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Promoting adolescent health is one of the core objectives of the Healthy People 2020 which primarily focuses on observing the developmental pattern of the teenagers in the United States of America. This health promotion policy usually targets the adolescents who are between the ages of 10 to 19 and upcoming adults who are between the ages brackets of 20 to 24 years. The fact that the government wants to minimize the cases of chronic diseases developing during the adulthood period forms part of the reason why the health of the teenagers should be kept under strict watch. Although the federal government has shown concern for the well-being of the youth in the United States, the heightened level of substance abuse among the teenagers has hindered the promotion of the policy. (Healthy People 2020, 2014).

Most teens, especially from minority families, are not in a position to access the necessary health care facilities and youth development and empowerment programs. This makes adolescents from these marginalized areas to fall, victims of various social problems since they are susceptible to contextual elements. Examples of the social problems include homicide, smoking, drug abuse, suicide, unplanned teenage pregnancies, and contacting of Sexually Transmitted Infections (STIs). Schalet, Santelli, Russell, Halpern, Miller, Pickering, Goldberg, & Hoenig (2014) in their study assert that apart from economic inequalities and racism, poverty has contributed to the partial fulfillment of the adolescent health in the country. Adolescents and adults contribute to 21% of the United States population. This is a clear indication that if we will not be able to take care of the teenagers’ health, then the chances are that we might end up spending more financial and human resources in treating chronic diseases such cancer in the days to come. Therefore, there is an urgent need for the government to promote adolescent health policy adequately.

Target population and setting

The study will be focusing on the teens between the ages of 15 to 19 in the United States. Reducing the proportion of drug abuse among the adolescents has been among the core building blocks of the adolescent health policy as stipulated in the Healthy People 2020. Promoting the policy has faced significant challenges such as increased abuse of drugs among the teenagers who are usually in their 9th and 12th grades. Although there has been a significant drop in the misuse of drugs and use of marijuana, there has been increased use of alcohol and e-cigarettes among the adolescents in high school. (National Institute of Drug Use, 2014). The survey conducted by Castillo (2012) revealed that 78% of the youths in the United States had drunk alcohol, and 81% of the adolescents said they had the chance of abusing the drugs. This means that although we are trying to move towards complete eradication of substance abuse among the teenagers, still there are few elements which need to be ironed out.

Application to advanced practice role

Understanding the problem will not only help to increase the awareness of the health policy but also to find solutions to elements that hinder its implementation. Finding the solutions to the problems will help to improve student understanding of the health policy. For instance in our case, drug abuse has been ranked as among the core elements that inhibit the full promotion of health among the adolescents. Apart from addressing the problems, getting answers to the problem will help to sharpen the student’s research capabilities. The learner can advance the nursing practice by working various research departments such as Department of Psychiatry. This department sole mission is to provide an excellent research on various health care problems such as drug addiction and finding solutions to them. Apart from increasing the knowledge on research and finding solutions to the problem, the study will help the student to venture in various advanced levels such as the study of pharmacology and toxicology. These are biomedical science disciplines which are used interchangeably in the field of medicine.

Pharmacology is the study of the location, effects, properties, and the ways in which the drug acts on the body of an individual. It concentrates on the way the biological systems interact with the chemical systems. (Ellis, 2013). Toxicology, on the other hand, addresses the negative effects which the chemicals cause in the body of an individual or an animal. It covers areas such as identification of the hazards, assessment of the dose response, the extent to which the body has been exposed to the chemicals and the risk characterization. Both the two parts rely on the biotechnological approach to understanding the drug and poison level in the body of the individual. Taking Pharmacology and Toxicology degree will enable the student to expand their nursing practice into various medical fields. At the technical level, understanding the substance abuse will allow the learner to venture in consumer products, biotechnology, and contract research organizations. Additionally, students who want to venture in understanding more about substance abuse can engage in other biomedical sciences such as veterinary medicine.

Theoretical framework

Substance abuse among the teenagers is influenced by various factors. The factors include the following;

The relationship between the parent and the adolescent. Research has shown that poor relationship between the parents and teens has been among the leading causes of substance abuse among the teenagers. Having a good parent-teenager relationship involves supporting the adolescents, giving them advice, showing them love, and protecting them from drugs. Research conducted by Zyl (2013) concluded by stating that parents played a significant role in the lives of the teenagers. Most adolescents follow the footsteps of their parents and guardians and therefore this means that if they (parents and guardians) are taking alcohol or abusing drugs, then automatically their children will stand a chance of following their footsteps.

