Fikile Mazibuko
Human Resources Development Institute Inc. (HRDI- Chicago, IL.),
former National Chairperson of the National Welfare
and Social Services Development Forum (NWSSDF-South Africa)
1. INTRODUCTION
Drug abuse, alcohol abuse and HIV/AIDS epidemic are some of the major burdens of societies in the 21st Century. Studies and statistics show that globally more preadolescent and teenage children are using drugs and alcohol (Australian Drug Foundation, 1999; Drug Nexus in Africa, 1998; National Drug Strategy Household Survey, 1995, 1998; National Household Survey on Drug Abuse 1994- 1999; World Drug Report, 1997). Drugs used and abused by children and youth include tobacco, alcohol, heroine, cocaine, mandrax, LSD, ecstasy, cannabis and hallucinogens.
The easy access and availability of drugs and other substances is another cause for concern amongst those in social development institutions and human social services. There are a number of social and psychological problems related to drug use and abuse, however this paper focuses on the critical mass of young people, whose involvement with drug abuse threatens the very fabric of social well-being.
II. GLOBAL OVERVIEW OF YOUNG PEOPLE AND DRUG ABUSE
One of the major concerns is that children seem to be targeted as the new market for the drug industry globally. In economic terms, both licit and illicit drugs are viewed as consumer goods that are traded in a competitive global market. Illegal drugs account for at least $400 billion of world trade marking it larger than the global iron and steel industries (James, 1999).
An article in the Chicago Sun-Time reflects the seriousness of how children are targeted by the illicit drug market An extract form this article reads "High school students must walk past drug dealers and gang members trying to enlist them..." (September 08 2000). Secondly, the World Population Trends Estimates for the period 2000- 2050 show a decline of young people in a number of countries (China, Sweden, Norway, Australia) in the age groups of 10- 19 (U.S. Census Bureau, 2000). In Africa, with an annual growth of over 3 percent, the youth is estimated to reach 258 million by the year 2025.
Presently the 15-24 age group constitutes about 20 percent of the total population of the continent (Fadayomi & Poukota, 1999; Makinwa-Adebusoye, 1999; World Population Prospects, 1998). Thirdly, the other factor that has to be borne in mind when addressing issues of drugs and young people is that the both the legal and illicit drug industries seem to be well organized, have sophisticated and persuasive marketing and publicity strategies, do their research meticulously on the consumption patterns and establishing new markets and developing high-tech modes of transporting illicit drugs.
One of the leading state newspapers in Illinois, the Chicago Tribune carried an article titled "Colombia finds sub (marine) being built to sneak drugs" (September 08,2000; p.14-Section 1). This was a sophisticated submarine involving highly skilled professionals who could be American and Russian as the article alleges.
Also, both the electronic media and drug industry campaigns against the legal and illicit drug industries send mixed, and sometimes, confusing messages to children and young people. All these messages are usually presented in very appealing, attractive and persuasive packages. Social development interventions therefore have to be alive to the realities and complex challenges posed by the drug industry.
Fourthly, children and young people who use and/ or abuse drugs become one of the most vulnerable groups to HIV/AIDS infection. The increase of drug use and threat of HIV/AIDS amongst young people globally are a cause for concern. Young people between 10-24 years are estimated to account for up to 60% of all new HIV infection worldwide (Fadayomi & Poukouta, 1999).
The illicit drug trade is gradually emerging as a serious problem in sub-Saharan Africa. More sophisticated and synthetic drugs such as crack, cocaine, opium, and ecstasy are finding their way into the continent. Africa has huge young and vulnerable populations which are becoming the target market for the illicit drug industry.
In Cote d'Ivoire more than half of the entire population is under 18 years and there is a growth in the numbers of "street children". In most African countries, the under 18 population is relatively large; Botswana, Cameroon, Central African Republic, Guinea- Bissau, Egypt, Kenya, Lesotho, Libya, Malawi, Mozambique, Namibia, Nigeria, South Africa, Trinidad and Tobago, Togo, Zambia, Zimbabwe (U.S. Census Bureau, 2000).
Drug usage in Africa amongst young people is associated with social and psychological damage produced by social upheavals and civil war. In other words it is associated with the challenging socio-economic material conditions found within most countries in the continent. A survey of young Kenyans suggested that 63 percent used drugs, including the culturally accepted qaat. In Ethiopia it is reported that 82 percent of the street children in Addis Ababa use some kind of a drug (James, 1999).
Beside the threat of increasing consumption amongst children and young people, Southern Africa is becoming a major trans-shipment point in the international drug trade as well as a major producer of dagga (Honwana & Lamb, 1998). All these factors are threat to the stability and sustained socio economic development initiatives in the southern Africa region.
Young people use or abuse drugs for a variety of reasons. One cannot generalise the reasons given by young people of Africa for the use or experimenting with drugs. In South Africa it is estimated that approximately 5.8 percent of the population over the age of 15 is dependent on alcohol and that there are indications of an in the abuse of illicit drugs and other substance. In South Africa children and young people are introduced into drugs in a number of ways.
