School Drug Education: Policy Position Paper for APSAD

Rationale:

1. Harm reduction is the dominant framework used at both national and state levels to define responses to drug related issues.(1) Broad strategies directed at the reduction of harm able to be used effectively within schools include(2) strengthening policy and guidelines development in the alcohol and drug area, working with other department and government personnel, creating and sustaining health-promoting settings within schools, strengthening individual motivation and capacity to avoid harm, supporting action in the local community in which the school is situated, and working with the local health and social welfare as well as criminal justice systems.
2. There are many factors both environmental and personal, which appear to predispose an individual to harm from their drug taking behaviour. Environmental circumstances are sometimes the most powerful determinants of level and pattern of use. Variation at the individual level also influences the degree of harm experienced. Personal risk factors include commencement of drug use early in life, non conventionality, inadequate social bonding, deviant behaviour, adult, parental or older sibling role models who use drugs, novelty or sensation seeking, personality factors such as early signs of aggression and noncompliant behaviour, low religiosity, self efficacy and self acceptance.(3) Differences are also evident between those who are experiencing their drug use at an early developmental stage and those whose harm from use is well established.
3. Drug use carries with it both personal and interpersonal meaning(4) and an inherent set of values which are dependent upon both the perceived benefits and negative consequences associated with use. Drug use occurs in young people as a result of complex and interrelated factors. These include peer group pressure, advertising, imitation of parents, boredom, the need to experiment and the individual's self image;(5) the expectation that using will be a beneficial experience which enhances socialisation;(4) positive experiences associated with an altered state of consciousness;(4) the excitement of risk taking;(4) the experience of social, economic and cultural change;(6) and a lack of support and guidance.(6)
4. School drug education has been the preferred approach to addressing drug related issues within educational settings. Often part of a more comprehensive approach, at a community or state level, the observable benefits from school drug education have been limited despite the expectation of successful outcomes. Education Departments in states and territories provide information, discussion sessions, skills building and decision making programs related to alcohol and other drug use. Interventions are sometimes one-off in nature and conducted by personnel from varying backgrounds and experience. There is general consensus these types of school drug education efforts are ineffectual in preventing or delaying use.(7) (8) (9) (10) As well, these programs fail to identify and meet many of the underlying needs and associated problems of young people who comprise the target group.(4) School drug education has been the preferred approach to addressing drug related issues within educational settings. Often part of a more comprehensive approach, at a community or state level, the observable benefits from school drug education have been limited despite the expectation of successful outcomes. Education Departments in states and territories provide information, discussion sessions, skills building and decision making programs related to alcohol and other drug use. Interventions are sometimes one-off in nature and conducted by personnel from varying backgrounds and experience. There is general consensus these types of school drug education efforts are ineffectual in preventing or delaying use.(7) (8) (9) (10) As well, these programs fail to identify and meet many of the underlying needs and associated problems of young people who comprise the target group.(4)
5. Based upon the results of sound research, approaches to school drug education which are not recommended include education strategies conducted in isolation from a wider school, community and environmental context;(11) drug prevention strategies which have illegal drugs as their main focus while the drugs associated with the most harm, such as tobacco, alcohol, over the counter medication and prescription drugs are ignored;(12) an analysis of alcohol and drug problems and a discussion of alternatives, coping skills, self concept and problem solving exercises conducted in isolation from other strategies;(8) the 'just say no' approach, which lacks validity with the target group, is not supported by research findings and fails to recognise the multiplicity of factors that influence drug taking decisions; those approaches which rely heavily on straight factual knowledge regarding alcohol and other drug use;(8) (13) (14) (15) (16) (17) (18) (19) using fear as the primary means of influencing behaviour;(8) (20) and 'one off' talks or programs which have neither sequence, progression nor continuity over time and do not form part of a sound school health education curriculum.(21).
6. The success of school drug education should be measured as part of an overall approach to substance use and the achievement of benefits, such as a reduction in harm in individuals, schools and the wider community. Results of past school drug education efforts provide an important guide to future strategy development. Drug related issues can be addressed within schools by strategies which aim to reduce harm from use. Personal, social and environmental factors can be used as entry points into drug/health related issues.(6) Strategies need to be consistent with specific needs of the target group in order to be effective.(22) For some drugs with some populations a harm reduction approach may require low risk use or non use.
7. A strong argument exists for drug prevention models that combine and coordinate multiple forces of the community with those valuable resources of the school.(23) (24) Achievements at the educational level within schools need to be supported by advocacy, wider policy development and structural change both in schools(25) and communities.(26) Multi component community interventions can prove highly successful when well integrated with school environmental change, school curricula and parent education.(27) Students input is of utmost importance in planning, policy development and strategy implementation. Parents' or caregivers' role in developing and supporting policies and strategies within schools is also recognised. The function of school based counsellors and others trained to address drug related use and harms within the student population is integral to successful strategy development.
8. Concerted efforts have been made to address the issue of school drug education in a comprehensive way at a state and national level. The National Initiatives in Drug Education project aims to further promote the importance of drug education in schools through an integrated information strategy targeting principals, administrators, teachers and the community. The initiative also aims to increase teachers' and parents' knowledge and skills level, and to assist schools and communities to address drug related issues in sustainable and integrative ways.(28) (29) (30) (31) Specialised and complementary approaches have been achieved across departments in several states.
9. The comprehensive 'Health Promoting Schools' framework is advocated as an effective way of addressing alcohol and drug, and other health related issues. Schools within this network seek to reinforce the classroom health and learning experiences by providing complementary health practices and policies(32) which can effectively include consideration of alcohol and drug related issues across varying levels of organisational structure and day to day functioning. This concept is based upon the five areas of action of the Ottawa Charter.(33) Some of the key elements of a health promoting school include integration of the physical, social, mental and environmental aspects of health, development of a comprehensive school health curriculum for all students, increased community participation within schools, close parental cooperation and support for health promoting programs, and increased student and staff participation in decision making and policy development.(34)
10. Health/drug education teachers need to be well equipped to undertake the range of roles and tasks necessary for school drug education and related strategies to be well delivered within their widest context. Comprehensive tertiary training needs to occur. Preservice training for all teachers covering important aspects related to drug use and strategy development should increase the capacity of schools to adequately address drug related issues within their own environment and the wider community. Access to post graduate inservice training should be available across the range of skills and knowledge necessary for structural change, and program and policy development to occur around health and substance related issues.

