Youth Substance Abuse

Overview

This overview provides a synopsis of the current knowledge base. Having considered all the information, we make sense of it by taking a stab at the following: 1) What are the priority issues that deserve attention, 2) What are opportunity areas that community or voluntary organisations can already take action on, and 3) What knowledge gaps deserve further investigation?

Priority Issues

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Actionable Opportunity Areas

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Knowledge Gaps

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Definitions

Substance Abuse

• [Insert definitions of different types of substances, eg Drugs, Alcohol, Glue?]
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Key Statistics & Figures

• Synopsis: Although there has been a decrease of drug abusers in Singapore, there has been an increase of youth substance abuses cases and majority of those arrested were under 30 years old.

Drug Abuse Trends

• According to the drug situation report (2016) [1] CNB arrested a total of 3,265 drug abusers in 2016. This was a 2% decrease from the 3,343 drug abusers arrested in 2015. While the number of repeat drug abusers arrested decreased by 6%, from 2,034 in 2015 to 1,917 in 2016, the number of new drug abusers arrested increased by 3%, from 1,309 in 2015 to 1,348 last year. Close to two-thirds of new abusers arrested were youths under 30 years of age.
• There are 151 young Singaporeans studying in primary to tertiary public educational institution caught for drug offences in 2016. There are 124 being caught in 2015 and 83 in 2014. With that, we can tell that as the years goes by, there are more and more numbers of youths in Singapore who are involved in substance abuse.

Youth Drug Abuse Trends

• According to CNB, 3,245 drug abusers were arrested last year, a 3 per cent decrease from the year before. The number of repeat drug abusers arrested also went down 7 per cent from 2,034 in 2015 to 1,898 last year.
• However, the number of new drug abusers arrested rose 3 per cent to 1,347 from 2015's 1,309. Among the new abusers arrested, close to two-thirds were below 30 years old, according to the latest statistics.
• About 41 per cent of the total drug abusers arrested last year were under 30, CNB figures showed.http://www.channelnewsasia.com/news/singapore/fewer-drug-abusers-arrested-in-2016-but-more-new-drug-abusers-ca-7592594
• [Knowledge Gap: To indicate the percentage of youths in Singapore who are involved in substance abuse. It would be good to compare the percentage with those in other countries. To insert a comparison table, possible elsewhere and link to that page]
  • Nearly 70 per cent of new drug abusers arrested in 2015 were aged below 30. The average age of drug dependency in South Africa is 12 years old and dropping. However, maybe South Africa should not be compared to Singapore since it's not doing as well as Singpore , thus it is normal to see South Africa having more youth involved in substance abuse. However when we look COMPARE Australia. Australia has seen 12–17 year-olds were drinking alcohol and the proportion abstaining from alcohol significantly increased from 2013 to 2016 (from 72% to 82%). Thus this shows youths in Singapore involved in substance abuse is still lower compared to other countries that are doing as well as Singapore such as Australia. (Perpetua response) http://darta.net.au/category/new-research-and-statistics/
  • "5-19 years old group has the claim of drug use; more males than females who are drug users and drug rehabilitation centres claim that majority of clients belong to age group of 25-29 years old. According to the SWS survey, 1996- 1.5M youth Filipinos and 1997- grew into 2.1M youth Filipinos are into substance abuse " https://politicsmeanspolitics.com/why-majority-of-drug-users-in-philippines-is-youth-57f323707e2d
  • "While there are no accurate statistics available, it is estimated by Dangerous Drugs Board as many as 3.7 millions in the Philippines are dealing with drug addiction just a year 2016, 65 percent of it -is young people. "
  • http://www.doh.gov.ph/adolescent-and-youth-health-program All in all, we are able to see that there is a huge difference when we compare the number of youth drug offenders in Singapore against Philippines. It is because of the difference in population in both countries which contributed in such difference in number. However, it can be seen in the statics of both countries which shows that there is a rising numbers of youth who are abusing substance.
• Incidences of Violence related to Drug Abuse:

Binge and Underage Drinking

• The legal drinking age in Singapore is 18 years. However, this time we do not have an accurate estimate of underage drinking in the country, but there is a vague but general sense of unease that it might be fairly pervasive. The dire consequences of early heavy drinking in the young can happen even before it develops into a disorder. Underaged drinking increased risks of fatal accident, self-harm, violent behaviour, criminality, unprotected sex, teenage pregnancy - and for girls, of being sexually assaulted. Heavy drinking over time damages the adolescent brain more than the adult brain and makes them less able to curb cravings for alcohol. This may explain why people who begin drinking at an early age are at greater risk of becoming alcoholics. References: http://www.straitstimes.com/opinion/keeping-an-eye-on-underage-drinking
• For alcohol consumption in Singapore, the legal age is 18 years old. Despite having the heavy law enforced in Singapore there’s still the number of underage drinking happening. The WHO study of 2004 has found out that 73.5% of males and 64.5% of the female between age 15 and 19 years old drank alcohol. When underage drinker is intoxicated they are more likely to be involved in the acts of vandalism and other serious crimes that they might commit with their friends. Underage drinking can cause impulsive act which the number of youth are getting into violent in fights which seem to be on the rise. Which during 2014, there at 322 underage drinkers were arrested for rioting that the percentage jump from 18.8% 2013. Seeing the statistics of American underage drinking, according to 2015 National Survey on Drug Use and Health, the estimated number of Americans between the age of 12 to 20 are reporting so alcohol consumption of underage drinking. Which this represents about nearly 20% of the age group who consume alcohol illegally. References: http://www.tnp.sg/news/singapore/more-young-people-singapore-turning-violence

Map of Key Needs & Issues

[This table and arrows acts as a kind of visual map that allows a sense of sequencing; of the broad preconditions necessary for longer term outcomes to be achieved. Hyperlink the categories below to the specific page or sub-header in the page for easy navigation, so that you can click on 'Employment' below for example, and get straight to that page / segment]

Click the links below to go directly to specific areas of interest:

			Community Integration	↘
					Social Inclusion
			Family & Caregiving	↗
					Financial Independence
			Employment	↗
	Education	↗

Sub-pages

• If there are population segments that have substantial enough information or interest, then create sub-pages for them. e.g. 'Autism' can be a stand alone pages linked to the Disability pages if the autism community is keen to populate more autism specific information. Or, artists with disability can populate a 'Arts & Disability' page.
• Insert links to these sub-pages.

