Zoë Lancelott

Co-ordinator for Substance Misuse Education

Rhondda Cynon Taf

University of Glamorgan

Paper presented at the British Educational Research Association New Researchers/Student Conference, 14 September 2005

Contact:

01443 744386

Introduction

Substance misuse, has, for many years, been viewed as ‘one of the most important problems, facing society, not just in the UK but in the Western World’ (Hansard, 1989b). Recent statistics show that levels of use for young people appear to be on the increase with the average age for first use and dependant use decreasing (WAG, 2002). Availability and treatment have always been paramount within government policy, and only relatively recently has education been given the position it needs within formal policy enabling it to make a valuable contribution towards addressing the issue of substance misuse in its wider context (Home Office, 1998).

Whilst it is largely accepted amongst professionals working in this field, that the main role of substance misuse education is to prevent and reduce drug related harm, the benchmark of its effectiveness is its ability to prevent drug use (Cuijpers, 2003). Government policy has cited drug education as the key player in the prevention of drug use, despite research suggesting that this is an unrealistic outcome (Cohen, 1992). The role of education has therefore been limited and unrealistic in its aims and intended outcomes, rendering it a less than effective tool in meeting the needs of individuals and governments. However, substance misuse education still lacks co-ordination and consensus on its fundamental aims. The UK during the 1980’s saw an explosion of hard-hitting media campaigns and an emergence of Government plans for substance misuse education for young people, which focussed on the dangers of illegal drug use. In order to provide effective future educational provision it is important to examine the environment at this time and explore the Government policies and media coverage that have shaped the design and delivery of and methodology behind the provision of drug education and prevention initiatives since the 1980’s.

This paper will outline the dominant themes in drug education over the last three decades, grouped into the following themes; government policy; (including campaigns, media coverage and public perception) practice and problematics. The final sections of this paper look at the role and use of research and the underpinning assumptions that make evaluation in this area problematic.

This paper looks predominantly at education regarding illegal drugs. The general social acceptability of legal drugs and the public fear of illegal drugs has led to clear differentiation in the way in which young people are taught about drugs and their use. The use of the term ‘substance misuse’ is a relatively recent development, intended to encompass illegal and legal drugs as well as prescribed and over the counter medicines, in order to discourage this differentiation. Therefore throughout this literature review ‘substance misuse’ relates to education on all drugs and ‘drug education’; illegal drugs.

Drug Education Policy

Prior to 1985 there was no linked Government approach to drug treatment, education, community safety, availability or supply. The responsibility for drugs lay with the Home Office as the lead Government department. In response to growing public and political concerns regarding drugs and their use in the UK the Home Office published the first version of its ‘Tackling Drug Misuse’ document in 1985. Often portrayed as the first UK strategy, it was more of a description of what was being done by the Government to address the issue of drugs in the areas of health, education and crime.

Policy Developments between 1985 – 1989

Government policy regarding drug education during this time period was largely focussed on the employment of mass media campaigns, however; the establishment of drug education in schools became a growing priority. In 1986 Drug Education Co-ordinators (seconded teachers) were appointed within Local Education Authorities (LEAs) in England to offer teachers guidance and support within schools and to highlight the national priority given to drug education (Druglink, 1987). Whilst drug education was seen as a priority for Wales the specific funding of Drug Education Co-ordinators remained an England only initiative (Hansard, 1989d).

A review of policy issues was initiated in December 1988 and concluded that if a significant ‘reduction in demand’ [for drugs] was to be achieved through education, then continuation of funding and the formation of a plan for schools had to be a main priority for the Government. The Government saw schools as having a primary function in the provision of drug education for young people.

Despite these developments, Government policy regarding drug education was subject to heavy criticism about its aims and focus. The Government’s belief in the effectiveness of primary prevention was said to be too simplistic as it was based on the flawed assumption that primary prevention affects behaviour change (Clements et al, 1988). It was asserted that most young people who use drugs are not influenced by drug education, as it does not examine perceptions or attitudes, therefore the focus needed to be placed upon secondary prevention strategies (ibid).

Commons debates in 1989 sought an approved consensus on future action and policy formulation regarding drug education. The subject was rarely debated and its inclusion for debate was greatly welcomed and heralded as ‘historic’ (Hansard, 1989b; 1989c).

Media Campaigns and Public Perception

One of the most prominent Government anti-drug campaigns launched in the UK was the ‘Heroin Screws You Up’ Campaign of 1985. The Government’s aim was to ensure that heroin was viewed, by both users and non-users, as an undesirable, ‘dirty’ drug, resulting in ‘demand reduction’. Subsequent evaluations of this campaign were mixed. It was deemed successful in that it ‘fostered and reinforced negative attitudes and beliefs about heroin use’ (Rhodes, 1990), however, other evaluations provided evidence that this campaign had been unsuccessful as there was evidence to show that it had gone some way in glamorising the drug for young people (Hansard, 1989c). Dorn (1986) criticises the stereotyping of drug users in Government media campaigns, arguing that the experiences of young people undermines this stereotyping and in turn the message attached to it. Bagnall and Plant (1987) asserted that there was no evidence to show that shock tactics worked at any level and implied that the ‘Heroin Screws You Up’ theme was therefore, counter productive.

