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%

What do we mean by prevention?

Photo by Flickr user sswj

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

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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