Write a critical analysis of one aspect of substance misuse policy and / or practice which relates to your own country

of origin (or a selected country), work or sphere of experience. This assignment needs to include critical appraisal of the scientific evidence-base and to make recommendations to improve policy and practice. 2500

Education nowadays is often considered as equal to accumulating skills and facts whereas health is opposed to illness (WHO, 1996). Instead, education is a prerequisite for health and both education and health are more general and undivided concepts (Ottawa Charter, 1986). This is why health promotion programs lanced in school settlements through education policies and prevention, treatment and referral could have a greater impact in students as these programs target students in the most crucial ages of their life (Evans-Whipp et al. 2004, WHO, 1996). It seems though that schools are seriously affected by societal problems with drug exposure

consisting a major one (Ross et al. 1995), since its initiation mostly coincides with adolescence and has a multifactorial base of genesis (Blum & Richards, 1979; Braucht, Follingstadt, Brakarsh, &Berry, 1973; Jessor, 1976; Millman & Botvin, 1983; Wechsler, 1976). A drug-free learning environment (Yamagushi et al. 2003) is
generally served via school policies that discriminate between possessing, using and supplying drugs (Murphy). Although prevention programs aiming at reducing illicit drug consumption should be applied in all schools this still remains requested in some parts of the world.

According to the Monitoring the Future Study (Johnston, OMalley, & Bachman, 2001), adolescent drug consumption begun to rise in early 1990s up to 1997 (Much et al. 2001-- Kraft). A point of serious concern for the American society is that drug use among American youth is the highest in the industrialized world (Johnston, Bachman, & O'Malley, 1988). This phenomenon drove the public to primordialize drug abuse as a crucial issue for public schools (Ross et al. 1995). A standard definition of drugs would be a chemical substance that, when taken into the body, alters the structure and functioning of the body in some way, excluding those nutrients considered to be related to normal functioning (Levinthal, 2008; Drugs, Society and Criminal Justice, Pearson Education). Addiction in America is mostly reflected in three views; the Colonial or Moralist which perceives drug use as a crime (zero tolerance policy) and is followed by punitive measures; the temperance view where drugs are considered addictive substances and policy should focus on smugglers and dealers who are the root of addiction and thirdly, the disease concept where addiction is viewed as a disease and drug policy should primordialize drug treatment and rehabilitation.

The authors of one Cochrane review of school-based drug prevention concluded that some programmes deterred early stage drug use (Faggiano et al., 2005), whereas other programmes did not. Specifically, programmes that teach social and coping skills

reduce drug use slightly relative to normal classroom instructional activities. In contrast, programmes that simply convey didactic information about drugs and their effects have no impact on drug use relative to normal classroom instructional activities. Combining results across studies of different programmes -- Life Skills Training (LST), Project ALERT (ALERT), a Classroom Centered (CC) intervention, a Cognitive Behavioural Intervention (CBI) and a programme called "Towards No Drug abuse" (TND, two studies) -- provides an estimate that cannabis initiation is somewhere between 1% and 23% less likely, over the shorter-term, when students are exposed to skills-based prevention, compared with usual classroom activities (the control group). Faggiano's review suggests that on average, modern school-based prevention programmes can delay or prevent the initiation of drug use, although effects on frequency of drug use are not so clear. Such programmes focus on improving school discipline and climate and strengthening teachers' classroom management skills. For example, although the Cochrane Review (Faggiano et al., 2005) has listed the Good Behaviour Game (GBG) as a component of a skills based intervention (the Classroom Centred curriculum (CC) mentioned above), much of the focus of the GBG intervention is on improving classroom behaviour management at Grades 1 and 2.

Drug policy is influenced by and influences society (Chilea & Chilea). Besides the adoption of a harm minimization approach towards drugs in Australia and Europe
where priority is given at education, prevention, referral and intervention and not on punishment (Murphy; Ministerial Council on Drug Strategy, 1998), most schools (almost 90%) in the United States adopt zero tolerance approaches for substance misuse (Yamagushy et al. 2003; Martin et al., 1999; Small et al., 2001, Brown, 2001) under the scope of minimizing drug use prevalence (Caulkins and

