On the importance of preventive education

Preventive education is founded on two essential premises: firstly, education is a tool of prevention, and secondly, prevention of drug abuse is possible. But, before analyzing the effectiveness of preventive education, it seems worthwhile to rapidly redefine a few concepts and put them back into context.

First of all, the use of drugs is a human phenomenon; it does not exist in the animal world ⁽²⁾. As it is within a socio-cultural context that the use and abuse of drugs is rooted and the reasons for this are to be found, it is, therefore, within that same context that prevention becomes possible. Whence the fundamental role of education for the prevention of drug abuse.

⁽²⁾ with but one or two exceptions

However, the issue is not that of eliminating the use of drugs by individuals, but rather a question of recognizing this fact as being a problem of society. Some anthropological studies indicate that society creates and sets in place integrated control mechanisms aimed at reducing or minimizing the harmful effects of drugs. When the fabric of society begins to crack, the wherewithal for control is lost.⁽³⁾

⁽³⁾ N. Zinberg. Drug, set and setting. Yale University Press, New Haven & London, 1974

What is usually understood by prevention?

Latin etymology (prae-venire: come before) places the preventive act in a chronological setting - to act in anticipation of the problem - thus creating a paradox. If the problem does not arise, it is impossible to subsequently verify whether the preventive act has been effective. Prevention becomes non-perceptible and, in turn, non-verifiable. This the first difficulty with which any preventive intervention has to contend.

Let us pass on to some definitions of " prevent " - to anticipate something undesirable in order to stop it or to ward it off; to satisfy in advance; to warn in a threatening manner; and " prevention " - a preconceived opinion about individuals or things with unfavorable connotations of mistrust; or a state of mind which is predisposed to one thing or another.

An analysis of these definitions reflects the difficulties inherent in preventive action. Considering what has to be prevented as " undesirable " returns us to the field of morals and, thus, of ideologies; prevention then becomes a sanctimonious enterprise. If to prevent is considered to mean " to satisfy in advance ", then no verification is possible and prevention becomes a form of voluntarism. Moreover, the popular meaning " prevention is better than cure ", is a direct link to the curative act, creating a bond between the realm of sickness and disease and the notion of prevention. Indeed, it is this latter concept upon which most existing intervention models are now based, just as it is the most customary definition of prevention.

The medical model of prevention, built up at the end of the XIXth century following Pasteur's discoveries about infectious diseases, is the product of deterministic Cartesian logic of the cause and effect type based on the history of diseases. This, in itself, is the fruit of knowledge acquired as to the origins of disease (the cause), recognition of symptoms (effects) and reconstruction of the mechanisms of propagation (linking effect to cause). The medical model of prevention is based upon certain characteristics of the origins of infectious diseases and their mechanisms of propagation: suppression of the cause, which is usually unique and identifiable, interruption of propagation mechanisms, which are normally natural, linear, able to be pinpointed and wiped out; and protection of the population, the widest expression of which is the vaccination campaign. Generally speaking, when everything is known about a disease, it is by combining these three strategies that the model of intervention would attain its level of excellence.

" It is important to emphasize that the medical prevention model created as a result of the fight against infectious diseases, has, thanks to its efficiency, rationalized the biggest fears and emotions of our overall powerlessness linked to the major epidemics that have marked the history of mankind. " ... " how much this model has acheived ... a strong credibility as a result of its capacity in provoking great collective fears and giving the human being a feeling of control over the curse that awaits them " ⁽⁴⁾

⁽⁴⁾ Rouge, Alain, Prevention: les limites du mod mcal. Les Cahiers de la CORIEF, No. 1. January 1988

The way the generalized spread of the abuse of drugs in modern societies is perceived as " the " scourge of the century, conjures up the image of an illusory world where fear and feelings of impotence remain the same as in the past. However, unlike the great epidemics of the last century, today it is the body of society that is attacked and undermined and not simply the physical body of the individual. Because symbolic strategies of educational action must be set in place there is a dangerous temptation to apply the linear model of medical intervention to the complex field of social phenomena.

According to UNESCO's Preventive Education Programme ⁽⁵⁾ «Prevention of drug abuse does not only mean equipping individuals to deal with this problem by providing them with the abilities to think, make choices, help them to relate to the past and become involved in the future of their physical and social environment. Prevention must essentially pro -vide the resources necessary to induce personal expression, restore dialogue and overcome indifference. Social activities in the sphere of the arts, music and sport are all preferential methods of communication which, not only procure pleasure, but also offer the means to replace the violence inherent in non-dialogue (and drug abuse is the most insidious), to promote authentic discourse, creativity and provide opportunities to enter into contact with others and to experience solidarity».

⁽⁵⁾ Drugs. Demand Reduction. UNESCO's contribution through preventive education, p.5 Position paper 1993

Through this Programme, UNESCO, in collaboration with the other agencies of the United Nations System, proposes a new conceptual field and a new pragmatic approach to the prevention of drug abuse. This strategy must be integrated as an innovative axis in the teaching-Learning process, because its nucleus is education and information and not merely the transmission of knowledge which has no effect on behaviour - " learning to be ". Preventive education presumes a reciprocal communication which fosters integration of knowledge and feelings, of the individual and his group, of public and private spheres -through dynamic interactions aimed at achieving harmonious human development.