reflection paper on drug education

Drug Education and Prevention Essay

The issue of drug abuse has been a threat to many economies of the world. This has propelled governments and other community organizations worldwide to formulate ways of curbing this menace from all corners. Among the methods that are used are frank, positive futures and the national drug strategy.

While each of these has its own salient features, they all serve the common goal of educating the public about the risks involved in drug abuse and also the ways of avoiding becoming victims of drug abuse. Some governments and organizations have gone a step ahead and created rehabilitation centers that help those persons recovering from the abuse of drugs.

The extent to which each of the methods used is efficient varies. This is due to the limitation of the policy in rearing some areas of life. In this paper, the modalities that are followed by frank and those that are followed by the positive futures are measured against one another with an aim of comparing their effectiveness and coming up with appropriate recommendations for each.

For the purpose of the study, the information that is contained in the course material chilling out: the cultural politics of substance consumption, youth and drug policy by Blackman S. is heavily relied upon (Spring1 2010, 30).

The biggest questions that the book-chilling out poses are; the connection between politics of drug war and the prevention of drug abuse, popular culture and also the consumption of drugs. The book is critical of many methods that are used in curbing the crime of drug abuse.

The various policies that are in place concerning drug abuse are critically looked into and the loopholes that are present are brought out in clear. The book brings out the relevance of the main economy to the policies that are made concerning the issue of drug abuse. The book also criticizes the assumptions that the policy makers have made as some of them are unrealistic (Blackman 2003, 45).

The author furthermore tackles the moral obligation of the various stakeholders in the policy making and implementation of the education and prevention of drug abuse. The books main target of the book is the prevention of drug abuse.

Its main take is that if enough prevention measures are put in place, then the cases of drug abuse will be relatively lowered and thus the costs that are incurred in the rehabilitation of the drug addicts are effectively lowered (Spring1 2010, 23).

The effect of art in the course of tackling drug prevention and education is also brought out in the light. The author applauds the efforts that are being put in place by the musicians, media, and the cultural studies in helping the society to learn the dangers of drug abuse.

The policies that are being made in enhancing the artists in their endeavors are also tackled in this book. The book is recommendable to any study into the cases of drug abuse education and prevention (MacLean 2005, 10).

The frank method works in a friendly manner. Then name Frank in itself sounds like a name of some individual. On the contrary it is not. The name was coined out of the method that the campaign is carried out and so frank is a friend mainly of the youth he understands what they are going through and talks to the youth with a tone of understanding.

He talks of the issues that affect the livelihood of the youth and relates that to the drug abuse and comes up with a way of solving these problems. The drugs that are mainly targeted are Tobacco, Cannabis, Opiates, alcohol, Ecstasy, Cocaine and derivates, Amphetamines, Methamphetamines and Inhalants/ solvents.

The main target of the program is the youth between the age of 11 and 18 years. The program considers that the persons at this age will be better advised in making their decisions when they attain the age of majority -18 years. Te target facilitators of the program are the parents and professionals whose routine work involves dealing directly with the youth who fall in this age group.

The major theme in the program which is a government initiative is to create awareness among the youth about how much drug abuse can deteriorate the life of the drug user. The program has also been used as a platform through which the government and other persons who would wish to communicate with the young generation have been using. It has been used successfully in learning institutions at the community level and also at the national level at passing down the various government policies that affect the youth.

The method that is used in positive futures is quite different. While Frank shows the youth and other drug users the effects of drug abuse, positive futures focuses on the benefits of living a drug free life. Though both may sound to be similar they are not the same.

The main focus in positive future is to make the youth know how much it shall be profitable to their lives if they shall be able to detach themselves from rugs. This makes it hard for any persons who would wish to glorify drugs as he or she does not get a premise on which to table the motions.

The method that is a national activity involving the youth at the age of between 10 and 19 years has recorded a high reception both on the local and the national levels. It is worthy noting here that it is at this age that most persons are initiated to drug abuse. While those youth who live in less advantaged environments are recorded to get involved in drugs at the ages of 10 to 14 while the others in the society usually get involved when they are between 15 and 19 (Spring2 2010, 33).

In comparison, both methods are seen to targets the youth. This is the first assumption that has been evidenced in both the methods that it is the youth who are adversely affected by the abuse of drugs. On the contrary it has been proved that even persons at advanced ages have fell victim of drug abuse.

The craving for more caffeine, alcohol, nicotine and other abused drugs increases with the increased usage as opposed to the thinking that it reduces. Thus even though both the projects help in reducing the occurrence of drug abuse and addiction at the young age and thus on the future old age, the current drug abusers who are beyond the age bracket are left out of the programs.

The usage of modern technology is so evident in both the Frank method and positive future method. While old persons may be content with the old technology, the young persons are always innovative and usually ready to try out new developments in the market.

The fact the two programs run websites which are regularly updated and are in line with current technology; it is a major booster to the programs. This makes it even easier for the policy makers to receive information and feedback from the youth.

The networking of the program has also been made better by use of the new technology. The youth would rather identify themselves with the technology based sources and channel of communication that print media (Spring1 2010, 15).

In contrast, the programs tackle the same topic on different dimensions. The main aims of Frank program is to educate the youth on the dangers of getting involved in drug abuse while the main target of the positive future is to educate the youth on the advantages of living a drug free life.

Thus the activities that are undertaken in positive future are based more on the life skills that are vital in alienating the mind of a young person form having the mentality of drug abuse. The activities involve sports, investments, discussions and also interactions among others.

On the other hand the activities that are included in the Frank method bring out the issue of drug abuse as a vice. This has posed as a threat to the system at last where the victims are turned into heroes and heroines by the spectators.

The other major contrast of the two programs is the persons who are involved in the facilitation of the projects. Frank as stated earlier acts as a friend who is out to help his fellow friend. It is more of a passive voice that knows much about drugs. Thus the program mostly relies on their websites and youth to youth facilitation.

This is in line with the aim of maintaining the confidentiality of the person that is seeking the services of the system. On the other hand, positive future depends on the assistance of parents and other stakeholders in the running of its projects. Unlike Frank whose facilitators are the fellow youth, the facilitators in positive futures are parents and other professionals who are involved in the daily life of the youth (Spring2 2010, 25).

The attainment of a drug free future is the other common goal of the two programs. The target of the youth at their early stages is a clear evidence of this goal. The generation that crops out of these persons are thus prepared to take life positively as well as being educated on the dangers of living in drug abuse. Thus both the Frank projects and positive future projects give birth to a drug free society.

The response that has been received from the Frank method has accusations of false presentation of truth. Due the fact that the method is usually purposed to be friendly to the youth works on the negative as the policy makers are usually too lenient on the youth so that they may not loose the prey.

This leads them to presenting half truths and the result is that the youth end up having only half baked information. Thus the judgment that the person relying on this information makes is not fully informed. The ability of the system to be uplifted to a pint where truth can be told in black and white is rare since the system has to remain youth friendly.

