3 Education and prevention
Current levels of drug usage
62. From 1996, the Crime Survey for England and Wales
(until April 2012, the British Crime Survey) has included questions
on drug use for those aged 16 to 59. These questions ask whether
respondents have ever used drugs in their life, whether they have
used them at least once in the last year, and in the last month.
The interviewer does not see the response to this question, which
the respondent puts directly into the computer and is then encrypted.
In 2011-12, 19.3% of 16 to 24 year olds had taken an illicit drug
in the last year (nearly 1.3 million people).[71]
Overall use of illicit drugs among young people has fallen between
the 1996 Survey (29.7%), and the 2011-12 Survey, due to a decline
in the use of cannabis.
63. As in previous years, cannabis was the most commonly
used type of drug among young people in the last year (15.7%,
equivalent to 1 million young people), followed by powder cocaine
(4.2%), ecstasy (3.3%) and mephedrone (3.3%). The current level
of cannabis use is a little more than half its peak level of 28.8%
in 1998.
64. Although not as dramatic, this change is reflected
across the all age groups measured by the Survey. An estimated
8.9% of adults had used an illicit drug in the last year; this
remains around the lowest level since measurement began in 1996,
when the corresponding figure was 11.1%. Again, this decline can
be partly attributed to a decline in cannabis use, from 9.5% in
1996 to 6.9% in 2011-12. At the same time, the levels of Class
A drug use have remained steady as an increase in the use of powder
cocaine has offset a decrease in the use of ecstasy and hallucinogens.
65. These findings are reflected in other surveys,
such as the NHS Information Centre survey of secondary school
pupils (2011), which found a risk-averse attitude among the pupils
surveyed:
Among pupils who had ever been offered drugs, 75%
said they had refused them at least once. The most common reasons
for refusing drugs were 'I just didn't want to take them', 'I
think that taking drugs is wrong', 'I thought they were dangerous',
or 'I didn't want to get addicted'.[72]
The decline in drug use among young people, as we
have already noted, has been reflected in the number accessing
treatment, from 22,000 in 2010 to 20,688 in 2011.[73]
The National Treatment Agency has maintained that this is likely
to represent a genuine fall in demand rather than limited access
to services.
specialist services are intervening quickly and effectively
to all young people with any substance misuse problem: 98% of
interventions in 2011-12 began within three weeks of referral,
while the average wait for a young person to start a specialist
intervention for the first time was just two days.[74]
Drug education in schools
66. Reducing demand is a key part of the 2010 Drug
Strategy. However, not all drug education is preventative - some
educational interventions, such as talking about different drugs
and the different physiological and psychological effects that
they can have, will not prevent drug use but are intended to minimise
the harm that people do to themselves if they do choose to take
drugs. Education which will actually decrease the risk of drug
taking is more likely to be classroom exercises which teach behavioural
and social norms rather than focussing on the harms of drugs.
Annette Dale-Perera of the Advisory Council on Misuse of Drugs
told us that the evidence showed that drug education did not necessarily
affect drug-taking decisions but did improve people's knowledge
about substances. She thought that the expectation that drugs
education will prevent people using drugs was misplaced and highlighted
alternative programmes which build up resistance to the use of
drink or drugs as being more effective as a preventative measure.
67. Ms Dale-Perera also emphasised the importance
of credibility when teaching children about drug use:
Young people often overestimate how many drugs they
use or how accepted it is by their peers, and if they realise
that drug use is a minority activity and is not necessarily accepted,
that can be used to modify behaviour. But the kind of messages
and the data presented must be given by credible sources, otherwise
the young people will not believe it. So these are slightly more
promising approaches than other methods, but they have to be provided
by people whom the young people respect, otherwise they do not
take any notice of them at all.[75]
68. The Department for Education told us that the
National Curriculum requires infant school children to be taught
about drugs as medicines whilst junior school pupils are taught
about the impact of alcohol, tobacco and drugs on the human body
and how they can effect health as well as what drugs are legal
and illegal. In the first three years of Secondary School (Key
Stage 3), children will learn the effect drugs can have on conception,
growth, development, behaviour and health. This is extended during
the last two years of Secondary School (Key Stage 4) where students
are taught about the effects that regular drug use can have on
human health. Throughout key stages 3 and 4, Personal, Social
and Health Education (PSHE) will focus on the legislation controlling
drugs and the potential impact that drug use can have both on
an individual and society as a whole.[76]
Fee-paying schools and academies do not have any requirements
to teach drug education although the Department notes that they
are "expected to provide a broad and balanced curriculum
and one that enables pupils to distinguish right from wrong and
to respect the law."[77]
69. The provision of drug education in English schools
has been criticised by Ofsted in a report published in July 2010[78]
and more recently in research commissioned by the Department for
Education[79]. Ofsted
found that lack of discrete curriculum time in a quarter of the
schools visited, particularly the secondary schools, meant that
programmes of study were not covered in full. This extended to
sex and relationships education and broader education about mental
health, as well as drugs and alcohol.[80]
70. The research commissioned by the Department for
Education found that the majority of both primary and secondary
schools deliver drug education once a year or less.[81]
In a case study on the need for discrete curriculum time the authors
describe a school that uses 20 minute tutor periods in the lunch
break to deliver their Personal, Social and Health Education lessons,
which teachers thought was inadequate to deliver the subject effectively.
