Effective anti-drug drives focus on roots, not killing addicts
WATCH: Anti-drug use campaign publicity. YOUTUBE
PORTSMOUTH, New Hampshire – A survey of scholarly literature on anti-drug campaigns reveals tried-and-true strategies that have significant long-term impact. These thoughtful approaches value each human life and focus on addressing the root causes of drug use, rather than on simply condemning, demonizing and even killing those in its grip.
Philippine President Rodrigo Duterte was reported to have said that most addicts are hopeless, justifying his extremely harsh view of drug users, who often peddle drugs on the side to finance their addiction.
That view, according to the U.S. National Institute of Health on Drug Abuse in Principles of Drug Addiction Treatment, is counter to decades of research that show how drug dependency can be reversed—stopping addiction, preventing a relapse and making the individual become a productive member of the community.
All in the family
Studies reported in the Journal of Child Abuse and Neglect (2012) and Pediatrics (2008) reveal that intervention at the family level can have significant impact if it starts as early as during pregnancy and early infancy for those with an addicted mother.
Being born to addicted parents puts a child in one of the highest-risk groups for drug use, but longitudinal studies show that visits by trained nurses or social workers tasked with helping the mother deal with practical life issues (health, housing, etc.) and with parenting challenges markedly reduced drug use when the child reached adolescence.
Programs that focus on teaching parenting skills not just to addicted parents, but also to the general population also proved to be effective in curbing drug use and related behavior, according to studies published in the Health Education Research (2008) and Drug and Alcohol Dependence (2007).
The programs studied trained parents to raise their children in a positive and caring environment and to know how to effectively communicate with their children, including the setting of rules and limits, and to discipline.
Programs that teach elementary school children to develop social and personal skills to gain a sense of general wellbeing and cope with daily challenges are effective in minimizing behaviors associated with drug use, according to A. R. Piquero in his book Effects of Early Family/Parent Training Programs on Antisocial Behavior and Delinquency.
Likewise, a systematic behavior-management program in the first grade, according to a study reported in the Drug and Alcohol Dependence (2008), yielded a significant reduction in substance-related disorders in early adulthood.
According to the United Nations Office on Drugs and Crime’s World Drug Report (2015), most of the effective early education programs “include interactive exercises to improve several personal or social skills, such as self-awareness, creative thinking, relationship skills, problem solving, decision-making and coping with stress and emotions.”
“Specifically with regard to substances, awareness of social influences on drug use is enhanced through critical thinking exercises. Creative thinking is used to identify functional alternatives to drug use, and communication skills are built so as to increase assertiveness in resisting offers of drugs.
Drug information focuses on short-term negative consequences and on normative education (that is, addressing the often exaggerated perception that adolescents have with regard to prevalence of drug use among their peers).”
School-based drug prevention programs, according to a meta-analytic review in the Health Education and Behavior (2010), resulted in a 28 percent reduction in drug use. The results were even better when the programs targeted adolescents 14 years or older; utilized interactive methods; were more intensive; and incorporated social learning, information and value education, according to a report in the Pediatrics (2008).
Among young school children, a Preventive Medicine (2008) study confirms that “programs (that) develop individual social skills are the most effective form of school-level intervention for the prevention of early drug use.”
This is further corroborated by a study in Hong Kong, where a longitudinal impact review reported in The Scientific World Journal (2012) shows how participants in a “positive development program” were dramatically less prone to use illegal drugs.
The Preventive Medicine study points out that scaring children with negative information about drugs and focusing only on building self-esteem were ineffective.
It takes a village
Community-based anti-drug programs are generally comprised of community stakeholders who decide on supporting school- and family-based programs that they deem are best suited to their local setting. A six-year study reported in JAMA Pediatrics (2014) shows that community initiatives can reduce alcohol, drug and cigarette use by up to 31 percent.
One community-based initiative in the U.S. that is attracting a lot of global interest for its success is called PROmoting School-Community-University Partnerships to Enhance Resilience (PROSPER).
According to its website, PROSPER “is a scientifically proven delivery system that facilitates sustained, quality delivery of evidence-based programs that reduce risky youth behaviors, enhance positive youth development and strengthen families.”
A study published by Preventive Medicine (2013) reports quite a dramatically lower 0.5 percent lifetime methamphetamine use among young adults who participated in a PROSPER community-university initiative, compared to 5.2 percent for the control group.
The “evidence-based program” delivered through PROSPER in the Preventive Medicine study is Iowa’s Strengthening Families Program (SFP). According to its website, SFP is “a nationally and internationally recognized parenting and family strengthening program for high-risk and general population families. SFP is an evidence-based family skills training program found to significantly improve parenting skills and family relationships, reduce problem behaviors, delinquency and alcohol and drug abuse in children and to improve social competencies and school performance.”
Treatment over prosecution
People in developed economies tend to view drug addicts as patients, rather than as criminals on the loose. In a Pew Research Center poll in 2014, for example, 67 percent of Americans said that the government should focus on providing treatment to users of hard drugs such as heroin and cocaine. Just 26 percent favored prosecution.
Treatment often includes medical, behavioral and social components. While the cost of treatment can be prohibitive, more so to poorer countries like the Philippines, various studies (Health Services Research, The Mount Sinai Journal of Medicine, Journal of Substance Abuse Treatment) show its net impact in terms of health and social costs has proved to be more than worth it.
Since there is no single cause of drug addiction, there is obviously no single solution. Most settings require a multi-pronged approach that includes controlling the demand side (prevention, treatment) and suppressing the supply side (crackdown on drug manufacturers and traffickers).
Studies on the demand side invariably suggest that the closer the solutions are to the root causes, the better. Simply condemning, demonizing and even killing those caught in its grip are as far from the root causes as one can get.
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