From among the youth the feedback has been on the affirmative. In its first year only, the program recorded a very high number of visits at its official website and many calls. This number has been rising steadily as the days go by. The fact that the youth can be able to comment or even ask questions at a platform that they feel is secure for them has encouraged persons who have issues of drug abuse to come open and share their experiences.

The confidentiality is further enhanced in that the persons running the websites need not know the real person is the one who is been attended to. Some of the youth fearing to be disclosed use fictitious contacts like the email. Their main aim is to benefit from the program (Spring 2 2010, 14).

The magnitude of the youth who participate in the program has made even more trust it even though they were earlier conservative about the program. The youth have been passing the information about the program to one another. Also the use of parents, guidance and teachers as the facilitators of the program has been received in good faith and has made the number of beneficiates of the program to rise. Then parents have been sending the information about the programs through their own social networks that is different form the official websites that the program uses (Spring1 2010, 33).

The response that is received from the positive futures has been good with a record 59000 youth at the age of 10 to 16 attending positive future projects in 2009. This was a 65% rise from the number that attended the projects in the previous year from the same age bracket. While this was not evident at the early stages of the program the trend is changing and many more youth are expected to take part in future projects.

Apart from taking part in the projects, the participants have received both awards and experience in the activities that they have been engaged in the positive future projects. Some have even made up their minds to take up some of these activities as their career choice. This has been so common in the sporting activities where the participants have been reported to take professional sportsmanship after getting involved in positive future projects.

Blackman has been critical of the areas that are covered by the Frank initiative. According to Blackman, the measures to counter the issue of drug abuse should be a continuous process that involves education at early stages of life. Thus there should be introductory classes for persons below the age of 11 that the program covers. This is to create preparedness on the youth even before they are involved with other more involving projects at the age of 11.

This is also the case for the positive futures. The introductory lessons are missing in the project at early stages. This at some point affects some learners considering that the ability to absorb information varies. The persons with slow learning capability may thus feel disadvantaged as opposed to when introductions are done at early stages. More over there are activities that can involve the persons at lower age groups.

The contribution that chilling out makes in the fight against drug abuse is however priceless. The book tackles the issue of art as a way of dealing with the cases of drug abuse. As we have seen, the above two and many other programs are targeted towards the youth since they are the most affected.

Similarly, the youth have a better taste for art than any other group. This qualifies the use of music, and other literal means in reaching out to the persons whom the information about drug abuse education and prevention is intended. This is part of the activities that positive future uses in its education projects. Like sports, the field of art has recorded a good number of persons who after passing through the projects decide to take as a career (Smart, 2005, 32).

For any of the programs to be sufficiently effective, it should have legality. This is an issue that Blackman does not leave out. He calls upon the government to make legislation that encourages the education and prevention programs. Both Frank and positive future programs have had legislation that help them in achieving both their short term and also long term goals. The availability of these laws assist and also guide the policy makers in coming up with projects that are legal and keeps them in the safe side of the law (Blackman 2003, 70).

In conclusion, the two programs can be termed effective each on its own way. The concurrent implementation of both projects has been praised by many persons as being counter productive in that the persons who fail the target of Frank method are easily captured in the positive future programs.

Recommendations are however made for the projects to cover even the victims of drug abuse who fall above the age groups that are represented by the two programs. Even though the government has other programs that cater for the persons in those age groups, the productivity of Frank and positive future programs has been rated so high in consideration.

This recommendation is made considering that the cut-off of the target group is at the age when most youth start to be engaged in income generating activities. This makes them vulnerable to many pleasures with drug abuse being one of them.

Blackman, S. 2003. Chilling Out: The Cultural Politics of Substance Consumption, Youth and Drug Policy . London. Amazon.

MacLean, S. 2006. Book review: Chilling Out: The Cultural Politics of Substance Consumption, Youth and Drug Policy . London. Amazon.

Smart, R. 2005. Book Review. Chilling Out: The Cultural Politics of Substance Consumption, Youth and Drug Policy . London: Amazon.

Spring. 2010. Models and Methods of Drug Education 1: Drug Prevention through Social Marketing . Manchester.

Spring. 2010. Models and Methods of Drug Education 2: Youth Development and ‘Diversionary Activities’ . Manchester.

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Article Contents

Introduction.

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Drug education practice: results of an observational study

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William B. Hansen, Ralph B. McNeal, Drug education practice: results of an observational study, Health Education Research , Volume 14, Issue 1, February 1999, Pages 85–97, https://doi.org/10.1093/her/14.1.85

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Understanding normative practice in drug education is a key to identifying means of improving preventive intervention outcomes. In this paper, we report findings of an observational study in which drug education in multiple periods of 146 middle school classes was categorized minute-by-minute according to the type of instruction provided to students. Results indicate that nearly half of all drug education focused on providing students with knowledge. Alternative methods, particularly those that have shown programmatic effectiveness, and those that address risk and protective factors known to be highly predictive of drug use onset, were relatively ignored. Further, teachers showed relatively low consistency in understanding concepts other than knowledge based on comparisons of their ratings of intended instructions with those of trained observers. Nonetheless, there is evidence that some teachers systematically attempted to address drug prevention from either a social influence or an affective education perspective. These findings suggest that if improvements in the effectiveness of drug education are to be seen in the future, a relatively radical transformation of approaches to teaching will be needed.

In 1987, the US Congress passed the Omnibus Anti-Drug Act. This significant public investment was intended to solve the nation's drug problems through interdiction, intervention, treatment and prevention. The Drug-Free Schools and Communities program provided funds that were intended to foster effective prevention in schools. Unfortunately, recent data ( Johnston et al. , 1996 ) indicate that drug use among teens is on the rise, suggesting that educational efforts have been ineffective. However, it must be remembered that specific programs and instructional approaches remain unevaluated. Even though there have been significant advances in our understanding of what constitutes effective prevention programs ( Hansen, 1992 ; Tobler, 1994 ), research on the normative practices of teachers who have been given the responsibility for completing drug education is lacking.

This paper presents findings of a recent research project that was designed to assess the normative practices of middle school teachers. Because of the overall failure of initial efforts to produce long-term changes in drug use, standard practices must now be dramatically improved. Models are clearly needed to bolster confidence that effective preventive practices can be identified, adopted, implemented, confirmed and sustained. Truly effective drug abuse prevention methods which are adopted and maintained at a significant level should be expected to meaningfully suppress all measures of drug prevalence.

A growing body of research has focused on the efficacy and effectiveness of specific programs ( Tobler, 1986 ; Bangert-Drowns, 1988 ; Hansen, 1992 ; Dusenbury and Falco, 1995 ; Tobler and Stratton, 1998 ). Much of this literature has focused on evaluating the effectiveness of research-generated programs. Less attention has been paid to commercially marketed programs ( Hopkins et al. , 1987 ) and, in contrast to both research-generated and commercial programs, normative prevention practice has not been intensively studied.

