1. Getting a Life Alcohol, Drugs and Early Years Alan Sinclair

2. How can Scotland reduce the damage to its population through alcohol and drugs by half by the year 2025?

3. PREVALENCE AND HARM Alcohol £3.5 billion industry in Scotland In last 25 years alcohol has become 62% more affordable Drugs, contradictory evidence on growth, by 2025 drug abuse could move from 1% of the population to 2-3%.

4. Growth Urgency Compass bearing

5. THE TERRAIN GENETIC NURTURE Free will Luck Fashion Deprivation Pleasure

7. NURSE FAMILY PARTNERSHIP Target : Two year support to very disadvantaged young mothers during and after first pregnancy 15 year follow up: 44% fewer maternal behavioural problems due to alcohol & drug abuse 56% fewer days of alcohol consumption on part of 15 year old children

8. Perry Pre School Target: Most disadvantaged inner city black children, between 3 and 5 years. Results on 40 year follow up: Programme GroupControl group Used sedatives17% 43% Sleeping pills/Tranquilisers Marijuana48% 71% Heroin0% 9%

9. The most important 6 years of a persons life are up to the age of 5 From week 20 of pregnancy until week 40 foetal brain volume increases x 17 From Birth to 5 years increases x4 Programme Hypothesis Growing sponges

10. Impact of Neglect

11. How do children develop? ATTACHMENT Sensitive care and response Empathy Neglect plus harsh discipline “Children are a reflection of the world in which they develop”

12. HORMONES CORTISOL prepares us for flight or fight Produced in normal amounts is helpful Overexposed and brain flooded – thermostat jammed Low cortisol associated with alcoholism, detachment and aggression High cortisol associated with fearfulness and depression By 6 months cortisol level is set for good or ill

13. American Academy of Science 2000 “From neurons to neighbourhoods” Genetic & environment work together in a dynamic way in brain development and human behaviour Early relationships - support and adaptation - risk and dysfunction Have the capacity to increase the favourable odds

14. Child Wellbeing in the EU Acute Drug Related Deaths Under 25yrs of Age in EU

15. Would you like £1 million each and every year for the rest of your life?

16. PUZZLE Why is it that in the face of the greatest horrors (e.g Nazi death camp) some people survive? Why is it that some people in the lap of comfort kill themselves or implode on alcohol and drugs?

17. DIEDLIVED Gave up on ‘inner hold’He who had a ‘why’ to live can almost bear any ‘how’ Loss of faith in futureMake a victory or challenge of the experience “Life ultimately means taking responsibility to find the right answers to its problems and to fulfil the tasks which it constantly sets for each individual.” Viktor Frankl

18. PREDICTIVE FACTORS FOR ILLICIT DRUG ABUSE Parental Discipline Family Cohesion Parental Monitoring Peer Drug Use Drug Availability Genetic Profile Self esteem Hedonistic Attitudes Rate of risk to protective factors Deprivation? Diversity? Source: Home Office. A Literature Review

19. FRONT FOOT Target = Prevalence and Harm Early years & protective factors Double hit parent and child Golden Moment

20. RESILIENCE Ability to adapt to different experiences – emotional well being against the odds. People I trust…….............at least one secure attachment I am a loveable person…..support of family & friends I can solve problems……..positive nursery, school or community experience

21. BUILD RESILIENCE & PROTECTIVE FACTORS Policy and Investment Priority Support Parents Children Centres Define services with respect to children Pedagogues

22. Double Hit Parent and Child Support parent – tone Risk assessment at pregnancy Engagement Whole household Home learning environment + good pre- school + good primary school

23. Rate of Return on Investment in Education Source: James Heckman

24. Like Stern Report 3:1 to 7:1 by 21 years 12-16% for £1 invested but gains through life Cost Benefit

25. Early Years - A PRIORITY 10 year strategy + 3500 Children Centres Ireland investment + Cabinet Minister Pedagogues in northern Europe Alliance of criminal justice, health, education, skills and economics Culture, what we do as people

26. Individual Relationship CommunitySocietal  Support for parents  Secure attachment  New norm on drug/alcohol abuse  Find meaning in one another  Target households and family  Engage  Recognise the problem  Change cultural norms  Parenting permission & knowledge  Support parents who struggle  Children can provide healthy networks  More parent self help networks  Investment in early years  10/20 year strategy  Priority status  Rolling consensus  Tax increases & regulation  More early years workers and higher quality  A secure attachment  Receive sensitive care  Empathy and love  Get security A Model of Sorts! Model to Reduce Prevalence and Harm from Alcohol and Drug Abuse

27. Conclusion Social- economic urgency Tackle harm and prevalence Early years = Protective It works

28. Thank you asinclair@theworkfoundation.com