Areas of Needs / Desired Outcomes

Drug Abuse

• Desired Outcome: [To insert]
• Synopsis: [To insert]
• Statistics: [To insert]

Existing Programmes	Gaps & Their Causes	Possible Solutions
Prevention Education Campaigns	Youth's Liberal Attitudes towards Drug Use From a survey, it concluded that more young people have liberal attitude towards drugs. The 'Youth Perception Survey' revealed that 58% of young people said that they learnt about drug-related content via social media. The survey also showed that there is a increase in the proportion of young people who perceived cannabis as a popular drug of abuse, with number standing at 35%, up from 17% in 2013. (http://www.straitstimes.com/singapore/courts-crime/more-young-people-have-liberal-attitude-towards-drugs-survey) Due to Legalisation of Cannabis in other countries the most common drug clients turn to - online buying on social media has made it easy. A Facebook page seen by The Straits Times had sellers openly advertising drugs such as ecstasy and cannabis to a group of over 1,200 members. Media:http://www.straitstimes.com/singapore/more-singapore-youth-seeking-help-for-cannabis-abuse
Rehabilitation	The Government's Task Force on Youth and Drugs commissioned a survey in 2015, which found that cannabis abusers came from either middle or high socio-economic households, unlike Ice abusers, who tended to come from lower-income backgrounds. The survey - which polled 700 young people aged between 12 and 29, including more than 200 drug abusers - found that a high proportion of cannabis abusers did well in school and only a small proportion had parents with drug histories.[Media:http://www.straitstimes.com/singapore/abusers-getting-more-brazen]

Prevention Programmes

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Rehabilitation Programes

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Category C Programmes

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Alcohol Abuse & Underage Drinking

• Desired Outcome: [To insert]
• Synopsis: [To insert]
  • Consequences of binge drinking: School problems, such as higher absence and poor or failing grades -Social problems, like fighting and lack of participation in youth activities -Legal problems, such as arrest for driving or physically hurting someone while drunk -Physical problems, such as hangovers or illnesses -Unwanted, unplanned, and unprotected sexual activity due to unconsciousness -Disruption of normal growth and sexual development as well as changes in brain development -Physical and sexual assault -Higher risk for suicide and homicide -Alcohol-related car crashes and other unintentional injuries, such as burns, falls, and drowning -Memory problems -Death from alcohol poisoning -Development of physical and emotional dependency on alcohol [1]
• Statistics: [To insert]
  • Binge drinking: In Singapore, binge drinking is more common among 18 to 29 year olds—18.7% of men and 12.2% of women. In 2010, the Singapore Mental Health Study found that about 3.5% of our citizens suffered from alcohol abuse at some point in their lives and 0.5% from alcohol addiction (or alcoholism). The WHO study of 2004 found that 73.5% of males and 64.5% of females aged 15 and 19 years of age drank alcohol. Studies show that underage drinkers who start drinking before age 15 years are six times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after age 21 years. Youths should therefore stay alcohol-free and be made aware of the consequences of drinking at an early age.
  • Violence and underage drinking: At Singapore's largest addiction treatment centre, the National Addictions Management Service (NAMS), counsellors saw 433 new cases from April 2014 to March 2015, compared with 415 cases a year earlier. In 2010, there were approximately 189,000 emergency rooms visits by people under age 21 in the U.S for injuries and other conditions linked to alcohol. This is because alcohol use directly affects cognitive and physical function. Hazardous alcohol use can reduce self-control and the ability to process incoming information and assess risks and makes them more likely to resort to violence in confrontation. Similarly, reduced physical control and ability to recognize warning signs in potentially dangerous situations can make some drinkers easy targets for perpetrators.

Existing Programmes	Gaps & Their Causes	Possible Solutions
Prevention	Peer influence, feel that it helps youth to relax and de-stress from their school work etc; important part of social life Social acceptability of drinking; modelling of parent behavior Accessibility of alcoholic beverages	Reduce Access to Alcohol by: Reduce commercial and social availability of alcohol Excise taxes Increase age of drinking consumption. For instance, Malaysia intends to raise the drinking age from 18 to 21 to prevent prevent underage drinking and limit the accessibility of alcohol to high-risk groups. Parental Roles Parents talk with child if there has been a history of alcoholism in the family — being open with them will encourage them to share their problems with parents Parents of child should lead by example. For instance, they should refrain drinking in front of their children or even stop drinking at all. Monitor children’s activities during adolescence
Rehabilitation	There are many Singaporeans who decided to travel further afield in search of help for their addiction. The Drug and Alcohol Rehab Asia is the leading destination for those looking for quality treatment in Asia. [Need to check if this info is really from the source]	Alternative court options for alcohol related misdemeanors for adults should be available and include education, treatment options and drug testing along with a screening process to determine appropriate level of intervention and use of predictive factors to focus treatment (Alaska)

Prevention Programmes

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Anecdotes and discussion on reasons for drinking [To insert into discussion page?]