The ability of programs to reduce the onset of drug experimentation has increased as models that target mediating processes that account for drug use have been developed and refined ( MacKinnon et al. , 1991 ). It is now widely accepted that programs produce their effects by changing risk or protective factors that account for drug use ( Hawkins et al. , 1992 ; Hansen and McNeal, 1996 ). One likely reason for failure may be that programs rely on strategies that have little chance for success by virtue of the fact that they either do not target appropriate mediating mechanisms or fail to have sufficient impact on correctly targeted mediators ( Hansen and McNeal, 1997 ).

Hawkins et al . (1992) discuss several risk and protective factors that education may address. Important risk factors that might be the target of education include building appropriate normative beliefs and developing appropriate attitudes toward drug use. Bonding to prosocial institutions may be of equal importance as a mediator that might be successfully targeted by intervention ( Hawkins et al. , 1992 ). Programs that have addressed mediating variables that statistically account for changes in behavior have shown promise ( Botvin et al. , 1990 ; MacKinnon et al. , 1991 ; MacKinnon and Dwyer, 1993 ).

The adoption of research-generated methods frequently lags behind the research that has produced those methods. In the case of drug education practice there is not yet evidence that findings widely published in the research literature have produced any significant shift in practice. One reason for this may be that decision makers are simply uninformed about effective methods. It is possible that there are competing interests which may serve as serious barriers to the adoption and implementation of effective programs. For example, Perhats et al . (1996) found that those who have the most say in deciding about policies and practices regarding drug education are the least likely to be informed about methods for achieving program efficacy. Without appropriate administrative support, effective programs are not likely to be adopted.

It is likely that teaching as practiced will follow overall trends in what has been emphasized in drug education. Meta-analyses of research-based programs suggest that programs cluster into knowledge, social influence and affective approaches ( Hansen, 1992 ; Tobler, 1994 ). It is quite possible that the selection of programmatic approaches is likely to be limited by the paradigm of the user. To date, however, there is no empirical evidence that teachers adopt a specific paradigm when they select program approaches.

Research is needed to understand how drug education is practiced. Understanding normative practices is an important first step toward developing and implementing effective programs. Studies conducted to date have relied solely on teacher and administrator self-report to determine the standards of practice ( Bosworth and Cueto, 1994 ). This study used trained observers to assess educational practice and addressed three questions. First, what evidence exists that concepts driving effective prevention practices are understood by teachers who are called on to deliver drug education curricula? Second, what programmatic content do teachers typically address in drug education? Third, what styles of drug education are observed in teaching?

Subjects and setting

Teachers in 12 middle schools in Forsyth County were solicited to participate in this study. All teachers who taught drug education were invited to inform project staff about planned drug education. Project staff encouraged teachers through direct appeals and through the establishment of paid coordinators at each site to participate. Teachers who volunteered were offered a $5 incentive for each class of drug education that project staff were allowed to observe.

Project staff were scheduled to visit teachers' classrooms based on the communication of future plans to teach drug education. Classrooms were identified by school, course and section number. In combination with the date, this created a unique identification number that was used to identify each observed class.

Staff were instructed to occupy a place in the back of the classroom. Staff were briefly introduced to students by the teacher if they were visiting for the first time. Their presence was explained as being in class to observe that day's teaching. In as much as possible, staff were to not interact with the teacher or the students.

During their visits, staff completed three forms for each classroom that was observed. The first form required staff to judge which of 12 concepts postulated to serve as drug-prevention mediators ( Hansen, 1992 ) were addressed in teaching on a minute-by-minute basis. Teaching was categorized into the following: norm setting, commitment building, values clarification, knowledge (beliefs about consequences and facts about drugs), resistance skills training, self-esteem building, goal-setting skills training, decision skills training, alternatives, stress management training, assistance skills training and social skills training. A separate category was provided if teaching addressed drug-related topics that fit with none of these concepts. Observers were encouraged to categorize instruction into at least one category if possible. Observers had the option of marking multiple categories of instruction if this reflected the teaching that occurred during that minute. There was also an option to note that no drug education of any sort was observed. Prior to participating in observations, project staff were trained in characteristics that defined each of the 12 concepts and how forms were to be completed. This form also required staff to note every 5 min which substances had been discussed during that 5 min period. Substances that were listed included alcohol, tobacco, marijuana, cocaine, heroin (opiates), inhalants, amphetamines, hallucinogens, steroids and other drugs.

The second form requested staff to make written comments, and a qualitative description of teaching and class activities. This form was completed concurrently with the rating form. This form was used as a memory aid in post-session debriefings about observations.

The final form required staff to make overall judgments about which content areas had been addressed during the class. This form required observers to rank the overall emphasis placed on each concept. Mediators that were addressed were ranked. Mediators that were not addressed were left blank. For analysis purposes, ranked categories were also scored as 1's and non-ranked categories were scored as 0's.

After each class, staff asked teachers to complete the third form and provide an overall assessment of what content areas they believed they had addressed in teaching. Teacher ratings were completed independently. Brief descriptions (operational definitions) of the meaning of each content area were available to teachers if they requested them. The teacher overall form and the staff overall form were identical in structure.

As often as resources would permit, staff were sent in pairs. Paired observations were completed without communication between staff except for coordinating time and identifying information. Upon completion of the observation, paired observers worked together to complete consensus minute-by-minute and overall forms. Individual forms were not changed retrospectively.

Observational database

During the 1992–93 and 1993–94 school years, a total of 1839 class sessions were observed. The frequency of observation varied greatly across teachers. The data include several teachers whose entire sequence of drug education was observed as well as teachers who were observed sporadically and infrequently. To remove any distortion in the findings due to over-representation of the more frequently observed teachers, observations were averaged by class period. After aggregation, the number of unique class periods totaled 232 (69 in 1992–93 and 163 in 1993–94). Of these, 86 class periods were deleted because the data collection was undertaken in large school-wide or grade-wide assemblies. The primary analysis reported in this manuscript represents these 146 class periods.

It should be noted that few sessions observed consisted of the delivery of a program in the sense that prevention researchers use this term. In one school, the middle school version of DARE was observed. However, in nearly every other case, the lessons taught had either been invented by teachers or had been liberally adapted from source materials. Other than traditional health textbooks, there were no standardized materials available to teachers from the district. There was also no standardization imposed by the district on what or how teachers could teach. Indeed, most of them had no knowledge of any official plan or curriculum from which they were expected to teach. Thus, the observed sessions represent what is likely to be observed when drug education is promoted but not managed or directed.

Agreement about observed constructs

We were able to observe 2828 min of instruction in which two data collectors both recorded ratings about the concepts taught in drug education. In addition, there were 981 class sections in which the data collector and teacher both provided overall rankings of program content. Table I presents κ coefficients for the paired observer–observer minute-by-minute categorizations, the paired observer–observer overall categorizations (from dichotomous scoring) and the observer–teacher overall categorizations.

