One+more+to+no+more.

= = = Goodbye Heroin, by 17-year-old Hannah Meredith. = **Dear Heroin** **I never want to touch you ever again, you've ruined my life, made me steal from my family, on probation 'cause of you, why I choose you I don't know?** **You're the worst thing that ever came into my life. Yes, I did love you but now it's time to say goodbye.** **I'm so ashamed of myself 'cause of you. I OD three times, you're a big risk to anyone that does it and to me.** **So I'm going to be strong and stay away from you and never touch you again. My family have supported me all the way but I just kick them up the backside taking advantage of them.** **Stole off my mother, granddad, Mam Iscoed. I borrowed money off her and didn't give it back. She's getting old now, and look what you've made me do, my nan — £120 stolen off her, once again 'cause of you.** **I love my family from the bottom of my heart, it's not nice being called a junkie or smacked.** **It feels horrible, you feel so small. Well I feel small, you made me feel like I'm worth nothing, just a dirty junkie sticking needles in my arms.** **You're out of my life now, don't need you no more. Yeah, you've messed me up nearly two and a half years of my life but I've still got my whole life ahead of me and I'm going to prove to everyone that I can stay away from you, going to college, getting a job and a car.** **Then get on with my life and get my family's trust back. Stop offending, that's the only reason I was doing all that 'cause of your dirty addiction. You make me sick to be honest with you.** **I did love the buzz of you but you're not worth it. By losing my family, thinking about you ps me off.** **But not anymore, I'll make sure you stay away from me, and I'll stay away from you.** **I was brought up by a good family not a bad one, yeah I've had a lot of problems in my life, been quite bad actually, all because of you (Heroin) (gear), (smack)!!** **You're a killer, you've killed a lot of people and really they are good people. I'm lucky that you haven't put me in a box cemetery. Lost loads of my mates and it hurts me, they sometimes blank me 'cause they know I've been on you (gear) it's not nice when I've got pin holes in my arms and marks, track marks.** **The illness that I go through when I use you and the after effects, cold turkey, clucking (corr), withdrawals, it's the worst feeling that you've put me through, being bad off you.** **Wanted to kill myself a few times 'cause I couldn't go through it. Well guess what (heroin) I can and did do it. I can beat you anytime. I can control you, you don't control me.** **I've got enough will power to get you out of my life for good. I'm strong and much stronger than you can ever be. I'm not losing anything over you. Goodbye heroin.** **Never again. Family comes first.** **Hannah Meredith** Published in UK’s The Telegraph in 2012 this heart wrenching cultural artifact represents the dire circumstances a young girl, only 17 years old, has experienced due to her long lasting drug addiction. This moving diary entry was written just days before Hannah’s death. It was published in the hope to raise awareness to other teenagers to steer clear of drugs. Hannah illustrates not only the heartbreak but the crime and life threatening danger associated with her drug addiction. The desperation expressed in Hannah’s diary entry sends a clear message that addiction is no fairy tale. The low that follows drug use far outweighs the high. Whilst it is possible to overcome addiction and reach full recovery the road to recovery is a long and painful struggle, which requires the support and encouragement of others. The changing face of addiction is well illustrated by the following quote
 * Name - Jessica Williams**
 * //Student number- n8866970//**
 * //Tutor- Judith M//**


 * // “ //****//The truth is the image of a listless young heroin addict collapsed in a filthy, dark alley is obsolete. Today, the young addict could be 12 years old, play video games and enjoy the music of his generation. He could appear smart, stylish and bear none of the common traces of heroin use, such as needle marks on his arm” (Foundation For A Drug-Free World, 2013. Para.4).//**

Public Health Issue The public health issue surrounding Hannah’s diary entry is the effect of illicit drug use/ abuse on both the user and society, with the focus on youth drug abuse. The diary entry depicts many of the public health issues that surround drug abuse, including mental illness, crime and social isolation. There are many creditable sources that describe the relationship between drug abuse and crime. Statistics show that the connection between drug abuse and crime is well known - one-half to two-thirds of inmates in jails and State and Federal prisons meet standard diagnostic criteria for alcohol/drug dependence or abuse (National Institute of Drug Abuse,). Therefore, finding the appropriate treatment for drug addicts should be seen as a major public health focus for society.

