drug abuse - summative (1)

7/30/2019 Drug Abuse - Summative (1)

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Write a critical analysis of one aspect of substance misuse policy

and / or practice which relates to your own country of origin (or a

selected country), work or sphere of experience. This assignment

needs to include critical appraisal of the scientific evidence-base

and to make recommendations to improve policy and practice.

2500

Education nowadays is often considered as equal to accumulating

skills and facts whereas health is opposed to illness (WHO, 1996). Instead,

education is a prerequisite for health and both education and health are

more general and undivided concepts (Ottawa Charter, 1986). This is why

health promotion programs lanced in school settlements through

education policies and prevention, treatment and referral could have a

greater impact in students as these programs target students in the most

crucial ages of their life (Evans-Whipp et al. 2004, WHO, 1996). It seems

though that schools are seriously affected by societal problems with drug exposure

consisting a major one (Ross et al. 1995), since its initiation mostly coincides with

adolescence and has a multifactorial base of genesis (Blum & Richards, 1979;

Braucht, Follingstadt, Brakarsh, &Berry, 1973; Jessor, 1976; Millman & Botvin,

1983; Wechsler, 1976). A drug-free learning environment (Yamagushi et al. 2003) is

generally served via school policies that discriminate between possessing, using and

supplying drugs (Murphy). Although prevention programs aiming at reducing

illicit drug consumption should be applied in all schools this still remains

requested in some parts of the world.

According to the Monitoring the Future Study (Johnston, OMalley, & Bachman,

2001), adolescent drug consumption begun to rise in early 1990s up to 1997 ( Much et

al. 2001-- Kraft). A point of serious concern for the American society is that drug

use among American youth is the highest in the industrialized world (Johnston,

Bachman, & O'Malley, 1988). This phenomenon drove the public to primordialize

drug abuse as a crucial issue for public schools (Ross et al. 1995). A standard

definition of drugs would be a chemical substance that, when taken into the body,

alters the structure and functioning of the body in some way, excluding those nutrients

considered to be related to normal functioning (Levinthal, 2008; Drugs, Society and

Criminal Justice, Pearson Education). Addiction in America is mostly reflected inthree views; the Colonial or Moralist which perceives drug use as a crime(zero tolerance policy) and is followed by punitive measures; thetemperance view where drugs are considered addictive substances andpolicy should focus on smugglers and dealers who are the root of addictionand thirdly, the disease concept where addiction is viewed as a diseaseand drug policy should primordialize drug treatment and rehabilitation.

The authors of one Cochrane review of school-based drug prevention concluded that

some programmes deterred early stage drug use (Faggiano et al., 2005), whereas otherprogrammes did not. Specifically, programmes that teach social and coping skills


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reduce drug use slightly relative to normal classroom instructional activities. In

contrast, programmes that simply convey didactic information about drugs and their

effects have no impact on drug use relative to normal classroom instructional

activities. Combining results across studies of different programmes -- Life Skills

Training (LST), Project ALERT (ALERT), a Classroom Centered (CC) intervention,

a Cognitive Behavioural Intervention (CBI) and a programme called "Towards NoDrug abuse" (TND, two studies) -- provides an estimate that cannabis initiation issomewhere between 1% and 23% less likely, over the shorter-term, when students are

exposed to skills-based prevention, compared with usual classroom activities (the

control group). Faggiano's review suggests that on average, modern school-based

prevention programmes can delay or prevent the initiation of drug use, although

effects on frequency of drug use are not so clear. Such programmes focus on

improving school discipline and climate and strengthening teachers' classroom

management skills. For example, although the Cochrane Review (Faggiano et al.,

2005) has listed the Good Behaviour Game (GBG) as a component of a skills basedintervention (the Classroom Centred curriculum (CC) mentioned above), much of thefocus of the GBG intervention is on improving classroom behaviour management atGrades 1 and 2.

Drug policy is influenced by and influences society (Chilea & Chilea). Besides the

adoption ofa harm minimization approach towards drugs in Australia and Europewhere priority is given at education, prevention, referral and intervention andnot on punishment(Murphy; Ministerial Council on Drug Strategy, 1998), most

schools (almost 90%) in the United States adopt zero tolerance approaches for

substance misuse (Yamagushy et al. 2003; Martin et al., 1999; Small et al., 2001,Brown, 2001) under the scope of minimizing drug use prevalence (Caulkins and

Reuter, 1997). As mentioned above, Zero tolerance represents those policies that

adopt a severe punitive approach without considering the seriousness of offence in

dealing with problems of school safety and discipline (Skiba & Peterson, 1999;