There was good overall agreement between observers in analyses of both the paired observer–observer minute-by-minute categorizations (average κ = 0.870) and the paired observer–observer overall categorizations (average κ = 0.869). There was perfect agreement for teaching that addressed building commitments. However, this is based on only 4 min of teaching about commitment. Other agreement scores were generally based on more observed minutes of teaching that addressed each topic. High in general agreement among observers were ratings of teaching that addressed goal-setting training, stress management training, the dissemination of facts about drugs and the consequences of drug use, and teaching that was intended to build self-esteem. The lowest agreement using the minute-by-minute ratings was observed for instruction that involved values clarification, normative education, and training in how to get and give assistance. The latter category had relatively good agreement when viewed as an overall focus of instruction as did values clarification; none of the minute-by-minute κ coefficients were below 0.750. Normative education received the lowest agreement on the overall form (0.725). Except agreement about decision making (0.790), all other coefficients were above 0.800. These findings indicate good agreement among observers.

In contrast to the observer–observer findings, the observer–teacher results about teaching content revealed an overall pattern of low agreement. The highest agreement was seen for teaching stress management skills, teaching about self-esteem, and giving information about drugs and the consequences of drug use. The lowest agreement was observed for teaching that stressed normative education, building commitment, teaching skills for getting and giving assistance, teaching about alternatives, teaching social skills, and teaching values clarification. The discrepancy between observer–observer agreement and observer–teacher agreement suggests that teachers often did not understand the concepts or the words and descriptions commonly associated with concepts that have been the focus of drug education.

Teaching emphasis by program content

We examined the distribution of effort given to each of the 12 drug-prevention concept areas. Three sets of analyses were completed. The first analysis assessed whether there had been any occurrence of a topic during the observations of any class. Thus, in classes that were observed on multiple occasions, any single occurrence of the concept would cause students in that class to be classified as having been exposed to the concept. In essence, this analysis describes the likelihood of students in any observed class ever having been exposed to a given concept. The second analysis assessed the total overall time devoted to addressing each content area. This number includes all observed minutes as its denominator. Thus, the result represents the percentage of time spent on each concept averaged across all class periods. This analysis describes the typical exposure to each concept that classes of students received. The final analysis represents a measure of intensity. If a given topic had been noted during any given observation, this analysis reflects the relative amount of time that was devoted to that topic during class sessions in which it was observed.

As can be seen in Table II , instruction that addressed knowledge about drugs and the consequences of drug use was the single most common component of drug education for all three analyses. Some level of knowledge focused intervention was seen in nearly all observed classes. On average, knowledge was the focus of drug education 45.9% of the time. Overall, the time on task devoted to programming designed to enhance knowledge comprised nearly half of all drug education that was observed. This was clearly the emphasis of most drug education. In some classes, drug education was nearly all devoted to teaching knowledge. For example, in one class unit, 95% of all observed time was focused on teaching about facts related to drugs and drug use consequences.

Resistance skills training programs were the next most commonly observed program elements. Some form of resistance skill training was noted in four of every five observed classes. While this represents a relatively frequent mention of this topic, resistance skills training accounted for only 8.2% of all drug education teaching time. Even in sessions in which resistance training was observed, it accounted for less than 10% of the total teaching time. Thus, while resistance training was observed relatively frequently, when it occurred it was of brief duration and low intensity. However, it should be noted that there was variability among classes. In one class, for instance, resistance skills training accounted for 53.3% of all observed drug education.

The next most commonly observed drug education strategy (defined by whether or not students were ever exposed to instruction in this topic) was assistance skills training. Approximately two-thirds of classes were exposed to some mention of getting or giving assistance. It is apparent from the extremely low percent of time devoted to this topic, however, that teachers focused on this concept almost in passing. This mostly consisted simply of admonishing students to get help if they develop a drug problem or give help if they know of someone else who has a drug problem. Similar findings were observed for values clarification and norm-setting methods. There appeared to be some exposure to the concept in the majority of classes. However, the amount of time spent on each topic and the intensity of instruction when the topic emerged was minimal at best. Indeed, the most intensely involved class that addressed norm setting spent only 25% of time addressing this topic.

Programming designed to build self-esteem was noted in about half of the observed classes. Overall, self-esteem building activities received less than 10% of the attention given to drug education. When addressed, self-esteem activities consumed just more than 10% of the class time. However, it should be noted that this was the second most intensively covered topic observed. That is, when teachers addressed self-esteem issues, they focused a relatively considerable effort to addressing self-esteem-related activities. As with resistance skills training, classes and schools differed in the extent of inclusion of self-esteem; the class that emphasized self-esteem enhancement the most devoted 62.1% of drug education time to this topic.

Social skills development training activities were observed in about half of the classes. Overall, social skills training accounted for just less than 3% of the time that was observed. Even when it was a part of the focus of class instruction, it was not addressed with meaningful intensely. However, in one class, social skills development accounted for 46.7% of the total time that was devoted to drug education.

Decision-making skills training activities were not observed frequently, with decision-making training being included in a third of all classes. Overall, not much time was given to teaching decision-making skills. However, when decision-making training was observed, it occupied a relatively important niche, being the fourth most intensely taught subject. Indeed, one class focused 85.8% of their total time to decision-making training.

Teaching students to manage stress and set goals, and encouraging students to think about alternatives to drug use and make personal commitments to not use substances was observed only rarely. Like decision-making training, stress management training was relatively intense when it occurred, being the third most intensely taught subject when it was included. Nonetheless, overall, these strategies account for very little of the drug education we observed.

Teaching emphasis by target drug

Drug use was analyzed in a similar fashion to concepts, with three analyses performed for each observed substance. Unlike concepts that were rated minute-by-minute, drug use was rated every 5 min. Therefore the denominator in each case reflected a 5 min block.

Alcohol was the most frequently discussed substance in drug education classes, being discussed in nearly all observed classes (see Table III ). Overall, alcohol was the focus of instruction just less than half of the time.

Tobacco, marijuana and cocaine were next most frequently discussed. All were very similar in the frequency with which they were included. Most drug education classes sooner or later addressed these drugs. However, they were much less likely than alcohol to be the focus of education, being given less overall attention when discussed and being dealt with less intensely than alcohol. Still, significant attention was given to each of these substances, reflecting a relatively high inclusion of drug-specific content in education.

The majority of classes were exposed to instruction that addressed hallucinogens, heroin, inhalants and amphetamines. However, much less time was spent discussing these substances. Not only were these substances mentioned in fewer observations, they tended to be given less attention when they were included. On average, these substances were all included in instruction about 10% of the time or less.

