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Other Reports LATEST REPORTS Policy and guidance Title: An Analysis of Date: 04/07 Author: Reuter, P., Stevens, A Population: General population in the Summary: Professor Peter Reuter of the University of Maryland, USA and Alex Stevens of the University of Kent, England reviewed the evidence relating to the UK drug problem and analysed the impact of current drug policies on behalf of the UK Drug Policy Commission (UKDPC). The UKDPC was launched in April 2007 as independent body, which was set up to analyse Summary of prevention section This study reports one of the main indicators used to assess drug policy is its effect on the prevalence of drug use among young people. Therefore, the efforts taken to reduce this rate should be examined. Prevention is cited as the main policy area aimed at reducing the initiation of drug use and continued use but this study states that there is no clear evidence that prevention efforts actually reduce drug use in the UK and argues that despite the amount of money invested by the government and the strategies in place, the UK has the highest rate of drug use and dependence in Europe. There are three main strategies for drug prevention: mass media campaigns to inform the public about the dangers of drug use, school drug education and raising awareness and changing attitudes in targeted populations for example vulnerable young people. The Frank Campaign is one of a series of drug prevention initiatives in the There has also been an increase in school drug education programmes and all schools are expected by the government to provide drug education to all pupils. Guidance on drug education recommends a whole school approach that includes all psychoactive substances, including alcohol and tobacco and advises that drug education is incorporated into other parts of the curriculum. Evidence based programmes are advocated. They should be interactive, skills-based and should provide knowledge on the actual rates of drug use among pupils’ peer groups. Significant improvements in coverage and quality of drug education have been reported by OFSTED, the schools inspectorate in Awareness and information campaigns have been targeted at young people most at risk of drug misuse by the government. The major targeted drug prevention initiative is the Positive Futures Programme, which aims to reduce drug use by involving young people in creative actives and sports. Agencies working with the programme are confident that it reduces drug use but there has been no evaluation of its actual impact. According to this review, there are two main limits to the likely return on investment in all three prevention strategies. Firstly, research evidence suggests that prevention rarely leads to reduced drug use and secondly, even if prevention does reduce some drug use it is unlikely that this will lead to a major reduction in drug problems. According to the authors, there is still little acknowledgement by the government that most drug prevention education has no impact on rates of drug use and although there are some examples of drug prevention initiatives that are effective in reducing drug use rates, the impact of these programmes remains small. Current evidence on drug prevention efforts suggests it is difficult to apply evidence on best practice to the reality of school life. Random drug testing has been introduced recently as a prevention initiative in British schools but the results of research on random drug testing in the This section of the report concludes by saying there is little reason to suppose that prevention will have substantial effects on initiation and prevalence of drug use among young people even though the government emphasises that drug prevention initiatives should be based on research evidence. However, with an emphasis on absolute prevalence of drug use, the authors of the report have in places mischaracterised the objectives of much contemporary drug prevention approaches. Work by the NCCDP (see NCCDP reports page) discusses this in more detail.Firstly, epidemiological studies show that young people’s substance use increases through teenage years, peaks in the early 20’s and then reduces in the late 20s. This is in line with the social normalisation of drug use. Despite the illegal nature of these activities, the majority of users will experience no adverse effects. Rather than measuring absolute prevalence at specific time points, evaluation of prevention should model how this pattern of use and the rate of increase during teenage years are affected by interventions. Rates of natural increase in substance use may be differentiated by the type of interventions received. Secondly, prevalence measures do not take into account that some young members of the population will be affected disproportionately by the adverse affects of drug use. Often, such populations will be experiencing other troubling biographical events. Much indicated and targetted drug prevention for so called vulnerable young people aims to address drug use in the context of wider biographies (see Edmonds et al., 2005{LINK TO VULNERABLE YP BRIEFING}). The objective of such specialised interventions is to ensure that complete needs of the young person are addressed in order to reduce the additional burden of consequences of drug use. In such instances reducing drug use may be a secondary or tertiary objective in the context of other acute needs. In accordance with government policy such as Every Child Matters, such interventions are classed as drug prevention, but are unlikely to impact upon use. Contemporary drug prevention intervention in the Title: RSA Commission on Illegal Drugs, Communities and Public Policy Responses to drug misuse: education and prevention Date: 03/07 Author: The Royal Society for the encouragement of the Arts, Manufactures and Commerce Population: Young People Summary: This paper discusses the efficacy of drug education in the UK; examines the evidence base for evaluating what works in relation to drug education and considers the following questions: What do we want drug education to do?; How can we successfully differentiate drug education?; when should drug education in schools start?; what should be the core focus of "generic" drug education?; and what are