Alcohol – the missing component of the new science curriculum

On the day that the new national curriculum is unveiled we see that according to surveys undertaken by the School Health Education Unit one in ten primary school leavers say they have drunk alcohol in the last week.

As we know the Department of Education’s standard line on these things is to point to the science curriculum and then say that this can be built on through PSHE education.

So it is worth looking at whether in this final version of the curriculum the DfE have made any changes to the way they describe what schools need to teach when it comes to smoking, drugs and alcohol.

Assiduous readers of this blog will recall we looked at the proposed curriculum back in February and will therefore be prepared for the scant attention that is paid to drug education as a part of the science curriculum.

• There is no reference to alcohol (except as part of organic chemistry in Key Stage 4).
• In Year 6 pupils “should learn how to keep their bodies healthy and how their bodies might be damaged – including how some drugs and other substances can be harmful to the human body.”  And might look at the scientific research about the relationship between drugs and health.
• In Key Stage 3 the biology curriculum includes teaching “the effects of ‘recreational’ drugs (including substance misuse) on behaviour, health and life processes.” What ‘recreational’ means isn’t defined.
• Also in Key Stage 3 there’s an expectation that science teachers will touch on the impact of smoking on the “gas exchange system”.
• Other than a mention for alcohol as part of organic chemistry there is no guidance for schools about teaching young people about drugs, alcohol, or tobacco between the ages of 14 and 16.

Overall this is, I think, the lightest of light touches and the failure to address alcohol specifically is worrying. I also can’t see how it will be credible for the next Focal Point report to say (as the last one did) that:

School-based drug education forms a central part of the United Kingdom’s approach to universal drug prevention.

What is clear to me is that without support from a fully developed PSHE curriculum it will be hard for schools to show how they are delivering a curriculum that meets the needs of their pupils when it comes to drug and alcohol education.

How long before the government’s prevention fig leaves get blown away?

Mentor has been quoted as part of a short debate on the Home Affairs Select Committee’s report on the government’s drug strategy.

Diana Johnson MP a Labour Party Home Affairs spokesperson, says:

Figures from Mentor, the drug and alcohol charity, show that at present 60% of schools deliver drug and alcohol education once a year or less. That education is often poor, incomplete or totally irrelevant; pupils aged 16 seem to get the same lessons as pupils aged 11. An example given was of sixth-form students being required to colour in pictures of ecstasy tablets as part of their drugs education. Earlier this year, Mentor told me:

“Drug and alcohol education should not be disregarded as a trivial add-on. It should be fundamental to pupils’ education. The links between early drug and alcohol use and both short and long term harms are clear, and there is compelling evidence showing longer term public health impacts of evidence based programmes. The cost benefit ratios are significant, ranging from 1:8 to 1:12.”

In terms of the wider debate there was a welcome focus on the role that prevention can play in reducing demand for drugs, but it is disappointing that all the Minister, Jeremy Browne, has to fall back on as concrete achievements of the drug strategy are the fig leaves of FRANK and the Choices Programme.

The evidence suggests that the FRANK website is unlikely to change behaviour on its own.  It may be that the helpline and other interactive services contribute to some preventative outcomes, but the Home Office have not (under successive government) undertaken or published any research on the behavioural impact of FRANK. Readers of this site will know that the EMCDDA recently recommended any mass media campaigns aimed at preventing drug use are accompanied by a robust evaluation. It is also worth noting that the budget for the services was been slashed to £500,000 last year suggesting that Ministers and officials don’t believe that it is an efficient way of spending money.

Mentor’s collaboration with Addaction on the Street Talk project was the largest single beneficiary of the Choices programme, so while we can be clear what we were able to achieve with the funding we also know that this was a one-off fund which allowed us to deliver the project for less than six months.  There has not been any suggestion from the Home Office that they will be continuing the programme.

It is also disappointing to see the Minister’s response on school based prevention, where he takes the line that good health education is somehow divorced from other educational entitlements.  Again readers of this site probably don’t need reminding of how interlinked risky behaviours and educational outcomes are.

If you are interested in reading the whole debate it can be found here.

PQ: Students, Ritalin and Modafinil

Conservative MP, Graham Brady, asks the Department of Health about what assessment the department has made on the misuse of Ritalin and Modafinil as cognitive enhancers, what they’re doing to restrict access, and inform students of the potential side effects.

The Minister answering, Norman Lamb, is on pretty solid ground when talking about the controls around the sale of these drugs – Ritalin is a Class B drug under the Misuse of Drugs Regulations, while Modafinil requires a prescription but isn’t controlled under the 1971 Misuse of Drugs Act.

He points out the restrictions around advertising Modafinil which apply to UK-based pharmacies, but admits these regulations don’t apply outside the UK, and goes on to say that the Medicines and Healthcare products Regulatory Agency (MHRA) have serious concerns about internet sales.

