Write a critical analysis of one aspect of substance misuse policy and / or practice which relates to your own country

of origin (or a selected country), work or sphere of experience. This assignment needs to include critical appraisal of the scientific evidence-base and to make recommendations to improve policy and practice. 2500 A critical analysis on zero tolerance school discipline policies in the U.S.A and recommendations to improve them. Education nowadays is often misinterpreted as an equal to accumulating skills and facts whereas health is simply described as the contrary of illness (WHO 1995). Instead, education is a prerequisite for health and both education and health are strictly related and undivided (WHO 1986). This is a reason that could explain why health promotion programs lanced in school settlements could more efficiently influence students targeting the most crucial developmental stages of their life (Evans-Whipp et al 2004, WHO 1995). However, schools do not remain intact;

they are seriously affected by illicit student drug exposure (Ross et al 1995), since its initiation mostly coincides with adolescence (Millman and Botvin 1983). A standard definition of drugs would be a chemical substance that, when taken into the body alters the structure and functioning of the body in some way, excluding those nutrients considered to be related to normal functioning (Levinthal 2012). School policies try in general to secure a drug-free learning environment (Yamagushi et al. 2003) via
discriminating between possessing, using and supplying drugs (Murphy 2000). Although those policies should be applied in all schools this still remains unrealized in some parts of the world.

According to the Monitoring the Future Study (Johnston et al 2001), adolescent drug consumption gave rise in early 1990s up to 1997 (Muck et al 2001). More specifically, in the U.S.A drug use among youth is the highest in the industrialized world (Johnston et al 2001), a phenomenon that urged society to primordialize drug abuse as a crucial issue to be dealt by public schools (Ross et al 1995). Addiction in America is mostly reflected in three views; the Colonial or Moralist which considers drug use as an illegal act (zero tolerance policy) and therefore is followed by penal sanctions; the temperance view where drugs are addictive substances and policy should focus on the root of addiction (smugglers and dealers) and thirdly, the disease concept where drug addiction is viewed as a disease and drug policy should mostly primordialize on treatment and rehabilitation (Rosenberger 1996). Drug policy is influenced by and influences societies (Chilea and Chilea 2011). Although the suggestion of a policy with reasonable and achievable goals is a reasonable target, the prevailing Colonial or Moralist view invokes high moral principles and propose a fight between good and evil with the ultimate goal being the complete disappearance of drugs from earth (Guzman 2003). This prohibitionist predominance perceives the drug issue as a war or crime or threat and permits no tolerance for less severe perceptions between acceptance of a crime or rejection (Guzman 2003). As a consequence, nowadays prevailing anti-narcotic policies are

firmly rooted in prejudices and remain almost irrelevant to reality (Cardoso et al. 2009). In U.S. almost 90% of schools adopt zero tolerance approaches for substance misuse (Yamagushy et al 2003, Brown 2001) under the scope of minimizing drug use prevalence (Caulkins and Reuter, 1997). As mentioned above, Zero tolerance reflects those policies that adopt a severe punitive approach regardless of the severity of offence in their effort to deal with problems of safety and discipline in school communities (Hanson 2005, Skiba and Peterson 1999). Punishment and penal sanctions are those aspects that better represent this approach which is known as punitive drug prohibition approach or moral/criminal justice model (EvansWhipp et al 2004, Aoyagi 1997). Aspects of the policies aiming at the implementation of these policies can entail anti-drug education (e.g., "Just Say No" curricula), drug testing, metal detectors, closed circuit cameras, sniff dogs and penal sanctions (expulsion, suspension and referral to law enforcement agencies) (EvansWhipp et al 2004, Yamagushi et al 2003, Brown 2001). As a consequence, most of the financial means in the US against drug use are channeled into interdiction and eradication efforts which have yielded concerns over the advantages and
disadvantages of controlling and punishing students (McKeganey 2005).

