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Question: Discuss About The Exploring Comorbid Use Of Marijuana Tobacco? Answer: Introduction: It has been estimated that alcohol addiction is experienced by more than one quarter of Maori people in their teenage life. The most vulnerable group that is highly affected by this addiction is the young individuals who are in their adolescence stage and this account to about 27%. This has been found to be the third cause of disorders in the teenagers after anxiety disorder (31%) .Moreover alcohol addiction was found to be the third leading cause of hospitalization for young teenagers in the Maori community which accounted for about 82 for 100000 between the year 2003 and 2005 (Jackson et al., 2016). It has been found that alcohol addiction disorders usually coexist with different types of mental health problems. Te Rau Hinengaro has been successful in finding out that 40% of those young individuals who have this form of substance misuse disorder also tend to develop anxiety disorder and among them about 29% have coexisting mood disorder. The following report will mainly discuss the issue in details, look over the initiatives done by the government and will also states how the government should try to aggravate the effects. This will also have recommendations with rationale Healthcare both private and public governance systems can take for benefit of Maori teenagers. Issues that occur when teenagers become addicted to alcohol: Different disorders remain associated with substance abuse in young people of Maori. These are different types of Mental Health disorders or chronic general health problem. Such individuals are also exposed to various accidental as well as intentional injury and even they. Violence and criminal offending all remain associated with this addiction (White, Walton Walker 2015). Moreover different types of negative work along with various educational social and financial consequences are also seem to arise because of the development of this habit. In case of girls it has been seen that substance abuse disorder have high effects on fetal development in their reproductive age and therefore it leads to issues during pregnancy. Prevalence among Maori teenagers and non Maoris: Different literature articles have stated that a alrhe number of alcohol related issues has been reported among young Maoris and as half of the Maori population is below 24 years of age they are especially affected by this addiction. Maori young people are more negatively affected by alcohol than non Maori in the country of New Zealand. Maori people (accounting to about 76%) who are aged 18 years and over state themselves as alcohol addicts and 36% of the rest identify themselves as binge drinkers. Moreover it is also said that the severe alcohol related problems in young are more than twice that of the non Maori normally. Moreover Maori young people also experience harms from their own as well as from their friends drinking habit. Also suggest that Maoris are 4 times more likely to die of alcohol related problems in a very tender age than that of an on Maori. It has been found that the Maori culture as fit as well as tolerate and open celebrate been drinking and getting drunk. Minis try of health had published results of the research conducted in the statistical analysis where is was found that hazardous drinking rates had found to be raised among young adults out of which 44% are male and 30% of them are female. They usually belong to the age group of 18 to 24. Moreover they are also found to have the highest rate of weekly binge drinking. This accounts for about six or more drinks on a particular occasion for about 20%. Hazardous drinking is found to increase in all age groups. This is said so as drinking rates have been seen to decline from 18% in 2006/07 to 15% in 2011/12. However, the rate again increased to 19% in 2015/16 (Annual Update of Key Results 2015/16, New Zealand Health Survey). The normalization of alcohol has been seen to be accepted by the culture and it is also believe that offering alcohol is considered as one of the part of being a proper host in the Maori culture (dAbass, 20150. It is very interesting to see that young people liking for al cohol to be increasingly being linked to their identity and take this edition as a normal course of life cycle. 43% of Maori consume alcohol when they are 14 years or even younger to them which is significantly more than the total population of about 32% of New Zealand. It has been also found that 45% of Maori who are between the age of 15 to 17 get drunk the most recent time they drank alcohol and 25% of them reported that they had planned to do so. They have perceptions that it is acceptable to drink in many situations. They have perceptions that it is acceptable to drink in many situations. Barriers faced by the teenage Maoris: 2007 to 2008 New Zealand alcohol and drug use survey have done researches and stated that 1 % of women and 2% of men had been successful to get help in reduction of the level of alcohol consumption in the past year. in addition to this it was also seen that 1.2% of Maori young wanted help for reducing the drinking habit but they did not receive it. The iwi governance and the New Zealand system of the government have seen that there are many barriers which prevent the young people from getting access to healthcare for treatment of their addiction. They have identified that psychosocial factors such as fear for about 34%, social pressure for about 27% and also lack of time for