This Week:

Quote of the Week

Teen Drug Education: "Just Say Know" Part II in the "Fantasy Versus Reality" Series

Drug Education: What Doesn't Work, and What Does

DARE Doesn't Work, Says DARE

Greetings,

One very good way to learn about a person, a nation, or a culture is to look closely at what they do when they are afraid and under stress. And what scares and stresses United Statesians more than sex, drugs, and crime? That's why I continue this week with the "Fantasy Versus Reality" Series. It's drugs this week; last week it was sex; next week I hope to talk about teen crime.

There are themes in the ways we deal with each of these social problems, and great lessons can be learned in the attempt to understand these themes, and the philosophy that gives rise to them. I hope to make all of this clear in the next week or two. Stay tuned.

It's another double issue this week. I guess that's how it is with this series. Depending on what you think of these double issues, I will say either "You're welcome," or "I'm sorry." Take your pick.

Until next week,

Nygaard

"Quote" of the Week:

"Abstinence [from drugs] is what every parent would prefer for their child but our efforts should provide a fallback strategy of honest, science-based education for teenagers who say 'maybe' or 'sometimes' or 'yes.' Educational efforts should define 'drugs' broadly, to include both illegal and legal substances. Programs should acknowledge teen's ability to make reasoned decisions; differentiate between use and abuse; and stress the importance of moderation and context. Curricula should be age-specific, stress student participation and provide science-based, objective educational materials.

"In simple terms, it is our responsibility as parents and teachers to engage students and provide them with credible information so they can make responsible decisions, avoid drug abuse and stay safe."

That's from the "Drug Education" page of the website of the Drug Policy Alliance's "Safety First: Parents, Teens, and Drugs" program at http://www.drugpolicy.org/safetyfirst/education/

Teen Drug Education: Just Say Know
Part II in the "Fantasy Versus Reality" Series

Most people think of human beings as sexual creatures. It's hard not to, since there's no other way to come into the world (in-vitro fertilization notwithstanding). But apparently most people do not think of human beings as drug-using creatures, despite the likelihood that drug use is nearly as universal to the species as sex. Perhaps that explains why the majority of school-based drug education programs in this country continue to be based on promoting total "abstinence" from drugs, as they have been for better than 40 years, despite having little or no evidence of success in reaching this elusive - and quixotic - goal.

Last week I said that the attack on comprehensive sex education was officially launched at the federal level in 1981 with the passage of the Adolescent Family Life Act, known as the "Chastity Bill." I talked about how the idea of telling kids to "Just Say No" to sex has not been popular with the people of the United States, on the whole, and how the response of the federal government has been to use federal funds to coerce school districts into pursuing the "Abstinence-Only" approach to sex education.

The nation's approach to drug education - the teaching of children about mood-altering chemicals - has a somewhat different history. In 1936, just three years after the passage of the 21st Amendment to the Constitution repealed the prohibition of "intoxicating liquors," the pseudodocumentary "Reefer Madness" hit the nation's movie screens. This classic of "scare tactic" anti-drug propaganda illustrates the nature of much of the nation's so-called "drug education" for the past 70 years (40 years in the schools). Which brings us to the DARE program. You know: "DARE to keep kids off drugs," and so forth.

The Birth of DARE

In 1983, just after the Chastity Bill kicked in, the Los Angeles Police Department and the Los Angeles School District launched the current drug-education program-of-choice in the United States: Drug Abuse Resistance Education, or DARE. A sort-of "Drug Chastity" effort, the program took its inspiration, in part, from the campaign initiated by First Lady Nancy Reagan that encouraged the nation's youth to "Just Say No" to drugs. DARE preaches an "Abstinence-Only" message, with program participants pledging to lead a "drug-free life."

The elementary-school DARE curriculum consists of 17 lessons, taught by DARE-trained uniformed police officers, with the stated purpose of providing students with decision-making skills, showing them how to resist peer pressure, and teaching alternatives to illicit drug use and violence. DARE is administered in the fifth and sixth grade, and short courses at lower grade levels and supplementary junior high school and high school programs are also available.

