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Drug abuse and wellbeing

There is no single age group of people more affected by drug abuse than youth. In some ways, it feels as an issue everywhere: in our homes, families, schools, communities.

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01. Difference between drug use and drug abuse

It can be hard to tell the difference between drug use and drug abuse. Drug use and drug abuse terms are often used interchangeably, although abuse and use carry different meanings. As a youth worker involved in the field of youth drug prevention, it is thus helpful to be aware of such differences as this can help with improving young people’s knowledge about how, when the use of a substance can become problematic and what a person can do. Indeed, understanding the problematic use of a substance has been a significant area of focus in the field of psychology and rehabilitation. Much of the research around problematic use of alcohol and other drugs examines the level of impact the substance may have on an individual’s life. To understand how drug use can transition to drug abuse, it is relevant to examine the patterns and consequences of the use of drugs. It is also important to understand the substance use of choice, as substance carries its own distinct characteristic and traits that can affect users differently. Research shows a strong connection between the number of negative consequences and the severity of drug use abuse. So, for drug use prevention efforts to contribute to more protective effects against drug abuse it is important to define drug use and drug abuse as distinct terms. 

Drug use is often referred to as a single episode of use of a substance both for medicinal and/or recreational purposes. Though substance of choice varies from person to person. Some of the most commonly used drugs include alcohol, tobacco, marijuana, caffeine, ibuprofen, etc. while the use of alcohol, tobacco, and other various drugs carry a sense of normalcy within society. For example, alcohol is often used frequently during celebrations, various rites of passages, and even during family dinners. Prescription drug use, similarly, can be effective for the treatment of ailments, especially when used as prescribed by a doctor. So, the question is: when does drug use transition into something more serious like drug abuse or addiction?

Drug abuse is often referred to as problematic use of alcohol or drugs. It differs from individual to individual as an abuser often overlook the consequences of drugs due to compulsion and/or extreme desire to continue using. So, the one distinguishing marker is often the frequency of use in combination with the level of desire and/or control. Drug use refers to the experimentation, low frequency, and/or irregular use of alcohol and drugs. On the other hand, drug abuse refers to regular or compulsive urges to use alcohol and drugs. Generally, drug abuse alters the individual’s lifestyles and influence psychological dependency on a substance. Drug abuse is not strictly limited to illicit substances. It can also be prescribed medications and legal drugs like alcohol or marijuana. A problematic pattern of drug use carries the potential of leading to drug abuse and even more so to addiction.

02. Drug abuse and youth well-being

Youthhood is recognised as a period for onset of behaviours and conditions that not only affect health outcomes limited to this period but also lead to adulthood disorders. Unhealthy behaviours such as smoking, drinking, and illicit drug use that often begin during youthhood; are closely related to an increased morbidity and mortality in the young people and represent major public health challenges. Poor academic performance, increased youth unemployment, a poor health and well-being, accidents, suicide, mental illness, and decreased life expectancy all have drug misuse as a common contributing factor that have a major impact on youth, families, and communities, as they effects are cumulative, contributing to costly social, physical, and mental health problems. Several factors enhance the risk for initiating or continuing substance abuse including socioeconomic status, quality of parenting, peer group influence, etc. which all have negative effects on youth health and well-being. 

Youth well-being is about how young people are doing and how they feel about their lives. Low well-being has been linked to poor mental health outcomes, which can lead to mental health conditions such as depression and anxiety. Hence, poor youth well-being not only impact their relationships with family and friends, but also how they feel about and interact with the world around them. So, high Youth well-being integrates mental health (the mind) and physical health (the body) resulting in more holistic approaches to disease prevention and health promotion. Drug abuse, the regular, compulsive urges to abuse tobacco, marijuana, alcohol, and drugs is linked to poor well-being among youth, which not only impact their relationships with family and friends, but also how they feel about and interact with the world around them. 

