Policy and practice briefingsSchools and colleges

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Issues

Adolescence and young adulthood are periods of risk-taking and experimentation that often includes substance use. Schools and colleges are important settings in which to reach young people, although some vulnerable groups may not be well-represented within them.

In schools the focus is mainly on preventing or delaying the initiation of substance use and on the development of skills to support healthy decision-making.

Poor school attenders, frequent truants or young people with behavioural problems, such as poor impulse control, are at increased risk of developing problematic forms of substance use. This makes schools an important setting for early identification of at-risk individuals.

The greater independence of young people attending colleges and the tendency to increased alcohol and drug use in this age group make colleges an important setting for harm reduction and for referral of those developing problems to specialist services.

Response options

Drug use among school populations is generally low and can be part of a wider pattern of behavioural problems and risk-taking. Interventions therefore need to address the wider determinants of risky and impulsive behaviour rather than the drug use in isolation.

  • Most prevention interventions in schools aim at having an impact on the whole student body and staff. Those that are supported by current evidence include: evidence-based universal prevention programmes that focus on developing social competences and refusal skills, healthy decision-making skills, and correcting normative misperceptions about drug use;
  • school policies around substance use; and
  • interventions aimed at developing a protective and nurturing educational environment that is conducive to learning and establishes clear rules about substance use.

Other approaches that may be beneficial include events or interventions involving parents and the use of peer-to-peer approaches.

European picture

Of the interventions for which there is good evidence of effectiveness, smoking bans in schools are reported in all countries providing information, while 21 countries reported that school policies around substance use are in place in the majority of schools. Programmes aimed at developing personal and social skills are less widely implemented, with only 11 countries reporting them in the majority of schools. This is lower than the level of provision of information only programmes, which have not been found to be effective, but are reported in the majority of schools in 16 countries.

Some evidence exists in support of other types of programmes. Among these, peer-to-peer programmes seem to be relatively uncommon, but creative extracurricular activities and events for parents are more widely available. Drug testing of pupils is not recommended and is rarely used; it was only reported as being conducted in a few schools in 10 countries.

Summary of the available evidence

Interventions in schools and colleges

Response option Quality of evidence

Effective school-based prevention programmes can delay initiation of use. These are manual-based and develop social competences and refusal skills, healthy decision-making and coping, and correct normative misperceptions about drug use. Ideally they should be provided within the context of a school drug policy.

moderate quality evidence

Substance use-related problems may be reduced by providing a protective and nurturing educational environment that is conducive to learning and establishes clear rules about substance use.

moderate quality evidence

There are evidence-based programmes for primary schools, which — without explicitly addressing substances — have effects on impulse-control and, therefore, potentially on later substance use and mental health problems. They have immediate effects on learning and classroom climate.

moderate quality evidence

Interventions that only provide information about the risks of drug use have not been found to be effective in preventing drug use.

higher quality evidence

Key

  • speedometer at high High quality evidence — one or more up-to-date systematic reviews that include high-quality primary studies with consistent results. The evidence supports the use of the intervention within the context in which it was evaluated.
  • speedometer at medium Moderate quality evidence — one or more up-to-date reviews that include a number of primary studies of at least moderate quality with generally consistent results. The evidence suggests these interventions are likely to be useful in the context in which they have been evaluated but further evaluations are recommended.
  • speedometer at low Low quality evidence — where there are some high or moderate quality primary studies but no reviews available OR there are reviews giving inconsistent results. The evidence is currently limited, but what there is shows promise. This suggests these interventions may be worth considering, particularly in the context of extending services to address new or unmet needs, but should be evaluated.

Implications for policy and practice

Basics

  • Schools are important access points to the adolescent population and their parents. They also have a role in identifying at-risk individuals for targeted interventions.
  • Education systems should ensure schools provide evidence-based prevention programmes and have appropriate drug policies in place. These should aim not only to reduce substance use, but also to reduce violence, improve learning, produce better academic achievements and create a better school climate, outcomes that are of intrinsic interest to the education sector.
  • Ineffective prevention programmes are often popular, but there is a growing number of programmes that have been shown to work and these should be used instead.

Opportunities

  • Establishing systems that encourage or require schools and colleges to use programmes supported by evidence instead of ineffective programmes and providing the necessary support for this would be a more efficient use of resources.

Gaps

  • The evidence for effective programmes in colleges is very limited, but this is a period of high risk of drug use and appropriate programmes are needed for this setting.

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