By classifying any and all drug use as "abuse," and by presenting what some have called a "bizarre, brazenly exaggerated depiction of drug use," the DARE program follows the tradition of using "scare tactics" to keep kids from trying drugs.

The idea of using scare tactics to keep citizens from using drugs has a long history, going back at least to 1914, when our currently-illegal drugs were made illegal by passage of the Harrison Act. (It's a little more complicated than that, but that's essentially true.) A 1914 headline in the New York Times, for example, in favor of the proposed "narcotics prohibition" law, screamed "NEGRO COCAINE 'FIENDS' NEW SOUTHERN MENACE." Race, drugs, hysteria - some things never change, it seems.

Two Approaches to Drug Education

I said last week, in talking about "Abstinence-Only" sex education, that "whether we like it or not the reality seems to be that children are sexual beings who can and do act on their sexual feelings." And so it is with drugs. Andrew Weil, in his groundbreaking 1972 book "The Natural Mind," tells us that "The use of drugs to alter consciousness is nothing new. It has been a feature of human life in all places on the earth and in all ages of history." In the U.S., the most recent data show that 44 percent of eighth-graders have used drugs, a number that grows to 77 percent by twelfth grade. I'm including alcohol here, as should any honest reference to "drugs." If we limit it to so-called "illegal" drugs, the experts say that 22 percent have used them by eighth grade and 51 percent by twelfth grade.

So, the fact is that kids use drugs, just a kids have sex. The question is, what do we do about it? As with sex education, the responses fall into one of two groups, based on different sets of beliefs.

One group focuses on reducing the harm that often comes with drug abuse. In fact, this approach is often called a "Harm-Reduction," or "Safety First" approach. This group accepts that kids live "in a world in which drugs of all sorts are ... widely abundant, legal and illegal, pharmaceutical as well as herbal," and that they will make decisions about whether or not to use drugs in that context. As the director of the Drug Policy Alliance, Ethan Nadelmann, puts it in speaking of that group's approach to teen drug education, "You basically want to start preparing [kids] with honest, accurate understanding. You want to explain to them that drugs can be medicines, that adults can use drugs like alcohol for other reasons, that there are dangerous and non-dangerous ways to use these things." Or, as medical sociologist Marsha Rosenbaum says, "We need a strategy [for drug education] that embraces safety as its bottom line."

For the other group, the idea that there may be "non-dangerous" ways to use drugs is wrong. This group sees all drug use (except their own use of alcohol, tobacco, caffeine, etc) as anti-social behavior that must be prevented. For people in this group, the decision to use drugs as a personal matter of "self-discipline," and a simple matter of personal "choice." Here we get back to the "Just Say No" idea, which implies that the decision is a simple, either/or, yes/no decision made by each individual child. This group appears to believe - and to base its drug education policies - on four common myths: That experimentation with drugs is not a common part of teenage culture; that drug use is the same as drug abuse; that marijuana is the gateway to drugs such as heroin and cocaine; and that exaggerated risks ("scare tactics") will deter young people from experimentation. I won't go into the details here, but these are indeed myths - every one.

How much do we spend on DARE?

Despite the fact that the ideology of "Abstinence-Only" drug education is myth-based, a lot of money is spent on it. It's hard to tell exactly how much money the U.S. spends on the DARE program specifically, because there is no centralized accounting of the funds, expenditures, and resources used to support the program. According to the Office of National Drug Control Policy, $41 million in federal support was provided to the DARE program in a recent year, but that's just the tip of a large iceberg. DARE programs are implemented at the local level and receive support from many sources, including local school districts, city or town budgets, local police departments. All of these local people have access to county and state funds, so who knows how much is actually spent, all told?

The best estimate, perhaps, comes from a 2001 paper called "The Economic Costs of DARE" by Edward M. Shepard. Shepard says that the U.S. spends roughly $1.04 to $1.34 billion per year on the program, or $175-270 per student each year. And, as Shepard tellingly puts it, "Some experts in drug education believe that DARE has negative effects on school children. This suggests that there may be additional costs associated with the DARE program which could not be considered in this paper."

Can drug education actually have "negative effects?" Read on...