the most practical and effective methods of spreading drugs messages outside schools? Title: Assessing Young People for Substance Misuse Date: 2007 Author: National Treatment Agency Population: Young people Summary: This document has been developed for service managers and practitioners delivering specialist substance misuse services to young people under the age of 18. It describes a framework for specialist substance misuse assessment, how specialist substance misuse assessment dovetails with the Common Assessment Framework (CAF) for children and young people (DfES, 2006a) and outlines the context of undertaking an assessment of young people and care planning arrangements. It is not an assessment tool but covers the essential elements of specialist substance misuse assessment and other factors that need to be considered. Title: Drugs: Guidance for the Youth Service Date: 2006 Author: DrugScope & Alcohol Concern Population: Young People Summary: This guidance provides support for the youth service on effective drug education and prevention, early intervention, management of drug-related incidents, drug policy development, and advice on training for youth workers in these areas. The aim of the guidance is to support the personal, social and health needs of all young people with whom the youth service interacts by: updating and clarifying policy and practice in the light of Transforming Youth Work (DfES, 2002); Every Child Matters (DfES, 2004) and other recent developments including the Green Paper Youth Matters (DfES, 2005) helping to raise the quality of provision in drug education, drug prevention and policy development enabling youth workers to offer young people effective drug education and support appropriate to their needs, including early identification of needs, harm minimisation andonward referral where appropriate providing support for youth workers and their managers in a challenging area of practice, in the context of the voluntary relationship between young people and the youth sector providing a basis for training of youth workers as part of the substance misuse workforce. Title: Drug Classification: making a hash of it? Date: 07/06 Author: House of Commons Science and Technology Committee Population: Young people Summary: By the House of Commons Science and Technology Committee. This Report is the second of three case studies under the Committee’s over-arching inquiry into the Government’s handling of scientific advice, risk and evidence in policy making. It addresses the relationship between scientific advice and evidence and the classification of illegal drugs. In the course of this case study, we have looked in detail at the role played by, and workings of, the Government’s scientific advisory committee on drug classification and policy, the Advisory Council on the Misuse of Drugs (ACMD). We have identified a number of serious flaws in the way the Council conducts its business. Although the Council has produced useful reports explaining the rationale behind its recommendations on drug classification decisions, we found a lack of transparency in other areas of its work and a disconcerting degree of confusion over its remit. We also note that the ACMD has failed to adhere to key elements of the Government’s Code of Practice for Scientific Advisory Committees. In response to these and other concerns about the Council’s operations, we have called for the Home Office to ensure that there is, in future, independent oversight of the Council’s workings. We have also highlighted the need for the ACMD to play a far more a proactive role in supporting the work of the Department of Health and Department for Education and Skills: the Government’s approach to drug education and treatment must be informed by scientific advice and stronger cross-departmental coordination will be vital if the Public Service Agreement targets on drugs policy are to be met. With respect to the ABC classification system, we have identified significant anomalies in the classification of individual drugs and a regrettable lack of consistency in the rationale used to make classification decisions. In addition, we have expressed concern at the Government’s proclivity for using the classification system as a means of ‘sending out signals’ to potential users and society at large—it is at odds with the stated objective of classifying drugs on the basis of harm and the Government has not made any attempt to develop an evidence base on which to draw in determining the ‘signal’ being sent out. We have found no convincing evidence for the deterrent effect, which is widely seen as underpinning the Government’s classification policy, and have criticised the Government for failing to meet its commitments to evidence based policy making in this area. More generally, the weakness of the evidence base on addiction and drug abuse is a severe hindrance to effective policy making and we have therefore urged the Government to increase significantly its investment in research. Finally, we have concluded that the current classification system is not fit for purpose and should be replaced with a more scientifically based scale of harm, decoupled from penalties for possession and trafficking. In light of the serious failings of the ABC classification system that we have identified, we urge the Home Secretary to honour his predecessor’s commitment to review the current system, and to do so without further delay. Title: Quantity thresholds for distinguishing drug possession from possession with intent to supply in Date: 07/06 Author: Dr Russell Newcombe, Lifeline Population: Drug users Summary: This paper reviews and evaluates evidence relevant to setting fair threshold quantities of drugs which distinguish possession from PIS (for a review of similar issues relating to cannabis cultivation, see Hough et al., 2003). Two types of evidence are considered: 1. The amount of drugs purchased and consumed by drug users in UK, including: (a) standard amounts purchased by consumers and sold by dealers (by weight or spending); (b) amount of drugs consumed per dose/session, and in set time periods (week/month/year). 