nacada presentation on AWARENESS SESSION ON ALCOHOL AND DRUG ABUSE seku.ppt

This was created by NACADA as part of sharing knowledge on mitigating alcohol dependency.

1. AWARENESS SESSION ON
ALCOHOL & DRUG ABUSE

2. 2
Introduction
•Drug abuse can affect anyone.
•Drug use and abuse is widespread and
transcends racial, ethnic, political, social and
economic boundaries.
•Drugs are used and abused by:
–Rural and urban populations; Youth
and adults; Rich and poor; High,
mighty and low

3. 3
1.0 Objectives of Training
•Know the terms associated with drug use and abuse
•Understand the Health and social effects of ADA at the
workplace
•Understand the campaign strategies and levels of prevention
at the Workplace.
At the end of this session, you will;

4. SESSION 1:
WHY THE WORKPLACE
SHOULD RESPOND TO
ALCOHOL AND OTHER
DRUG ISSUES

5. Alcohol and Other Drug
Use in kenya
•70% of Kenya consumed alcohol during the past 12 months

•35% drank at short-term risk levels
•Nearly 10% drank at long-term risk levels
•33.6% had used cannabis at some time in their life and 11.3% had used
in the previous 12 months
•18.6% used some other form of illicit drug at some time in their life,
while 8.3% had used during the past 12 months
•7.6% have used prescription drugs for non medical purposes at some
time in their life, while 3.8% have used during the past 12 months

6. Causative Factors
•Macro- level; Income, Social environment,
•Micro-level; family, school , workplace, peers
•Personal Characteristics; genes, stress reactivity

7. Workplace Factors Associated with
Alcohol and Other Drug Use
•Physical environment
•Availability
•Stress
•Job characteristics
•Management style

8. The Impact of Alcohol and Other
Drug Use in the Workplace
•Accidents
•Absenteeism
•Lower productivity
•Costs to the individual employee
•Costs to other employees

9. SESSION 2:
TYPES OF DRUGS,
CLASSIFICATION OF DRUGS,
THEIR EFFECTS

10. •Which are the Common drugs of abuse in Kenya?

11. 11
Common Drugs of Abuse in Kenya
•Alcohol
•Tobacco
•Bhang- Marijuana, \cannabis Sativa
•Miraa (Khat)- Muguka
•Inhalants
•Heroin
•Cocaine
•Prescription drugs

12. MODES
•Orally
•Nasally
•Intravenously
•Intramuscular
•Subcutaneously
•Per rectal

13. Modes of administrationModes of administration

14. KUSH COOKIES/
HASH BROWNIES

15. Hookah- Smoking Shisha

16. 16
IntravenousIntravenous

17. Why Do People Use Alcohol
or Other Drugs?

18. •For enjoyment
•To socialise
•To relax or relieve stress
•Because of boredom
•To relieve physical or emotional pain
•Because of peer pressure / cultural norms

19. Common terms

21. PERSONAL DOMAINS

22. •A brain disease expressed as a compulsive
behavior
•The continued abuse of drugs despite negative
consequences
•A chronic, potentially relapsing disorder
After repeated drug or alcohol use, drugs change the
brain!
Drug Addiction
22

23. •A general term used to describe policies or
programmes directed at reducing the consumer
demand for psychoactive drugs.
•Programmes include; educational, treatment, and
rehabilitation strategies, as opposed to law
enforcement strategies.
Demand reduction
23

24. •A general term used to refer to policies or
programmes aiming to interdict the production and
distribution of drugs, particularly law enforcement
strategies for reducing the supply of illicit drugs.
Supply reduction
24

25. •(1) The process by which an individual is withdrawn
from the effects of a psychoactive substance.
•(2) As a clinical procedure, the withdrawal process
carried out in a safe and effective manner, such that
withdrawal symptoms are minimized( In a
detoxification centre, detox centre, or sobering-up
station).
Detoxification
25

26. •A pattern of heavy drinking that occurs in an
extended period set aside for the purpose often with
intervening periods of abstinence.
•Four or more drinks for a female and five or more
drinks for a male at one sitting
Binge drinking,
26

27. 27
7.0Drug Addiction
Drug addiction is an
•uncontrollable,
•compulsive drug seeking and use,
•even in the face of negative health and social
consequences.