Reuter, 1997). As mentioned above, Zero tolerance represents those policies that adopt a severe punitive approach without considering the seriousness of offence in dealing with problems of school safety and discipline (Skiba & Peterson, 1999; Hanson, 2005). The prevailing picture of these policies is the punishment and penal sanctions and the approach is known as punitive drug prohibition approach or moral/criminal justice model (Evans-Whipp et al. 2004; Aoyagi, 1997; BEYOND PUNITIVE PROHIBITION). Aspects of the policies serving zero tolerance purposes may include anti-drug education (e.g., "Just Say No" curricula), drug testing, metal detectors, closed circuit cameras, sniff dogs and penal sanctions such as expulsion, suspension and referral to law enforcement agencies are (Evans-Whipp et al. 2004, Yamagushi et al. 2003, Brown 2001). As a consequence, most of the financial means for fighting drug use are spent in interdiction and eradication efforts in
the US which has raised serious concerns over the advantages disadvantages of controlling and punishing students (McKeganey 2005). and

CRITICAL ANALYSIS OF PUNITIVE PROHIBITION Growing piece of evidence shows that the fight against illegal drugs in the U.S. has been historically characterized as one of the most unsuccessful

of its policies (Guzman, 2003). Although zero tolerance initial aim was the improvement of society, these heterogeneous policies have led to a dramatic increase in suspensions and expulsions ( Hanson 2005, Insley 2001, Essex 2001). These policies raise serious concerns to many leading psychologists, as James Comer and Alvin Poussaint are, in relation to their consistentency with healthy childhood development contradicting those schools that consider the reduction of expulsions as a positive aspect of zero tolerance (Insley, 2001). A serious problem in the U.S is the fact that its Constitution does not consider the right to education as fundamental, therefore students suspended and expelled abandon their schoolwork and suffer from feelings of alienation, situation which increases the possibility to drop out of school and to be deprived from alternative educational opportunities (Insley, 2001; Brown, 2001). The most severe implication though is that automatic exclusion can criminalize students in a way that permitting students to be left unsupervised, while at risk for dangerous behaviors, can consequently exacerbate misbehavior, unemployment, gangs, and crime (Ashfold, 2000, Insley, 2001). Moreover, such policies are
conflicting in nature at school administrators, teachers and counsellors too (Pentz et al., 1997), since suspending and expulsing students without taking into consideration the risk factors forcing them in drug use has no efficiency in preventing them from continuing drug involvement (Hallfors and Van Dorn, 2002). Finally, those policies induce feelings of fear or shame in students and they fail to engage with educators. This is because discussing only drug issues but not getting involved in students own cognitive and emotional development is a highly insufficient way in dealing with the fight against drug use (Brown, 2001).

Zero tolerance school discipline policies have clearly resulted in inequities and have violated the rights of individual students (Hanson, 2005). This is the result of those policies that do not take under serious consideration the target populations of concern to apply prevention programs, that fail to weight the severity of the developmental stage of the person enrolled in a program or the severity of the offense, the students history, the duration of the program and the role of the person realizing the program (e.g., teacher, law enforcement officer, peer) (Essex, 2001). Therefore, an alternative education aiming at succeeding a balance between safety environment and the rights of students being supervised or involved in long term expulsion could minimize the undesirable outcomes of zero tolerance policies (Essex, 2001). Education needs to be more interactive and decreasing drug consumption through education should be one of the guiding principles of minimizing drug consumption in the society (Cardoso et al. 2009). At a first level, there is a need to reorientate and enforce policies targeting all age classes in schools irrespective of the beliefs of educators (Ashfold, 2000). that
younger students are easier to manage without formal policies therefore are often considered as less of a priority for schools (Evans-Whipp et al. 2004).

Secondly,

there is an increasing belief that other prevention and intervention strategies could offer better solutions for dealing with drugs at school than zero-tolerance expulsion. Alternative schools based on prevention and planning could help children using drugs not only to be

supervised but to continue their school while working with counselors (Ashfold 2000, Skiba and Peterson 1999,

http://www.stanford.edu/class/e297c/poverty_prejudice/paradox/htele.html; Cardoso et al. 2009). Long-term planning could be very beneficial and according to Brown (2001) drug prevention education programs should be divided into three categories: a) information programs where avoidance of substance use comes from informing students with facts about drugs, b) affective programs where students personal communication skills enhancement aims at increasing their self-esteem and c) social skills or influence programs where special emphasis is given on how to refuse substances proposed by others. Basic life and/or drug resistance skills could be also taught. In addition and according to Greenberg (2003) prevention in schools should
include counseling, mentoring, self-control, and social competency instruction (individually focused interventions) along with establishing norms or expectations for behavior and school wide discipline management interventions (environmentally focused interventions). Self-control or social competency programming that used cognitivebehavioral and behavioral instructional methods consistently was effective in reducing dropout and nonattendance, substance use, and conduct problems. (Greenberg, 2003).

