It has been more than 40 years since drug use was declared a national security problem in Malaysia in the 1980s. From the latest drug statistics available, the National Anti-Drugs Agency of Malaysia reported in January to June 2020, around 67% of people who use drugs in Malaysia were adolescents and youth, which represents almost 67 thousand individuals.
This alarming fact caught my attention and inspired me to dive into substance use prevention. Therefore, it was a privilege for me to participate in the United Nations Office on Drugs and Crime (UNODC) Youth Forum 2021 on Substance Use Prevention.
Before joining the Youth Forum, I was fully aware that the known overwhelming impact of substance use on individuals, families, and communities and the reality of the potentially life-long and complex recovery process of substance use requires effective, supportive, and comprehensive-collaborative interventions.
While I kept wondering what makes one get involved in substance, little did I realize that determining the cause(s) will be endless as it is more complicated, and it would never be that straightforward or clear cut.
The vulnerability factors may come throughout the developmental and life phases and are interrelated between individuals, family, school, and community – sometimes leading to a vicious cycle. Understanding this fact is one of the core points in substance use prevention because it will help us be more empathetic and less judgemental.
Substance use prevention aims to avoid or delay the initiation of substance use, or if someone has already engaged in substance use, it will be more effective to engage in treatment interventions to stave off the development of substance use disorders.
During the Youth Forum, I had an “aha” moment and realized that the overall aim of substance use prevention is much broader. It aims to ensure the healthy and safe development of young people and their well-being and resilience so that they can discern and optimize their talents and potential and become altruistic contributing members of their community. Thus, prevention interventions should begin as early as infancy. His means not only parents, but every member of the society shall be empowered with appropriate skills such as social life skills, parenting and caregiving skills, and decision-making skills. Effective prevention forwards children, youth, and adults positive and constructive engagement with their families and schools, workplaces, and communities.
I was impressed with the way Ms. Elizabeth Mattfeld, a Project Coordinator with the Prevention, Treatment, and Rehabilitation Unit of UNODC, enlightened us on substance use prevention, making it more understandable. She started explaining substance use prevention by emphasizing what is not; “substance use is not treatment, nor punishment.” She then highlighted that in prevention, it is never about telling people the danger of drugs or any other psychoactive substances, or commanding people not to befriend people who use drugs or any other don’ts; or labeling and identifying who are at risk. Instead, prevention aspires to improve skills, endurance, educate the do’s, and subsequently promote individuals to function in a healthy physical and socio-cultural-spiritual environment in the long run. And there is no way for us to ignore any aspects of physical health, mental health, nutrition, education, family well-being, financial, policy-making, or law in substance use prevention, let alone to look at those aspects independently. Substance use prevention is indeed a long-term strategy within a holistic approach to preventing individuals from engaging in drug abuse by focusing on evidence-based programs that can strengthen protective factors and reduce risk factors; and everything in between.
Reflecting on what we have or used to do worldwide, we must agree that many countries are yet to have successful models or efforts in prevention. I acknowledge all agencies’ or ministries’ commitment to creating a society free of drug threats to ensure the community’s well-being, maintaining national stability and resilience.
However, it is always good to take a step back and ponder on the efficiency and efficacy of the intervention taken. Moving forward, we could do better - prevention shall be more inclusive and voluntary, rather than spending resources on the selective approach like prevention education programs conducted among families, primary school students, and youth who are at risk or already identified engaging in substance use.
Besides, we should pay more attention to how we practice substance use prevention, what works, and how we evaluate its efficiency. For example, some may think the lack of knowledge about substances and the consequences of their use are among the main factors that increase an individual’s vulnerability or contribute to the initial reasons for drug use initiation. But I was a bit surprised that knowledge or information alone does not change behavior and does not work for substance use prevention. When policies and practices rely only on feeding the public with knowledge about substances and their adverse effects, substance use prevention is compromised.
We should refine our actions and comprehend that developing skills such as communication, decision-making, rational thinking, and stress reduction are critical as part of a comprehensive substance use prevention program.
In substance use prevention, we must be determined to adhere to evidence-based approaches. We must be ready to unlearn our old beliefs and usual practices that may be inconsistent with science. Substance use prevention is not a taboo or gut feeling, it is scientific, and it is worth fighting for. Unfortunately, Even when considerable funding is spent on treatment, only one in eight people worldwide can access this treatment. Investing more diligently in prevention, we can save up to 10 dollars for every dollar spent, reduce substance use and protect our young generation worldwide.
In conclusion, I am now well-informed that to make substance use prevention successful, we need continuous multiple prevention programs at every community level involving many stakeholders. Those are what we need to create a healthy, effective, and sustainable prevention system. All elements of prevention and roles taken (or ignored) by individuals are interconnected; strengthening every single element will cause a snowball effect; anyone could start the positive action and give sustained results in return, like a domino effect; and we need everyone’s small and light touch in substance use prevention to bring the butterfly effect; ultimately lead to what we all have been dreaming for: healthy, happy, resilient and proactive young people who can contribute to the community and society. Yes, long way to go, but I have the utmost faith that prevention works.
1 International Standards on Drug Use Prevention. (2018). Retrieved 20 March 2021, from https://www.unodc.org/unodc/en/prevention/prevention-standards.html
2 National Drug Policy. (2017). Retrieved 15 January 2021, from https://www.adk.gov.my/wp-content/uploads/Buku-Dasar-Dadah-Negara-EN.pdf
3 Annual Report National Anti-Drugs Agency. (2019). Retrieved 15 January 2021, from https://www.adk.gov.my/wp-content/uploads/Buku-Laporan-Tahunan-AADK-2019.pdf