The youth, sexually active young girls and street children are some of the most vulnerable and high-risk groups when it comes to drug and substance abuse (Framework for a National Drug Master Plan, 1997; South African National Council on Alcoholism and Drug Dependence, 1993; White Paper for Social Welfare, 1997). A study done by Peltzer and Phaswana (1999) amongst South African university students showed that young people are introduced into drugs in different ways, namely (1) friends and acquaintances (2) cigarettes (21%), (3) cannabis (11%), (4) family member or relative (7%).
Other drugs that are prevalent and readily available to children and young people in South Africa are glue sniffing, dagga, mandrax, cocaine and to some extent ecstasy. Generically high-risk groups include the youth, commercial sex workers and pregnant women (Framework for a National Drug Master Plan, 1997). Glue sniffing is popular within the age range of under 10 years to about 13 school going and street children. In certain parts of Africa - Cameroon, Cote d'Ivoire, Ethiopia, Kenya - drug and substance abuse amongst the children and youth is attributed to social pressures, socio-economic uncertainties, vulnerability of children (street children, child labor)(Drug Nexus in Africa, 1999; James, 1999; World Drug Report, 1997).
With the young people in the United Kingdom, some of the reasons given for using drugs are (1) relaxation or stress relief, (2) fun, (3) excitement and happiness. Young people in the United Kingdom have made very few negative associations with drugs, namely health (10 percent) and hangovers/after effect (8 percent for both) (UK trends and update, 2000). These negative associations and percentages show the level of ignorance and lack of information about drugs amongst young people.
In Russia and Eastern Europe there is a rising drug problem amongst children and young people. An announcement made by the Ministry of Interior in Russia (Blagov, 1998) estimated that the country has 2 million drug users; of the 20,000 who are formally registered users, one third (6,700) are minors. In Belarus 87 percent of persons infected by HIV were drug users (Blagov, 1998).
In Australia young people use drugs for the same reasons as adults and youth in other parts of the world. They use drugs for relaxation and fun; dealing with inhibition; coping with pressure and frustration; to relieve stress and anxiety or pain; and to overcome boredom. Some of the drugs are perceived as acceptable norms in society (Australian Foundation, 2000; Nielsen, 1999).
In Australia the experimentation or beginning of drug use starts at the ages 12-14 years; progresses into the 15-17 years age group and become problematic between the ages 18 -24 years. Australian children and young people experiment with a range of drugs ranging from tobacco to heroin. Like most young people the Australian youth give very little consideration to the harm done by the use of drugs. In some instances drugs have been cited as the cause of death.
The United States has the highest number of drug abusers in the world (Flowers, 1999; Turenne, 2000; Weinstein, 1999). Statistics show a prominent but varied use of drugs amongst children and young people. Some statistics show that the inhalants continue to increase in popularity among eighth graders and twelfth grade. Illinois youth adolescents within the age group 12-17 years continue to use illicit drugs specifically alcohol, marijuana, and cocaine.
Though changes have been reported in the use of illicit drug use in this age group between 1998 and 1999; the change is not significant; 6.2 percent in 1998 and 7.0 percent in 1999, (U.S. Department of Health & Human Services - HRSA, 1999). The fact that 56 percent of the adolescent surveyed in 1998 reported that marijuana was easy to obtain; 30 percent said cocaine was easy to obtain and 21 percent said heroine was easy to obtain; says a lot about availability and accessibility. The proportion of adolescents reporting the use of marijuana in the past month decreased from 9.4 percent in 1997 to 9.9 percent in 1998.
The drop did not represent a statistically significant change. A statistically significant decrease in the use of inhalants amongst the age group of 12-17, from 2.0 percent in 1997 to 1.1 percent in 1998, was reported (HRSA, 1999). Accessibility and availability remain major critical challenges in efforts to deal with illicit drug abuse amongst children and young people. Cigarette smoking amongst 8th graders, boys and girls, is on the increase at least by 50% (SAMHSA, 1998; University of Michigan Institute for Social Research-Monitoring the Future, 1998).
Overall, drugs are part of experimentation and risk taking for during the period of early and late adolescence. In some instances young people have viewed experimentation with drugs and other substances as a way of negotiating developmental transitions (Maggs, 1997; Peltzer & Phaswana, 1999; Silbereisen & Reitzle, 1992). Studies undertaken in different countries in the 1990s show that persons who use and abuse drugs are starting at a younger age (pre-teens).
Also drugs are used and abused by children and youth from all socio-economic and racial/ethnic backgrounds. From the tables cited in this presentation and from the studies conducted on the youth/adolescence and drugs, this population is vulnerable. These young people may later, in their late teens and early adulthood use harder drugs like heroin and cocaine. They maybe more frequently involved in criminal activities that should generate income to feed the habit or the addiction (Baker, 1998; National Center on Addiction and Substance Abuse, 1994, 1997; Salmelainen, 1995; Trimboli & Coumarelos, 1998).
