The substance of youth - the place of drugs in young people's lives today

By Perri 6, Ben Jupp, Helen Perry and Kristen Lasky, November 1997

8. Policy implications

In this concluding chapter we draw out the key implications of our research for policy makers.

Current policy goals
If a drug is illegal, then by definition one policy goal is to enforce prohibition. But public authorities also have goals of education, diverting people from drug use, harm reduction, and the reduction of related crimes. The Conservative Government's White Paper, Tackilng drugs together[49] - which Labour, whilst in opposition, broadly accepted - defined the goals of British government policy as:

Vigourous law enforcement
Accessible treatment
A new emphasis on education and prevention to:
- increase community safety from drug-related crime
- reduce the acceptability and availability of drugs to young people
- reduce the health risks and other damage related to drug misuse

This research has identified some circumstances and attitudes of non-users, recreational users and problem users. This allows two broad types of conclusion:

approaches by agencies which may be more effective because they take account of the attitudes of their 'target' groups and the resources which these 'targets' themselves may have in relation to drug use
approaches which may help change the circumstances or attitudes of one group to make them more like another - e.g. make problem users more like non-users by making them less isolated.

Although it cannot be proven that in any individual case a change in behaviour will take place as a result of taking circumstances and attitudes into account, it seems reasonable that such approaches may have a better chance of success than those that ignore them.

The conclusions of this project suggest approaches for policy that is aimed at getting young people to abstain from drugs altogether, policies aimed at harm reduction among recreational users and policies aimed at helping problem users. The next section deals with abstention, followed by sections on harm reduction in general, with particular reference to recreational users and problem users.

Abstention
This study is not concerned primarily with investigating the feasability or desirability of prohibition and abstention. However, our findings on the attitudes of young people towards the acceptability of drug taking suggests strongly that many remain to be persuaded of the case for prohibition and abstention, and are least persuaded in respect of the most widely consumed drug, cannabis. A number of respondents also described others' condemnation of cannabis but acceptance of alcohol and nicotine as hypocritical. These findings are supported by the results of recent quantitative surveys which indicate that the majority of under-25-year-olds believe that cannabis should be legalised in one form or another.[50]

Cultural norms have a long history of influencing the extent and nature of drug use. During the early twentieth century, cocaine use in the United States dropped dramatically as the drug became associated with crime and violence. Likewise, after crack became associated with crime during the late 1980s its consumption fell, except in the most deprived inner cities.[51]

However, there are few social norms for abstention which agencies can support. No recreational users reported that they were significantly concerned about their friends' reactions to their drug use, although many were somewhat worried about their parents' reactions.

Drug use and leisure activities
Many efforts at diverting young people from drug taking have sought to offer experiences of excitement and exhilaration - usually from some kind of sport or physical activity - in the hope that these might substitute for those offered by at least certain kinds of drugs. The theory behind such measures appears sensible at first glance. We found that young non-users usually express similar levels of desire for excitement to recreational drug users, and these were often satisfied through leisure activities such as sport. However, during more detailed interviews it became clear that these activities and facilities, while valuable, and while seriously lacking in deprived communities, are often seen by young recreational users as complements rather than substitutes for drug use. For many, drugs are an integrated aspect of other social activities, be that clubbing, seeing friends or sport. Consequently, it is difficult to find simple substitutes to fill time or provide excitement.

Harm reduction
Reducing the harm that drugs cause requires many strategies, as Tackling drugs together recognises. But harm reduction strategies must take account of the social and cultural environments in which they are implemented. A number of general lessons for drug education and health promotion can be drawn from our findings on each of the clusters of values and attitudes that we examined.

It would be wrong to assume that everyone who uses drugs - or even that most of those who use them regularly - are in need of assistance from formal organisations to reduce their risks of harm. Those who manage their use in this way could be very valuable if recruited to assist and support others who are at risk.

Authority
If harm reduction is to be a key principle of drugs policy in Britain, it is crucial that young people do not perceive drug-related services to be part of law enforcement. Many authority figures command a good deal of respect amongst young people, but trust in the police was very low amongst both recreational users and problem users.

Agencies offering public information, such as the Health Education Authority, need to enhance their credibility and trustworthiness by reinforcing the message that their principle organisational goals are not those of law enforcement, but health promotion. In addition, as new drugs are developed and marketed, the importance of messages to the effect that 'no-one knows the associated risks' will be of greater importance in establishing credibility. In general, reliance on fear-raising tactics tends both to reduce the credibility of the message with young drug-takers, and to increase stereotyping of users by non-users.[52]

However, the role of a national drugs czar could run counter to these messages. We therefore suggest that he or she should be a champion for local services, rather than a champion for law enforcement.

Using parents as channels for advice
Over the last 20 years, trust in all sources of advice on specific issues has become more contingent on the particular expertise of the person. People in general, and young people in particular, are less likely to place unconditional trust in anyone, be they parents, teachers, or the government, simply by virtue of their status.[53]

However, this research does find that trust in and respect for families remain strong and important to most young people, irrespective of whether they use drugs, pointing to the family as possible advisors and guides to young people in the context of drug use. It is a role which harm reduction strategies could utilise.

Keeping parents informed about drugs and why people use drugs is therefore more important than ever before if the latent trust and respect which exists in many families is to translate into listening to advice on drugs. Parent awareness programmes, such as that organised by Cambridgeshire County Council, are one way to convey such information.[54]

Harm reduction for recreational users
The credibility and trust needed by agencies involved in harm reduction for recreational drug users can only be gained if they are prepared to commit themselves to a message that is perceived as endorsing the validity of youth cultures and independence for young people, including commercial leisure and the value of pleasure-seeking lifestyles. When harm reduction messages have been heard by young people as denying any of these elements, they have lacked credibility and trustworthiness.