Lack of teaching materials was also identified as a problem, with
a plethora of companies offering consultancy services in the area,
but with no clear means of assuring the quality of this provision
for schools.[82]
71. We took evidence on drugs education from Mentor,
a UK charity which focuses on protecting children from the harms
caused by drugs and alcohol through evidence based programmes,
and the Angelus Foundation, which is dedicated to combating the
use of legal highs and party drugs in UK. They stated unequivocally
that the Drugs Strategy's vision of high-quality drug and alcohol
education for all young people was not happening.[83]
Mentor went further, telling us that
We are spending the vast majority of the money we
do spend on drug education on programmes that don't work.[84]
They advocated the introduction of professionally-trained
PSHE teachers, rather than having the curriculum delivered by
a teacher who is a specialist in another subject.[85]
72. Because education about the effects of drugs
is expected to be preventative, many students will feel that the
harms of drugs use are exaggerated. Several of our witnesses emphasised
the importance of being completely truthful when talking about
the effects of drugs.[86]
Chip Somers, who runs Focus 12, a rehabilitation charity, told
us that
It is no good just going into schools and saying,
"Drugs are bad. Stop it". Because in each of those schools
there will be people who are using cannabis, who are using ketamine,
who are using ecstasy. Not all the schools but some of them will
be. If you don't give people both the good and the bad of drug
use they will not listen to you. There are lots of people in schools
who are smoking cannabis and not dropping dead. You have to give
both the positive and the negative side of it, and I don't think
we are doing that. We are giving too much of the negative side
of it and not giving honest information. People won't listen unless
it is honest.[87]
73. Instead of using scientific evidence to discourage
drug use in teenagers, studies have shown that programmes which
are focused on classroom management or teaching social skills
are much more effective. Our witnesses told us about two such
programmesThe Good Behaviour Game and Preventure:
a) The Good Behaviour Game works with children
from the ages of five to seven or eight. It is a tool for managing
classroom behaviour. The class is divided into two teams, and
each team gets a point for each instance of inappropriate behaviour
by one of its members, such as leaving their seat, shouting out
or otherwise being disruptive. At the end of the day, the team
with the fewest points gets a reward. If both teams keep their
points below a specified level, then both teams share in the reward.
Witnesses told us that a study over 15 years showed that children
who played the game had a 60% higher rate of university admission.
The Game does not focus on drugs at allrather it is intended
to equip children with the resilience and self-control to make
positive choices in life.[88]
b) Preventure is more explicitly focused on issues
such as drug use. It uses psycho-educational manuals within interactive
group sessions with students aged 13-16 years, focusing on motivational
factors for risky behaviours and coping skills to aid decision-making
in situations involving, anxiety and depression, thrill seeking,
aggressive and risky behaviour (e.g. theft, vandalism and bullying),
drugs and alcohol misuse. We were told that it had been shown
to dramatically reduce the incidence of drug-taking among participants.[89]
74. When we asked the Department for Education how
often either of these programmes along with two othersLife
Skills Training and Unpluggedwere used in schools, we were
told that they "do not monitor the programmes or resources
that schools use to support their teaching."[90]
We contacted a number of local authorities and asked them to survey
the secondary schools in their area, asking them whether they
used Life Skills Training, Unplugged or Preventure. None of those
that replied used any of the programmes. According to Mentor,
it would cost £500 per student to implement a preventative
education programme for all students. This is a small cost compared
to the overall cost of state-funded education per student (£71,000)
or their estimated cost to society of a drug user over the course
of their life (£820,000).[91]
75. It is surprising that apparently cost-effective
programmes to dissuade young people from using drugs Life
Skills Training, Unplugged or Preventureare not more widely
used in schools. While we do not wish to endorse these particular
programmes over others which might be equally good but were not
drawn to our attention, we believe that there is a compelling
case for the use of behaviour-based interventions in schools which
are proven to reduce the chances of young people taking drugs.
