positive alcohol response on a genetic level.

The variety of environmental factors embodies the different spheres of life a person encounters throughout the lifespan. They include culture, religion, society, family, the level of neighborhood advantages, access to alcohol, economic status, and childhood adversity or trauma (Enoch and Albaugh 462; Mennis et al. 6; Wall et al. 66-67). All of these factors might have positive (constraining) or negative (reinforcing) effects. Indeed, cultural traditions related to drinking are inherently philosophical and socially accepted. As the findings of a study conducted by Wall et al. demonstrate, cultural differences imply various alcohol consumption patterns (67).

For example, Confucian culture cultivates moderate drinking as a norm, thus obstructing excessive alcohol consumption, which might become a constraint for people (even those genetically predisposed to alcohol addiction). In comparison, Korean culture pays much attention to alcohol use, which is thought to be important “to socialize and drink heavily, which may result in greater acceptance of heavy drinking and alcohol problems or religious” (Wall et al. 67). Given such a significant difference in cultural factors, it is expected that people’s drinking patterns in behavior will be different depending on the cultural domains they live in.

In a similar manner, the neighborhood to which a person belongs also plays a pivotal role in determining the likelihood of excessive drinking. Indeed, it is found that disadvantaged neighborhoods are commonly impacted by high poverty levels, high crime prevalence rate, diminished health quality, and other adverse characteristics of life. Therefore, people who live in such neighborhoods are continuously exposed to negative influences and stress. Therefore, “residing in neighborhoods characterized by disadvantage and disorder can produce chronic stress due to the trauma of continuous economic struggle and exposure to this disorder,” resulting in substance abuse as a coping mechanism (Mennis et al. 4). Thus, an individual with a genetic predisposition to alcohol dependence is much more likely to develop alcohol use disorder in a disadvantaged neighborhood.

Another important issue that should be discussed within the context of environmental factors is access to substances. As defined by Mennis et al., “ready access to substances lowers the barriers to acquiring, using, and abusing substances, thus facilitating substance use initiation and potential abuse” (3). On the contrary, the lack of access to alcohol, which might be manifested through policy constraints regulating the selling or serving of alcoholic beverages, economic inability to buy a drink, or other determinants, become barriers. Thus, even an individual with a genetic predisposition caused by the presence of gene variations contributing to addiction will not be able to develop alcohol use disorder without having the ability to obtain a beverage.

Data for Objective 4: The Influence of Environmental Factors on Adolescent Alcohol Use Disorder Development.

While environmental factors are observed to be highly influential across the lifespan, they play a particular role in the development of alcohol addiction in minors due to their developmentally conditioned vulnerability to outside influences. Teenagers come through a developmental phase when socialization is pivotal. Peer pressure, social roles, and the opinion of others are the leading triggers of an adolescent lifestyle choice and behavioral patterns. Therefore, adolescents’ susceptibility to environmental influences is more vividly manifested than in any other age.

The family environment is highly demonstrative of the acceptable behaviors for teenagers. If parents are drinkers, a child is more likely to initiate alcohol consumption at an earlier age regardless of genetic predisposition to dependence on substances. The studies that have investigated the drinking patterns in families with adopted children vividly demonstrate this pattern. Indeed, as Wall et al. state, in families with adopted adolescents, “the effect of ALDH2*2 was moderated by environmental influences of parental alcohol use and misuse as well as sibling alcohol use” (67). This goes in accord with the findings concerning the effects of the factor of access to substances. The presence of alcoholic drinks at home increases the likelihood of a teenager initiating consumption that might trigger abuse (Mennis et al. 3). Therefore, family and access to alcohol play a decisive role in teenagers’ excessive drinking.

Hypothesis Testing Results

The presented data related to each of the four objectives allows for synthesizing the findings and stating whether the hypothesis can be proven true or false. The hypothesis that was tested in the present study was as follows. The presence of genes of alcohol metabolism outweighs the influence of environmental factors in the development of alcohol dependence in teenagers.

The collected data indicating the particularities of gene variants associated with adolescent alcohol use disorder and the environmental factors contributing to the development of alcohol dependence allows for proving the hypothesis false. The findings retrieved in the result of the integrative literature review do not allow for accepting the hypothesis. There have been insufficient data collected to establish that the presence of alcohol metabolism genes prevails in alcohol addiction in comparison to environmental factors.

The diversity of opinions related to the dominant role of either genetics or environment in alcohol addiction appears to obtain a more prominent direction toward the environment as a driving force for adolescent alcoholism. Indeed, several studies have shown that despite evident genetic correlations between alcohol metabolism genes and consecutive alcohol use disorder development, much contribution is reliant on environment (Chartier et al., Interactions between Alcohol Metabolism Genes and Religious Involvement 395; Tawa et al. 508; Vadigepalli and Hoek 845; Wall et al. 61).

It was directly stated that “many of these genetic risk variants are dependent on gene-environment interactions and replication of findings has been difficult due to the generally small expected effect size … and genetic heterogeneity” (Tawa et al. 509). Moreover, Edenberg and McClintick identified that apart from the identified types of enzymes responsible for the quality of alcohol metabolism in the liver, there multiple other genes that regulate the interaction with the environment (2297). Thus, the strengths of genetic predispositions are significantly adjusted to the quality of environmental influences.