Roles And Responsibilities of APSAD

1. To promote the adoption of comprehensive and sustainable approaches to addressing alcohol, tobacco and other drug related issues within schools and communities.
2. To promote the development of school based policy and procedures to support classroom school drug education and related health activities.
3. To promote the Health Promoting Schools concept as an effective and appropriate way of providing wider structural support for school drug education and related health issues within schools and communities.
4. To promote the delivery of preservice training covering health and drug related information and skills to all teaching and senior administrative personnel.
5. To promote the delivery of ongoing training to teachers and senior administrative personnel regarding health and drug related information and skills.

Recommendations

APSAD Recommends:

1. That school drug education be conducted within the health curriculum of schools and be taught by school based education personnel.
2. That school drug education and related activities be supported by school based policy, guidelines and activities which address substance related issues within a wider school and community context.
3. That the Health Promoting Schools concept be adopted as a comprehensive approach to addressing alcohol, tobacco and other drug use within schools and the wider community context.
4. That preservice training be provided to all teachers to enable school based staff to be well educated and skilled in addressing health and substance related issues both within the classroom and wider school environment.
5. That ongoing training be provided to teachers covering information and skills regarding health and drug related education and skills based learning opportunities.

References

1. National Drug Strategy Committee. National Drug Strategic Plan: 1993-1997, 1993. 
2. World Health Organisation. A European Alcohol Action. Regional Officer for Europe, 1992. 
3. Newcomb M, Maddahian E, Bentler P. 'Risk Factors for Drug Use Among Adolescents: Concurrent and longitudinal analyses'. Am J Pub Health 1986; 76:5.
4. Wallack L, Holder H. 'The Prevention of Alcohol-related Problems: A Systems Approach'. In Holder H (ed), Control Issues in Alcohol Abuse Prevention: Strategies for States and Communities, Advances in Substance Abuse: Behaviour and Biological Research, Supplement 1.
5. Macfarlane A. 'Health Promotion and Children and Teenagers: Why is mainly the government's responsibility'. British Medical Journal 1993: 306, 6870,81. In Chu C, Simpson R. Ecological Public Health: From Vision to Practice. Nathan: Griffith University, 1994. 
6. Chu C, Simpson R. Ecological Public Health: From Vision to Practice. Nathan: Griffith University, 1994. 
7. Chapman Walsh D, Elinson MS. Effectiveness of Measures to Prevent Alcohol-Related Problems; An Update. Medical and Occupational Disease Policy Branch, Ontario Workers' Compensation Board, 1992. 
8. Ogborne AC. 'School-Based Educational Programs to Prevent the Personal Use of Psychoactive Drugs for Non-Medical Purposes'. Australian Drug and Alcohol Review 1988; 7. 
9. Canada's Drug Strategy. How Effective are Alcohol and Other Drug Prevention and Treatment Programs: A Review of Evaluation Studies. Canada: Health and Welfare, 1992. 
10. Palin M. 'Is Classroom-based Drug Education a Waste of Time'. Connections 1992; May-June. 
