EXPLORING COMMUNITY RESPONSES TO DRUGS

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EXPLORING COMMUNITY RESPONSES TO DRUGS

• Betsy Thom
• Institute for Social and Health Research
• School of Health and Social Sciences
• Middlesex University

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• Community Responses to Drugs
• Michael Shiner, Betsy Thom and
• Susanne MacGregor
• with
• Dawn Gordon and Marianna Bayley
• Funded by
• The Joseph Rowntree Foundation

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Multi-component programmes an approach to
prevent and reduce alcohol-related harm

• Betsy Thom and Mariana Bayley
• Funded by Joseph Rowntree Foundation

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But what do we mean by COMMUNITY?

• A housing estate, street, village, town, health
  authority area
• A religious or faith based group
• A therapeutic community
• People working in the same industry or workplace
• Associations or groups of people with shared
  interests, characteristics or identities

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Community

• I always cringe when I hear it..... I dont
  think that is a very real concept...
• It is almost a mythical term, isnt it? .....but
  we still need a word or phrase, dont we, to
  describe this almost mythical thing.
• Just a buzz word

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Policy local solutions to local problems

• Involving the community is a part of dominant
  policy discourse
• Area based initiatives (ABIs) are a central
  feature of Government policy
• Citizen participation is a key element
• Partnership is an important mechanism for
  achieving change
• Target disadvantaged communities

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Dangers and Ambiguities

• Concept of community
• Pathologising areas and residents
• Ignoring heterogeneity and diversity of interests
• Ignoring issues of power and responsibility
• Disrupting existing relationships, networks,
  systems

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1. Heterogeneity

• Partysafe Project (Midford et al. 2003) - an
  isolated, discrete community, well established
  community structures, low population turnover,
  contact between project officer, local networks
  and citizens frequent and informal.
• Operation Safe Crossing (Voas et al. 2002) -
  youths crossing from USA to Mexico for binge
  drinking a transient group, scattered
  throughout/ outside the San Diego area.
• UK - city centre safer drinking information
  disseminated via email to businesses -
  expectation - messages cascaded to employees,
  reaching an audience of up to half a million
  people.
• Home Counties travellers and alcohol related
  violence. Due to the transient and less organised
  nature of the travelling community educational
  measures expected to have limited effects.

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2. POWER AND RESPONSIBILITY

• Appropriate for the community to be involved
  ACTIVITIES
• Consultation- 77 (23)
• Delivery of services/initiatives- 35 (62)
• Fundraising- 41 (44)
• Management- 16 (61)
• Commissioning- 22 (52)

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POWER AND RESPONSIBILITY

• Appropriate for the community to be involved
  Areas of work
• Education/ prevention- 64 (34)
• Diversionary activities- 64 (33)
• Support users/family- 67 (27)
• Campaigning- 59 (34)
• Aftercare/ relapse prevention- 37 (44)
• Law enforcement- 18 (38)
• Delivery of treatment- 14 (43)

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Trust

• If I look back, the one thing that absolutely
  struck me was that it was the laying out of trust
  and the concrete element behind it. So whether or
  not its pound notes or computers or something
  else, take it, use it, we trust you. And then
  they will deliver (drugs prof. Sub. Town)

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TRUSTI would like to thank (church
minister) for the tremendous contribution he
makes locally and across London, and in
contributing to the Home Office with his
supportDavid Blunkett, interview in the local
paper
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As soon as someone in the community
springs up as a leader there is so much
antagonism to themself appointed leaders have a
really tough time they are seen as getting above
themselves(but) the local authority likes
working with community leaders. It makes it much
easier for themthey love it(but) it is actually
quite divisivecommunity member, suburban area
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3. Disrupting the status quo

• Moore and Holder (2003) community prevention is
  inherently disruptive to existing social and
  economic arrangements in the community because it
  disturbs the system.
• tensions between the expectations and
  understandings of different groups regarding, for
  instance, the major aims of the programme
• action may increase the exclusion of some groups
  (e.g. the young, most disadvantaged, drug users).
• need to assess the limits of community
  willingness and ability to participate.

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Disrupting the status quo

• How do programmes impact on different sectors of
  the community, particularly the most
  disadvantaged?
• What is a realistic level of citizen involvement?
  How is this influenced by the structures and the
  investments in human and social capital which are
  made in the project?
• Can tensions between institutional/professional
  goals and project goals be resolved?
• How do the projects affect, if at all, social
  cohesion within the community? And does it
  matter?
• Casswell (2000 70)

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A multi-component approach to preventing and
reducing harm

• a strategic framework with a theoretical basis
  for action,
• identification of problems defined at local
  levels,
• a programme of co-ordinated action (projects) to
  based on an integrative design where singular
  interventions run in combination with each other
  and / or sequenced together over time,
• identification, mobilisation and co-ordination of
  appropriate agencies, stakeholders and local
  communities,
• clearly defined aims, objectives, indicators and
  measures of effectiveness for the programme as a
  whole,
• evaluation as an integral part of the programme
  from the start

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Example Holder (2000)- a systems approach

• community mobilisation to develop community
  organisation and support,
• responsible beverage service to establish
  standards for servers and owners/managers of
  on-premise alcohol outlets,
• a drinking and driving component to increase
  local drunk driving enforcement efficiency and
  increase the actual and perceived risk of
  detection,
• an underage drinking component to reduce retail
  availability of alcohol to minors,
• an alcohol access component to use local zoning
  powers and other municipal controls of outlet
  numbers and density to reduce alcohol
  availability.

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Component 4 activities to tackle underage
drinking

• employee training- employees knowledge of
  underage laws, procedures for age identification
  and detection of false identification, methods
  and skills for refusing sales,
• enforcement of the underage alcohol sales laws-
  warning letters from the police to sales outlets,
  decoy operations,
• media advocacy- news coverage of the enforcement
  activities, other news events which highlighted
  more general issues.
• (Holder 2000)

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Does it work?

• Operation safe crossing
• A significant 45.3 reduction in 16-20 yr old had
  been-drinking-crashes. No significant effect
  among 21-25 yr olds.
• Overall 50-60 bar-goers aware of increased
  enforcement.
• A significant 31.6 reduction in late-night
  border crossers and a 39.8 decrease in number of
  underage drinking pedestrian returnees.
• A significant 29 decrease in ratio of
  pedestrians with BACs at 0.08 (driving limit).

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UK Example home counties night time economy

• Objective tackle violent crime
• Key priority reduce alcohol-related crime
• Enforcement anti-social behaviour orders
  -banned from the town centre for two years
• Intelligence gathering / sharing information
  about offenders visiting the area
• Pubwatch scheme
• Media / marketing messages on water bottles
• CCTV
• Responsible beverage service to discourage binge
  drinking via trade promotions.

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Community responses the issues

• National policy local needs
• Community involvement
• Transferring programmes
• Sustaining initiatives and successes
• Institutionalising change

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• Central government policies on
  participation, while not necessarily bringing
  citizen and user voices to the centres of
  decision making power, were producing a culture
  of change
• Newman et al. (2004) Public participation and
  collaborative governance Jnl. of Soc. Policy 33
  (2) 203-223