Despite these criticisms about the 1985 campaign, the ‘Smack Isn’t Worth It’ campaign (1987) aimed to show people the effects of heroin use on a range of societal issues yet reinforced the same messages. Again, in attempting to address users as well as non-users, the messages and images used alienated drug users, making them less responsive to official sources of information and help (Rhodes, 1990).

The main reason behind the use of mass media campaigning is the influence this method can have on the reinforcement of beliefs (Budd and McCron, 1981). However mass media anti-drug campaigns have been criticised for reinforcing negative beliefs regarding drugs and drug users and manipulated for the purpose of agenda setting (Tones, 1981). By 1989 it was widely accepted by ministers that the evaluative evidence proved that anti-drug campaigning was ineffective (Hansard, 1989a).

The media coverage during the latter part of the 1980’s largely contributed to the increased public fear of illegal drugs. It made it impossible for public debate to inform policy and strategy as the messages portrayed, that appeared entirely rational, were implicitly moral rather than educational and at best confusing (Rhodes, 1990). An opinion poll showed that by 1989 the British public deemed illegal drugs to be the single greatest threat to the UK (Hansard, 1989b).

Policy Developments between 1990 – 1999

Drug education became a statutory order for the National Curriculum for Science in 1991 in England and Wales. Curriculum Guidance 5: Health Education (NCC, 1990) was issued in 1990 and extended drug education beyond the statutory requirements of outlining the physiological effects of drugs to exploring the link between drugs, society and behaviour (Allot et al, 1999).

It was not until 1995 that the UK had a recognised drug strategy. Substance misuse had evoked political interest and the drugs agenda had become of significant political importance for it to be recognised as a cross cutting theme. The publication of ‘Tackling Drugs Together’ in 1995 encouraged the involvement of other Government departments, however, responsibility still lay with the Home Office. Government research had concluded that drug education was the general public’s first choice for dealing with the drug problem and that the responsibility for delivery lay with the Government and schools (Leitner et al, 1993). In May 1996, the Welsh strategy ‘Forward Together’ was launched which tackled alcohol as well as drugs. Four objectives were identified to prevent the misuse of drugs and alcohol by young people one of which included education in schools.

The change of administration in 1997 led to a number of changes in the implementation of the UK drug strategy. That November the newly elected Labour party employed the UK Anti-Drugs Co-ordinator, or Drug Czar, to hold non-ministerial responsibility and to co-ordinate all departments concerned with the drug agenda. Keith Hellawell supported the application of soundly based good practice in the provision of drug education, commenting that despite lots of initiative, insufficient evaluation led to negative impact (Baker, 1998). Questioning whether drug education should seek to change behaviour or impart knowledge, Hellawell concluded that to believe that young people who have received drug education will never take drugs is unrealistic. 1998 saw the launch of the new 10 year strategy; ‘Tackling Drugs to Build a Better Britain’.

Policy Developments since 2000

The Anti-Drugs Co-ordination Unit, set up in 1997, was abolished in 2001 following its failure to co-ordinate a multi-departmental Government response. It had been criticised for having produced ill thought out targets however, the failure was attributed to the fundamental differences in approach to the issue of the key players, the shifting political climate and the undermining of the Unit by the competing agendas of different departments. (Drugscope, 2004). The responsibility for strategy delivery returned to the Home Office.

A House of Commons Debate in 2003 acknowledged the need for drug education programmes to be credible and honest about relative health problems associated with different drugs. Six months later, a session in the House of Lords painted a quite different picture, criticising the demise of prevention programmes in favour of the ‘dangerous sophistry of harm reduction’ based drug education that could encourage drug use (Hansard, 2003, Col 290).

The most recent Government review of its drug policy took place in February 2005. The ‘what works’ theme runs throughout the report, with one of the 2002 recommendations focusing on the need for the Government to undertake rigorous analysis of drug education and prevention work. The response is ‘Blueprint’, a five-year Government funded drug education pilot, currently underway in 23 secondary schools in England. Due to be completed in 2007, the comprehensive evaluation will provide the basis for future guidance (HASC, 2005).

Discussion

Through the political use of mass media anti-drug campaigns over the last three decades, the government has forged a continuing interdependency between itself and the media. Criticisms arise on both sides. The media criticise government policy and the government criticise the media for their lack of self-regulation regarding their coverage of the drug scene in the UK and neglecting their ‘duty to evaluate their presentation’ (Hansard, 1989b).