That is, youth who persistently abuse substances experience an array of problems, including academic difficulties, health-related problems including mental health, poor peer relationships, the involvement in violence and development of risk and aggressive behaviours. Additionally, these have consequences for family members, the community, and the entire society. Most often, the youth who start using drugs have very little information about them: they cannot tell the difference between physical and psychological effects, they know nothing about what physical and psychological addiction means, they do not have the knowledge and skills to take into account the consequences for their social life (friends, family, school). Indeed, many youths start with a positive outlook on drugs, occasional drug use, the problem is then setting the limit since the line between drug use, drug abuse, addiction is very thin and uncertain. And once the realm of drug abuse has been reached, it paves the way for addiction, and the way back is difficult.

03. Drugs’ characteristics and classification

Drug is a natural or synthetic substance, which by its chemical nature determines the alteration of the functioning of an organ and changes the mental state of a person. The term drug refers to psychoactive substances, especially illegal ones, but also socially accepted ones (alcohol, tobacco, caffeine). Scientifically drug is referred to as any substance that has the ability to determine a state of physical and/or mental dependence (addiction) and/or tolerance. Addiction is the strong compulsion felt by the user to continue taking the drugs. 

There are two types of addiction: physical and psychological, sometimes being combined:
(a). Physical addiction: it is not found in all drugs but occurs in substances with a depressing effect on the central nervous system, for example: opium derivatives such as heroin and morphine, tranquilisers, alcohol. The state of physical withdrawal that occurs in addicts who stop taking drugs or consume drugs in a smaller quantity manifests itself in the form of pathological conditions: tremors of the limbs or even of the whole body, joints and bone pain, nasal discharge, frequently encountered signs of a flu-like state, but much more accentuated. To overcome them, the person needs to consume a new dose of the drug.

(b). Psychic addiction: it is the most important and it is found in all drugs, consisting of a change in behaviour and a particular mental state, accompanied by the imperative psychological need for periodic or continuous administration of the drug to obtain a state of well-being or to overcome a psychological discomfort.

Tolerance consists in the gradual disappearance of the effects of a drug that is administered repeatedly, over a certain period of time, so that in order to obtain the same effect, a progressive increase in the dose is required (a dose that for a normal person could be fatal). Withdrawal refers to physical and mental effects that a person experiences when they reduce or completely quit the use of a substance that has created an addiction. If the use of that substance is suddenly stopped, the body is unbalanced and thus withdrawal occurs. Its symptoms can vary in intensity and severity, depending on substance that caused the addiction. Drugs are classified according to several characteristics (depending on the effect they have on the consumer, depending on their natural or synthetic origin, from the point of view of the legal regime, etc. The classification of major importance used in the medical and prevention field (the most appropriate classification according to the WHO) is made according to their effects on the central nervous system (CNS) of the consumer. Drugs can also be grouped by how or where they are commonly used.

04. Drug addiction and substance abuse disorder

The journey: drug use -> drug abuse -> addiction -> substance use disorders -> health problems. Drug abuse occurs when a person takes legal drugs or socially accepted drugs in the ways that are not beneficial. It is the intermediate stage between drug use and drug addiction. A person may abuse drugs to feel good, to relieve stress or to avoid reality. If in the case of substance abuse, the person changes their own healthy habits, when the person develops a psychological or physical addiction to a substance they cannot stop anymore. Despite unwanted consequences of continual substance abuse, drug addict feels an uncontrollable urge to obtain and use the drug, maintaining their destructive behaviour, even if they want to quit. Although the initial decision to use drugs is a voluntary decision for the most people, the changes that occur in the brain over time ultimately determines addicts' ability to resist urges to use drugs and to limit self-control. 

