Rajiv Gandhi University of Health Sciences Bangalore, Karnataka s28

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGALORE, KARNATAKA.

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION.

Mr. SOMASHEKAR.S.AKALAD.

FIRST YEAR Msc.Nursing,

CHILD HEALTH NURSING.

DHANVANTARI NURSING COLLEGE,

41/3, VINAYAK NAGAR,

NEAR CHICKKABANAVAR RAILWAY STATION,

HESSARGHATTA ROAD,

CHIKKABANAVAR, BANGALORE - 90.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1 / NAME OF THE CANDIDATE AND ADDRESS / Mr. SOMASHEKAR.S.AKALAD.
FIRST YEAR M.Sc. NURSING,
DHANVANTARI NURSING COLLEGE ,
41/3, VINAYAK NAGAR,
NEAR CHICKKABANAVAR RAILWAY STATION,
HESSARGHATTA ROAD,
CHIKKABANAVAR,
BANGALORE-90
2 / NAME OF THE INSTITUTION / DHANVANTARI NURSING COLLEGE,
BANGALORE-90.
3 / COURSE OF STUDY AND SUBJECT / 1st YEAR M.Sc. NURSING,
CHILD HEALTH NURSING.
4 / DATE OF ADMISSION TO THE COURSE / 15-06-2010
5 / STATEMENT OF THE PROBLEM / “A STUDY TO EVALUATE THE EFFECTIVENESS OF PLANNED TEACHING PROGRAM FOR ADOLESCENTS (14-16 YEARS OF AGE) REGARDING KNOWLEDGE OF DRUG ABUSE AND ITS HAZARDS IN SELECTED HIGH SCHOOLS ,BANGALORE”.

6. BRIEF RESUME OF THE WORK INTENDED STUDY

6.1. INTRODUCTION

Power is sweet; it is a drug, the desire for which increases with a habit.

- Bertrand Russell

“Drug Abuse is the harmful use of mind altering drugs. Drug abuse may be defined as the “arbitrary” over dependence or miss-use of one particular drug with or without a prior medical diagnosis from qualified health practitioners. "Adolescence" is recognized as a phase rather than a fixed time period in an individual's life. The Government of India, however, in the National Youth Policy defines youth as the 15-35 age group and adolescents as 13-19 years. It is important to note that adolescents are not a homogenous group. Their needs vary with their sex, stage of development, life circumstances and the socio-economic conditions of their environment.1

June 26 is celebrated as International Day against Drug Abuse and Illicit Trafficking every year. It is an exercise undertaken by the world community to sensitize the people in general and the youth in particular, to the menace of drugs. The picture is grim if the world statistics on the drugs scenario is taken into account. With a turnover of around $500 billion, it is the third largest business in the world, next to petroleum and arms trade. About 190 million people all over the world consume one drug or the other. Drug addiction causes immense human distress and the illegal production and distribution of drugs have spawned crime and violence worldwide. Millions of drug addicts, all over the world, are leading miserable lives, between life and death.2

Children start on drugs for a number of reasons, from curiosity, recreation to the need to cope with stress but drug abuse and addiction lead to a complex set of social, medical and economic problems with serious implications. Some substances present in easily available products like cough syrups, pain relief ointments, glue, paint, gasoline and cleaning fluids are directly toxic and often abused by children. Regular abuse of inhalants can result in serious damages to vital organs including brain, heart, kidney and liver as well as in mental complications. Physically, the body also develops tolerance for it. This can lead to increase in consumption, which eventually leads to physical dependence.3

Drug misuse is when you take illegal drugs, or when you take medicines in a way not recommended by your doctor or the manufacturer. Taking medicines in very large quantities that are dangerous to your health is also an example of drug misuse. some of the commonly misused drugs are alcohol , painkillers, tobacco , sleeping tablets, and cold remedies, khat ,glues, aerosols, gases and solvents, cocaine, Decanals, heroin ,LSD; (lysergic acid diethylamide; nicknamed acid, trips, blotters, tabs), mescalin, methylamphetamine (crystal meth), methadone, morphine, opium , pethadine ,poppy straw , psilocybin, amphetamine ,codeine ,Ritalin, barbiturates, cannabis, cannabis resin and cannabinol (marijuana, grass, pot, weed), anabolic steroids, methaqualone, benzodiazepines ,ketamine (nicknamed special K, vitamin K, green), including valium, and rohypnol (nicknamed roofies and sometimes referred to as date-rape drugs. 4