Lamb argues that there are regular warnings issued by the MHRA about buying medicinal drugs over the internet, and a quick look on the MHRA website turned up the a page on buying drugs off the internet and video which was uploaded to YouTube in December last year, since when it’s had 760 or so views.

The video, as you’ll see, takes a very traditional cautionary approach with a fictionalised account of a young adult needing emergency treatment because of his misuse of drugs bought from the internet.  At the end it advises viewers to visit www.RealDanger.co.uk which redirects to a Pfizer branded website, where interestingly there is a link to the same video, but this time on the Pfizer YouTube channel where it has had over 34,000 views.

The Pfizer site also links to a press release about a survey of pharmacists that suggests they think that internet sales of prescription drugs is rising, but doesn’t – as far as I can see – back this up with any data about the prevalence of misuse of medicines, or the number of hospital visits as a result of this.  They do however say that over the last 5 years the MHRA seized more than £34 million worth of medicine supplied illegally.

Of course what isn’t clear is how much of the seized medicines were the ones that caused Mr Brady to ask his question, nor on the prevalence of the misuse of these drugs, or whether the approach that Pfizer and the MHRA are taking is being successful in preventing further misuse.

Returning to the Minister’s response to the question, Mr Lamb, also comments on the role the national curriculum plays in informing younger students about drugs.  He rightly points out that the science curriculum has some broad words about teaching ‘the effects of drugs on behaviour, health and life processes’ and that this can be extended by PSHE teaching.

The prevalence of the misuse of medicines by school age pupils isn’t really measured by the Smoking, Drinking and Drug use survey.  They are able to show that 0.4% of pupils between 11 and 15 years said they took a Tranquilizer in the last year, as you’d expect they found that the proportions saying they’d used went up by age.

I will need to check with Liz Fuller and her colleagues at NatCen that do the survey every year to check whether they ask about other medicines like Ritalin or other cognitive enhancers but certainly if they do the proportion is so small that they get gathered up in the ‘other’ category.

An emerging movement around evidence based education

While we will continue to be baffled about the current liaise faire approach that Ministers have to health education I can’t help admire the speed at which they are trying to advanced the cause of evidence based education.

The latest example is that the DfE have commissioned two new Randomised Controlled Trials of programmes – one for maths and science the other looking at a child protection assessment tool.

Michael Gove says:

We need more hard evidence in the education debate. We also need to develop a better understanding of what counts as effective social work. Randomised controlled trials offer us the opportunity to establish which policies genuinely help children. I am delighted the DfE is embracing a more rigorous approach towards evidence.

The question for me then is whether the prevention field has already got a head start in this field – in that there is a history of running school interventions with RCTs and in producing meta–reviews of those trials – and whether that might be a way of engaging the Secretary of State in seeing the benefit of the field to educational and health outcomes?

But it isn’t just the Secretary of State for Education who has embraced this agenda it seems to me that there are many enthusiasts amongst teachers and school leaders as well – for example this LinkedIn group has a couple of hundred members, while this conference in September is likely to be oversubscribed many times over.

A final thought, this time from Tim Harford, who writes for the Financial Times and presents for Radio 4, who on his blog, The Undercover Economist, argues that it would be wrong to see this movement as a one way street.  Talking about how research and practice are not mutually exclusive he argues:

In short, evidence-based practice in medicine isn’t a case of doctors, brainwashed into believing whatever clinical trials tell them, passively awaiting instructions. It’s a two-way street, where some of the best ideas for research are suggested by practitioners, and best practice spreads sideways from clinician to clinician rather than being handed down by diktat…
One can see why Dr Goldacre calls this a “prize”. Teachers are better placed than anybody to generate new research questions, based on years of observation of subtleties that would escape any educational statistician.

This seems right to me and fits, I think, with the model of programme development that is set out in the EMCDDA’s standards for drug prevention which talks about justifying the need for an intervention, understanding the target population and tailoring it to the needs of that population – all things where research and practice need to be working hand in hand.

Parliamentary Question – DfE spending on drug education

Conservative MP Nick Dubois asks the DfE:

(1) how much the Department spent on educating young people on the risks associated with Class (a) A, (b) B and (c) C drugs in each of the last five years;

(2) how much the Department spent on advertising the risks associated with Class (a) A, (b) B and (c) C drugs via the Frank drug information campaign in each of the last five years.

The DfE Minister, Elizabeth Truss, responds:

The Department for Education does not explicitly fund drug education. School pupils are currently provided with education on the physiological effects of drugs as part of the statutory National Curriculum Programmes of Study for science. They may also receive wider drugs education as part of non-statutory personal, social, health and economic (PSHE) education.