Quitting is not just a matter of willpower, nor is it simply a choice, as addiction involves physical and mental changes in the brain that make it difficult, if not impossible, to quit without external qualified help. Although drug addicts are considered delinquents, they are sick people who have reached a state of irresponsibility for their actions. The Diagnostic Statistical Manual for Mental Disorders (DSM) is a publication for the classification of mental disorders that uses a common language and standard criteria and has been published by the American Psychiatric Association. Since its first publication in 1952, revisions have gradually added to the total number of mental disorders (psychiatric illness that affect people's thoughts, behaviour, and social ability) and eliminated those that were no longer considered to be mental disorders. A manual widely used together with the WHO - International Statistical Classification of Diseases and Related Health Problems (ICD). The initial impulse of the first edition of the DSM in 1952 to create a classification of mental disorders established a single category "idiocy/insanity" (insanity was associated with: alienation, dementia, derangement, insanity, mental illness). 

In DSM 5th edition (2013) (known as DSM-5), diagnoses of substance abuse and substance dependence were merged into the category of substance use disorders, and they are rated by severity as mild, moderate, or severe. Drug addiction is itself a disorder/a disease that can lead to other psychiatric disorders (for example, alcohol addiction produces delirium tremens, while cannabis use accelerates the onset of pre-existing psychiatric diseases to which the person is predisposed, or aggravates existing ones: psychosis, paranoia, schizophrenia, etc.). For the addicted person to be able to return to a normal life, a complex combination of medical, psychological, social measures is needed; detoxification process can be a first step in achieving abstinence from depressant drugs.

05. Drug addiction recovery and rehabilitation

The right to health is one of the most essential rights that we enjoy throughout our lives. According to the World Health Organisation (WHO), the fundamental human right is health or, more precisely, the access to medical information and services that have the role of maintaining the health and well-being of all people. In many countries, awareness about mental, emotional, behavioural, substance use disorders are very limited, especially in low-middle-income countries (LMICs). Numerous publications and reports highlight that the people living with mental, emotional, behavioural, and substance use disorders often face extensive human rights violations, stigma, or discrimination within the health system and in public discourse. The 2020 European report on drugs shows that the average mortality rate caused by overdoses in Europe is 22.3 deaths per million among the people aged 15-64. Bringing a person who has fallen into the mirage of drugs back to the normal world requires hard work because addiction is a drama that is difficult to describe in its true intensity.

If physiological addiction can be treated quickly, mental addiction is difficult to overcome because the person who has consumed drugs for years is vulnerable and relapses are extremely easy. When the addicted person admits that they have a drug addiction problem; the first step towards recovery and rehabilitation is made. In general, however, addicted people deny having drug addiction problems and hesitate to seek treatment. In this situation, family, friends, co-workers, or others who care about the person struggling with addiction, by consultation with health care provider, mental health professional, licensed alcohol and drug counsellor, must intervene to motivate the addicted person to accept and get help before things get worse or before it is too late to accept and start recovery treatment, which is not a quick fix but a long process that require patience and trust to achieve the desired effect.

The definition of recovery remains divided and subjective in drug rehabilitation, as there are no established standards for measuring recovery. The Betty Ford Institute defined recovery as achieving complete abstinence as well as personal well-being, other studies consider drug addiction recovery as near abstinence to be a more suitable definition. An effective treatment means an individualised intervention according to the needs identified in the case of each consumption in all spheres of life: physical, psychological, vocational, relational, legal, spiritual. In many cases, several courses of treatment may be required for the patient to fully recover. The two main categories of treatment are: Behavioural treatment (cognitive-behavioural therapy CBT): which consists of changing unhealthy patterns of thinking and behaviour. The individual learns strategies to manage cravings, avoid cues and situations that lead to relapse.

06. Socially accepted drugs vs. illegal drugs

Drugs have been used legally or illegally for thousands of years, and therefore, consideration should be given to why, how, and when they are used. From one stage of society's evolution to another, what is legal has been credited to either one drug or another. But beyond the social acceptance or rejection of drugs by society, their negative effects on the individual's health and social relationships are undeniable. This is because some drugs have long been accepted by society. Alcohol, nicotine from tobacco, and caffeine and theine from coffee and tea are drugs that can cause some degree of addiction to those who consume them. Campaigns against smoking have become more vehement since its health risks were realised, and while drink-driving was banned because it led to serious road accidents. 