28. ADDICTION PROCESS
The Addiction Process is characterised by five stages:
1. Experimental
2. Social
3. Instrumental
4. Habitual
5. Compulsive

29. Experimental Stage
•The motive for experimental use includes:
- Curiosity
- Risk taking
- Peer Pressure
- Thrill for adventure (Thrill Seeking)
- Rebellion

30. Social Stage
•The primary motivation for use is social acceptance.
•The individual remains functional.
•This level of use is rarely identified as risky by
adolescents and young adults.
•Warning and cautions are ignored and no one
believes that negative consequences will happen to
them.

31. Instrumental Stage
•Individual learns to use substances
purposely to manipulate emotions and
behavior of other people.
•The individual discovers that alcohol and
other drugs can affect feelings and actions in
the following ways;
–Suppress feelings
–Enhance feelings
–Dis-Inhibit behavior

32. Habitual Stage
•Symptoms of dependence start to appear.
•The abuser’s lifestyle becomes progressively
centered around using the drug as a means of
coping and recreating.
•The individual uses the substances to relieve their
discomfort arising from non-use.
•The individual starts to sense their impending
dependence and reacts to it by establishing various
self imposed rules and limits.
• They begin to break the rules.
•Drugs become ‘medicine’ for problems.

33. Compulsive Stage
•Its compulsory(must) take your drug of choice.
•Seek Help.
33

34. 34
What follows?
•Detoxification if need be
•Rehabilitation
•Reintegration back into workplace and society
•Continuing care
•Relapse prevention

35. 35





HIV/AIDS
Drug and Substance Abuse
Poverty
Weak awareness
programmes
Breakdown of
traditional values
Funding
constraints
Dysfunctional
families
Peer
pressure
Idleness
Easy availability
of drugs
Risky sexual
behaviour
Non-productive
behaviour
Crime and
violence
Social burden, Poverty, Disease burden, economic burden
Limited
enforcement
Unemployment


High level
outcomes
Result
Immediate
causes
Immediate
effects

36. Health Effects of Alcohol
36

37. Short term Effects; Alcohol
37

38. 38

39. 39

40. 40
•Normal Liver

41. Liver cirrhosis

42. Kidneys
•Poor re-absorption of water causing dehydration,
Frequent passing out of urine- hangover
•Retention of poisonous by products (e.g. uric acid
which leads to gout) in the body
•Kidney cancer
•Kidney failure which leads to early death
42

44. 44
Brain of baby with
            
Brain of baby with heavy
no exposure to alcohol
    
prenatal exposure to alcohol

45. Differing Views of alcohol Use
“In drunkenness of all degrees of every variety,
the church sees only the sin,
the world only the vice,
the state the crime.
On the other hand, the medical profession
uncovers a condition of disease.”

46. Screening Tool: CAGE
•The CAGE questionnaire asks the following
questions:
•Have you ever felt you needed to
 
Cut down on your
drinking?
•Have people
 
Annoyed you by criticizing your
drinking?
•Have you ever felt
 
Guilty about drinking?
•Have you ever felt you needed a drink first thing in
the morning (Eye-opener) to steady your nerves or
to get rid of a hangover?
[2]
46

47. •Two "yes" responses indicate that the possibility of
alcoholism should be investigated further.
47

48. TOBACCO
•Tobacco is the only drug which when taken
will surely cause disease, disability and early
death.
• Tobacco products contain nicotine plus more
than 4,000 chemicals and a dozen gases
(mainly carbon monoxide)
•Nicotine is absorbed readily from tobacco
smoke in the Lungs- in 8 seconds its in the
brain
48

49. 49
Stimulants

50. 50

51. 51
•Buerger’s Disease. Blood vessels get blocked and this
starves the body parts which may lead to amputation of
arms.