Anabolic steroids used illicitly for building muscle mass were included only rarely. When included, they were not the focus of discussion. Overall, there was very little emphasis on this topic of substance use.

Teaching approaches

The pattern of focus on the different drugs that constitute society's concern is, in many respects, what might be expected for drug education. There was a heavy emphasis on alcohol, tobacco, marijuana and cocaine, with less emphasis on other drugs. Similarly, the heavy emphasis on communicating basic knowledge about drugs and their effects is also not surprising. However, there are interesting differences in approaches to teaching that simply noting the frequency and intensity of instruction do not capture.

The variability observed among classes in their emphasis on both constructs and substances suggested that there may be several patterns of teaching related to drug use that might be definable through factor analysis. Our approach to analysis was to include the 13 concept variables and nine drug variables in a principal components factor analysis using a Varimax rotation procedure. Table IV presents our findings. Our experience with factor analysis in the past is that with 22 variables, the analysis could reasonably be expected to result in a relatively few number of factors (three or four). This should be especially true given the degree to which the variables are theoretically related to each other and the underlying process. However, our analysis yielded eight factors with eigenvalues greater than 1.0; the scree plot indicated that there were only five salient factors. Therefore, we present the loadings for these five factors. Factors not presented in tabular form include loadings for resistance skills and assistance skills, decision skills, and alternatives.

The factors that emerge identify distinctive approaches of teaching about drugs. The first factor included an emphasis in teaching about cocaine, heroin and marijuana, and stressed disseminating knowledge about drugs and their consequences. Thus, those who concentrate on knowledge also tend to focus on a specific set of illicit hard drugs. The loadings for inhalants, steroids, amphetamines, hallucinogens, alcohol and tobacco do not suggest these topics are specifically avoided; they are just not emphasized. Depending on the teacher, this suggests these other drugs may or may not be discussed. The core set of items for this approach of drug education teaching is to focus on cocaine, heroin and marijuana—drugs that have relatively high visibility as being illicit.

The second factor included teaching that focused on inhalants, steroids, amphetamines and hallucinogens. No conceptual issues from our set of 12 mediator-focused teaching methods was associated with this form of instruction. This suggests that teachers who emphasized these substances used multiple approaches to address this topic. Clearly, simply providing knowledge was not the only strategy employed.

The third factor included an emphasis on teaching about alcohol and tobacco. Programs that emphasized these most common and legal substances tended to emphasize norm-setting methods. The negative loadings on self-esteem and social skills training suggests that this teaching approach not only emphasizes alcohol and tobacco from a largely normative perspective, but that self-esteem and social skills were specifically avoided.

Stress management, goal-setting training and values clarification approaches made up the fourth factor. This factor includes methods that have been associated with affective education in the past. Self-esteem, often thought of as the quintessential affective education component, loaded on this factor, but not with sufficient strength to allow us to identify it as an element of teachers who use this approach.

The final factor included teaching that attempted to build commitment as well as our eclectic other category. The inclusion of commitment is easiest to interpret. However, this suggests that there may be more active approaches to drug education than prior research suggests.

The fact that teaching about how to give and get assistance, resistance skills training, decision-making training, and alternative training did not load on one specific factor suggests that these methods may have actually been used randomly in combination with other methods and may have been applied at random to substances. Resistance skills training was somewhat associated with the norm-setting (not self-esteem or social skills training) factor, although the association was not strong.

Conceptual understanding

Results of this project provide clear insights to the field about how drug education is normally practiced. Researchers and program developers have given significant effort to creating a diverse repertoire of strategies for preventing drug use through education. Drug education as practiced, however, appears to be faced with many challenges. First and foremost among these appears to be a general lack of understanding about the concepts that serve as a basis for existing drug-prevention approaches. There was high agreement among trained observers about the implementation of the 12 approaches we were scheduled to observe. Teachers in the field, in contrast, demonstrated low agreement with observers about the teaching strategy they employed. Teachers have often been trained in very different methods than those employed in drug education and such differences are to be understood rather than criticized. The discrepancy in understanding, however, does serve as a potential barrier to the adoption and delivery of effective drug education. In addition to providing teachers with better programs, a major emphasis may be needed to train teachers in the concepts that underlie prevention approaches. Of particular importance may be training that helps teachers distinguish from among approaches that may, at this point in time, seem very similar on both intent and method. Even though the 12 terms were understood at some level by the teachers we observed, it is likely that the terms themselves require extensive further elaboration to make them understandable.

Strategy focus

We observed that drug education is focused primarily on one strategy—teaching students what drugs are and what the potential consequences of use will be. Indeed, in terms of the overall time spent and focus of instruction when addressed, teaching about drug use facts and consequences occupies nearly half of what was observed as drug education. It should be noted from the descriptions captured during observation that most of this education focused on health consequences associated with drug use. Data exist that do suggest perceived harm is correlated with the prevalence of drug use ( Bachman et al. , 1988 ). However, it is not clear that beliefs about health consequences predict the onset of drug use ( Hansen et al. , 1993 ). It is more likely that beliefs about health consequences are adopted after behavior has been initiated reflecting adjustments predicted by classical social psychological theories that predict adjustments in beliefs to reduce cognitive dissonance ( Festinger, 1957 ).

Several of the remaining strategies, notably resistance skills training, training in getting and giving assistance, values clarification, and norm setting, were touched upon by a majority of teachers in their classes. However, in contrast to knowledge, these approaches received slight attention. Resistance skills training—teaching students to identify and resist peer and other social pressures to use drugs—became a popular focus of drug education on a national scale during the 1980s. This strategies has been the focal element of many of the research-based efforts that have been shown to be effective ( Hansen et al. , 1988 ; Botvin et al. , 1990 ) Yet, even with its popularity, less than 10% of instruction we observed directly addressed this strategy.

Other analyses completed as part of this project have demonstrated that the mediators most likely to have a payoff in instruction include such approaches as norm setting, commitment building and values clarification ( McNeal and Hansen, 1995 ; Hansen, 1996a , b ; Hansen and McNeal, 1997 ; Hansen et al ., unpublished). Collectively, these three approaches accounted for only 4.6% of the overall drug education time observed. Based on the assumption that time on task is expected to be an important marker of the potential of programs to alter mediating variables that account for drug use, there is little hope for drug education as practiced to achieve its overall goal—the reduction of drug use prevalence. To the extent that these findings are typical of other school systems, it is no wonder that drug education efforts have not been effective at stemming the recent increase in drug use ( Johnston et al. , 1996 ).

There was a trend among all strategies, other than knowledge, for instruction to be relatively brief. In class periods in which these other strategies were observed, the time on task given to the topic averaged less than 10%. The one exception to this was for instruction about self-esteem. However, even here, attention to the topic was not intense, averaging 12.8% in those sessions we observed. In a 45 min class period, this means that when self-esteem was addressed by a teacher, on average less than 6 min was devoted to the topic. It is likely that teachers who tried other-than-knowledge methods were well intended, but that they lacked programmatic resources that would allow them to implement the approaches they desired to the depth needed to create changes in postulated mediators. That is, once many teachers got beyond the initial steps associated with a novel method of drug education, they may have simply run out of resources and fell back to addressing knowledge-based subjects. Simply having the appropriate concept in mind may be insufficient without an extensive arsenal of methods that can effectively be used to address that concept.