• - Mostly all underage drinkers are caused by their peers around them having peer influencing an individual to join them for a drink. Which youth gather together to have a drink and to have fun that helps the youth to feel relax and escape their stress from their school work etc. In addition, it reduces their inhibited that makes an individual feel at ease when socialising with their friends, chatting and having fun while drinking.
• - Next, one of the main reasons is a growing tolerance for social drinking. Nowadays, it's not uncommon for adults to drink socially in front of children. Hence, this set of behavior will make children think that it is alright to drink as well. This causes them to model their parents behaviour which causes drinking from a young age.
• {My parents are non-alcoholic drinkers but my relatives are like any other typical Singaporean uncles and aunties who loves to consume alcohol even when there is no special occasions like Chinese New Year. As such, I started to learn to drink as there will be many leftover beer cans at home which look tempting to me as I have always wondered what's so nice/interesting about beer that my relative loves to consume them as much as I love coke. I tried it and it somehow got to me that there is nothing nice about it but something about it just make me feel so calmed. This lead me to getting addicted to drinking when I was in secondary 4. I would drink every night at home to calm my mind from all the stress and worries I have to deal with during the day due to the preparation of my major exams, O Levels. After a few months of that routine, I found that I would feel light-headed frequently and would faint out of nowhere even if I had eaten. My parents bought me to the doctor and found out that I have very low blood sugar due to the amount of alcohol in my body.}
• - Parent’s neglect of their child’s adolescence period. During the adolescence period, teens tend to be more sensitive when they are not able to receive the attention they needed their parents. They will then try to be problematic and cause trouble for themselves or for parents, usually so that they will get their parents’ attention. Thereupon, parents should pay more attention to their child especially during adolescence, and monitor their child activities at all time. [need reference]
• - Furthermore, if a child does not receive the affection and attention they seek from their parents or family, they will turn to their friends as an "alternate" family and seek guidance from them. If the friends they mix with are a bad crowd that participate in deviant activities like underage drinking, the child is more likely to participate in them as well to fit in with the friend group.
• {My friend who was 16 at the time had been pressured into underage drinking at her void deck. She was accompanied by two boys that were 18 and felt the need to fit in by drinking with them. Underage drinking is already illegal in itself, but so is drinking in public. She did not care for the consequences as she was too worried about being left out.}
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• - Also, alcohol is easily accessible. Even convenient stores such as 7-Eleven have alcohol for sale. It is not tough for these youths to get them as they are able to ask their legal-age friends to purchase it for them.
• - In addition, it is due to the curiosity. They are interested or have a desire to find out what it feels like to be high or intoxicated causing them to have the first drink. Subsequently, this behaviour when not monitored will lead to alcohol abuse. [need reference]
• - Ease of applying for credit cards as means to sustain drinking habit. There are even credit companies that do not require adult consent for those aged 18 to apply. Thus, this will cause youths to spend more money on drinking. [need reference]
• -There also has been an increasing number of night spots in Singapore. This outlets may become areas for youths to socialise and there is a likelihood that they will drink. [need reference]
• https://drugfree.org/parent-blog/top-8-reasons-teens-try-alcohol-drugs/ Popular media. A lot of shows portray actors and idols drinking. Youths would be compelled to mimic them as well. An avenue to relieve stress. Some teens face problems and emotional struggles in their growing years and they turn to drinking to alleviate their worries, escape reality and make them feel good. Boredom. They seek fulfilment in their lives. Some might turn to turn to drinking and similar youths to fill the emptiness within themselves. Rebellion. Instant gratification. They enjoy immediate stimulants and temporary happiness. Lack of self-confidence. http://www.straitstimes.com/singapore/health/worry-over-young-binge-drinkers a way to break away from insecurities and enjoy themselves. Misinformation. Wrong information spread to the teen by peers. Hence, they do not know the real consequences of drinking.

Rehabilitation Programmes

• Alcoholics Anonymous Singapore: a fellowship of men and women who support each other in an attempt to quit alcohol. There are meetings in a number of places in Singapore and they can be contacted on 6475 0890.
• National Addictions Management Service: offers advice on all types of addiction problems. This service is located in Buangkok View and can be contacted on 6389 2387
• WE CARE Community Services Limited: offers support for anyone affected by addiction in Singapore. They can be contacted on 6471 5346.
• Teen Challenge Singapore
• The National Addiction Management Services
• National Institute on Alcohol Abuse and Alcoholism

Category C Programmes

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Information to integrate to above:

• Subjective Concerns about Underage Drinking -There are different views on underage drinking with parents supervision. Some people from a Singapore forum known as Reddit Singapore, think that as long as there is parent supervision, there is no problem as the parent can help if any situation arise. Furthermore, drinking wine has proved to be good for health when consumed correctly. For example, my friend's uncle approved of underage drinking with supervision and moderate consumption as it is said to reduce risk of developing and dying from heart disease. A Singaporean parent claim that it does not serves as a problem, so long that the child understands the effects and consequences of drinking in a forum.
• - Whereas, others in the forum called Reddit Singapore, disagree in underage drinking with parents supervision. My primary school friend's mother refuses to allow underage drinking for their children in fear that my friend might get addicted and binge on alcohol, even with supervision. Over consumption of alcohol can cause damaging effects to kidney, and even death.Therefore, parents do not allow underage drinking even with supervision.
• - Another issue is the age that youth first drinks alcohol. In America, the average age for a girl and boy to consume their first alcohol is 13 and 11 respectively. They begin drinking regularly at an average age of 15.9 years. In Singapore, the average age that youths started drinking is about 12 to 13 years old. It is similar to the result from America. Many youths are starting alcohol on a very young age nowadays. In Straits Times, a senior director for youth services at the Singapore Children's Society, say that the reason this occurs is due to adults constantly drinking in front of youths. This can be a case of influence from families. Families are the primary agents of socialisation. Thus, children will follow their parents' examples.
• - Ms Lena Teo, assistant director of counselling at the Children-at-Risk Empowerment Association (Care Singapore), says that the accessibility of alcohol in Singapore is a reason when interviewed by Straits Times. Although the legal age to buy alcohol is 18, youths now have found a way to gain access to alcohol. They will seek help from their peers who are of the legal age, and get alcohol from them. They may even give an excuse, stating that their mother need wine for cooking. There are many places to gain alcohol in Singapore due to the increasing night clubs and shops selling alcohol.
• - My secondary school friend thinks that youths who drink are "cool". Many people are drinking alcohol, thus it is seen as a "trend" to drink alcohol. Drinking alcohol makes them feel like an "adult". They want to gain recognition from their peers as a youth, especially if they are not given attention from their families. Thus, they might drink to impress their friends by drinking alcohol as it is "cool".
• -Drinking alcohol is not necessary bad but it should not be abused. Children should know the limit of drinking alcohol such as how much will caused them to be drunk. Exposing children to alcohol since young is also good as this cause their tolerance level to be higher and girls will be taken advantage easily by others when drinking alcohol
• - Another concern that the people have is the dangers of underage drinking. For example, my parent might think that underage drinking can cause accidents to happen. As the youths are not sober enough, they are more prone to making mistakes. For example, they may cross the road without looking for cars, which can cause a fatal car accident to occur. Others think that it can lead to a mistake such as having sexual intercourse due to the heat of the moment. Hence, parents might fear that their child may make mistakes that cannot be reverse due to drinking.
• http://www.straitstimes.com/singapore/social-workers-sound-alert-on-new-generation-of-young-drinkers https://www.helpguide.org/harvard/the-dangers-of-teenage-drinking.htm#early
• - Upon asking my parents and gathering their concerns on the matter, i discovered that most of their concerns were that we might end up ruining our life or suffer from alcohol related diseases. As a parent, they fear that we might get drawn into drinking alcohol and get addicted to it due to peer pressure. The need to "fit in" or "depression" can lead to teens drinking alcohol which has multiple negative side effects, such as liver cancer as stated from https://www.knowyourlimits.info/know%E2%80%A6-effects-alcohol, if abused. In addition to this, they also fear that we may end up having jail time, which can affect our abilities to find jobs, just like Favian Kang Kok Boon, cited from http://www.straitstimes.com/singapore/courts-crime/lawyer-gets-jail-fine-and-ban-for-2nd-drink-driving-offence.
•  Alcohol: Teenagers consuming alcohol in Singapore are on the rise as well. The age group is getting younger and younger, that teens of 12 to 13 years are consuming it instead of the global average of 15 to 16 years old. The impact is very harmful because the earlier one starts to drink, the more likely one will abuse alcohol due to its effects on the developing brain. Their cognitive effects will be worsened that will affect their learning and memory skills. Based on my knowledge, though there’s a policy that people below 18 are not allowed to buy alcohol from stores, these underaged youths are able to consume them from their older friends or relatives. Thus, this is how they are influenced heavily and are able to get their supply. The reasons why they consume alcohol are because they want to get relief from their problems, they also see that it is a relief based on watching movies, and it is a form of fun social gathering with their friends. But researchers argue that the usage of such drug should be closely monitored to prevent an overdose which could result in chest pains and even death. Hence, contingency management, which uses low cost incentives such as vouchers and prizes as immediate rewards when drug-free urine samples are produced, is a safer approach.
• But there are rehabilitation centres and other measures to treat these teenagers with alcoholic habits. For example, Teen Challenge Singapore rehabilitates alcohol addicts. While there is behavioural therapy focuses on social and familial relations, incorporating counselling and highlighting alcohol’s role in the addict’s impaired functioning in social settings. Motivational Enhancement Therapy, meanwhile, helps to motivate a client to see the bigger picture that the family would get upset if he persists in alcohol abuse, and at the same time strengthen his beliefs in engaging treatment. Medicine such as Traditional Chinese Medicine (TCM) and therapeutic treatment can also be combined to treat addiction. TCM uses acupuncture to balance the body's elements and helps to calm the nervous system, which in turn weakens the cravings for alcohol. Meditation gives a person inner calm and contentedness, thus removing the association between an addict and his desire to drink. https://www.smu.edu.sg/perspectives/2016/03/30/social-impact-alcoholism-singaporean-environment
• Smoking: Smoking has been on a rise as well. Smoking is a popular activity for many people who continue to enjoy it even though they are well aware of the health risks. The main reason for this is nicotine addiction. Tobacco contains nicotine - a stimulant which affects both the mind and the body. It increases heart rate and breathing and causes a surge of adrenaline which gives that ‘buzz’ that smokers enjoy.Teens as young as 12 would start smoking as it causes the smoker to feel relaxed as well as stimulated which is due to the production of a chemical called Dopamine. Dopamine is released into the blood stream which causes feelings of pleasure and well being. Youths are attracted to smoking as they see it is a sign of being an adult or an action that is cool and would drive attention to themselves. This is the main reason why Youths are influenced to smoke as there is a high chance that their close group of friends have started smoking already.They would start as well because they would still want to fit in to their group of friends and not be left out. 

Prevention

• Desired Outcome: [To insert]
• Synopsis: [To insert]
• Statistics: [To insert]

Existing Programmes	Gaps & Their Causes	Possible Solutions

Information from previous wikithon to sort

 According to The Strait Times, a story of Jesscia of her trying on drug. She has tried on weed when she was 15 years old. She has been on weed from 15 years old until she was in polytechnic. When she was in polytechnic, she and her friends would be smoking at the school toilet or nearby park or went to somebody house on a high drug. She has been arrected and caught for drug comsumption and be placed on a year's probation. [1]

The Effects of Drug Abuse [this section needs references]

On teens - Emotional problems. Drug abuse can cause or mask emotional problems such as anxiety, depression, mood swings, suicidal thoughts and schizophrenia. In fact, among teens with major depression, 34.6 percent report using drugs. Unfortunately, drug use can also increase the severity of these emotional problems. For example, teens that use marijuana weekly double their risk of depression and anxiety.

- Behavioral problems. Teens who abuse drugs have an increased risk of social problems, depression, suicidal thoughts and violence. According to a recent survey by the Substance Abuse and Mental Health Services Administration, teens who abuse drugs are more likely than teens who don’t abuse drugs to engage in delinquent behaviors such as fighting and stealing.

- Addiction and dependence. Studies prove that the younger a person is when they begin using drugs the more likely they are to develop a substance abuse problem and relapse later in life.

- Risky sex. Teens that use drugs are five times more likely to have sex than teens who don’t use drugs. Teens that use drugs are also more likely to have unprotected sex and have sex with a stranger. This leads to higher risks of STDs, teen pregnancy and sexual assault.

- Learning problems. Drug abuse damages short-term and long-term memory and can lead to problems with learning and memory later in life.

- Diseases. Teens who abuse drugs with needles increase their risk of blood-borne diseases like HIV, AIDS and Hepatitis B and C.

- Brain damage. Drug abuse among teens can result in serious mental disorders or permanent, irreversible damage to the brain or nervous system. Brain damage among teens who abuse drugs includes brain shrinkage; impaired learning abilities; amnesia and memory problems; impaired reasoning, perception and intuition; increased or decreased socialization; and changes in sexual desire.

- Car accidents. Teenagers who abuse drugs are more likely to be involved in car accident-related injuries or death. One study showed that 4 to 14 percent of drivers who are injured or die in traffic accidents test positive for THC.