The issue of drugs and youth should be viewed and tackled in relation to a number of social, economic, cultural and political factors. Any intervention, process or plan cannot be treated in isolation of other factors. As Gerstein and Harwood aptly note " Drug treatment is not a single entity but a variety of different approaches to different populations and goals." (1990, p.132, Trimboli & Coumarelos, 1998, p.4).
III. CONCEPTUAL AND PHILOSOPHICAL FRAMEWORK
This paper is informed by the conceptual and philosophical framework of social development. It views young people as a critical component of any population or society and as a crucial asset in the development of human capital globally. It emphasizes a proactive focus wherein social change processes and social service programmes should not be primarily about responding to crises and providing perpetual remedial interventions but rather should focus on areas of prevention and socialization.
The well-being of societies, amongst other things, hinges on stable and healthy socio-economic development programmes. In the context of social development, prevention and socialization are other dimensions that are critical in addressing environmental issues of substance and drug abuse, especially among children and young people. This paper is also informed by the view that young people form a critical component of any population or society. Children and young people are crucial assets in the development of human capital and are social change agents within the particular stages of human development (late childhood and adolescence).
Studies and statistics show that drug abuse is linked to other social problems, namely, child neglect, poverty, social pressures and traumas, crime and HIV/AIDS (Baker, 1998; Flowers, 1999; National Center on Addiction and Substance Abuse, 1994, 1997; Salmelainen, 1995;Trimboli & Coumarelos, 1998). It is therefore not surprising that children and young people in some of the rehabilitative programmes cited in this paper have behavioural problems in the school system or are mandated by the criminal justice to be in the programmes.
Children and young people in poor or materially deprived communities are therefore more vulnerable to drug use or other socially unacceptable behaviours related to drugs and substance abuse. Studies show that some of the crimes committed by young people are frequently a result of the need for the money to support their drug habits and addictions (Baker, 1998; Flowers, 1999; National Center on Addiction and Substance Abuse, 1994, 1997; Salmelainen, 1995; Trimboli & Coumarelos, 1998).
Not only does alcohol and drug abuse influence the social problems above, it also threatens the fundamentals of the social fabric of societies such as values, beliefs, and cultural systems; and can cause a range of mental illnesses which are not necessarily reversible. In my opinion social resources and social service programmes in an ongoing developmental social change process are viewed as tools of growth, prevention of social ills, creation of opportunities and mechanisms by which excellence and quality of life can be achieved.
The theory of socio-cultural change - risk and protective factors, as posited by Trommsdorff (2000), is used to argue that the individuals are shaped and nurtured by the context and quality of the social environment in which they are nurtured and socialised. This theoretical perspective suggests individual development takes place within distal (that is political), and proximal (income and family structure) contexts.
During the life course, different aspects of the environment are important for the socio emotional and cognitive development of the individual. Within the change contexts or the social environment, the individual is expected to develop attachment (working model), self-efficacy and problem solving abilities. The family and peer group function as the social resource systems for the individual. The individual goes through the psychological, social, cognitive, emotional and motivational developmental processes.
The developmental outcomes or negotiated changes are: a) an individual with self-efficacy (belief system); b) self-esteem; c) social competence; d) planning/problem solving and decision-making. A preventive and developmental approach in addressing problems of drug and substance use and abuse will therefore be mindful of this theoretical perspective. On the basis of Trommsdorff (2000) theory, individual development and well-being are mediated by a range of socio-political, economical and individual. A balanced and positive interaction amongst the distal, proximal factors would possibly reduce the vulnerability to drugs and substance abuse.
IV KEY FEATURES OF THE SOCIAL DEVELOPMENT APPROACH
The social development approach is adopted for the purposes of this paper because of its several key features. It caters to all people; it facilitates the integration of economic and social policies; it creates opportunities for growth and self-actualisation for members of the society; it develops and sustains clear plans and processes for programmes and the ability to engage a range of disciplines in social development programmes.
Social development seeks to enhance the human well-being in the context of an ongoing process of development. Social development does not cater primarily to needy individuals (Midgley, 1995, 1997). This suggests that institutions or sectors such as social welfare should not necessarily be established to operate as "safety valves/measures' per se to the disadvantaged members or communities. Social welfare should be a powerful tool of eliminating possible chances of creating social problems and inequities that produce disadvantaged members of society (illiteracy, school-drop -outs, drug abuse and addiction, lack of creative and recreational opportunities for children and young people).
Social development seeks to integrate economic and social policies (Midgley, 1995, 1997). The kind of domestic social and economic policies that we generate in our societies all over the world should be complimentary. The human capital or human capacity that we generate through our social policies should ensure that to a great extent the economy absorbs it, thus facilitating economic growth and economic self-sufficiency. It is of grave concern that in the 1980s and 1990s some part of the continent of Africa witnessed an increasing emigration of young human capital in which they had invested so much developing and enhancing.
