Problems related to tobacco smoking, alcohol drinking and taking opioid drugs, psychiatric and physical complications and comorbidity represent a significant burden for public health services and the improvement of mental health. The aim of primary prevention is to recognize and remove the precipitating factors, to prevent or reduce the disease frequency and prevalence in general population. Addiction diseases can be prevented since the causal factors are known, so once the disease occurs, the treatment should begin as early as possible. The rehabilitation should be carried out according to principles applied in chronic relapsing diseases. Primary prevention can be divided into general, special and indicated prevention. General prevention is directed towards general population through psychosocial health education, reduction of availability of opioid drugs (production, distribution, consumption). Special or selective prevention is directed towards the population's subgroups at high risks, e.g.: prenatal and infant age, childhood, puberty and early youth (2-14 years of age), late youth and early mature age (15-25 yrs), mature age, elder people, women, risky occupations, traffic, etc. Indicated prevention is directed to population with minimal and recognizable symptoms that do not satisfy diagnostic criteria of the disease (the concept of early diagnosis and treatment). We can draw the conclusion that primary disease prevention is marginalized and there is need for long lasting planning and evaluation of action plans for the prevention of addiction diseases in the community and a demand for rules that would support its full incorporation in the national and local policy of mental care protection.
Keywords: primary, secondary and tertiary prevention; indicated prevention; early interventions
There is a constant need to study alcohol, tobacco and opioid drugs abuse and dependence. Problems related to them are a significant burden for public health service and are demanding for the organization and carrying out of the mental health protection in that field.4 Persons of all age suffer from harmful effects of opioid drug abuse. Infants exposed to opioid drugs during pregnancy can be born premature and underweight with a slower intellectual development and later behavioral disorders. Adolescents who abuse drugs often have poor results at school and they drop out of it. They run the risk of developing bad behavior, violence, unplanned pregnancies or infectious diseases. Adults who use drugs often have problems thinking clearly, remembering, paying attention, making decisions and they seem to have problems with motor abilities. Parents who use drugs often create a chaotic, stress-filled home and they abuse and neglect children.30
The scale of the problem
Drug abuse and addiction cause considerable damage to each nation if their combined medical, economic, criminal and social impact is taken into consideration. Epidemiologic data suggest that tobacco smoking has been stagnating among the Croatian children and adolescents in the last decade, while the frequency of alcohol drinking before the age of 12 is in increase. In 2007 it accounted for 84%, slightly above the European average which was 82% .2·8·32·29 In experimenting with cigarettes, 15 year-old girls almost achieved the same results as boys. According to ESPAD report, experimenting with marijuana stabilized in 32 European countries. In 1995 12% of the Croatian boys and 5% of the girls had taken marijuana at least once in life. In 2003 24% of the boys and 17% of the girls had tried marijuana and in 2007 20% of the boys and 15% of the girls claimed to have experimented with marijuana. We should be cautious since the share of young people who took marijuana more than 40 times at the age of 15 and 16 years has been continuously increasing.5-28·32 In Croatia 7500 persons are treated from drug abuse annually, 6175 men and 1288 women. …