In reviewing the information that was compiled in the country consultations with young people, two points are evident. The first is that there is a great deal of similarity in experience and perspectives of the young people within our region. Second, on the whole, the young people who participated in these consultations feel that their country’s current efforts in addressing drug issues are generally ineffective. This second perspective applies to a range of programs from prevention to treatment to supply reduction. In addition, the young people felt that in the area of harm reduction, there were in fact few programs, which promoted this perspective. Further, they felt that in the cases where harm reduction messages were promoted, the information was often incomplete or inaccurate. As professionals, we can receive this information in a number of ways. One reaction could be to dismiss it as the sincere, yet uninformed opinions of young people. A second would be to embark on an effort to conform all program approaches to the advice they have provided. Yet as is often the case, the best response is perhaps somewhere in the middle. The perspectives of young people are invaluable and should be balanced with our collective understanding of what well-designed research has demonstrated as effective practice. In that regard, it is interesting to note that much of the information the young people have provided in these consultations in fact reflects what the research literature would suggest. For example, in the area of prevention the young people dismissed the effectiveness of scare tactics and instead recommended the teaching of decision making and other appropriate skills; with regard to treatment they suggested that programs be of adequate length, involve families and provide strong aftercare. Those familiar with the literature on effective prevention and treatment know that these suggestions are verymuch in accordance with what the research on these topics would support. The following three sections will summarize young people’s views on the nature of drug use, the various types of approaches that have been used in their country to address this issue, and their recommendations for developing effective programs.
Nature of Drug Use Among Young People
I had refused my friends when they asked me to try to smoke drugs the first time. My friends said that it would make me feel good after smoking it. Finally I tried it after my friends had persuaded me for several times. I could not sleep after I had tried for the first time. I didn’t even know it was yaba (amphetamine).
The young people who participated in the consultations identified a number of reasons why young people use drugs. These reasons include issues related to personal feelings and beliefs, family factors, peer influences and social conditions. Personal feelings and beliefs range from the desire to seek positive outcomes associated with drug use such as improved school and work performance to the need to cope with life’s problems and stresses. In identifying the extent to which family factors contribute to drug use, the young people suggested that parents who constantly fight, put pressure on their children or show little interest might lead young people to use drugs. With regard to peers, the young people spoke of both external and internal pressures to use drugs. In some instances they identified situations where peers activity encouraged their involvement in either using or selling drugs. In one case, they spoke of a progressive scheme designed to lure them into drug use and then involve them in selling drugs to others. In other instances the pressures were internal. The young people simply wanted to fit in with others and felt that using drugs would lead to a more interesting social life. Finally, with regard to social conditions, young people suggested that the easy availability of drugs, coupled with media images that made use attractive, created an environment that was conducive to drug use. In reflecting on the young people’s discussions on the nature of drug use several points are worth noting. The first is, that as the literature would reinforce, drug use is often the result of a series of complex factors including conditions that are present in both an individual and the environment in which he or she lives. Secondly, as one examines the reasons advanced for initial use versus continued use, it is clear that there is a shift in why an individual uses drugs over time. While the reasons for initial use was to some degree attributed to dealing with problems, it was for the most part seen as a way to enhance one’s experience. When the young people discussed why some people continued using drugs, it was clear that enhancing effects became less important and the degree to which the drug could be used to cope with life became more important. Also of note, is that as drug use continued, the role of peer influences also increased. Finally, in some cases the addictive nature of drugs was mentioned in that young people continued using because they found it difficult to stop. With regard to the effects of drugs, young people are aware of the many physical harms associated with drug use. They also felt a major negative consequence of drug use was being arrested and/or killed by either police, dealers, or the continued use of drugs. In other instances, they reported what they felt were the positive effects of use including an increased sense of selfesteem and acceptance by peers and boy/girlfriends. Little was said about the long-term psychological impact of drug use, although some young people did speak about the extent to which drugs can take away your sense of value and dignity. In some cases, the young people were also aware of the relationship between injecting drug use and HIV/AIDS, but others were not. In many cases even those who were aware of this relationship did not have an accurat understanding of how to protect oneself from infection. In the case of factors that contribute to young people stopping drug use, it was interesting to note that the role of the family was mentioned by a number of young people. In other instances peers were also identified as key factors, especially the support of a boy/girlfriend who does not usedrugs and disapproves of use by others. In other cases, young people attributed stopping drug use to lack of availability or high prices (especially as a result of government crackdowns on drugs). These young people also pointed out that they were afraid of being arrested and sent to detention centres by the police. Other reasons cited had less to do with fear of negative consequences and were more related to young people’s desire to achieve a sense of self-worth, as well as the respect of their family and community. Finally, others pointed to their interest in maintaining a job to be able to help support their family.
Young People’s Impressions of Programs Designed to Address Drug Issues
The government does not provide any alternative activities. They only arrest us and send us to detention centers. If you would like us to stop using drugs, putting us in a detention center is not the right way. It doesn’t solve the root of the problem.
The impressions of young people regarding programs that address drug issues can best be summarized in the form of a chart. Exhibit One identifies seven key program areas that young people reported having some level of experience with in this region.
The seven key areas are (1) School-Based Preventio(2)Communications/Media/Social Order Campaigns (3) Faith-Based Programs (4) Harm Reduction (5) Treatment (6) Aftercare and (7) Supply Reduction.