The Drug Abuse Information Rehabilitation and Research Centre (External website that opens in a new window) (DAIRRC) is a registered Charitable Trust that is involved in rehabilitation of addicts. It was founded in 1982 in the city of Mumbai. This centre provides a wide range of rehabilitation services such as Heroin addiction treatment, Cocaine addiction treatment, Solvent Abuse Treatment, Treatment for addiction to Prescribed Medication, Methadone addiction treatment and Treatment for addiction to all Other Drugs of Abuse. 5

By considering all the above, the researcher felt that there is a need to know the knowledge of the adolescents about the drug abuse and should educate them for improving their knowledge regarding drug abuse and positive attitude. Hence the investigator designed the study on knowledge and attitude regarding drug abuse and its hazards among adolescents in selected high school at Bangalore”

6.2. NEED FOR THE STUDY

Drug abuse is emerging as a problem. A major section of drug users are below 20 years. Forty percent of them started taking drugs when they were between 15 to 20 years of age (UNDOC, 2002). Social factors such as illiteracy, economic background, unemployment, rural residence and family disharmony increase vulnerability to drug abuse.6

Studies reveals that drug use among young people between the age group 14-18 have typically employed students or special high risk groups rather than general samples. The results indicate that cannabis was the most frequently used drug. Factors associated with drug problems were: being older, living in cities, not participating in religious activities and being a worker rather than a student. Very few of those with problems had been treated or felt the need for any treatment.7

Studies have consistently demonstrated that Adolescents have high rates of substance abuse, which has been associated with deleterious effects on mood, attention, and behavior. The findings presented here that it is imperative to improve the detection of substance abuse and treatment of sleep problems in children and adolescents. By treating sleep disturbances and targeting poor sleepers with additional counseling and education regarding the risk of substance use, clinicians may be able to prevent or delay the adverse effects of addiction 8

Use of alcohol and other drugs is associated with the leading causes of death and injury (e.g., motor-vehicle crashes, homicides, and suicides) among teenagers and young adults; for example, nearly half of all deaths from motor-vehicle crashes in this age group involve alcohol use (1,2). This article presents self-reported data about the prevalence of alcohol, marijuana, and cocaine use among U.S. students in grades 9-12 during 1990.9

Use of alcohol, tobacco, and other drugs is a worldwide problem and affects many children and adolescents. The use of opiates, cannabis, tobacco, and alcohol have been well recognized for centuries in India and the use of drugs and alcohol within the context of religious beliefs and local traditions has been historically documented. Children & adolescents are exposed to alcohol, cannabis products, and tobacco product. Several risk factors and protective factors have been identified. . In India the use of pan masala, and home brewed products containing marijuana and alcohol have special significance. Pan Masala is shown to have carcinogenic, genotoxic, and clastogenic properties. The pediatrician can play a vital role in the appropriate recognition and early referral.10

Epidemiological studies among intravenous drug abusers have shown a high frequency of blood borne STIs including HIV, HBV and HCV infections and syphilis. In Manipur, in 2000, the prevalence of HIV among intravenous drug abusers was 80% and vaginal discharge was strongly associated with HIV positivity.147 A study of sexual behavior among drug abusers in Delhi showed a higher number of sex partners, higher rate of anal intercourse (25.7%) and an increased frequency of visits to CSWs leading to a significantly higher prevalence of STIs.11

Recent studies shown that the drug abuse has become more acute and alarming. The rate of drug abuse amongst student-population has gone up phenomenally. The cases of these hard-core addicts and ex-addicts are reported to be largely in the age group of 15-30 of age. Main causes towards drug indulgence particularly among adolescents are family conflicts and poor communication at home, apathy and alienation, rejection of parental and social values, social incentives like acceptability, availability and vast appealing publicity through media, culturally and socially permissive attitude for drugs, continued loneliness, deprivation of affection, aggressive, personal failure in a competitive society, impulsive, search for personal identity, search of feelings for adulthood and their expression, subconscious destructive motives, desire to experiment, inability to accept oneself, absence of positive values and lack of correct ideology in personal and found much less among neurotics and psychotics as compared to general population. 12

The De-addiction Centre, NIMHANS, caters to more than 70% of the patients seeking treatment for substance abuse problems in the city of Bangalore. The Centre also treats patients from different parts of Karnataka, Andhra Pradesh, Tamil Nadu and Kerala. Referrals are received from other states of the country prominently including Gujarat, Rajasthan, Delhi, West Bengal and the North - Eastern states and recently there has been a spate of referrals from other countries like Bangladesh, Sri Lanka, Nepal the USA and Russia as well. The clinical services consist of inpatient and outpatient consultations for substance abusers (alcohol and drug abuse) with approximately 2000 new consultations per year [2050 in 2002-03] for long term management for substance abuse. 13

