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Pharmacology, Policy, and Professional Responsibility

The Brain and Addiction

• Dopamine reward pathways: drugs hijack the brain's learning system
• Adolescent brains are uniquely vulnerable — prefrontal cortex not fully developed
• Addiction is a neurological condition — not a moral failing
• This changes how we should respond professionally

Harm Reduction vs Abstinence

• Abstinence model: 'don't use' — clear message, limited evidence of effectiveness
• Harm reduction: accept use, minimise risk — strong evidence base
• Portugal: decriminalisation + treatment investment → 80%+ fewer deaths
• UK: politically resistant to harm reduction — despite evidence

UK Drug Policy: Where Are We?

• Misuse of Drugs Act 1971 — largely unchanged for 50+ years
• Psychoactive Substances Act 2016 — broadened the net
• Contested: medical cannabis, drug consumption rooms, decriminalisation
• Evidence and policy are frequently disconnected

Professional Safeguarding

• Parental drug use: significant child protection risk factor
• Young person's drug use: when is it a welfare vs safeguarding concern?
• Non-judgmental conversations increase disclosure — judgmental ones close it down
• FRANK, CAMHS, and DSL referral pathways: know them all

The Evidence on Education

• Fear-based 'just say no' approaches: little evidence of effectiveness
• Accurate, non-judgmental information: more effective at reducing harm
• Skills-based approaches (refusal, decision-making): most effective
• Peer-led programmes: strong evidence base

Your Professional Role

• Safeguarding duties apply across all professional roles
• Holding non-judgmental conversations is a professional skill
• Signposting is not the same as investigating
• You do not need to have all the answers — you need to know who does

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Better information saves more lives.