The evidence suggests that early intervention should be an integral
part of any policy which is to be effective in breaking the cycle
of drug dependency. We recommend that the next version of the
Drugs Strategy contain a clear commitment to an effective drugs
education and prevention programme, including behaviour-based
interventions.
76. There is strong evidence that expenditure on
preventative measures is highly cost-effective. Classroom interventions
which can be delivered effectively at very little cost need only
to be effective in a few cases to repay their cost many times
over. Failing to provide funding for the professional training
and resources which are needed to deliver these programmes is
therefore potentially, in the long-term, a very costly mistake.
We recommend that Public Health England commit centralised funding
for preventative interventions when pilots are proven to be effective.
Government focus on prevention
and education
77. There is no real understanding as to why the
levels of drug use have fallen in the past sixteen years. As our
predecessor Committee found, there is little research in to what
constitutes effective prevention and education and it may even
be the case that prevention measures are not behind the current
decline in drug use. There are suggestions that social inequality
increases prevalence of drug use. Dr Alex Stevens told us that
We see a correlation between countries that have
the least generous welfare states [based on levels of unemployment
benefit, sickness pay and pensions: how much you can get services
without access to the market and being able to pay for things]
tending to have the highest rates of cannabis use among their
population. There is also a correlation between the least generous
welfare states having the highest rates of injected drug use.[92]
This is supported by a number of studies, dating
back to the 1960s, which show that neighbourhoods with high levels
of poverty, unemployment and deprivation are also more likely
to have high levels of drug use.[93]
78. Dr Claire Gerada of the Royal College of General
Practitioners also highlighted this as a reason
We know from quite a few studies, including by the
Joseph Rowntree Trust, that the pathway to addiction is poverty
and social inequality, and that some of the factors that give
children resilience include stable parenting and good education.
There is a body of knowledge.[94]
In 2003, the ACMD estimated that there were between
200,000 and 300,000 children in England and Wales with one or
two parents who have serious drug problems.[95]
According to Addaction, the children of problematic drug and alcohol
users are seven times more likely to develop a problem themselves.[96]
A 2010 review of prevention measures found that the interventions
which have the most impact have two things in common: they focus
on early intervention with the proximal social environment, either
the classroom or the family, and they address issues other than
drug use by focusing on social and behavioural development.[97]
79. The 2010 Drug Strategy includes several preventative
measures: breaking inter-generational paths to dependency by supporting
vulnerable families; providing good quality education and advice
and early intervention with young people and young adults.[98]
A Social Justice Strategy paper produced by the Department for
Work and Pensions in March announced that one of the methods to
help those with drug and alcohol dependence problems was about
focusing on the family.
The family is the first and most important building
block in a child's life and any government serious about delivering
Social Justice must seek to strengthen families. So many of the
early influences on a child relate to the family setting in which
they grow up. When things go wrong, we know that this can increase
the risk of poor outcomes in later life. Even more importantly,
we know that family breakdown and other risk factors worklessness,
educational failure, mental ill health or drug and alcohol dependency
can feed off one another, compounding their effects, and
leading to outcomes that can be very damaging for those affected
and costly to society as a whole.[99]
80. This recognition however, does not always translate
into effective support. The Crime Reduction Initiative told us
that education and early intervention should be at the core of
any cost effective drug strategyevery £1 spent on
interventions may save between £5 and £8 for the NHS
and other agenciesbut they were concerned that they were
seeing significant disinvestment in drug related expenditure,
with local spending decisions having an adverse impact on drug
education and prevention provision for young people delivered
in school settings, drug treatment for young people who are already
using drugs and alcohol, and support for infrastructure organisations
for professionals working in the sector.[100]
81. This view was supported by Mentor, who told us
that new figures from the Department for Education show local
spending on drug and alcohol services for young people falling
by £7 million next year. At the same time, money for drug
prevention, which comes to local councils via central Government's
Early Intervention Grant, has been cut by 23% between 2010 and
2012.[101]
The Inter-Ministerial Group on
Drugs
82. As part of an effort to co-ordinate drug policy
across Departments, the Government have set up the Inter-Ministerial
Group on Drugs. The role of the IMG is to bring "together
Ministers across Government to drive forward and oversee implementation
of the Drug Strategy."[102]
The following Ministers are invited to meetings of the IMG:
Home Office (Chair) |
Jeremy Browne MP, Minister for Crime Prevention
|
Department for Communities and Local Government
| Mark Prisk MP. Minister for Housing
|
Department for Education
| Elizabeth Truss MP, Parliamentary Under Secretary of State (Education and Childcare)
|
Department of Health |
Anna Soubry MP, Parliamentary Under Secretary of State
|
Department for Work and Pensions
| Esther McVey MP, Minister for Disabled People
|
Ministry of Justice |
Jeremy Wright MP, Parliamentary Under-Secretary of State (Prisons and Rehabilitation)
|
Cabinet Office | Oliver Letwin MP, Minister for Government Policy
|
Source: Home Office. Ministerial representatives
will be invited from the Department for International Development,
Ministry of Defence and Foreign and Commonwealth Office when there
is a relevant agenda item.