Peer pressure. It has also been ranked as among the key components which contribute to the drug abuse among the youths in the United States. Most adolescents tend to live by the perception of their friends that the drugs are harmless. (Feit & Taylor, 2015). Most teenagers prefer to address their problems and frustrations to their friends instead of addressing them either to their parents or teachers. Drugs and alcohol among these teenagers are usually taken in groups and the loyalty of an individual in the group is determined by the drugs. Any member who is likely to go against the will of the peer group is expelled.

Substance availability. Most teenagers are susceptible to the abuse of drugs and drinking of alcohol since they are readily available at the outlets. The majority of the liquor stores are not licensed meaning they are in a position to sell the liquor to the high school children. Since the substances are affordable, research has shown that the teenagers use their pocket money to purchase the tobacco and other products. The school has been mentioned as the primary source where the drugs are first initiated. Moreover, most adolescents learn about the abuse of drugs while in the school. For those who are chronic addicts of the drugs and alcohol, they frequently use various crude means to obtain money to purchase the substances. Some of the methods included stealing from their fellow students and exchanging money for sex in cases of females.

Religion. Religious beliefs and taboos played a significant role in reducing the addiction to drugs and liquor. Muslim faith, for instance, prohibits the intake of alcohol. It states that whoever drinks his or her prayers will not be answered in 40 days. Religious practices and beliefs have been seen as the protective factors which help to minimize the alcohol and substance use.

Conceptual framework

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Substance abuse theories

Operant learning theory. This approach involves the formation of the relationship between the responses and the cues. Under the operant theory, the occurrence of a particular behavior is influenced by the positive or negative elements. Positive reinforcers increase the possibilities of occurrence of prior acts while negative reinforcers limit the chances of occurrence of previous behaviors. (Pappas, 2014). Positive reinforcement under drug abuse may involve a situation a teenager may be at a party. The ingestion of the cocaine through the nose will automatically increase the chances or the likelihood of this activity to be repeated more and more in the future. This urge for more ingestion of cocaine is brought about by the neural adaptation. The neural adaptation is what increases the chances of occurrence of a given response once the cue is triggered. Under the negative reinforcement, the drug addicts ingest in more heroine to avoid dangerous withdrawal symptoms.

Drive theory. This theory tries to explain that human beings are born with particular psychological requirements, and failure to meet these requirements is likely to put the individual in an adverse condition. Motivation arises when there is an urge to satisfy a certain biological need. For example, one takes food when they are hungry, drinks water when they feel thirsty, and sleeps when they feel sleepy. The same case applies to drug addicts who continuously smoke cigarettes when they feel the urge to do so. (Cherry, 2014). The drive is minimized or reduced once the requirement is satisfied. This continuous satisfaction eventually forms an addiction. Therefore, for one to maintain their homeostasis levels, the individual has to induce the stimuli.

Literature Review

The drug abuse significantly contributes numerous premature deaths which are being witnessed in the United States today. A survey conducted by Eaton, Kann, Kinchen, Shanklin, Flint, Hawkins, Harris, Lowry, Mcmanus, Chyen, Whittle, Lim, Wechsler, & Centres for Disease Control and Prevention (CDC) (2012) showed that deaths which occur between the ages of 10 to 24 are caused by engaging in highly risky behaviors such as using marijuana and drinking of alcohol. The study further indicates that 38.7% of the high school students had taken part in drinking alcohol, and 23.1% had experienced marijuana. Although there has been a measurable change in drug abuse in the country since 1991, more needs to be done concerning the substance use among the adolescents in high school.

Research conducted by Henry, Knight & Thornberry (2012) on the rate of school dropouts in the 8th and 9th grade showed that among the core causes of dropout include the use of drugs such as heroin and cocaine. Achieving the adolescent health policy as enshrined in the Healthy People 2020 may be an uphill task given the various adverse complications the drugs cause to the adolescents. A study conducted by Degenhardt & Hall (2012) revealed that continuous use of some drugs such as marijuana is likely to cause mental disorders, dependence, and death. Moreover, using marijuana can affect the development of the brain, can lead to poor performance in school, rampant cases of road accidents, the risk of brain illness, and other health conditions such as cancer. (Volkow, Baler, Compton & Weiss, 2014).

