Sep 23, 2003 - The Christian Science Moniter

In Search of the 'Anti-drug'

More money is being pumped into drug education than ever. Yet the image of drugs continues to be one of glamour rather than danger. As teen drug use holds steady, this much is clear: No one seems to know just what to teach kids about drugs - or how, or when.

By Elizabeth Armstrong, Staff writer of The Christian Science Monitor

NEW YORK ­ When George Bush delivered his State of the Union address last January, he was quick to proclaim his administration's faith in drug education. "We are fighting illegal drugs," the president told a roomful of applauding legislators, "by cutting off supplies and reducing demand through antidrug education programs."

In fact, the number of experts who still embrace the "cutting off supplies" approach to the war on drugs is an ever-increasing minority. But at the same time interest in drug education as a means of battling illegal drug use remains strong. For the past decade, experts and politicians across the political spectrum have been stepping up the argument that education, rather than tough drug laws and border control, will be the most effective means of turning teen drug use in America on its head.

A whole lot, then, is riding on the success of existing drug education programs, and the Bush administration knows it. Among the provisions of this year's National Drug Control Strategy: $170 million earmarked for the National Youth Anti-Drug Media Campaign and $694 million for the Safe and Drug-Free Schools and Communities Program.

And yet, during a summer rife with the results of studies on drugs, anti-drug campaigns, and drug prevention, it became increasingly clear that no one seems to know just what to teach, or how, or when. A few scenarios show that some of the methods adults use to push kids away from drugs may actually be drawing them nearer.

• In June, drug czar John Walters proposed drug testing in schools across the country just weeks after a multiyear study funded by the National Institute on Drug Abuse found that students in schools that have drug testing are likelier to use drugs than those in schools that don't.
• In late July, on the same day that Cheech & Chong - long associated with marijuana use - announced work on their first film in 20 years ("They have a whole new generation of fans out there," New Line Cinema's Kent Alterman beamed), the Harvard School of Public Health released its College Alcohol Study. Education programs aimed at reducing drinking at college may encourage it, the study found.
• In August, shortly after participating in an antidrug film, a 15-year-old boy in England was found in his grandfather's garden after overdosing on a fistful of Ecstasy pills. The tablets had been stamped with kangaroos, and three 16- and 17-year-old boys were arrested on suspicion of supplying them. How could a student so involved in drug prevention, the world asked, so completely escape its message?

Experts continue to wonder why it remains so hard to identify the elements of a truly effective drug program. Considerable time, money, and effort have been thrown at the question, and yet the hearts and minds of many young people seem to remain largely resistant to the cautionary messages of adults. Drug education programs may have statistics, case studies, and "just say no" techniques on their side, but drugs have supposed glamour, adventure, and the promise of peer acceptance on theirs. Messages coming from teachers and adult seem only rarely able to compete.

Reefer madness

The history of drug education is short and poorly documented. Many drug experts are as uncomfortable discussing it as they are talking about illegal drug use, in part because it is riddled with failed programs, and in part because of the implicit admission that it is still too early to declare any of the latest ones effective.

One of the first attempts at drug education came in the form of a 1936 pseudodocumentary, "Reefer Madness," which hyped the harmful effects of marijuana, "the killer weed." A cult classic since its rescue from the Library of Congress in the '70s, the film was the first in a wave of scare tactics that would play a pervasive role in drug-education programs for the next 50 years.

In the late '80s, when an egg and a frying pan were used as a metaphor for the brain on drugs, the campaign was shunned into oblivion. Out of the backlash was born the popular slogan, "A mind is a terrible thing to confuse with an egg." Kids weren't buying it, and antidrug campaigners admitted that fear and exaggeration don't work.

"Kids today are rightly suspicious," says Meredith Maran, author of the recently released "Dirty: A Search for Answers Inside America's Teenage Drug Epidemic," in which she shadows three adolescent drug users to try to find out why they use and who, if anyone, is helping them stop.

"Teenage disbelief and suspicion of drug prevention programs is rooted in scare tactics," she says. "When I was 16 and started reading stories about drugs I was taking, and compared my reality to that, I said 'that's that.' To this day I don't trust anything from those sources."

Even today, some drug education experts are reluctant to talk about what has become the most widely used prevention program - Drug Abuse Resistance Education (D.A.R.E.) - since the Los Angeles Police Department founded it in 1983.

