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A Life Course Approach to Preventing drugs and alcohol risksAndrew Brown (Mind)Michael O’Toole (Mentor UK)
Links between drugs, alcohol and crime
Photo by Flickr user Rob Best
Sexual offences and alcohol
Rape of a female; aged 16+
Sexual assault on a female; aged 13+
Rape of a female; aged 13-15
Sexual activity involving child; aged 13-15
Sexual assault on a female; under 13
Sexual activity involving a child; under 13
0 5 10 15 20 25
Proportion of sexual offences recorded by the police which were
‘alcohol related’
Source: Experimental Statistics 1: New data on police recorded violent and sexual offences, year ending March 2015
Using data from 26 police forces (accounting for 56% of police-recorded sexual offences in the year ending March 2015) it appears that that 10% of sexual offences in England and Wales were ‘alcohol-related’.
Violent crime – perceived links to alcohol and drug intoxication
Yes No Don't know0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50% 47%45%
9%
19%
46%
35%
Alcohol Drugs
In the year ending March 2015, victims believed the offender(s) to be under the influence of alcohol in just under half (47%) of all violent incidents, or an estimated 592,000 offences.
In nearly one-fifth (19%), or an estimated 241,000 violent incidents, the victim believed the offender(s) to be under the influence of drugs.
Source: Overview of violent crime and sexual offences
Offender perceptions of substance misuse and their offending behaviours
Believe offending is linked to drug use Believe offending is linked to alcohol use0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
25%
42%46%
30%
Young offender Adult offender
Source: Needs and characteristics of young adults in custody, Ministry of Justice (2015)
Drug use and acquisitive crime
Almost half (47%) of people in drug treatment had committed acquisitive crime(s) in the 4 weeks before starting treatment.Source: Jones A, Hayhurst K, P, Millar T, Pierce M, Dunn G, Donmall M, Short-Term Outcomes for Opiate and Crack Users
Accessing Treatment: The Effects of Criminal Justice Referral and Crack Use. Eur Addict Res 2016;22:145-152
Yes47%No
53%
Classifying Prevention – form and function
Universal Selective Indicated
Environmental
• Making behaviours illegal
• Tax policy
• Reducing alcohol retail density in high risk areas
• Laws restricting the ability of violent individuals from accessing firearms
Developmental
• Parenting programmes
• Classroom behaviour management
• Life-skills programmes
• Home visiting programmes for at-risk mothers
• Parenting programmes for high risk families
• Multi-systemic therapy for individuals with serious anti-social behaviour
Cognitive
Advertising campaigns
• Screening and brief interventions; normative feedback
• Substantive cognitive or motivational interventions with problem behaving individuals
Source: Professor David Foxcroft, EUSPR 2011
Life course approachA holistic, life-course, systemic approach to prevention:
Developing life skills that build resilience to risk.
Throughout a young person’s lifetime
CMO
annu
al re
port:
201
1 ‘O
n th
e st
ate
of th
e pu
blic’
s he
alth
’
Life course approachA holistic, life-course, age appropriate approach to
prevention
building resilience, life skills and self-efficacy.
implementedin a varietyof settings
throughouta young person’s lifetime
Protective factors and systemic settings
Environment
Family
School
Community
A system approach to prevention
COMMUNITY
YOUNG PERSON
FAMILY
SCHOOL
Carers
Parents
Teacher & staff training
Healthy Schools
Extracurricular activities
Leadership
Resilience education
Life-skills education
PSHE
Faith-based organisations
SchoolpolicyHealthcare
services(incl. mental
health)Emergency
services
External service
providers
Research and resource centres
Local Education Authorities
Media and advertising
Youth / community
groups
Child protection
servicesRehabilitation
services
Prisons
Charities
Government
National policy
Data collection Legal services
Carers’ support services
International policy
NGOs
Businesses
Work experience PRUs
Peers
Life Skills PreventionCritical thinkingDecision-makingCreative thinkingEffective communication
Relationship skillsSelf-awarenessEmpathyCoping with emotionsNormative beliefs
What doesn’t work×Emphasising harms will disincentivise use×Young people given enough information
make rational decisions about their health×One off interventions are enough×School drug and alcohol
education/posters/TV adverts
Role of schools• School interventions reduce substance use and
improve academic outcomes• Strong attachment to schools is in itself a
preventative factor• Opportunity for learning with peers – normative
beliefs• Multi-sessions and regular follow-up to reinforce
learning
Evidence-based approaches
What we do
Promising evidence-based prevention approaches
PreVenture
Don’t forget drug treatment
Used heroin last 4 weeks
Used crack last 4 weeks
Acquisitive offending last 4 weeks
Injected last 4 weeks
Offending to fund drug use last 4 weeks
Shared equipment last 4 weeks (% injectors)
Non-fatal overdose last 3 months
0% 20% 40% 60% 80% 100%
Follow up Baseline
Source: Jones A, Hayhurst K, P, Millar T, Pierce M, Dunn G, Donmall M, Short-Term Outcomes for Opiate and Crack Users Accessing Treatment: The Effects of Criminal Justice Referral and Crack Use. Eur Addict Res 2016;22:145-152
“Significant, and substantive, improvements in most behavioural measures were recorded, and were achieved within a relatively short period of time following enrolment in treatment. The study demonstrates that these successful outcomes continued to be the norm for the English opiate- and/or crack-user treatment population, despite a doubling in the number of drug users treated, and changes in referral patterns and drug use profiles.”
Don’t forget alcohol treatment
Genera
lDriv
er
Violent
Acquisit
ive Total
05,000
10,00015,00020,00025,00030,00035,00040,000
Pre-treatment Post-treatment
“We observed a reduction in offending during a two-year follow-up after treatment for AUD (crude pre-treatment and post-treatment offending rate per 1000 falling from 221.5 to 169.4). Less offending was independently associated with completion of treatment (and long retention) and inpatient withdrawal management and/or pharmacological therapy.”
Source: Is treatment for alcohol use disorder associated with reductions in criminal offending? A national data linkage cohort study in England
Resources• UNODC – International Standards on Drug Prevention http://
www.unodc.org/unodc/en/prevention/prevention-standards.html • EMCDDA – European Drug Prevention Quality Standards http://
www.emcdda.europa.eu/publications/manuals/prevention-standards • ACMD – Prevention of Drug and Alcohol Dependence https://
www.gov.uk/government/publications/prevention-of-drug-and-alcohol-dependence
• Washington State Institute of Public Policy – Cost Benefit Results http://www.wsipp.wa.gov/BenefitCost
• Public Health England – Why Invest Slides http://www.nta.nhs.uk/Why-Invest-2014-FINAL.aspx
Thanks for your attentionContact details
Andrew Browna.brown@mind.org.uk@andrewbrown365
Michael O’Toolemichael.otoole@mentoruk.org @otoole_michael
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