2. Threshold quantities for distinguishing possession from PIS (or misdemeanour drug offences from criminal offences) in other countries - notably those in North America, Title: Assessment in Drug Education A briefing paper for Teachers and other Drug Education Practitioners Date: 06/06 Author: Drug and Alcohol Education and Prevention Team, DrugScope and Alcohol Concern Population: Children and young people Summary: The briefing summarises: • Current guidance and thinking on assessment in Personal Social Health Education (PSHE)/Drug Education and identifies: • Assessment activities suitable for different types of assessment and different settings WHO IS THE BRIEFING FOR? The briefing will be of particular relevance to teachers and other drug education practitioners working in schools and youth work settings, including: Title: Joining Forces Drugs: Guidance for Police Working with Schools and Colleges Date: 2006 Author: DrugScope and Alcohol Concern, for the Association of Chief Police Officers of Population: young people Summary: In this guidance we comment on the three main approaches to drug misuse: enforcement, treatment and education. The police have a key role to play in each. Enforcement is often seen as the major focus of police work but joint intervention with arrest–referral can help gain access to treatment and limit the impact of the criminal justice system on young people’s lives. Police working together with schools and colleges in an education setting can help to inform young people about drugs, the law and the potential risks and effects of using drugs. link to report Research Title: Teenage Thinking...on Teenage Drinking Date: 2008 Author: McKay, M., Milligan, E., Crouch, G. Population: Teenagers in Northern Ireland Summary: This report was funded by the Eastern Drugs and Alcohol Co-ordination Team and was published by the YMCA Lisburn. The report is a "snap shot"of young people's attitudes and behaviours in respect of teenage alcohol consumption. It gives young people the opportunity to talk about their own and/or their friends' drinking behaviours. It does not contain references to other published work. The authors say that it is their intention that the report will act as a catalyst for deeper questioning and searching for better and more effective responses to teenage alcohol coonsumption. Overall, the authors conclude that the issue of teenage alcohol consumption needs effective management by all stakeholders, and a realistic longer term vision needs to be adopted. Teenage drinkers are at risk of getting into trouble with parents and the Police. They are at risk of alcohol-fuelled accidents/incidents, underage sexual activity and illness as well as academic underachievement and alcohol related chronic illness. The authors found that young people no longer see alcohol use as deviant behaviour. They differentiate between drug use and drinking alcohol, and consider the former to be "mad" or "risky". However, alcohol use is not considered in the same way. They also conclude that young people plan, enjoy and reflect on drinking experiences, and young people of all creeds, from all areas and school types. Some do it more covertly than others and some do it more safely than others. They know its effects, if not through first hand experience then through the experiences of their friends. The report concludes that alcohol education needs to respond accordingly. For a copy of the report email: Michael.McKay@liverpool.ac.uk or Telephone: 028 9267 0918 or contact: YMCA Lisburn, 28 Market Square, Lisburn BT28 1AG. Title: 2007 NATIONAL REPORT (2006 data) TO THE EMCDDA by the Reitox National Focal Point Date: 2007 Author: Eaton, G., Davies, C., English, L., Lodwick, A., Bellis, M.A. McVeigh, J. Population: Drug users in the Summary: Section on Prevention: A review of the evidence of the effectiveness of prevention programmes found that school-based drug prevention is effective, especially amongst low risk groups, and that programmes based on life skills show the most consistent effect. Parent education shows some evidence of effectiveness. The evidence for other universal interventions; primary school based drug prevention, peer education, family interventions, and mass media was less clear. In A considerable amount of work in the field of drug, alcohol and tobacco education in schools has been undertaken in There has been a high focus on vulnerable young people. The National Institute for Health and Clinical Excellence has produced public health guidance on communitybased interventions to reduce substance misuse among vulnerable and disadvantaged children and young people. Toolkits for developing local profiles of drug use among vulnerable young people and for evaluating the effectiveness of interventions have been developed. The Advisory Council on the Misuse of Drugs has reported on the implementation of its recommendations on the children of drug using parents. There is now work underway to address the needs of children in the care of the Local Authority, in both Title: European Monitoring Centre for Drugs and Drug Addiction (2007) Annual Report 2007: The State of the Drugs Problem in Date: 11/07 Author: European Monitoring System for Drugs and Drug Addiction (EMCDDA) Population: Drug users in Summary: The report on the state of the drugs problem in Target groups include: policy-makers and their advisors (primary target); specialists and practitioners in the drugs field. The 2007 Annual report on the state of the drugs problem in Title: 2007 World drug Report Date: 06/07 Author: United Nations office on Drugs and Crime (UNODC) Population: Drug users aged 15-64 Summary: The World Drug Report presents the most comprehensive statistical view of today's illicit drug situation. This year's edition reports signs of long-term containment of the global problem. However, the overall trend masks contrasting regional situations, which the report examines in detail. For instance, while an impressive multi-year reduction in opium poppy cultivation continued in South-East Asia, Title: Drugs and poverty: A literature review Date: 03/07 Author: Shaw, A., Egan, J., and Gillespie M. Population: Deprived communities / families / individuals Summary: The Scottish Drugs Forum (SDF) produced this report on behalf of the Scottish Association of Alcohol and Drug Action Teams. This review provides an overview of the main literature found during a five day literature search that explores the links and relationships between drugs and poverty. Title: Being Healthy: The implications for youth work of Every Child Matters Date: 2007 Author: Hunter, B. and Payne, B. Population: Young people Summary: This Briefing Paper, outlines the policy context for Being Healthy, discusses some different perspectives on young people’s risktaking, and then examines four key areas of health identified in government papers: Being physically healthy; Being mentally and emotionally healthy; Being sexually healthy and Making healthy lifestyle (drug use) choices. Under each of these four headings, it outlines the current state of young people’s health; government concerns and initiatives; and the contribution that youth work can and does make.