Interventions

Study information demonstrates that unassuming decreases in the utilization of the traditionally well-known drug cannabis included the real divide of brought down numbers. This reduction conceals a proceeding with the increasing use of substances by our adolescents. For example, the rate of secondary school seniors reporting lifetime marijuana use has dropped by 0.5%. However, the rate of high school seniors reporting lifetime break use has expanded by 0.5%. Twice the same number of learners reported utilizing heroin by the eighth grade in 1998 as was accounted for in 1991. Almost three times the same number of students said using a break by the eighth grade for the same time frame. (National Institute of Drug Abuse, 2014). Trading marijuana use for break and heroin is unmistakably not the sort of exchange off that most guardians might want to see. The ONDCP's inability to specify any of these huge issues in their official press articulation cheats guardians, teachers, and writers out of their capacity to comprehend the measurements of the adolescent medication use. The following are the measures which can be used to intervene the problem;

Interventions

Study information demonstrates that unassuming decreases in the utilization of the traditionally well-known drug cannabis included the real divide of brought down numbers. This reduction conceals a proceeding with the increasing use of substances by our adolescents. For example, the rate of secondary school seniors reporting lifetime marijuana use has dropped by 0.5%. However, the rate of high school seniors reporting lifetime break use has expanded by 0.5%. Twice the same number of learners reported utilizing heroin by the eighth grade in 1998 as was accounted for in 1991. Almost three times the same number of students said using a break by the eighth grade for the same time frame. (National Institute of Drug Abuse, 2014). Trading marijuana use for break and heroin is unmistakably not the sort of exchange off that most guardians might want to see. The ONDCP's inability to specify any of these huge issues in their official press articulation cheats guardians, teachers, and writers out of their capacity to comprehend the measurements of the adolescent medication use. The following are the measures which can be used to intervene the problem;

Increasing the current budget on National Drug Control Strategy. Regardless of cases that the War on Drugs is being battled to spare future generations of youths from being snared on medications, the Office of National Drug Control Policy (ONDCP) spending plan is not adequate to fund the measures towards curbing drug use among the adolescents. The measure of the funding is horrifyingly low and ought to be essentially expanded. For a powerful medication control methodology, I recommend that no less than 33% of the financial backing ought to be centered around decreasing youth drug use; in this way, I prescribe that the ONDCP ought to venture up its financial plan offer to 34% for eradicating youth and adult substance use.

Directing the resources and efforts towards the areas which have proved success. Liquor and drug abuse have a tendency to be picked actions which are undertaken amid unstructured and unsupervised time. Along these lines, existing and extended financing ought not to be spent on oversimplified anti-drug campaigns efforts, yet rather ought to be invested in youth. Programs which give positive and enhancing exercises, by counterbalancing the appreciation for, or address the issues typically filled with alcohol, tobacco, and drugs.

Analysts have noticed that adolescent is a period in which the teenagers reject the nature and customary power figures with an end goal to build up their particular autonomy. Drug abuse might be a "default" movement occupied with when youth have few or no chances to affirm their autonomy in a valuable way. Helpful exercises and coaching programs give a solid domain to adolescents and young grown-ups to reject all types of substance use and give advantages over a wide exhibit of markers, for example, school performance and self-regard. These sorts of systems ought to be fundamental to our endeavors to lessen youth and adults drug abuse since they work.

Avoiding the use of scare-tactics to educate the teenagers. Education is the key part of any arrangement to change self-ruinous conduct. For the sake of efficiency, training must be entirely real and balanced. By depending on panic strategies and unwarranted attestations, the present drug policy has failed to accomplish its motivation. No place would this be able to be more plainly seen than where overstated cases about marijuana make youth and adults to question data about harder medications as well. Since half of all children attempt marijuana before moving on from secondary school, there is a lot of casual learning about the substance use among the youth. Being told by authorities that there is no substantive contrast amongst marijuana and different medications like heroin and cocaine, can prevail the wrong information to kids – prompting experimentation with more perilous drugs. By centering instructive crusades on data which is deductively exact, we can accomplish our instructive objectives and turn into a more believable power with the more youthful era.

Advanced Practice Nurses (APNs) assume a critical part in advancing general well-being. Generally, the center of well-being advancement by medical caretakers has been on prevention of diseases and transforming the conduct of people positively concerning their well-being. Be that as it may, their part as promoters of health is more mind boggling, since they have multi-disciplinary information and experience of wellbeing advancement in their professional practice. APNs can act as advocates for the above-mentioned interventions by establishing the teaching programs where they will be teaching the adolescents on the importance of living a drug-free life.

Outcomes

Successful interventions on substance abuse will help to reduce various social evils and promote a healthy nation. As indicated by some evaluations, countless homicides in the America can be credited to brutality between criminal gatherings battling for region and force made conceivable by the drug exchange. Therefore, if we will able to control the drug abuse in our country, we will be able to minimize violent acts. Most parts of Central Asia and some parts of Eastern Europe have been adversely affected by various preventable health epidemics such as HIV/AIDS. Among the primary causes of the disease is the substance use which involves the exchange of syringes and injections by individuals. By educating the young generation on the dangers of engaging in drugs, we will be able to have a healthy generation in the future. Moreover, the complete drug-free nation will enable the government to channel the resources which could be used in substance use prevention projects to other productive projects which can help to raise our country’s production.