11. Goodstadt M. 'Substance Abuse Curricula vs School Drug Policies'. Journal of School Health 1989; 59: 6. 
12. Wragg J. 'The Longitudinal Evaluation of a Primary School Drug Education Program: Did It Work'. Drug Education Journal of Australia 1990;4 :1. 
13. Woodcock J. 'Solvent Abuse from a Health Education Perspective'. Human Toxicology 1982;1. 
14. Moskowitz J, Schaps E, Schaeffer G, Malvin J. 'Evaluation of a Substance Prevention Program for Junior High School Students'. International Journal of the Addictions 1984; 19. 
15. Durrell J, Bukoski W. Preventing Substance Abuse: the State of the Art. Public Health Reports 1984; 99. 
16. Wright J, Pearl L. 'Knowledge and Experience of Young People of Drug Abuse'. Br Med J 1986; 292. 
17. Swadi H, Seitlin H. 'Drug Education to School Children: Does it really work'. Br J Addict 1987; 82.
18. Farrell S. Review of National Policy Measures to Prevent Alcohol Problems. Geneva: World Health Organization, 1985.
19. Reilly C, Homel P. Strategies for the Prevention of Drug and Alcohol Problems. Rozelle: Directorate of the Drug Offensive, NSW. Department of Health In House Report Series, 1988.
20. Coggans N, Shewan D, Henderson M, Davies JB. 'The Impact of School-Based Drug Education'. Br J Addict 1991; 86:9.
21. University of Canberra: Faculty of Education. Principles for Drug Education in School. A collaborative initiative of the States, the Territories and the Commonwealth of Australia, coordinated by the School Development in Health Education Project, 1994.
22. U.S. Department of Health and Human Services. Drug Abuse Prevention Intervention Research: Methodological Issues; NIDA Research Monograph 107, 1991.
23. Barnes, Z. A Critical and Comparative Review of the Prevention of Drug and Alcohol Abuse in Israel. J Drug Ed 1989; 19:1.
24. Kaltreider DL, St. Pierre TL. Beyond the Schools: Strategies for Implementing Successful Drug Prevention Programs in Community Youth-Serving Organisations. Journal of Drug Education 1995; 25:3.
25. Hawks D. 'Whistling in the Wind, or, Health Education as it is Usually Practised". Drug Education Journal of Australia 1991; 5:1.
26. O'Connor J, Saunders B. 'Drug Education: An appraisal of a popular preventive'. The International Journal of the Addictions 1992; 27:2.
27. Augustyn M, Simons-Morton BG. Adolescent Drinking and Driving; Etiology and Interpretation. Journal of Drug Education 1995; 25:1.
28. Commonwealth Department of Human Services and Health. Drug education: Do It (A curriculum profile). Australian Government Publishing Service, Canberra, 1996.
29. Commonwealth Department of Human Services and Health. Drug education: Do It Well (Teacher competencies). Australian Government Publishing Service, Canberra, 1996.
30. Commonwealth Department of Human Services and Health. Drug education: Do It Together (School and agency interaction). Australian Government Publishing Service, Canberra, 1966.
31. Commonwealth Department of Human Services and Health. Drug education: Do It Resourcefully (Selecting resources). Australian Government Publishing Service, Canberra, 1966.
32. Cameron C, McBride N. 'Promoting Health Promoting Schools: Lessons from the Western Australian School Health Project'. Health Promoting Journal of Australia 5: 1, 1995. 
33. World Health Organization. Ottawa Charter for Health Promotion, 1986.
34. National Health Strategy. Pathways to Better Health, Issues Paper No 7, 1993.