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Increased focus on prevention and early intervention
Magic Mushrooms © Pretty Drug Things
In part 2 of her Review of Drugs, Dame Carol Black says we need increased focus on primary prevention and early intervention.

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Reinvigorating drug prevention

This is the latest in a series of blog posts I’m writing covering the detail of Dame Carol Black’s second part of her independent Review of Drugs which sets out a way forward on drug treatment and recovery for the government and which was published last month (8 July 2021). There is consensus across the field that the Review is the most important drugs report of the century so far. This week’s post looks at Dame Carol’s recommendations that we should place an increased focus on primary prevention and early intervention. You can read the full series of posts summarising both Part 1 and Part 2 of the Review of Drugs here.

Dame Carol has, interestingly, not confined herself to examining the drug treatment system but has also recommended that government should engage in a tri-partite drug prevention approach comprising:

  1. drug-focused prevention programmes in schools,
  2. non-drug focused support for young people to reduce their risk for many problems including but not limited to drugs, and
  3. population-wide approaches to reduce recreational drug use.

Drug prevention in schools

Dame Carol recommends that the Department for Education make an assessment of the support available to teachers in rolling out the new Relationship, Health and Sex Education (RSHE) curriculum. Dame Carol makes clear that the international experience with prevention shows that support for front-line workers and evaluation of outcomes is critical for success. She says that teachers will need high-quality training programmes to deliver the new drug prevention curriculum effectively and is adamant that the new prevention effort should be subject to scientific evaluation fed back in a fashion that promotes continuous improvement.

Non-drug-focused programmes that build youth resilience

Dame Carol rehearses the evidence which shows that the same factors that increase childhood risk for drug use also increase risk of alcohol and tobacco use, poor academic performance, mental health problems, and harm to self and others.  Risk factors include chaotic, unrewarding environments, unremitting stress, social exclusion, and individual risk factors such as having difficulty managing emotions, coping with challenges, and exercising behavioural self-control. She says that prevention programmes which target these core risk factors in schools, in the community and in the family, can reduce drug use as well as many other problems that blight the lives of young people.

Dame Carol also makes a strong case for restoring positive activities for young people outside school hours, addressing children’s mental health issues early in life and providing specific support to families with parental drug misuse.

Dried Poppies
© Pretty Drug Things

Reducing recreational drug use

Dame Carol highlights increasing use of recreational drugs, such as cannabis, powder cocaine and ecstasy and says that many young people in treatment are there because they are struggling with cannabis harms. She says that although many recreational drug users do not consider their use to be problematic, recreational use carries risks and it fuels the illicit drug market. 

Dame Carol recommends that the government looks to understand better the drivers for recreational drug use and what measures can be taken to influence behaviour. She acknowledges that there is little research, either in the UK or internationally, which shows what can be done to put this rising trend of recreational drug use into reverse. Mass communications based on anti-drug messaging have been shown to be ineffective and can compound user attitudes and behaviour.

This leads Dame Carol to conclude that innovation is needed to identify new ways of influencing the behaviour and attitudes of recreational drug users. She says that any campaign should be grounded in behavioural science and include a package of targeted interventions that complement the broader drug prevention and treatment system.

She concludes by recommending the creation of an innovation fund to develop effective campaigns.


Thanks to Pretty Drug Things for the images in this post. Pretty Drug Things  explores different visual aesthetics and marketing techniques used in either promoting or demonising different psychoactive substances in our society.

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