about 9% are some of the reasons which have acted as barriers in helping the adolescence to get help from the Health Care Centers. It is also seen that different organizational barriers also exist (Medina-Mora et al., 2015). The individuals of the Maori are not well educated and knowledgeable and therefore they d o not know where to go (26%), No appropriate service, unable to come in touch with the service, no local service available, lack of Transportation system, appointment time and suitable cost Of Health Care treatment. Therefore they are of the opinion that there are a large proportion of people who want help for their drinking habits but there is also a larger proportion of Maori people are yet to recognize that their drinking is a big problem for them as that might affect their future. How the government should handle the issue effectively: The government therefore should take an important role in managing the present issue which are faced by the Maori in young people regarding their drinking habits. It is mainly to bring out different kinds of initiative which would management the Maori people to shift their focus from alcohol drinking and perform more productive activities in their life. They should be given the scope of trying out different forms of activities which might include different co curricular activities as well as proper schooling where they can learn about the negative aspects of drinking. Education is one of the most important social determinants of Health and therefore it is the duty of the government to introduce proper education systems for the young individuals (Ashton et al., 2014). Only introducing education systems will not be enough as government also have to take the initiative that proper monitoring body are allocated for the different schools and colleges so that it can be noticed that whether the education system are bringing out benefits for the young individuals and also describe the modification in the thought process of the Young individuals after schooling and health promotion programs are implemented. As the idea of drinking alcohol in inculcated in their culture, it would be a very difficult ask for the government to erase away the the habit of drinking from their tradition but they can take some of the important initiatives which would help them to become more responsible with their health. Introducing education systems and establishing Health Promotion program in the community it is also important to develop proper engagement plan of the Maori people so that they do not go for binge drinking. They can be allocated for different types of handicraft activities, co curricular activity and many others so that they remain busy and do not think of drinking alcohol. And other important initiatives that the government should take in this regard is to develop a policy w hich would act as a guidance for the parents of such individuals and help them to tackle their children in a more skilled way. a very interesting fact was found by the government when they had conducted the survey among the many people. They have stated that Whanau has influence on its members when it comes to drinking (Kypri et al., 2014). In the Search it was found out that 19% of parents thought it was acceptable for their teenagers to get drunk in certain cases. 57% of the parents also admitted that day or other parent caregiver took part in the supply of alcohol to the teenagers therefore the government should also target the parents and other members of the group so that they can provide them with information on the harms of drinking and how they can take proper measures to keep their children safe. The policy will mainly be including encouragement in the delay of the onset of drinking habits for their children, and they should also reconsider before supply alcohol to their te enager children. Therefore education, proper engagement of the children in different activities, financial support to the different families, and introducing guidelines for empowering the paper parents on the discus topic which will help controlling the issue of drinking among young children to a great extent. Different initiatives taken by the government over the years to reduce drinking habits: Different initiate have been taken by the government over the years point one of them is the Crown entity Reform Act which was passed in the year 2012. comprised of three separate app which are the New Zealand public health and disability Amendment Act, the mental health Commission Amendment Act and the charities Amendment Act. another was also the blueprint to act which mainly provided a ten-year guide in the year 2012 to improve the delivery of Mental Health and addiction services. It recognized that resources such as funding and workforce are are needed to be increased. The vision of the blueprint to was mainly made through enhancing the cost sector collaboration that intern involved with the government as well as community sector and also help in increasing the amount of flexibility DHBs have in the way that the recent mental health funding is used point this weekend mainly comprised of key sectors which included education help justice social mental health and addiction sector (B urns, 2015). This involved and introduction of a stepped care as it would involve intervening in the least intrusive way intrusive way so that the best Resorts can be caught. We should ensure that all the services and matching with the needs of the client. Blueprint 2 has included mental health and addiction issues in children and young