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Pontifications on Poison

Being some ramblings on events associated with poisonous plants.

Wednesday 5th March 2014

Maybe I’m too much of an optimist but I really do think that there are very few people who deliberately set out to cause harm to others when it comes to promoting their own view of how to approach the use of psychoactive substances of all sorts.

It would be tempting to put Peter Hitchens into that very small group but I can’t. For someone to qualify as intentionally wanting to spread harm they would need to be aware that their beliefs are wrong and dangerous. It is perfectly obvious that Hitchens is wrong in his core beliefs, such as that cannabis is more harmful than heroin, but he doesn’t know he is wrong so he can’t be blamed for the harm that results from other people believing what he does.

With the American group Smart Approaches to Marijuana, it is more difficult. The links between that group and those with a vested interest in increasing the number of people in treatment are strong so the temptation to see it as a cynical exploitation of the issue is great. That temptation is made stronger by the repeated misinterpretation of information by Kevin Sabet and his refusal to amend his remarks when that misinterpretation is pointed out to him.

But, today, I’m more interested in much subtler matters related to the promotion of, possibly, wrong-headed views. This results from two stories about two charities both seeking to reduce the harm done to young people as a result of the use of intoxicating substances.

The first concerns the award of a £4.3m lottery grant to the Resilience Programme For Schools, a project being run by the Amy Winehouse Foundation (AWF) in association with Addaction. The second is a story  about the work of Mentor Scotland.

The two organisations seem to take very different approaches to the same mission; educating young people about the potential harms from psychoactive substances. The Resilience Programme For Schools is described as intended to deliver targeted drug and alcohol education in schools. Its core philosophy is to use recovering addicts to deliver information about their ‘real-life stories’.

The AWF website talks about what it learned about the level of knowledge of those in treatment from numerous visits to treatment centres and says…

‘All of this has inspired the Foundation to create a drug and alcohol awareness programme that works with people in recovery, who understand what lies behind drug and alcohol problems, and which provides comprehensive training and education for pupils, parents, teachers and more.’

Mentor’s approach to reducing the harm to young people caused by alcohol is based on ‘peer-led initiatives to enhance protective factors among young people and reduce alcohol misuse’.

I may be doing the AWF a disservice by my interpretation of their plans for the Resilience Project because, elsewhere on its website, there is information about its support for a peer led education programme but there is nothing in the details about the Resilience Project to suggest that there is any sort of peer element in the programme. The Mentor website, on the other hand, has this pdf about what is known about the effectiveness of drug education programmes. Though it acknowledges that the evidence base is limited, it concludes that interactive peer-based programmes seem to show better results that ‘delivered’ programmes.

Here’s my problem. When I deal with tobacco during my talks I quote a statistic (statistics are always open to dispute, it seems) and a non-statistic that rings completely true. The statistic is that 50% of those who smoke shorten their lives as a result. The non-statistic is that 100% of smokers assume they are in the other 50%. ‘That’s not about me’, is a common response to information about risk.

For substance use education to be effective, it seems to me, the young people receiving that education have to be convinced that they are at risk. As I saw during my time at the Alnwick Garden, using stereotypical representations of substance abusers to deliver education messages does not engage the attention of ‘normal’ young people who do not, in any way, identify with those presentations.

I fear that the Resilience Project will also fail to engage young people because they will view anyone in recovery as being a failure and no-one accepts that they could also fail. I’m basing that on my personal experience and my own views, I fully realise, but I’m having to do that because I haven’t found any evidence that suggests the AWF approach has been tested and found to be effective.

A look at Twitter didn’t allay my fears but did add to my confusion.

David Foxcroft Tweeted;

David Foxcroft ‏@davidfoxcroft  • Mar 3 
Sigh..still a long way off evidence based prevention MT @andrewbrown365 £4.3m funding to @AmysFoundation @AddactionUK

Eliciting this reponse from Addaction;

Addaction ‏@AddactionUK  • Mar 4 
@davidfoxcroft Hi. We're conducting largest ever RCT of YPs (10K) engaging in drug/alc awareness programmes in England, overseen by Harvard.

That seems to be saying that there is, as yet, no evidence to support the Resilience Project but it also confuses me because the Big Lottery Fund website says that the project will ‘deliver a five-year Resilience Education programme to 250,000 secondary school children across England’, not that a pilot study of 10,000 is being conducted.

I don’t know if this means the full rollout of the project (and, hopefully, the full payment of the grant) is conditional on the success of the RCT or whether the spend is going ahead regardless.

Obviously, I’m not privy to the details of the application made for the lottery grant and it may have given details demonstrating the effectiveness of the proposed programme but I worry that the decision to award this grant was based on subjective assessments by adults of what they believe young people will respond to.

If young people thought the way adults think they think there would be far fewer problems, of all sorts, for young people.

I’m writing this piece in the sincere hope that I shall be forced to return to this subject in two or three years in order to admit that I was wrong once the Resilience Project has been shown to be an overwhelming success. But my feeling, at the moment, is that this money has been awarded because this is a celebrity charity rather than because there is evidence that this approach will be successful.

But, I'm also writing it because of my concern that a well-intentioned group of people acting on belief rather than evidence could do inadvertent harm to an unknowable number of young people.

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