These countries did not have the economic capacity and economic environment to utilize the highly skilled human capacity they had produced (Amissah, 1994; Apraku,1991). Social development, therefore is a lost cause without economic development, and economic development is a lost cause without the positive nurturing of the well-being of the population; especially those in the prime and peak of their productive years. The number of children who drop out of school in some developing countries is another concern.
Midgley (1997) notes that in most countries the problem is not the absence of economic development but rather a failure to harmonize economic and social objectives and to ensure that the benefits of economic progress reach the population as a whole. For the social welfare sector this suggests, not only a paradigm shift, but a shift in the culture of programme design, operation and implementation. It suggests and poses a challenge to move away from a consumer-orientated funding tradition.
It suggests developing clearly defined strategies, operational plans, outcome plans, measurable objectives, and tools that will demonstrate changes brought or not brought for the interventions (outcomes). If for example the programme is designed to help school going children with drug problems; the programme should have an Outcome Plan that will demonstrate the duration of the programme, the number of children who come out clean and integrate into the education system and finish high school.
Social development requires that governments and other funding institutions invest financial resources into processes and plans, support systems, evaluations. Processes are as important as the plans in social development. Social development is not a programme of chance it is a planned and organized effort which demands heavy investment of human, financial and technological resources.
Social development is multi- and inter-disciplinary in nature. I would suggest that in the 21st century it will draw knowledge from a broader spectrum of social sciences, information sciences, economic disciplines, management and planning and natural sciences. It requires knowledge of human behaviour, models of treatment and development, information technology and techniques of communicating, generating and imparting knowledge.
It further requires a fair understanding and analysis on economic policies and processes, making budgetary projections for development social welfare; and techniques of analysing data, making projections about the future; environmental analysis; and measuring effectiveness and efficiency of programmes. Social development therefore is not confined to modest self-help and community development initiatives.
V. COPENHAGEN DECLARATION ON SOCIAL DEVELOPMENT
The Copenhagen Declaration on Social Development adopted 10 Commitments (1995). For the purposes of this paper Commitment 6 is most appropriate. Commitment 6 reads "We commit ourselves to promoting and attaining the goals of universal and equitable access to quality education, the highest attainable standard of physical and mental health, and the access of all to primary health care, making particular efforts to rectify inequalities relating to social conditions and without distinction to race, national origin, gender, age or disability, respecting and promoting our common and particular cultures; striving to strengthen the role of culture in development; preserving the essential base of people-centred sustainable development; and contributing to the full development of human resources and to social development. The purpose of these activities is to eradicate poverty, promote full and productive employment and foster social integration"(p.16-17).
VI. SOCIAL INFLUENCES ON DRUG ABUSE
A number of social factors may influence or make children and young people most vulnerable to drug use and abuse. Some of the factors are related to the developmental needs, peer pressure, family discord and disruption and poor social and coping skills. In relation to Trommsdorff (2000) socio-cultural change theory, the social factors in this section are symptoms and manifestations of poor or unstable distal and proximal contexts in society. In generating preventive, curative and /or educational programmes on drug abuse, it is essential to address the social influences as it is to address policy, legal and biomedical factors.
1. Developmental Needs
Pre-teen and adolescence stages are developmental stages for children and young people. Adolescence is viewed as one of the critical transitional stages especially in models that study adolescence in the context of social change or social development. As early as age 14 young people are expected to develop social skills; what Shanahan and Hood (2000) refer to as planful competencies; Trommsdorff (2000) refers to these as social competencies and self-efficacy. In other words, they begin to carve pathways or chreods (Gottlieb, 1992; Waddington, 1975)into adulthood. This is an adulthood that requires competitive technical skills, strong coping mechanism, education and the ability to compete in the labour market.
The developmental needs for children and adolescence have to prepare them for a life of macro structural pressures and individual propensities with limited or heavily eroded social resources. It is a time when children need a lot support in a form of growth-promoting activities. These activities can be provision of resources, definition of boundaries of acceptable behaviours, responding and growing in various community settings. Leaving children to independently satisfy needs that adults should manage make children vulnerable to drug use and abuse (Weinstein,1999). This is one situation which justifies the need of strong and focused secondary or peer agencies that engage in assisting young people to develop a repertoire of coping and survival techniques in hostile, turbulent and competitive socio- economic environments.
2. Peer Pressure
Peer groups or relations usually provide important mediating variables influencing the experience of environmental change and personal development for children and adolescents. Peer pressure is strong particularly during the preteen and adolescence stages; when there is a lot of search for identity, insecurity about their identity and need to be accepted (Delgado, 1997; Nielsen, 1996; Weinstein, 1999). In instances where the peer influence is negative, the risk of drug and substance abuse is greater. Therefore the risk of experimenting with and later becoming addicted to drugs is connected to the challenges of individual development within dynamic and turbulent socio-economic environments (Delgado, 1997; Padilla & Synder;1992; Weinstein,1999; Trommsdorff, 2000).
