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RECENT PEDIATRICS & PARENTING STORIES

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May 29, 2000
PEDIATRICS & PARENTING
Truth or DARE
"Just say no" drug-use prevention programs are not effective
By Maia Szalavitz

illustration: Michael Alto

The party line on drug-use prevention is clear: Parents need to communicate with their children, Drug Abuse Resistance Education (DARE) officers should teach teens to "just say no," and school officials must use zero-tolerance policies to expel even first-time users.

But if these policies have worked so well, why are just as many teens using drugs today as in 1975? Why are more than 49 percent of high school seniors still trying marijuana, and why is the use of heroin and ecstasy (MDMA) rising?

Prevention programs are simply not effective, say the experts. A 1998 study of more than 100 federally funded drug-use prevention programs found that none of the programs produced long-term effects -- even those recommended by the National Institute on Drug Abuse.

Joel Brown, executive director of the Center for Educational Research and Development, worked on the study of drug-use prevention programs as far back as 1995 for the state of California. Among the programs studied was the traditional DARE program used in 75 percent of American schools. "Not a single scientifically sound long-term study that we know of shows that DARE prevents kids from using drugs," Brown concluded in his study.

One problem, he explained, is that Congress mandated that all federally funded prevention programs must present a "zero tolerance" message that all drug use -- be it pot smoking or cocaine use -- is "equally bad." According to Brown, this philosophy dooms current programs to failure.

Other experts agree, saying that teens are more logical about drug use than adults realize. Rod Skager, professor emeritus at the UCLA Graduate School of Education, notes, "During adolescence, people develop formal reasoning skills. Part of that is questioning what they learned as kids. When you present teens with indoctrination that is easily discounted by their own experience, you lose them fast."

Regarding one of the central messages promoted in prevention classes -- that drug use results from deficits in social or other skills -- teens see evidence to the contrary every day. "[That message] is probably true for problem users," says Skager, "but it's certainly not true for most teens. Drug and alcohol use is a pillar of adolescent social life and is accepted by virtually all teens, even those who don't use themselves." For teens, drug use is a social activity, not an antisocial one.

sidebar: Drug Facts

Teens speak up

John, a 16-year-old from Pennsylvania, remembers the conflict between the messages given in prevention programs and his own experience. "We had DARE in sixth grade," he recalls. "I don't think it had an impact on whether or not kids tried alcohol or drugs. Most of my class has tried alcohol; a few have tried pot. It definitely makes you distrust prevention [when you witness little harm from pot.]"

Another problem in the DARE program, say teens, is the lack of autonomous decision-making. Caitlin, a senior at the Urban School of San Francisco, had the DARE prevention class when she was in junior high school. "They give you the idea that you have to make a decision, but the right decision is 'no' -- that's not a decision," she explains.

"It didn't occur to me then that I might want to try drugs," Caitlin says. "Freshman year, I was seeing kids who smoked a lot of pot and I said, 'Wait, this doesn't hold up.' They're getting straight As, they're going to Harvard; they're not dying."

Caitlin says that while most of her schoolmates did not use hard drugs, one of her peers became a heroin addict. "He smoked pot and said, 'Wait, I'm not dead.' He's 16 now and is a recovering heroin addict. I would like to think that if he had had better information, he would have made better choices. I would say he made the decision to try heroin partially based on the thought, 'I didn't get addicted to pot, it didn't happen the first time, so it won't happen the second time.'"

sidebar: What About Treatment?

Improving results

What could improve prevention? According to Marsha Rosenbaum, Ph.D., author of Safety First: A Reality Based Approach to Teens, Drugs and Drug Education, drug education programs should focus on reducing the risks involved in teen experimentation, rather than attempting the impossible task of preventing all drug use. "Teens will use," Rosenbaum says. "It's a matter of being pragmatic -- it's irrelevant whether we condone or condemn it. They do what they do."

Rosenbaum believes that teaching teens awareness could reduce harmful effects and accidental deaths. One lesson, for instance, could be not to mix drugs in a dangerous manner -- particularly those with similar effects that could compound each other, like alcohol and Valium. Education programs could also concentrate on teaching teens not to drive under the influence of drugs and not to get into a car with someone on drugs.

Skager stresses that drug education needs to be genuinely interactive -- so that kids can ask any questions they have without fear of judgment or punishment. He also believes that teens need to be taught to recognize the signs of addiction in themselves and in others, and how to help someone with a problem. "You need to know how to approach someone," he says, in order to help.

For many students, hearing from their peers could be the most powerful lesson. "I don't understand why so many adult voices are being heard about this, yet no kids are saying anything," laments Caitlin. "I still wish I had access to all the information I need. It's really hard to find information that's accurate. If the drug programs are directed at us, and they're failing us, why aren't we speaking up?"