National Amphetamine-Type Stimulant Strategy Background Paper

84
4.4 Challenges of applying prevention and harm reduction
strategies to amphetamine-type stimulants
There are a number of challenges in any attempt to apply prevention and/or harm reduction
approaches to ATS use and related problems. In particular, a large number of ATS users do
not perceive themselves as drug users and do not access many of the services or resources
that may be accessed by other drug consumers. Furthermore, as indicated above, there are
diverse target groups suggesting that there may be a need to develop specifically targeted
and appropriate approaches.
At present, there is only limited evidence to guide the implementation of ATS-specific
strategies to prevent and reduce problems, and most of this has focused on specific
campaigns and peer-interventions. Although a range of interventions have been
implemented, most reports are descriptive and thorough evaluation and formal publication
are often lacking. Based on a general analysis of prevention, Hando and colleagues (1999)
suggested the following key principles be adopted in designing harm reduction strategies:
• Comprehensive and consider the full range of social influences and institutions on use;
• Sustainable;
• Clearly targeted, particularly regarding age and stage of drug use;
• Developmentally appropriate and culturally sensitive;
• Based on research knowledge and use of sound methods;
• Clear objectives;
• Reduce risk factors and increase protective factors; and
• Evaluated for both positive and negative effects.
Gowing and colleagues (2001) reviewed prevention activities specifically in relation
to ecstasy. As in other research, they noted that it was critical to base any prevention
strategies on an understanding of the subjective functions that the drug might serve.
Consistent with research with other drugs, they observed that subjective functions of
drug use are likely to be more influential on decisions to use and continue using than
knowledge or experience of negative effects. Observing no compelling evidence for
preference for any particular approach, they identified the criteria that underpinned
successful programs. These included:
• Target clearly identified settings and cultures;
• Subsequently tailor interventions for specific groups;
• Adopt a multifaceted approach (e.g., schools, families, broad media; community
and health services);
• Ensure integrated and consistent approaches and messages;