The latest government campaign, FRANK, differs from those employed in the 1980’s as it moves away from the direct provision of anti-drug messages in the media. Instead, it opts to use the media for marketing of and signposting to the sources of drug related messages. There is also a role for the media in supporting government policy through the highlighting of effective drug education programmes and good practice research that aims to increase public understanding and positively inform public opinion.

Drug Education Practice

Whilst research over the last three decades has agreed the key role and place that drug education has in tackling the issue of drug use, the issue of validity is still of great debate (Coggans and Watson, 1995). Since the 1960’s drug education in the UK has consisted of and been influenced by five main discernable approaches, outlined by Lowden and Powney (1999):

  • Information Based
  • Life skills and Values Deficit
  • Resistance Training
  • Alternatives Based
  • Peer Education

Information Based Approaches

Since the government media campaigns of the late 1980’s, information based drug education has been the most high profile approach to tackling problematic drug use in young people. However, there is a wealth of research that suggests that the impact of such an approach has a higher perceived value amongst adults than it does amongst its target audience.

Information based approaches to drug education are characterised by the emphasis on giving objective factual information about different drugs and the short term and long term effects of their use. Underpinning theory is based on the belief that information leads to abstinence. If young people are given the straight facts, they are able to assess the risks for themselves and will make informed choices not to use drugs. Delivery methods include literature dissemination and the use of video resources, the mass media and formal and informal talks.

Life Skills and Values Deficit Approaches

Life skills and values deficit (LSVD) approaches view drug use as a symptom of an underlying problem in young people’s development and seek to prevent drug use by addressing these problems at an early age. LSVD approaches focus on the development of young people’s skills and values in order to compensate for a lack of personal living skills. Based on sound developmental theories of delinquency, this theoretical approach to combating drug use developed in the 1970’s and 1980’s. It seeks to address the aspect of a young person’s development that is lacking and in turn results in drug use (HEBS, 2003). Asserting that users of drugs lack self-esteem, social skills and personal relationship skills, which leads to difficulties for them in resisting pressure, this approach aims to increase self-esteem, decision-making skills and promote morals, with which drug use can be avoided. Drug education that employs the LSVD approach advocates a varied methodology including talks, worksheets, role playing and discussion. This approach has had considerable impact on drug education and is often employed within the wider Personal and Social Education (PSE) curriculum within schools (SCRE, 2000).

Resistance Training

Like LSVD approaches, resistance training seeks to intervene in young people’s lives at an early age and equip them with the skills deemed necessary to avoid drug use. The resistance education approach relies heavily on the assumption that the main reason for young people’s drug use is peer pressure. Based on the belief that primary prevention of drug use is achievable, this approach focuses on equipping children and young people with the skills to say ‘no’ in relation to drug offer situations. Favoured by the Government, this approach has been often described as a ‘vote winner’ for politicians as it promotes a simplified moral message about drug taking (Cohen, 1996b). The vast majority of Government and media campaigns over the last two decades have used the resistance approach to inform drug education messages. This approach has also been employed by police led drug education initiatives, where the messages given lie within the moral and legal domain.

The theory behind resistance training lies in behaviourist perspectives, believing in drug education terms that health interventions are most effective in improving the relationship between a person’s personality and environment. This approach with similarities to the social deficit approach, is concerned with external influences and factors that result in social pressure that may compromise this relationship (Lowden and Powney, 1999). Some contend that this approach coupled with resistance training is more effective than both information-based and skills deficit approaches as it practically equips young people to resist immediate pressures (Polich et al, 1984; Botvin and Dusenbury, 1989; Hansen, 1990).

Alternatives Based Approaches

Again, like the LSVD approach, alternatives based drug education seeks to address the underlying causes of drug use rather than address the drug use itself. Where LSVD perceives personal developmental problems as the underlying cause of drug use, alternatives based approaches however, address social exclusion issues.

The common element in theories supporting alternatives-based drug education is the need to improve an individual’s social environment in order to reduce the attraction of drugs and drug use. Participation in community-based activities that promote health is identified as the key to both preventing and reducing drug use (Lowden and Powney, 1999). Whilst this approach acknowledges the many motives for drug use, it asserts that with adequate access to fulfilling and stimulating activities to alleviate the boredom, frustration and low self esteem that cause drug use an individual is less likely to use drugs (Swisher and Hu, 1983; Reilly and Hommel, 1988; Lowden and Powney, 1999; HEBS, 2003). However, its moral ambiguities in the advocacy of positive risk taking (Cohen, 1996a) and complexity make it unpopular with some practitioners and its relatively high financial cost makes it unpopular with policy makers.