Eric Carlin’s Blog

I’ve been lucky to be engaged in a number of activities recently which make me both proud of our work and the people we work with and hopeful that we can make progress in getting more effective drug policy and practice.

At the United Nations earlier this month I took part in the “Beyond 2008″ global NGO conference where we brought together NGOs from all round the worlld, with different experiences and ideologies who agreed to work together to try to influence the United Nations and national governments. We agreed - all by consensus, with no dissension - a Political Declaration and three Resolutions which will now be put forward to the Commission on Narcotic Drugs 2009. The web site of the Vienna NGO Committee on Narcotic Drugs (www.vngoc.org) has now been updated to include much of the material presented at the Vienna Forum. On the Home Page you can find a link to the Final Declaration and Resolutions.

This week Mentor UK hosted a meeting of European NGOs who are working together to find out how we can support kinship carers in UK, Sweden, Lithuania, Romania, Belgium, Spain and Italy to support drug prevention for the children in their care. It was inspirational to work with people from completely different backgrounds and to share our experiences and begin planning pilot projects. As with the United Nations activities, I am optimistic that when we collaborate in this way we can achieve so much more than we can on our own.

Finally, I was really pleased that today’s English Schools Survey and the British Crime Survey are showing progress on drug use among young people. Of course we also know that we can’t be complacent; there remains a minority who by using drugs are doing great harm to themselves, their families and the communities they live in. However, let’s celebrate some progress.According to the English Schools Survey, illegal drug use amongst young people in England has fallen by 4% since 2001 . Other figures from the same report are equally encouraging:

9% of pupils reported taking cannabis within the last year, a proportion which has fallen from 13% in 2001

4% of pupils report having taken one of the eight Class A drugs asked about

only 5% of pupils overall take drugs once a month or more

Separately the British Crime Survey has found that among 16 to 24 year olds there was a decrease in the use of any illicit drug in the last year, from 24.1% to 21.3%.

Drug Use, Smoking and Drinking among young people in England 2007 can be found on the Information Centre’s website: http://www.ic.nhs.uk
Crime in England and Wales 2007/2008 can be found on the Home Office website: http://www.homeoffice.gov.uk/rds/crimeew0708.html

I attended 3 days of the CND meeting at the UN in Vienna, spending most of my time with the NGOs as part of the Vienna NGO Committee on Narcotic Drugs and in preparation for the Beyond 2008 NGO Forum.

Antonio Maria Costa, Director of UNODC, addressed the NGO Forum. He made a lot of useful and constructive points, talking about the need to stop dividing harm reduction from prevention and the need to engage with NGOs. He also talked about the need to develop policy and practice based on evidence of effectiveness. Great - we all agree with that. However,  he then went on to state his support for random drug testing of pupils in schools. Now, whatever you think about that as an approach, there is certainly not sufficient research evidence to argue that this is an evidence-based way of preventing young people getting into trouble with drugs. More than that, I’d argue that such an approach potentially breaks the trust between students and teachers and is likely to drive the most vulnerable young people, the most likely to get into trouble with drugs, out of school, away from the opportunities to receive education, counselling and support and onto the streets where they’ll come into contact with more drugs and get involved in more crime than if they were still at school. Let me repeat - drug testing in schools may seem a good idea to some but the research evidence is at best inconsistent.  UNODC needs to give a lead on this.

Other presentations at the NGO Forum included a US presentation which again talked about evidence based approaches but then argued that we should cease any treatment approaches which do not lead to abstinence. We should also stop needle exchanges and, of course, we should promote random drug testing in schools.

In relation to the first point, of course abstinence is the safest option but it is not always going to be achievable, particularly for long-term users.

In relation to point two, needle exchanges have been extremely successful in reducing spread of HIV and other blood-borne viruses; moreover, a well-run scheme does not just dosh out needles, it also seeks to engage the user in improving their health and well-being, including accessing treatment. As a member of the audience said, of course you will achieve your abstinence outcome if all your drug users have died of AIDS from sharing needles. Is that what you want?

In relation to point three, this is not evidence-based but ideology-based; people should argue their positions honestly, not cite spurious research to support it.

This all sounds like it was depressing; not at all. I believe the NGO community is working more closely with national governments and with UNODC. More than that, the partnerships forged between NGOs who often have very different ideological positions to work on Beyond 2008 are inspiring and offer hope that we can work together on what we agree on - preventing and dealing with drug-related harms, even though we will always disagree in some areas about how to achieve that.