- Lack of emotional and physical control. Youths might start bullying others as a form of reliving their stress as part of the lack of physical control. if they do not have the access of drugs, they would have to do other things to relieve their stress. Adding on, drug abusers are emotionally immature as they are stuck in negative emotions.

reasons why youths take drugs [need reference]

- to change how they feel because they want to feel better or different - socialising with friends, peer pressure or the need to feel part of a group

- relaxation or fun - curiosity, experimentation or wanting to take risks - to escape from psychological or physiological pain

There are many symptoms of drug abuse, but some of the most common signs your teen is abusing drugs are:

- Problems with the law, such as DUI, breaking curfew, stealing, etc. - Problems at school, such as excessive tardiness, poor grades, suspension, etc. - Mood swings - Loss of interest in favorite activities - Drug paraphernalia - Violent behaviour - Withdrawal - Depression - Poor hygiene - Missing money

Subjective Nature of Drug Problem

Religion playing a part in the decision of using drugs - Religion may play a part in people's decision to use drugs - For some religion, some may think that using drugs is a sin and should never be done, however, some others may be okay with the use of drugs. - For people who are very religious, they would refrain from using drugs and will view it as something bad. With this mindset, it may cause them to misunderstand those who use drugs and will automatically think that they are doing something bad. - Religion tends to control people by doing drugs. Religion helps "stabilize" oneself as it helps one control one's desire as Religion provides a guideline or a set of rules for one to follow.Those who are religious tend to follow these rules. However, this is not the case for all teens.

Conflicting views that society holds - When someone uses drugs, one automatically judges that it is "not right" and would look down on these people who use drugs. - Even from the older times, traditionally, it is deemed to be wrong to use drugs and people would judge these drug users and look down on them. These drug users would also be seen as the people who do not contribute to society constructively. - Also, one can be easily influenced by what others around us think. For example, if our friends and family view drug usage as a bad thing, we would not question why they think that way and automatically believe that what they think is right. - With such conflicting views, drug users are deemed to be "criminals" of the society as they are doing something that is against social norms. - Society wants the drug abusers to be rehabilitate into a beneficial citizen, however when one has a history of drug abuse, all opportunities for them are gone, which could let them return to drugs due to being rejected by society.

Subjective Concerns about Drug Use in Singapore

-Concern 1: Influence towards the younger generation According to a research done by YoungParents.com.sg, kids are easily influence by adults. Another article by ChannelNewsAsia, it can be seen that many new Yuppies are not afraid using drugs. What is interesting about this 2 articles is that these yuppies will end up being parents who are not afraid of the uses of drugs. Influence of parents may affect the children.

-Concern 2: Future= {I know someone who had a great future ahead of him. However due to influence, he left it all behind. He has been in and out of jail now. Is there a way to change these people? It used to believe this help can be given however, success rates for people to recover are low.}

-Concern 3: More education on drugs {Personally, in my whole 13 plus years in school, I've only attended 2 COMPULSORY seminar for education on Drug Abuse. There should be more. According to Channel News Asia, Yuppies are not as scared of drugs as they were before. Is there a need for students to learn about the dangers more?}

- Different people have different opinions on drug abuse in Singapore. Generally speaking, usage of drugs in Singapore is frowned upon, and getting caught trafficking drugs could result in death penalty, life imprisonment, etc. Singapore implemented so many programmes (as stated above) for adolescents, so as to expose them to the negative effects of drugs and hope that they can stay away from it. So, what do the different people in society think about people who use drugs?

- Government: The Singapore government places utmost importance on fighting against drugs. Also, it is obvious that they really frown upon the idea of drugs in Singapore, making the fight against drugs a "national priority".

- Activists: There are different sides each activists choose to take, but most of them, after digging deeper into the use of drugs in Singapore and its consequences, choose to campaign against the death penalty. In addition, there are many others, who felt that regardless of the crime, death penalty is too harsh, and that it shows how Singapore "shows flagrant disregard for human life." Most agree that while they should be punished, the capital punishment should not be used as one has no right to take the life of another.

- Youths: As much as the government tries to expose our youths to the negative consequences of drugs and educate them not to do drugs, it has been reported that many youths today do not see drugs as a serious issue. They have a liberal attitude towards drugs, and are even open to experimenting with them. The social media platforms they spend time on glamourises the use of drugs, causing these youths to be influenced into taking them just to seem cool.

- Parents: Of course, almost every parent will be against their child taking drugs. Parents want advancement for their children — their well-being to be enhanced — they encourage people to talk about this matter precisely because drugs are a major issue in Singapore. They want their children to be aware of the pitfalls and dangers.

-= Central Narcotics Bureau: https://www.cnb.gov.sg/drugsituationreport/drugsituationreport2016.aspx [2]

Channels News Asia: http://www.channelnewsasia.com/news/singapore/yuppie-drug-abusers-are-on-the-rise-and-checking-into-s-19-000-a-8753548

Government on drugs: http://www.channelnewsasia.com/news/singapore/singapore-to-make-fight-against-drugs-a-national-priority-shanmu-8710276 http://www.todayonline.com/singapore/reckless-irresponsible-decriminalise-drug-use-says-shanmugam

Activists on drugs: https://www.opendemocracy.net/drugpolicy/kirsten-han/how-discovering-truth-about-singapore-s-war-on-drugs-led-me-to-campaign-to-abolish-death https://www.amnesty.org/en/latest/news/2017/10/singapore-executions-continue-in-flawed-attempt-to-tackle-drug-crime/

Subjective Concerns about Drug Use outside of Singapore

Country 1: United States of America - Have competing views on drug use. - In the older times, the concern was that marijuana is a dangerous drug as it can destroy an individual brain cells. - In recent times, the view on marijuana has change. People now view Marijuana as a type of medicine. This is so as the effects of Marijuana have been seen to not harm humans but to help them. It have been proven to help with illnesses such as Glaucoma, an eye disease.

Country 2: United Kingdom - Concern on the effect of drug abuse. - 46% of the British view that the effect of drug abuse will lead to the decrease of the levels of street crime if the drugs were decriminalized. - On the other hand, 54% said that it would make no difference. This further supports the stand where it won't make a difference as 95% say that they have never committed a criminal act to fund their purchase of drugs. - Thus, one side view the function of drugs to be the cause of the increasing rates of crime and the other view it differently.

References: https://www.theguardian.com/society/2014/oct/05/-sp-drug-use-is-rising-in-the-uk-but-were-not-addicted

- As we all know, Singapore is extremely strict about drug issues. However some other countries like Portugal, Uruguay and Netherlands are more tolerant on drug issues. In fact, Portugal decriminalized drug usage in 2001 and Uruguay was also the first country which legalized the consumption of drugs such as marijuana. Marijuana, or Cannabis, are sold all over coffee shops in Netherlands and pharmacies in Uruguay and they can be bought for personal use. Recreational marijuana is tolerated by the people and even the authorities there as well. Moreover, marijuana is the most misused illegal item in the world as many people claim that they consume it as it is less dangerous as compared to heroin.

