Drug Aware is a campaign run in Western Australia to combat cannabis abuse. Stakeholders treat the consequences cannabis abuse seriously, and therefore prioritize action to discourage people from the drug. The paper will examine Drug Aware in terms of conceptual framework, planning and evaluation structures that are in place, the compliance it exhibits with regard to conventional health promotional initiatives. These include the Ottawa Charter, and the extent to which the campaign’s objectives are representative of what is needed to solve the problem at hand, which is, preventing those who have not began using cannabis from doing so, enabling those who are using abandon it or reduce, and encourage those with problems because of its use to seek help. The paper will present these aspects of the Drug Aware campaign in Western Australia in relation to health promotion principles. It will also shed light on the strengths and weaknesses of the campaign, taking a step further to make suggestions for improvement. A conclusion summing up the issues covered in this appraisal will follow.
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Drug Aware: An Overview
Drug Aware is a collaborative effort between the Government of Western Australia and the Western Australian Network of Alcohol and Other Drug Agencies (WANADA). Through message generation and dissemination, Drug Aware reaches out to people whose age range lies between 12 years and 29 years. At the end of the day, everyone in Western Australia regardless of age is a target of this campaign that is geared towards substance abuse. The Drug Aware achieves this by increasing knowledge about health risks of cannabis use among the at-risk age groups. There are media channels used by Drug Aware campaigners. Nearly all of them utilize message dissemination and they are as follows:
- Using online message transmission methods such as Twitter, MySpace, YouTube, and other websites such as the Drug Aware campaign that has information pertaining to the Drug Aware initiative (Drug Aware, 2011)
- Youth festivals
- Outdoor advertising and cinema advertising
- Radio and television outreach
Besides dissemination of anti-cannabis use messages to create awareness, the Drug Aware campaign involves other cannabis-use prevention strategies. It provides information on treatment options available to cannabis users hooked to the habit. This approach is particularly important in rehabilitating cannabis users who are prone to cannabis dependence. The Drug Aware campaigns messages discourage the advertising of alcohol or tobacco near schools or learning institutions.
The involvement of many media channels Drug Aware helps support its campaign against cannabis use, and this is essential for health promotion (McQueen 2001, 261-262). In particular, the dissemination strategy helps people to become aware of the health risks of substance abuse and refrain from cannabis use (NSW Department of Education and Training, 2003). Thus, the use of multiple media platforms by Drug Aware campaigns is primarily to increase its outreach. In effect, the Drug Aware campaigns will inform the community of the risks associated with cannabis use.
Cannabis abuse is a serious problem in Western Australia. According to the Drug and Alcohol Office of the Western Australia government, there is a direct relationship between cannabis abuse and crime (Haynes et al., 2010, p. 14). The Drug and Alcohol Office further notes that abuse of cannabis closely associated with harm to individuals, including disability and death (2010, p.14). As an indicator of how serious the cannabis issue is in Western Australia, politicians have joined the discussion with liberals promising tougher laws regarding cannabis. These politicians describe current laws as soft, and claim that they send the wrong message to young people (AAP, Perth Now, August 2008). In the liberals view, cannabis is neither soft nor harmless, a view that is shared by the other stakeholders who are working with the government of Western Australia to eliminate cannabis.
Best Practices in Controlling Cannabis: A Literature Review
Cannabis abuse poses serious health problems to users. Psychosis is one of the risks that users run into (Henquet et al., 2005, p. 11). This assertion is also made by Williams McKim (2002, p. 400) and McLaren et al., (2008, p.12). The United Nations Office on Drugs and Crime’s report entitled “Why we should care” deals with sensitization and strict laws as one of the effective strategies in cannabis use prevention (Roffman, & Robert, 2006, p. 14). Additionally, in Australia, the National School Drug Education Strategy promotes a number of school-based educational programs for cannabis use prevention. These include affective education, sensitization/information dissemination, and skills on social resistance (Botvin, & Griffin, 2002, p. 92). Affective education involves discussions and didactic instruction to raise self-esteem and facilitate responsible decision-making among students. It often does not include information about drug use but emphasizes on interpersonal growth. Information dissemination (through audio/video programs, posters, pamphlets among others) is the most common approach to cannabis use prevention. It aims at increasing knowledge on drugs and arousing fear by emphasizing on the consequences of drug use to foster anti-drug attitudes among the youth. Furthermore, Botvin, and Griffin (2002, p. 101) recommend a generic approach that incorporates school-based and family-based prevention approaches in case of parental addiction to cannabis use.
Drug Aware utilizes campaigns in form of online sensitization materials as well as radio and posters that reach all members of the society. Community-based approaches to substance abuse prevention are highly effective as they increase knowledge and alter attitudes about cannabis use (National Institute on Drug Abuse, 1997, p. 11). The dissemination of information and creating community awareness on cannabis use underlie the Drug Aware campaigns.
