· Drug policy. Drug
policy in the UK has undergone considerable change over the last 20 years. It
used to be internationally regarded as one using treatment and opiate
prescription, rather than law enforcement to control and prevent drug problems.
According to Dorn (25), education, once considered almost synonymous with
prevention, is now seen as a supporting system. By the late 1980s, drug
prevention was effectively defined as an enforcement problem first, and a
medical, social and educational problem second. The main objective now is to
attack the drug problem on five fronts:
- reduce supplies from abroad;
enforcement even more effective;
- maintain effective deterrents and tight
- develop prevention and education;
- improve treatment
25) Dorn. N. British Policy on Prevention. In:
Ghodse, H. et.al. Drug Misuse and Dependence. Parthenon, Lancs.
The first three policy objectives deal with supply, and the last
two with prevention, treatment/rehabilitation and demand reduction. An Advisory
Council on the Misuse of Drug established by the British Government in 1984
recommended that preventive measures be developed according to two basic
- reduce the risk of an individual engaging in drug
- reduce the harm associated with drug misuse.
Several prevention programmes have since been carried out.
Mass Media Campaign. In February 1985, the British
government commissioned a London advertising agency to develop a wide-ranging
and striking anti-heroin campaign, targeted at all youngsters aged 13-20 '28),
especially those running a high risk of using heroin (an estimated 15% of all
youngsters). The campaign "Heroin screws you up", consisted of two TV
commercials broadcast regularly on Channel 4 Television. One commercial shows a
boy who proudly announces that he controls his heroin use, but slowly
deteriorates. The other shows a girl who, despite her efforts with make-up,
looks worse and worse. Full-page advertisements in nineteen different fashion,
music and girls' magazines brought the message "Heroin screws you up" to the
attention of the younger generations.
28) Irving. A. The Role of Advertising in the
Prevention of Heroin Misuse: the UK experience. In: Proceedings of 15th ICAA
Institute on the Prevention and Treatment of Drug Dependence.
A special campaign for parents, educators and intermediaries was
also developed, with especially written brochures on drugs "How to act when your
child uses drugs". Three different advertisements published in some weeklies and
monthlies drew attention to the heroin problem and the brochures.
The goal of the first campaign was to get across the negative
short-term physical and social effects of heroin use in a penetrating way. The
second campaign also demonstrated through TV commercials, posters and adverts,
how youngsters can turn down an offer of drugs without losing face. During
recent years this anti-drug campaign has increasingly become modified into an
HIV/AIDS prevention (Anti-Injecting) campaign addressed to drug users and, on a
broader level, all those concerned by drugs, to meet the policy objective of
reducing the harm caused by drug misuse.
The Anti-Injecting campaign "Shooting up once can screw you up.
Forever" used the different media of television, posters, teenage newspapers and
radio annoucements and which focused on the risk of contamination through shared
use of syringes to communicate the general idea that the syringe is a deadly
weapon "Screw up your blood, your liver, your life"
- even though individual use of a syringe is never
discussed. The inherent risk is amplified by the advertising slogan which
reduces time to a simple equation: Once = Forever.
· School drug prevention.
The UK has built up a long tradition of school drug education programmes,
including low-level scare tactics, factual person-focused health promotion and
mixed approaches. Most programmes and packages have been developed by Health
Education Authorities or by agencies like ISDD, TACADE '29). There is, as argued
in the Chapter V, no overwhelming evidence available to help in decisions as to
what would be the most effective drug prevention approach in the school context.
Probably this is the main reason for distributing a variety of drug education
programmes and packages in primary and secondary schools, such as the two very
different programmes, "Drug Wise Drug Education for Students, 14-19" developed
jointly Health Education Council, TACADE and ISDD, '30 and the "High Profile
Youth Work Curriculum about Drugs", developed and distributed by ISDD (31). The
"Drug Wise" programme is a broad, factual person/skills focused prevention
programme, including many educational methods (lecturing, discussion, peer
support, materials etc.). The "High Profile Curriculum" is a rather traditional,
cognitive based educational programme that fits into most subjects of the
curriculum, whatever the type and level of education or professional training.
Dorn illustrates this approach in the following table:
29) Free to Choose: an approach to drug education.
TACADE, Salford. IRK. 1984
30) Drug Wise Drug Education for Students, 14-19.
ISDD, London. 1986
31) See Note. 19
DRUG ISSUES IN EDUCATION CURRICULA
Drug Related Matter includes
Calculating spread of HIV, drug surveys
Drugs in literature
Central nervous system and effects of drugs
The UK also pays much attention to training teachers and school
counselors how to educate their pupils and students and how to deal with young
people with drug problems. Since 1986 several drug education video programmes
and packages are available for a variety of educational settings.
· Training programmes for
health professionals. Most of the drug prevention programmes described so
far deal mainly with primary prevention. Health professionals are often
confronted with substance abuse problems at an early phase, in hospitals, or
during primary care and crisis intervention. Many are not familiar with coping
and intervening with drug problems, scant attention having been paid to this
aspect during their medical training. There are several attempts to fill this
gap, one of the best known being the post-graduate "Diploma Course in Addiction
Behaviour", developed and taught by the Addiction Unit of the Maudsley Hospital
in London (32). This very intensive, one-year training course is addressed to
physicians, psychiatric nurses, psychologists and other health professionals
confronted with early addiction problems in their work. It is interesting to
note the high international participation in this training course, with
professionals from Africa and Asia who return to their countries and train their
colleagues in education and intervention with drug misusers. An international
example of the "teaching the teachers" training model.
32) Glass. I. B. Diploma Course in Addiction
Behaviour. paper presented for WHO Consultation Meeting "Substance Abuse
Education for Health Professionals". Vienna. 1987
· Community prevention
projects. So far as this author is aware, there are no striking examples of
community drug prevention projects directed at primary or secondary prevention
levels. What we do have, however, are examples of projects that try to reach
local drug users in big towns and cities. In Manchester, for instance, a harm
reduction comic called "Smack in the Eye" has been distributed to drug users
(33). It uses popular cartoons to get messages across about safe drug use and
safe sexual behaviour. In Brighton, a harm minimization project using local
radio and telephone lines to warn young people about the dangers of mixing
sedatives, including solvents, produced wrapping paper with printed messages
about drugs 34).
33) See Note. 27: p. 143
34) Dorn. N. Can Local
Drug Prevention Sizzle? Druglink. 1990
· Evaluation of drug
prevention in the United Kingdom. No general evaluation data is available to
determine the effects of all preventive measures, either on supply reduction, or
on demand reduction, to decide whether the British drug policy is a successful
one. And it is virtually the same for the prevention and education programmes
described above where no quantitative data is available to indicate success or
failure. However, there is evidence that the British mass media campaign was
successful to some extent, research findings indicating that negative attitudes
of youngsters towards the use of heroin had increased by 10% after the campaign
'35) Heroin Misuse Campaign Evaluation. Report of
findings stages I-III. Research Bureau Limited. London.