Date: 2006 Author: National Advisory Committee on Drugs (NACD) Population: Travellers Summary: This report presents the findings of an exploratory study aimed at assessing the nature and extent of drug use amongst the Traveller community in Title: Pathways to Problems; Hazardous use of tobacco, alcohol and other drugs by young people in the Date: 09/06 Author: Advisory Council on the Misuse of Drugs (Crown Copyright). Population: Young people Summary: This report highlights numerous factors which influence whether or not young people will use tobacco, alcohol or other drugs hazardously. It is reported that some of the key factors include early life experiences, family relationships and circumstances, and parental attitudes and behaviour. The authors make several key recommendations arising from the findings. Title: Parents Underestimate Teens' Concerns About Drugs Date: 08/06 Author: The Population: Young people Summary: While drugs are the number one concern for teenagers, parents underestimate how important this issue is to teens, according to data from a national telephone survey conducted earlier this year.*More than one-fourth of youths ages 12 to 17 reported that alcohol, tobacco, and other drugs were the most important problem facing people their age. Yet only 12% of parents of teenagers reported that drugs were the most important problem facing teenagers. In contrast, parents overestimated teens’ concerns with social pressures—58% of parents said that social pressures were the number one concern of teens, compared to only 21% of teenagers. Previous research has found that parents also underestimate the level of alcohol and illicit drug use by youth (see CESAR FAX, Volume 15, Issue 31). CESAR FAX Title: Positive Futures impact report: end of season review Date: 03/06 Author: Positive Futures Team, Home Office Population: Vulnerable young people Summary: Positive Futures is a national sports-based social inclusion programme, managed up to the end of March 2006 from within the Home Office Drug Strategy Directorate. It is currently delivered through 115 local partnership projects located throughout Following its launch in 2000 and the roll-out of two phases of projects, Positive Futures produced a strategy document that outlined the programme’s guiding principles and objectives for the next three-year strategy period to March 2006. Published in June 2003, Cul-de-sacs and gateways provides the benchmark against which to assess the programme’s achievements as it moves towards the end of this period. In Cul-de-sacs and gateways, Positive Futures set itself some ambitious goals. Almost three years on it is clear that many of these goals have been met. Title: Young people and drugs. Key findings: intensive fieldwork into early identification and intervention with vulnerable young people in Bolton, Date: 02/06 Author: Home Office, DSD Population: Vulnerable young people. Summary: As a part of a wider programme of identifying promising practice and sharing learning on effectivedrug prevention, early intervention and treatment in late 2005 officials from the Home Office, Department for Education and Skills and the National Treatment Agency with assistance from the Prime Minister's Delivery Unit and the Office of the Deputy Prime Minister undertook a piece of intensive fieldwork in 3 local areas in order to: · Identify and share experience and approaches to early identification and intervention withvulnerable young people in three High Focus Areas Background Analysis of progress in implementing the Every Child Matters Young People and Drugs guidance at mid year 2005 highlighted that interventions with truants have presented the greatest challenge to High Focus Areas. Progress on identification and early intervention with looked after children was also variable across the country. Performance data indicated that High Focus Areas achieving high numbers of young people accessing treatment services have strong systems in place for identification of vulnerable groups. In order to maximise the impact of the visits they were therefore focused on the way in which 3 areas were building provision around the needs of vulnerable children and young people. In addition the fieldwork is aiding the development of a drugs toolkit for regeneration practitioners by Office of the Deputy Prime Minister, by specifically looking at local responses to substance misuse in areas affected by multiple deprivation. The September 2005 Young People and Drugs Programme Board agreed that the intensive fieldwork should focus on truants, excludees and looked after children in Bolton, Camden and Hull to generate practical examples which could be used in other areas to support the engagement of mainstream services. Title: Risk of Teenagers Developing a Drug Use Disorder Date: 02/06 Author: Ken C. Winters, Ph.D. & Population: Young people Summary: New research from the This prior work provides a general picture of how age is associated with risk for a drug use disorder. We wanted to describe a more detailed picture of this association. Our research question was this: What is the risk of developing either an abuse or dependent disorder at each chorological age during youth? We explored this question separately for the drugs most commonly abused by youth: alcohol and marijuana. A better understanding of the association of recent use and risk for developing substance use disorders will help prevention programs target youth at their highest risk ages. Title: Bottling it up The effects of alcohol misuse on children, parents and families Date: 2006 Author: Turning Point