Life-skills education programmes
The Ofsted report, Drug education in schools, states that effective teaching seeks to 'increase pupils' knowledge and encourage the pupils to improve their self-esteem...develop self-confidence; develop assertiveness in appropriate situations' and a range of other life skills.[55]

However, we found that most recreational drug users had equal or greater social and life skills or competencies than those who do not take drugs. Respondents with a more introvert outlook were less likely to have tried drugs. The Exeter University Schools Health Education Survey found a similar pattern of higher self-esteem amongst 15- and 16-year-olds who had ever tried drugs.[56]

Although life skills education programmes, which seek to give students the social skills to resist drug taking, are extremely popular in the United States, our research sheds some doubt on their likely effectiveness in this area. While schools may want to encourage life skills as part of a broad education, policy makers should not expect such an approach to reduce recreational drug use.

There have been some trials in Britain, including a pilot project in three Hackney schools. However, these programmes are not a standard part of the curriculum,[57] and their effectiveness in Hackney will need to be carefully monitored. So far, studies have found that 'no consistent pattern of positive results emerges from evaluations of values and skills based approaches'[58] and our findings perhaps help to explain why this is the case.

Using the social norms of youth sub-cultures
It is difficult for governments to influence social norms, particularly amongst young people. But harm reduction (and abstention) campaigns succeed most when they work with cultural norms. There are plenty of examples from the wider field of health promotion that make this point: for example, campaigns to reduce back injuries among nurses have been successful when they have worked with the whole culture of patient care rather than simply providing information.[59]

However, our data suggest there are important resources amongst young people who take drugs that can be drawn upon in minimising the harm drug use can cause. For example, there is disapproval of people who are out of control, who borrow money or steal to finance consumption, and a sense of duty to rescue other people in trouble. And we found examples of how young people take practical steps to try to stop the harm drugs can cause by helping out friends with financial problems or trying to get them jobs.

This suggests there is a case for more resources and effort being put into strategies of 'enrolling' users themselves in peer-led work to explain and encourage safe use, and to stigmatise harmful practices. Recreational users are no more susceptible to peer influence than young people in general, but peer pressure is a real, if resistable, phenomenon. Although peer influence can spread misinformation if not channelled sensibly,[60] it makes sense to inform and mobilise it wherever possible.[61]

Of course, sometimes peer pressure works precisely because it is about resistance to authority, and many studies have found that drugs are often attractive to some young people precisely because they are illegal.[62] Our data suggest, therfore, that the way forward in such strategies is to brand them in ways that sharply distinguish them from the efforts of law enforcement agencies and not to depend too much on arousing fear or moralising.[63] This, in effect, is the insight underpinning some of the more successful local initiatives.[64]

The most important lesson from our findings with regard to the cultural role of drugs is that local policy makers need to have a clear understanding of the different cultural norms within various local youth cultures. Greater understanding can be achieved by the local use of some of the methods that we have used in this study, as well as more ethnographic work.

A crucial finding of our research is the variety of local sub-cultural groups in which drugs are taken. Moreover, even the rave culture - itself a locally specific phenomenon - is splitting into many very different music and dance scenes - 'happy hardcore', 'jungle', 'drum and base', 'house' and 'garage', and 'techno' and 'trance'. We found groups in which drug use signified mild individualism, while in other parts of the country such individualism was more manifest in not taking drugs.[65] The fact that there are such big differences between local youth cultures argues that policies to reduce the harm that drugs can do cannot be designed effectively at the national level.

Approaches to help problem users and reduce the incidence of problem use
Family roles and isolation
The isolation of problem users was a consistent finding of our research into relationships and trust. It is an important difficulty. Harm reduction strategies for problem users should develop new ways to enable and encourage forms of social networking with other people who are not also problem users.[66]

For some problem users, such as those we interviewed in Wythenshawe, both their parents and children were often extremely important and could be a source of integration with wider society. Therefore, wherever possible it would be important to support problem users in their family roles. Unfortunately, we found evidence that problem users often do not seek such support from social services for fear that their children may be taken into care. If social services are to provide the most useful support possible, efforts must be made to allay such fears.

Problem users formed the only group who did appear to have a less confident outlook. It is difficult to distinguish whether problem drug use is a cause or an effect of such an outlook, though some help with developing life skills may be appropriate for problem users.

Depressed aspirations in areas lacking resources
Many young people who have tried drugs express less concern about challenges in their lives than do their non-drug taking peers, but this appears to be especially so for young people in particular environments. This was reflected in our research in Wythenshawe. Wythenshawe illustrates that one clear effect of the concentration of poverty is to depress aspirations and expectations, which in turn reduces young people's efforts to succeed, and their willingness to use drugs safely.[67] In Wythenshawe, we found drug use to be more associated with filling time, or even escapism. General urban regeneration policies to improve facilities and prospects in areas such as this may be as important as any policies aimed specifically at current drug use.[68]

Conclusions
On balance, our findings have optimistic implications for policy makers working in this field. While the techniques of drug education, peer involvement, information provision and support for recreational users in place in Britain may still need further development, there are strong reasons for continuing to innovate in these fields. Authoritarian strategies have high costs in credibility with young people, and do not have an influence on Britain's youth cultures. However, there are resources to be drawn upon in the values and attitudes of yong people themselves.

There remain areas of deprivation and misery where drugs can reinforce the great problems already existing, however understandable it is that trapped young people in such places will turn to them. In these settings, social policy makers need to take more account of the potential impact on drug taking of their strategies for housing, training, transport, leisure and so on.