3. Family discord and disruption
Literature show consensus that the family forms the cornerstone of efforts to socialize about, prevent and treat drug abuse (Fileds, 1995; Heinicke & Vollmer, 1995; Padilla, & de Salgado, 1992; Weinstein, 1999). Disrupted family circumstances (not necessarily poor families) can lead to poor adult care of children at home. Working parents have jobs or are out looking for jobs leaving children with grossly inadequate adult supervision.
Urbanization and migration have also facilitated the breakdown of a range of community support structures which assumed locum parenting roles. Parents or any other adults who should serve as parental surrogates may not be readily available or have conditioned children not bother them. Parents may be intolerant, punitive or unapproachable to their children. One way of responding to this family situation can be use of drugs. A number of factors are threatening the strengths of the family as a source of socialization and support.
4. Poor social and coping skills
Children and young people with limited, poor or no coping skills may develop destructive coping mechanisms for problem solving, anger, depression or conflict management. This may include experimenting or binging with drugs.
VII. POLICIES AND LEGISLATION
Most of the countries that have drug policies such as South Africa and the United States have adopted demand reduction and supply reduction policies. Despite the massive financial, human and technical resources invested in implementing these policies, the decrease of drug abuse and the rate of recidivism has been minimal. As indicated earlier on in the text, the illicit drug industry is becoming more sophisticated in its operations. These policies are discussed briefly and recommendations to adopt the Netherlands approach on drug policies are made.
1. Demand reduction, and supply reduction policies
Drug policies in countries like South Africa and the United States on demand reduction and supply reduction. The American drug policies have concentrated on reducing supply of illicit drugs through law enforcement, interdiction and eradication in the drug producing countries (Block, 1992; Duncan et al, 2000).
Drug reduction in the United States became a foreign policy issue because most of the illicit drugs, such as cocaine, heroine and marijuana, supplied and consumed came from outside its borders (McCoy & Block, 1992; Block 1992; Lee III, 1992). The success rate of the supply reduction and demand reduction strategies has been doubted by a number of authors (Duncan et. al, 2000; Janssens, 2000; McCoy & Block, 1992). This does not necessarily imply that these strategies must be abandoned.
Literature and studies show that in countries where drug education and substance abuse prevention are part of social policies drug use tends to be low (Japan, Norway, Scotland ). Some of the social policies are related to poverty, family life, health care, crime and violence (Weinstein.,1999) In other words governments should generate and support policies that allow people to achieve their goals in life; promote education and health, individual growth opportunities, financial security, investment in human capital and distribution of common citizen wealth.
These kinds of policies can reduce the social costs of escaping poverty and lack of opportunity through drugs. One posits that empowering and need based social policies combined with strict drug laws or policies have a better potential of giving an overall reduction of the drug abuse problem. One observes that in countries where family policies are solid, the family remains the primary safety net and socializing agency, unemployment rate is low; the drug problem is low (Japan, Norway, Netherlands, Egypt). Authors like Weinstein (1999), McCoy and Block (1992) associate drug problems as by-product of the failure of the U.S. social and welfare policies.
2. Harm reduction programmes: The Dutch Drug Policy
In the United States the supply reduction and demand reduction strategies have been central in the drug policy since the enactment of the Harrison Act of 1914. This strategy has concentrated on reducing supplies of drugs through law enforcement. Law enforcement included interaction with foreign policy wherein the eradication extended to the drug producing countries outside the borders of the United States (Caribbean, Mexico, Panama and many South American countries).
Heavy penalties and sentences are metered against both suppliers and users - users generally easier to identify in the inner cities. Though the penalties are heavy, there is an increase of drug users and suspects, for example in Washington, DC , a jump from 10 percent in October 1990 to 26 percent in July 1991. The number of cocaine suspects amongst the juvenile jumped from 7 percent in March to 17 percent in July (McCoy & Block, 1992). On the other hand, billions of federal dollars are invested in national and international efforts to reduce supply and demand.
The harm reduction model is used in Australia and other European countries like Norway. The Program for Adolescent Life Management (PALM) is an example of a harm reduction intervention developed jointly by the National Drug and Alcohol Centre and the Ted Noffs Foundation (Spooner & Howard, 1996; Spooner, et. al 1998a, 1998b). The PALM Model is both a holistic and social development approach. It is alive to the individual and social environmental realities that are part of the drug problem.
It recognised the human weakness to stop drug use or to be "clean" within specific short time frames. It uses a specific treatment model - cognitive -behavioural. This demonstrates that social development does not undermine clinical interventions but advocate for appropriateness and effectiveness. This model advocates for the reduction of risk factors and the enhancement of supportive and protective factors.
