Prescription drug abuse (PDA) is an epidemic nationwide and has disproportionally impacted the Southern Appalachian region. Situated within a geographic area known for pervasive PDA and its consequences, The Gatton College of Pharmacy and Academic Health Sciences Center (AHSC) at East Tennessee State University are proactively engaging the Region and its health professions students to address the problem. Over the College’s six-year history of community engagement in PDA, efforts have focused on primary prevention activities, PDA treatment, awareness, education, and interprofessional collaboration as the key impact sectors. Notable programs include Generation Rx, Operation Rx Disposal, continuing education (CE) programming, and establishment of the ETSU Diversity-promoting Institutions Drug Abuse Research Program. In 2013-2014, 3 faculty and 38 Generation Rx pharmacy students engaged 4000 children and adolescents in PDA prevention education. Operation Rx Disposal employed 5 faculty members and 35 student pharmacists to assist more than 1000 households in removing unwanted medication from their homes through conduction of drug take-back events. Over 2000 health care providers from regional communities participated in PDA CE events conducted by 3 pharmacy faculty members. Additionally, 3 externally funded, PDA-specific grants totaling $2.26 million were awarded to pharmacy faculty members to engage communities, health care professionals, and students in innovative PDA prevention research. The College’s efforts have been nationally recognized by peers, professional organizations, state boards of pharmacy and within the evidentiary literature.

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This study employs interviews to measure the perceptions of sixteen teachers, nine school principals, and seven School Resource Officers on the Drug Abuse Resistance Education (DARE) program, offered to grade six students in one small (population approximately 70,000) city in western Canada. Perceptions in three areas are examined: curricular content, program delivery, and efficacy. Subjects overwhelming viewed the curricular content favourably. Similarly, there was strong agreement that the program was well delivered. The efficacy of the program was judged less positively; however, this did not mitigate the subjects' strong desire to continue implementation of the program. These results are consistent with the research literature on DARE which documents the popularity of the program, but acknowledges that it appears to have limited effects upon reducing student drug use. The results of this study are used to examine five options for delivering an in-school program for preventing or reducing drug abuse and violence among students. The options explored range from retaining the DARE program in its current form, to eliminating it, reforming it, implementing an alternative program, or designing an entirely new drug and violence prevention program. The conclusion drawn is that the DARE program should be withdrawn and replaced with an entirely new drug and violence prevention program and curriculum specific to community realities and needs. / vii, 109 leaves ; 28 cm.

O primeiro objetivo do presente estudo, de cunho metodológico, foi verificar a viabilidade da realização de uma pesquisa com usuários de ecstasy via internet. A metodologia desenvolvida para o recrutamento e coleta de dados atingiu os objetivos propostos, demonstrando-se viável e profícua, além de apresentar grandes vantagens em relação à coleta de dados presencial. O segundo objetivo foi oferecer subsídio para futuras intervenções de Redução de Danos para o uso de ecstasy. O questionário on-line foi respondido por 1.140 pessoas, primordialmente jovens, com boa formação escolar, inseridos no mercado de trabalho e/ou estudantes, pertencentes às classes socioeconômicas A e B, e poliusuários de drogas. As respostas dos participantes foram descritas estatisticamente e os dados comparados através dos testes t ou chi-quadrado, e analisados por regressão categórica (CatReg) em que se relacionaram os comportamentos de risco associados ao uso de ecstasy com as variáveis independentes relevantes. Os resultados não fundamentam a elaboração de materiais preventivos com direcionamentos específicos, seja para gêneros, para opções sexuais ou para classes socioeconômicas. Indicam, porém, locais privilegiados para a distribuição de material preventivo: ambientes de lazer noturno, festas e eventos ligados à música eletrônica, eventos como paradas comunitárias, e universidades públicas e privadas. São discutidos os principais conteúdos a serem veiculados, tendo sempre como princípio básico a transmissão de informações cientificamente comprovadas. Os dados mostram ainda que é crescente a disponibilidade de ecstasy no Brasil indicando urgência na implantação de um primeiro programa preventivo brasileiro voltado para essa droga. A acolhida e as declarações de interesse dos participantes demonstraram que o projeto inspirou confiabilidade, que existe demanda por intervenções na área e que uma proposta de Redução de Danos teria grande receptividade dos usuários de ecstasy, embora sua implantação dependa do interesse das autoridades responsáveis pela política pública brasileira em relação às drogas ilegais. / One objective of this study was methodological investigating the feasibility of conducting a Web-based survey with ecstasy users. The method developed for participants recruitment and data collection attained the propose proving feasible and fruitful, as well as showing great advantages as compared to personal data collecting. The second objective was to provide subsidies for future Harm Reduction interventions on the use of ecstasy. Participants (N=1.140) were mostly youngsters, with high schooling levels, and currently employed or studying, of A and B social-economic classes, and polydrug users. The data were analyzed using chi-square or t tests and categorical regression (CatReg). The latter evaluated users’ risk behaviors and related them to relevant independent variables. The results do not set the grounds for the drafting of specially-oriented preventive materials, be it for genders, sexual orientation, or even social-economic classes. They do, however, indicate privileged places for the distribution of preventive materials: evening entertainment places, parties and events related to electronic music, events such as community Parades, and universities. The main contents to be conveyed are discussed, always keeping the communication of scientifically proven information as the basic principle. The data also show that there is increasing availability of ecstasy in Brazil, thus pointing to the urgent need of implementing a first Brazilian ecstasy preventive program. The buy-in and the interested statements from participants demonstrate that the project inspired reliability, that there is a demand for interventions in the area and that a Harm Reduction proposal would be highly accepted amongst ecstasy users, although its implementation depends on the interest of authorities responsible for the Brazilian public policy towards illegal drugs.