Since teenagers are particularly susceptible to external influencers, their environment becomes a driving determinant of alcohol-related behavior. Such gene-environment correlation predetermines two options. The first one entails a scenario according to which a teenager genetically predisposed to alcohol use disorder encounters negative environmental influences. In such a case, alcoholism is practically impossible to avoid. However,

“in positive conditions with ample resources and support such as intervention, … genetic susceptible individuals achieve better outcomes” (Zheng et al. 80). Without exposure to the triggers of alcohol consumption and only living among the barriers to alcohol intake, a person with a genetic predisposition will be able to neither initiate nor abuse alcohol. This conclusion provides a solid basis for rejecting the hypothesis.

Conclusion

In summation, alcohol use disorder is a severe psychiatric condition that affects millions of people around the world on an annual basis. The adverse consequences of binge drinking and addiction to alcohol include physical health imperilments, mental disorders, diminished overall quality of life, and high mortality rates. Teenagers, as a vulnerable population, from a developmental point of view, are particularly susceptible to alcoholism. Since the recent scientific findings indicate that alcohol addiction is genetically predisposed, it is important to investigate how this genetic predisposition correlates with environmental influences to which individuals are continuously exposed.

The initial scholarly sources overview was used to construct a hypothesis that claimed that the presence of genes of alcohol metabolism outweighs the influence of environmental factors in the development of alcohol dependence in teenagers.

In the course of integrative literature review, data contributing to the understanding of the genetic mechanisms and environmental factor interaction in relation to alcohol use disorder development in teenagers was collected. As a result, the hypothesis was rejected due to the lack of direct claims that the availability of enzyme isomorphs responsible for favorable alcohol metabolism dominates over environmental factors. The implications of diverse and multifaceted interaction between genotype and environment have been found. The limitations of the present research study are related to the sporadic choice of research articles.

Also, since there are constraints in terms of the opportunities to conduct a quantitative study with participants due to the global epidemic, the study was conducted as a literature review concentrating on qualitative content analysis. Despite minor limitations, the study results allow for obtaining evidence-based insights into the dependence of alcohol use disorder on environmental and genetic factors. Further research is encouraged to enhance the findings and articulate functional and effective treatment interventions for adolescent alcohol abusers.

Works Cited

Byrnes, Hilary F., et al. “Association of Environmental Indicators with Teen Alcohol Use and Problem Behavior: Teens’ Observations vs. Objectively-Measured Indicators.” Health & Place, vol. 43, 2017, pp. 151-157.

Chartier, Karen G., et al. “Environmental Influences on Alcohol Use: Informing Research on the Joint Effects of Genes and the Environment in Diverse US Populations.” The American Journal on Addictions, vol. 26, no. 5, 2017, pp. 446-460.

Chartier, Karen G., et al. “Interactions between Alcohol Metabolism Genes and Religious Involvement in Association with Maximum Drinks and Alcohol Dependence Symptoms.” Journal of Studies on Alcohol and Drugs, vol. 77, no. 3, 2016, pp. 393-404.

Edenberg, Howard J., and Jeanette N. McClintick. “Alcohol Dehydrogenases, Aldehyde Dehydrogenases, and Alcohol Use Disorders: A Critical Review.” Alcoholism: Clinical and Experimental Research, vol. 42, no. 12, 2018, pp. 2281-2297.

Enoch, Mary‐Anne, and Bernard J. Albaugh. “Genetic and Environmental Risk Factors for Alcohol Use Disorders in American Indians and Alaskan Natives.” The American Journal on Addictions, vol. 26, no. 5, 2017, pp. 461-468.

Jain, Subodh Kumar, Sapna Sedha, and Meeta Mishra. “Genetic Polymorphism and Alcohol Metabolism.” Genetic Polymorphisms. IntechOpen, 2019. Web.

Jones, Tiffany M., et al. “Understanding the Interplay of Individual and Social-Developmental Factors in the Progression of Substance Use and Mental Health from Childhood to Adulthood.” Development and Psychopathology, vol. 28, no. 3, 2016, pp. 721-741.

Mennis, Jeremy, Gerald J. Stahler, and Michael J. Mason. “Risky Substance Use Environments and Addiction: A New Frontier for Environmental Justice Research.” International Journal of Environmental Research and Public Health, vol. 13, no. 6, 2016, pp. 1-15.

Snyder, Hannah. “Literature Review as a Research Methodology: An Overview and Guidelines.” Journal of Business Research, vol. 104, 2019, pp. 333-339.

Tawa, Elisabeth A., Samuel D. Hall, and Falk W. Lohoff. “Overview of the Genetics of Alcohol Use Disorder.” Alcohol and Alcoholism, vol. 51, no. 5, 2016, pp. 507-514.

Vadigepalli, Rajanikanth, and Jan B. Hoek. “Alcohol and Epigenetic Regulation: Do the Products of Alcohol Metabolism Drive Epigenetic Control of Gene Expression in Alcohol-Related Disorders?” Alcoholism, Clinical and Experimental Research, vol. 42, no. 5, 2018, pp. 845-848.

Wall, Tamara L., Susan E. Luczak, and Susanne Hiller-Sturmhöfel. “Biology, Genetics, and Environment: Underlying Factors Influencing Alcohol Metabolism.” Alcohol Research: Current Reviews, vol. 38, no. 1, 2016, pp. 59-68.

Yuen, Wing See, et al. “Adolescent Alcohol Use Trajectories: Risk Factors and Adult Outcomes.” Pediatrics, vol. 146, no. 4, 2020, pp. 1-11.

Zaso, Michelle J., et al. “Meta-Analysis on Associations of Alcohol Metabolism Genes with Alcohol Use Disorder in East Asians.” Alcohol and Alcoholism, vol. 54, no. 3, 2019, pp. 216-224.