- Some drugs such as Marijuana are known to have positive medicinal effects on one that could possibly improve one's health condition. On the other hand, it is a double-edged sword which could have negative effect on one as well. When using Marijuana, chemicals from the drug may travel from your bloodstream to other vital parts of your body. This could result in increased heart rate and slower coordination of actions etc. Marijuana can cause a host of lung problems, particularly chronic bronchitis and emphysema. It can also increase the risk of lung cancer, depression and amotivational syndrome.

Existing Resources and Limitations

-YARE: youth at risk engagement framework Preventing risk of offending [such as peer/family relationship issues, bullying, and addiction to drinking/cyber activities, etc.]. CYGO appointed 10 agencies. But each agency have their own way of running their program, eg sports, or adventure based counselling or C&C. ([3])

[Limits: -It is only limited to youths aged between 12 to 21 years old, ruling out people who are younger than 12 or people who are slightly older than 21 who may be facing the same issues -There are only 10 at-risk traits (there could be more) -Introduced in 2016, the programme lasts for up to only 3 years. -There is no clear description what an 'at risk' youth is. -Programmes offered are mentoring & character developmet through sports and arts. Not every youth at risk might be attracted to the programmes offered as they are limited to two categories.

Challenges: -The 10 agencies have their own way of running the program, so there is no standardized way of carrying out the program, which can result in the aim of the program not reached -It difficult to find all the youths who are at risk of offences (they will miss out some, which results in the youth not receiving the proper counselling needed) -The programme is funded entirely by VWOs-Charities Capability Fund. If the organisation runs in trouble, funding can be cut off. -Some organisations may not have the same competencies, therefore after the assesmemt they have to refer the youths to more appropriate services.]

-Youth crime prevention roadshow and anti-drug campaigns (NYGR).

[It is a campaign that aims to spread awareness of crimes and drug use among youths. The youth crime prevention roadshow educates youths on ways to avoid committing crimes or becoming victims of crimes. It tries to prevent crime by telling youths about the consequences of crime and the effects it will have on their future (such as unemployment, black list). The anti-drug campaigns are events that aim to raise awareness of the dangers of drug abuse.

[Limits: -The events are open to everyone as a preventive measure but those who do drugs/crime are unlikely to go to these events, so they don't receive the message the events are trying to send. -It doesn't directly deal with the issue of crime and drugs among youths. -Anti Drug Talks focus solely on those who are still in the education system, targeting primary, tertiary & international schools as well as tertiary institutions. Youth offenders outside the education system might not attend these talks. -Activities like DanceWorks! focuses on youths aged 25 and below, youth offenders outside the education system might not attend these such activities.

Challenges: -They can't force those who are at risk of crime or drugs to attend the event, so the message doesn't reach them. -A lot of money is being spent on the event instead of dealing with the issue directly. -Those who commit crime or do drugs will probably do it anyway regardless of whether they go the the events. -Since crimes are often irrational decisions, roadshow not likely to have much effect. -Campaigns and events need to be stratigically planned and carried out in order to target the right audience]

-Preventive Drug Education (PDE) DRC Visit Programme. Institutes of Technical Education and VWOs working with youth identify high-risk youth to visit the Drug Rehabilitation Centre (DRC) located within the Changi Prison Complex(NYGR).

[Aims to ensure that students are aware of and understands the consequences of drug abuse and the strict regime that they will undergo if they are incarcerated. During the visits talks are also given by Central Narcotics Bureau and prison officers.] [Not all youths who take drugs come from broken families, there are youths who have loving and well to do families but still resort to drugs as a result. Some youths do not have any family drug abuse and have proper guidance at home. These youths are influenced by peers, people they hang out with on a daily basis. Drug situation is under control in Singapore. However there are more youth abusers coming from middle-class families and who are doing well in school. Therefore this programme aims to help these youths to get back on the right track.]

Some limits of Preventive Drug Education (PDE) DRC Visit Programme is that students sent to witness the Drug Rehabilitation centre (DRC) may not pay attention to what they are witnessing. Firstly because of their peers around them. They may get distracted by their peers and not pay attention harsh realities of drug abuse and life behind bars. They may laugh about it and be influence to react the way their peers arouund them react, some reasons for that could be because they are afraid of being judged if they make the decision to be better in front of their friends and thus the witnessed they have made will not be of a huge impact to them and thus they forget about it in time to come. For the Prison Visit Education Programme for Schools (PVEPS) which is for students who have high discipline records in their school and they are invited to witness the harsh life in prison, similarly to what was mention earlier about the PDE DRC programme, students may not pay attention to what they are witnessing again, probabily because they are afriad to face the reality of what will happen if they commiit a crime. In addition, they might be too young to fully understand and to take the matter seriously and decide to become a better person. In summary, students visiting DRC and taking part in PVEPS may not have the maturity to take the consequences seriously and because they are young, they are prone to peer pressure and thus if they see their peers not paying attention to what they are witnessing, they will not pay attention as well, and this will cause these programmes to be ineffective.

The limitations of the Preventive Drug Education (PDE) DRC Visit Programme is that it is only a visitation where these youths experience the harsh realities of drug abuse and life behind bars for a short while. While it may scare them for the moment, it may not be enough to ensure that they will never take or consume drugs. For instance, one of the ways that they can be lead to drug abuse is through peer pressure. These visits don’t educate and teach them how to deal with peer pressure and other real issues. While talks may also be given on these visits by the Central Narcotics Bureau and Prison Officers, the youths will only take in what they want to take in. There is no guarantee that the talks will stop them from ever doing drugs. These youths need a lot of guidance and reminders and it takes a lot more than visits and talks to do that.

There will always be limitation and challenges to such Drug education programme for students because it may not effective to deter the students from touching drugs in the future. They may understand what is the consequences and see what it is like in the rehabilitation centre but they may not know what it is to suffer from strong addictions and the seriousness of it how it leading to death hence they think it is fine to do drugs as it pleasures them, in a way that takes away their stress.

Also, talks may not be effective as all students may be not be attentive during the talks as they may be distracted by their peers during the talk or using their mobile phones. Such talk will only work if the students are actually listening and also talking to a small group of students at a time, so students can be monitored whether they are listening by the speaker and teachers through stopping them from talking or asking questions for the students to answer to know their understanding of the talk.

