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primary prevention
- prevent use before it starts
- aimed primarily at younger people
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secondary prevention
- curtail further problematic or risky use
- prevent addiction and disorder
- aimed at person who have used substances
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tertiary
- intervention, treatment, recovery
- aimed at people who have developed substance use disorders
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social influence model
- training in refusal skills
- countering advertising
- normative education
- use of peer leaders
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the four A's in substance use policy change
- Availability
- Affordability
- Acceptability
- Attractiveness
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three strategies other states use to prevent drug use
- Drinking age 21 for bars and restaurants
- Alcohol taxes
- Sobriety checkpoints
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environmental prevention strategies
- outlet density ordinances
- social host ordinances
- deemed approved ordinances
- conditional use permit
- alcohol taxes
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outlet density ordinances
decrease the number of establishments to obtain a substance within a defined area
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social host ordinances
making it unlawful to provide an environment where underage drinking takes place, regardless of who provided the alcohol
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deemed approved ordinances
sets performance standards for all off-sale alcoholic beverage premises
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conditional use permit
allows the city to consider uses which may be essential or desirable
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effective policies for reducing prevalence of opioid addiction
- statewide prescription drug monitoring databases
- penalties for doctors who overprescribe
- require pain clinics to register with the state
- pharmacies, drug wholesalers, and pharmacists obligated to report questionable purchases
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Wisconsin HOPE agenda
require a practitioner to check patient's record before prescribing a monitored prescription drug for the first time
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opioid antidote
naracan (naloxone)
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ROSC acronym
recovery oriented systems of care
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ROSC
- accessible services that engage and retain people seeking recovery
- ac continuum of services rather than crisis-oriented care
- caret that is appropriate for the individual's unique needs
- where possible, care in the person's community and natural supports
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what healthcare should be for according to the institute of Medicine
Safe, Effective, patient-centered, timely, efficient, equitable
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10 guiding principles to recovery
- person-driven
- many pathways
- holistic
- peer support
- relational
- culture
- adresses trauma
- strength/responsibility
- respect
- hope
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elements of an effective ROSC
- family and other ally involvement
- individualized and comprehensive services across the lifespan
- systems anchored in the community
- continuity of care
- responsive to personal belief systems
- commitment to peer recovery support
- inclusion of voices of recovering individuals
- integrated services
- education and training
- ongoing monitoring and outreach
- outcomes-driven
- based on research
- adequately and flexibly financed
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examples of recovery-oriented activities
prevention
- early screening before onset
- collaborate with other systems
- stigma reduction activities
- refer to intervention treatment services
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examples of recovery-oriented activities
intervention
- screening
- early intervention
- pre-treatment
- recovery support services
- outreach services
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examples of recovery-oriented activities
treatment
- menu of treatment services
- recovery support services
- alternative services and therapies
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examples of recovery-oriented activities
post treatment
- continuing care
- recovery support services
- check-ups
- self-monitoring
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Barriers/Difficulties with ROSC
- moving from deficit-focused thinking to strengths-based
- addiction professionals' pride and power
- lack of protocols and financing for support services
- absence of ethical codes for peer services
- weak infrastructure of addiction treatment organizations and turnover
- fidelity monitoring
- record keeping
- reliable evaluation data
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