Hanson, 2005). The prevailing picture of these policies is the punishment and penal

sanctions and the approach is known as punitive drug prohibition approach or

moral/criminal justice model (Evans-Whipp et al. 2004; Aoyagi, 1997; BEYOND

PUNITIVE PROHIBITION). Aspects of the policies serving zero tolerance purposes

may include anti-drug education (e.g., "Just Say No" curricula), drug testing, metal

detectors, closed circuit cameras, sniff dogs and penal sanctions such as expulsion,

suspension and referral to law enforcement agencies are (Evans-Whipp et al. 2004,Yamagushi et al. 2003, Brown 2001). As a consequence, most of the financialmeans for fighting drug use are spent in interdiction and eradication efforts inthe US which has raised serious concerns over the advantages and

disadvantages of controlling and punishing students (McKeganey 2005).

CRITICAL ANALYSIS OF PUNITIVE PROHIBITION

Growing piece of evidence shows that the fight against illegal drugs in theU.S. has been historically characterized as one of the most unsuccessful
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of its policies (Guzman, 2003). Although zero tolerance initial aim was theimprovement of society, these heterogeneous policies have led to adramatic increase in suspensions and expulsions (Hanson 2005, Insley2001, Essex 2001). These policies raise serious concerns to many leadingpsychologists, as James Comer and Alvin Poussaint are, in relation to their

consistentency with healthy childhood development contradicting thoseschools that consider the reduction of expulsions as a positive aspect ofzero tolerance (Insley, 2001). A serious problem in the U.S is the fact thatits Constitution does not consider the right to education as fundamental,therefore students suspended and expelled abandon their schoolwork andsuffer from feelings of alienation, situation which increases the possibilityto drop out of school and to be deprived from alternative educational

opportunities (Insley, 2001; Brown, 2001). The most severe implicationthough is that automatic exclusion can criminalize students in a way thatpermitting students to be left unsupervised, while at risk for dangerousbehaviors, can consequently exacerbate misbehavior, unemployment,gangs, and crime (Ashfold, 2000, Insley, 2001). Moreover, such policies are

conflicting in nature at school administrators, teachers and counsellors too (Pentz etal., 1997), since suspending and expulsing students without taking into considerationthe risk factors forcing them in drug use has no efficiency in preventing them fromcontinuing drug involvement (Hallfors and Van Dorn, 2002). Finally, those policiesinduce feelings of fear or shame in students and they fail to engage with educators.

This is because discussing only drug issues but not getting involved in students owncognitive and emotional development is a highly insufficient way in dealing with thefight against drug use (Brown, 2001).

Zero tolerance school discipline policies have clearly resulted ininequities and have violated the rights of individual students

(Hanson, 2005). This is the result of those policies that do not takeunder serious consideration the target populations of concern toapply prevention programs, that fail to weight the severity of thedevelopmental stage of the person enrolled in a program or theseverity of the offense, the students history, the duration of theprogram and the role of the person realizing the program (e.g.,teacher, law enforcement officer, peer) (Essex, 2001). Therefore, analternative education aiming at succeeding a balancebetweensafety environment and the rights of students being supervised orinvolved in long term expulsion could minimize the undesirableoutcomes of zero tolerance policies (Essex, 2001).

Education needs to be more interactive and decreasing drugconsumption through education should be one of the guiding principles ofminimizing drug consumption in the society (Cardoso et al. 2009).At a first level,there is a need to reorientate and enforce policies targeting all ageclasses in schools irrespective of the beliefs of educators (Ashfold, 2000). thatyounger students are easier to manage without formal policies therefore are often

considered as less of a priority for schools (Evans-Whipp et al. 2004).Secondly, there is an increasing belief that other prevention andintervention strategies could offer better solutions for dealing with drugs

at school than zero-tolerance expulsion. Alternative schools based onprevention and planning could help children using drugs not only to be
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supervised but to continue their school while working with counselors(Ashfold 2000, Skiba and Peterson 1999,

http://www.stanford.edu/class/e297c/poverty_prejudice/paradox/htele.html;Cardoso et al. 2009). Long-term planning could be very beneficial andaccording to Brown (2001) drug prevention education programs

should be divided into three categories: a) information programswhere avoidance of substance use comes from informing studentswith facts about drugs, b) affective programs where studentspersonal communication skills enhancement aims at increasing theirself-esteem and c) social skills or influence programs wherespecial emphasis is given on how to refuse substances proposed byothers. Basic life and/or drug resistance skills could be also taught.In addition and according to Greenberg (2003) prevention in schools shouldinclude counseling, mentoring, self-control, and social competency instruction (individuallyfocused interventions) along with establishing norms or expectations for behavior and school wide

discipline management interventions (environmentally focused interventions). Self-control or social

competency programming that used cognitivebehavioral and behavioral instructional methodsconsistently was effective in reducing dropout and nonattendance, substance use, and conductproblems. (Greenberg, 2003).