Substance focus

Teachers tended to emphasize gateway drugs in their instruction. Alcohol was almost universally included in classes we observed and was mentioned in nearly half of all 5 min time periods we observed. Tobacco and marijuana was included by many teachers in their instruction, but occupied less time in class. Forsyth County is the home of R. J. Reynolds Tobacco Company. Tobacco may have been discussed less frequently in drug education in local schools than might otherwise be expected because of this company's presence.

Cocaine was discussed about 20% of the time. Prevalence studies show that cocaine use is actually quite low among students ( Johnston et al. , 1996 ). In Forsyth County, the prevalence of lifetime cocaine use among high school seniors has been around 7%. Students are more likely to use amphetamines and inhalants. The fact that cocaine may be discussed more than these other substances may reflect both the coverage of cocaine in the media as well as a lack of understanding about gateway processes and prevalence estimates. It is not necessarily the case that less attention should be given to cocaine. However, given the recent increase in inhalant use ( Edwards, 1993 ; Hansen and Rose, 1995 ) and meth-amphetamine use ( Johnston et al. , 1996 ), it may be wise to encourage drug education that includes a stronger emphasis on these drugs.

Teaching approach

The general findings discussed above need to be tempered by the fact that there was significant variation from teacher to teacher in the specific sets of strategies and substances they discussed. We found that there were several distinctive approaches to drug education that teachers tended to take. Based on the factor analysis summarized in Table IV , there were some teachers (Factor 1) who tended to gave extra attention to illicit drugs—cocaine, heroin and marijuana. These teachers also tended to give greater than normal attention to teaching about drug facts and consequences. There was a subset of teachers (Factor 2) who paid attention to less frequently mentioned drugs—inhalants, steroids, amphetamines and hallucinogens. These teachers did not seem to have a preferred strategy for teaching, although there was a slight de-emphasis on norm setting. It is possible that these teachers were simply more aware of or interested in the diversity of substances that might be addressed in instruction and that they adjusted their teaching to accommodate this awareness.

One group of teachers (Factor 3) tended be those who were most likely to emphasize alcohol and tobacco, the gateway substances most prevalent among the target age group. These teachers placed increased emphasis on norm-setting methods. Such methods often point out the discrepancy between estimated and actual prevalence of substance use ( Sussman et al. , 1988 ; Hansen and Graham, 1991 ). There may also be an attempt to focus attention on social acceptability ( Hansen, 1996b ). It is of interest that teachers who adopted this approach tended to de-emphasize self-esteem instruction and social skills training. Thus, this approach to teaching not only reflects a heightened reliance on one specific method, but the avoidance of other methods. It is worth noting that these teachers also tended to evidence a slight increase in emphasis in the teaching about resistance skills (0.38), drug use facts and consequences (0.31), and included marijuana slightly more often (0.25). This pattern of findings suggests that these teachers have adopted either programs or philosophies that are based on a rationale that goes beyond intuitive thinking that appears to be common with much of the drug education that is practiced. This group was most closely aligned to what has been suggested based on drug-prevention research.

One set of teachers (Factor 4) placed a great deal of emphasis on stress management, goal setting and values clarification. These topics are common to an approach of drug education known as `affective education'. It is interesting that the next largest positive loading observed on this factor was for self-esteem (0.35). It is also interesting that there was a slight negative loading on this factor for teaching about drug use and its consequences (–0.36). This pattern of values all fit with the affective education approach and provides evidence that there are teachers who are actively and systematically attempting to utilize this approach in prevention. In light of this, it is interesting that teaching decision-making skills did not load on the factor (0.00). Perhaps decision skills training is associated with multiple methods and is not viewed as an exclusive method associated with affective education.

The final factor we observed (Factor 5) included teaching that addressed building commitment to avoid drug use as well as the group of methods that were not categorized a priori . It is not surprising that there are drug education methods other than those listed that have emerged as part of drug education. It is of interest that these approaches loaded with building commitment. Our method was to include any teaching method that did not fit within the 12 predefined concepts into this category. Therefore, these other methods are not expected to reflect a singular strategy. However, it is possible that one specific, as yet unidentified approach was commonly observed. These data may reflect instances of this approach. Given that there was a high association between the other category and building commitment, it may be that one approach to drug education focuses on building personal responsibility, a recent theme of character education which has become popular with teachers ( Lickona, 1991 ).

Understanding the approaches to drug education that teachers adopt may be helpful to the field. Knowing that teachers tend to approach drug education from different perspectives (knowledge, social influence process, affective education process and character education process) may assist program trainers. Training to state-of-the-art strategies requires both changes in conceptual understanding and methods. Trainers can expect resistance to both if a paradigm other than what is being trained to has been adopted. For example, teaching about social influence process concepts to teachers who come from a primarily knowledge or affective education focus may need to be specifically designed to overcome or transform an allegiance to these other paradigms. Thus, teachers may need to unlearn as much as they may need to learn. Such training can be expected to be considerably more difficult than has been anticipated in the past.

Perhaps one method that might be explored might be to develop a pre-test measure of what teachers view as their adopted method of instruction, including an assessment of the role they are to play as teachers. Not only will teachers apparently tend to identify with one approach or another, it is likely that there will be variability among teachers' strength of affiliation. Teachers who are less vested in alternative approaches or who are highly vested in the approach that matches proposed training might be systematically selected to participate above teachers who are most heavily vested in approaches that may be in conflict with new training.

We postulate that approaches to teaching drug education are primarily the result of past efforts and practices. That is, what has become known as affective education (stress management training, goal-setting training, values clarification and, to some extent, self-esteem building) has emerged because program designers have created programs and training that reflects this specific combination of concepts. Similarly, the social influence approach has traditionally come to include resistance skills training, norm setting and teaching about short-term health consequences. Other patterns may emerge in the future based on how program developers design programs and how widely those approaches are disseminated. Thus, even though the factor structure we observed is instructive, it reflects rather than defines practice. If more effective approaches that combine different concepts are developed and adopted, the factor structure observed might be expected to change.

Policy implications

Throughout the field of drug education, success hinges on the confluence of three attributes, access to appropriate information, selection of materials, and quality of teaching and implementation. This study, because of its observational nature, does not speak directly to the larger issues decision makers must address as they consider how drug education can be improved. Nonetheless, the overall implication of these findings is that the selection of program materials and implementation of interventions all need improvement. There is also a likely need for access to relevant information. Methods for achieving improvements in all three areas are needed.

