Challenges and Opportunities in Drug Demand Reduction (Continued)
Agustin Vélez
General Director
Trusteeship for the Institute for
Street Kids and Addictions
Mexico
Gracias, John. There is no doubt that the
workplace is an important place for preventing
the use of substances irrespective of which they
are. Our research project that is being changed
once again shows that drug use is a preventable
behavior. Prevention of this behavior without
doubt, has as a purpose, a goal: that a larger
number of individuals at a given point in time in
a society would prefer to promote their interest
for health rather than have a brain disorder. So,
the questions we must answer with preventive
actions or activities are not only in children and
young people or in adults. We must be at
schools and the workplace. That is where we
must put in place prevention programs.
Intervention is quite broad and leads us to
intervene with preventive activities at any time
in the life of individuals and at any place where
they can meet. They can be intervened with
prevention.
In recent years, we have made great efforts to
guide our interventions towards children and
teenagers that find themselves studying and
going to school through many information
activities. We tell them about their risks, and
strengthening those factors that protect them.
However, at schools where our children attend,
there are also adults – both the teachers and
those who have other duties in the field of
education. And these adult individuals in this
workplace called school express their attitudes,
and with their words, concepts that would not
necessarily be favorable to avoid the use of
substances. Quite the contrary, some how
concepts that can lead people to think that
substance use is a behavior that is allowable.
And this is in most workplaces, including
schools.
For those of us who are between 20 and 50
years of age, this age of life is of our greatest
work productivity. This is also the age where
more substances of any type are used. Clearly,
we can say that a large number of workers at
schools where our children attend, are using
some type of substance—alcohol, tobacco and
some other type of substance. School must be
seen as a place for intervention to tell all the
students about the risks involved in using these
substances, but to we must also consider it as a
workplace under a care modality that I will
mention later. So, this workplace will be a
priority place for preventive intervention.
Research is pointing out that at any point in
time in life, we must do prevention activities and
we must not consider all substances as risky.
They can lead to addiction. We must not neglect
actions addressed to avoid the use of alcohol
and tobacco as we address the use of other
basically illegal drugs.
Every year in the world, billions of dollars are
lost due to the use of alcohol and of other drugs
also in the workplace. And this is due to the fact
that substance use is behind absenteeism,
injuries, and low productivity in companies.
There are many studies that try to measure the
cost. Many of them fall short because cost due
to the loss of days of work and the loss due to
cost in injuries does not take into account the
impact within a social network: the use of
alcohol on the rest of the family. Because they
don’t go to work, there’s no income and there
are other repercussions in the family setting. A
prevention program on the use of alcohol and
other drugs in the workplace must consider at
least this space where people work together as
a simulation of what happens at home or a
simulation of what happens in the community.
For a long period of time, different types of
people are together. Values, traditions,
standards and laws regarding the use of
substances are at stake every day. This is why
this type of program should consider the
creation of an infrastructure inside the company
that will take into account the owners, senior
management, the employees through their
union organizations, and health and manpower
offices who are the ones that will carry out a
preventive action in the workplace. Of course,
it’s necessary to put in place any value with a
model that includes all substances and includes
all the ways in which these substances are used.
The major components of this type of program
must develop the necessary human resources
for this end, must strengthen primary health
care, and must include the component of the
family and the community within the same
workplace. A program of this type must be part
of a more comprehensive one that ensures
quality in the company and can be reinforced
with health, safety and well-being policies
included in the organization’s documents and
made available to any worker, manager, or
anybody who’s in the workplace.
This way, top management and unions must
reach an agreement about the various aspects
and objectives of the type of program. You
become committed to the project. If the heads
and senior management agree that this is a very
important subject, the workers will understand
that senior management is worried for them and
they will have greater interest to follow a
program. There are two basic strategies in the
programs for workplaces—those programs that
address the existing problems and those that
address prevention. For problem-oriented
programs, the strength of the concept is also
their greatest weakness. They are focused on
the individual that is already sick and is already
a problem. Most people feel that this approach
is stigmatizing, and makes it difficult to seek or
accept help when it’s needed the most. It’s more
effective to offer prevention before workers
have developed any type of dependence and
have infringed upon the work bylaws repeatedly.
The highest losses in the worker’s performance
may not come from addicts that have been
identified as such, but rather of the rest of the
workers of the organization. The most acute
risks are related to sporadic incidents like
drinking too much, or being under the influence
of alcohol or drugs at the wrong time and the
wrong place.
All this affects the mechanisms that individuals
have to face in a given situation. The risk, the
critical task now is to go beyond the care of
individuals in order to face broader social issues
through prevention methods that will be part of
the structure. They must be a part of the
company. Programs must focus on prevention.
The major goal is prevention while less
emphasis is made on treatment and
rehabilitation. If we use the metaphor of a
traffic light, green is primary prevention and its
concept would be that those who are free of
drugs and alcohol. A yellow light tells us about
the risk and we must create possibilities to go
back to the green light. A red light is when a
worker has very severe health problems due to
addiction. This requires constant treatment.
In a culture that accepts the use of alcohol,
primary prevention must be pragmatic rather
than dogmatic. Instead of intending to avoid
drinking, we should focus people on how to face
alcohol and how to do it in their daily life and on
special occasions. Union leaders and managers
are also exposed to the same risks. Thus, they
should also be part of a comprehensive policy of
any company.
And finally, it’s important to recall that in a
workplace where workers have problems, such
use of substances also indicates problems in the
social network, basically within the family
setting. So, the support of the family is a
fundamental part of a program that begins in
the workplace. Thank you very much.
