New situations need new thinking
Mike Cadger and Colin Sime
Crew 2000, 32 Cockburn Street, Edinburgh, EH1 1PB, UK E-mail:
Peer education is an effective way of working. It is a complementary service and it can enhance the work carried out by traditional drug services. Crew 2000 started at the end of 1991, when it was noticed that although more and more young people were starting to experiment with psychedelics and stimulant drugs, none were presenting themselves to drug services. This could have been for two reasons. Either no young people were experiencing difficulties with their drug use, or traditional drug services were not seen as a place that young people could get information from. It was believed that the second option was the case, and so a group of young people who were involved in the ‘rave’ culture and a couple of drug workers decided that they were in a good position to try and contact these young people.
The project made an application to the Scottish Office to produce a leaflet called ‘Jelly time’. At the time it was not seen as a good idea to give money to drug users, but with a lot of persuasion the money was secured. The leaflet was intended to directly target young people. They were using temazepan and a bottle of buckfast as an alternative to ecstasy because of the poor quality of ecstasy circulating in Scotland at the time. The leaflet caused a great deal of controversy with the funders because the dreaded ‘F’ word was used and it did not tell people not to use but tried to educate them instead. It had the opposite effect on the target group, however. After months of meetings in pubs and people’s houses, and more funding, an office was secured. Crew 2000 are now in a shop front premises in a busy city centre street, alongside head shops and independent record shops, so that young people will be attracted to the street. Crew quickly became a well-respected agency.
At present Crew consists of a management committee of workers, fund-raisers, psychiatric nurses and at one point a member of the Scottish Office. This even split ensures a healthy balance when it comes to decision-making and also a continuation of a volunteer led project. There are 20 volunteers, and at the time of evaluation there were 3 full-time members of staff and 2 part-time workers. Crew 2000’s work is split up into six main areas. These are the shop-front drug information service, a safer dancing outreach service, information production, training, a street outreach service and peer support.
Take-up of services
The shop front is where most people come into contact with Crew and over 6 months in 1999, 3515 young people came in for information: of these, 1275 wanted drug information; 543 wanted condoms; 28 required referrals to other agencies; 13 had major enquires; and loads of people wanted club information. The safer dance outreach service has attended 9 events in the last 6 months, providing a service to 90 people with crisis intervention. A total of 22,000 people attended the various events, where there were 25,000 leaflets and 10,000 condoms distributed. The information group has produced 17 leaflets and postcards including ‘Jelly time’, ‘Women and drugs’, ‘Drugs and driving’, ‘Opiates’, ‘Tranquillisers’, Two different leaflets on the law, one advertising Crew’s services and one on 2CB, ketamine and mixing ecstasy. The information group has also produced 6 adverts which were placed in toilets in clubs. The adverts addressed safe sex whilst under the influence of drugs, dehydration, the law, mixing drugs, drugs and driving and also advertising Crew’s services.
One of the most important services the group can offer is a rapid response to tablet testing, like an early warning system. Within a day of getting a ‘dodgy’ tablet (such as ‘flatliners’ or 4MTA) tested, the information can be back out on the streets and in the clubs. Incidentally, one week after getting the information about ‘flatliners’ out into the clubs, the local drug squad issued the same warning.
The training group has provided training on recreational drugs to 14 different groups, including schools, homeless projects, drug projects, trainee psychiatrists, police and club staff. The outreach street workers have managed to contact over 150 young people who are not in touch with other services, distributing over 500 leaflets and over 500 condoms.
The latest project is a peer support service, which was brought about because there was a large gap in services for young recreational drug users who are the largest population of the legal drug users and also the least funded. As most of the young people that were referred onto other counselling services did not follow through with the referral, in conjunction with the traditional service there is now a CB Therapist to work with people who are experiencing panic attacks and anxiety due to the over-use of stimulants. Those who do not need to see a therapist will be offered one-to-one support with a trained volunteer, and when the time is right for them also have the option of volunteering with us.
The funders insisted on a process evaluation. The evaluation took the form of four distinct kinds of work. First of all direct observation was carried out for a period of 3 months and all of the work of the project was scrutinised. A couple of questionnaires were designed by the Centre for Drug Misuse Research at Glasgow University and were handed out to the target group of Crew 2000. There was then a separate survey and interviewing of agencies that had come into contact with Crew, usually because we had provided some kind of training or consultancy for them. Then there was a collection of interviews of our volunteers, who tended to be individuals active in the scene and likely to be recreational stimulant drug users themselves, which adds additional value in terms of what they bring to the service.
The central philosophies of Crew 2000, the harm reduction and peer education in practice all met with approval, although that statement requires additional analysis because that is not always borne out by the practices of other drug agencies. In response to the survey, agencies said they were not concerned about Crew 2000 volunteers being drug users, although this view is not always echoed in private. Nevertheless, amongst this group there was a good satisfaction rating in terms of the service that they received from Crew 2000, which was at around 97%.
86% of people who use Crew 2000’s services are aged 16 –25 so therefore the target group of young people involved in the scene has been reached. Of that group, the majority fall into the youngest category of 16- 20 years of age range. The drug use prevalence rates are extremely high; the mean level is 91%. It is not surprising that most of them at some point have been involved in poly-drug use because that is the normal situation for young people in Edinburgh.
One of the most important findings was the fact that about 42.5% of the people who contacted Crew in that period of time, and were therefore surveyed, had previously had contact with the organisation. Therefore there was at least a level of trust amongst that group to encourage them to return. We were still able to attract 3 out of every 5 people that were coming to the service for the first time.
Consequences for Crew 2000
On a theoretical level the evaluation validates the existing practice, although that does not necessarily mean at a practical level that the work is validated or that pots of cash are going to flow into the service. In measurements of efficacy and in terms of interventions with young people who are involved in drug use, the goal posts seem to change all the time. A particular service can be measured by a bums-on-seats approach, but efficacy is measured differently in relation to a relatively radical drugs project. This is not necessarily fair to Crew or the young people. Young people come to Crew 2000 and return because the organisation is flexible in its practice, people are listened to, and the work is adapted as a result of what they tell us.
All of the information provided will emanate at least in its initial stage from the street and from dance clubs themselves, because that is where people are involved in activity. Crew 2000 are flexible and can respond more quickly than statutory services and most of the other voluntary services, including those involved in the enforcement services. A warning can be out within a period of 24 – 48 hours. On a local basis, Crew can provide trends analysis and trend data as to what is actually happening on the Edinburgh club scene.
As a matter of urgency, a European-wide network of projects like Crew 2000 needs to be established, as Crew are the only ones who are placed to gather this evidence quickly enough. Then it would be possible to pick out aspects of the Edinburgh drug scene that are relevant to what is going on elsewhere. Crew do not experiment with monkeys or rats. They are involved with real people who use real drugs in real life situations, and are talking about what young people do on a Thursday, Friday, Saturday and Sunday night. That is why their knowledge has some validity and some importance.
The truth is that in the UK the practice of clubs is poor, and even though there may be shining examples of good practice in terms of safer dancing that is not the universal situation. The experience of the Australian club promoter of Sublime was shocking rather than particularly positive, because he was increasing his prices to give young people the privilege of getting free water. That is not good enough. Also, so-called experts from the UK or other countries frankly know too little to be able to pontificate on these areas. What is needed is much closer international work and to look at local groups like Crew 2000 who offer a model of working. Crew do not want to impose their model on anybody else but offer the model for people to use and to adapt.