Several recent publications ( Dusenbury and Falco, 1995 ; NIDA, 1997 ) have outlined principles that underlie drug abuse prevention program effectiveness. There may be examples of schools that do well either because they have adopted and effectively implemented programs or because they have created their own programs that embody these principles. We expect these schools to be the exception rather than the rule. In contrast, we expect most schools to be similar to those we observed. The gap between recommended and actual practice is large, and will require significant effort and resources to bridge.

There is now evidence that national and state agencies are actively promoting consideration of science-based and research-based programs. It is not yet known whether this will result in an increase in the adoption of researched and evaluated programs. It is further not know whether this policy change will increase the quality of teaching and increase focus on changing mediators that account for drug use onset. Practitioners and policy makers alike must face, understand and address this challenge. Researchers should investigate the outcomes that any such changes in policy produce.

In conclusion, normative drug education practice needs to be understood as part of a national effort to improve the effectiveness of drug education. Results of this study suggest that significant effort has been expended on behalf of drug education. Future efforts should focus on: (1) increasing teachers' conceptual understanding of concepts relevant to drug use prevention, (2) increasing teachers' understanding about the distribution of drug use behavior and the normal pattern of drug use onset and experimentation, (3) increasing training effectiveness for building an allegiance to research-based strategies for prevention, and (4) training specifically geared to emphasize the execution of methods associated with changing mediating variables associated with drug use including the large-scale adoption of proven research-based programs.

Agreement ( κ coefficients) in ratings of program content between paired observers and between observers and teachers

Average observed emphasis of drug education using three methods of assessing exposure

Average percent of time when specific substances were the target of drug education

Rotated factor pattern associated with overall time spent on various drug education constructs and focus drugs

This research was supported in part by a grant from the National Institute on Drug Abuse, grant no. 1-R01-DA07030.

Bachman, J. G., Johnston, L. D., O'Malley, P. M. and Humphrey, R. H. ( 1988 ) Explaining the recent decline in marijuana use: differentiating the effects of perceived risks, disapproval, and general lifestyle factors. Journal of Health and Social Behavior , 29 , 92 –112.

Bangert-Drowns, R. L. ( 1988 ) The effects of school-based substance abuse education—a meta-analysis. Journal of Drug Education , 18 , 243 –264.

Bosworth, K. and Cueto, S. ( 1994 ) Drug abuse prevention curricula in public and private schools in Indiana. Journal of Drug Education , 24 , 21 –31.

Botvin, G. J., Baker, E., Dusenbury, L., Tortu, S. and Botvin, E. M. ( 1990 ) Preventing adolescent drug abuse through a multimodal cognitive-behavioral approach: results of a 3-year study. Journal of Consulting and Clinical Psychology , 58 , 437 –446.

Dusenbury, L. and Falco, M. ( 1995 ) Eleven components of effective drug abuse prevention curricula. Journal of School Health , 65 , 420 –425.

Edwards R. W. ( 1993 ) Drug use among 8th grade students is increasing. International Journal of the Addictions , 28 , 1621 –1623.

Festinger, L. (1957) A Theory of Cognitive Dissonance . Row, Peterson, Evanston, IL.

Hansen, W. B. ( 1992 ) School-based substance abuse prevention: a review of the state of the art curriculum 1980–1990. Health Education Research , 7 , 403 –430.

Hansen, W. B. ( 1996 ) Aproximaciones psicosociales a la preventión: el uso de las investigaciones epidemiológicas y etiológicas para el desarrollo de intervenciones efectivas (Psychosocial approaches to prevention: using epidemiology and etiology research to develop strategies to develop effective interventions). Psicologia Conductual , 3 , 357 –378.

Hansen, W. B. ( 1996 ) Pilot test results comparing the All Stars program with seventh grade DARE: program integrity and mediating variable analysis. Substance Use and Misuse , 31 , 1359 –1377.

Hansen, W. B. and Graham, J. W. ( 1991 ) Preventing alcohol, marijuana, and cigarette use among adolescents: peer pressure resistance training vs. establishing conservative norms. Preventive Medicine , 20 , 414 –430.

Hansen, W. B. and McNeal, R. B. ( 1996 ) The law of maximum expected potential effect: constraints placed on program effectiveness by mediator relationships. Health Education Research , 11 , 501 –507.

Hansen, W. B. and McNeal, R. B. ( 1997 ) How DARE works: an examination of program effects on mediating variables. Health Education and Behavior , 24 , 165 –176.

Hansen, W. B. and Rose, L. A. ( 1995 ) Recreational use of inhalant drugs by adolescents: a challenge for family physicians. Family Medicine , 27 , 383 –387.

Hansen, W. B., Johnson, C. A., Flay, B. R., Graham, J. W. and Sobel, J. L. ( 1988 ) Affective and social influences approaches to the prevention of multiple substance abuse among seventh grade students: results from Project SMART. Preventive Medicine , 17 , 1 –20.

Hansen, W. B., Rose, L. A. and Dryfoos, J. G. (1993) Causal Factors , Interventions and Policy Considerations in School-based Substance Abuse Prevention . Report to Office of Technology Assessment, US Congress, Washington, DC.

Hawkins, J. D., Catalano, R. F. and Miller, J. Y. ( 1992 ) Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention. Psychological Bulletin , 112 , 64 –105.

Hopkins, D. H., Mauss, A. L., Kearney, K. A. and Weisheit, R. A. ( 1987 ) Comprehensive evaluation of a model alcohol education curriculum. Journal of Studies on Alcohol , 49 , 38 –50.

Johnston, L. D., O'Malley, P. M. and Bachman, J. G. (1996) National Survey Results on Drug Use from the Monitoring the Future Study 1975–1995. Volume I: Secondary School Students . National Institute on Drug Abuse, Rockville, MD.

Lickona, T. (1991) Educating For Character: How Our Schools Can Teach Respect and Responsibility . Bantam Books, New York.

MacKinnon, D. P. and Dwyer, J. H. ( 1993 ) Estimating mediated effects in prevention studies. Evaluation Review , 17 , 144 –158.

MacKinnon, D. P., Johnson, C. A., Pentz, M. A., Dwyer, J. H., Hansen, W. B., Flay, B. R. and Wang, E. Y. I. ( 1991 ) Mediating mechanisms in a school-based drug prevention program: first year effects of the Midwestern Prevention Project. Health Psychology , 10 , 164 –172.

McNeal, R. B. and Hansen, W. B. ( 1995 ) An examination of strategies for gaining convergent validity in natural experiments: DARE as an illustrative case study. Evaluation Review , 19 , 141 –158.

NIDA (1997) Preventing Drug Use Among Children and Adolescents: A Research-Based Guide. National Institute on Drug Abuse, Rockville, MD.

Perhats, C., Oh, K., Levy, S. R., Flay, B. R. and McFall, S. ( 1996 ) Role differences in gatekeeper perceptions of school-based drug and sexuality education programs: a cross-sectional survey. Health Education Research , 11 , 11 –27.