Zheng, Yao, et al. “Glucocorticoid Receptor (NR3C1) Gene Polymorphism Moderate Intervention Effects on the Developmental Trajectory of African-American Adolescent Alcohol Abuse.” Prevention Science, vol. 19, no. 1, 2018, pp. 79-89.

The problem of tobacco use remains one of the most acute for several decades. It is connected with significant medical and social consequences of this phenomenon, wide spread of fatal complications connected with smoking. Of particular importance is tobacco use among adolescents because it is fraught with the development of much more serious disorders of body systems. Adolescents who smoke or use tobacco in other forms have problems with metabolic processes in the body, especially the ones with the absorption of vitamins A, B1, B6, and B12. This is the reason that the overall development is retarded, and growth slows down. Because smoking often develops anemia, as well as myopia, inflammatory processes occur in the nasopharynx.

Large-scale studies covering a purposive sample of adolescents have been presented to determine the prevalence of smoking and to evaluate existing mechanisms of smoking control. Scientists have noted the formation of more severe nicotine addiction, especially when adolescents use e-cigarettes and hookah as alternatives to traditional smoking (Essau & Delfabbro, 2020). This makes it urgent to fight all forms of tobacco and nicotine use in order to preserve the health of adolescents.

Typical members of this social group are young girls and men aged 14 to 17 who live in middle-class, full families and are in school. The interest in tobacco addiction among these people was caused by the fact that a superficial analysis may not find prerequisites for such deviations (Essau & Delfabbro, 2020). Their families are considered to be financially and structurally sound, and they do not grow up in a dysfunctional environment that encourages tobacco use as a way of adapting to a difficult environment.

The overriding reasons for this social group are the need for new sensations, interests, and the desire to imitate adults. Moreover, often such means as hookah and vaping become factors uniting companies, as this type of tobacco is often used in groups. These kinds of chemical addictions become romanticized as traits of an intense life (Weinberger, 2022). Although the harms of smoking are a well-known fact for teenagers, alternative forms of tobacco use are viewed, on the contrary, as relatively safe and sometimes even helpful (Desai, 2020). This stereotype is largely due to successful advertising campaigns on the part of vape and hookah manufacturers. The effects of chewing tobacco remain largely unknown to young people.

Teenagers’ low awareness of the harms of all types of tobacco is a key factor in the need to develop educational programs devoted to this topic. School teachers, guidance counselors, and medical staff who conduct routine screenings of students can be the people in charge of implementing the plan. Their task is to use a variety of interactions to break the stereotype that alternative forms of tobacco use are harmless.

The most effective forms include the use of informational posters in schools and clinics, joint trips with students to pulmonology departments, and conversations with doctors who practice treatment of respiratory tract affected by tobacco use. It is not unimportant to organize project works among students who need to study the mechanisms of effects of vaping and hookah on the body systems. If the idea that smoking is harmful is trivial, the idea that all tobacco products are equally harmful is new to teenagers and may arouse increased interest.

For those who have an established addiction, the steps to break free from it should be explained in detail. Teachers can also provide information on breathing exercises and various activities that help them recover from the harms of tobacco. People in the study population are financially able to afford a variety of recreational activities. Therefore, educators need to make sure that when a student stops using substances, he or she can refocus on something useful, including sports, art, or science.

In case when a child has no obvious deviations in the family and there is no information about psychological traumas suffered, the reason for the addiction is the absence of meaningful activities in life. Therefore, those who have special difficulties with quitting tobacco need individual psychological and pedagogical support (Essau & Delfabbro, 2020). Conversation with a therapist and teacher should help the student feel the significance of his or her steps and open up new perspectives. An important result of such work is the teenager’s conscious desire to lead a healthy lifestyle.

Thus, the plan of work with this social group includes thematic lessons, giving information about the mechanisms of influence of different forms of tobacco on the body. Within the framework of the program, an obligatory point is cooperation with doctors, who, based on real stories of patients, can demonstrate the harm of such addiction. It is also necessary to introduce project activities that imply the independent and deeper study of the problem by students. The plan has several goals, the primary ones being reducing more than half the number of adolescents who use tobacco within six months and increasing the percentage of students interested in the problem by more than 60 percent over the same period. Halving the percentage of people who miss physical education classes because of breathing problems during the school year will also be an important indicator.

Reference

Desai, A. N. (2020). Preventing tobacco use in children and adolescents. JAMA, 323(16), 1626.

Essau, A. C., & Delfabbro, P. (2020). Adolescent addiction: Epidemiology, assessment, and treatment (2nd ed.). Academic Press.

Weinberger, A. H. (2022). Socioeconomic status and tobacco use.Nicotine & Tobacco Research, 24(6), 805–806.

Addiction interferes with a person being a success in life and happiness. People with this problem often do not admit or deny their addiction for long and sink to the social bottom. Some seek help from medical institutions and get a good chance to improve their lives. The purpose of this critical writing is to understand why people begin to want to get rid of the shackles of addictive behavior.

The first reason patients start necessary treatment is their financial situation. People with addiction come to work stoned, breaking every possible rule of behavior. Spending on substances or alcohol takes a large part of their income (“The wake-up call: 5 reasons people seek help for addiction”, 2018). The person can no longer pay, e.g., the mortgage, buy food and pay the bills. Losing income or a place to live is a powerful motivator for a dependent human. Addicts begin to acknowledge their problems because the situation is clearly out of control.