Cannabis Abuse Risk Factors
Cannabis abuse is a result of a number of factors. Since it is a health problem, the paper considers factors that make an individual more likely to abuse cannabis as risk factors while those that make it less likely for an individual to abuse cannabis are protective factors. Interplay of risk factors and protective factors determine the outcomes in a community as far as cannabis abuse is concerned. The risk factors and protective factors for cannabis use are many and varied. The United Nations Office on Drugs and Crime (2006, p. 2) identifies three categories of risk/protective factors that predispose adolescents to cannabis use. They include:
- Government policy on cannabis use: A tough policy will make it harder for cannabis abusers to operate while laxity will create an atmosphere that is conducive.
- Drug culture of a place: Cultures with beliefs that glorify cannabis will witness more abuse of the drug while those that avow cannabis will witness reduced use.
- Public awareness campaigns from all stakeholders: Presence of parents, the government, and non-governmental organizations in the campaign against cannabis will reduce its use while a single party approach will realize less success in fighting its use.
Other risk factors associated with onset of cannabis use among adolescents include; prior use of alcohol or tobacco, parental drug abuse, criminal activity and behavioural problems (Botvin, & Griffin, 2002, p. 99). The dissemination of information primarily involves the use of online media channels. However, the campaign also involves churches and learning institutions to disseminate the information (Drug Aware 2011). The involvement of multiple stakeholders is essential in dissemination of information to different segments of the population (Keleher, 2007, p. 113-115). The International Union for Health Promotion and Education report on health (IUHPE, 2000) also underscores a multi-sectoral approach. The messages designed and disseminated by Drug Aware provide information about the health and social consequences of cannabis abuse. The main aim is to foster individual and community attitudes towards anti-cannabis use. This is an effective implementation strategy in health promotion, as focuses on creating enabling conditions (De Leeuw 2007, pp. 55-58).
Drug Aware: A Conceptual Framework
Drug Aware’s activities rely on a socio-ecological model that takes into account social factors as well as the attributes of the region under consideration, in this case, Western Australia. Drug Aware recognizes that different domains of human occupation are interdependent, i.e. the schools, the neighbourhood, residences and the surrounding community within particular settings bear some interdependence. As such, this health promotion combines the evidence on appropriate actions in the specific community context before disseminating the messages. In this way, the planning of Drug Aware reflects the core concepts of social ecology that include recognition of the multi-faceted nature of environmental factors on health, environmental controllability to achieve well-being (through the emphasis on healthy lifestyles) and the value of involving behavioural, environmental and educational approaches during the awareness campaigns.
Besides that, Drug Aware employs a multi-pronged message dissemination strategy to increase its reach. Thus, the campaigns are community-wide. In particular, to reach a large number of youths, the campaign involves new media channels such as Twitter and You Tube; channels that are commonly used by the youth. The involvement of multiple media channels serve a very significant purpose, which is, ensuring that all the necessary media resources are assembled from the various points so as to carry out the anti-cannabis use campaign. The campaign also relies on records on cannabis use obtained from the government of Western for its planning and analysis. In this way, Drug Aware’s framework reflects the principles of best practice, which include involvement of the local government, knowledge transfer, planning, and evaluation that relies on statistics from the government of Western Australia.
Drug Aware: Ottawa Charter
Drug Aware has exhibited a high degree of compliance with the Ottawa Charter as far as the fight against abuse of cannabis is concerned. The Ottawa Charter ideas manifest themselves in the Drug Aware campaign in the following ways:
- The Drug Aware initiative relies on statistics from the government of Western Australia to come up with ways of dealing with cannabis use, which is a widespread problem in Australia. According to the United Nations Office on Drugs and Crime the percentage of cannabis users in 2004 in Australia was three times the proportion of cannabis users globally (3.8% and 11.3% respectively). This calls for a concerted effort from all sectors. However, the Drug Aware campaigns only involved the government of Western Australia in planning and evaluation of the initiative.
- Through dissemination of information and the identification and referral of cannabis users, Drug Aware is creating awareness and recognition that cannabis use is a widespread problem (Drug Aware, 2011). In addition, by undertaking the campaign itself through the new media, Drug Aware ensures the message reaches the at-risk age groups with access to new media platforms.
- The initiative was solely implemented by Drug Aware based on statistics from the government of Western Australia. The campaigns primarily increase awareness about cannabis use, its consequences and the laws relating to cannabis use. By relying on governments statistics, the most affected areas are easily identified, planning carried out to ensure that information reaches the target population. The Ottawa Charter talks about the need for evidence-based health promotion, and Drug Aware meets this milestone in an exceptional manner.
- Drug aware also uses the help centers to teach the cannabis abusers personal skills. This is a very significant capacity building initiative proposed by the Ottawa Charter. The personal skills taught to cannabis abusers include the manner in which they ought to deal with withdrawal syndromes when they withdrawal from cannabis, how to seek for help when their health deteriorates, and learning how to fight against relapse after withdrawal. This reflects the principles highlighted in the Ottawa charter.
