Tuesday, May 28, 2013

An open letter to the Expert Advisory Group for Reducing the Alcohol and Drug Toll.

To the members of  the Expert Advisory Group for Reducing the Alcohol and Drug Toll

It’s come to my attention that you want to improve drug and alcohol education in Victorian Schools. Specifically your Victorian Alcohol and Drug Strategy paper states that you want to;
Better promote awareness of drug and alcohol issues in schools through comprehensive, evidence-based alcohol and drug education and health promotion programs that will strengthen well being and resilience among young people.”

That’s a combination of two topics- drugs and education- that are both of interest to me. I’d like to offer you my own thoughts which come from over eight years working in the drug and alcohol field with both adult and youth clients as well as sending my own child off to prep this year.

Firstly the problem; We have school leavers who have a very poor understanding about how drugs and alcohol work. Young people rely on scattered and unauthoritive information about specific substances from the media, friends, dealers and government but lack the skills to evaluate what they are hearing. Consequently they are making uninformed decisions about drugs and alcohol use. They are also unable to give sound advice to friends and family about drugs and alcohol. Lastly they don’t as citizens shape drug and alcohol policy from an informed perspective. This can mean that policy makers can feel that a sensible drug and alcohol policy has to be sheltered from community opinions. This is rightfully understood as an affront to democracy.

This is how I conceptualise the problem; not in terms of the number of drug overdoses or chronic addictions, which I see as the tragic symptoms, but in terms of a lack of people’s individual and collective control over their own lives in relation to drugs and alcohol. When you are looking at education as your solution this is the only way to conceptualise the problem. Education ought to see all problems in terms of peoples control over their lives. This is because belonging to such a democratic project is what gives Education its moral high ground to insist students attend to it. Anything else is propaganda and justifies being ignored.

Politicising drug and alcohol education as propaganda is what we usually do. We usually have political objectives such as the reduced use of illegal substances and we measure our education programs by their impact on this goal. This is sometimes what is called “evidence based”. However evidence based is a term borrowed from drug and alcohol treatment programs which can legitimately use it in this way only because they have explicit goals around reduced use. Evidence based is great – the only way to proceed certainly – but the progress that must be evidenced can’t borrow the goals of treatment which have the consent of patients. 

Instead we should politicize drug and alcohol education in the same way that good teaching will politicize history. That is, not to push a particular patriotic agenda, but to teach kids that with a knowledge of how to do history comes power. The power to make connections between events, to appropriately credit the past and to foresee the future are all derived from the ability to do history. A good teacher capitalizes on the brains evolution as a tool to unmask deception and shows how historical knowledge and skills makes you less of a fool and a tool in the hands of others. Best of all a teacher might be able to encourage a young historian to pit their skills directly against either propaganda or a culture that only knows the recent.

Eg. A Toy company might want to sell kids some version of knucklebones with an added rule or two that requires extra purchasing – like the need to collect randomly packaged special knuckles. Teaching kids the history of children’s games can help them see through the marketing to recognize merely a repackaged idea that they might be able to play much cheaper, or even learn of games they can play with no purchasing required.

The first step then in drug and alcohol education might be to teach kids about who are the other vested interests in the topic. Government, parents, liquor merchants and pharmaceutical companies, cafes and other drug dealers all can be identified as people with their own agendas and thus only partial allies to the democratic agenda of education around drugs and alcohol. Cigarette smoking is an obvious example topic for older kids given the amount of resources that exist mapping the changes over tobacco laws in recent history. However better still is to look at sugar, a ubiquitous substance that serves to elevate energy levels and boost mood, has become synonymous with celebration and self-reward – and lies close to even the youngest kids heart.

Caffeine is another great one for kids to investigate because caffeine dependence is rife amongst adults (and growing amongst teens). This means that many teachers and parents can talk about their own dependence, tolerance, withdrawals and cravings for caffeine. Kids can be encouraged to monitor caffeine usage in their families or to identify where and how caffeine is sold and marketed.