Other factors that play an important role in struggling with addiction are social and psychological. The problem is the loss of adequate relationships with people close to them. Dependents avoid communication and refuse to discuss topics related to their illnesses (“The wake-up call: 5 reasons people seek help for addiction”, 2018). In this case, relatives offer a choice between them and addiction. Many addicts start treatment because they are afraid of losing their families. Sometimes the nature of addiction recovery is compulsory, as people enter the hospital with a drug or alcohol overdose. In more negative scenarios, treatment can be a court sentence. Stories have been known in which drunken parents driving a car cause accidents in which their children die (“The wake-up call: 5 reasons people seek help for addiction”, 2018). In these cases, recovery from addiction is an important step in a person’s return to a social environment after serving a sentence.

Ultimately, it is very important to note that seeking help promptly increases a person’s chances of living a normal life. The main thing is to do it in time before the problem takes its most terrible form. Then the likelihood of preserving family, income, and prospects remains high. Modern medical approaches make the patient’s recovery process as gentle as possible. Many positive stories of recovery are eloquent confirmation of this thesis.

Reference

The wake-up call: 5 reasons people seek help for addiction. (n.d.). Web.

Warm Hand-Off Initiative

The Warm Hand-Off Initiative in Pennsylvania enables patients to immediately start treatment to replace the previous act of giving the patient an appointment card after discharge from the hospital after surviving an overdose (Mauck, 2018). Previous research indicates that most overdose survivors leaving the hospital without practitioner intervention often overdosed recurrently. The city counties and law enforcement ensure that health professionals use emergency service protocols to successfully transfer overdose survivors using an individualized treatment plan with assessment and clinical placement criteria. Therefore, the Warm-Hand Off initiative is a reliable, viable, and long-term approach that works to reduce the prevalence of overdose incidents.

The Audience

The audience for this information is the primary care providers, city counties, criminal justice populations, Substance Use Disorder (SUD) treatment providers, family members, recovery specialists, social workers, law enforcement leaders, first respondents, state agencies, public health officials, mental health agencies, health personnel, and the healthcare insurance providers. The first responders facilitate the identification of survivors needing emergency health care systems

A Summary of the Policy Issue

House Bill 424 of the General Assembly of Pennsylvania (2019), known as the Warm Hand-Off to Treatment Act, provides a comprehensive initiative that facilitates the transfer of overdose survivors to addiction treatment. Under the Overdose Recovery Task Force, Pennsylvania’s Department of Drug and Alcohol Programs (DDAP) initiated an intervention that directly transfers overdose survivors from the hospital’s emergency department to the drug treatment provider (The General Assembly of Pennsylvania, 2019). The policy ensures that health professionals dealing with survivors understand the intense stigma and shame that a drug addict experiences. Hence, health care providers need to treat overdose survivors with care and respect (Miller et al., 2016). Therefore, the warm hand-off policy saves the patient’s life while ensuring that they receive the support needed to avoid a relapse or even death resulting from subsequent overdose.

Identified Key Stakeholders

The key stakeholders of the Warm Hand-Off policy include the first responders who constitute the emergency medical care providers, the law enforcement officers, the family, the social workers, recovering community members, and firefighters (The General Assembly, 2019). The Warm Hand-Off programs need information from the first responders who report repeated overdosing experienced by survivors who do not successfully transition into recovery support service or treatment (Miller et al., 2016). Hence, the community and health care system suffers strain from admission or death reports from survivors that never fully recovered due to a lack of comprehensive treatment and recovery systems.

The collaboration of efforts from first respondents and primary care providers ensures that patients received urgent care to save their lives after an overdose while reporting the occurrence to the program’s officials (Burton & Martin, 2020). The city counties, state agencies, and law enforcement leaders ensure that the stakeholders follow the regulated procedures on admission and reporting. Substance Use Disorder (SUD) treatment providers, as recovery specialists, work to treat and offer recovery from addiction to avoid repetitive overdose incidence (Technical Assistance Center, 2016). The family members, social workers, public health officials, and mental health agencies work to offer a supportive environment for people with drug addiction to reduce associated stigma levels to ensure persisting recovery.

Suggested Policy Action and Identified Policy Arena

The Warm Hand-Off policy ensures that emergency medical services effective practices that medically stabilize addiction victims (The General Assembly of Pennsylvania, 2019). The state’s involvement ensures that the program establishes warm hand-off and overdose stabilization centers accessible for detoxification, referral, assessment, and direct placement to recovery support services (Barnes & McClughen, 2017). The Warm Hand-Off to Treatment Act ensures the coordination and full continuum of recovery support and treatment to address overdose survivor needs for the long term. The Warm Hand-Off to Treatment policy mandates the DDAP to license detoxification facilities that metabolically assist drug-intoxicated, alcohol-intoxicated, alcohol-dependent, and drug-dependent individuals to reduce the physiological risks (Mirigian et al., 2018). Therefore, the suggested policy action offers a comprehensive technique to reduce the prevalence of overdose events in Pennsylvania.

The Rationale for Proposed Action

The rationale for immediate action of transferring a patient from the emergency room to the drug treatment provider is the high risk of repeat overdose after survival. The call to action came to respond to the reversal of 6,500 opioid overdoses across Pennsylvania by January 2018 (Pennsylvania Department of Drug and Alcohol Programs, 2018). As of 2017, the state recorded 5,460 deaths related to overdose prevailing at the top rank in the United States (The General Assembly of Pennsylvania, 2019). These alarming statistics prompted the need to develop a warm-hand-Off initiative to mitigate these rising cases through immediate response. Research indicates that the overdose survivors, once saved, would routinely return to drug usage, increasing the probability of experiencing another overdose (Houry & Adams, 2019). Therefore, identifying, assessing, screening, treating, and tracking as proposed actions under the Warm-Hand-Off to Treatment Act works to save the lives of overdose survivors.

