Allan's legacy

Children in the greatest danger of drug addiction are being badly let down , says Neil McKeganey, who has just conducted the largest-ever survey in the UK of pre-teen substance abuse. By identifying 'at risk' pupils early, he argues, deaths like that of 13-year-old heroin victim Allan Harper, could be prevented

In January the name of Allan Harper was added to the list of people who have died of a heroin overdose in Glasgow. Allan was 13 at the time and his death shocked many in Scotland and beyond. But was his death an isolated incident or a symptom of the age at which young people in the United Kingdom now are starting to use illegal drugs?

Researchers at Glasgow University recently surveyed nearly 1,000, 11 to 12 -year-old pupils and found that as many as one in 10 was already using illegal drugs. While most of the drug use at this age involved cannabis, more than a quarter of the pre-teen drug-users had consumed magic mushrooms, nearly 20 per cent had used Temazepam and 6 per cent had used heroin. Over half of the drug-using pupils had tried more than one illegal drug.

There will be those whose response to such statistics is to say "Ah yes but that is Glasgow and we all know about Glasgow's drug problem". In fact the research involved children from all social classes in urban and rural areas across Scotland. Other research carried out in England has shown that the Scottish research is by no means unique in the level of drug misuse identified among such young children.

Although the children who are using drugs at this young age are not addicts they stand a pretty good chance of becoming the addicts of tomorrow. Research carried out in the United States, for example, has consistently shown that the earlier the age at which illegal drug use starts, the greater the likelihood of becoming an addict in later life.

In the light of such statistics it is not surprising that the Government's anti-drugs co-ordinator recently called for drug education to be provided to pupils as young as five. It is one thing though, to charge schools with the responsibility of providing drug education so young but quite another to know exactly what schools should be doing in the case of those pupils who have already started to use illegal drugs by their teenage years.

There is no shortage of drug-education packs that primary and secondary teachers can use. In the case of those which are designed for the pre-teen pupils almost all of the packs start out from the assumption that illegal drug use has not already started.

While it may be an uncomfortable message for many of us to hear, the research evidence is beginning to give a different picture. If illegal drug use is now starting to occur at a younger age than we have become used to, does this mean that we have failed in our drug education?

My own view is not that we have failed in general, but that we are almost certainly failing particular pupils.

In parts of the United States trained drug counsellors work alongside teachers with pupils who have been identified as at particularly high risk of using illegal drugs. These may be pupils who are known to have a parent with a drug or alcohol problem, with brothers or sisters who are using illegal drugs or who are growing up in areas where illegal drugs are widespread.

By targeting attention on the high-risk pupils it is felt that one stands a better chance of reducing the development of patterns of drug misuse in later life. Within the UK by contrast we do not focus upon such high-risk pupils, preferring instead to provide much more class-based drugs education.

But how feasible is it for a teacher to provide drugs education which is appropriate for the majority of pupils who have not started to use illegal drugs as well as the three of four pupils who take such drugs.

The answer is probably that it is not possible to meet the needs of both groups and that at the present time we are probably failing those pupils who have started to use illegal drugs at this young age.

Does this mean that we should follow the US route of targeting high-risk pupils? While my own feeling is that this is precisely what we should be doing there are many difficulties in adopting such an approach. For a start many teachers will not know which pupils are abusing illegal drugs. Others will feel that even where they can make an educated guess as to who is using what drugs the difficulties of addressing this issue "head-on" are too complex to envisage.

Within the UK we generally have fairly poor communication between agencies such that even where a parent is being treated for a drug problem school staff are unlikely to know anything about this. For many people this is entirely as it should be given the importance of client or patient confidentiality. At the same time, however, we know that having a parent with a drug problem increases the risk of such drug use for the child.

So shouldn't teachers be aware of particular pupils' vulnerability so that they can modify their own approach to these children? In other contexts we use the notion of an "at risk register" to identify pupils at risk of physical or sexual abuse. No such register is used in relation to illegal drug use but perhaps it ought to be - after all illegal drug use at this young age is no less pernicious nor the potential consequences any less tragic. Part of the value of such an at risk register would be one of identifying at least some of the pupils at greatest risk allowing us to begin to meet their particular needs.

If teachers are going to help those pupils who have started to use illegal drugs by the latter stages of their primary school they are going to need the support of other agencies. But who might teachers turn to in such circumstances?

The natural choice would be the child's parents. Other findings from the University of Glasgow research suggest that this may be more problematic than might first appear. Many of the children who were using illegal drugs at this young age had other drug-users in their family. For many of the pupils this was an older brother or sister; however, for some of the pupils it was their own parent.

Specialist drug services may also have less to offer in this context than one might expect. Within the UK such services are generally geared to working with addicts in their twenties or thirties, not children who are barely into double figures.

If we are to meet the needs of the pre-teen drug users it is likely that we will have to change the approach to drugs education in our schools, to target the high risk pupils whatever their ages and to pool information between agencies as to the circumstances of the most vulnerable pupils. We will also have to re-focus our specialist drug services, enabling them to work with a much younger age group than they have in the past. If we fail to meet the needs of the pre-teen drug-users in time, the typical addict may not be in his or her twenties or thirties, but the boy or girl next door in their late teens.

Professor Neil McKeganey is director of the Centre for Drug Misuse Research at the University of Glasgow. The research described in this article was funded by a grant from the Scottish Office Department of Health


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