I want to stress that it does not matter that young people are learning about sugar and caffeine when the bigger health risks for them lie in cannabis and alcohol or even methamphetamines. It is a misconception that drug and alcohol education can ever teach kids the right content. Firstly drugs are evolving constantly and what is sold on the street is not what is talked about in textbooks. Cannabis is a hugely different drug today than it was ten years ago primarily due to concentration of THC. The facts about drugs and alcohol can only ever be responsibly taught to kids as the “historical facts”.

Secondly young people themselves are going to be (if they aren’t already) confronting widely divergent questions about drugs and alcohol. For some the issues will be around a party drug sold as ecstasy, for others it will be the anti-depressants their GP prescribed. In both those situations and no matter how drugs change there is still a process similar to the process of doing history, that is, how to consider drugs and alcohol. It’s this  process of what questions to ask and how to answer them that should be taught and can just as easily be taught about caffeine as about sugar as about heroin. Just as in the teaching of history where what history you cover is less important than how to do history, what drugs a teacher covers is less important that how the class studies them. It may be better to pick substances relevant to most or it might be better to pick substances that are easiest to teach (the Opium War is a spectacularly dramatic event), whatever engages the student.

Regardless of the topical substance, drug and alcohol education should introduce students to the following ideas;
1. That drugs work because our brains have their own chemistry which is how we feel different moods.
2. That our taste buds can begin to identify tastes according to the effect we anticipate on our brain’s chemistry from substances.
3. That we can adapt to regular substances and experience both tolerance and dependence – the substance becomes necessary just to achieve what was normal before without it.
4. That once dependence has occurred, the absence of a substance doesn’t feel normal but instead is experienced as withdrawal.
5. That repeated patterns of experiencing withdrawals trains us on a subconscious level into patterns of addiction.

Key concepts in this process are efficacy, side effects, reliability, tolerance and dependence. The investigation of efficacy and side effects for substances which affect our mood should be broadened to include comparisons with other ways of affecting mood. A sleep-in is an option for treating tiredness instead of caffeine. It has different side-effects such as missing class. A range of other wake-up methods could be investigated. An enterprising young person might even invent an alternative to caffeine such as a scary short movie designed to wake a person up with a quick shot of adrenalin. Figuring out efficacy will introduce mathematical concepts such as statistical significance. The notion of the placebo effect would be interesting to most.

Addiction is a huge idea that is worth talking about in the context of non-chemical addictions as well. Addiction will be a part of many young peoples life’s in regard to computer games or the internet and particularly social media usage. Some of their parents will deal with gambling addictions. Some high school students do too. If young people understand that their brains have the chemistry that produces the effect of drugs and that substances merely trigger them, then the notion of addiction to behaviours that trigger changes in brain chemistry without substances will still make sense to them.

All of this however needs to be located in its democratic and wider civic context. Why not encourage high school kids to set their own individual or even class policy around something like facebook usage for example? Young people can ask the hard questions of whether it is better or fairer to develop a school wide rule or whether individuals should be allowed to set their own limits. What about caffeine usage? Does the school have a policy about energy drinks? 

There are consistent historical relationships between prohibition of substances, the amount of people using those substances and the harms associated with using those substances. Generally when substances are illegal they become both less commonly used and more harmful for those who use them. These would be great relationships for young people to explore. What are the ethical issues about permitting the sale of addictive substances? What are the ethical issues about penalizing people for taking addictive substances?

Note that I don’t think it should be the goal of any education program to finally answer these questions, just pose them. These are after all the questions adults have to ask each other in the formation of society’s rules.

Lastly if you agree with what I’ve said so far you will probably also agree with who should be the people developing and delivering this program. Alcohol and Drug counselors know their stuff but they don’t have the skill set to encourage class room reflection. It’s teachers that need to be recruited. Particularly teachers with a passion for science and social studies and the democractic projects they are a part of who are crucial to this programs success. They should be resourced with oodles of kid-tasty illustrative facts, but putting it together or rather encouraging the kids to put them together is ultimately a skilled teachers job.

I really hope that we wont just see more of the usual educational pushes to come out of this Victorian Alcohol and Drug Strategy – essentially a well-designed pamphlet and poster drop and a visit by a drug and alcohol counselor to share war stories. I care too much about both drug and alcohol issues and education, including my child’s to be satisfied with that. I urge you to at least consider a process focused drug and alcohol education that explicitly aims to give people more control over their lives. 

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