Knowledge and experience of young people regarding drug misuse, 1969–94

KNOWLEDGE OF ILLICIT DRUGS

Cannabis was the most commonly mentioned drug in 1994 and cocaine the second most commonly mentioned drug. The misuse of cocaine has increased rapidly in recent years. The significant decrease between 1989 and 1994 in the proportion of pupils mentioning opiates is probably associated with the fact that in 1994 there was less publicity than in the late 1980s, the time of the government's campaign against heroin. The dramatic 10-fold increase between 1989 and 1994 in the mentioning of ecstasy was probably influenced by media coverage of this drug.

The proportion of pupils mentioning amphetamines in 1989 and 1994 also increased significantly. In Wolverhampton concern exists not only about the increased availability of illicitly produced amphetamines but also about the fact that a large proportion of users are injecting. The proportion of pupils mentioning solvents, however, has not increased over the past five years, which is surprising, considering not only the number of deaths from misuse of volatile substances nationally (122 in 1991)7 but also the extent of national media coverage. The reason could be that in recent years the local press has, to its credit, given more responsible coverage to misuse of solvents. The proportion of pupils who replied to the question, “What dangers do you know of these drugs?” has increased over the 25 years of the study, but the level of knowledge of some of the dangers has decreased over the past five years. The replies in 1994 continued to be limited and often inaccurate. The 1994 results seem to be closer to the 1984 results than to those of 1989.

Between 1989 and 1994 the proportion of correct responses to the question, “How are these drugs taken?” increased significantly for lysergide and amphetamines, but decreased significantly for opiates. Other research also indicates limited knowledge of the dangers of illicit drugs.8

EXPOSURE TO DRUGS

Between 1969 and 1994 the proportion of pupils who knew someone taking drugs more than quadrupled, and the proportion who were offered drugs increased ninefold (figure 2). It is of concern that these proportions more than doubled between 1989 and 1994. Although many of the pupils may know the same person, this increase still indicates a greater exposure to drugs. In their 1986 survey of teenagers aged 14 and 15 in Portsmouth, Brown and Lawton found that 41% knew someone taking drugs.9 Bean et al reported the same figure in their 1987 survey in Nottingham.10 Balding's 1993 survey of the United Kingdom showed that 64% of boys and 69% of girls knew a drug user.8 In a 1992 survey of eight schools in the north west of England, Measham et al found that 59% had been offered drugs.11

A much greater proportion of pupils in 1994 stated which drugs had been offered to them than in previous years. The drugs mentioned by those who knew someone taking drugs and by those who had been offered drugs were cannabis, lysergide, ecstasy, cocaine, and amphetamines (table II). Surprisingly, the proportion of pupils mentioning solvents, which were first mentioned in 1979, reached a peak in 1984 and has been decreasing since then. These findings were similar to those of a study in 1990 by Smith and Nutbeam in Wales of teenagers aged 15 and 16 who were offered cannabis, solvents, and psilocybin.12

It is interesting that in Balding's study and in the present one opiates were rarely mentioned, which is consistent with a current view that people who inject heroin are out of favour on the drug scene. A greater proportion of pupils replied to the supplementary question, “Where were these drugs offered?” in 1994 than in previous years (table II). Up to 1979 the most commonly mentioned place was “party” but since then has been “street.” Between 1989 and 1994 the proportion of pupils mentioning “discos” increased significantly, which is probably linked to the rave and music scene. It is of concern that among those who had been offered drugs “school” has also become a significantly more common source of drugs in the past five years.

REASONS FOR TAKING DRUGS

Consistently over the years, “to feel big, show off, feel grown up” has been the most commonly mentioned reason for taking drugs (table III). In 1994 the second most commonly mentioned reason was “for kicks, for fun, to feel good,” which replaced “because friends do, trendy.” Pupils continue to see social and peer group pressures as the main influences on a decision to start taking drugs, a view endorsed by Swadi.13 The perception that drugs are taken “for kicks, for fun” shows that these young people are aware that drugs do have pleasurable effects, a point often ignored by educationalists.

EDUCATION ABOUT DRUGS

During the 25 years of our study television has continued to be the main source of information about drugs, though it was less often mentioned in 1994 (table IV). Friends have replaced newspapers as the second most commonly mentioned source. “Talk in school” has become a significantly more common source since 1989. The role of parents as a source of information has increased over the years, although parents were only the fifth most commonly mentioned source in 1994. It is of concern that over the 25 years the approaches to and methods of effective education about drugs for young people remain largely illusory. Ignorance, however, does not help, and doing nothing is not an option. Education about drugs is needed for young people, professionals who are in contact with young people, parents, and, through the media, the general public. Moreover, while television continues as the main source of information about drugs, producers must give responsible coverage and avoid glamorising the subject.

In his review of a range of primary prevention strategies Cohen concludes that none of these strategies has reduced drug use among young people.¹⁴ Assuming that many “normal” young people will inevitably experiment with drugs and that they expect to do so with minimal risk, Cohen and others argue for a secondary prevention approach, through “harm reduction drug education,” the goal of which is “to reduce the number and severity of casualties.”¹⁴ 15 A shift of approach to include harm reduction drug education, however, could have dangers, and the approach might give the wrong message to young people. Careful planning and thorough evaluation are essential.

It is also vital that education about drugs does not take place in isolation. Within the framework of the national curriculum substance misuse should be taught in both primary and secondary schools through a wider programme of personal health and social education. The danger is that other demands of the curriculum may mean that personal health and social education is not given the importance that it deserves. If this approach is to be successful then teachers must be well trained and kept up to date. This point is endorsed by the Advisory Council on the Misuse of Drugs.16

In relation to the need to educate parents any programme should not only give information but should also help them with parenting and communication skills. Family background and parenting styles have been found to predict later adolescent drug misuse.13 Some drug prevention teams funded by the Home Office have successfully worked with “parent empowerment” groups. A leaflet published recently by the Department of Health carries the message, “If you don't talk to your child someone else will” and emphasises the role of parents.17

For some people a religious faith can make a positive contribution to their not starting to take drugs.18 In addition, many users have found a new quality of life without drugs through their Christian faith.¹⁹

CONCLUSIONS

The results of this study should be interpreted in the light of national and local changes relating to drugs in medicine, law, society, and coverage by the media. From this and other studies, however, it is clear that an increasing proportion of young people are in contact with illicit drugs from their early teens; that a greater variety of drugs are more widely available both socially and geographically; and that young people expect to enjoy the pleasurable effects with minimal harm. If prevention of drug misuse through education is to have a sustained impact then adequate resources of both trained teachers and suitable materials must be available. The health education coordinators should again be funded centrally if their vital coordinating and training role is to be implemented.

The authors thank D Dervos; D F Goda; K Grice; L Fisher; Dr K Hackett; I Handley; J Hatton, from the Institute for the Study of Drug Dependence; T M Page; A Parkes; E L Price; P Tilstone; and the three participating schools. We thank also the Royal National Institute for the Blind's express reading service for reading on to tape many of the articles referenced.