Side event: Family-oriented policies in drug prevention

Organised by European Monitoring Centre on Drugs and Drug Addiction, Pompidou Group (Council of Europe), United Nations Interregional Crime and Justice Research institute and UNODC Drug Prevention and Health Branch

 

Leif Villadsen: Good afternoon, everybody. And welcome. The purpose of this side event will be to discuss practices, policies and interventions which have proven to have a positive impact on the prevention of drug use within a family context. The families are playing a very important role in the recovery process. UNICRI has recently launched a study in relation to the role that families can play in drug use and related policies. This side event today will be an excellent opportunity to discuss and identify within effective services, the role of families.

Bettina Tucci Bartsiotas: The consumption of drugs continues to be an issue that needs to be addressed. Last year, more than 270 million people in the world were affected by drug use – 5% of the world population. Many of these cases are extreme. We need to make sure that we find the right support, the right advice, so that these people can be treated. We need to learn from the experts here today as to their involvement in the policies and the regions to address this issue. In UNICRI we are very pleased to be here because it is an important study that we are undertaking and we hope that this session today will provide impetus to everyone’s role in combating this plague.

Alessandro Cortese: Italy is a strong supporter of the Institute – we value its expertise and its mandate. A strong relationship between UNODC and UNICRI is welcome and mutually beneficial. Preventive policies are an important part of a balanced approach to the drug problem.

While it is somehow self-evident that families can play a crucial role in preventing drug use, this must be designed on scientific evidence – not ideologies. The UNODC/WHO guidance on this issue constitutes essential reading. I’m glad that the Italian government has decided to publish guidance of UNODC to advance the implementation of these standards in South-Eastern Europe, in particular through family interventions.

It is important in intervention that we take into account the connection between families and schools and communities and promote dialogue. We have a programme in Italy which trained 15,000 teachers on the drug problem. Two teachers per school her create the support network by liaising with other teachers, institutions, as well as the families, especially marginalised communities, to detect behaviours.

More research is needed on the role of families – positive in preventing drug use, but can also be negative in creating conditions leading to drug use. The Italian government is therefore contributing to the research from UNICRI to identify necessary interventions.

Gilberto Gerra (UNODC): I worked for 20 years as a doctor before coming to the UN, treating people affected by drug use. It is encouraging to look to the issue of family, because it shows we are starting to understand the interconnection.

There was a previous programme created in the United States on strengthening family. Now our programme has reached 40 countries, developing personnel to deal with this issue. We discovered in the US adapted well to other settings and, was sometimes better in low resource settings. We demonstrated the benefits of this programme in towns in Italy.

These programmes not only prevent drug use, but violence, early pregnancy and problematic behaviour. Someone said that substance use disorders are an expression of attachment disorder. When you have an insecure and uncertain, disorganised attachment, you are in trouble – not only substance use disorder, but other issues, too.

The hippocampus – it has been seen that in school age children, this was smaller when their environment was characterised by neglect and abuse. The form of the brain is therefore changed by this kind of condition, too.

Provide undivided time to your child. Do you need a psychologist to understand this? Clean your room twice a week, shower every day – this does not need therapy. If you fail a test in school, I don’t blame you – I start to work with you.

Monitoring and supervision: ask your child what we are going to do when they get back – the classic response was – I can’t say in this room what the response was. They say that they do what they want because they are an adult at 15 years old. Do you know what happens to the hippocampus of the child – it says my parent is bothering me, for nothing. But within the other brain – it says – my parent is bothering me so much because I am a value for them.

When you want to target an entire community, we found in our experience that parents who were saying they never devote undivided attention to their child – because they did not think it was important. And those that were depressed, it was because we were sure that they didn’t respect the rules. A small suggestion to the parents: making comparison with other parents in the community and starting to change their life. I give an example of a mother who said her life has changed as a result. Let me finish with an example, another message which is – don’t wait for 16 years old to target prevention. When you do prevention in school, you have to focus on the early life and the early life environment. One last thing: if we have sometimes parents who are not taking care of their children, it is not necessarily because it’s their fault, but because they don’t have the resources. We have to invest resources to give family the time to do something good for their children.

Leif Villadsen: That is the end of the welcoming remarks.

 

Sharifa Noaman Al-Emadi, Doha International Family Institute (presentation): Thank you to Gilberto, he said all the theories evidenced in our studies. As a practitioner I work with drug addicts and families. I discover that many of the issues relating to family, decrease the number of addicts when children aren’t monitored – or when other protective/risk factors came from the family.