However, neither attendance at the meetings nor the
agendas of the meetings are published (although the agendas were
made available on request following an FOI request). On 9 July
2012, the Home Office announced via a Written Parliamentary Question
that
Ministerial attendance varies according to the agenda
of the meeting and their availability. Other Ministers or senior
officials and advisers may attend subject to the agenda. The IMG
on Drugs has met 15 times since May 2010.
Prevention and education forms a key part of the
drug strategy as part of the reducing demand theme. The IMG regularly
discusses progress at its meetings on each of the themes of the
strategy.[103]
As the area of prevention has no obvious lead department
we make our recommendations to the Inter-Ministerial Group on
Drugs.
83. We
believe that the current, inter-departmental approach to drugs
policy could be strengthened by identifying a Home Office Minister
and a Department of Health Minister, supported by a single, named
official, with overall responsibility for co-ordinating drug policy
across Government. We recommend that the Home Secretary and the
Secretary of State for Health should be given joint overall responsibility
for co-ordinating drug policy. By giving joint lead responsibility
to the Home Office and Department for Health, the Government would
acknowledge that the misuse of drugs is a public health problem
at least as much as a criminal justice issue.
84. We recommend
that the agenda, a list of attendees and minutes of each meeting
of the inter-ministerial group on drugs be published on a government
website. We would also welcome work addressing the harmful effects
of drug consumption.
71 Statistics in this section are all taken from Drug
Misuse Declared: Findings from the 2011-12 Crime Survey for England
and Wales, 2nd edition (Home Office, July 2012). Back
72
NHS Information Centre, Smoking, drinking and drug use among
young people in England in 2011 (July 2012), p 9 Back
73
National Treatment Agency, Substance misuse among young people
2011-12 (October 2012), p 2 Back
74
National Treatment Agency, Substance misuse among young people
2011-12 (October 2012), p 3 Back
75
Q370 Back
76
Ev w376, para 6 Back
77
Ibid, para 7 Back
78
Ofsted, Personal, social, health and economic education in
schools, (July 2010) Back
79
Department for Education, Personal, Social, Health and Economic
(PSHE) Education: A mapping study of the prevalent models of delivery
and their effectiveness, (January 2011) Back
80
Ofsted, Personal, social, health and economic education in
schools, (July 2010), pp 5-6 Back
81
Department for Education, Personal, Social, Health and Economic
(PSHE) Education: A mapping study of the prevalent models of delivery
and their effectiveness, (January 2011), p 48 Back
82
Drug Education Forum, PSHE and Drug Education in England, (February
2011), Accessed November 2012: http://www.drugeducationforum.com/images/dynamicImages/7881_377172.pdf Back
83
Q96 Back
84
Q97 Back
85
Q101 Back
86
Q120;285 Back
87
Q254 Back
88
Q90 Back
89
Q92 Back
90
Ev w375, para 3 Back
91
Q111 - 114 Back
92
Ev 199 Back
93
Babor et al, Drug Policy and the Public Good (Oxford University
Press, 2010), p 43 Back
94
Q188 Back
95
Advisory Council on the Misuse of Drugs , Hidden Harm - Responding
to the needs of children of problem drug users (2003) Back
96
Sophie Kydd, Natalie Roe, 'A better future for families: The
importance of family-based interventions in tackling
substance misuse' Addiction
(March 2012), pp 14
Back
97
Babor et al, Drug Policy and the Public Good (Oxford University
Press 2010), p 120 Back
98
Home Office, The drug strategy, 'Reducing demand, restricting
supply, building recovery: supporting people to live a drug-free
life' (2010), p 9 Back
99
Department of Work and Pensions, Social Justice: transforming
lives (March 2012), p 15 Back
100
Ev w178 Back
101
Mentor UK, Drug prevention and early intervention agenda buried by cuts,
(October 2012) Accessed November 2012: http://www.mentoruk.org.uk/2012/10/drug-prevention-and-early-intervention-agenda-buried-by-cuts/ Back
102
Inter-Ministerial Group on Drugs, Putting Full Recovery First,
(March 2012), p 2 Back
103
HC Deb, 9 July 2012, c82W Back
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