Parents, Teachers and Youth: The differing ethos of Knowledge and Attitudes to Addiction.
Glimpses from the Kripa Research Activity - 2008 to 2016.
A Report by
Dr. M. S. Menon, MBBS, MD. Major, AMC (Retired).
(Medical Director & Head- Kripa AIDS Initiatives)
The Kripa Foundation (www.kripafoundation.org) is recognized as a Scientific and Industrial Research Organisation (SIRO), by the Government of India, Ministry of Science & Technology. The focus of research is on understanding the nature of addiction, its impact on individuals and society and developing methodologies to better address the situation and provide appropriate therapy with benefits that help individuals and community at large to make life enhancing changes in the long term.
The differing geographical and socio-ethnic considerations in the country define addiction and its outcomes as a disorder and practice with huge variability depending on location, population and cultural background, drug trade and practices, differing therapeutic options and the considerations of the ‘Law of the Land’. In India the number of drug addicts is increasing day by day. Changes in lifestyle, along with easy access to media and internet have among other factors, lowered the age of exposure to drugs and alcohol among youth. In fact substance use by young people is on the rise globally, and initiation of use is occurring at ever-younger ages. India per se also has a huge at-risk young population with 40% being below the age of 18 years.
According to UN Convention Reports on Narcotic Drugs and Psychotropic Substances in 1961, 1971 and 1988, it is estimated that, in India, by the time most boys reach the ninth grade, about 50% of them have tried at least one of the gateway drugs. Many young adolescents are also observed coming in for treatment with drugs getting more potent and newer synthetic and highly addictive drugs being easily cooked up in home labs. Drug abuse continues to emerge as a strategy used by youth to cope with multiple problems of unemployment, abuse, neglect and violence. Be that as it may, there are socially integrated young people of the industrialized and developing nations who also indulge in considerable drug abuse. This could be attributed partly to the fact that a significant portion of the world’s youth population is being exposed to a more ‘drug use tolerant culture’ and that too at a much younger age.
Two research efforts were undertaken in the quoted period. One was directed at understanding the attitudes and family dynamics of parents / codependents and their drug using children in a singularly closed in semi rural community in a relatively remote region (the state of Meghalaya) and the other study was located in the metropolis of Mumbai and was directed at evaluating the outcomes of a single awareness intervention for teen age students, their parents and teachers.
In the first study where parents attitudes to their substance using child / ward was studied, the criteria for making diagnosis for co-dependent were as follows: 1. Continued investment of one’s self-esteem in the ability to control one’s self and others in the face of serious adverse consequences, 2. Assumption of responsibility for meetings other’s need to the exclusion of one’s own anxiety and boundary distortion with respect to intimacy and separation, 3. Enmeshment in relationship with personality distorted, chemically dependent, other co-dependent, and/impulse-disordered individuals and 4. Three or more of the following: excessive reliance on denial; constructions of emotions; repression; hyper vigilance; compulsions; anxiety; substance abuse; stress related medical illness; being the victim of past and current physical or sexual abuse; remaining in primary relationship with an active substance abuser for at least 2 years without seeking help.
Family and relatives suffers bio-psycho-social stresses as a result of living in this environment, which may impact on physical and mental well-being and lead to the development of problems both for themselves and other family members. This is a world wide phenomenon. These relatives need help, both for themselves and for the addict in order to deal constructively with their substance misusing relation.
In the study, majority of the parents/ guardians responded in the following manner: (a) don’t accept the substance user child (b) were aware of withdrawal symptoms (c) agree that special help is needed (d) were willing to help the child.
Parents felt the following would help the child to overcome addiction: (1) religious teaching and interactions with a religious teacher (2) professional counseling (3) rehabilitation programme and (4) medical treatment. Parental suggestions on the best way to help the affected child included-teaching religious values, ensuring a safe peer group, counseling by the parents and help from professionals. Overall, a reasonably responsive parent group was studied, who needed further in-depth understanding of the nature, extent and manifestations of codependency and more facilitation towards empowerment.
KEY WORDS: parental awareness, health education, professional counseling, rehabilitation, codependency.