But smoking and drinking have both been left up to each individual to decide. The socially accepted drugs in Romania are alcohol, nicotine, volatile substances, but also certain substances from the class of amphetamines that are found in certain slimming products and drugs with psychoactive effects, but only with a medical prescription and with numerous specifications. The most used illegal drugs are cannabis (in some countries there is a controlled consumption of this drug, and this makes it socially acceptable), cocaine, ecstasy, heroin, LSD, methamphetamines, poppers, ketamine, GHB. Alcohol is consumed and spread everywhere. Todays, even from a young age, children begin to consume it. It is a psychoactive drug, with an immediate potential for overdose, poisoning and physiological dependence (or alcoholism). 

And alcoholism has become one of the most common causes of addiction in the world. Physiological dependence caused by alcoholism means that the addicted person goes through withdrawal (in form of a headache known as a "hangover," increased anxiety known as "chills," and fatigue or trouble sleeping) when its use ceases or decreases. Ethanol has been consumed by humans since prehistoric times, that was done for a variety of reasons: hygienic, food, medicinal, religious, entertainment. Nicotine is an alkaloid present in tobacco leaves and which, when consumed in small concentrations (about 1 mg of absorbed nicotine), acts as a stimulant, being the main factor responsible for addiction. The pharmacological and behavioural characteristics that determine tobacco addiction are similar to those of heroin and cocaine addiction. Tobacco was used in past for earaches and toothaches and occasionally as a poultice. Or smoking was a cure for colds, especially if the tobacco was mixed with sage leaves, or Indian balsam root. Nicotine and its metabolites were studied for the treatment of diseases such as: Parkinson's disease, Alzheimer’s disease. Amphetamines, also known as Speed, Uppers, are stimulants of the central nervous system that are used by doctors to treat conditions such as: attention deficit, narcolepsy, or obesity.

07. Alcohol, tobacco, and drugs abuse in youth

Adolescence is the age when the need to identify, find and understand oneself and the people around appears. It is the age of personal experiences, the age of searching for the coordinates of the soul and body, the age of discovering the dimensions of reality. And the drugs often take the form of such an experience, which brings together: curiosity, the desire to try something new, to experience everything, the desire to progress and elevate intellectual performance and even the desire to simply be modern. Drug starts to be more and more present in the youth groups during teenager based on the entourage and the school. It is what determines the formation of a biopsychosocial model, which is developed by the interaction between psychological, environmental, and physiological factors. 

Often, both in the school and the university environments, as well as in ordinary circles, there is a phenomenon of group imitation, in which teenagers, copying their hero, resort to drugs, and in which the psychological factor is decisive. Any user also demonstrates a pathological desire to make followers, the personality being misunderstood by those who have not come into contact with the drug. It is certain, however, that under the influence of the drugs, teenagers seem to overcome difficulties and uncertainties and find an illusory security and identity. And research this phenomenon shows that hallucinogens allow users to float; it is a journey that makes user evade from their daily difficulties and contradictions and feel in control of the situation. Adolescence is also the age of emotional tensions and anguish, apparently incomprehensible to those around. Many times, for teenagers troubled by their own questions of identity and belonging, more or less real, from the outside, drugs seem the only and best solution to get by. 

The psychological profile of the young consumer is dominated by neurotic traits, affective dependence, intolerance to frustration, separation anxiety, isolation, irritability, shyness, and hypersensitivity. And then there is an opposition of the ego against the world, which is considered an aggressive, unjust, and oppressive element. So, the solutions that the adolescents find to resolve these conflicts is to withdraw into a world constructed, determined, and maintained by the drug. This world makes them happy, satisfies their primal instincts, and thus fades their conflict for a while. Some studies have found, in drug users, the presence of an uncontrolled and demonstrative emotional state, in the sense of alienation from those around them and a weak control of impulsivity. Self-knowledge and self-definition, solving one's own problems is also limited by adolescent's cognitive immaturity. The main risk factors that can determine drug use could be related to mental, emotional, and behavioural disorders, anxiety, depression, loneliness, frustrations, or interpersonal conflicts.

