Module 12: working with intoxicated young people: learner's workbook

Possible answers for writing exercise questions

Page last updated: 2004

Topic 2
Topic 5
Topic 6

Topic 2

2.1 What is intoxication and why is it a problem?

Question - What do you think may be some of the harms associated with intoxication?

Possible answers - The types of harm associated with intoxication include:
  • drink/drug driving charges and accidents (including pedestrians)
  • water-related accidents (particularly diving accidents)
  • workplace accidents and absenteeism
  • accidents when operating machinery
  • aggression and violence
  • relationship and domestic difficulties
  • impulsive crime
  • unprotected sex
  • further unsafe drug use (e.g. sharing a needle)
  • overdose
  • choking on vomit when unconscious
  • anxiety/panic attacks, and less commonly, a psychotic episode
  • acting on suicidal impulses.
This list is not exhaustive, but does give an idea of the range of risk factors associated with intoxicated young people.

Topic 5

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5.2 How to carry out brief interventions

Question - What factors may assist you in implementing a brief intervention with a young person?

Possible answers include:
  • assess the situation (is the environment safe or hostile?)
  • assess the young person's level of intoxication
  • listen to what a young person has to say
  • notice what they haven't said or what they are avoiding
  • observe how they react
  • empathise with them and their situation
  • consider what you may already know about them
  • talk in a non-threatening manner
  • avoid lecturing.
Question - When might it not be appropriate to undertake a brief intervention?

Possible answers include:
  • when the person does not wish to engage in conversation and becomes visibly distressed or angry by your questioning
  • when a person is in a highly emotional state
  • when a person is extremely intoxicated and will gain little benefit from any conversation or intervention until they begin to sober up
  • when a person is on medication that is mood/mind altering (i.e. methadone or some anti-psychotics).

Topic 6

6.1 Environmental factors that influence the experience of intoxication

Question - What are some environmental factors that might influence a young person's experience of intoxication?

Possible answers include:
  • Social setting: The social setting of drug use has a major impact on the experience of intoxication. It also has a direct relationship to the degree of harm that may result from intoxication. Whether or not use occurs alone or with others, in a relaxed or stimulating environment, will affect the experience of drug-use.

  • Immediate circumstances: Many factors in the immediate circumstances surrounding drug use will affect both the experience and the associated risk (for example, if young people are driving or swimming while using alcohol and/or other drugs).

  • Cultural norms/sub-cultural norms: The cultural norms that influence young people will affect the type of drug use and how the experience is viewed. It is important to take into consideration the types of sub-cultures that young people participate in. Intoxication may be viewed as an integral part of the sub-culture they belong to. Various trends in pop-culture, music and media also influence a young person's environment.
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6.2 Individual factors that influence the experience of intoxication

Question - What individual factors might influence a young person's experience of intoxication?

Answer:
  • Physiological factors

    • Height and Weight - There are basic differences in the rate at which drugs are processed (or metabolised) in large and small people, and in males and females. Smaller people will generally become more intoxicated at lower doses because they have less body fluid in which alcohol can be diluted.

    • Gender - Females, with a higher body fat to fluid ratio than males (as well as generally being smaller), tend to get considerably more intoxicated than males at comparable doses.

    • Absorption rate - An empty stomach also produces more intense intoxication, as food will slow down the rate of absorption of alcohol (and other orally administered drugs), into the bloodstream.

  • Psychological factors

    • Stage of development - A young person's maturity and history of AOD use will influence the drug-use experience.

    • Emotional state/mood - e.g. relaxed, distressed etc. People with very stable mood and anxiety states may experience remarkably uneventful intoxication, with little risk of problems. Others who are prone to high levels of anxiety and mood instability may experience a chaotic, unpredictable, intoxication. On occasions a young person may strongly desire intoxication, and then experience the feeling very quickly even at low doses. Many factors can contribute to this. Even the responses of other people, both positive and negative, may be part of the 'fun' of being smashed. This is not to say such intoxication is being faked by the young person. Rather, intoxication can be exaggerated by mood.

    • Mental Illness - Young people who have mental health problems (particularly severe conditions such as bi-polar or manic-depressive disorder and schizophrenia) may greatly exacerbate their symptoms when taking drugs. Those who tend towards impulsive, risk-taking behaviour or aggression when sober, are far more likely to have an accident or be involved in a criminal act when intoxicated.

  • Experience of drug use and expectations

    • Tolerance - Regular, heavy, use of a drug(s) over a prolonged period will result in the development of a tolerance to the drug. This is because the central nervous system adjusts to the constant presence of drugs in the body. The person therefore needs to take more of the drug to obtain the same effect. This effect is known as drug tolerance. A lack of tolerance in young, na´ve drug users can result in very dramatic intoxication at low levels of intake, which makes them prone to overdose.

    • Lack of judgement - due to immaturity and lack of experience of drug use.

    • Expectations - A young person's expectations of what is 'supposed to happen' may also influence the drug-taking experience, at a low or higher level of intoxication (i.e. Placebo effect). Expectations may be formed by a young person's values or beliefs that have been influenced by family, peer, social or media roles.

    • Youth sub-culture - Young people's values and beliefs around their drug use and what are regarded as the 'in' drugs at the time can strongly influence what drug young people use, with whom they use and how it is used. Music, media, trends in clothing and even language styles, shape various youth sub-cultures. Fitting an 'image' will often influence drug use and intoxication in young people.
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6.3 Drug-related factors that influence the experience of intoxication

Question - Identify low-risk and high-risk factors for the "Nick and Heather" case study.

Answer

Nick's experience of intoxication:

Factors relating to the:
  • Environment

    • Low-risk factors
      • At home (no driving, machinery, water-sports, crowds)
      • Close group of friends will help each other in a crisis

    • High-risk factors
      • Volatile situation with neighbour could lead to an argument/violence
      • Sharing of drugs (use gravitates towards heavier users)

  • Individual (Nick)

    • Low-risk factors
      • Prefers relaxed time with no drama
      • Dedicated to his studies

    • High-risk factors
      • Easily swayed by his mates into heavier use

  • Drug(s)

    • Low-risk factors
      • No intravenous use
      • Supplies limited to those brought along to Nick's flat

    • High-risk factors
      • Mixing drugs - potentiating effects
      • Not able to keep count/ estimate of drinks or joints with pooling of drugs
Top of pageHeather's experience of intoxication

Factors relating to the:
  • Environment

    • Low-risk factors
      • Sticks with her close friends
      • Has ready phone contact with family
      • Has plan of escape (parent endorsed taxi)

    • High-risk factors
      • Wandering the streets (unpredictable events)
      • Interacting with strangers
      • Risk of sexual assault
      • Volatile interaction with bouncer

  • Individual (Heather)

    • Low-risk factors
      • Acknowledges there are risks associated with drug use

    • High-risk factors
      • Young, still na´ve drug user with low tolerance
      • Female with small build
      • Seeks high arousal and stimulation
      • Feisty, anti-authority stance

  • Drug(s)

    • Low-risk factors (none identified)

    • High-risk factors
      • Unpredictable drug interactions (dose and type of drugs unknown)
      • Prolonged intoxication with extreme moods
      • Overdose potential
      • Possibly shared a needle