Drug Education: What Doesn't Work, and What Does

Since school-based drug prevention programs for adolescents, based on scare tactics, zero tolerance, and "Just Say No" have been in use since the 1960s, they have been studied extensively, in many different communities and demographic groups. At this point in history, it is safe to say that they - and specifically DARE, by far the most widely-used program of this type - simply do not work. By "do not work" I mean they do not reduce rates of drug abuse among our youth.

I had to clarify what I mean by "work" since DARE proponents often mean something different than I do when they talk about whether or not their programs "work." As an example, the DARE website has a page called "DARE works…and we can prove it!" This page does not mention drug abuse, so they must mean it "works" in some other way. The brief, 127-word article simply reports the opinions of teachers, parents, and principals, who apparently "believe students will be less likely to use substances after the DARE program." There is no evidence offered to support these "beliefs."

And this is very typical of the proponents of the DARE program, as I found in looking at innumerable documents - the "success" of the program is often based on surveys that show large numbers of people who believe that it works. Rarely is there any documentation that it actually does work. That is why it makes sense for the Drug Reform Coordination Network to make this statement:

"If the measure for success of DARE is popularity, then yes: DARE has been enormously effective in attracting widespread popular and financial support, and has achieved a level of visibility unparalleled by any other single drug education program... If the measure for success of DARE is whether it is effective in reducing drug use (let alone abuse) among young people, the evaluations uniformly conclude no, DARE is no more effective than any other drug education program, nor more effective than no program at all. Although many evaluations have been done, no scientific study has discovered any statistically significant difference in drug-usage rates between students who had taken DARE and those who had not."

And I found that last statement to be correct. Although some studies show some short-term effect on drug use, all the studies that have looked at incidence of drug use and/or abuse over time indicate that DARE students are no different than non-DARE students.

What Doesn't Work: The DARE Program

I suppose it would be responsible of me to tell you about a few of these studies. The majority of studies evaluating DARE focus on the elementary school curriculum in effect before 1994, since by that time its ineffectiveness had been pretty well established. But more keeps coming, so for the record:

* A report "Project DARE: No Effects at 10-Year Follow-Up" was published in the August 1999 issue of the "Journal of Consulting and Clinical Psychology." It said: "Few differences were found between [DARE students and non-DARE students] in terms of actual drug use, drug attitudes, or self-esteem, and in no case did the DARE group have a more successful outcome than the comparison group."

* A report in the August 2002 issue of "Health Education Research," called "Will the 'Principles of Effectiveness' Improve Prevention Practice? Early Findings from a Diffusion Study," stated: "DARE has been widely studied and found to have relatively small short-term effects with no long-term benefits on substance use behavior."

* The popular press is filled with articles about the ineffectiveness of DARE. Here's the Rocky Mountain News of December 18, 1997: "A book-length 1994 review of the evidence conducted by the Research Triangle Institute and the University of Kentucky for the National Institute of Justice concluded that the [DARE] program effectively increased children's knowledge of drug use (though that is not an end in itself), but did very little to change their attitudes and behavior." (If you'd like more media reports, write to me; I've got a list of about a dozen or so recent ones.)

* When I said elsewhere in this issue that the DARE program may actually have negative effects, I was thinking, in part, of an article in the March 19, 1999 issue of the Portland Oregonian, which said "A recent study shows the [DARE] program had no effect on drug use by high school students and, in fact, found a higher likelihood of drug use. DARE. is endorsed by school administrators, applauded by parents, accepted by teachers and loved by kids."

The DARE program has been so ineffective that the program is being revised and re-worked. It looks like the new version is guided by basically the same ideology, but it's too early to know if it will work any better.

What Does Work

Put most succinctly, the programs that work in reducing harmful drug use are the ones that go beyond "Just Say No" - which may be appropriate to use with elementary school kids - to the more complex and respectful "Just Say Know" that older kids need. That is, honest, accurate, and realistic information about drugs, minus the moralizing and fear-mongering that characterizes so much of what adults currently pass off on kids.

There are a lot of programs out there that aim to help people stay off drugs. No one, not even the DARE officials, believe that a bunch of lectures given by cops do much good by themselves. What appears to work is, as DARE itself says, "a multiple grade level, integrated, and comprehensive prevention strategy." The information part of that strategy would do well to base itself on the philosophy of the Drug Policy Alliance, as is spelled out in this week's lead article and this week's "Quote" of the Week.