people earlier so that they can reduce the lifetime impact. It also consisted of other positively influencing high risk pathways which included providing earlier as well as more and more effective responses for different young and young adults who are at risk or who are involved in social justice or forensic mental health or addiction services. He Nuka Mo Nga Taitamariki is also another work plan for children and youth mental health services where they identified the high priority groups to receive additional funding. It is included firstly the Maori children and other young people from the whanau (Goodwin et al., 2016). Secondly it applied on pacifi c children and young adults and then children and young people with several multiple needs along with their families/wh?nau/ caregivers and fourthly, groups with other areas of high need. It is included the (rural groups, those with alcohol and drug dependency, those at risk of suicide and those experiencing stigma). A current policy which is planned by the by the Ministry of Healths plan is the Te Tahuhu 2005 to 2015 which included different factors. This included the increase of the services which are funded keeping in mind the children and young people it also contained building a workforce which would be delivering services for the children and also for the young people (Barnes et al., 2017). It also included improvement of the availability as well as access to different quality addiction services and thereby strengthens the alignment between the addiction services as well as services for people with mental illness. They have correctly recognized that problem gambling and substa nce abuse have become increasing problems for many young people. Three principles Of the Treaty of Waitangi which would be included in the recommended programs: They should follow the three important principles of the Treaty of Waitangi. Proper partnership involving the working together with the different Maori communities and providing appropriate health services and disability services is the first principles (Hutton Right, 2015). The second is the principle of participation which involves the Maoris to be involved in all the levels of health and disability factors and also include them in decision making, development and delivery of health services. The other one is called the protection principle which involves the government to ensure that the Maoris have the same level of health like that of the non Maori and also protect their cultural preferences, values and practices. First recommendation: establishment of healthcare centers with efficient and culturally competent healthcare professionals The first recommendation that should be provided for the proper handling of the sensitive issue of alcohol drinking in the young individuals is the establishment of proper Primary Health Care Centers where they can visit in order to tackle the issue of alcohol addiction. Health Care Centers should also increase in number so that each and every community of the Maori people have a proper ratio of Health Care Centre to that of Maori teenagers (Lyons et al., 2015). Moreover the quality of service provided by the health professionals in the nursing centers in the community should also improve so that we can meet the demands and expectations of the patients who come there for the treatment (Kypri et al., 2013). The Healthcare professionals who would be appointed for working as members of the Healthcare Team should be aware of substance misuse and addiction and thereby provide patients with empowerment tools and provide for scoptes to different types of addiction and consider routine scree ning of the patients who arrive for treatment. They should also be culturally aware of their preferences and thereby use proper questioning method to know about the concerns of the patient without harming their cultural preferences. They should be using proper identification or formal screening tools to know about their cultural consideration and the intensity of their addiction,. They should also use culturally appropriate processes and at the same time assess the level of risk and thereby manage the other disorders which often follow alcohol addiction. They should also provide motivation to patient to seek for treatment and thereby established the concept of the patient of what wellbeing is meant to them in order to set a treatment goal (Bertholet et al., 2016). They should also maintain engagement and motivation among the patients so that they were remain adhered to the treatment. They should also develop monitoring bodies that would monitor the adherence of the patients to treat ment Strategies and also prevent relapse. Installing a feeling of self motivation and self responsibility will help the patients to overcome their addiction. Second recommendation: implementation of healthcare projects for health promotion in every residential community of the Maori people. Effective health promotion program organized by expert professional will help in handling the issue of alcohol addiction in teenagers Maori form the very root. The previous recommendation is the curative measure whereas this would be the preventive measure taken for the benefit of the Maori teenagers (Gupta et al., 2016). A proper research plan would be finalized by the teams where they would be mainly determining the social determinants of health that are mainly resulting in the occurrence of the disorders. After identification of the social determinants of health which may be either cultural tradition, low financial income, improper