Literature Review Drugs have been part of our culture since the middle of the last century. Popularized in the 1960s by music and mass media, they invade all aspects of society (Foundation For A Drug-Free World, 2013). However, drug addiction is a rising concern amongst society within the twenty first century. Of particular interest is the prevalence of youth related drug abuse. Only two national surveys have attempted to provide overall rates of illicit drug use among representative samples of young Australians— the Australian Secondary Students Survey of over-the-counter and illicit drugs (ASSS) and the National Drug Strategy Household Survey (NDSHS). The results of these surveys are documented in the table below. It is obvious that by far the most commonly used drug amongst juveniles is cannabis, followed by Amphetamines. Above all, both surveys found the highest percentage was the use of any illicit substance, this indicates that young people are willing to consume any illicit substance, despite what it is. Whilst drug addiction is an increasing concern, the severity of drugs and their effects on the individual and society is a further concern. In recent years there has also been increasing concern specifically of the rise in recreation drug use among juveniles. Recreational drug use is common in clubbing and festival atmospheres where users are looking to enhance the experience (Drug and Alcohol Rehab Asia, 2008). However, any illicit drug use and related harm results in significant economic, social and health costs to individuals, families, communities and the nation (Public Health Association of Australia (PHAA), 2010). A strong positive association between youths’ drug use and crime has been well established. A report published by the Australian Institute of Criminology found that in six months before entering detention, 71% of youths had used one type of substance regularly and 29% used more than one type of substance regularly. This shows a clear indication of drug use amongst juvenile offenders within the Australian society. Involvement with drugs or alcohol increases the likelihood of continued and serious contact with the juvenile justice system (Young, D. W., Dembo, R., & Henderson, C. E, (2007). Higher levels of involvement with substance use also increases the rate of offending, the severity of the committed offense, and the duration of antisocial behaviour (Young, D. W., Dembo, R., & Henderson, C. E, (2007). The key risk factors for alcohol/drug abuse and criminal offending amongst juveniles have also been identified. These risk factors are categorised by individual risk factors, family, school, peers and community/neighbourhood. Some the many risk factors included boredom, family instability, academic failure or low levels of achievement and peer drug use (Prichard, J., & Payne, J, 2005). In the report published by the Australian institute of Criminology it stated that Juvenile detention does not appear to assist young people in breaking habits of drug abuse. Therefore the importance of treatment is essential in lowering the rates of juvenile crime amongst the Australian society.

Along with crime there are a range of significant health problems that are associated with drug abuse, both physically and emotionally. It increases the risks of blood-borne diseases (such as AIDS and hepatitis B and C), suicide, and psychological as well as physical dependence (Australian institute of Criminology, 2009). The risk of contracting many of these blood borne diseases is significantly increased through injecting drugs. Sexually transmitted diseases are also more likely with users being involved in drug driven sexual activities involving multiple sex partners. Additionally to the increased risk of communicable disease the effect of drug abuse can be detrimental to the users psychological health. According to the Public Health Association of Australia (2010), illicit drug use attracts significant media attention, the majority of which is negative and sensationalist. This attention can contribute to the marginalisation of people affected by drug use, further limiting access to and engagement with effective treatment.

In the past, society viewed drug addiction as a moral flaw. Popular "treatments" involved imprisonment, sentencing to asylums, and church-guided prayer. Not surprisingly, these methods were generally ineffective (Learn. Genetics, 2013). However, today we understand that addiction is a brain disease characterized by fundamental and long-lasting changes in the brain. Therefore, modern treatments are based on scientific research (Learn. Genetics, 2013). Scientists now have a good understanding of the neurobiology of drug addiction, which is a major step forward in the treatment process for drug addicts. The neurobiological basis of addiction is based on the activation of common neural systems associated with “reward” (Tieu, M, 2010). This reward system is in place to subserve normal biological functions such as obtaining food and other resources for survival. The distinguishing feature of addictive drugs is their ability to directly, and with greater intensity, activate the brain’s reward system. Thus addictive drugs alter the body’s natural motivational hierarchy of needs, placing drugs higher than the essential needs for survival such as food and shelter (Tieu, M, 2010).

Because drug abuse and addiction have so many dimensions and disrupt so many aspects of an individual's life, treatment is not simple. Effective treatment programs typically incorporate many components, each directed to a particular aspect of the illness and its consequences (National Institute on Drug Abuse, 2009). Drug treatment may also differ depending on the patient and there individual behaviours and attitudes. Most patients require long-term or repeated episodes of care to achieve the ultimate goal of sustained abstinence and recovery of their lives.

Whilst researching the study of juvenile drug use there were limitations apparent. The most obvious limitation was that in Australia there has been relatively little empirical work on juveniles and drug use. Much of our knowledge is based on overseas research or derives from research on adult offenders and their drug use patterns (Australian Institute of Criminology, 2009). Additionally a lot of the research that was available was dated over a decade ago, therefore the data may not accurately reflect the current circumstances.

Cultural and Social analysis It is important to understand the social and cultural theories surrounding the use of illicit drugs amongst juveniles in Australia to understand the complete picture. Psychological and socio- cultural factors play an important role in determining juvenile drug abuse. All aspects of a teenager’s environment can help determine whether they will try drugs. The Factors that affect whether or not one engages in drug use include one's self-esteem, the way one's peer group perceives drug use, and whether or not one is cognizant of the pyschological and emotional toll that drug use can have on people (Boundless, n.d). Substance use can be a way of simply avoiding the problems and challenges of growing up. Children and teens who have untreated mental disorders (such as ADHD or anxiety), or who were physically or sexually abused, are at heightened risk of using marijuana and other drugs at an early age (Boundless, n.d).