52. Tobacco can cause oral cancer.

53. Gum disease

54. Increased tooth decay

55. 55
SMOKING CAUSES CANCER
OF THE MOUTH

56. 56
SMOKING CAUSES CANCER
OF THE LARYNX

57. BHANG
57

58. 58

59. •Bhang contains a substance called THC
(delta-9-tetrahydro cannabinol).
•Bhang is different from other drugs as it is fat
soluble rather than water soluble.
•This allows the psychoactive chemical in marijuana,
delta-9 tetrahydrocannabinol (THC) to be more
readily stored in the body.
•Due to it being fat soluble, THC has a half-life of 2-
10 days.
59

60. EFFECTS
Brain
•False confidence of wellbeing
•Spontaneous laughter
•Short memory loss
•Confusion of past, present and future
•Hallucinations (seeing imaginary things)
•Increased heart rate
•High blood pressure
60

61. •Paranoid feelings (Fear)
•Altered perception of time
•Shrinking of the brain
•A motivational syndrome
•Chest problems;
•Blood-shot eyes
61

62. Miraa
•Miraa(khat) is legal and is grown as a commercial
crop mainly in the Eastern region.
•Miraa is not considered an illegal product in Kenya.
•Miraa contains Cathinone and Cathine- Classified as
Class c drugs
•Miraa farming is both a political and economic issue
to both the producers as well as the consumers
•Other concerns for miraa are its poly drug use with
prescription medicines such as diazepam to bring
about depressant effects.

63. EFFECTS OF MIRAA
•Rapid talking, Restlessness, Lack of sleep
(insomnia)
•Poor concentration, False feeling of well-
being, Browning of teeth and foul breath
Long-term
•Major memory loss (brain crash),
•Mouth sores and ulcers, tongue, lip and
Oral cancer

64. EFFECTS OF MIRAA
•Nerve damage leading to numbness,
Hallucinations, Excessive irritability
•Breathing problems, Risk of cancers – mouth,
lung, throat
•Mental problems – depression

65. Men in Diapers
What grown men are
forced to do when they
have Spermatorrhea
65

66. BEFORE

68. 68
6.0LEVELS OF PREVENTION.
1. Primary Prevention:
•Preventing people from starting or
getting initiated to drug use. (or
Delaying the onset of use).
What works;
I.Information on ADA among children
II.Problem-solving skills; decision making skills
III.Self efficacy; self worth, self esteem
IV.Reinforcement of antidrug attitudes and norms

69. 69
PREVENTION.
2. Secondary prevention:
Early identification of drug use and
influencing/convincing occasional or
regular users to seek help at an early
stage and stop using drugs.
What works;
I.Team Awareness;
II.Healthy Workplace Program [all integrate
substance use prevention material into health
promotion programs]

70. 70
PREVENTION.
3.Tertiary Prevention.
•Reducing the social and health risks associated with
drug abuse- Addiction
WHO DEFINITION
•To stop or delay the progress of a disorder, a
process or a problem and the consequences
thereof, even if the underlying condition
continues to exist.

71. Way Forward
•Frequent sensitization and awareness to the public
on ADA.
•Active role by the society (whistle blowing)/
Community policing.
•Mainstreaming/institutionalizing a DRUG SUBJECT
in our schools, colleges and all training
institutions – to make students/participants aware
71

72. •Economically sustainable/stable communities
•Opportunities and rewards for pro-social community
involvement/availability of neighborhood resources
72

73. 73
Is there hope

74. 74
Yes!

75. ADA workplace programme
Main components
•Prevention
•Early detection and
•Support
75

76. 1.Prevention
•Education and sensitisation - to create awareness
on the dangers of ADA
•IEC material dissemination
•Counselling, positive leisure activities
•What opportunities exist for ADA prevention in
Youth Fund
76

77. 2. Early detection
•Formal identification by utilising official channels and
policy documents
•Informal identification by workmates – suggestion
box?
•What role can employee assistance programme
play?
77

78. 3. Support
Treatment and rehabilitation
Create an atmosphere that is conducive for treatment
and rehabilitation.
“Addiction is a disease”
Why this view? Improve health seeking behaviour of
employees
Accept problem and seek help
Reintegration into workplace, family etc
Aftercare and drug free life thereafter
78

79. Employee Assistance
Programme
•Employee Assistance Programs (EAPs) are “job-based programs
operating within a work organization for the purposes of identifying
‘troubled employees,’ motivating them to resolve their troubles, and
providing access to counseling or treatment for those employees
who need these services.”
•Form an EAP group- peer educators, counsellors, management rep.
79

