4 April 2004

Can you 'drug-proof' children? Of course not, but you can empower them.

Harm minimization in school drug education: final results of the School Health and Alcohol Harm Reduction Project (SHAHRP). McBride N, Farringdon F, Midford R, Meuleners L, Phillips M. Addiction (2004) 99:278-291

Dear Colleagues,

This may be the most significant study of its kind and its findings are a shining beacon in the sometimes murky field of prevention. It shows significantly less alcohol use and reduced high risk behaviours over a three year period in adolescents who were exposed to a comprehensive school-based education program, in comparison with others who received the existing school approaches in Perth, Western Australia.

The title, ‘harm minimization’ may confuse some readers. Its meaning appears to be comprehensive, evidence-based and informative education with a pragmatic approach to issues. We should not be surprised at the results. If children were given structured information on any other aspect of life from cooking to hygiene, it would be expected that they would cope better with those matters than children who did not receive such education.

This important lead research paper in the Addiction journal also has four commentaries, two from New Zealand, one from South Australia and a rather wry one from Holland. These wrest the gist of the paper, only Peter Anderson from Holland being critical. He states that alcohol problems are so pervasive in our community that schools projects like this are ‘barking up the wrong tree’. This view is so clearly amiss that one wonders if he is being purposely perverse.

The findings are dramatic and significant, yet they are in no way surprising if we follow what most educationalists have been saying for many years. Drug education (like personal hygiene, sex, politics, religion, etc) should usually be taught by existing teachers in the normal course of school classes. The courses should be evidence based, factual and appropriate to the level of understanding of the age being taught. Hence, learning more about alcohol, its many dangers, possible benefits, history and place in society can hardly disadvantage a young person coming into contact with the substance. Some will wisely choose not to drink, following the legion logical reasons for abstinence. Some may choose to drink small amounts in the company of family or others. Others still may choose to binge drink, thus taking the (informed) risks and suffer the predictable negative outcomes.

The authors caution that this is a single study and its findings need to be corroborated in further work. Whether the benefits are sustained beyond the teenage years is also unknown. The field is of such importance that it should take a high priority for official funding, like interventions for smoking, illicit drugs and other dangerous behaviours. The results contrast starkly with the American DARE (Drug Abuse Resistance Education) experience in which armed, uniformed police administer drug education to children. Evaluations have shown either no effect on drug use or, in one case of rural children, worse outcomes!

Even at this stage, it would seem appropriate that a comprehensive education curriculum should be introduced into schools with the aims of reducing alcohol related harms.

comments by Andrew Byrne ..

Education package: http://www.curtin.edu.au/curtin/centre/ndri/shahrp/

Full citation: McBride N, Farringdon F, Midford R, Meuleners L, Phillips M. Harm minimization in school drug education: final results of the School Health and Alcohol Harm Reduction Project (SHAHRP). Addiction (2004) 99:278-291