Harm reduction vs. prevention

Mentor examines recent dialogue around harm reduction regarding drug use, arguing that ongoing discussions around drug policy needs to be refocused on bringing prevention into the mainstream.

3 February 2015 | Policy

The tragic deaths of four men since the New Year, all believed to be the result of the same pink “Superman” pills, has again projected the debate on UK drug policy and strategies for harm reduction into the spotlight. The fatalities appear to be the result of a drug called PMA, likely taken under the impression that it was ecstasy (MDMA).

The spate of drug-related deaths sparked criticism of the UK’s “illogical and punitive drug policy” by Professor David Nutt, among others, who argued that the emergence of PMA is a direct result of international efforts to prevent the use of MDMA. The prohibition of the production and sale of MDMA (in particular a recent crackdown in Cambodia) has caused, they argue, the re-emergence of PMA and its close relative PMMA as a “toxic surrogate” for ecstasy.

In addition, a number of organisations, including DanceSafe, have called for improved harm reduction measures, in particular education on how to test drugs. Referencing drug policy in Switzerland – where users can check the chemical components in pills on location at festivals; and where no-one has died due to taking drugs at an event in seven years – organisers of events in the UK, such as Manchester’s Warehouse Project, have mooted the introduction of testing kits. Yet, as Missi Woolridge, the executive director of DanceSafe, admits, it is a “short-term solution”. Creating safe environments for drug use may prevent immediate harm, but it should not be the cornerstone of long-term drug policy.

The debate around a damage limitation approach will continue; however, the reaction to recent drug-related deaths is somewhat short-sighted. Rather, we should be concentrating our efforts and resources on building protective factors around children from a young age; on fostering ambition; on giving young people opportunities to thrive.

Evidence tells us that children who do not have aspirations are far more likely to experiment with drugs; recent work suggests that a lack of social connectedness drives addiction and long-term substance misuse. By giving young people confidence and inspiring them to succeed we can therefore avert problematic drug use and its associated risks.

Mentor has evidenced this in our work. In Scotland, Breaking Out has demonstrated the impact of youth-led peer education on the aspirations and outcomes for young offenders in Polmont YOI. In England Mentor is trialling the Good Behaviour Game in primary schools, building evidence to show that a new classroom management approach can engender improvements in behaviour among primary school children that will translate to reduced risk-taking in later life.

We believe that these types of initiatives – programmes grounded in evidence – are what we should be pursuing in order to empower young people to make positive choices. Prevention or the earliest possible intervention holds the best hope for protecting young people from the harms of drug use. Yet still only 4% of government spending is allocated to preventative initiatives. While harm reduction is important in the short-term, the debate is clouding the issue: the discussion around drug policy needs to be refocused on bringing prevention into the mainstream. As long as we fail to do so, the lives of young people will continue to be tragically affected by substance misuse.