80. 80
WAY FORWARD
 ADA Workplace Policy.
Peer counseling
Purpose to say NO as an Institution
Be your brother’s and sister’s keeper
Awareness campaigns among staff and funded
groups.
Get professional help if addicted
Counseling. NACADA 1192(free)
Treatment, rehabilitation, reintegration and
psycho-social support

81. 81
Join the Achievers!
Stay healthy,
Smart and focused.
FREE yourself off drugs and alcohol abuse

82. Summary
•Alcohol and other drug use has potential negative
consequences for the workplace
•Drug effects vary depending on a variety of individual,
environmental, and drug-related factors
•Problems are not restricted to the relatively small number
of dependent users
•Infrequent and moderate users contribute to a large
proportion of alcohol and other drug problems in the
workplace

83. SESSION 3:
DEVELOPING A
COMPREHENSIVE AND
EFFECTIVE ALCOHOL AND
OTHER DRUG POLICY

84. Guidelines for Developing and
Implementing a Policy
•Consultation
•Universal application
•Organisation specific
•Comprehensive
•Instructions and procedures
•Drug testing consideration
•Gradual and informed change
•Publicity
•Information dissemination, education and training
•Evaluation

85. The Process of Developing and
Implementing a Policy
Phase 2:
Implementation
The design, implementation, and management phases of an alcohol and other drug policy
Agreement within the organisation
(management/union)
Appointment of steering committee and
coordinator
Feasibility study and risk assessment
Development and production of policy
document
Reduction/removal of risk factors
Awareness and information campaign
Education and training
eg., managers, supervisors, health and
safety personnel, other groups
Access to counselling, treatment and
rehabilitation
Evaluation
Phase 1: Design
Phase 3:
Management

86. Issues to be Considered in Feasibility
Study and Needs Assessments
Feasibility Study:
•External infrastructure
•Organisational support
•Resource availability
Risk Assessments:
•An assessment of external
conditions
•An assessment of internal
conditions

87. Summary: Effective Responses
•Development of a written alcohol and other drug policy
•Effectiveness of the policy development and
implementation depend on:
–consultation
–feasibility study and risk assessment
–continuing implementation/management process

88. SESSION 4:
EDUCATING EMPLOYEES

89. Why Educate?
Educating Employees:
Enhances acceptance of the policy
Raises awareness of the policy & how it operates
Raises awareness of health and safety implications of
alcohol and other drug use
Raises awareness of alcohol and other drug problems in
the workplace
Helps prevent alcohol and other drug problems in the
workplace

90. What Should be Included in the
Education Strategy?
•Details of the policy and how it operates
•Information on:
–the effects of alcohol and other drugs
–the impact of harmful alcohol and other drug use on family
members and the workplace
–symptoms of harmful alcohol and other drug use in the
workplace
–self-assessment tools
–where to get assistance
–legislations and regulations
–stress management techniques
–importance of support from colleagues and families

91. How to Develop and Deliver the
Education Strategy
•Can be developed using existing and readily available
information or by using the expertise of external
consultants
•Should be initiated in the early stages of policy
implementation and continued throughout the life of the
policy
•Methods and activities can be used include:
–health promotion
–factsheets, leaflets or flyers
–copies of the policy
–audio-visual material
–discussion of the policy and alcohol and other drug issues
–part of occupational health and safety training

92. Summary: Employee Education
•Employee education can enhance acceptance of the policy
and help influence employees’ alcohol- and other drug-
related attitudes and behaviours
•Strategies need to include a policy brief and provide
information concerning the health and safety aspects of
alcohol and other drug use
•Ongoing and delivered via a variety of media is a key to
effective employee education

93. SESSION 5:
TRAINING SUPERVISORS
AND OTHER KEY STAFF

94. Why Train Supervisors and
Other Key Staff?
•Credibility, acceptance, and overall success of any
workplace alcohol and other drug policy highly depend on
attitude and actions of supervisors and other key staff
•Training is required for:
–supervisors
–OH&S personnel
–employee representatives
•Regular and ongoing training necessary

95. What Should be Included in the
Training Strategy?
•Rationale behind the policy
•How to implement the policy and procedures
•How to identify and address alcohol and other drug-
related harm in the workplace
•Communication, interviewing, and supervision skills