Population: children of alcohol misusing parents Summary: This report, based on interviews with children and parents, highlights the far-reaching consequences of parental alcohol problems on everyone in the family. The impact on children can begin pre-birth and lead to a sustained, damaging legacy into adulthood. As they grow up, children have to cope with a multitude of behavioural, emotional and social problems. Families generally receive little support to help address the practical and emotional issues that arise, yet children and parents are clear about the positive impact that the right services could have on helping them to manage or overcome their situation. Title: Nonmedical users of pain relievers: characteristics of recent initiates Date: 2006 Author: Population: Persons aged 12 and older who initiated nonmedical use of pain relievers and Oxycontin in the 12 months prior to the survey Summary: An estimated 31.8 million Americans have used pain relievers nonmedically in their lifetimes, up from 29.6 million in 2002. OxyContin® (controlled-release oxycodone hydrochloride) is a prescription pain reliever that first became available in 1995. Although it accounts for a small proportion of overall pain reliever misuse, this drug is of particular concern because of its increasing use in recent years. Lifetime nonmedical use of OxyContin® increased in the The National Survey on Drug Use and Health (NSDUH) asks respondents aged 12 or older questions related to their nonmedical use of prescription-type drugs, including prescription pain relievers, during their lifetime and past year.2 Respondents who used prescription pain relievers nonmedically are asked when they first used them.3 This report focuses on persons aged 12 or older who initiated nonmedical use of pain relievers and OxyContin® in the 12 months prior to the survey.4 In 2004, among persons aged 12 or older, 2.4 million initiated nonmedical use of prescription pain relievers within the past year. This is more than the estimated numbers of initiates for marijuana (2.1 million) or cocaine (1.0 million). In 2004, there were 615,000 new nonmedical users of OxyContin®. This number includes persons who had used other pain relievers nonmedically prior to using OxyContin®, as well as those for whom OxyContin® was the first pain reliever they had used nonmedically. Title: Have we got our priorities right? Children living with parental substance use. Date: 2006 Author: Patricia Russell, Aberlour Population: Children of drug using parents Summary: This is the report of a Think Tank on the impact of parental drug and alcohol use. The Think Tank was drawn together by Aberlour from commissioners, managers, practitioners and researchers working in health, education, social work, criminal justice and drugs and alcohol services across Current estimates suggest that there are nearly 60,000 children affected by parental drug use and over 100,000 by parental alcohol use. It is likely that these are under-estimates. Politicians, policy-makers and service providers are increasingly concerned. The UK Hidden Harm report 2003, the Getting our Priorities Right guide in Scotland (2001 and 2003) and the Scottish Executive response to Hidden Harm (2004) have been key drivers to improve responses at national and local level. New initiatives such as the Education (Additional Support for Learning) (Scotland) Act 2004, the Getting it Right for Every Child review and the development of an Integrated Assessment Framework will all contribute to more effective services. The Scottish Executive’s forthcoming Title: Neighbourhood Effects on Youth Delinquency and Drug Use Date: 2006 Author: Susan McVie Centre for Law and Society The Population: Young people This report aims to investigate whether the characteristics of residential neighbourhoods exert an influence on two forms of problematic adolescent behaviour, criminaloffending and drug use, that is independent of factors relating specifically to the individual. It draws on the findings of the Edinburgh Study of Youth Transitions and Crime (the Edinburgh Study), a longitudinal research programme exploring pathways into and out of offending for a cohort of 4,328 young people, who started secondary Epidemiology Title: NDTMS Themed Report; Individuals aged under 25 in contact with treatment services in the Date: 01/07 Author: Khundakar, A., Sumnall. H., Marr, A., McVeigh, J., Bellis, M.A. Population: Young people under 25 in contact with treatment services Summary: This report focuses on those individuals in contact with drug treatment services in the North West of England in 2005/06 aged under 25. This report uses the NDTMS to detail the number, drug use, referral sources and discharge reasons of individuals aged under 18 in contact with structured drug treatment services in the Title: Drug Treatment in the Date: 07/06 Author: Khundakar A., Marr A., McVeigh J., Bellis M.A Population: Clients in contact with structured treatment services. (high threshold tier 3 and 4). Summary: The National Drug Treatment Monitoring System (NDTMS) was established in 2001 to collect data on all clients in contact with structured (high threshold tier 3 and 4) treatment services. NDTMS figures are used as a key source for monitoring the number of individuals in contact with drug treatment services, whilst also being the basis for examining the success of the Government’s commitment to double the number of individuals in drug treatment between 1998 and 2008. The NDTMS regional team, based within the North West Public Health Observatory at the Centre for Public Health, collects data from all treatment providers in the Between April 1st 2005 and March 31st 2006 there were 35469 individuals in contact with drug treatment services in the Title: Statistics on Young People and Drug Misuse. England 2006 Date: 25/05/06 Author: The Information Centre , Lifestyles Statistics. Population: Young people. Summary: This statistical bulletin presents information on drug misuse among young people. The key sources used within this publication are Drug Use, Smoking and Drinking among Young People in • In 2005, 11% of secondary school children in England reported using drugs in the month prior to interview while 19% reported using drugs in the year prior to interview; • Among 11 year olds, 4% had sniffed