If you like specifics, write to me and I'll send you some information on actual approaches that seem to work. Or, visit the site of the Drug Policy Alliance at http://www.drugpolicy.org/

DARE Doesn't Work, Says DARE

In the "Research" section of the official DARE.website (http://www.dare.com) there are links to 13 examples of "research" on the DARE program. I looked at each of them to see if the research cited by the program showed any success. And, by "success" I mean a reduction in the abuse of drugs by kids. Simple enough.

More than half of the sites (eight of thirteen) make no mention whatsoever of the incidence of drug abuse, let alone the effect that the DARE program may or may not have in this regard.

One link simply sent me to the White House "National Drug Control Strategy." Another one gave me a short summary with some possibly positive points, but the links to check out the actual study the points supposedly came from turned out to be dead links (that is, when you click on them, there is no page available). One link references the "DARE. Scientific Advisory Board" but it, too, is a dead link.

OK, that covers 11 of the 13 references that DARE gives for "research." The final two are the most interesting. One is the reference called "Suggested Response to Principles of Effectiveness." This references a set of rules that all "anti-drug and anti-violence programs" have to follow in order to receive certain federal funds. Principle #3 says that these programs must "provide evidence that the strategies used prevent or reduce drug use, violence, or disruptive behavior." In this context, DARE references four studies. It doesn't say anything about them, it just cites them. So I went and looked up the actual studies. Here's what I saw:

One 1998 study I could not find in full text. It's too deeply buried in the academic archives.

A second study, from 1995, of 3,000 Ohio 11th-graders claimed to show that students who had been through DARE at least twice "showed the lowest level of drug involvement" among the groups studied. That sounds good, although the report I saw was poorly documented. Maybe it's true.

I was amazed when I read what the third study said: "The results indicate that DARE. had no long-term effects on a wide range of drug use measures..." No effect!

And the fourth study, the most recent one, said essentially the same thing. A published report from the group who did the study said that, while DARE participants had lower rates of use of certain drugs, "[S]tudents who had DARE were more likely to have tried marijuana than students who did not have DARE," [emphasis in the original] and "55 percent of the DARE students said they had 'never used drugs and never will,' compared to 61 percent of the non-DARE students."

So, two of the four studies that DARE says are "evidence" that the their program "prevents or reduces drug use" say that, in fact, the DARE program either has no effect or actually increases illegal drug use. So, that's it for the 12th of the 13 examples of "research" on the DARE program offered by DARE.

The final research example from DARE was the most remarkable, however. This is the one titled "What Does the National Research Say About DARE.?" On that page you will find the following startling statement: "The impact of DARE. on long-term, drug use prevention is not well supported." Ignore the inappropriate comma, and consider what the official DARE. website is telling us: The DARE. program does not decrease the use of drugs.

Shortly after that statement I found what I refer to as the "Coco Pops Rationale." On every box of Coco Pops, which is a breakfast cereal basically made of rice, sugar, and chocolate, Kellogg's tells us that it is "more than just a great chocolate taste," but is "important as part of a balanced diet." In other words, if most of the food you eat is actually nutritious, then eating Coco Pops probably won't hurt you. Maybe that's true. And maybe it's also true, as DARE says, that "Communities can strengthen the impact of the program by ensuring that DARE. is part of a multiple grade level, integrated, and comprehensive prevention strategy, not a stand-alone, one-time program." In other words, if do some things that are effective in reducing drug abuse, then maybe the DARE program won't hurt.

The article goes on to say that "The second issue brought out by a literature review is the role of the DARE. police officers-as instructors, role models and community members. The studies that looked closely at the role of the officers, found them to be well trained, dedicated, and an important part of the success of the program." (The non-existent "success," as acknowledged above.)

This piece is worth looking at in detail, and you can find it at
http://www.dare.com/new_site/natl_research.htm (Don't expect any references or footnotes, however. As with most DARE propaganda, there are none.)

So, even DARE admits that its program does not work. Yet it is the largest, most widely-disseminated drug education program in the United States. I'll talk a little bit about why that might be...next week.