96. Training Should Enable
Participants to:
•Understand their own role
in implementing the policy
•Explain to other employees
what is in the policy and
how it works
•Identify changes in
individual workplace
performance and behaviour
•Intervene with impaired
employees
•Refer employees to
services
•Provide information to
employees about the
availability of services
•Support the needs of
rehabilitated employees
and monitor their
performance
•Assess the working
environment

97. How to Develop and Deliver
the Training Strategy
•Information concerning training
is readily available and easily
accessible (e.g., An Information
and Resource Package)
•Principles of adult learning
•Training should be held regularly
•Necessary when a new staff
member is appointed
•Periodic supervisor training
Resources
and time
available
External
consultant
or
EAP
Limited
resources
and time
Develop
and
deliver
own
training
Workplaces
Training
Strategy

98. Summary: Training
•Training plays a crucial role in determining overall
effectiveness of the policy
•Training is essential if responsible staff are to implement
and manage the policy
•Training should focus on:
–increasing knowledge concerning the policy and procedures
–increasing understanding of the roles and responsibilities of
key staff in implementing the policy
–increasing the level of skills required to implement the policy
•Should to be ongoing, and adaptable to changing
circumstances

99. SESSION 6:
DEALING WITH ALCOHOL
AND OTHER DRUG ISSUES IN
THE WORKPLACE

100. How to Deal with Alcohol and Other
Drug Issues in the Workplace
•An employee’s alcohol or other drug use only becomes
relevant when it affects their performance or behaviour on
the job
•Focus on work performance and workplace safety
•Relying on physical symptoms of alcohol and drug
dependence can be problematic
•Make clear that illicit drugs use will not be tolerated at work
for both legal and safety reasons

101. Intoxication at Work
•Primary consideration must be given to the safety of the
individual and others
•Any decision to act should be based purely on
considerations of safety and work performance
•Employers & employees have responsibilities concerning
drug use and safety under occupational health and safety
legislations
•Employees should not be allowed to work until they are
considered fit to safely and productively perform their job

102. Dealing with an
Intoxicated Employee
•Avoid using judgmental words such as ‘drunk’ or ‘stoned’
•Avoid confrontation. Be brief, firm, and calm. Don’t be
provoked into a debate
•Keep the focus on safety
Follow Up
•When the employee returns to work they should be
interviewed and given opportunity to explain
•Constructive confrontation process should be initiated

103. Work Performance
•Even small amounts of alcohol and other drugs can reduce
productivity
•Criteria for evaluating work performance:
–lost time
–quality of work
–quantity of work
–safety
–effects on work team
–effects on clients or customers
•Informal approach in the first instance
•Followed by formal, constructive confrontation approach if
informal approach fails

104. A Flow Chart of the Constructive
Confrontation Approach
Poor work performance Written
details recorded
Informal discussion of work
performance problems
Work performance continues to
be unacceptable
Work performance continues
to be unacceptable
Work performance
continues to be
unacceptable
INTERVIEW 1: ADVISE person of
problem Monitor performance
Assessment of whether work
performance has improved
INTERVIEW 2: CAUTION about
the effects of continued poor
performance Continue
monitoring performance
Assessment of whether work
performance has improved
FINAL INTERVIEW:
CONFRONT with
consequences, including
dismissal
Continue monitoring
performance
Assessment of whether
work performance has
improved
Work performance
continues to be
unacceptable
DISMISSAL
FORMAL APPROACH
Satisfactory work
performance, resume
supervision

105. Constructive Confrontation:
1) Advice
•Offer help and discuss possible
disciplinary action
•Keep a written record
•Do not try to diagnose the
problem
•Sick leave
•Confidentiality
•Monitoring
INTERVIEW 1
ADVISE person of
problem
Monitor performance
Assessment of whether
work performance has
improved

106. Constructive Confrontation:
2) Caution
•Evidence of continued poor
performance
•Keep offering help and discuss
possible disciplinary action
•Keep a written record
•Should be cautioned of possible
dismissal
•Continual monitoring
INTERVIEW 2
CAUTION about the
effects of continued poor
performance
Continue monitoring
performance
Assessment of whether
work performance has
improved

107. Constructive Confrontation:
3) Confront
•Dismissal
•Documentation
•Industrial relations legislation and
unfair dismissal
•Other considerations
–unions
–complementary health and safety
practices
–workers compensation
–workplace factors
FINAL INTERVIEW
CONFRONT with
consequences, including
dismissal
Continue monitoring
performance
Assessment of whether
work performance has
improved