I did this radio interview after the NGO Forum.  I’ll also put up later the paper I put to the CND plenary on behalf of the Vienna NGO Committee.

http://www.csdp.org/audio/WS_30025.WMA

The heartbreaking story of the murders of 5 young women in Suffolk highlights the importance of what we’re doing working in drug prevention. There’s a common theme - these young women would not have died, had they not been addicted to drugs. They would not have become addicted to drugs, and at such an early age, had something not gone wrong in their families, their communities, their schools, with their peers. They would not have been despised and rejected by “mainstream” society, including the “respectable” men who used them as objects to relieve their frustrations and lust. What happened to these young women at such a young age and how could it have been prevented? Why was the blankness and darkness which the drugs gave them better - or more accessible - than exploring life’s opportunities? Treatment is too late for these 5 young women. Moreover, for a lot of the media and the public, they’re just the latest “prostitute” victims; in death as in life the drugs have dehumanised and devalued them.  

Reading the account in today’s “Guardian” of Tracey Russell, who narrowly escaped being number 6 just brings home to me the strength of the connections - “We were worried, but when you are on drugs, you think if you can open a car door…you would know it is the murderer.” Also,

“Their life, she said was “horrible”. “You learn to blank it out over the years, and because you are on drugs, you just think of something else. I know that sounds odd, but you do. ‘Cos you get used to it and it’s over within seconds. Hopefully.”

When I worked in a street drugs agency, with a lot of women sex workers as clients, I sometimes heard the same types of comments - not often though, their situation was ongoing so they had to, as Tracey puts it, “think of something else”. I believe that almost all our clients wished they had never got into taking drugs and that they would be the best advocates for prevention. (As this was not their situation of course, my staff worked with great respect for them to give them support and to try to help them improve their lives; no more than one human being should do for another.)

I referred in my last blog to my frustration with the politicising of the drugs debate. Regardless of the legal situation - and there are perfectly reasonable arguments on either side - our focus must be on trying to stop children and adolescents getting into misusing drugs in the first place - offering them protection, support, discipline and opportunities, also letting them know that these drugs that they come into contact have huge risks. I often hear the argument that if drugs were legalised and regulated we would be more able to support drug users and protect them from harm. Although I agree that throwing people into jail is not the answer, I have to say that I’m not convinced that, legal or illegal, Tracey wouldn’t have still got into Steve Wright’s car - nor poor Annette, Paula, Gemma, Anneli and Tania.

I’ve been privileged this week to take part in a national conference organised by the Right Start Foundation in Birmingham drawing attention to the needs of BME communities to have more effective prevention and treatment services. Right Start have done some amazing work, in particular helping Asian women with drug users in their families access support for the drug user and themselves and, really importantly, expressing their feelings, hopes and fears publicly. They’ve also been working to help young Muslim people express their concerns about and experience of drugs. You know, this is so important and I felt humbled by the opportunity to take part.  Supporting these often ignored, not particularly politicised groups just to say in public how it is helps to change things - not immedately but drip by drip. In relation to young people, and particularly for communities which are challenged socially and economically and by prejudice, so much policy is created for them and done to them without properly engaging them in assessing what the problems are that the policy is intended to solve, devising and implementing the solution.

The front line work of engaging with communities - and not just the “usual suspects”  is so important. On the other extreme, I was depressed at various points in an international NGO meeting where I heard anti-drugs people condemning “harm reduction” and legalisers engage all over again in their sterile, unconstructive arguments. They are apparently diametrically opposed to each other, despite the fact that they all seem to acknowledge that all drugs can and do cause harm. I was told by one person that “a drug user cannot be a good mother”, by another that “prevention doesn’t work”. If only they’d listen to each other and to themselves they’d realise that this positioning doesn’t benefit anyone.  

It happens in the UK also. I sat through the ACMD public discussions about the classification of Cannabis and subsequently read a number of blogs which made me wonder if I had been sleeping throughout as these people had heard different things than I had. According to some blogs and journalists, the ACMD has apparently already decided about the classification of Cannabis, despite the fact that the Committee won’t report until the end of April. I thought that in the public session the Committee heard evidence; it certainly didn’t indicate in any way its likely decision. Nonetheless, these bloggers are either satisfied or angry already, depending on what they seem to have sussed the outcome, which apparently has already been decided, is and what they think about that. What a load of nonsense. 

