Ex-ice users lecturing school kids isn't the answer to preventing drug use

Australia is following the lead of the United States and sending ex-ice users into schools in the hope they can have an impact on kids' attitudes towards drug use and prevent use.

The Australian Anti Ice Campaign has recently rolled out a program based on the Montana Meth Project. Former users show confronting images of some of the negative effects of ice use and share personal stories of suicide attempts, mental health problems and deaths from ice.

But, although well-intentioned, there’s little evidence this type of program is effective. It may even serve to normalise, and therefore increase, drug use.

So what works in school-based drug education and how should schools implement drug policy?

What works for school drug ed?

According to the United Nations Office on Drugs and Crime (UNODC), programs are more likely to be effective if they:

• use interactive methods
• are delivered by trained facilitators
• are delivered through a series of structured sessions, often with refreshers
• normalise the non-use of alcohol and other drugs
• impact perceptions of risk associated with substance use
• provide opportunities to practise and learn personal and social skills.

Programs are more likely to be ineffective if they:

• use non-interactive methods like lecturing
• are information-only, particularly if they are based on fear
• are based on unstructured chat sessions
• focus only on building self-esteem and emotional education
• address only ethical or moral decision-making or values
• use ex-drug users as testimonials
• use police officers to deliver the program.

Australia’s broader drug policy is based on “harm minimisation”. This acknowledges it’s impossible to eliminate drugs from society and that most people will use drugs only occasionally and for a short period in their lives. So reducing harms associated with drug use is the priority.

The Australian government’s Principles for School Drug Education state that drug-education outcomes should contribute to the overall goal of minimising drug-related harm.

In Australia, school programs that adopt a harm-minimisation goal have been shown to prevent and reduce alcohol and other drug use.

Who should drug ed programs target and how?

Universal programs

Universal school-based alcohol and other drug-education programs are delivered to all students, regardless of level of risk. They have the advantage of reaching large audiences at relatively low costs.

Many of the available universal programs are ineffective at best. Some have even been shown to increase risk of alcohol or other drug use.

Most school-based programs have had very little evaluation, but among those that have been evaluated with Australian students, Climate Schools has the best evidence. A number of other evidence-based universal programs are available.

Selective programs

Selective programs are designed for adolescents and young people who are at greater risk for developing substance-use problems.

They often show bigger impacts on drug use than universal programs, but are often not used in schools because of practical limitations and risk of stigmatisation.

Only one selective program has been evaluated in Australia. “Preventure” has been shown to reduce drinking and problematic drinking among high-risk youth.

Online programs

Some 87% of all households and 97% of households with 15- to 17-year-olds in Australia have access to the internet. Most children also have internet access at school. This makes online programs increasingly important for alcohol and other drug education, and a number do appear to be effective.

The online programs Consider This and Climate Schools have the most evidence for reducing alcohol and drug use.

What should schools do?

Based on what we know about programs that are and aren’t effective, programs like the Meth Project are unlikely to have any significant impact on drug use. But they may increase acceptability of drug use among students.

An evaluation of the US program, on which the Australian program is based, showed no evidence of positive outcomes. It found an increase in the acceptability of methamphetamine and a decrease in the perceived danger of using drugs among school students exposed to the program.

Schools should ensure their school drug policy is comprehensive and includes only elements we know to be effective, meaning they have been shown to reduce alcohol and other drug use.

In December 2015, the Commonwealth government launched the Positive Choices portal as part of the government’s drug and alcohol prevention strategy for schools. This provides evidence-based drug prevention resources for teachers, students and parents to support positive choices about drug and alcohol education for young people.

Nicole Lee provides alcohol and other drug policy development and training to schools and other workplaces as a private consultant. She has previously been awarded funding by Australian and state governments, NHMRC and other bodies for evaluation and research into drug prevention and treatment.

Nicola Newton currently holds a research fellowship from the Society for Mental Health Research and her research into drug prevention has been funded from the Australian Government Department of Health and the National Health and Medical Research Council. She is co-director of Climate Schools Pty Ltd.