Drug Aware: Objectives
The objectives of Drug Aware campaign are specific, measurable, attainable, realistic, and timely. The specificity points to the manner in which the Drug Aware objectives are designed to help handle a certain issue in the abuse of cannabis. Measurability is about gauging the number of people who stop using cannabis or reduce their usage of the drug. Attainable and realistic show how the stakeholders of the Drug Aware campaign have not deluded themselves into thinking that they can eliminate cannabis use in Western Australia in a day or two. Timely objectives mean that within a certain period, a certain number of people abandon cannabis use. The objectives of the Drug Aware initiative are not measurable. They include:
- To lower the prevalence rate of cannabis use through the supply of information on its dangers to discourage new users and encourage regular users to stop the practice
- Delay the age at which those who wish to use cannabis eventually get to use it as a way of avoiding youthful problems associated with cannabis abuse
- To increase the number of people in Western Australia who are willing to quit the habit of using cannabis.
- To encourage people who are suffering from the side effects of cannabis abuse to seek help from the available help centers
- To sensitize Western Australians on the laws governing the possession and usage of cannabis
When gauged against best practice principles in health promotion, the objectives come out as sound and on point.
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Drug Aware: Planning and Needs Assessment
Planning is a crucial step in any undertaking. This is also true for what Drug Aware is doing. Together with the planning, is the research to find out what the area under consideration requires? An educational and ecological approach in the formulating and disseminating of the messages is the planning framework that Drug Aware utilizes (Slama et al., 2007, p. 151). This framework is appropriate for the task that Drug Aware campaign is meant to accomplish. Given the significance of planning, it is mandatory that it be carried out in a collaborative manner by involving all stakeholders (Green & Kreuter, 2005, pp. 3-5). In planning the campaign, the collaboration between WANADA and the Drug and Alcohol Office brought together the professional work, communication experts and the local administrators. Although this reflects the Ottawa charter concepts, important stakeholders such as the youth and the parents were left out. This reflected the Ottawa charter core concepts; it led to the sharing of responsibility of health promotions among various sectors. However, a multi-sectoral approach can derail the implementation and evaluation of the initiative. Keleher (2007) also emphasizes the consideration of social determinants in planning for health promotion. Drug Aware only focused on the popularity of the new media among the youth in disseminating information. Thus, in Drug Aware campaigns, the information that is available for use in the campaigns employs popular online media used by the youth. Twitter, Facebook and YouTube are integrated in Drug Aware website the dissemination of information.
Additionally, other segments of the population are reached through traditional communication channels such as the radio. For instance, the radio reaches the older people while posters placed in public places and public events reach all age groups.
Drug Aware: Evaluation
Nutbean (1998, pp. 27-29) stresses the importance of evaluating what has been done in health promotion. This evaluation is important for purposes of measuring effectiveness (Roffman & Stephens, 2006). In the case of cannabis, Emmett & Nice (2009) as well as Solowij (1998) assert that evaluation of progress for those trying to withdraw is important to enable the people trying to help them know how to use their time and other resources properly.
The Drug Aware initiative relies on the records obtained from the government of Western Australia regarding drug use and crime. Given that the decrease in drug use can be attributed to a number of reasons, any decrease in drug use cannot be attributed to Drug Aware campaigns alone. According to Australian Secondary Students’ Alcohol and Drug Survey, the percentage of students reporting cannabis use decreased by half (36% to 18%) between 1997 and 2005 following anti-drug campaigns (White, & Hayman, 2006, p. 34).
In any social undertaking, evaluation is based on the objectives. Health promotion initiatives evaluation relies on evidence from surveys and the consistency of the research findings to determine the success of the initiative. Drug Aware’s evaluation focuses on whether cannabis abuse is being eliminated, and if so, at what pace. This is determined by the measuring part of the objectives. In other words, evaluation takes into account the numbers of people pledging not to touch cannabis and having avoided it before, the number of those abandoning it, and the number of those reducing its use. In addition, the number of people reporting to help centers seeking help for addictions is part of the evaluation process. At the end of the day, investment in this campaign will only be meaningful if the evaluation process shows that the project is accomplishing its mission. All the tools of evaluation seem to be available for Drug Aware to gauge its performance. The evaluation results indicate that cannabis use is declining among the youth over the last five years, i.e. 18% in 2005 to 11% in 2010 (Drug Aware, 2011).
Fruitful Health Promotion Programs
Drug Aware has mounted a successful health promotion effort when viewed through the prism of best practice principles in health promotion. These include community involvement, evidence-based planning and evaluation, knowledge transfer and multi-disciplinary approach (involving all stakeholders). The multi-disciplinary approach was particularly important in:
- Message formulation where messages are accompanied by illustrations and diagrams to capture the attention of the public
- The dissemination of information through the internet and the radio (Nutbeam, 1998, p. 25)
The Drug Aware initiative employed in campaigning against the abuse of cannabis in Western Australia turns out well when examine under the best practices in health promotion. Proper planning, good evaluation, excellent objectives, consideration of socio-ecological factors and network creation in their efforts are all done well, meaning that getting to stop people from using cannabis is possible.
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