The Dutch model of harm reduction is informed by three principles, namely, (a) separation of markets, (b) low threshold treatment and (c) normalization of drug abuse treatment. In essence the Dutch Drugs policy adopts a non-emotive and demystifying approach when it come to drug use and abuse. Through the Opium Act certain drugs have been legalized, regulated and penalties relaxed. Secondly the use and sale of hashish and cannabis is acceptable at specific public places known as "hash and coffee shops".
Treatment programs are made accessible and user friendly. There is an acknowledgment that it is not easy to stop the habit; however there is goal of improving the health and social functioning of the addict. The drug problem is viewed as one of the many social problems that prevail in human societies ( Duncan, et. al 2000; Janssens, 2000; van Wijngaart, 1990). However the burden to decide how to view or perceive, present, prevent and respond to the drug problem rests with individual countries.
VII. STRATEGIES OF INTERVENTION ENHANCING LIFE OF SCHOOL GOING CHILDREN AND YOUNG PEOPLE
Any social or psychosocial interventions must understand the economic benefits and sophistication of the illicit drug industry. The interventions cited in this paper have been designed by the Human Service Development Institute (HRDI) for specific communities and youth populations in the South side of the city of Chicago.
1. Statist strategies
Though statist strategies have been criticized for heavy reliance on government intervention my opinion is that the intensity and magnitude of social problems and conditions such as drug use/abuse and HIV/AIDS requires a visible collaboration between governments and civil societies. Large scale programmes; youth awareness; public educational campaigns; training personnel, staffing programmes and processes usually require large financial resources, infrastructure and technical resources. Governments should not necessarily bear the absolute responsibility of resourcing and implementing interventions for drug and substance related activities.
Government could provide or facilitate a developmental policy environment; provide part of the financial and technical resources. All these provisions must be accompanied by accountability & monitoring procedures, accreditation and outcome-based plans. On the other hand, the range of civil society and community-based organisations, including youth formations, provide the capacity and infrastructure to implement, monitor and present programmes and services with tangible and measurable outcomes. In other words, clear collaborative plans and processes should be developed between government and civil society. Governments, through their specific ministries and agencies, could undertake the primary responsibility of "declaring war" against the big time illicit drug trafficking and supply industries.
The statist strategy can be combined with what Midgley (1997) calls the communitarian strategies; given the strength and capabilities of each partner in a developmental approach - the state strength in providing or generating fiscal resources and social policies and the civil society's in the capacity to provide resources and capacity for delivery at community level. The combination of the two strategies is applied by a Chicago based agency that work with predominantly disadvantaged communities in the South side neighbourhoods of Chicago.
This community- based agency; Human Services Development Institute (HRDI) works primarily with children and adults who have substance abuse and mental health problems. HRDI operates comprehensive and integrated residential programmes for individuals with mental illnesses, drug and alcohol dependence. The programmes facilitate goal planning and individual habilitation and treatment plans both to adolescent and adult service consumers. It provides the capacity to deliver professional and appropriate services to children and adults with problems related to substance abuse and/or mental health. The federal and state contract and provide dollars for the provision of services.
Organizational Framework: Organisational framework involves creating organisations that can assume responsibility for social development (Midgley, 1997). Midgley (1997) asserts that "it is important that organizational frameworks be created to enhance collaboration between economic development agencies and organizations that are responsible for social service policies and programs" (p.191). Organisational framework therefore is crucial for a successful implementation of programmes within the conceptual framework of social development. For the purposes of discussing this aspect HRDI will be used as a point of reference.
Leadership and management: The organisation has a Board of Directors who are actively involved in the policy making, planning and accreditation activities of the agency. Board members undergo an Induction Programme to understand the mission, foci, service consumers, internal and external environment affecting the substance abuse and mental health industry.
The first tier of senior management are the Chief Executive Office Associate Vice Presidents who are responsible for dialoguing with the external environment, environmental analysis (mental health, substance abuse), deal with issues of legitimation and authority at international, national (federal), state (provincial) and community levels. The Board of Directors and Senior Management are primarily responsible for leading the collective processes of giving the organisation a conceptual framework and annual strategic goals.
The second tier of management is responsible for co-ordinating, managing and supervising personnel that are implementing organs that handle the day-to-day operations of the agency. These are skilled and competent staff persons who provide services within the programmes and within the supportive services. Some of the staff are young people who were drug abusers, went through HRDI programs, are "now clean" (i.e. rehabilitated).
After achieving this level of treatment they went back to school, got appropriate formal training and licensing, then joined the organisation as staff. There may be a handful of this type of staff but the point made here is about the readiness to invest financial resources and take calculated risks developing human capacity over a period of time. This is part of the challenge of development.
