DRUGS: by Jill PearmanNews Weekly
Community drug prevention
, December 1, 2001
Jill Pearman is a professional teacher with over 19 years’ experience in drug prevention in the family, school and community settings. She is the Director of Prevention Resource Centres International and DrugWatch Australia.
This is an edited version of the paper she presented at the Drug Summit meeting, held in Perth on September 29, 2001, under the auspices of the Family Council of Western Australia.The Australian public is subjected to a continual debate on the best way forward with regard to drug policy. Unfortunately, the most successful strategy is missed in most of this debate, that is, the policy of Community Drug Prevention and Mobilisation.
Our parents and communities are rightly concerned about the existing level of drug use, particularly with young people. Very few of the solutions offered adequately answer the community concern in this vital area.
Extensive research in the prevention field, however, demonstrates that it is only through a concerted effort of prevention policy and practice that this drug use rate will decrease.
Throughout Australia, people are becoming more aware of the problems that drug abuse causes for themselves, their families and their quality of life. Virtually no community remains unaffected by substance abuse. Prevention requires social change, and change will not happen without community wide support.
To be successful in community mobilisation, it is important to identify the components of community and to think broadly about its application.
A cohesive and successful drug policy should have as its primary objective two aims: to prevent the use of drugs, and reduce existing drug use.
Certainly the reduction of harm is important in a treatment setting, but this policy objective should not be the overriding goal, as it presently is in Australia.
The only proven way we can ensure drug demand reduction is to provide each individual with knowledge and skills to make informed decisions to reject drugs.
In order for this to happen, the individual needs clear and unambiguous messages on the health risks of drugs.
These messages must be delivered and supported by all sections of the community, in such a way that a climate of anti-drug use becomes the norm, and a child or adolescent facing drug use choices finds clear disapproval: both from authoritative figures and organisations and, possibly more importantly, the peer group.Community mobilisation
The mobilisation of communities to create a healthier, safer and more drug-free society extends far beyond the term of an elected government. Indeed, if communities are activated in such a way as to instigate long-term drug prevention initiatives, the balance of focus would progressively lean towards longer-term, more lasting solutions, reducing over-emphasis on drug maintenance treatment.
On an international level, we have agreement about drug demand reduction. At the United Nations General Assembly Special Session in New York in 1998, all member countries signed a declaration to reduce drug use rates in their countries by the years 2003 and 2008. Australia was a signatory to this resolution.
I would encourage anyone interested in reducing drug use to revisit this declaration and its attached guiding principles.
An individual’s value system is drawn from experiences within his own family and community. It is the responsibility of the community to address issues actively and promote standards that will lead to safe, healthy environments.
There is a need to protect people, and mainly young people, from ideas and values detrimental to the community through tolerance of drug use. Mobilising communities to recognise and overcome these new forces is essential for their well being.The normalisation of drug use
Since 1985, Harm Reduction has formed the cornerstone of the national drug policy in Australia. There has been a lack of prevention focus, with its accompanying healthy lifestyle concept, and a lack of co-ordination of community action.
The latest statistics from the 1998 National Household Survey demonstrates an alarming increase in drug use across the population, and particularly with our young people. Some highlights include:
Establishment of positive values
- The proportion of teenagers recently using heroin increased from 0.6 per cent in 1995 to 1 per cent in 1998.
- The proportion of teenagers recently using marijuana increased from 20 per cent in 1995 to 35 per cent in 1998. The largest increase in recent use of marijuana was with adolescent girls, where the increase was 18 percentage points.
- The proportion of teenagers ever using marijuana increased from 36 per cent in 1995 to 45 per cent in 1998 (1998 National Household Drug Strategy Survey. Australian Institute of Health and Welfare, August 1999).
The effect of community action in the area of drug demand reduction can be seen in different countries throughout the world. Over the past decade we have generally seen a growing push in the acceptance of drugs. In Australia, there has been a constant push from a vocal minority to allow heroin trials, injecting rooms, decriminalisation of marijuana, and increases in needle handouts, all collectively under the banner of harm reduction.
The results of this are significant increases in the prevalence of drug use, particularly in the 14-19 age bracket.
In the United States, where prevention has been the main drug policy and where community coalitions have been extremely active and well-funded, we see a marked decrease in illicit drug use. In 1979, 25 million, or approximately 10 per cent of Americans, used an illicit drug, whereas in 1998 the figure was 13.6 million or less than 5 per cent (1998 National Household Survey, SAMSHA). Compare this with the Australian figure in 1998 of 22 per cent of the population having used an illicit drug. The figure in 1995 was 17 per cent (National Household Survey, AIHW, 1999).
The success of prevention and community action is also evident when comparing the United States and Australian adolescent marijuana use. The Annual Household Surveys from the two countries for 1998 show that the rate of recent marijuana use in the USA by those between 12 and 17 is 8.3 per cent, compared with Australia’s 38 per cent for the same age group. It is clear that young people in America have responded to the anti-drug-use climate.
As a result of a cohesive prevention policy focussing on community mobilisation, drug use in the United States decreased dramatically in the years 1985-92. Marijuana use was reduced by 50 per cent and cocaine use by 79 per cent. (Gold MS, International Prevention Symposium London 1994).
Another country, which has full agreement about the need for prevention is Sweden. They have agreement from all levels of society on prevention and rehabilitation as the best way forward. They deliver a comprehensive prevention and treatment policy that has given them one of the lowest rates of illicit drug use in the world. Comparative data extracted from the United Nations World Drug Report
1997, Oxford University Press, show major differences in drug use rates for Sweden and Australia (See box).Encouraging Signs
In June last year, some 25 non-government organisations combined to stage a drug summit in New South Wales. This event attracted significant media coverage nationally and promoted the concept of harm prevention. Leading from this, there have been many other forums held throughout the country.
Prevention research shows that if an individual has not taken a drug by mid-adolescence, the likelihood of his becoming involved in drug-taking is greatly reduced. Therefore, I believe that the focus of community mobilisation and prevention activity should be on young people.
Indeed, a good indicator of a successful community action plan in this area can be seen by examining the prevalence of use with young people, as they are often the biggest risk-takers. Young people will experiment. It is in the nature of a young person to test and try new experiences, to push against existing boundaries. However, there is a well established body of research that shows that if young people think it is normal to use drugs, drug use will increase. Conversely, if they see the health risks and perceive a social risk, drug use goes down. (Johnson et al., Drug Use Among American High School Seniors, College Students and Young Adults
, 1975-1990, DHHS Publication no. ADM 911813, Washington, DC: US Government Printing office.)Communal responsibilities
As a community we have a duty of care
for our young. They have developing brains and bodies and need support and guidance in order to grow successfully to adulthood. Our young people are part of a family, a school, a community, a media catchment zone, a culture and a country. They are not immune to the messages that are being generated by all those sectors, and in fact, these messages can form and influence their decisions.
If we are serious about preventing drug use and reducing demand, then we must be mindful of the messages that are being sent to our youth; we must educate and involve parents and communities; and we need to increase the health risk information about drugs while developing skills for young people, parents and communities.