08. Effects of alcohol, tobacco, and drug abuse

Alcohol is an easily accessible drug and the most common substance of abuse that disturbs the activity of the nervous system through the chemical reactions it produces in the brain, affecting the way people think, speak, feel, and/or move. Alcohol has sedative effects, although it is initially characterised as a stimulant, due to the state of euphoria it causes, effect of short-term alcohol consumption, encountered immediately after consumption, consist of slowed responses to the environment, decreased coordination, and the ability to think clearly, temporary memory impairment, vomiting, impaired vision-balance, loss of consciousness, coma, suffocation with own vomit etc. Excessive alcohol consumption leads to addiction, causing serious diseases especially of the liver, such as hepatitis or cirrhosis. 

Though the long-term complications of alcohol can consist of frequent fatigue, short-term memory loss, gastrointestinal disorders, hypertension, heart failure, stroke, diabetes, weakened bones, erectile dysfunction, mental illness, but also problems in the relational or/and social sphere, such as: physical, verbal violence, rape, domestic, work and road accidents, crimes, divorce, loss of job, poor results at school or school dropout, loss of home, divorce, etc. Although smoking is a habit accepted by society, it is also the cause of serious illnesses. It creates pleasant sensations without too much effort since it activates the secretion of dopamine. Smokers quickly feel a state of relaxation, which can sometimes suppress the desire to quit smoking. That is why people who smoke continue this habit, even when it is obvious that their lives are in danger. This feeling of feel-good does not last long, because the nicotine is detached from the neurons that secrete dopamine, then reaches the liver, where it is eliminated through the kidneys and skin. 

Thus, after about 45 minutes, the smoker begins to have unpleasant sensations, of nervousness, impatience, irritability, due to the lack of dopamine that occurs because of the decrease in nicotine in the blood, a fact that leads to withdrawal. That is why the brain asks for another dose, that is, another cigarette or another tobacco product. Tobacco addiction is due to nicotine, which once in body has the same effects as morphine. Once tobacco consumption is suddenly stopped, the effects such as dizziness, tremors, fits of anger, insomnia, increased appetite, poor concentration occur. So, the possible complications in the case of tobacco use are lung cancer, larynx, oesophagus, bladder, pancreas, premature aging, infertility, erectile dysfunction, high risk of abortion, serious problems in the new-born. The individual health risks of cannabis use for example are generally accepted to be lower than the risks associated with heroin or cocaine. Marijuana rarely contributes to fatal overdose, but its use can increase the risk of premature death and the development of pathologies such as cancer or suicide.

09. Alcohol addiction: a substance use disorder

Alcohol is a legal substance, widely available, accepted by most societies, with potential for abuse and acute and chronic toxicity. It has a depressing effect on the central nervous system, causing the decrease in neuronal activity, it has an anxiolytic, antidepressant, relaxing and sedative effect, being used by too many people who face anxiety, depression, or insomnia. At the brain level, it acts on pleasure centres mediated by dopamine, that partly explains the establishment of alcohol addiction. Alcohol use disorders include a wide range of problems, from binge drinking to addiction.

Psychiatric disorders associated with alcohol consumption: (1). Personality disorders (antisocial, avoidant) appear due to prolonged ethanol consumption. (2). Anxiety and depression are present in 90% of chronic users, both during consumption and during early/late withdrawal. (3). Suicide is much more common in people addicted to alcohol, because of the involvement of serotonin, which mediates the aggressive-impulsive behaviour of alcoholics. One out of three suicide cases are based on alcohol consumption. (4). Hallucinosis refers to opinions/impressions, whose authenticity the individual tries to test; as he is preoccupied with a possible partner's infidelity, frequently having delusional ideas of jealousy, him being inundated with ideas of persecution, of harm. (5). Ethanol intoxication: shortly after an abusive consumption of alcohol, an uninhibited behaviour appears, the consumer being communicative, expansive, emotionally unstable, can become easily irritable, aggressive, or violent. If the intoxication worsens, the patient becomes confused, disoriented, or lethargic, with an obvious decrease in the level of consciousness.