The engagement in drug use as a social behaviour is also common. These users typically don’t use drugs as a way of managing negative emotions but to fit in as a group. A social theory that has recently been applied to the use of illicit drugs amongst Australia’s youth is the concept of normalization (Holt, M, 2005). Normalisation refers to a social process through which ideas or actions of an individual or group come to be seen as “normal” or natural in everyday day life. There is mixed evidence about whether the normalisation of illicit drug use is occurring among Australian youth in general. Drug use is certainly common among some groups of Australian young people, particularly those involved in clubbing and alternative music subcultures, and aspects of the normalisation approach may be useful for understanding their drug use in context (Holt, M, 2005). The possibility that certain types of illicit drug use are becoming common among Australian young people poses challenges for those working in drug education and health promotion (Holt, M, 2005).

The stigma associated around drug use leads to the social isolation of many users during a time where they need support and encouragement. Drug users have a lot in common with other marginalized groups in society, such as sex workers, people with disabilities and asylum seekers in that many people have never met them and know very little about the reality of these peoples lives (Taylor, D, 2010). This stigma is based on a fundamental misunderstanding of drug users and the nature of drug use. As mentioned earlier drug use often coincides with a history of childhood abuse, dysfunctional family life, social exclusion and various emotion traumas (Taylor, D, 2010). It is easy for those who have never experienced these circumstances to marginalise drug users based on the social stigma that has been created. A failure to understand the starting point of addiction often leads to polices that are made which are unlikely to translate into successful outcomes for users. Many drug users are able human beings who often with the right support and treatment can make a positive contribution to society. Treatment can help problematic drug users but without kindness, support, empathy and an absence of judgmentalism it will fail many.

Analysis of the Artifact and Learning Reflections The cultural artefact is a harsh realisation of the ultimate consequence of juvenile drug abuse. To me, the artifact demonstrates perfectly both the consequences drug abuse has on the individual, emotionally and physical, as well as the effects it has society as a whole. The diary entry leaves nothing unsaid and addresses the complete truth of drug addiction. Addressing the public health issues associated with drug abuse including crime, mental illness and social isolation, this artifact summed up perfectly my topic. The artifact illustrates the importance of drug awareness and also the importance of treatment. This artifact made me see the concept of drug addiction from another point of view, the view of those suffering. Studying juvenile drug abuse has opened my eyes to the severity of drugs. I was unaware of the multiple effects it has on the individual’s life and mental health, as well as surrounding family. This assessment piece and Health, Culture and Society as a subject has enabled me to analyse public health issues from a different perspective. I have found myself questioning my initial judgements and looking at the issue from the alternate perspectives. I now believe that I have a more complete view of the issue and see it from a less bias perspective.

References

Australian Institute of Criminology (2009, July). Drug use among a sample of juvenile detainees. Retrieved October 2013, from [] Boundless (n.d.). Psychological and cultural factors influence drug use. Retrieved October 2013, from [] Drug and Alcohol Rehab Asia (2008). Continuum of Substance Use. Retrieved October 2013, from [] Foundation For A Drug-Free World (2013). Heroin Statistics, Teenage Substance Abuse, Prevention & Education: Foundation for a Drug Free World. Retrieved October 2013, from [] Foundation for a Drug-Free World (2006). The Truth About Drugs, Substance Abuse & Addiction: Foundation for a Drug Free World. Retrieved October 2013, from [] Holt, M. (2005). Young people and Illicit drug use in Australia (3). National Centre in HIV Social Research. Learn.Genetics (2013). Addiction Treatments Past and Present. Retrieved October 2013, from http://learn.genetics.utah.edu/content/addiction/issues/treatments.html National Institute on Drug Abuse (2010, September). Is drug addiction a mental illness? Retrieved October 2013, from [] National Institute on Drug Abuse (2009, September). Treatment Approaches for Drug Addiction. Retrieved October 2013, from [] Prichard, J., & Payne, J. (2005). Alcohol, drugs and crime: a study of juveniles in detention (67). Retrieved from Australian Institute of Criminology website: [] Taylor, D. (2010, August). Not just junkies: the stigmatising of drug addicts. Retrieved October 2013, from [] The Telegraph (2010, February 25). Drug addict's 'letter to heroin' published after her death - Telegraph. Retrieved October 28, 2013, from [] Tieu, M. (2010). Understanding the Nature of Drug Addiction. Bioethics Research Notes, 22(1), 7-11. Retrieved from [] Young, D. W., Dembo, R., & Henderson, C. E. (2007). A National Survey of Substance Abuse Treatment for Juvenile Offenders. Retrieved from National Institute of Biotechnology Information website: []

Learning Engagement
 * 1) 1- https://healthcultureandsociety2013.wikispaces.com/share/view/64697682
 * 2) 2-https://healthcultureandsociety2013.wikispaces.com/share/view/64697900