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Psyc 330 Chapter 16 Summary
This is a comprehensive and detailed summary on Chapter 16; prevention of substance abuse.
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CHAPTER 16: PREVENTION OF SUBSTANCE ABUSEDefining Prevention
Prevention in this context pertains broadly to the avoidance or alleviation
of problems associated with substance use.
Prevention of substance abuse has traditionally been divided into three
types of intervention: primary prevention, secondary prevention, and
tertiary prevention.
Primary Prevention attempts to avoid substance use or abuse before it
has a chance to occur.
o One goal of primary prevention is to have people never start using
the drug in the first place. (“Just Say No” advertising)
o Another goal of primary prevention for some substances is the
development of responsible attitudes and substance use behaviors,
such as responsible drinking behaviors.
Secondary prevention refers to interventions when substance use
problems already have begun to appear.
o Secondary prevention is frequently used in the legal response to
substance misuse. (Ex: people arrested for DUIs are referred to
alcohol education programs)
o Central to such efforts is the early identification of these drug
problems.
Tertiary prevention includes treatment interventions used in treating
people who are beyond the early stages of substance abuse or
dependence.
o The goals of tertiary prevention are essentially to terminate use of
the substance and thus avoid further deterioration in the person’s
functioning.
Models of Prevention
There are three major prevention models: Sociocultural model,
distribution of consumption model, and the proscriptive model.
Sociocultural Model
The Sociocultural framework to understanding prevention posits that
social norms directly influence the use and abuse of psychoactive
substances. This model has been used primarily in efforts to prevent
alcohol abuse.
When applied to drinking behavior, the model consists of three basic
components:
1. An emphasis on the culture’s normative structure
2. A need to integrate drinking into socially meaningful activities
3. A focus on providing for the gradual socialization of drinking
behavior
One of the strongest advocates of the sociocultural model is Rupert
Wilkinson. In his 1970 seminal work, which remains applicable today,
Wilkinson identified 5 proposals for modifying drinking patterns culturally
, 1. The need to have within the culture a low level of emotionalism about
drinking and at the same time a lack of ambivalence about alcohol use.
a. A more measured and nonreactive approach will have the added
benefit of reducing societal ambivalence about drinking and thus
provide more clarity about drinking norms.
2. There must be a distinction between drinking per se and drunkenness.
3. After identifying what drunkenness is, there should be firm taboos on
its occurrence.
4. Drinking should be integrated into a broader social context; that is,
alcohol consumption should not be the focus of activity as any given
gathering but instead should be the adjunctive to other activities.
5. Society should allow the serving of alcohol only when food is also
available. The belief here is that when food is available, alcohol
consumption will not necessarily be the sole focus of activity.
Taken together, these proposals designate acceptable and unacceptable
forms of drinking and thus clearly identity desired patterns of responsible
drinking.
The goal of the sociocultural approach is not the cessation of drinking but
rather changes in social norms regarding drinking.
There are several criticisms about the sociocultural model:
o A major criticism of the sociocultural model is that it may not be
widely applicable.
o Another criticism is that the sociocultural approach, while
emphasizing moderate consumption, fails to account for the value
and pleasure many people attach to heavier drinking.
o A third concern with the model is that it assumes attitudinal
changes in the culture will result in the desired behavioral changes.
o A final critique is that the sociocultural model does not adequately
consider physical problems associated with alcohol consumption.
Distribution of Consumption model
The distribution of consumption model is based on research showing fairly
consistent statistical distribution of alcohol consumption across cultures.
The model was conducted by the French mathematician Sully Ledermann
in the 1950s.
The distribution of consumption model has three central propositions:
1. The proportion of heavy alcohol users in a given population is
positively correlated with the mean level of alcohol consumption in
that population. Meaning, the number of heavy drinkers in a society
increases with the society’s per capita consumption.
2. Heavy alcohol consumption increases the probability of negative
alcohol-related consequences, such as mental/emotional, physical, and
social problems.
3. Societies should attempt to reduce the negative consequences of
alcohol consumption by restricting the availability of alcohol.
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