(6). Ethanol withdrawal: the signs of withdrawal appear at the earliest 4-6 hours after the drop in blood alcohol concentration and are manifested by tremors of the extremities, nausea, vomiting, sweating, tachycardia, increased blood pressure, anxiety, nervousness, dysphoric mood (sad, irritable), insomnia, sometimes fever. In the uncomplicated form, these symptoms last for a few days, then decrease in intensity. In the next 2-3 days, tactile, auditory, and visual hallucinations may appear (they claim to see animals: reptiles, mice, cockroaches, etc.). (7). Delirium tremens: the most severe complication of withdrawal and generally manifests 2-4 days after stopping alcohol consumption with psychomotor agitation, confessional state, hallucinations, fever over 40 degrees, sweating, tremors of the extremities, of the chin, of the tongue, speech difficulties, the pulse is over 100 beats/min, disorientation in space and time and visual hallucinations. Its complications are pneumonia, liver, kidney, heart failure, electrolyte disorders and acidosis, which can lead to death. (8). Late withdrawal: Appears after a period of 3-6 months after the cessation of consumption and is manifested by a dysphoric mood, discrete tremors, insomnia, hypertension.

10. Youth against drug and substance use

Every young person is different, and the reasons why they may be attracted to drugs are also different. That is why the ways that help them resist temptations and avoid drug use, abuse, and addiction vary form one context to another. So, the prevention substance abuse must start at a relatively young age (even from pre-school education, focusing on the development of a healthy lifestyle, as the basis of later prevention), consisting appropriate family education (courses for parents to familiarise themselves with how to have conversation on drug, which can also include intra-family relationships, parent-child, child-child, spending quality time with family, active listening, etc.). The goal should be encouraging healthy habits and promoting good family communication, the existence of strong emotional bonds between parents and young people, the existence of general, clear, stable family norms: self-respect increase the confidence of adolescents and encourage them to set their priorities and make the right decisions in what they do. This increases the individual capacity of the adolescent to solve their problems. It is important that the youth are surrounded by an environment that responds to healthy principles, where there is no drug use or peer pressure. 

If, there is however peer pressure then the young person must be prepared to respond or behave when faced with this situation: (a). If drugs are offered, the young person can refuse firmly and without justification, because the decision not to use drugs belongs to him; for example, humour can be a solution to cope with the situation as it can be difficult to say "NO", but the convictions must be stronger and thus the young person can gain the respect of others. (b). Young people need to feel that they belong to a group, and no one wants to be left out of the group for the wrong reasons, but if you are firm about what the young person wants or does not want to do, then they will be respected by their friends. (c). Young people should not worry about what others say about them, but on the contrary, they should focus on their own opinion. (d). Young people should be aware that peer power is a way for people to seek approval for their behaviour and should think about whether they really want to encourage others to justify their drug use. (e). Information about drugs, effects, risks will also increase the level of confidence in the decisions made.

Youth against drug and substance use could be achieved through initiatives that aim to connect and empower youth to become active in schools, communities and youth organisations for substance use prevention and health promotion. It an approach that provides a platform for youth to share their experiences, ideas, and creativity, and get support for creating their own substance use prevention and health promotion activities. These can include activities such as sport events, religious gatherings, study circles or artistic circles, etc.

11. Youth organisations in drug prevention

Alcohol, tobacco, and drugs harm people other than the users, whether through violence on the street, sexual and domestic violence in the family or simply using government resources, notably through the costs of providing health care, youth unemployment and incapacity benefits, as well as dealing with crime or disorder. Furthermore, the disadvantaged young refugees, at-risk youth or youth living in disadvantaged areas, experience more harm than any other age groups. Hence, increased youth empowerment and awareness-raising about effects of alcohol, tobacco, and drug abuse on mental health, well-being, and healthy lifestyle and their consequences: school dropouts, unsafe sexual practices, sexual or domestic violence, communicable diseases, etc. can mitigate the impacts of these effects on economic downturns and mental, emotional, behavioural, and substance use disorders among youth. 

