Selective prevention

National drug strategies and action plans are increasingly and explicitly mentioning vulnerable groups to be particularly targeted by prevention measures. This focus is even stronger in the new Member States: Estonia (street children, special schools), Cyprus, Hungary, Malta, Poland (neglected children and young people from dysfunctional families) and Slovenia.

Because the vulnerable groups targeted by selective prevention often have considerable experience with legal and illegal drugs, most selective prevention interventions are restricted to the provision of tailor-made information, individual counselling and creative or sports alternatives. However, it should be remembered that the techniques used in the comprehensive social influence programmes of universal prevention are equally as effective, if not more effective, in selective prevention. Normative restructuring (e.g. learning that most peers disapprove of use), assertiveness training, motivation and goal-setting, as well as myth correction, have proved to be very effective methods among vulnerable young people (Sussman et al., 2004) but are rarely used in selective prevention in the EU. However, intervention techniques in recreational settings (see ‘Prevention in recreational settings’) mostly take the form of the provision of targeted information.

Selective prevention in schools

The main focus of selective prevention in schools is crisis intervention and early identification of pupils with problems. The aim is to find solutions at school level in order to avoid at-risk pupils dropping out or being expelled and thereby aggravating their situation. Programme-based approaches are offered in Germany, Ireland, Luxembourg and Austria (Leppin, 2004), while Poland and Finland provide teacher training courses or guidelines on how to recognise pupils with problems, including drug use, and take appropriate action. Traditional individualistic approaches include Educational Psychology Services (as in France and Cyprus), which depend on (self)-referrals. Ireland has a new intensive educational welfare service to work with schools and families in educationally disadvantaged areas in order to ensure that children attend school regularly.

Selective community-based approaches

Selective community-based approaches mostly target vulnerable young people on the streets. In the Nordic countries, the 'Nightwalkers’ approach engages parent groups in patrolling the streets. Austria has invested heavily in improving the balance between drug prevention, social education and social work structures through courses, quality guidelines and joint seminars, e.g. for youth social workers in recreational settings. The aim is also to use youth social work structures for professional drug prevention interventions. Along the same lines, Norway boosts cooperation and strengthens interdisciplinary efforts between school, child protection services and social services. RAR (rapid assessment and response) methods (36) – the speedy gathering of information (statistical material) combined with interviews (questionnaires, focus groups) and/or observations of the problem area – are used in these projects in Norway, but also in Germany and the Netherlands.

Interventions focusing on high-risk neighbourhoods have a tradition in Ireland, the United Kingdom and, to a small extent, the Netherlands and Portugal. However, Germany (Stöver and Kolte, 2003, cited in the German national report) and France have now also proposed action in this area. It is new for these countries to target drug prevention to particular geographical areas according to social criteria.

Member States are also increasingly targeting specific ethnic groups in their selective prevention policies (e.g. Ireland, Luxembourg, Hungary). For example, the focus on ethnicity is an important aspect in Hungary, where the Roma population is at high risk of drug-related problems owing to its social and cultural characteristics and disadvantageous living conditions. There peer training, self-help groups, supervision, various prevention programmes and low-threshold services for Roma are operated by non-governmental organisations (NGOs).

Vulnerable families

Universal family-based prevention, mostly evening events, lectures, seminars and workshops for parents, is still popular in many Member States (Germany, France, Cyprus and Finland) despite the lack of evidence for its effectiveness (Mendes et al., 2001). However, in Greece, Spain, Ireland and Norway there have been interesting developments in selective prevention with families through the introduction of innovative concepts that go beyond families/parents with drug problems and recognise the role of social, economic and cultural factors in drug use. In the Netherlands, the evaluation of drug prevention projects for immigrant parents concluded that a standardised intervention offered via immigrant networks, with women and men addressed separately, would be a feasible new direction (Terweij and Van Wamel, 2004). In Norway, parent management training (PMTO, the Oregon model), originally a training method for families with children with serious behavioural disorders, has been implemented and evaluated in three municipalities. In another two countries, the Iowa strengthening families program (ISFP) has been implemented. This intensive family intervention programme for families at risk combines teaching methods for students (10–14 years) with an educational programme for their parents, aiming at drug prevention through strengthened family competence and family ties (Kumpfer et al., 2003).

(36) World Health Organization: The rapid assessment and response guide on psychoactive substance use and especially vulnerable young people.