6.3. REVIEW OF LITERATURE

Dechenla Tsering, Ranabir Pal, Aparajita Dasgupta. (2010). A cross-sectional study was conducted in West Bengal, India on Substance use among 416 adolescent high school students in classes VIII, IX, and X. The result was Out of 416 students, 52 (12.5%) used or abused any one of the substances irrespective of time and frequency in lifetime; 26 (15.1 %) were among the urban students and 26 (10.7 %) were among their rural counterparts. More than two-thirds (73.07%) of the respondents expressed a desire to quit substance use and 57.69% had tried to stop. 'Easy availability' and 'relief from tension' were the most frequent reasons for continuation of substance use. Level of knowledge on harmfulness of substance use among students was very high (urban - -84.6% and rural - 61.5%). The conclusion was made that Inspite of being aware of the harmful effects of substance use, adolescents take up this habit. 14

Winters KC, Leitten W, Wagner E, O’Leary Tevyaw T (2007 Apr) conducted a study on Use of brief interventions for drug abusing teenagers within a middle and high school setting. The method reviews several clinical and school contextual issues pertaining to the scientific efficacy, feasibility, and application of brief interventions for students who are abusing drugs. The result shown high base rate of students with mild-to-moderate drug involvement and the likelihood that school counselors can readily learn BI techniques. Caveats of implementing BIs include practical, systemic, and clinical barriers. The conclusion was made that despite concerns, schools are a viable setting in which to screen youth for drug abuse problems and to conduct a brief interventions.15

Saluja BS, Grover S, Irpati AS, Mattoo SK, Basu D (2007 May) conducted a study on Drug dependence in adolescents 1978–2003: A clinical-based observation from north India. The method used was Data on demographic and clinical features were extracted from available case notes of adolescent patients who presented to the centre during 1978–2003 (n=85).The result was Many adolescents came from nuclear family (63.5%), of urban background (83.5%), and were school dropouts (54.1%). Mean age-at-first-use of the primary substance was 14.8 yr and mean age at first presentation was 17 yr. The commonest used primary class of substance was opioids (76.2%). The most common reason for starting the use of drugs was curiosity (78.8%). The conclusion was made that the development of substance dependence in children and adolescents is a combination of familial and social vulnerability factors, including the drug culture of the social milieu.16

Griffin KW, Botvin GJ, Nichols TR, Doyle MM (2003 Jan) conducted a study on Effectiveness of a universal drug abuse prevention approach for youth at high risk for substance use initiation. The method used was the effectiveness of a universal drug abuse preventive intervention was examined among youth from 29 inner-city middle schools participating in a randomized, controlled prevention trial. A subsample of youth (21% of full sample) was identified as being at high risk for substance use initiation based on exposure to substance-using peers and poor academic performance in school. The Findings indicated that youth at high risk who received the program (n = 426) reported less smoking, drinking, inhalant use, and polydrug use at the one-year follow-up assessment compared to youth at high risk in the control condition that did not receive the intervention (n = 332). The Conclusion was made that universal prevention programs can be effective for a range of youth along a continuum of risk.17

Cuijpers P, Jonkers R, de WI, de JA (2002 Jan) conducted a study in Holland on the effects of drug abuse prevention at school: the 'Healthy School and Drugs' project. The method used was A quasi-experimental study in which students of nine experimental (N = 1156) schools were compared with students of three control schools (N = 774). The groups were compared before the intervention, 1 year later, 2 years later and 3 years later. The findings showed that some effects on the use of tobacco, alcohol and cannabis were found. Conclusion was made that Healthy School and Drugs project as implemented in Holland may have some effect on drug use in the children exposed to it.18

Dent CW, Sussman S, Stacy A w (2001 Jun) conducted a study on Project towards No Drug Abuse: generalizability to a general high school sample. The method used was a replication of a previously tested prevention program in a general high school population was conducted with 1-year follow-up data. Classrooms within each of three schools were randomly assigned to two conditions, classroom education or standard care control. The result was Statistically significant effects on alcohol and illicit drug use were achieved in this population through a 1-year period following the program, although effects were not achieved on cigarette smoking and marijuana use. Conclusion was made that this program (Project towards No Drug Abuse) has applicability to a wide range of older teens.19