Cost Considerations

The expenditure needed for the Warm-Hand-Off initiative include the purchase of drug supplements, wages for providers of emergency medical services, harm reduction, intervention, transport, and recovery support services, and peer specialists. The Warm Hand-Off Initiative provides incentives to facilitate operations in the highest priority overdose stabilization centers. The Legislative Reference Bureau offers $25,000 per grant to qualified centers in different counties in Pennsylvania (P.A. HB424, 2019). The initiative uses a prorated basis not to award monetary resources to emergency departments and county drug and alcohol administrators that exceed the appropriate amount. Therefore, the state agencies submit annual reports on the use before qualifying for another influx of cash.

Ethical Considerations

The ethical issues facing the Warm Hand-Off policy include the informed consent, privacy, and confidentiality concerns of patients receiving emergency services to save their lives while also being transferred to treatment. Based on the stigma and shame surrounding drug addiction, most overdose survivors do not consent to health care interventions. When patient experiences an overdose, they are incapable of consenting to recovery options used to rehabilitate their status (Burton & Martin, 2020). The short-term drug treatment program fails to achieve long-term benefits if the health care specialists cannot uncover other comorbidities such as their nutrition and income status. Most of the time, practitioners cannot determine the patient’s willingness to participate in the program as indicated by most that repetitively overdose if they do not receive a warm hand-off. Therefore, the programs aim to achieve patients’ consent by making sure that they gain full treatment and consciousness before being transferred to the treatment facility (Ahmed et al., 2019). When the healthcare professionals have sufficient knowledge of drug addiction and the high probability of relapse, they can use a comprehensive healthcare procedure that ensures that the patient does not continue to use drugs after discharge from recovery and support services.

The other ethical consideration is the interdisciplinary disposition of the patient’s health information lacking privacy and confidentiality. Patients, therefore, need information from the healthcare providers about what information is useful. Practitioners also undergo training that enables them to understand that they can use patient data for treatment purposes only and not share it with persons that are not working on that specific patient (Ahmed et al., 2019; Barnes & McClughen, 2017).

Failure to conform to privacy and confidentiality regulations warrants the practitioner’s heavy penalties.

Identified Legislator and Voting Record in the Voting District

The State Representative, Karen Boback, was a sponsor of the warm-hand-off bill, first introduced in 2018 (P.A. HB2727, 2018). House Bill 2727 was a slight partisan appeal with a republican 5-2 vote, which achieved a 25% with no further progression (P.A. HB2727, 2018). Based on the legislator’s position as the chair of the committee, she would expand the grant to cater to overdose survivors’ socioeconomic disparities. Boback should support an initiative that offers a comprehensive solution to the rising incidences of deaths from an opioid overdose. The demographic that experiences the most overdosing incidences occurs in the homeless community, which is rapidly growing. Most homeless people indulge in drug use to escape the inhumane conditions on the streets. When specialists treat them and release them back into the streets, it only predisposes them to indulge more as a coping mechanism. The bill needs to address homeless dynamics. Besides, the results from use result from the youth’s failure to engage in economically productive activities, hence experiencing idle time they occupy with drugs. The lack of socially constructed supportive frameworks fails to equip the youth with coping mechanisms for typical life struggles.

References

Ahmed, O. M., Mao, J. A., Holt, S. R., Hawk, K., D’Onofrio, G., Martel, S., & Melnick, E. R. (2019). A scalable, automated warm handoff from the emergency department to community sites offering continued medication for opioid use disorder: Lessons learned from the EMBED trial stakeholders. Journal of Substance Abuse Treatment, 102, 47–52.

Barnes, M. C., & McClughen, D. C. (2017). Warm handoffs: The duty of and legal issues surrounding emergency departments in reducing the risk of subsequent drug overdoses. University of Memphis Law Review, 48, 1099–1164.

Burton, W., & Martin, A. (2020). Opioid overdose and addiction treatment: A collaborative model of compassion, patience, and respect. Journal of Nursing Scholarship, 52(4), 344–351.

Houry, D., & Adams, J. (2019). Emergency physicians and the opioid overdose action: A call to aid. Annals of Emergency Medicine, 74(3), 436–438.

Mauck, S. B. (2018). Drug dealer or murderer: Pennsylvania’s approach to drug delivery resulting in death. Pennsylvania State Law Review, 123(3), 813–837.

Miller, T., Lauer, A., Mihok, B., & Haywood, K. (2016). A continuum of care approach: Western Pennsylvania’s response to the opioid epidemic [PDF document].

Mirigian, L. S., Pugliese, M. F., Pringle, J. L., & Gaydos, M. F. (2018). The role of community coordinated efforts in combating the opioid overdose crisis: The Pennsylvania opioid overdose reduction technical assistance center. Commonwealth, 20(2-3). Web.

P.A. HB2727, Pennsylvania House Bill 2727, 2017-2018 Reg. Sess. (Penn. 2017-2018).

P.A. HB424, Pennsylvania House Bill 424, 2019, Reg. Sess. (Penn. 2019).

Pennsylvania Department of Drug and Alcohol Programs. (2018). Department of drug and alcohol programs: Opioid epidemic response [PDF document].

Technical Assistance Center. (2016). [PDF Dcoument].

It is hard to disagree that providers try to do their best to avoid being judgmental when helping their patients. While it is rather easy with some clients, it can be challenging to forget about personal assumptions and attitudes when working with people with different addictions. Unfortunately, providers can sometimes use stigmatizing or biased language, which can hurt their patients. In this paper, I will talk about my beliefs about persons with addictions.