volatile substances in the last year while 1% had taken cannabis. Among 15 year olds, 7% reported using volatile substances compared to 27% who used cannabis; • Among secondary school children who had taken drugs in the year prior to interview in 2003, 43% reported wanting to give up immediately, but 13% said they did not want to stop; • In 2003, 17% of secondary school children thought it was acceptable to try cannabis, 10% thought it acceptable to try sniffing glue and 4% believed it OK to try cocaine; • 26.3% of young adults aged 16-24 reported using drugs in the year prior to interview in • More young men than young women reported using drugs in the year prior to interview (32.9% compared with 20.8%); • Between 1998 and 2004/05, the reported prevalence of drug use among young adults in the month prior to interview decreased from 20.8% to 16.3% and in the year prior to interview decreased from 31.8% to 26.3%; • Among young people aged between 10 and 25 living in England and Wales in 2004 who had ever used drugs, almost half (48%) reported first using a drug between the ages of 10 and 15; • Deaths related to drug misuse fell between 2000 and 2004. Among young people under the age of 30, deaths fell from 583 to 401. http://www.ic.nhs.uk/pubs/youngpeopledrugmisuse2006 Prevention Title:An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): a cluster randomised trial Date: 05/08 Author: Campbell, R., Starkey, F., Holliday, J., Audrey, S., Bloor, M., Parry-Langden, N., Hughes, R., Moore, L. Population: 12-13 year olds in England and Wales Summary: Background: Schools in many countries undertake programs for smoking prevention, but systematic reviews have shown mixed evidence of their effectiveness. Most peer-led approaches have been classroom based, and rigorous assessments are scarce. The authors assessed the effectiveness of a peer-led intervention that aimed to prevent smoking uptake in secondary schools. Methods: The authors undertook a cluster randomised controlled trial of 10730 students aged 12-13 years in 59 schools in England and Wales. 29 schools (5372 students) were randomly assigned by stratified block randomisation to the control group to continue their usual smoking education and 30 (5358 students) to the intervention group. The intervention(ASSIST [A Stop Smoking in Schools Trial] programme) consisted of training influential students to act as peer supporters during informal interactions outside the classroom to encourage their peers not to smoke. Followup was immediately after the intervention and at 1 and 2 years. Primary outcomes were smoking in the past week in both the school year group and in a group at high risk of regular smoking uptake, which was identified at baseline as occasional, experimental, or ex-smokers. Analysis was by intention to treat. This study is registered, number ISRCTN55572965. Findings: The odds ratio of being a smoker in intervention compared with control schools was 0·75 (95% CI 0·55–1·01) Funding MRC (UK). Correspondence to: Prof R Campbell, Department of Social Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK Title: Expertise zur Prävention des Substanzmissbrauchs. (Forschung und Praxis der Gesundheitsförderung Band 29). Date: 2006 Author: Bühler, A. & Kröger, C. Population: Substance users Summary: The original report is in German but it will be translated into English later this year. Please see the NCCDP summary of a presentation on the findings of this report by the author: Dr Anneke Buhler: NCCDP summary of "What can be learnt for prevention from scientific evidence?" Report on prevention of substance abuse (Buhler and Kroger, 2006) The aim of the report was to provide an up-to-date record of research results on substance abuse prevention. The method employed was a systematic search and analysis of 49 high quality reviews and meta-analyses. This resulted in evidence based conclusions about the effectiveness of preventive measures (avoidance, delay, or reduction of substance use behaviour). The research was mainly from the The strength of the evidence rating has been graded as follows: The conclusion is based on: ***** meta-analyses including high-quality studies; ****a systematic review including high quality studies; ***meta-analyses or systematic review including all types of studies; **an unsystematic review; expert interview or best practice survey; *a generalized empirical result which does not directly inform about or test the assumption and - a contradictory body of evidence. Prevention of illicit substance use through all types of behavioural measures: It was found that psychosocial prevention measures have short term preventive effects on the consumption of cannabis and other illegal substances but we should consider what works for whom in which setting? Family: Comprehensive family - orientated approaches (training for parents, children and whole families) have preventive effects on consumption behaviour (in relation to alcohol). Preventive measures for pre-school children (Aged 3 - 5 years) ahould be family orientated. School: Interactive school-based programmes have preventive effects on consumption behaviour (for tobacco, alcohol, cannabis and other illegal drugs). However, non-interactive programmes such as information giving alone, affective education alone, value clarification and decision making alone are not effective. Peers / Leisure time: There is no aggregated information available in the report concerning peer interventions or leisure time. Media Campaigns: Mass-media campaigns in combination with other components (school-based, community-based and national programmes) have preventive effects on consumption behaviour (in relation to tobacco) but isolated mass-media campaigns have no preventive effects on consumption. Community: Collaborative initiatives aimed at getting laws or regulations introduced are effective when the laws and regulations work. There is inconclusive evidence to show that muti-level projects have preventive effects on consumption behaviour. Policy and regulations: Higher tobacco prices reduce the prevalence and quantity of tobacco consumption but isolated measures to prevent the sale of tobacco to young people under the legal age do not reduce consumption. Raising the minimum legal drinking age reduces alcohol consumption and