I looked at drug addicts as young as nine years old. We thought that we have to think of a good programme to prevent our children from addiction. We looked at different programmes in the region and international; we thought that most of them focused on educating the children and talking about addiction. We looked at the Icelandic programme as it matches our culture in Qatar.

Also we tried to talk with the government and the Education Minister to engage them in this programme, so we started to do a pre-questionnaire and then we have some figures from this. Then we conducted an intervention programme for the family and the children, based on the UNODC programmes, but implemented to match our culture. After that we did a post-questionnaire to see how it worked with the children and the family.

This programme focused on increasing protective factors and reducing risk factor. To bring all the family and the community together to support all entities, we did a pilot study for seven schools – four were private and three were government schools. Our study was with 12-15 year olds, 65% were Qatari and 35% were non-Qatari. 60% male, 40% female. Total sample size was 1,157.

The results:

43% of these children spent less than 9 hours a week with their family.

90% were satisfied with their relationship with their dad – but what of the 10% who were not? This is one of the risk factors that leads to addiction and other destructive behaviour.

94% were satisfied with their relationship with their mother. That means there is a risk factor here with this 6%.

89% said they get emotional support from their father easily.

95% said they get emotional support from their mother easily. This is very important. It also shows that 5% are not getting this – but as said already, if 5% have drug problems – this tells us something.

22% had meals with their families less than four times per week – which is linked to communication with families etc.

11% said their parents did not enforce rules.

71% said their parents wouldn’t accept them dropping out of schools – meaning 29% it is OK, or they don’t care – which is a big risk factor.

39% never read books with their children.

59% of parents never played video games with their children, so they don’t know their children’s relationship with social media and who they contact.

69% thought smoking was acceptable at their age – which is a big risk factor as these are 12-15 year olds, especially as most addicts we know they used to be smokers.

12% played sport with their parents.

27% played sports in general. We know that sport is preventing our children from destructive behaviour.

43% eat 3-7 times a week fast food, meaning it’s a big problem in their health – and they don’t care, which means it’s easy for them to smoke and easy for them to take drugs.

60% preferred to spend time on the internet rather than with their families.

78% think that their parents use social media excessively

36% say there are no rules for internet using.

30% ‘hit each other’ – the parents.

45% of parents argue in a scary way, which is a very big risk factor.

What we will do is implement this plan with the parents because we showed them all these figures, these are to encourage parents to do this programme with us and engage with us and work with us. I hope we can present the post-questionnaire findings.

 

Mr Francesco Polino (Deputy National Prosecutor, National Anti-Mafia and Anti-Terrorism Directorate (DNAA), Italy): We need to explain to families that drug consumption is hazardous. The consumption of drugs can affect the nervous system of young people; the nervous system is not completed yet meaning there can be irreversible damage on bodily health.

I would like to emphasise the role of technology – we mentioned internet; up to some 20 years ago, parents could monitor their children in a totally different way. Nowadays we have internet, smart phones, tablets. So our young children do not necessarily need to communicate with their families or their peers by seeing them; he or she can communicate staying in his or her room. Here, the parents find it difficult to monitor who the child is speaking to.

Technology, on the one hand, hampers the monitoring from the parents – but it can also assist and help us – as we can get in touch and set up chats on Whatsapp among parents. This is an extremely important channel. All the information we gather on our children can be communicated by other parents. We can talk about some playmates or school mates or acquaintances which might not be advisable, so this can be a prevention tool, also.

We can have a virtual circle and make sure our children meet with other level-headed children. The role of the family cannot be isolated; together with families, also schools have to come in – there has to be a cooperation between the two. Our children spend a long time in schools; the teaching staff, they can also pay attention to behaviours – maybe when their performance at school starts decreasing or they see them meeting up with risky people. If we set up a chat we have another platform to exchange information between parents and teachers. Information increases when we have information coming from parents chats and parents and teachers chats – we can put together all this information to pick up on behavioural issues. So, setting up chats is a good idea and sharing news as well as meeting up with specialists in schools (in the main rooms where we can talk about the consequences of drug consumption, the irreversible damage, so if the child hears it from the family, maybe the message goes through.

As for the treatment and rehabilitation of drug users, states have to support the recovery process through dual facilities, state facilities, or state-sponsored centres. In Italy we also have several private managed centres dealing with treatment of drug users. So parents can be active but in terms of rehabilitation it is up to the state.