2. Community education and information programmes
These kinds of programmes can be generated at different levels. The theory of social capital can be applied in generating and implementing community education and information programmes. Youth formations themselves are a form of social capital that can be engaged to generate educational and information programmes. Through their structures, young people can be part of initiative and processes of education and information sharing.
Earlier on, I indicated that peer influences can be negative; in this instance peer influences can assume the functions of socializing the children and adolescents on life and social skills that increase their coping strategies and decision making capabilities and just developing a sense of purpose in life. Organized and focused youth structures can be the barometer of understanding youth thinking and behaviour; soliciting and engaging their opinions and inputs on social change and other activities about them. Young people should not always be viewed as a potential problem - but part of solutions and change processes in society.
There could be incentives for young people; for example scholarships, exchange programmes, attending national and international conferences on drug and substance abuse; not as spectators or entertainers but as participants whose inputs are invaluable. The HRDI for example has an incentive for good behaviour, of two or more young persons to attend and participate in the prestigious " Annual Conference of People of Color"; nationally or internationally.
These are the kind of positive reinforcements that children and young people need to experience, especially if they come from deprived and depressed environments. One would assume that with the access and interest in technology, the youth of the 21st Century can generate more effective educational and information strategies.
3. Alternatives to incarceration
Chemical dependency is one of the criminogenic factors that contribute to the high crime and recidivism rates. Studies have shown a correlation between drug abuse and crime and unacceptable behaviour amongst children (Flowers, 1999; Males, 1996; U.S. Department of Human Services-HRSA), 1999; Weinstein, 1999). Rather than adopting harsh punitive measures all the time there is a drug use, drug abuse or misbehaviour associated with drugs, alternative programmes that nurture and rehabilitate in a community social environment can be considered.
In collaboration with the Chicago Public Schools (CPS), HRDI, as a community-based organisation, runs a preparatory school program. This program prepares students removed from the traditional school system due to behavioural problems; to return to their regular schools, or graduate from high school and enter the workforce or post secondary education directly from the program.
This project aims at improving the social functioning and behaviour of children who might be potential drug abusers or school dropouts. In this type of intervention the cognitive / behaviour model of treatment is applied. Simultaneously children are given an opportunity to continue with their education. The model has less punitive elements and it attempts to emphasize primary prevention and treatment and social coping skills.
4. Prevention programmes
Through the Center for Children, Youth and Family Services, HRDI has a prevention programme which provides youth leadership training, school based services, health and wellness, an annual summer camp, HIV/AIDS/STD prevention and violence prevention seminars. These programmes target the preteens and adolescent children who come from disadvantaged communities which are socio-economically vulnerable and easily targeted by the illicit drug industry. These young people are not necessarily using or doing drugs.
This is a nurturing and empowering programme that instills values and social coping skills. They are carefully and systematically planned by full-time staff, parents of the children involved in the program, volunteers, community members and members of the governance structure of the organization. HRDI engages in creative fund-raising strategies and outreach activities to implement and sustain these activities and their processes.
It is programmes like these that give children and young people the opportunity to be heard, to participate in their own growth processes. These types of programmes facilitate the transition from childhood to young adulthood, especially in societies where there is relatively little institutional structure to do so (Hamilton, 1990; Hurrlemann, 1990).
This type of programme uses the community asset model of intervention. Through these types of programmes, societies could begin addressing the weakening social moral against drug and substance abuse and related conditions. The family breakdown, poor parent-child relationships leave young people vulnerable to peer pressure and readily available misinformation. The visibility and interest of parents in such programmes might make a difference.
5. Adolescent Family Life Programme
One of the most vulnerable or high-risk groups in drug and substance abuse are young and sexually active girls. These young girls could be from a racial or ethnic background, usual school drop -outs, low-skilled or not skilled at all, and are likely to have a history of smoking and substance abuse or dependence. This is a gender-and -age responsive substance programme for pregnant, parenting and at risk teenage girls aged 12-19. Teenage pregnancy is viewed as another manifestation of the breakdown of the moral social fibre within communities. The rationale and reasons for this gender specific programme are that: (Kassebaum, 1999).
5.1 Substance abuse is the leading factor in the explosion of female offenders in prisons and jails including female juvenile population. Between July 1, 1997 and June 30, 1998, female prison population grew at a faster rate than men, 5.6% compared to 4.7% (Bureau of Justice Statistics Bulletin: U.S. Department of Justice, Office of Justice Programs march 1999, NCJ 173414).
5.2 Women in prison suffer from multi-faceted risk factors including poly-substance use/abuse and other chronic problems that predispose them to relapse and high recidivism rates.
5.3 There is lack of continuity of care for substance abusing females upon release from custody.
5.4 Most available treatment programmes in the justice system are inappropriate for females.
Given the fact that the girls have multi-faceted problems when they enter the program, the philosophy is to provide holistic, nurturing and empowering interventions.