higher "full" alcohol prices (inclusive of indirect costs) have effects on alcohol consumption as well. It was found that decriminalising cannabis does not increase its consumption. Selective prevention: Selective prevention measures have preventive effects on consumption behaviour if they are implemented in the form of school-based social-skills programmes or mentoring programmes. There is a risk with selective measures of consumption behaviour being influenced in a non-preventive direction. Sringer et al. conducted a national Cross-Site Evaluation of High-Risk Youth Programmes with 48 programs with over 10,500 youths at high risk. It was found that behavioural life skills and recreation focused programmes are effective and have the following characteristics: life skills development content; intense contact (>3h per week); connection building methods; introspection methods and coherence of programme theory. What can be learnt so far? Behavioural and environmental measures can be effective but certain measures are ineffective. Effective measures are based on a coherent programme theory; include behavioural, general and specific content; use interactive measures and have a certain intensity. To prevent cannabis use: different developmental pathways require universal and selective approaches. Non-specific elements are relevant for all substances, as cannabis use occurs after legal use. A lifetime persistant pathway needs an early prevention strategy and a cross-domain approach is necessary to tackle problem syndrome. Title: Community and structural approaches to prevention Date: 09/06 Author: Bosco Rowland, Research Fellow, Centre for Youth Drug Studies, Australian Drug Foundation Population: Young people Summary: The summaries that follow provide a sample of the recent literature relating to community and structural interventions associated with alcohol use. They attempt to make research publications more accessible to practitioners. They also aim to help inform clinicians of good practice and key findings and developments in alcohol research. The first two summaries focus on multilevel community interventions, one undertaken in Title: Hidden Harm: Next Steps: supporting children - working with parents Date: 05/06 Author: Scottish Executive Population: Children of drug using parents Summary: “Hidden Harm” vividly describes the situation of many children and young people living in substance misusing households. They often suffer in silence; they are often not known to services; they often do not know to whom they can turn for help; and the impact of poor parenting on them can have long-lasting and devastating effects.All professionals who come in contact with substance misusers and/or their children have a responsibility to ensure that children in these circumstances are identified as early as possible and are given appropriate support and protection. Early identification and the right kind of support – both for parents and children – can often mean that children can remain with their parents, but there are some circumstances, for example, serious and chaotic drug use, when the risks to the child are so severe, that staying with their parents cannot be an option. For all professionals the needs of the child must take precedence over the needs of the drug using adult. This document identifies, and brings together, a range of actions and initiatives that the Scottish Executive is taking forward and will take forward, in partnership with a range of local partners – Alcohol and Drug Action Teams (ADATs), NHS Boards, local authorities, the police, the courts and the Scottish Prison Service (SPS) and their partner agencies – to improve the way in which agencies identify, protect and support children and young people Title: Models of care for the treatment of adult drug misusers: Update 2005 Date: 10/05 Author: National Treatment Agency for Substance Misuse (NTA) Population: Adult drug misusers Summary: Models of care for the treatment of adult drug misusers (NTA, 2002)1, hereafter Models of care 2002, set out the national framework for commissioning the treatment of adult drug misusers in Models of care: Update 2005 outlines: Discussion Evaluation Title: Coastal and Ex-Mining Areas Project Evaluation Date: June 2007 Author: Research and Service Development Centre (RSDC) Population: Young people living in coastal and ex-mining areas. Summary: In 2003, the Department of Health, The Henry Smith Charity and the Lloyds TSB Foundation funded Mentor’s fifteen-month rural research project. The full project report was published and launched at a national conference focussing on drugs and rural areas in November 2004. Following the findings of the research project, Mentor UK approached the Department of Health and the Henry Smith Charity with a new proposal for a drug prevention project targeted at young people living in coastal and ex-mining areas (CEMA project). The project received funding and began work in October 2004. Project objectives were: to undertake a literature review and mapping exercise of work in coastal and ex-mining areas, identifying models of good practice and work which is promising and has been effectively evaluated; to research and develop 12 pilot projects, targeting young people living in coastal and ex-mining areas, their parents/carers and those working with young people in order to address the issues of isolation, parenting and alcohol and drug misuse; also to engage and support young people and local agencies to develop and implement local projects to address local needs; to share the learning gained from the 12 pilot projects with policy makers, funders and practitioners in order to encourage the effective implementation of drug and alcohol misuse prevention projects in coastal and ex-mining areas across the UK and internationally; to increase the knowledge of policy makers about the drug and alcohol prevention related needs of young people in coastal and ex-mining areas; to raise the issue of drug and alcohol misuse prevention up the list of policy priorities. The CEMA project has been evaluated and the findings are reported by the Research and Service development Centre. For the full report click here. Title: Results of the evaluation of a school-based program for the prevention of substance use among adolescents Date: 2007 Author: The EU-Dap Study Group Population: School children/Adolescents Summary: NCCDP Summary of EU-Dap Final Technical Report n. 2: Results of the evaluation of a school-based program for the prevention of substance use among adolescents