Early efforts in adolescent treatment were based on adult models that didnot seem to consider the unique needs of adolescents. Recently, however,there has been an increased emphasis in developing and evaluatingtheoretically based and empirically supported substance abuseintervention models designed specifically for adolescents (Wagner,Brown, Monti, Myers, & Waldron, 1999;Much et al. 2001). Whether calledbehavior therapy, cognitive therapy, or cognitive-behavioraltherapy (CBT), all behavioral approaches view substance abuse as a

learned behavior that is susceptible to alteration through the applicationof behavior modification interventions (Miller & Hester, 1989). The goal ofbehavioral approaches is to teach adolescents to unlearn the use ofdrugs and to learn alternative, prosocial ways to cope with their lives.

Thus, treatment focuses on the factors that precipitate and maintainepisodes of substance use (Kaminer, Burleson, Blitz, Sussman, &Rounsaville, 1998, p. 684). According to Ashfold (2000) conflict resolution,behavior management, screening and early identification of troubledchildren along with implementing discipline plans for disruptive behaviorswould be of great efficiency. Behavior support teams, consistent andindividualized response to disruptive students, and emergency and crisisplanning are effective plans to be followed. In particular, cognitive-

behavioral techniques attempt to alter thinking as a way to changebehavior. Behavioral techniques are used in residential and outpatient

settings as part of group or individual therapies (Muck Kraft).

Specific skills vary by program but may include drug and alcohol refusalskills, resisting peer pressure to use drugs and alcohol, communicationskills (nonverbal communication, assertiveness training, and negotiationand conflict resolution skills),problem-solving skills, anger management,relaxation training, social network development, and leisure timemanagement. New behaviors are tried out in low-risk situations (e.g.,during group therapy role-plays and individually with a counselor) andeventually are applied in more difficult, real-life situations. Homeworkassignments, such as trying out a new behavior or collecting problemsituations to discuss during therapy, are common. Staff members and
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parents are encouraged to provide positive reinforcement for the use ofnew behaviors. Behavioral contracting is another technique used inbehavioral approaches. The adolescent and counselor agree on a set ofbehaviors to be changed and develop weekly incremental goals for theadolescent. As each goal is reached, the adolescent is highly praised orotherwise reinforced. Behaviors are explicitly defined on the contract, with

criteria and time limitations noted (Muck Kraft).

Unfortunately, a shift from zero-tolerance to these types of preventionpolicies is not likely to occur anytime soon. Such strategies take time todevelop and even more time to implement. But it is clear that much moreresearch is needed to determine if zero-tolerance is a truly effectivestrategy for keeping our schools safe from those who would inflictweapons-related violence on others (Ashfold, 2000).

. Thus, America needs to decriminalize drug use ().(http://www.stanford.edu/class/e297c/poverty_prejudice/paradox/htele.html)

The suggestion of a policy with reasonable and achievable goals andfunctional means has been branded as immoral and wrong. On thecontrary, those who invoke high moral principles, use metaphors as war,propose a battle between goodness and evil, and promise a final triumphin which drugs will disappear off the face of the earth are seen as thegood, the moral and the ethical ones. Words such as hero, are often

invoked to define those who are highly compromised with the war ondrugs. In the public debate on illegal drugs, those who defend a cost-benefit approach are seen as malleable and immoral while those whoinvoke the old struggle of good vs. evil are seen as brave and fearless.Again, this paradox is the result of the prohibitionist predominance thatpostulates the drug issue in terms of crime and threat, and by doing this,leaves no space and tolerance for less radical approaches. If drugconsumption is a crime there are two options: you accept it and you arean accomplice of crime with all the implications, or you reject it and youare a moral and principled person. There is not and there could not be agray area in between those two options. (Guzman, 2003).Anti-narcoticpolicies applied up to now are firmly rooted in prejudices and fears that

sometimes bear littlerelation to reality (Cardoso et al. 2009).


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One case of zero tolerance policy towards illicit drugs is the case ofpersonal use of marijuana and cannabis. Marijuana is the most commonlyused illicit drug, used by 81% of current illicit drug users14 (Chilea,.). There ismore and more tolerance of the public towards certain types of drugs, namely inthe case of legalizing marijuana. The first note to be made about the clegalizationof marijuana and any drug in general is that it would be more appropriate to talk

in this particular context about decriminalization rather than legalization:decriminalization means that possession ofmarijuana above a certain established quantity would constitute a civil offenserather thana criminal one, and punishment would be a fine, not imprisonment.

ALTERNATIVES TO PUNITIVE PROHIBITION

make recommendations to improve

drug abuse - summative (1)

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