In the second study, a well known private high school in Mumbai approached Kripa Foundation to conduct a preventative educative drug awareness session for their students (Grade 8 to 12, age 14 upwards), their teachers and parents. The session aimed to (i) increase the awareness of drug addiction and related issues (ii) enable students to make informed choices and choose healthier lifestyle options by reducing high-risk behavior and (iii) provide relevant inputs so as to sensitize parents and teachers to risk and protective factors in addiction, so that they can respond to relevant concerns in an appropriate manner.
In general, factors that may contribute to youth experimenting at an early age and that which may influence their usage patterns include the following: (1) Increasingly independent lifestyles of both parents and children (2) Increasing substance use related media exposure in children (3) Declining outdoor physical activities (4) Heightened risk taking, sensation seeking behavior, easy access to drug (5) Easy accessibility of drug (6) False Consensus and (7) Adolescents differ from adults in the way they behave, solve problems, and make decision.
Drug abuse is a persistent public health problem in modern society, and a disturbing new trend is the increased recreational use of so-called “designer drugs,” “legal highs,” or “research chemicals.” These drugs, collectively known as “new psychoactive substances” (NPS), are synthetic alternatives to traditional illegal drugs of abuse. There is a tendency to overestimate the extent to which others share one's own attitudes and behaviors. Recent research by scientists at the National Institute of Mental Health (NIMH) using magnetic resonance imaging (MRI) has found that the teen-brain is not a finished product, but is a work in progress. This may help to explain certain teenage behavior that adults can find mystifying, such as poor decision-making, recklessness, and emotional outbursts.
Prevention programs are often designed to enhance “protective factors” and reduce “risk factors”. Protective factors are those factors that are associated with reducing the potential for drug use, and risk factors are those factors that increase the likelihood of drug use. One way to implement prevention strategies in schools is through comprehensive health education. Effective health education curricula employ practices that are grounded in research and focus on skill development such as accessing information (such as telephone help lines, information on how to help oneself or a friend etc.), advocacy (advocating for your own health and the health of others), analyzing influences (positive and negative influences of media, peers, family, self), strengthening coping mechanisms and interpersonal communication skills (refusal skills, negotiation skills).
In this study, the primary benefit of the awareness session for both groups was in the perception of alcohol as a drug. It is interesting to note that both groups, students as well as teachers and parents showed a post session increase in the percentage of correct responses to the informative item ‘Alcohol is a drug’. A related informative item ‘Alcohol causes as much problem as drug abuse’ also showed a post session increase in the percentage of correct responses. This study also highlighted the difference in the harm perception between legal and illegal drugs in the society.
Students were animated in their discussion about how the youth nowadays prefer marijuana over cigarettes and its considered more ‘herbal’ or ‘safer’, which could be the result of aggressive negative promotion of cigarettes, where youth have started substituting it with other products which are also derived naturally from plants. Another point of intervention that could be further explored in detail with both sets of audiences (students as well as teachers and parents) is brought out through the responses which talks about the relation between Addiction and HIV AIDS. Both these are coexisting co morbidities driven by high risk behaviors.
KEY WORDS: educative preventative drug awareness, substance abuse, high risk behaviors.
A focus on the development of the self and self regulation along with values clarification, communication and interpersonal skills, decision making and critical thinking would go a long way in facilitating positive choices among the youth.
In conclusion, it has been observed that there exists a rapidly growing need for educative sessions focusing on prevention of drug use and high risk behavior owing to the highly dynamic lifestyles youth nowadays is exposed to. This approach although limited in its capacity, gives a good insight on the potential areas of primary intervention.
Acknowledgements on original research work:
To Fr. Joseph H Pereira - Managing Trustee Kripa Foundation
In Shillong: Z. Tsenthunglo Ezung (Master of Science Candidate); Kripa Shillong Team.
In Mumbai: Krishna Iyer- Development Manager, Kripa Foundation; Aninha Lobo - Associate Professor and Head, Department of Psychology, Sophia College for Women
Mr. Linus Pinto ,Mr. Mozen Heredia and Team.
Comments and correspondence may be addressed to Dr M. S. Menon at firstname.lastname@example.org