6. Professional Counselling Center
This is another alternative to incarceration intervention using the Therapeutic Community Model. It targets young and old adult males from the criminal courts that are addicted to alcohol and other drugs. The programme offers a 90-day community base and residential programme. Relapses are common; however it is a time-consuming but rewarding effort. Some of the men get trained in employment related skills, acquire a formal education and at least three of the professional and registered counsellors have been through this programme. The program provides chemical dependency treatment, therapeutic community model, individual counselling and service linkages.
7. Community-based interventions
Just being a community-based organization is not enough to provide services to persons with mental and behavioural problems resulting from substance or drug abuse. The organization or social agency should have a solid and functional infrastructure. The community-based agency therefore should demonstrate the appropriate technologies for prevention programmes, behaviour modification, capacity building or treatment, socialization and information systems, target system, providers of complimentary services, providers of legitimation and authority - in short, a solid task environment (Hasenfeld,1983; Perlman, 1975: Thompson, 1962).
Using HRDI as a reference again, the organization has created more than 38 sites in the South side and in Chicago downtown to address drug and mental problems of the different groups in society: teenage mothers; young school going boys; school going boys and girls who are already in trouble with drugs or have developed behavioural problems; young men and women from correctional services because of drugs and other substances.
The organizational framework of this agency is designed to address drug use in the diverse youth population of the South side of Chicago. It is worth noting that in the mid-eighties and the early 1990s, Reagan-Bush era, heavy mandatory prison sentences on drug offenders, whether major dealers or casual users, were imposed. An increase in the prison population and prison expenditure was observed. In 1989-1990 the prison population increased by 6.6 percent at an annual cost of $20.3 billion.
As the New York Director of Criminal Justice explained the "Drug offenses continue to be the principal driving force behind these significant increases"(McCoy & Block, 1992, p.6). Part of the population that the HRDI treats are young men and women who have been through the justice system for drug related offences. It is a framework that adopts preventive, treatment and corrective measures of intervention.
Though the effectiveness of the community-based interventions has not been measured empirically within HRDI, one observes relapses, modest rates of success and continued effort on the part of the service consumer to stay clean within a very turbulent drug environment. Internal and external referrals are made to ensure maximum utilisation of community-based resources.
8. Research and monitoring data
Research and data monitoring are the areas that need strengthening especially in developing countries. Data on drug use and abuse amongst young people, including children, can be utilized for a number of purpose. Data can be used to mobilize political will and give powerful images of the magnitude and the possible risks in so far as development and allocation of resources are concerned.
Data can be utilized for education and training purposes for professional and skilled persons who have to work in the Substance and Drug Abuse field. Data can be used for community education, justification of resource allocation and programme evaluation. In short, data can be used for planning for prevention, care and evaluation. Research and monitoring data is part and parcel of social development agenda that is alive to efficiency and effectiveness; and is outcomes.
The points made by mentioning these programmes are that:
The preventive and treatment interventions may have to target different sub-populations of young people.
A comprehensive and integrated approach using different models and treatment interventions seems to have an effect.
It is community-based agencies with clearly articulated visions, missions that can be translated into strategic goals and measurable outcomes that can make a difference.
Community-based organizations and other formations working with young people should engage in collaborative working relationships; merge if necessary; and define the nature and levels of micro and macro interventions; lobby and advocate for relevant drug policies and resources.
Part of the collaboration can be with the government departments or units; the governments creating the appropriate policy environments, subcontracting human and community-based agencies to deliver preventive, treatment and research programs.
The organizational framework and personnel should be culturally sensitive.
VIII. CONCLUSION
In conclusion, if we share the belief that children and young people are a precious asset for human population and future human capital, we need to invest our intellect, social resources and a range of resources in nurturing them and protecting them against two of the deadly social conditions of the 21st century, HIV/AIDS and Drugs. This will be in the interest of long-term benefits for the socio economic agenda globally.
There are no easy solutions to the challenges posed by drug abuse and HIV/AIDS, particularly amongst children and young people as the most vulnerable groups of the population. The complexity of these two issues requires careful and non-emotive planning and intervention. They may change the face and character of our human services, educational and social institutions.
My view is that the interventions, processes and strategies are not necessarily the absolute responsibility of the government. However the governments in the name of social development should continue to take the lead in creating policy environments that facilitate appropriate intervention, provide resources and national infrastructures, research funding and accountability systems.
Civil society structures face the challenges of creating and sustaining effective delivery mechanisms that are collaborative, multi-faceted, preventive and remedial in character. The family in particular should seriously re-examine its role and responsibility as a socializing and nurturing agent. The family as an institution is breaking down; on the other hand, it is continually cited as one of the powerful agents of social change and social support system in most clinical interventions.
All the strategies and policies cited in this paper have merit. The challenge is what kind of mechanisms and processes can societies generate to combat and respond to the challenges of drug abuse borrowing from these strategies and policies. Young people have powerful organization, which should play a very visible and important role in addressing and responding to needs of young people.
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