To begin with, I think that there are numerous severe reasons why people become addicted or use substances. First of all, mental illnesses and conditions like anxiety, depression, ADHD, and bipolar disorder may force patients to become addicted to alcohol, drugs, or smoking. Additionally, some traumatic events may be so unbearable for a person that they need to feel better, and substances seem a great option. Genetics and negative examples shown by close relatives also increase the risk. Finally, it is known that famous people and celebrities like musicians and actors use drugs and alcohol to have more energy and get distracted from their everyday activities and the attention they receive. Therefore, in my opinion, the main reason people get addicted is related to the desire to forget about the problems of this reality and feel differently. Since these substances act on the production of certain hormones, the body gets used to it and requires an increase in the dose of alcohol or drugs.

In my opinion, all addictions are challenging to recover from. It does not matter if one is addicted to chocolate, drugs, the internet, coffee, alcohol, or smoking. If it is a real addiction, the help of a professional and a comprehensive approach is needed to heal the physical and emotional states of a person. I think that recovery always begins when one recognizes and acknowledges the existence of their addiction and appeals to the socialists. Further, the person must follow all the recommendations despite the desire to surrender, psychological and physical resistance, and a short-term deterioration. After successfully passing these stages, the patient becomes much better, their body removes the remaining substances, and the state returns to normal. According to my observations, a person who, for example, gets rid of addiction to cigarettes is afraid to smoke one again since there is a great chance of becoming addicted again.

Introduction

Clinical evaluation refers to a set of continuous activities that use scientifically proven techniques for conducting assessment and investigation of medical information. An evaluation plan is a guideline for performing the analysis process. Counseling entails a conversation between a therapist and the client and involves solving emotional matters. It allows the patient to fully acknowledge and understand the cause of their mental issues. The clinical trials and the program appraisal generate information and skills needed for counseling purposes. Clinical practices produce results that are used to offer counseling and guideline.

Screening

The sequence is formulated through financing from centers for disease control and organization for preventive teaching and research purposes. They are actions that include the identification of unknown illnesses through tests, medical examinations, and clinical procedures for drug addicts. Screening and identification form the basis for understanding the level at which the addict has been affected. Thus, the procedure is a factor in reducing the morbidity rates that are connected to certain illnesses. It entails understanding the patient’s cognitive behavior, physical examination and analysis, and conducting accurate laboratory tests. The presence of drugs after the test stimulates early diagnostic actions to reduce the progression of the effects.

There must be good criteria to facilitate good screening activity. For instance, it has to be cheap, ensure human safety, be readily accessible, and have an excellent medical treatment plan. It has to be accepted by the users to ensure it affects their health positively. It has to be scientifically proven with good reasonable research evidence and the ability to correctly predict the use of harmful substances. For instance, it should give a clear outline and the actual test obtained from the drug user. The experts should conduct regular screening to enhance the chance to know the stage it has reached and act accordingly.

There are various defined concepts for evaluating screen tests, which include validity and reliability. Validity shows the correctness and significance of how the conducted tests match the patient’s clear clinical signs. Reliability shows an experiment’s clinical ability to produce similar results even after doing the procedures more than once. Various types of reliability are used; for instance, sensitivity evaluates the drug users who have been addicted to substance abuse. Specificity provides an evaluation of those who lack the symptoms (Kirss, 2017). The use of multiple screening experiments has improved the effectiveness and accuracy of the predictive values.

During the clinical evaluation, several factors have to be considered; the researcher should include the correct group of individuals who use the drug and the adequate performance of a control experiment. The sample used to conduct the analysis should be good enough to obtain accurate results, thus, the larger the sample, the more accurate the findings. The methods used should have the capability of producing the required results. Therefore, researchers should perform the re-screening activities to obtain consistency (Daldere et al., 2018). The screen test conducted should improve the present state of chemical products and technologies used.

Ethical considerations and acts should have to be examined to avoid violation of the regulatory procedure and rules. It ensures that there is respect for all persons regardless of their race and religion. The users have to be educated on the danger of consuming bhang and future effects that can completely ruin their lives. The counseling sessions should be conducted regularly to allow the victim to understand important points.

The human rights and personal privacy issues of the concerned individual should be observed throughout the procedure, and the therapist should always abide by the patient’s consent. They are working with the family members and relatives towards concluding individual health matters. A screening program is set and implemented to ensure that a series of medical events are followed before diagnostic results are given out. Therefore, screening for drug and substance users is essential as it allows both the patient and therapist to know the level of the drug content and the necessary measure to be undertaken during treatment.

Examination and Analysis

Assessment involves a sequence of activities to gather information and come to satisfactory conclusions using psychosomatic and neurological experiments. It is aimed at determining the drug addicts’ problems and the available clinical symptoms. The clients’ readiness and willingness to undertake a treatment process is vital and should be regarded as the primary key factor. The collected data provides the caregiver with the necessary information regarding the patient. The above information may also assist in revealing the characteristics of the person, their emotional status, mental functioning, and contextual challenges (Wilborn et al., 2018).

Thus, this helps determine ways to deal with users in terms of being counseled, and if necessary, a treatment plan is formulated. However, proper concepts and techniques of treatment should be applied to assess if the procedures used are recommendable and consistent. Clinical services provided should follow a systematic process that ensures that only the needed services are applied. The validity involves comparing two different techniques and determining which method best serves the common purpose—predictive validity forecast about the upcoming events or what will happen in the future.

Standardization has to be used to ensure that patients’ experiences and different clinical services are the same, regardless of the process. Various methods of assessment are used; for instance, observation can be laboratory or naturalist. Laboratory actions entail keen looking into the specimen like a blood smear to obtain data that is used for assessment and evaluation (Harvey et al., 2019). Clinical interviews are done where there is a confrontation with the client and obtaining required data. This process facilitates the collection of the required information to help in different assessment stages.

