The role of health and welfare practitioners in substance abuse prevention is discussed in relation to three areas: their involvement in multi-agency coordination; a concept of prevention which takes in health, social, legal and financial considerations at levels of the individual, family and community, and wider society; and their facilitation of educational efforts. As far as working with others at local level is concerned, there are as yet unsolved problems around the question of central government’s policy of localisation of responsibility for prevention strategy and for its funding. Positively, there are prospects for a broadening of the concept of minimising drug-related harm, from health considerations (in which containment of HIV looms large), to wider questions of how to reduce social distress (e.g. of family members) and how to reduce legal harm and other forms of drug-related problems (e.g. by diversion of drug users out of the criminal justice system). Educational interventions in the mass media (including local radio), schools and youth clubs are described as powerless to reduce drug use directly but as potentially useful in reducing drug-related harm and as facilitating other goals, such as enhancing public understanding and involving young people in lively and intellectually rigorous investigation of a multifaceted social problem. The contribution of health and welfare professionals to ‘solving’ drug problems is described in terms of damage limitation in the shorter term, with the possibility of an enhancement of their role as active citizens in the longer term. Modesty and openness to a variety of voices may be the better parts of valour.
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