WHAT INFLUENCES DRUG USE BY CONSUMERSTRAINERS NOTESPURPOSE AND CONTENTThis session aims at encouraging participants to identify the various factors which influence drug use by consumers. The factors they identify are grouped into layers of influence: the family level; the community; the health-service institutions; the national level; the international level.The module thus provides participants with a framework which links individual drug-use behaviour to the multi-layered environment which shapes drug use. The framework presented forms the basis for an analysis of drug-use problems; and the development of interventions which aim at changing drug use behaviour as well as at changing the environment in which drug use takes place, to enable more appropriate use of drugs.OBJECTIVESAt the end of the session, participants will be able to:1. Identify factors that determine drug use by consumers in each of the five levels of influence (individual/family/community/health care institutions/the national level/international level).2. Recognise the relative importance of the factors with respect to efforts to promote rational use of drugs by consumers.PREPARATIONParticipants are expected to:1. Read the Session Notes.2. Reflect on drug-use problems in their country and the factors that influence them at each of the five levels. 3. Read the two case-studies in Activity 1.What influences drug use by consumersTrainers Notes3The trainer needs to:Select three drug-use stories: The session can start with three very short stories on a specific type of drug use. Examples of short drug-use stories are given below. If possible, the stories are presented by participants themselves. Try to identify two participants who have done drug use studies, or who work in communities and thus have good insight into what people do with drugs. Ask them if they are willing to present a drug-use story (duration around 3 minutes). Discuss in detail with the two selected participants what they will present. And prepare a short drug-use story yourself as well. It is best if the stories present different types of drug use practices and can help participants in identifying a wide range of factors. Clarify that the presentation should only describe in detail what people do, not why they do so. The why will be discussed in the session.Make sure there are two flipcharts in the front of the meeting room, with thick markers. These will be used to list factors which influence drug use by consumers raised by participants in response to the drug-use stories.Get a good overview of the factors by level By reading the session notes, the facilitator can make sure (s)he is familiar with factors which influence drug use by consumers by layer of influence. This will enable him/her to make a good synthesis of the factors which are identified during the session.Prepare for the activity Read the case studies given in Activity 1 carefully, and prepare a brief summary to be presented when introducing the activity. Make sure core library texts (see listing) are available for distribution The core readings should be available for distribution. Distribute them at the end of the session when people are filling in their evaluation forms. The trainer should briefly explain why the readings are “core”.CORE LIBRARYWHO (1988) WHO Ethical Criteria for Medicinal Drug Promotion. Geneva, World Health Organization.Mintzes B (1998) Blurring the boundaries. New trends in drug promotion. HAI-Europe, Amsterdam.What influences drug use by consumersTrainers Notes4ORGANISATION AND KEY POINTS OF THE SESSIONStructure and timing of the session1. Introducing the session - 5 minutes2. Three drug-use stories - 15 minutes3. Participatory identification of factors which influence drug use by consumers - 25 minutes4. Family and community level factors - 30 minutesBreak - 15 minutes5. Short summing up of health institution level factors - 5 minutes6. National level factors, including drug promotion - 30 minutes7. Activity - 50 minutes plus 20 minutes feedback8. Summing-up - 5 minutesVISUAL AIDS1. Title slide 2. Objectives 3. The session 4. Layers of influence 5. The family level 6. Perceived safety and efficacy 7. Gender roles and medicines 8. The community level 9. Community drug distribution 10. The health institution level 11. Extent to which health worker advice is sought 12. The national level 13. Drug promotion 14. WHO ethical criteria on drug promotion 15. Ethical criteria adoption 16. OTC advertising: IOCU study 17. Increase in promotion towards consumers 18. Top DTCA expenditures 19. The international level 20. Zyban: Information from the InternetWhat influences drug use by consumersTrainers Notes521. Activity tasks 22. DTCA discussion questions 23. Discussion questions: drugs used as abortifcientsWhat influences drug use by consumersTrainers Notes61. INTRODUCING THE SESSION (5 MINUTES)Introduce the session by explaining its objective (OH 2)Th