Professor Judith Aldridge

A framework for measuring outcomes for harm reduction drug education programmes

The recent White Paper “Ten Year Strategy” places a ‘strong emphasis on research and evaluation to determine ‘what works’ in providing drugs education and prevention for young people. Outcome measures used to gauge the success of programmes which aim primarily to stop young people taking drugs are fairly straightforward: we need only compare whether the young people receiving the programme are less likely to take drugs than those who did not. However, ‘what works’ in terms of more broadly defined harm reduction drugs education is less straightforward. If the goal of such a programme is not simply to discourage use but to reduce the harm associated with drug use, then the traditional outcome measure – whether young people have tried an illegal or illicit drug or not – is of limited use.

This paper presents a framework for measuring outcomes from harm reduction programmes. It is argued that measures used to determine ‘what works’ in the way of harm reduction education programmes must take into account people’s actual drug using behaviour and their experience of their drug use. The framework suggests that we can usefully measure both the harms that result from drug use as well as risk behaviours that increase the potential for harm. The framework also suggests that measurement of outcomes can occur either at the level of the individual (self-reported harmful outcomes and risk behaviours) or at the population level in which local ‘official’ statistics are utilised. The advantages and drawbacks of both levels of measurement will be discussed. However, it will be argued that primarily self-report data gathered at the level of the individual represents the least methodologically ‘fraught’ way to ascertain in research terms whether broadly defined harm reduction education programmes ‘work’.