Evaluation plan

The success of the interventions can be measured using various methodologies. For example, periodic surveys can be carried out to ascertain the level of substance use among the teenagers. The efficacy of the interventions can also be analyzed based on the quarterly reports provided by various organizations such as the Office of National Drug Control Policy concerning the prevalence of drugs among the youths in the United States. Conclusion

Abuse of narcotics has been marked as among the factors which inhibit the full implementation of adolescent health policy in the United States. Among the teenagers, substance abuse is influenced by various factors such as parent-teenager relationship, peer pressure, substance availability, and religion. There are various theories which try to explain substance abuse among the individuals. Examples include the operant learning theory and drive theory. For effective implementation of the policy, drug addiction needs to be controlled. It can be controlled by using various methods such as pumping in more resources to educate the youths and directing the resources to the areas which have proved to be successful when it comes to combating drug addiction. The success of the methods can be measured in various ways such as the use of periodic surveys to ascertain the prevalence of substance abuse.

References

Castillo M. (2012). Survey Reveals Shocking Levels of Teen Drinking, Drug Abuse. CBSNEWS. Web. June 2, 2016. http://www.cbsnews.com/news/survey-reveals-shocking-levels-of-teen-drinking-drug-abuse/ par. 3.

Cherry K. (2014). Drive-Reduction Theory. Web. 4th June 2016. https://www.verywell.com/drive-reduction-theory-2795381 par. 1-9 Degenhardit L., Hall W. (2012). Extent of illicit drug use and dependence, and their contribution to the global burden of disease. THE LANCET. Web. 4th June 2016. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2961138-0/abstract?cc=y= par. 2

Eaton D. K., Kann L., Kinchen S., Shanklin S., Flint K. H., Hawkins J., Harris W. A., Lowry r., McManus T., Chyen D., Whittle L., Lim C., Wechsler H., Centers for Disease Control and Prevention (CDC). (2012). Youth risk behavior surveillance- United States 2011. Europe PMC. Web. 4th June 2016. http://europepmc.org/abstract/med/22673000. par 1-3

Ellis J. (2013). Top 10 Tips for Pharmacology Nursing Courses. The CHAMBERLAIN Blog. Web. 3rd June 2016. http://www.chamberlain.edu/blog/top-10-tips-for-pharmacology-nursing-courses/

Feit M. D., Taylor O., D. (2015). (Contemporary Substance Use Research. Taylor & Francis Online. Web. 3rd June 2016. http://www.tandfonline.com/doi/full/10.1080/10911359.2015.1029362 page 287.

Healthy People 2020 (2014). Adolescent Health. Healthy People.gov. Web. 2nd June 2016. https://www.healthypeople.gov/2020/topics-objectives/topic/Adolescent-Health par 1-16.

Henry K. L., Knight K. E., & Thornberry T. P. (2012). School Disengagement as a Predictor of Dropout, Delinquency, and Problem Substance Use During Adolescence and Early Adulthood. Springer Link. Web. 4th June 2016. http://link.springer.com/article/10.1007/s10964-011-9665-3 par. 1 National Institute of Drug Use (2014). Drug Facts: High School and Youth Trends. Web. June 2, 2016. https://www.drugabuse.gov/publications/drugfacts/high-school-youth-trends par. 1

National Institute of Drug Abuse (2014). Drugs, Brains, and Behavior: The Science of Addiction. Web. 4th June 2016. https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preventing-drug-abuse-best-strategy

Pappas C. (2014). Instructional Design Models and Theories: Operant Conditioning Theory. eLearning Industry. Web. 4th June 2016. https://elearningindustry.com/operant-conditioning-theory par. 1-7.

Schalet A. T., Santelli J. S., Russel S. T., Halpern C. T., Miller S. A., Pickering S. S., Goldberg S. K., & Hoenig J. M. (2014). Invited Commentary: Broadening the Evidence for Adolescent Sexual and Reproductive Health and Education in the United States. Journal of Youth and Development. Web. June 2, 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4162986/

Volkow N. D., Baler R. D., Compton W. M. & Weiss S. R. B. (2014). Adverse Health Effects of Marijuana Use. The NEW ENGLAND JOURNAL of MEDICINE. Web. 4th June 2016. http://www.nejm.org/doi/full/10.1056/nejmra1402309.

Zyl A. E. V. (2013). Drug Use amongst South African Youths: Reasons and Solutions. Web. 3rd June 2016. http://www.mcser.org/journal/index.php/mjss/article/viewFile/1640/1645 page. 583.