 

Betsy Thorn, Drug and Alcohol Research Centre – Middlesex University: I’m going to introduce the details of children we interviewed for the ‘EPPIC’ project.

All the young people had experienced a wide range of problems – not just drugs and crime, problems with school and their home life – everything. It was a complex set of problems that affected them and their families. We concluded from this that for policy problems just responding to drugs or crime was not enough – you needed to include the whole array in order to help these children and their families.

Family also had a very particular meaning – it wasn’t just mum and dad, it was aunties and uncles – or carers. They came from very disrupted families and often moved from one home to another very quickly. They needed a safe space which they often didn’t have. Families were often frightening rather than safe, because they were facing drug use, problems with poverty, sometimes abusive situations. This is where families needed to be assisted to provide a safe enviornment.

The other thing was that they weren’t able to talk to their parents. When they did, they often told them lies. The relational aspects of the families had been destroyed, and these needed attention to allow children to connect with their families.

One young Italian: “The fact that I didn’t want to go to school any more didn’t help me…when I got a good mark…they just said it was my duty”. Families need to support children’s abilities to feel like autonomous people.

There were some positive aspects: if you had a partner, or if your family was supportive, that of course made a difference. One Italian said that quitting was much easier because family was involved, even after the crime happened. Support makes a huge difference in desistence from drugs and crime. Another who found her mother after a long period of absence gave up drugs, this was important too.

However, young people also stressed that they wanted boundaries and guidelines. One young person said: if you’re a parent, if you go screaming at them, you’re going to get an angry teenager. If you be honest with them (including about own drug use) then perhaps they will talk to you.

Parents need to be attentive but not oppressive, otherwise you need to escape from them – said one child.

Looking back at what we heard, this was supported by practitioners we heard from. The policy implications: early intervention is an absolute necessity; these young people had started using substances (or criminal activity) before they were 14. Secondly, policy needs to cross different domains – it can’t just be drug policy, it has to include education, social welfare etc. so that a coordinated response is available to families. When it gets to the family level, a whole family approach is needed.

Finally, a big need is tackling social norms which stigmatise this group of young people and their families – and having support services that help build positive self-identity and a sense of agency, for young people and their families.

Mr. Wadih Maalouf, UNODC Drug Prevention and Health Branch: We have a top-down approach. The focus is shifting to the person in helping that person develop and assisting them through different social institutions (including school, but family is one too).

We don’t talk about family playing the role of the police officer; we talk about communication, trust, problem-solving and family resolution. This is the primary call of prevention. I have the privilege of working in this programme for the last decade – we’re now operating in 42 countries. Most recently we have two new programmes.

In countries where we are working, sometimes copyright fees make it harder for some of the countries to adopt these programmes.

The Strong Families Programme: this is a selective programme for families in challenged settings – including post-conflict settings and with refugees. It’s a brief programme to be piloted in these communities. In a nutshell, we are talking about caregivers and children sitting in different rooms, before coming together as a family section and practicing what they’ve learned.

We have a pyramid of different programmes available. These include for families who have faced trauma – which has been piloted in Syria and Lebanon.

Family UNited: this is universal. It is four sessions long. It is in Indonesia and Bangladesh. Next week we’ll be training eight new countries on strong families to deal with refugees, the displaced, and their own populations. It’s very important to note that because of the context of the work, we aren’t working alone – we’re working with other UN partners. Parenting skills are linked to violence – including youth violence, and can help avoid violence in general – improving the health of children.

Leif Villadsen: I liked that you said you are focusing on problem-solving skills.

We will go to the concluding remarks.  I go to the Secretary of the Pompidou Group.

Denis Huber: (Executive Secretary, Pompidou Group, Council of Europe): I feel that family prevention plays a really important role. Our colleague from Qatar referenced the Icelandic model and I wanted to say about this because we organised a seminar on this before. I must say it’s quite impressive.

Family is an important component of the Icelandic model.

I wanted to mention a recent (last Tuesday) judgment of the European Court of Human Rights: YI v Russian Federation, it is about a woman, 40 years old, who has been deprived of parenting authority because she is using drugs. This is possible under the Russian family code, so she has taken the complaint to Strasbourg, the ECtHR made a unanimous decision (including a Russian judge) that this was a violation of the European Convention on Human Rights because such a drastic measure can only be justified under exceptional circumstances. Just because a person is using drugs, you can’t deprive them of their parenting responsibilities. Especially because this woman herself was engaging in trying to find a job and has an excellent relationship with her three children. So she won the complaint.

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