Drugs: Breaking the Cycle - Home Affairs Committee Contents

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 programmes—The 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 all—rather 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 others—Life Skills Training and Unplugged—were 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 Preventure—are 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 strategy—every £1 spent on interventions may save between £5 and £8 for the NHS and other agencies—but 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 OfficeOliver 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


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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Prepared 10 December 2012