Sussman, S., Dent, C. W., Mestel-Rauch, J., Johnson, C. A., Hansen, W. B. and Flay, B. R. ( 1988 ) Adolescent nonsmokers, triers and regular smokers' estimates of cigarette smoking prevalence: when do over estimations occur and by whom? Journal of Applied Social Psychology , 18 , 537 –551.

Tobler, N. S. ( 1986 ) Meta-analysis of 143 adolescent drug prevention programs: quantitative outcome results of program participants compared to a control or comparison group. Journal of Drug Issues , 16 , 537 –567.

Tobler, N. S. ( 1994 ) Meta-analysis of adolescent drug prevention programs . Doctoral Dissertation, State University of New York at Albany. Dissertation Abstracts International , 55 (11a) , UMI-Order no. 9509310 .

Tobler, N. S. and Stratton H. (1998) Effectiveness of school-based drug prevention programs: a meta-analysis of the research. Journal of Primary Prevention , 17 , in press.

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United Nations

Office on drugs and crime, youth initiative.

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Substance Use Prevention; a Personal Reflection

Written by nur raihana binti zakaria.

Illustration by Karthika Pillai

It has been more than 40 years since drug use was declared a national security problem in Malaysia in the 1980s. From the latest drug statistics available, the National Anti-Drugs Agency of Malaysia reported in January to June 2020, around 67% of people who use drugs in Malaysia were adolescents and youth, which represents almost 67 thousand individuals.

This alarming fact caught my attention and inspired me to dive into substance use prevention. Therefore, it was a privilege for me to participate in the United Nations Office on Drugs and Crime (UNODC) Youth Forum 2021 on Substance Use Prevention.

Before joining the Youth Forum, I was fully aware that the known overwhelming impact of substance use on individuals, families, and communities and the reality of the potentially life-long and complex recovery process of substance use requires effective, supportive, and comprehensive-collaborative interventions.

While I kept wondering what makes one get involved in substance, little did I realize that determining the cause(s) will be endless as it is more complicated, and it would never be that straightforward or clear cut.

The vulnerability factors may come throughout the developmental and life phases and are interrelated between individuals, family, school, and community – sometimes leading to a vicious cycle. Understanding this fact is one of the core points in substance use prevention because it will help us be more empathetic and less judgemental.

Substance use prevention aims to avoid or delay the initiation of substance use, or if someone has already engaged in substance use, it will be more effective to engage in treatment interventions to stave off the development of substance use disorders.

During the Youth Forum, I had an “aha” moment and realized that the overall aim of substance use prevention is much broader. It aims to ensure the healthy and safe development of young people and their well-being and resilience so that they can discern and optimize their talents and potential and become altruistic contributing members of their community. Thus, prevention interventions should begin as early as infancy. His means not only parents, but every member of the society shall be empowered with appropriate skills such as social life skills, parenting and caregiving skills, and decision-making skills. Effective prevention forwards children, youth, and adults positive and constructive engagement with their families and schools, workplaces, and communities.

I was impressed with the way Ms. Elizabeth Mattfeld, a Project Coordinator with the Prevention, Treatment, and Rehabilitation Unit of UNODC, enlightened us on substance use prevention, making it more understandable. She started explaining substance use prevention by emphasizing what is not; “substance use is not treatment, nor punishment.” She then highlighted that in prevention, it is never about telling people the danger of drugs or any other psychoactive substances, or commanding people not to befriend people who use drugs or any other don’ts; or labeling and identifying who are at risk. Instead, prevention aspires to improve skills, endurance, educate the do’s, and subsequently promote individuals to function in a healthy physical and socio-cultural-spiritual environment in the long run. And there is no way for us to ignore any aspects of physical health, mental health, nutrition, education, family well-being, financial, policy-making, or law in substance use prevention, let alone to look at those aspects independently. Substance use prevention is indeed a long-term strategy within a holistic approach to preventing individuals from engaging in drug abuse by focusing on evidence-based programs that can strengthen protective factors and reduce risk factors; and everything in between.

Reflecting on what we have or used to do worldwide, we must agree that many countries are yet to have successful models or efforts in prevention. I acknowledge all agencies’ or ministries’ commitment to creating a society free of drug threats to ensure the community’s well-being, maintaining national stability and resilience.

However, it is always good to take a step back and ponder on the efficiency and efficacy of the intervention taken. Moving forward, we could do better - prevention shall be more inclusive and voluntary, rather than spending resources on the selective approach like prevention education programs conducted among families, primary school students, and youth who are at risk or already identified engaging in substance use.

Besides, we should pay more attention to how we practice substance use prevention, what works, and how we evaluate its efficiency. For example, some may think the lack of knowledge about substances and the consequences of their use are among the main factors that increase an individual’s vulnerability or contribute to the initial reasons for drug use initiation. But I was a bit surprised that knowledge or information alone does not change behavior and does not work for substance use prevention. When policies and practices rely only on feeding the public with knowledge about substances and their adverse effects, substance use prevention is compromised.

We should refine our actions and comprehend that developing skills such as communication, decision-making, rational thinking, and stress reduction are critical as part of a comprehensive substance use prevention program.

In substance use prevention, we must be determined to adhere to evidence-based approaches. We must be ready to unlearn our old beliefs and usual practices that may be inconsistent with science. Substance use prevention is not a taboo or gut feeling, it is scientific, and it is worth fighting for. Unfortunately, Even when considerable funding is spent on treatment, only one in eight people worldwide can access this treatment. Investing more diligently in prevention, we can save up to 10 dollars for every dollar spent, reduce substance use and protect our young generation worldwide.

In conclusion, I am now well-informed that to make substance use prevention successful, we need continuous multiple prevention programs at every community level involving many stakeholders. Those are what we need to create a healthy, effective, and sustainable prevention system. All elements of prevention and roles taken (or ignored) by individuals are interconnected; strengthening every single element will cause a snowball effect; anyone could start the positive action and give sustained results in return, like a domino effect; and we need everyone’s small and light touch in substance use prevention to bring the butterfly effect; ultimately lead to what we all have been dreaming for: healthy, happy, resilient and proactive young people who can contribute to the community and society. Yes, long way to go, but I have the utmost faith that prevention works.

1 International Standards on Drug Use Prevention. (2018). Retrieved 20 March 2021, from https://www.unodc.org/unodc/en/prevention/prevention-standards.html

2 National Drug Policy. (2017). Retrieved 15 January 2021, from https://www.adk.gov.my/wp-content/uploads/Buku-Dasar-Dadah-Negara-EN.pdf

3 Annual Report National Anti-Drugs Agency. (2019). Retrieved 15 January 2021, from https://www.adk.gov.my/wp-content/uploads/Buku-Laporan-Tahunan-AADK-2019.pdf

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