Health communication has gained worldwide recognition as one of the most effective methods for tackling global health challenges; a conclusion that is supported by a range of studies showing generally positive results. Literature in the field has tended to focus on one of two perspectives: either individual behaviour change or a cultural/critical approach. This dissertation, which falls into the latter category, extends previous work on health communication and culture into a new context, namely Saudi Arabia. The thesis is motivated by two main research questions. First, how has culture influenced health communication in Saudi Arabia specifically in initiatives against illicit drug use and alcohol abuse? Second, how has this communication developed? At the heart of this study is the role of Saudi culture in health communication in an increasingly interdependent and connected world. The dissertation makes use of mixed qualitative data collection methods. Principally, it utilised semi-structured interviews with key officials and focus groups with young Saudis and health promoters in Saudi Arabia as well as attendance at and observation of health-communication events and permanent exhibitions as a subordinate method. The study reveals promising findings supporting the growing scholarly interest in the cultural dimension of health communication. It concludes that the key influence of the Saudi culture on health communication against substance abuse is Islamic beliefs about health, in particular those about substance abuse. These beliefs created a rejection of illicit drug abuse in Saudi society, thereby shaping a supportive environment for promotion activities against risky health behaviour. In addition, Islamic influence inspired the related regulations and laws in the kingdom. Islamic and local influences exert a powerful influence on the practical side of health communication in Saudi Arabia, including the content of messages, the appeal used to attract the specific audience, and the communication channels used to promote the campaigns. The study engages with four concepts constituting the Islamic model of health and illicit drug abuse: prohibition (haram), promotion (Da’wah), repentance and inclusiveness (Tawbah), and treatment and rehabilitation (Elaj). The study also examines controversial issues about health communication in the country, such as the predominance of top-down communication, the absence of participatory communication and cultural diversity. In short, a lack of innovation and creativity in delivering health communication messages. The study illustrates the major role the Saudi government has played in communicating health and substance abuse since the 1980s, when officials realised the need to modernise the means of communicating health and drug issues from mosque-based only to include modern methods such as televised campaigns, school-based programmes and hospital-based health education. Since then, government-led health communication initiatives have been well established in the kingdom. The dissertation is able to demonstrate a critical understanding of the reality of health communication against substance abuse in Saudi Arabia and make a range of recommendations to improve the efficacy of current policies and suggest new avenues for future research.

Perinatal complications resulting from either alcohol or drug abuse include a high incidence of stillbirths, fetal distress, asphyxia, prematurity, low birth weight, pneumonia, congenital malformations, cerebral infarction, and an increased risk to acquired immunodeficiency syndrome.

This project explores the perceptions of fourth and fifth grade students who participated in a substance abuse prevention program. Risk and protective factors are presented to assist the reader in understanding this project.

Dr. Robert Pack is Professor of Community and Behavioral Health, Associate Dean for Academic Affairs in the College of Public Health at East Tennessee State University, and Director of the new ETSU Center for Prescription Drug Abuse Prevention and Treatment. The Center grew out of a university and community collaborative that was started in 2012 to address the regional problem of prescription opioid abuse. At least five funded projects and dozens of other academic products have grown out of the Working Group. Dr. Pack is currently PI of the NIH/NIDA-funded Diversity Promoting Institutions Drug Abuse Research Program at ETSU, the research component of which is the five-year set of three studies titled Inter-professional Communication to Prevent Prescription Drug Abuse and Misuse. He was trained in health education/health promotion at the UAB Royals School of Public Health and is experienced in designing, running and disseminating theory-based intervention studies. In 2014, he was trained at the NIH-funded Training Institute for Dissemination and Implementation Research in Health (TIDIRH, Boston, 2014).

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Background: Prescription drug abuse is a major public health concern in the United States, associated with dramatic increases in morbidity and mortality over the past two decades. In recent years, disposal of unwanted, unused, and expired medications has been a pillar of national prevention efforts. Acknowledging increased policy and advocacy emphasis on improving prescription drug disposal behaviors of consumers, the purpose of this study was to evaluate the impacts of a targeted promotional campaign on participation in community-based drug take back events (TBE) in NE Tennessee. Methods: Between October 2013 and October 2017, 45 drug take-back events were held in 5 municipalities across NE Tennessee. A region-wide, promotional campaign including direct to consumer advertising (television, print, radio, etc) initiated spring 2014. Two methods of data collection were implemented: 1) donor surveys; and 2) drug donation weights (pounds) and dosage units collected. Controlled substance (CS) donations with identifiable dispensing dates were used to calculate donors’ possession time in months. One-way ANOVA, paired t-tests, and chi-square procedures were utilized to assess trends in donation weights, time to donation, and donor characteristics across the study period. Results: Total Disposal donations increased by 2.35 times (CS 2.61 times) from baseline after the initial promotional campaign. A total of 2300 CS donations were collected, with a spike in total pounds collected observed in spring of 2014 following initial marketing interventions. Donor possession time hdecreased by approximately one year during the length of the study (62.01 to 50.5 months). More than 1500 donor surveys were administered during the study. Half of all participants reported hearing about TBE through television promotions. Participants at urban events were 52.6% more likely than rural participants to hear about the event through newspaper promotion. Conclusion: Collaborative marketing across a TBE concentrated region increases CS disposal weight and decreases donor possession time.