CHAPTER I Drug use prevention
These results corroborate the qualitative conclusion of a systematic review suggesting that “programs which develop individual social skills are the most effective form of school-level intervention for the prevention of early drug use” (cannabis and other drug use).129 In contrast, presenting children with fear-arousing information is ineffective in this particular age group, as is focusing only on building self-esteem or emotional education.130 It has been estimated that if adolescents aged 10 to 15 years receive a comprehensive programme, per month they drink alcohol on 12 days less and use cannabis on 7 days less than if they receive drug information only.131 Figure 22 illustrates how a comprehensive positive development programme shaped illegal drug use among participants in Hong Kong, China.132 Computer-based universal prevention programmes without any teacher involvement have also been implemented in the school setting and have yielded effects in terms of less smoking and less alcohol use among participants.133 Fully automated software leads students through a series of sessions in which they identify social influences and are animated to correct their false perceptions of social norms. Internet-based programmes of this kind may work outside the school context as well, but reaching the target group may be a challenge. In a study in the United Kingdom, middle-school students with an elevated risk level due to certain personality factors benefited from personal and social skills training tailored to the specific developmental challenges caused by their behavioural tendencies.134 Figure 23 shows how substance use developed for ninth graders with elevated scores in anxiety sensitivity, hopelessness, impulsivity and sensation seeking and therefore with elevated risk for drug use, 128 Spoth, Greenberg and Turrisi, “Preventive interventions addressing underage drinking” (see footnote 109). 129 Faggiano and others, “School-based prevention for illicit drugs use: a systematic review” (see footnote 124). 130 Ibid. 131 M. Lemstra and others, “A systematic review of school-based marijuana and alcohol prevention programs targeting adolescents aged 10-15”, Addiction Research and Theory, vol. 18, No. 1 (2010), pp. 84-96. 132 Daniel T. L. Shek and Lu Yu, “Longitudinal impact of the project PATHS on adolescent risk behavior: what happened after five years?”, The Scientific World Journal, vol. 2012 (2012). 133 K. E. Champion and others, “A systematic review of school-based alcohol and other drug prevention programs facilitated by computers or the Internet”, Drug and Alcohol Review, vol. 32, No. 2 (2012), pp. 115-123. 134 P. J. Conrod and others, “Effectiveness of a selective, personalitytargeted prevention program for adolescent alcohol use and misuse”, JAMA Psychiatry, vol. 70, No. 3 (2013), pp. 334-342.
Illicit drug use composite score
interactive methods, had more sessions, were of longer duration and were mediated by persons other than teachers. The life-skills approach also serves as an effective drug prevention tool for older adolescents with higher vulnerability for substance use, such as students who are considered at-risk of not graduating at the normal pace.128
Extent of illicit drug use among adolescents who participated in a school-based positive youth development programme at age 12
0.035 0.03 0.025 0.02 0.015 0.01 0.005 0 12
Approximate age Intervention in secondary school Control Source: Shek and Yu, “Longitudinal impact of the project PATHS on adolescent risk behavior” (2012). Note: Graph shows the extent of illicit drug use among adolescents in Hong Kong, China, who participated at age 12 in a school-based positive youth development programme compared with the extent of illicit drug use among those who did not participate.
depending on whether they were offered a tailored intervention or not. The two-session programme included goalsetting exercises, education about coping strategies typical for those personality traits and healthy alternatives, behavioural management and changing dysfunctional beliefs that often accompany such traits. Although alcohol and drug use were only a minor focus of the intervention, problem drinking was less probable among participants after the intervention. Apart from implementing individual-oriented interventions, preventive effects can also be achieved by targeting the general climate and drug-specific rules of schools. Feeling left out motivates people to act against conventional norms. As a major socializing agent, the school system has the potential to integrate marginalized students and facilitate positive development. With children at risk, schoolbonding activities to improve school attendance and attachment to school, in addition to promoting learning of age-appropriate language and numeracy skills, may have a positive influence in terms of developing important protective factors for students in middle childhood.135,136 Overall, interventions that promote a positive school ethos and enhance student participation and commitment to school, conjointly with rules that strongly discourage drug 135 P. Lucas and others, “Financial benefits for child health and wellbeing in low income or socially disadvantaged families in developed world countries”, Cochrane Database of Systematic Reviews, No. 2 (2008). 136 A. Petrosino and others, Interventions in Developing Nations for Improving Primary and Secondary School Enrollment of Children: A Systematic Review, Campbell Systematic Reviews, No. 19 (2012).
WORLD DRUG REPORT
United Nations Office on Drugs and Crime Bones Private Collection