Gaps and Their Causes

Doing what we can, but the work done by youth agencies alone cannot be the only work, need family work and structural changes. Youth work focus on competencies and awareness and oppor to build competencies. Family work important.

Trybe: - YARE in midst of being evaluated: schools will help to identify and recommend. in HK the outreach model is high, will knock on doors and talk to parents. But in Singapore, hard to capture those within radar. Schools may not detect all youth at risk or different types of at risk issues. Focus is on visible at risk behaviours, and capturable by schools. How to reach out to youths hanging out at home or in cyberspace. Youth who were past probationers, who refer friend. - Siblings of offenders may also be at risk.

Some drugs not able to detect by urine test.

ADD TO YOUTH WORKER COMPETENCY -The movement by CYGO is to coordinate nationally, prevent silos. YWAS also moving towards that, move towards all encompassing framework, whether paid or volunteer, we want to increase the standard of anyone engaging young persons.(CARE)

-Ecosystem perspective, have ot be able to work with family work, youth centric family work for example.

- Youth crime prevention roadshow and anti-drug campaigns (NYGR): organize annual programmes and set up booths for youths that are seeking help and counselling. Limits and challenges: It is up to the individuals on whether they want to speak out about the crimes that they have committed or their drug addictions. Some of them do not even know that they are addicted to drugs in the first place. Hence, it is difficult to reach out to them and help them. Eventhough friends and family of youth-at-risk do know of the campaigns and roadshows, they may find it difficult to persuade these youths to get help as they might be against it or are unwilling to get help. These roadshows can only be helpful in helping youths to avoid crime to a certain extent as crimes are done as an impulsive act. The anti-drug campaigns may be helpful to a certain extent as well as those that have tried drugs will be aware of the consequences and will decide to get help. However, the roadshows may not convince those who are already the addicted to drugs well as they are not willing to give up on drugs.

Possible Solutions

Get probation youth to refer friends to YARE--a group that have not offended. Especially for youths who have been exposed to drug use. eg reach out to youths who have tried once, but not caught. youth ambassadors cna be used to detetc and refer.

- Keep these youths under close watch and provide them with the necessary support to stop. - Encourage more family involvement as the teens may have lacked parental supervision or did not have a proper parental figure . - To avoid drug abuse, prevention programmes such as workshops and school talks can be properly implemented in youths' everyday life from education like school to household like parenting.

- Using programmes, youths are exposed to different risks that drug abuse can bring. Perception of drugs would then be changed as they are aware of the consequences. When youths are heavily exposed to substances the consequences are bad as they might face the damages to their brain at a young age which will lead to more risks. So preventing it from a young age by raising awareness in schools and at home can help youths to think before turning to drug abuse.

-[Using the universal programme, it addresses risk and protective factors common to all children in a setting such as school or community. Selective programmes would work too as it targets a group of children and teens who have factors that put them at increased risk of drug use. Last but not least it is the Indicated programme as it is designed for youth who have already begun using drugs. Prevention is better than cure.] [4]

-[Communication is a key factor in avoiding drug abuse. Talking to someone and being honest may prevent casual drug use from turning it into drug abuse. Focus on the behavior of the person and not the individual, as drug use is dangerous but it does not mean he/she is a bad person.] [ Parents can also talk to their children about drug abuse, so the youths will know the serious consequences of drug abuse and not start taking drugs. ] [5]

-[Avoiding Temptation and Peer Pressure. If you have friends or family who are pressuring you to consume drugs, avoid them. Make new friends who practice healthier habits, who do well in school and are motivated to work for their goals.] [6]

-[Practice healthier Living Habits. Exercise, eat well or even meditate as these are excellent ways to avoid using drugs and recover from it by substituting dopamine with adrenaline. This makes managing stress and trauma easily manageable.]

- [7] the website also explained the top 10 ways to help youth avoid drug abuse and it stated that parents, public, government all plays apart in helping youths

- How to prevent drug use in teenagers -Foster a close and trusting relationship with your child from an early age, and support and encourage positive behaviour. -Model appropriate behaviour, such as drinking moderately, not smoking and not using illicit drugs. -Establish agreements and guidelines about what is acceptable behaviour around alcohol and drugs. -Encourage a healthy approach to life, including good foods, regular exercise and sports. -Encourage your child to have more than one group of friends. -Allow your child to practise responsibility and develop good decision-making skills from an early age. -Keep yourself informed about drugs and educate your child on the dangers of drug use. Do not exaggerate or make information up. -Have open and honest discussions about drugs References: https://www.betterhealth.vic.gov.au/health/healthyliving/drugs-teenagers

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[these are effects in general, not on youths, to be moved]

- Serious consequences of abuse can include severe acne, heart disease, liver problems, stroke, infectious diseases, depression, and suicide. Drug combinations. A particularly dangerous and common practice is the combining of two or more drugs.

- Article from National Institutes of Health (NIH) highlights that drug abuse can cost mental health problems such as Depression, Anxiety, Bipolar disorder, ADHD and Antisocial personality disorder.

- Cocaine addiction can cause chronic pulmonary conditions that increase the risk of heart attack. Heart disease in itself is common to chronic cocaine users, due to the overexertion of the heart as a result of the drug’s stimulant effects. Cocaine users also experience perforated or deviated septums, strokes and heart attacks (the latter two conditions a result of exceeding high blood pressure and tachycardia overtaxing the heart). Additionally, cocaine can also lead to a heightened risk for cancer and associations have been made between the drug and lung cancer, particularly in freebasing users.

- Benzodiazepines — also known as “benzos” — are sedating drugs given mainly for anxiolytic purposes. Chronic users of benzodiazepines can experience abdominal problems and fatal blood clots. Additionally, the reproductive system becomes affected by benzodiazepine addiction, and can lead to loss of sex drive, erectile dysfunction and birth defects in children of addicted and pregnant mothers

- Ketamine, a powerful dissociative narcotic, can also lead to physical and psychological damage after long-term use. With chronic abuse, ketamine addiction can cause a condition known as “Olney’s lesions,” where vacuoles begin to form within the brain, affecting cognition, learning and memory. Ecstasy can cause psychological conditions, such as severe depression, dissociative disorders, and Hallucinogen Persisting Perception Disorder (HPPD), a flashback-producing condition that also occurs with LSD use and can persist long after Ecstasy addiction subsides. PCP can cause Irritable Bowel Syndrome (IBS), seizures and paralysis with chronic use.

