Preventing Prevention?

Thu 31st August 2017 |

Following the release of the 2017 UK drug strategy there was much criticism of the lack of bravery or willingness on behalf of the Conservative Government to try any more sensible, evidence based or honest approaches to tackling the issues associated with problematic drug use. As gnarly old public health practitioner and former substance misuse worker with a background in both adult and under 18’s services it was no great surprise that the strategy only gave the most tertiary and fleeting mention to young people; after all; we are used to being an afterthought despite it being my longstanding belief that the spend is weighted the wrong way round and much greater gains would be made by spending the bulk of drug budgets on young peoples services. Recreational and non-problematic drug use is also given little attention and the one mention of ‘harm reduction’ is used in relation to the use of tobacco. It would appear that ‘recovery’ is still the one and only goal despite the alarming (yet predictable) increase in drug related death rates published just last month.

The one welcome addition to the strategy was the reference to a commitment around a preventative approach across the life course that utilises the Healthy Child Programme as a framework for delivery. The funding of Mentor-Adepis as a source of evidence-based information and tools for alcohol and drug education and prevention for schools is to be celebrated as for those of us who have worked with schools around substance misuse education and prevention have all too often seen the delivery of the ‘scare tactics’ and potentially harmful programmes that the 2017 strategy makes reference to and seeks to guide education settings away from.

However; despite these apparent positive changes and references to evidence based preventative approaches the glaring omission to support these statements is the utter lack of any cohesive or structured plan of implementation and delivery. This combined with no mention of additional (or even maintained) funding for the roll out and promotion of the programmes schools could be using. School Heads and Governors are not likely to be thumbing through the latest drug strategy anytime soon and few are aware of the excellent resource that is Mentor-Adepis and the worry is that very little if any of this proposed work will ever make it through the school gates

Substance misuse is an extremely emotive issue that can often elicit highly charged debate. It is also one of the few subjects where everyone believes they are an expert and understand exactly how to prevent young people from using drugs and what should be done with those who do even when the evidence is clear that particular approaches simply do not work. This ‘knowledge’ and ‘expertise’ is often the result of many years of being drip fed alarmist and factually incorrect headlines that warn of the disproportionate dangers and prevalence of drug use in young people.

The issue of implementation is further complicated by the lack of honest and open discussion around young people and drug use. Prevention work is only likely to be fully embraced when the reality that young people use (and enjoy) drugs is accepted. We know that young people have, do and will continue to use drugs and that occasionally some will unfortunately come to serious harm as a result of their involvement, yet we still maintain a reluctance to offer basic harm reduction messages in the place of the ‘scare tactics’ that the strategy aims to displace. A huge culture shift is required for the types of evidence based programmes to be embraced within cautious schools fearful of parent outrage or run by those who impose their own morality over the safety and well-being of children and young people for whom they have a duty of care.

@andyinhaler

Thu 31st August 2017