education, poor access to health care centers others. After recognizing this, the experts should plan out education mediums to help them overcome each of the determinants of health with quality workshops, strategies and proper health education planning (Utter et al., 2017). Avery helpful framework that can be applied by the healthcare professionals are the FRAMES approach. it is a kind of intervention where each of the six letters of the word FRAMES help in providing a step towards managing the behaviors of the Maori teenagers helping them to overcome nay behavioral disorders, addictions of similar others. F stands for feedback where the health promotion experts would be providing feedback to the Maori teenagers about the rationale explaining why alcohol use may result in the causing of disorders and poor quality life. By making them included in the program, they would be given the scope of striking a partnership where they would themselves be benefitted from the health promotion program (Nelson, White Newcombe, 2015). The next letter R stands for responsibility where the teenagers need to be encouraged to take the responsibility for changing their addiction behaviour and in the following way they may be actively participating in the program where their culture, tradition, autonomy and also dignity will be cared for besides makin g them responsible for their changing the particular behaviour. Following letter A stands for advice where strategies for reducing drinking habits will be provided. The next letter is M where the experts should give them menu of options by providing them information for visiting other services from where they will receive protection and help. The letter E stands for empathy where the healthcare professionals need to acknowledge to them that although the process may be difficulty but in long run they will have health gains. The last would be Self efficacy where the experts would be praising and encouraging the teenagers for their willingness to consider a change (Moewaka et al., 2016). All these would be arranged by a good number of professional and proper planning which will help in bringing out behavioral change and will be mainly preventive in nature. Third recommendation: establishment of policy at local levels beside national levels so that each and every Maori community can be included and addressed for changes. Proper policies need to be adopted after through discussion with the Maori heads and making them participate in the decision making. They should act in partnership while developing the local policies for the Maori teenagers before them so that they feel that their autonomy and dignity is not threatened (Bertholet et al., 2015). Moreover the third principle of protections will also be inculcated in very interventions of the theory. First, the audience of the policy would be the teenagers themselves and also their parents and family members. This policy would provide them with guidelines about how simple steps can help them change their lives (Clark et al., 2013). Suggestions for engaging in different co curricular activities should be entertained and the local community should therefore develop workshops, employment centers where they can earn their pocket money as well. Keeping them engaged will lessen their chance to engage in groups where smoking is promoted. Secondly, schools of t he community will be instructed to include education about smoking harms making them aware of the ill effects they might face in future. This education in school should be made mandatory to reduce the risk of smoking habits. The thinking of the parents also needs to be changed and therefore they should also be provided health education and guidelines through this policy (Kypri et al., 2015). They would be instructed to follow the guidelines and contact respective authorities if they are unable to handle the behaviors of their teenagers (Lyoins Gough, 2017). For effective reduction of the drinking habits for the teenagers, parents need to set an example by themselves. Similar other issues will be noted down in policy before rolling them to the residents of the communities of Maori. Conclusion: Smoking habits are found to have reached large extent among the Maori teenagers. Cultural traditions, low financial stability, lack of health literacy and low employment scopes aggravate the issue. Various crimes, murders, occurrence of co morbid disorders, loss of quality life in future, low academic performance and others all take place due to this habit. Various policies have been provided over the years which are working at a slow pace and trying to help such individuals with proper services. However both preventive and curative measures are important and for this reason recommendations are proposed following the principles of Waitangi. Establishment of healthcare centers in every community with perfect ratio of healthcare professional and Maori teenagers is important. The professionals should be efficient and culturally competent. Secondly, health promotion program for behavioral change of the teenagers would be taken into consideration. Lastly, local policies addressing every M aori household would be suggested. All these would aggravate the pace of the reduction of the drinking habits of the teenagers and provide them a successful future life. References: 2015/16 New Zealand Health Survey. (2017).https://www.health.govt.nz/system/files/documents/publications/alcohol-use-2012-13-new-zealand-health-survey-feb15-v2.pdf. 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