The aim of the project was to plan a school-based drug prevention program and to assess its Nine partners (two of them enrolled with their own funding) implemented the project. The partners were from seven different European countries. All the partners have been actively involved in all project’s activities and have been responsible for intervention administration in their country. This collaboration has produced the definition of validated programmes standardised at a European level, which have been adapted to the National context of the partners. Reasons for the project Existing school-based drug prevention programmes have used various approaches and can be classified into knowledge-based interventions that aim to build negative attitudes towards drugs; affective interventions based on the assumption that psychological factors place people at risk of using substances; social skills, including refusal skills and life skills programmes; a variety of combinations of programmes (for example knowledge plus affective interventions) or alternative approaches involving activities like sport as an alternative to drug use. The evidence on the effectiveness of these programmes is rather weak. According to a recent Cochrane Review of school-based interventions to prevent drug use, only programmes based on enhancing social skills have some chance of being effective (Faggiano 2005). The Eu-Dap Unplugged programme The following components were identified by Tobler as critical in increasing the effectiveness of school-based interventions (Tobler 2000): (i) interactive curriculum; (ii) information about drugs, including their effects; (iii) focus on personal, social and resistance skills; (iv) emphasis on normative education and reinforcement of awareness that most adolescents do not use substances; (v) structured broad-based skills training such as goal-setting, communication skills and general social skills; (vi) teacher training and support from programme developers or prevention experts; (vii) active family and community involvement; (viii) cultural sensitivity – for example by including activities tailored to the cultural experience of the classroom (Komro 2002). The the Eu-Dap school programme, called Unplugged, starts with these components and is based on a comprehensive social influence approach (Tobler 2000, Komro 2002). It was designed by an expert group including behavioural scientists and public health evaluators. The programme consists of 12 one hour units delivered weekly by teachers at the participating schools. The teachers attended a three day training course. It targets both experimental and regular use of alcohol, tobacco and illicit drugs. The curriculum consists of three parts: firstly it aims to improve knowledge of risks and protective factors, as well as to build attitudes against substance use; the second part focuses on interpersonal skills, beliefs, norms and realistic information about prevalence; the third aims to develop intrapersonal skills such as coping competences, problem solving/decision making and goal setting. The intervention manual is published as Eu-Dap Final Technical Report n.1. The programme is offered in three formats: • Class curriculum alone The effectiveness of the Unplugged programme has been evaluated through a cluster randomised controlled trial using schools as experimental units. The intervention was compared with a “usual curriculum” group. Results A total of 170 schools in nine centres agreed to participate in the study and were then randomised. Twenty-seven schools (15.9%) dropped out following their random allocation to a study arm, but before the baseline survey. The rate of withdrawal from the study varied across study arms, being higher for the intervention arms (23.5% versus 4.4% for controls). Thus, 143 schools and 345 classes (an average of 2.4 per school) were actually included in the study Of the 7,409 eligible students in these classes (196 students were excluded because of incapability or lack of parental consent), 7,079 (95.7%) participated in the baseline survey in September-October 2004 and were, therefore, included in the study. Four centres enrolled students in the 7th grade (13 years in 6,604 students participated in the follow-up survey (May 2005), at least three months after the completion of the program. 6,370 out of 7,079 (91.5%) baseline questionnaires matched to the corresponding follow-up questionnaire. The matching procedure was based on the anonymous code: it started using all the 9 digits, and followed limiting to 6 codes. A manual linkage was also carried out independently by two researchers, at the level of class. Effectiveness of the Unplugged programme Unplugged was found to work at least in the short term. Three models were used in the study and model three shows a clear protection for students in the intervention groups compared with the controls. Interventions groups smoked 12% less during the past 30 days, 14% less in a regular way and 30% less daily, when compared with controls. The frequency of drunkenness in the past 30 days was also reduced by 28% and 31% for at least once and regularly respectively. The consumption of cannabis was reduced by 23 and 24%, at least once (ALO) and regularly respectively, and the use of other drugs, although rare, was reduced by 11%. The programme worked better for alcohol and cannabis than for smoking and for higher frequent use than for sporadic users. It also worked better for boys than girls. There are big differences in the effectiveness of the programme between centres that need to be explained. For the complete report including tables, see: www.eudap.net/PDF/FinalReport2.pdf Title: Evaluation of the Effectiveness of Drug Education in Scottish Schools Date: 03/07 Author: Stead M., Mackintosh, A.M., McDermott, L., Eadie, D., Institute for Social Marketing, Population: Young people Summary: ARCHIVED REPORTS LISTED ALPHABETICALLY - PLEASE CLICK ON THE LINKS BELOW
Title: Annual Report 2007: The State of the Drugs Problem in
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