The new Drugs Strategy comes out next week. Aside from the content, I hope that there will be a genuine - and funded - commitment to consulting with real people in communities and not just the campaigners with their intransigent attitudes and quite unsophisticated and unhelpful politicising of issues which affect real people’s lives.

I was invited to a preview of the key themes of the new Government English Drugs Strategy at the Home Office yesterday, Monday, 11^th February. This follows an extensive consultation period in which we actively participated, including providing opportunities for young people to contribute. The new Strategy is due to be launched on 27^th February. Separate strategies operate in Wales, Scotland and Northern Ireland.

I was hoping in particular to hear some change in relation to prioritising prevention work and to making it effective.  It was good to hear about the new Public Service Agreement (PSA) which includes “a new focus on prevention and families”. However, it seems unlikely that we will see at last the large scale investment in research and development of evidence-based prevention which is necessary if we are at last going to make a major impact on reducing the numbers of young people who get into trouble with drugs. Overall funding for drugs is not going to increase. Also, unfortunately, alcohol and drugs are still to be dealt with separately, with the rather lame excuse being given by one presenter that this had to be the case because one was legal, the other illegal.

If we re-orientated our thinking to regard drugs prevention primarily as a Public Health issue, the legal status of the drugs wouldn’t matter as we could focus our energies primarily on developing and using instruments which would reduce misuse and harm to the individual and to communities.

We are and will be engaged in the implementation plans, particularly in relation to prevention and families. We need to get the messages out to the young people who don’t misuse drugs that they are the norm and that they can still be “cool”. It’s also clear that we need to help parents and carers re-discover their confidence in giving guidance and support to their children and that we need to back this up with properly resourced, well-trained teachers and youth services, including in the voluntary sector.

We also believe that it’s vital that we monitor and raise the standard and broaden the scope of drug prevention activities and that’s why Mentor UK is developing a Quality Mark for drug prevention which we hope to establish as an “industry” norm.

What was said at the Home Office

I heard the following - There will be 4 key areas, which I hope I’ve summarised accurately:

Supply and crime – led by Home Office: This will remain a major focus of the Strategy. In fact there will be more emphasis on disrupting the criminal market, including increasing asset seizures.

Prevention and families – DCSF lead: There will be more support for families, including families of drug users, extending family intervention partnerships and support for parenting. There will be more emphasis on providing support for young carers and targeted youth support.  There will also be improved specialist treatment for young drug users. The role of schools and drugs education will be strengthened and reviewed and in particular there will be an assessment of how schools can support vulnerable young people.

Treatment – Department of Health lead: There will be more emphasis on treatment and social re-integration with planning and delivery focussed on localities. Clinical Governance will be emphasised through NICE and treatment will be evidence-based. The new PSA will prioritise heroin and crack and drug users who cause the most harm to themselves and others. There will be renewed efforts to join up services in prisons and in the community.

Public information, communications and campaigns – Home Office lead: FRANK will continue to be prioritised. Communications will have two main objectives; to support the new PSA by reducing drug use and also reducing the public’s anxiety and fears about drug use. FRANK will do more work in schools and to support parents and will link with local community activities. There will be increased support to Drug Action Teams and local partnerships to publicise their activities. The “Tackling Drugs, Changing Lives” awards will continue to recognise achievements, as will National Drugs Week. There will be more coalitions and partnerships and a particular strand of work will include looking at how to publicise good role models for young people.        

I went to a meeting called by the Home Office last week to give initial feedback on the consultation findings. It was good that they were opening up for us to hear their thoughts so far and to contribute to the strategy’s development. However, the findings and proposals have not yet been to Ministers and ideas may yet change. Next steps after this meeting will include: 

• Ongoing stakeholder engagement
• Final drafting of the new strategy in January 2008
• Implementation discussions from February 2008
• New strategy in place by April 2008 – 10-year strategy with 3-year action plans

 In relation to the consultation, Mentor UK had four separate inputs as follows: 

• We provided a formal written submission, following the official template.
• I was 1 of 20 national stakeholders interviewed by Ipsos Mori.
• Our Youth Involvement Project held a special meeting and Andrew Brown and Susi Farnworth wrote up the findings and went to meet with officials at the Department for Children, Schools and Families to feed in.
• As hosting organisation and members of the Drug Education Forum and with myself as current Chair, we contributed to the Forum’s response.

