Should I take my child to a drug treatment centre to show them the reality of drugs? Do shock tactics work?

Over the last couple of weeks I have received a couple of emails asking my opinion about the effectiveness of taking their child to a drug treatment centre in an effort to try to deter their child from possible drug use in the future (some of the parents who contacted me said that they had heard John Laws mention the idea in relation to 'ice' on his radio show recently which seems to have stirred the pot a little!). Here is one of those emails, slightly edited to ensure anonymity:

Hi Paul, my name is Susan and I have 3 children aged 3, 13 and 14 and work in the health area. I am concerned about what I'm hearing in the media re: the ice epidemic. I was listening to the radio the other day and I heard a suggestion that I think would be good to help deter kids from taking drugs. I would like to know what your thoughts were on this. The announcer said to take your kids to a drug rehabilitation centre to see what goes on there. Could you give me some advice on this?

The idea of attempting to show a child the 'reality' of drug use by taking them to a treatment facility is not a new one. In the US they even have a TV reality show where high-risk young people are taken to prison and shown just what their future could hold if they keep going down a dangerous path, most often related to drug use of some description. One of the most highly publicized examples of this 'strategy' was when Prince Harry admitted to getting drunk and experimenting with cannabis when he was much younger. His confession received a great deal of media coverage, but it was his father’s response that received much praise from more conservative commentators, suggesting that he was considering taking his son to a rehabilitation centre to talk to 'addicts' in an attempt to make him see the errors of his ways.

Before I talk specifically about so-called 'shock tactics', let's clear up some myths about treatment centres and what you're going to see when you go to one! Firstly, most of the centres I have ever visited don't have 'zombie-like' creatures walking the halls and people screaming with pain due to withdrawal in locked rooms ... they're not terribly scary places. Of course there are people who are going through an extremely difficult time but for the most part these facilities try to be places where their patients feel safe and where they are going to be looked after - they're not terrifying prisons! Some of the patients certainly have a range of health and social problems and some certainly look extremely unwell, but there are also many others who look just like the average person on the street and it's not until you talk to them that you realize the issues they may be having ... walking your teen through a centre and hoping that what they are going to see will swear them off drugs for life is not necessarily going to happen!

I couldn't tell you how many times I've been contacted by parents who want to know my views on this issue. They had either recently discovered that their child had used a drug (usually cannabis) and wanted to know whether I knew of a treatment centre that would allow them to visit and take their teen to 'scare the pants off them', or, like Susan, were just concerned about media stories about escalating drug use and felt like they needed to do something to protect their kids! This is what is known as 'shock tactics' - the idea of presenting a young person with a terrible story, horrific image or getting them to listen to someone (usually an ex-drug user) who has been through an awful situation in an effort to discourage them from particular behaviour. As far as drugs are concerned, the strategy usually highlights images of needles and syringes and injecting and infers that this is 'where all drug users end up' ...

So what do we know about the effectiveness of 'shock tactics'?

Those who have had little to do with drugs often regard it as the perfect solution to a difficult problem.  To them, this makes great sense - ex-drug users tell their personal stories and how their substance use caused them great problems, the young people will see the obvious harm that occurred and as a result the drug taking will stop.  Many involved with the drug culture, however, see this response as a waste of time – believing that shock tactics like these rarely have an effect on a young person who is likely to be enjoying, or at least getting some perceived 'positive benefits', from their drug of choice at that point in time.

So what does the research say about shock tactics and do they have a place in educating drug users in our community?

Shock tactics encompass a variety of different techniques.  Many will remember a police officer coming into your school and showing you pictures of terrible car accidents in an effort to prevent speeding and/or drinking and driving.  Photographs of diseased lungs and other body parts were often used in health lessons to dissuade young people from smoking.  One of my earliest memories of health education was a young man being brought into our classroom who had had cancer caused by smoking.  He had lost his voice box and was forced to talk through a machine held against his throat.

Yes, these images shock and horrify– but do they really stop young people from partaking in the risk-taking behaviour?

Young people process information very differently to adults - no matter what we tell them and how well we do it, they simply don't believe that 'it is never going to happen to them'.  Remember, they are missing the part of the brain that deals with reasoned thinking and judgement, and as a result every decision is made using the emotional part of their brain. This results in their decisions not necessarily being rational or practical - they are based on one simple premise - 'if it feels good, I'll do it!' No matter what you tell them, no matter how good the information is, no matter how shocking the image – for many, their behaviour will not change unless something happens to them directly (and even then I have seen cases where even the drug-related deaths of close friends has not made any difference).  The number of people who have come up to me and told me their own personal drug story is amazing.  The start of the conversation is nearly always the same – "I’d read all the information but I never believed it would happen to me …."

I think the main reason that parents believe scare tactics could be an option is due to the fact that they believe this strategy worked for them. The problem is, even if it did work for you, it may not necessarily have the same effect on your child.

Certainly young people can be moved by stories of terrible hardship and death, particularly when delivered by a person who is close to their age and a talented speaker, but does this necessarily lead to a change in behaviour? On the limited research there is in this area, the evidence says that for those young people who were not interested in using drugs, this strategy works well - reinforcing everything they already believe. However, for those who are already using drugs, they look at the speaker talking about their problems and simply reject their story, believing that it was a 'personal weakness' that led to the substance issues and that it would not happen to them.

Susan's children are quite young and I firmly believe that a visit to a treatment centre to try to prevent future drug use makes little or no sense at this time. Even getting them to talk to a person who has had, or is experiencing a drug problem, is most probably not appropriate at this time (unless maybe it is a family member or a close family friend and the conversation comes naturally and is not forced). I know it sometimes seems like you're not doing enough and the media keeps on telling you about a scary world, but the best way for a parent to prevent alcohol and other drug use is to simply keep connected, talk to your child and remember the three golden rules:

• know where your child is
• know who they're with, and
• know when they'll be home

Shock tactics certainly have a place in public health education (and maybe even in parenting if used sparingly and at the right time in the right way!).  They obviously work in preventing some people from taking part in risky behaviour.  The question needs to be asked though – would those people have ever become involved in that activity in the first place?