The FRANK service provides information and advice to young people about drugs. The Home Office, Department of Health and Department for Education work together to support the service. Funding is not allocated to advertising the risks associated with specific classes of drugs.

Here’s an example of the sort of information and advice FRANK has been providing young people.

Mr Gove’s view on evidence based policy

Given that Michael Gove is reported as leading the charge against Minimum Unit Pricing for alcohol I thought it may be helpful to point to his views (see page 21) on the use of evidence for developing policy.

Gove says that he is a fan of evidence based policy and points to the report that Ben Goldacre produced for the Cabinet Office calling for more rigour in the evaluation of social policy.  But he adds a caveat:

it is outside my bailiwick, but there was a discussion in the last Parliament between Alan Johnson and Professor Nutt about drugs policy. The professor said, “This is the evidence for the effect of drugs”, and Alan Johnson said, “That is fine. I am the politician, I am responsible. I have taken account of it, but I take a different view.” I think it is possible to do that. On the whole I prefer to rely on the evidence.

With thanks to my Mentor colleague Liam for pointing me at the quote.

Draw a veil

In many ways the Foreign Secretary, William Hague, is a very good role model, but it seems that for some students the lesson they’ve taken to heart is his self reported binge drinking, with York University Conservatives saying there will be medals for those students able to drink the full 14 pints.

The Spectator reports an interview Hague gave in 2009 in which he says:

‘I get students writing to tell me about having a Hagueathon: they are trying to drink 14 pints, or have a three-legged one where two of them drink seven pints. That is my contribution to the English language. Margaret Thatcher contributed ‘Thatcherism’, all I’ve contributed is the name of a drinking contest.’

I’m sure that Hague’s influence on student drinking culture is being over-exaggerated in these stories, and that were Hague not to have inspired this particular drinking game that others would not be played.

But it did set me thinking about whether there’s a broader point as highlighted by the research reported in the Daily Telegraph recently that suggested that adults when asked about drug use by their children should not necessarily be open about it.

Perhaps when asked about these things by the media it would be wiser, all round, for politicians and celebrities to draw a veil over their own excesses.

Nick Clegg on Drugs…

Nick Clegg has responded to the Home Affairs Select Committee report on drug policy, sharply disagreeing with David Cameron about the need to consider reform.

He seems to reiterate a view that Ken Clarke gave the committee, that the ‘war on drugs’ is not being won.  Clegg says:

“After all, this is a war, the war on drugs, in which over 2,000 people are losing their lives in Britain every year, in which one in five 11-15 year olds in this country now say they’re trying drugs, where young people now are telling us that it’s easier to get hold of drugs than it is to get hold of alcohol or tobacco”

As we said when Ken Clarke made very similar points what these statistics miss is the historical context, and oddly they are also slightly out of date.

The last SDD report found:

Around one in six (17 per cent) 11 to 15-year-olds surveyed in 2011 said they had ever taken drugs. This compares to 2001, when 29 per cent of pupils in the same age range reported that they had.

While the number of deaths caused by drugs has also seen falls in recent years, with the annual report on drug deaths from earlier this year telling us:

There were 1,883 notifications of drug-related deaths occurring in 2010 in the UK and Islands. This represents a decrease of 299 (13.7%) over the same reporting period in 2009.

That said our position compared to other European countries is dire as you’ll see from the following presentation.

The effects of the English Baccalaureate

The DfE have published some research they commissioned into the effects of the English Baccalaureate.

While there is no mention of PSHE or drug education in the report what comes across is that for a significant proportion of schools the emphasis on the subjects that are in the EBacc comes at the expense of those which are not.

The report says that 17% of schools are going to drop some subjects while 18% say that they expect to offer a narrower curriculum.

This is important to us in recognising just how difficult it may be to encourage secondary schools to introduce life skills programmes which take 10 or more sessions over the course of a year.

Particularly if there isn’t strong and enthusiastic backing from Ministers in the DfE.

David Laws MP on Life Skills

Election 2010 Day 16 – Nick Clegg & David Laws launch ‘A Fair start for Children’, a photo by Liberal Democrats on Flickr.

David Laws has just been reappointed to the government as a Minister for Children and Families.

At the end of the last parliament in 2010 he was interviewed by some young people from the National Deaf Children’s Society.

In the course of the interview he spoke about PSHE and life skills:

One of the problems, again, is that quite often in the past this area of the curriculum, the life skills area, is one where the teachers haven’t always been very well trained for it. The quality of the education is sometimes not as good in some schools as it should be, and it’s often thought of as being a bit of a kind of low priority for the school partly because you often don’t set an exam in it so people think it’s less important. But actually a lot of the things that we learn through life skill classes can be incredibly important and can lead to a big benefit in people’s lives, I think.