Moreover, Australia and Europe that have adopted a harm minimization approach where priority is attributed at education, prevention, referral and intervention (Murphy 2000) are associated with lower levels of illicit drug use and decreased correlation of social detachment with substance use in relation to the punitive policies adopted by the U.S. (Beyers et al 2004). Unfortunately, growing piece of evidence shows that drug education
remains highly controversial in the U.S. due to its long history of failure (Guzman 2003, Sycamnias 2000).Although zero tolerance initial aim was the improvement of society, these heterogeneous policies have in contrary led to a dramatic increase in suspensions and expulsions (Hanson 2005, Insley 2001, Essex 2001). Serious concerns are raised by leading psychologists, as James Comer and Alvin Poussaint are, that relate those policies with unhealthy childhood development, contradicting those schools that perceive the aim of reducing the number of expulsions as a positive aspect of zero tolerance (Insley, 2001). The fact that the Constitution in the U.S. does not consider the right to education as fundamental exacerbates the deprivation of alternative educational opportunities to those students suspended and expelled and growing feelings of alienation increases the possibility to drop out of school (Insley 2001, Brown 2001). The implications of leaving school are numerous but the most severe of them can be the criminalization of students since once left unsupervised, misbehavior, integration to gangs and crime acts are of serious concern (Insley 2001, Sycamnias 2000, Ashford, 2000). Moreover,

such policies bring conflicts at school administrators, teachers and counsellors too (Pentz et al 1997), since suspending and expulsing students is believed inefficient in preventing them from illicit drug consumption (Hallfors and Van Dorn 2002). Finally, those policies induce feelings of fear or shame in students and they fail to engage with educators because simply by discussing drug issues but not getting involved in students cognitive and emotional development is of minor contribution to the prevention of drug use (Brown, 2001).

Zero tolerance school discipline policies have clearly brought inequities and have violated students rights (Hanson, 2005). This is the result of those policies that do not take under serious consideration the target populations of concern to apply prevention programs, that fail to weight the severity of the developmental stage of the person enrolled in a program or the severity of the offense, the students history, the duration of the program and the role of the person realizing the program (e.g., teacher, law enforcement officer, peer) (Essex, 2001, Sycamnias 2000). Finally, sociology and psychology have demonstrated that children, like adults, are more likely to listen, understand and respect experiences or advice if educators and parents alike are willing to listen and discuss (Sycamnias 2000). Therefore, an alternative education aiming at succeeding a balance between safety environment and the rights of students being supervised or involved in long term expulsion could minimize the undesirable outcomes of zero tolerance policies (Essex, 2001). Education needs to be more interactive and decreasing drug consumption through education should be one of the guiding principles of minimizing drug consumption in the society (Cardoso et al. 2009). Modern educational needs on drug education ought to ensure that young people understand all drug use impacts and prepare for living in a drug using society and moreover to develop those abilities they could reduce drug-related harm in their personal lives as the capacity to reduce and manage stress without resorting to drugs is (Sycamnias, 2000). In addition, the belief that younger students are more manageable without formal policies leading to be regarded as less of a priority for schools needs to be reoriented towards enforcing policies targeting all age classes irrespective of educators beliefs (EvansWhipp et al. 2004, Ashford, 2000). Therefore, different prevention and intervention strategies could offer better solutions for dealing with drugs at school than zero-tolerance expulsion and alternative schools based on prevention and planning could help children in this direction (Ashford 2000, Skiba and Peterson 1999,

http://www.stanford.edu/class/e297c/poverty_prejudice/paradox/htele.html;
Cardoso et al. 2009).

Due to the fact that substance abuse problems do not yield to simple prevention strategies, prevention efforts need match the intensity of the problem and provide continuous focus on the solution and amplify the level of communication, and organizational cooperation (Sycamnias 2000).

Drug prevention education programs and long-term planning could be divided into information programs where information on substance use leads to the desirable results, affective programs where enhancing students own communication skills increases their self-esteem and social skills or influence programs in which the way to refuse substances is of primary importance (Brown 2001). In addition, and according to Greenberg (2003), prevention in schools should also

entail mentoring, self-control, counseling and social competency instruction along with establishing behavioral expectations and discipline management interventions.

