Prevention Update

The Drug Strategy 2010 is structured around three themes: (a) reducing demand (b) restricting supply (c) building recovery in communities.

Findings on Their Early Intervention Activities:

• Early intervention activities were central to achieving the Drug Strategy 2010’s aim of reducing demand for illicit drugs.
• Designed to tackle the risk factors associated with drug misuse and other risky behaviours, early intervention activities can prevent a wide range of adverse social outcomes relating to offending, family, education and employment.
• However, due to the time-lag between interventions taking place and their (desired) effect, there is a lack of evidence supporting their long-term impact.
• When implemented according to the broader evidence base of what works, early intervention activity can be effective in reducing risk factors associated with drug use, and in turn drug use itself.
• Approaches most likely to be beneficial are those targeted at multiple risk behaviours, as opposed to targeting drug use alone.
• Interventions most likely to be effective include pre-school and family-based programmes.
• There is promising evidence that interventions such as Personal Social Health And Economic (PSHE) education, family nurse partnership programmes, family intervention projects and MyPlace can positively impact on reducing risky behaviours and subsequently drug use. However, the strongest evidence typically comes from the United States of America (which has different health and education structures), with evidence from the UK tending to be less robust methodologically.
• Estimates suggest that central government spending on early intervention activity under the Drug Strategy 2010 may have fallen from an estimated £269 million in 2010/11 to £215 million in 2014/15.
• Due to the absence of sufficient data (on expenditure, reach of early interventions, and drug use outcomes), it was not possible to produce value-for-money estimates for early intervention activities.

Full Report: http://findings.org.uk/PHP/dl.php?file=HM_Government_8.txt&s=eb

Changing patterns of substance misuse in adult prisons and service responses.
HM Inspectorate of Prisons [UK] HM Inspectorate of Prisons, 2015.

Inspection findings on individual prisons were supplemented by fieldwork in eight prisons in 2014 to generate an overall picture of drug use and responses to it in prisons and England and Wales. In the face of rapidly changing and varied drug use patterns, policy and operational responses were seen as insufficiently flexible and dynamic.

Prisoners are more likely than the general population to have histories of drug misuse, and in some cases this misuse continues in prison. When work on this inspection began, there had been a recognised shift away from the use of opiates and drugs controlled under class A of the Misuse of Drugs Act [such as heroin, cocaine and amphetamines] towards the misuse of medication in prisons. During this work patterns of substance misuse in prison changed again and the use of new psychoactive substances (NPS), and in particular synthetic cannabis, emerged as a major problem.

The inspection drew on 61 reports on prisons published by HM Inspectorate of Prisons between April 2014 and August 2015. A total of 10,702 survey responses were included in the analysis.

These inspection findings were supplemented with findings from fieldwork conducted in eight prisons between June and November 2014, including 1,218 responses to a confidential survey which asked prisoners about their drug use before going into custody and in their current prison.
Full Article: http://findings.org.uk/PHP/dl.php?file=HMIP_1.txt&s=eb

The objective was to report 24-month outcomes of the Teacher-Delivered Personality-Targeted Interventions for Substance Misuse Trial (Adventure trial) in which school staff were trained to provide interventions to students with 1 of 4 high-risk (HR) profiles: anxiety sensitivity, hopelessness, impulsivity, and sensation seeking and to examine the indirect herd effects of this program on the broader low-risk (LR) population of students who were not selected for intervention.

The design was a cluster randomized controlled trial in secondary schools in London, United Kingdom. Participant were a total of 1210 HR and 1433 LR students in the ninth grade (mean [SD] age, 13.7 [0.33] years).
Schools were randomized to provide brief personality-targeted interventions to HR youth or treatment as usual (statutory drug education in class). Participants were assessed for drinking, binge drinking, and problem drinking before randomization and at 6-monthly intervals for 2 years.

Two-part latent growth models indicated long-term effects of the intervention on drinking rates and binge drinking rates and growth in binge drinking and problem drinking for HR youth. The HR youth were also found to benefit from the interventions during the 24-month follow-up on drinking quantity, growth in drinking quantity, and growth in binge drinking frequency. Some herd effects in LR youth were observed, specifically on drinking rates and growth of binge drinking, during the 24-month follow-up.

Findings further support the personality-targeted approach to alcohol prevention and its effectiveness when provided by trained school staff. Particularly novel are the findings of some mild herd effects that result from this selective prevention program.

Full Article: http://jamanetwork.com/journals/jamapsychiatry/fullarticle/1558064

Conrod PJ, O’Leary-Barrett M, Newton N, Topper L, Castellanos-Ryan N, Mackie C, Girard A. Effectiveness of a Selective, Personality-Targeted Prevention Program for Adolescent Alcohol Use and MisuseA Cluster Randomized Controlled Trial. JAMA Psychiatry. 2013;70(3):334–342. doi:10.1001/jamapsychiatry.2013.651

New research suggests that college students who regularly consume energy drinks are at a greater risk for future alcohol use disorder, cocaine use or nonmedical use (misuse) of prescription stimulants. The research was funded by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

Scientists from the University of Maryland, College Park, asked college students who were approximately 21 years old about their past-year use of energy drinks – highly caffeinated products marketed primarily to teens and young adults. Participants were followed over the next three years to determine whether probabilities of past-year energy drink use increased, decreased or remained consistent, and at year five were assessed for past-year substance use. In groups that showed consistent or increasing probabilities of using energy drinks over the years, researchers found higher rates of cocaine use, prescription stimulant misuse and alcohol use disorder – but not marijuana or tobacco use. This finding held true regardless of how often subjects consumed the drinks (infrequently, occasionally or frequently) and even after accounting for prior substance use and other risk factors.

Although these findings are consistent with animal studies suggesting that caffeine can prime the still-developing teen brain for later drug use, this study does not establish that energy drink consumption directly causes an increased risk for substance use in humans. Further research on energy drinks is needed to guide prevention and policy efforts in teens.
https://www.drugabuse.gov/news-events/news-releases/2017/08/energy-drink...