Exhibition One
|
Program Type |
Young People’s Comments | Young People’s Assessment |
| School-Base Prevention | Young people identified prevention as an important activity that should be age and culturally appropriate, and both provide information as well as teach refusal skills and decision making. | These programs are generally ineffective since programs are either based on scared tactics or are inadequate with regard to the information presented. Also, teachers are not properly trained. |
| Communication/Media/Social Order Campaigns | Campaigns of this nature have been developed in each of the countries involved in the consultation. These campaigns involve a range of media including brochures, speeches, parades, and billboard messages. | These campaigns are ineffective because the messages are usually too general (examples: Bad people use drugs or don’t use drugs). This messages will not work with young people, especially drug users. |
| Faith-Base Programs | Young people identified faith-based treatment approaches that ranged from exorcism to residential treatment programs. | While issues of faith were identified as important factors for stoping drug use, the young people suggested that religious program staff don’t always understand drug users and sometimes treat them in a hars and judgmental manner. |
Exhibition Two
|
Program Type |
Young People’s Comments | Young People’s Assessment |
| Harm Reduction | The young people had some exposure to harm reduction messages in some countries, and no exposure in others. Programs included presentations on clean needles and syringes as well as distribution of brochures. | Overall, even in those instances where harm reduction was addressed, the young people felt that much more should have been done. Further, they reported that many providers are not familiar with harm reduction or gave inaccurate information about drugs.Note: The lack of accurate information was reinforced in the young people’s discussions of harm associated with drug use. For example, manny unaware of danger associate with drug use especially in relationship HIV/AIDS |
| Treatment | The young people were aware of many types of treatment approaches including outpatient, inpatient, detox, therapeutic communities, faith-based programs and rehabilitation centers (included boot camps). | Overall the young people felt that treatment programs were not effective. The major reasons were two fold. One concerned the availability and/or the cost of accessing treatment. The second pertained to program staff. Young people felt that program staff often don’t adequatly understand drugs and drugs users. They also felt that staff were judgmental, disrespectfull and mistreated young drug users. |
Exhibition Three
|
Program Type |
Young People’s Comments | Young People’sAssessment |
| Aftercare | Some young people in the consultation groups were familiar with the concept of aftercare, but generally did not know of programs that provided such services for drug users in their community. | Young people pointed out that aftercare is an important part of treatment but is generally not available. One participant observed that the only extent to which follow-up occurs is that they are told to report periodically to the police after they are released from detention and rehabilitation centres. When they meet with the police they are encouraged to identify other drug users and sellers in the community as opposed to being offered support. |
| Supply Reduction | The young people were very aware of high-profile government effort to control the supply of drugs. These efforts included police crackdowns on deallers and users. | The young people felt that these campaigns were generally effective in the short run by both decreasing the availability of drugs, as well as driving up the price to a level that is prohibitive for many young people. On the other hand, they reported that most people just turn to cheaper and sometimes more dangerous drugs (like glue sniffing). They also said that the effects of these action would be temporary and that in time the drug users who are arrested and placed in detention centres will return to drugs use and that systems for selling drugs will be re-established |
Recommendations of Young People
The recommendations advanced by the young people who participated in the consultation groups concerned a number of key areas. With regard to prevention programs, young people suggested that governments need to promote the active involvement of communities, schools, and families. With regard to specific program development, the young people noted that the age of first use is getting younger, so prevention programs need to begin with young children prior to their first exposure to drugs. Programs should also focus on skill development as opposed to providing only information and should be age and culturally appropriate. Schools should play an important role, balanced by alternative programs in the community and support for families. Teachers and other professionals should receive proper training to provide accurate and relevant information. The young people also recommended the use of positive peer pressure both in school andcommunity settings including the establishment of youth camps that provide opportunities for discussion, skill development and positive alternative activities. Specific mention was also made of issues of harm reduction. Young people noted that very little information was available on this topic and recommended that programs be developed to educate young people about ways in which to reduce the harms associated with drug use – especially the harm related to the use of needles and syringes as it pertains to HIV/AIDS infection. With regard to treatment, the young people suggested that service providers should consider the importance of early intervention including outreach services designed to educate and motivate young drug users. For example, they recommended developing programs that help young people learn the risks associated with drug use, as well as the steps one must take to quit using drugs. In addition, the young people made some specific recommendations for treatment programs. They suggested that programs find ways to encourage voluntary entrance to treatment and have varied courses of treatment depending on the nature of an individual’s drug use. They also recommended that programs require the participation of families. Further, they felt that in many cases, service providers needed to stop being judgmental of young drug users and instead deal with them in a professional and compassionate manner. Given the fact that most young drug users are distrustful and resentful of service providers in general, it is all the more important for providers to consider ways to create supportive environments for treatment and rehabilitation. Finally, they suggested that due to the huge gap between need and treatment services, alternatives to rehabilitation centres, such as family and community-based programs, should be considered as effective options for young drug users. Finally in the area of supply reduction, the young people recommended reconsidering the strategy of conducting police crackdowns on drug distribution as a sole strategy. The young people observed that while these programs typically have impressive short-term effects they often drive users to seek cheaper and more dangerous drugs (such as glue, fake drugs) and/or resort to crime to get additional money. In addition, they felt that once these initiatives are completed, networks for drug distribution are quickly re-established and old patterns of drug use resume.
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November 7, 2007 at 7:39 am
[...] an interesting post today on Meeting on Regional Consultations on Young People, Drugs and …Here’s a quick [...]