Psychological tests help in understanding the individuals’ mental and biological functioning. Performing neurological test help the professional understand the analytical disorders caused by brain actions. Behavioral assessment helps in determining the target characters and understanding the severity of the condition. The serious and life-threatening case should be handled by a higher level of care. This is done under authorization from the expert dealing with the client.

The assessment finding should be well documented for further analysis. Close supervision and monitoring of clinical activities have to be put in place to facilitate the keen collection of required data. Each examination level should provide detailed information about what has been examined. The analyst’s level of knowledge and competence should be a reflection of what has been obtained from the user. Training is required where necessary to boost the individuals’ expertise level.

An effective procedure has to be formulated to ensure that the drug addicts can restore their health and reduce the effects. Suitable treatment recommendations and prescriptions are to be made to ensure patients’ well-being (Maugeri & Musumeci, 2021). For instance, drug users should be placed in rehabilitation centers to get enough counseling and the necessary medical attention. The legalized procedure should be applied where necessary, and consequences implied for violation of practice. The written information has to be kept in privacy, and only the authorized personnel should have the right to access it. In cases where the clinical issues are complicated, specialized medical services ensure effective service delivery.

References

Daldere, D., Zacharias, N., & Hinz, O. (2018). Which collaborative activities should firms perform to become gatekeepers in collaboration networks? Academy of Management Proceedings, 2018(1), 14392. Web.

Harvey, H., Keen, J., Robinson, C., Roff, J., & Gross, T. (2019). Quantitative analysis of approaches to group marking. Assessment & Evaluation in Higher Education, 44(8), 1133-1147. Web.

Kirss, T. (2017). Those who decide about the fate of the foreigner. Anthropological Journal of European Cultures, 26(1), 128-133. Web.

Maugeri, G., & Musumeci, G. (2021). Adapted physical activity to ensure the physical and psychological well-being of COVID-19 patients. Journal 0f Functional Morphology and Kinesiology, 6(1), 13. Web.

Wilborna, D., Kramer, M., Stevenson, B., & Dvorak, R. (2018). Should I stay, or should I go? Approach/avoidance conflict and emotional functioning. Personality and Mental Health, 12(4), 298-308. Web.

The significance of addiction is recognized by various scholars worldwide. The scholars state that a full understanding of addiction issues is only possible through proper research into cultural differences between populations (Paul et al., 2017). Even though the scope of addiction studies is quite broad, it bears particular importance for the subject of counseling. In this essay, unique challenges for the American Indian individuals with substance addiction use will be reviewed, and the problems of gender issues and counseling will be further explored.

Sex differences can often be a significant problem in individual experiences. As stated by Becker et al. (2016), women are most susceptible to substance abuse and have an increased possibility of relapse. In the case presented by Paul et al. (2017), the distinctions between male and female addicts can be seen in the cultural features and traits of the American Indian population. The women’s experiences are likely to be more influenced by the traumatic events in their lives, and they may be judged by society (Becker et al., 2016). Overall, it is crucial to consider sex differences when exploring addiction issues.

The process of therapy can be positively influenced by the quality of the rapport. In some cases, it might be crucial to broach the communication between the therapist and their customer, elevating the possibility of a successful outcome. Paul et al. (2017) state that many American Indian individuals suffer from traumatic experiences, and culturally-related interventions that address this trauma might be more efficient for this population. In order to provide support for the person in counseling, it is crucial to consider their cultural characteristics.

To conclude, sex differences in addiction can account for strikingly different experiences for the two genders. Acknowledging such incidents should be an essential part of the counseling process. Moreover, addressing the cultural background and extending the relationship between the therapist and the client can be of exceptional use for the general outcomes. Discussing their unique experiences with the individual should be implemented as a part of the counseling.

References

Becker, J. B., McClellan, M., & Reed, B. G. (2016). Sociocultural context for sex differences in addiction.Addiction Biology, 21(5), 1052-1059. Web.

Paul, T. M., Lusk, S., Becton, A., & Glade, R. (2017). Exploring the impact of substance use, culture, and trauma on American Indian adolescents.Journal of Applied Rehabilitation Counseling, 48(1), 31-39. Web.

In the 21^st century, the prevalence of various addictions is an alarming tendency on a global scale. There are different components to the formation of such factors, and some of them are directly related to the childhood period. This stage of life is essential to both physical and psychological development of a person. The foundation for the behavioral patterns and key personality traits is laid during childhood. Accordingly, being exposed to addiction-associated factors at this stage is highly alarming. It is not limited to the immediate environment of a child, as long-term addictions are formed that persist into adulthood. Thus, the elimination of such factors is a key part of the global agenda today.

As it is generally accepted, prevention is always better and more feasible than the cure. In their pilot study, Copeland et al. (2010) introduce a school-based alcohol, tobacco, and drug prevention program titled The Wise Mind. This framework effectively embeds “psychoeducational, social influence, and social competence components” (Copeland et al., 2010, p. 522). The purpose of it was to eliminate the age-related rise in positive drug, alcohol, and tobacco expectancies among the participating children. The implementation of the method relied on the use of advanced questionnaire that provided the researchers with sufficient data to reflect and address the children’s inclination toward any form of addiction. The study saw an active participation of the educator staff who promoted healthier attitudes among their students. As a result, the authors of the project report an observable decrease in addiction-forming expectancies among the participants.