Initial efforts in adolescent treatment had as basis adult models that failed to consider the unique needs of adolescents. Recently, however, increased attention has been attributed in developing and evaluating substance abuse intervention models specifically designed for adolescents (Wagner, Brown, Monti, Myers, & Waldron, 1999; Muck et al. 2001). In all behavioral approaches irrespective of whether called behavior therapy, cognitive therapy, or cognitive-behavioral therapy (CBT), substance abuse is encountered as a learned behavior eligible to modifications via applying behavior modification interventions (Miller & Hester, 1989). In particular, cognitive-behavioral techniques attempt to modify behavior via altering the way to think (Muck et al 2001).The desired outcome of such approaches is to enable adolescents to unlearn drug use and to learn alternative ways to cope with their lives by establishing behavior support teams, consistent and individualized response to disruptive students and emergency and crisis planning (Miller & Hester, 1989). Application of specific skills leads to testing new behaviors in low-risk situations and applying them in more demanding real-life incidences. They vary according to the followed program and can include drug and alcohol refusal skills, resisting pressure to use drugs, communication skills, problem-solving skills, anger management, relaxation training, social network development, leisure time management and homework assignments. Finally, behavioral contracting is another technique used during which the student and the counselor explicitly define to arrange a set of behaviors to be altered on a weekly basis and the expected weekly goals to be reached by the adolescent as well as the criteria and time limitations. As each goal is reached, the adolescent is highly reinforced (Muck et al 2001). Schools rarely use the effective strategies [Ennett and Burritt 2000, Hansen and McNeal 1999 WB) despite the fact that modern school-based prevention programs could delay or hinder drug use initiation. In reality school-based drug prevention programs are found to be contradicting in improving student health outcomes. There are several studies that show that interventions for handling aggressive behavior and therefore ameliorating early stage drug use are judged successful (Lochman and Lenhart 1993, Faggiano et al 2005). In addition, self-control or social competency programming that used cognitivebehavioral and behavioral instructional methods consistently are judged as effective in reducing dropout and nonattendance, substance use, and conduct problems, (Greenberg, 2003) whereas, programs teaching social and coping skills have lower impact in reducing drug use in relation to normal instructional activities in class (Faggiano et al 2005). Moreover, programs that simply convey didactic information about drugs and their effects were found to be the least efficient. Despite the fact that in general the most effective programs are highly interactive and stress comprehensive life skills or refusal skills [Tobler et al 2000, Tobler and Stratton 1997) a rigorous study on group school counseling, however, yielded cautionary and

contradictionary findings in the effectiveness of group counseling that finally led to increased drug use [Gottfredson 1986]. This and other study findings have led researchers to caution against the positive contribution of some policies. To change policies and practice, prevention should be accustomed to the mission, and focused on the target population. Since financial means and reimbursements strongly influence the application of the policies, linking prevention to the cost effectiveness of proposed interventions would be important. School-based prevention coordinators can support improved prevention by accessing information about effective prevention programs for high-risk youth and advocating their adoption in schools. They can also open institutional doors (barriers) to research with prevention scientists. For their part, prevention scientists must recognize school priorities and pressures and show flexibility and respect for school needs, timelines, and scarce resources. Teachers can support prevention by documenting truancy and allowing evaluation activities, such as school surveys, to be conducted in their classrooms. They can also be actively involved in the faithful implementation of effective prevention programs and should communicate their advice to prevention scientists about how these programs can be improved (Halfors and Van Dorn 2002). Unfortunately, a shift from zero-tolerance to these types of prevention policies which are consistent with the cultural role of schools and the needs of students and do not burden drug education with fantastic objectives are not likely to occur anytime soon. Such strategies take time to develop and even more time to implement. But it is clear that much more research is needed to determine if zero-tolerance is a truly effective strategy for keeping our schools safe from those who would inflict weapons-related violence on others (Ashford, 2000).

. Thus, America needs to decriminalize drug use (). (http://www.stanford.edu/class/e297c/poverty_prejudice/paradox/htele.html)

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