 My conclusions There was much aspiration that fits very well with Mentor’s aims.  Mentor is very keen on are developing quality standards for drug prevention and we also want to ensure that young people have an ongoing input to the strategy’s implementation.  When the new strategy is launched we would like to see these included in the key objectives, plans and targets to achieve the aspirations. We would also want to see a clear presentation of the role of the prevention voluntary sector and how it would be funded. Key themes that I heard were that: There has been progress but that there is still much to be done. There are still around 330,000 problematic drug users. Also, progress is often not recognised by the public.  Areas for improvement include work on prevention, with the most “at risk” groups, covering gaps in the evidence base and using evidence that we do have. Priorities should include: 

• To help young people avoid drug problems in the first place
• Fast-track referrals to treatment
• Disrupting local supply
• Streamlining administration

 …all supported by 

• More active community engagement
• Improved information and research
• Better communications

 Key themes for young people should include: 

• Reducing misuse
• Expanding the prevention agenda to include preventing school failure and anti-social behaviour and encouraging aspiration
• Protecting children of drug misusing parents
• Focussing on vulnerable children and families
• Building knowledge of effective prevention

 A new package for families should include: 

• Maximising their protective role
• Helping pregnant drug misusers
• Helping parents in treatment develop their parenting skills
• Early identification of “at risk” families

 The prevention agenda should be “mainstreamed”, to include strengthening the role of schools from an early age and youth services. There should be an increased emphasis on identifying early risk factors for drug problems rather than assuming its inevitability and only taking action after use has already started. The FRANK information campaign will continue and will consider its role in alcohol misuse prevention. 

Young people’s treatment services will also aim to improve, in line with evidence.

I ran what, at least for me, was a very interesting workshop on helping prevent under-age drinking at a conference at the Barbican on Tuesday. From the numbers who attended it’s clear that people are waking up to the need to encourage healthy behaviours to prevent teenagers wrecking their lives when young and as adults. We focussed very much on what young people themselves said about why they drank to excess - and supply wasn’t the only thing; there was also that attitude of “why not?”. The most interesting observations in the discussion for me were, however, when we talked about the need for adults - yes, you and me - to think about and modify our own drinking behaviour, rather than just continually going on about the need to prevent youngsters binge drinking. It’s a difficult one though; unless something really extreme happens, adults - like teenagers - don’t think their drinking is a problem.  The UK definitely has a cultural difficulty with alcohol. When young people I’ve worked with have described their families introducing them to drinking, this hasn’t been the idyll of the big Italian family sharing a social experience; rather it’s been the parents getting cut-price lager from duty frees to keep the kids off the streets or buying them drinks in the bar and then sending them off to a corner so the parents can be uninterrupted. Parents, teachers, politicians and others who want to educate young people may need to face up to some harsh realities about themselves.

The Ofsted report today that describes how many teenagers are misusing alcohol and other (for them) illegal drugs reinforces Mentor’s ongoing case for more and better prevention activities, starting as early as possible. This does not mean just drugs education but must include properly joined-up activities which improve young people’s aspirations and ability to resist pressure to use drugs.

It was also noticable that young people expressed great concern about issues such as bullying. Drug misuse prevention activities must encourage young people to thrive and have aspirations, to value themselves and to contribute to society. By combatting issues such as bullying, we can enable this to happen. We will also see reductions in other anti-social behaviours.

For Mentor, the fact that young people are often more worried about bullying is no surprise. Within our alcohol project we interviewed young people about what they thought was leading younger and younger people to misuse alcohol. They told us very clearly that they were worried about being bullied and fitting in, with the transition period from primary to secondary school being the most worrying time.

The answer therefore is holistic prevention, reinforcing and encouraging healthy and social behaviours and responsibilities, not “Just say no”.

Yesterday I spoke at the Federation of Drug and Alcohol Professionals’ annual conference about evidence based drug prevention. It was clear that people supported the idea that we need more and better prevention and this needs to be properly resourced through the new Drugs strategy.

Although we know that scare tactics are only effective with small numbers of people, politicians still focus on these rather than investing in building environments - in schools, in communities, in families - where young people can thrive and have aspirations. We also need to spend less on criminal justice and supply reduction and more on effective demand reduction.

We need more evaluation of prevention activities in the UK and Europe, diversion of funds into research on prevention and investment in holistic approaches thatw ork. We shouldn’t be having visitors going into schools to deliver 1 or 2 sessions to young people and expect that that will protect them. We also shouldn’t cite the fact that that kind of approach has little effectiveness as evidence that “prevention doesn’t work”.