Preliminary studies showed a rapid reduction in drug use among the fifth- and sixth-graders who went through the program, and nearly two decades of federal funding followed. But in the late '90s, a new wave of studies deemed the program not only ineffective, but a possible cause of rising drug use among teens. More kids who had been through D.A.R.E. said they were trying drugs than those who hadn't.

Despite these findings, D.A.R.E. remains the program of choice in 80 percent of US public school systems - and the curriculum has yet to be replaced or improved upon.

Herbert Kleber, director of D.A.R.E.'s Scientific Advisory Board, admits the program continues to be used in part because of its monopoly on drug education. It had parents, teachers, and legislators enraptured for 15 years, he says, and there was little room, not to mention money, to develop other programs. "If D.A.R.E. disappeared tomorrow, money wasn't going anywhere else," Dr. Kleber says. "So the way to deal with it was not to kill it, but to fix it."

With a grant from the Robert Wood Johnson Foundation, the board appointed Zili Sloboda at the National Institute for Drug Awareness to develop an improved curriculum.

D.A.R.E. would stay, says Kate Kraft, the foundation's senior program officer, for logistical reasons. "D.A.R.E. has quite an effective distribution network," she says. "The issue was, if you could create a prevention curriculum that followed state-of-the-art evidence about what works, and distribute that through a ready-made distribution center - D.A.R.E. - could it be effective?" They are betting that it can.

THE HIGHS AND LOWS OF TEEN DRUG USE: Despite a sharp decline in drug use between the late 1970s and early 1990s, which the study's executive author, Lloyd Johnston, attributes to "a period of rising concerns about the use of drugs," teen drug experimentation is almost back to its 1975 high.

Revamping the message

Dr. Sloboda has been working on the new curriculum for four years, and the conclusion she has reached - that a 10- or 17-lesson antidrug program in fifth or sixth grade isn't enough - is one that ninth-grader Isabel Maremont grasped long ago, baffled that it took a task force of experts four years and thousands of dollars to understand this.

"I don't really remember anything from D.A.R.E.," Isabel says with a shrug. "We only had it in sixth grade, and I threw away my binder a long time ago. But now is the time we start wondering whether we'll ever try anything."

Which is why Sloboda is testing her D.A.R.E. revamp, "Take Charge of Your Life," in seventh and ninth grades, when students are reputedly at the highest risk of experimenting with drugs. The study is being implemented over a 10-lesson period in 88 school districts throughout Detroit, Houston, Los Angeles, New Orleans, St. Louis, and Newark, NJ.

As for the curriculum itself, Sloboda rattles off a six-pronged formula for success that includes understanding the risks of drugs, developing assertiveness and refusal skills, and avoiding potentially violent situations. Last on the list: "Make positive quality-of-life decisions."

What students don't learn is how the drugs work, what effects they have on the brain, and why they are harmful. "You've seen the pictures of the lungs and all that stuff," Sloboda says. "It goes right over their heads."

That isn't the kind of credit Isabel thinks she and her peers deserve. "I think they're almost scared to tell us the truth," she says. Isabel learned nothing about the club drug Ecstasy, for example - which has doubled in use among eighth graders in the past 10 years - when she went through D.A.R.E. two years ago.

She does know, however, that cocaine and heroin are harmful "because you can overdose on them." Nicotine "is just bad." And alcohol? "If you have a glass of wine at dinner or a beer or something, if you're an adult," she says, "it doesn't matter."

But Sloboda is uncomfortable with teachers focusing in the classroom on the specific characteristics of each drug. It is much more effective to teach kids the skills to say "no." "The kids," she says, "need resistance skills to be able to say 'no' when they want to."

The wrong messengers?

But what happens when they don't want to say no? What happens when the reason isn't peer pressure or what they have or haven't learned, but curiosity?

In May, less than 10 percent of high school students surveyed about drugs and drinking named peer pressure a "major problem," according to "The State of Our Nation's Youth," while 27 percent reported that it is a "minor problem," and 65 percent "not a problem."

Just when many children are beginning to wonder what drugs feel like, they are learning little more than how to avoid them. And that kids hear this message from teachers or police officers in programs such as D.A.R.E. has sometimes been the source of public ridicule. While there is no hard evidence that using police officers to teach kids about drugs doesn't work (no studies have yet been done to determine this), most experts suggest that law enforcement may not be the most effective mouthpiece.

"We're looking at that now," Sloboda says. "Things have changed. Since Sept. 11, there's a renewed respect for firemen and police officers and the military."