108. Summary: Dealing with Alcohol and
Other Drug Issues
•Informal approach
•Formal constructive confrontation approach if the situation
does not improve
•Leave medical and problem diagnoses to doctors
•Provide confidential professional counselling opportunities
•Focus on workplace safety and productivity

109. SESSION 7:
ADDITIONAL STRATEGIES

110. Additional Strategies
•Counselling, Treatment, and Rehabilitation
•Can be achieved by:
–the use of an employee assistance program (EAP)
–the use of community non-profit organisations

111. Employee Assistance Programs
(EAPs)
•Can address a range of problems including alcohol and
other drug issues
•Access to EAP can be voluntary or compulsory referral
•Refers employees with extensive problems onto specialist
treatment agencies
•Can be used to assist with the development of an alcohol
and other drug policy and the delivery of education and
training

112. Brief Interventions
•The use of in-house staff to assist employees modify
their alcohol and other drug use
Strategies include:
–the provision of health and safety related alcohol and other
drug information
–conducting brief assessments of an employee’s alcohol or
other drug use and providing feedback about how this use
may be contributing to harm
–providing alcohol- and other drug-related self-help booklets

113. Health Promotion
•Not restricted to alcohol and other drug use
•Focus on a range of strategies to improve health of
employees
•Consideration should be given to health promotion
strategies in early stages of AOD policy development

114. Drug Testing
•Testing Programs:
–pre-employment screenings
–testing for cause after an accident or incident
–random testing
•Methods of Testing:
–onsite test kits
–laboratory analysis

115. Type of Test Advantages Disadvantages
Breath Testing
• Onsite test that can indicate
alcohol intoxication
• Non-intrusive
• Can detect current or recent
use
• Can only detect alcohol use
• Relatively expensive and
requires high maintenance
• Cannot detect ‘hangover’
effects
Oral Fluid Testing
• Relatively non-intrusive –
requires swab wipe only
• Can detect current/recent
use
• Requires subsequent
laboratory analysis
• Can often be difficult to
collect sufficient fluid for
reliable analysis
• Cannot detect
intoxication / impairment levels
Urinalysis
• Least expensive of all
testing
• Extremely intrusive
• Requires subsequent
laboratory analysis
• May not detect very recent use
(0- 4hrs) or intoxication / impairment
The Three Most Common ‘Types’ of
Drug Tests

116. Other Concerns with Testing
•Places emphasis on illegal drugs
•Can have a negative impact on employee morale
•Can result in the use of more dangerous, but less
detectable drugs
•Raises privacy and legal issues

117. Summary: Additional Strategies
•Counselling, rehabilitation, and treatment
•EAPs
•Brief interventions
•Health promotion
•Testing

118. SESSION 8:
EVALUATION

119. Evaluation
•Important as it:
–determines if the policy is achieving its aims and goals
–identifies the strengths and weaknesses and indicates
what can be done to improve the policy
•Three Levels of Evaluation
–process
–outcomes
–impact

120. Process Evaluation
•Easily achieved and basic yet most important
•Can be used to determine. For example:
–the number of employees who have participated in employee
education and awareness programs
–the number of employees who have gone through the
constructive confrontation process and successfully
improved their work performance

121. Outcome Evaluation
•Determines if the aims and objectives of the policy have
been achieved
•Requires base line data and data comparison after
implementation
•Can examine workplace outcomes resulting in changes to
employees’ knowledge, attitudes, and behaviours. For
example:
–changes in absenteeism rates
–changes in the number of incidents or accidents involving
alcohol or other drugs
–changes in levels of productivity

122. Impact Evaluation
•More long term and requires a high level of expertise in
evaluation
•Goes beyond the stated objectives and goals of the policy
to examine if there were any consequences not planned
for or expected. For example:
–stronger workplace involvement in community initiatives
–closer working relationship with union initiatives

123. Summary: Evaluation
•Important component of any workplace strategy
•Can utilise a range of evaluation methodologies depending
on the available needs and resources of individual
workplaces
•Needs to be ongoing
•Input should be obtained from all stakeholders including
members of employees’ families