The core of The Wise Mind study can be expanded and utilized for the implementation of a full-scale prevention program. As can be inferred from its examination, most measures currently undertaking to address the problem are related to the informational support at school. Furthermore, middle school appears to be the crucial stage that largely determines addiction expectancies in the long-term. In order to address the problem in its entirety, the proposed program should not be limited to the school environment exclusively. On the contrary, it should encompass a child’s activities in their entirety, including the domestic and extracurricular activities. One of the key actions to take is to provide them with healthy alternatives that are incompatible with addiction. As such, policy-makers can introduce new, affordable athletic opportunities for young people. This doesn’t have to be any form of professional sports, as even light exercise will stimulate healthier behavior.

Nevertheless, school occupies a position of pivotal importance in a young person’s life. While today’s institutions make efforts to the prevent the development of addiction among their students, the issue persists. This implies that the measures require a quality expansion to become a full-scale element of the education process. Schools can organize specialized boards for the prevention of alcohol, tobacco, and drug use, comprising medical workers and psychology experts, which can be done in collaboration with local public health institutions. The work of the board will include regular lessons on the risks of addiction, promoting healthy behavior. More importantly, early adolescents seek more profound peer integration, imitating their own role models. At this age, children become more distant from their parents, and this is when addiction-forming factors are encountered (Knight, 2017). Thus, the participation of older students who can serve as the ultimate role models in a mentor-mentee relationship is a highly beneficial novelty of the proposal.

Evidently, the role of the parents is not to be underestimated, as well. In spite of the age-conditioned alienation, children always continue to rely on their families. Thus, the educational element of the program should not be limited to the classroom. Instead, the Board and its partners can actively engage in community outreach, teaching parents from an adult perspective. This way, family bond and influence as one of the most important cultural elements are engaged. This multi-level approach will facilitate the prevention of addition-forming behavior among children by placing them in a healthy environment with the prevailing role of positive values.

References

Copeland, A. L., Williamson, D. A., Kendzor, D. E., Businelle, M. S., Rash, C. J., Kulesza, M., & Patterson, S. M. (2010). A school-based alcohol, tobacco, and drug prevention program for children: The Wise Mind study. Cognitive Therapy and Research, 34(6), 522-532. Web.

Knight, Z. G. (2010). A proposed model of psychodynamic psychotherapy linked to Erik Erikson’s eight stages of psychosocial development. Clinical Psychology & Psychotherapy, 24(5), 1047-1058. Web.

Article Injecting Drugs Can Ruin a Heart. How Many Second Chances Should a User Get? takes an in-depth look at this problem and confronts the facts that affect it. Above all, the main problem is the reluctance of pharmaceutical companies to find a common approach and method of facing opium addiction since the first thing to think about is profits, just like any other firm (Goodnough, 2018). While this strategy has logical explanations, it does not apply to this case. In many ways, competition is a priority for users because, in this case, it brings many positive aspects for other service users. In this case, the problem of opium addiction is too severe. That is why the merger of different firms is one of the most successful steps to solve the problem without looking at doing business (Norton, 2021). If he is the key to the issue, it is worth noting the marketing side of it.

On the other hand, it is essential to understand that the cost of so much effort may not recoup the possible profits, which plays an essential role in the merger. Solving the problem of opium addiction, among other things, would eliminate the need to buy therapeutic drugs and would have an impact on revenues (Kilic, 2021). But it is worth understanding that human lives are at stake, and as much support as possible must be given to the recovery of patients, who will be able to attract customers with other ailments in the future.

There can only be two development scenarios, namely a merger or continued competition. From a business point of view, the second option is more preferable, but from a social point of view it is important to comply with the first one. The best method for solving this problem is to create a powerful alliance to find an appropriate solution. In this way it is necessary to support other producers and to create a fighting fund. That would cover the cost of implementation and also attract the attention of the world. This way there will be no loss to the manufacturer and the reputation will be improved, as well as a solution for the addiction.

References

Goodnough, A. (2018). Injecting Drugs Can Ruin a Heart. How Many Second Chances Should a User Get?The New York Times. Web.

Kilic, A. (2021). Infective Endocarditis: A Multidisciplinary Approach. Elsevier Academic Press.

Norton, B. L. (2021). The opioid epidemic and infectious diseases. Elsevier.

Maia Szalavitz is a former cocaine addict who has been in recovery for eight years. This fact gave her an opportunity to become a journalist and serve as a researcher for Close to Home despite having a rather severe, challenging, and horrible relationship with drugs (Moyers, 1998). She shared her recovery story in the Portrait of Addiction, and though she was successful on her way to a normal life, a systemic intervention approach would make it much easier and more comfortable for this woman to recover and feel free from cocaine.

Systemic therapy is a special method of addressing patients’ problems and understanding their needs through their relationships with their families and close ones. This approach may include systemic family therapy or couples counseling in order for a specialist to get an idea of the dynamics of the relationships and the possible reasons for the patient to become an addict (Morgen, 2016). Since Maia Szalavitz did not mention her parents or husband in her interview, it is only possible to make assumptions based on her story.

According to Szalavitz, she first tried cocaine together with her boyfriend before starting to attend Ivy League school, which probably means that her family was not poor (Moyers, 1998). In this case, a specialist should study the situation with Szalavitz’s parents and learn why she had an opportunity and desire to use drugs. Since she mentioned not being popular among her peers, maybe she also lacked her family’s attention, which is a problem that had partly led to her addiction (Moyers, 1998). If this woman came early in recovery to a specialist together with her partner or family member, it would be possible to solve some issues that prevented her from living in real life and help her get rid of her addiction sooner.

References

Morgen, K. (2016). Substance use disorders and addictions. Sage.

Moyers, B. (1998). Portrait of addiction. Films on Demand.