Thus, youth organisations in drug prevention are key in facilitating youth empowerment in drug prevention; by ensuring that youth have access to relevant services and resources concerning drug abuse and drug abuse prevention, and resources for organising drug prevention interventions.

Drug prevention in youth work by youth organisations is a youth work that aims at tackling drug abuse among youth and promoting youth health and well-being through a wide range of School, Community, and/or Media-based interventions. And therefore, the overall objective of drug prevention in youth work by youth organisations is to counteract misinformation and disinformation around drugs while communicating an accurate information that seeks to: (1). Prevent or delay the start of drug use; (2). Deter drug misuse or abuse; and (3). Prevent or reduce drugs' effects on youth health and well-being. So, drug prevention interventions planned, designed, and delivered by youth organisations in youth work target all young people, but most importantly, target specific groups with specific needs, such as youth who have already tried drugs or who are considered at-risk youth. 

Though there is no protocol for drug prevention interventions in youth work as they operate in the realm of non-formal education, for interventions to be more effective they should be run by both youth and youth workers, and they should consider: 1. Enhancing protective factors and reducing risk factors. 2. Strengthening skills to resist drugs, problem-solving skills, and social competencies. 3. Blending interactive, participatory methods with the traditional educational techniques. 4. Targeting youth and giving special attention towards identifying the youth who are most at risk. and 5. Generating norms that are strengthened against drug use and being sensitive with respect to ages, cultures, and developmental stages.

12. Impact pathway to drug prevention

Pathway to Social Change or an Impact Pathway, is a logical causal chain from drug prevention intervention’s context to drug prevention intervention’s impact. It looks at how changes in risk factors for drug abuse are anticipated to happen based on the drug prevention intervention undertook by young people. Thus, a community-based prevention intervention is at the core of an Impact Pathway. For community-based prevention intervention to achieve changes in risk factors for drug abuse which contribute to protective factors for drug abuse within the community and among young people, is always a challenge.

It requires youth workers and their youth organisations to create the conditions for realising both the interventions short-term and medium-term results within the intervention’s lifecycle, which contribute to achievement of protective factors for drug abuse among youth. Such a thinking is built on the impact pathway; emphasising and visualising the contribution of a drug prevention intervention towards long-term results, accompanied by monitoring, evaluation. It outlines plausible pathways on how through education and training activities, drug prevention intervention’s inputs contribute to its results at the Output level, and how through post-training activities, the use or satisfaction of Outputs by training beneficiaries at the individual learners, organisational, or community level contribute to results at the Outcome level, and finally, how the use or satisfaction of Outputs by post-training activities beneficiaries contribute to Impact.

Drug prevention intervention’s Logical Framework is an analytical tool used for conceptualising drug prevention intervention’s objectives. Logframe tool is built on planning concept of a hierarchy of levels linking drug prevention intervention. There is an assumed cause-and-effect relationship among these elements, with those at the lower level of the hierarchy contributing to the attainment of those above. The analytical structure of the logframe outlines the causal means-ends relationships of how a drug prevention intervention is expected to contribute to its objectives. It is then possible to configurate the indicators for monitoring implementation and results around such a structure by displaying an intervention’s own design logic: (1). Inputs: A drug prevention intervention’s inputs are used to undertake the educational and training activities by youth workers with youth people, which lead to the delivery of outputs. (2). Outputs: A drug prevention intervention’s outputs are used to undertake post-training activities events by both youth workers and young people for young people, which that lead to the attainment of outcomes. (3). Outcomes: A drug prevention intervention’s outcomes are used to undertake community-based actions by youth organisations, youth workers, and young people, which lead to impact that contributes to promoting protective factors for drug abuse among young people.


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