Early efforts in adolescent treatment were based on adult models that did not seem to consider the unique needs of adolescents. Recently, however, there has been an increased emphasis in developing and evaluating theoretically based and empirically supported substance abuse intervention models designed specifically for adolescents (Wagner, Brown, Monti, Myers, & Waldron, 1999; Much et al. 2001). Whether called behavior therapy, cognitive therapy, or cognitive-behavioral therapy (CBT), all behavioral approaches view substance abuse as a learned behavior that is susceptible to alteration through the application of behavior modification interventions (Miller & Hester, 1989). The goal of behavioral approaches is to teach adolescents to unlearn the use of drugs and to learn alternative, prosocial ways to cope with their lives. Thus, treatment focuses on the factors that precipitate and maintain episodes of substance use (Kaminer, Burleson, Blitz, Sussman, & Rounsaville, 1998, p. 684). According to Ashfold (2000) conflict resolution, behavior management, screening and early identification of troubled children along with implementing discipline plans for disruptive behaviors would be of great efficiency. Behavior support teams, consistent and individualized response to disruptive students, and emergency and crisis planning are effective plans to be followed. In particular, cognitivebehavioral techniques attempt to alter thinking as a way to change behavior. Behavioral techniques are used in residential and outpatient settings as part of group or individual therapies (Muck Kraft). Specific skills vary by program but may include drug and alcohol refusal skills, resisting peer pressure to use drugs and alcohol, communication skills (nonverbal communication, assertiveness training, and negotiation and conflict resolution skills), problem-solving skills, anger management, relaxation training, social network development, and leisure time management. New behaviors are tried out in low-risk situations (e.g., during group therapy role-plays and individually with a counselor) and eventually are applied in more difficult, real-life situations. Homework assignments, such as trying out a new behavior or collecting problem situations to discuss during therapy, are common. Staff members and

parents are encouraged to provide positive reinforcement for the use of new behaviors. Behavioral contracting is another technique used in behavioral approaches. The adolescent and counselor agree on a set of behaviors to be changed and develop weekly incremental goals for the adolescent. As each goal is reached, the adolescent is highly praised or otherwise reinforced. Behaviors are explicitly defined on the contract, with criteria and time limitations noted (Muck Kraft). Unfortunately, a shift from zero-tolerance to these types of prevention policies is not likely to occur anytime soon. Such strategies take time to develop and even more time to implement. But it is clear that much more research is needed to determine if zero-tolerance is a truly effective strategy for keeping our schools safe from those who would inflict weapons-related violence on others (Ashfold, 2000).

. Thus, America needs to decriminalize drug use (). (http://www.stanford.edu/class/e297c/poverty_prejudice/paradox/htele.html)

The suggestion of a policy with reasonable and achievable goals and functional means has been branded as immoral and wrong. On the contrary, those who invoke high moral principles, use metaphors as war, propose a battle between goodness and evil, and promise a final triumph in which drugs will disappear off the face of the earth are seen as the good, the moral and the ethical ones. Words such as hero, are often invoked to define those who are highly compromised with the war on drugs. In the public debate on illegal drugs, those who defend a costbenefit approach are seen as malleable and immoral while those who invoke the old struggle of good vs. evil are seen as brave and fearless. Again, this paradox is the result of the prohibitionist predominance that postulates the drug issue in terms of crime and threat, and by doing this, leaves no space and tolerance for less radical approaches. If drug consumption is a crime there are two options: you accept it and you are an accomplice of crime with all the implications, or you reject it and you are a moral and principled person. There is not and there could not be a gray area in between those two options. (Guzman, 2003). Anti-narcotic
policies applied up to now are firmly rooted in prejudices and fears that sometimes bear little relation to reality (Cardoso et al. 2009).

One case of zero tolerance policy towards illicit drugs is the case of personal use of marijuana and cannabis. Marijuana is the most commonly used illicit drug, used by 81% of current illicit drug users 14 (Chilea,.). There is more and more tolerance of the public towards certain types of drugs, namely in the case of legalizing marijuana. The first note to be made about the clegalization of marijuana and any drug in general is that it would be more appropriate to talk in this particular context about decriminalization rather than legalization: decriminalization means that possession of marijuana above a certain established quantity would constitute a civil offense rather than a criminal one, and punishment would be a fine, not imprisonment.

ALTERNATIVES TO PUNITIVE PROHIBITION

make recommendations to improve