- Opiates — a class of potent narcotics spanning from heroin, morphine and codeine to prescription painkillers — can cause a host of long-term physical diseases and conditions. Opiate users, particularly those who inject, are at high risk for hepatitis and HIV transmission from needle-sharing. Collapsed veins can also result from chronic injection of opiates. Heroin use can cause long-term digestive issues, including a form of chronic constipation that is highly dangerous while addiction persists.

- Amphetamines, the drug take an unimaginable toll on the body. Common conditions associated with amphetamines addiction include insomnia, anorexia and eyesight degradation. Amphetamine-addicted individuals also can experience stunted growth, hypertension, frequent urinary tract infections (UTIs) and hyperactivity. Amphetamines can also cause a condition known as dermatitis, the development of skin disease. Liver and heart disease are also associated with amphetamine addiction.

- Methamphetamine, it can cause a host of physical conditions, ranging from liver damage to lung disease. Meth can irreparably damage the brain’s blood vessels, incite hypertension (high blood pressure), and create an compromised state (making the body more susceptible to diseases, infections and cancers). Methamphetamine abuse can also cause heart disease, stroke occurrence, and severe depression or mania in users.

- Inhalant abuse — the inhalant of household and industrial chemicals colloquially known as “huffing” — can also lead to a host of chronic physical conditions. In addition to instantaneous death caused by Sudden Sniffing Death Syndrome, inhalant abuse can lead to tachycardia, heart disease and an array of damage to the vital organs, including diseases of the liver, kidney and lungs. Chronic bronchitis can arise from inhalant abuse, and some inhalant-addicted individuals also encounter tremors and chronic grand mal seizures. 

Some MISC info to sort & insert

Rise in Incidences of Violence Related to Drug Abuse

The use of alcohol and drugs can negatively affect all aspects of a person’s life, impact their family, friends and community, and place an enormous burden on American society. One of the most significant areas of risk with the use of alcohol and drugs is the connection between alcohol, drugs and crime.

Alcohol and drugs are implicated in an estimated 80% of offenses leading to incarceration in the United States such as domestic violence, driving while intoxicated, property offenses, drug offenses, and public-order offenses.

Our nation’s prison population has exploded beyond capacity and most inmates are in prison, in large part, because of substance abuse:

• 80% of offender’s abuse drugs or alcohol. • Nearly 50% of jail and prison inmates are clinically addicted. • Approximately 60% of individuals arrested for most types of crimes test positive for illegal drugs at arrest. • Each year, more than 600,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking. • 95% of all violent crime on college campuses involves the use of alcohol by the assailant, victim or both. • 90% of acquaintance rape and sexual assault on college campuses involves the use of alcohol by the assailant, victim or both.

From the statistics present, we would agree with the statement that there is a rise in incidences of violence related to drug abuse not only in our own country but in other regions as well.

[1]

[2]

In the article above, it is said that youths lead to abuse towards parents when asking for money to cover for their substance abuse. This is an immoral behaviour that youths have adopted because of their crazy addiction.

Rise in number of new addiction cases Two hospitals here have seen more new addiction cases in recent years. From 2013 to 2014: - New cases of drug addiction rose by nearly 12% from 591 to 661. - New alcohol addiction cases rose from 415 to 433, which is about 4% increase - New gambling addiction cases rose from 418 to 526, which is about 26% increase - The number of inpatient cases (both new and repeat) with alcohol addiction rose 27%, from 259 in 2013, to 329 in 2015. [3]

• In Singapore*

Singapore has one of the strictest laws on drug related offences which makes Singapore one of the few countries in the world that could dealt effectively with the drug problem. By having a tough legal framework against traffickers and abusers. Singapore will carry out intensive efforts to educate Singaporeans on the dangers of drug abuse — and all these are complemented by comprehensive rehabilitation measures. Such as crimes committed under the influence of drugs will be punish accordingly.

Although Singapore have low percentages of poeple committing drug related offences, there are still a small percentage of poeple who does.

I would be using the article as an clear examples of how drug can influence us and hurt people around us. [4] A 39-year-old man has been arrested for suspected drink-driving, drug-related offences and for injuring three police officers when he resisted arrest. Which shows us that drug abuser does not only harm themselves but also harm others, as the drugs will control over your mind and body. Nonetheless, Singapore Police was able to handle this solution quickly, and have charged that man for his crimes.

The Prevalence of Youth Drug Abuse based on Family History Family backgrounds such as income, parenting, and education will affect the likelihood of their children abusing drugs. Children of more affluent families may be at greater risk, of facing anxiety and depression as these children experience more pressure from family such as doing well in school and life. The pressure and isolation from parents resulted them in using drugs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1950124/

Growing up in a family that emphasizes getting "high" from legal or illegal substances can cause an adolescent to think drug use is acceptable. Mayo Clinic explains that this unhealthy family influence may be a factor in a youth's initial drug experimentation. Exposure to family members who reach for a substance to cure every pain or ailment can cause a youth to do the same. Youths get many of their values from parents and other adult influences, and often mimic what they see.

Thus, it is important for parents to set a good example and provide good guidance on shaping the lives of our young ones. Children will always look up to their grandparents,parents or even siblings and pay closely attention to their actions and tend to mimic the way they behave. They may feel that it is acceptable for them to do if their parents, siblings or grandparents have done so. This is crucial when it comes to severe matters like drinking, doing drugs or even gambling.

Genetics make up to 50% of risk for alcohol and drug usage. Children are likely to develop the same drug habits as their parents. Certain people are more prone to addiction and it could be run in the family.

- Family, parenting all gives factor to a child's mentality and behaviour. Since family is one of the first and main point of socialization, the type of parenting and guidance will affect the youths attitude. If the children have good role model parents, they will likely to follow their path considering the type f household they have. However, if children grows up in a how where he/she sees their parents doing vices (smoking, alcohol or drugs) they might get the perception that these activities are normal and alright. Although there are some research that addiction in drugs or alcohol can be inherited, huge factors come from the youth's surroundings such as peers and family. Therefore, it is important to have families that are giving correct guidance and making sure that they are displaying the correct behaviour. (e.g. personal experience : growing up in a household where vices is looked down upon too, we have the mentality not to engage in such activities as guidance is taught from young).