Others argue that students learn best from people who can impart some sort of wisdom based on experience. And yet it is a rare program that allows students to hear from current, or former, drug users.

Ron Clark, the 2001 Disney Teacher of the Year and author of the best-seller, "The Essential 55," says the message itself is muffled if kids cannot relate to the messenger. "A lot of people in these programs just aren't the right individuals," he says. "They don't bring a real passion to the subject, and the kids get bored to tears. Whoever is doing the awareness program has to be someone the kids like and trust."

AS DRUG USE FLUCTUATES, PROGRAMS RARELY ADAPT: Patterns of drug use shift regularly - and sometimes dramatically - often without apparent explanation, yet drug-education curricula generally fail to adapt to such changes. "The perpetual introduction of new drugs," the study finds, "helps to keep the country's 'drug problem' alive."

Talking about drugs: The toughest conversation

By the time I neared the end of my dozens of interviews for this series, I had it down to a science: two minutes. No more, and rarely less. I had two minutes to convince each person that this was a story they could be a part of without giving up too many secrets.

Maybe it's because, with so many people having either tried an illicit drug or knowing someone who has, the subject feels too personal. Or maybe it's a more general concern about having one's name attached to something so dark, so forbidden.

But one pattern quickly emerged: No one wants to talk about drugs - and that's especially true for adults.

I don't mean to imply that his voice didn't drop an octave when Jordan Temple spoke of his aunt, who has used crack cocaine for as long as he can remember. Or that he didn't choke up when he spoke of his siblings and the need, if only as a role model, to stay clean.

And I don't mean to imply that she didn't blush when I got around to asking Isabel Maremont some of the tougher questions: Has she ever tried drugs? Does she think she ever will? A tiny voice in the back of my mind wondered: Is it any of your business? Her eyes, so honest, so disarming, almost said, "Yes, it is."

What struck me more than the shyness of the students was the language of the experts. Sure, they'd like to discuss drug education. Sure, they had plenty to say about what they have and haven't learned.

But the moment I asked why kids might be attracted to drugs, the language transformed into policy speak, into a prose so formal it was unclear whether I was getting even the tiniest glimpse of their beliefs.

"We're putting in place additional quality control measures to ensure proper diffusion," one expert told me. Another surmised: "You can't go into a very brief intervention with kids and say their developmental course has been changed forever."

It was as if I'd set off an alarm. I couldn't help but wonder if these kids - who constantly spoke of the importance of "keepin' it real" - trust adults a little bit less when the language strays from sincerity to discomfort and obfuscation.

Programs that hold promise

CASASTART - www.casacolumbia.org

Developed by The National Center on Addiction and Substance Abuse at Columbia University, CASASTART (Striving Together to Achieve Rewarding Tomorrows) is a community-based, school-centered program designed to build resistence to drugs and crime in "high-risk preadolescents" between the ages of 8 and 13. The program brings together some of the key stakeholders (schools, law enforcement, social services, and health agencies) under one umbrella and works daily with children.

FAST - www.wcer.wisc.edu/FAST

Designed to build protective factors for students ages 4 to 12, and to empower parents to be directly involved in their own children's understanding of the dangers of drugs, Families and Schools Together (FAST) was developed in Madison, Wis., in 1988. Its key distinction: Team members do not lecture at FAST, but plan participatory activities that involve turn taking, experiential learning, and parental support. FAST is now implemented regularly in 45 states and five countries - Canada, Germany, Australia, Austria, and Russia.

Too Good For Drugs - www.mendezfoundation.org/educationcenter/tgfd

Too Good For Drugs is a school-based prevention program designed to reduce the risks and enhance the protective factors related to alcohol, tobacco, and other drug use among students grades K-8. Each grade level follows a separate curriculum, and each curriculum is designed with the specific goal of lifelong retention in mind. Too Good For Drugs also focuses on five broader skills: goal setting, decision making, bonding with peers, identifying and managing emotions, and communicating effectively.

Peers Making Peace - www.pmuinc.com

Developed with children grades six through 12 in mind, Peers Making Peace offers unique "peer-mediation training" in groups of 15 to 24 students. Using students as active mediators, each participating school develops a program that deals with conflicts among students to reduce suspensions and expulsions, as well as to improve school attendance and academic performance. The idea behind Peers Making Peace is rooted firmly in the importance of helping children take responsibility for their actions.

Fighting Back: www.fighting-back.org

Although still little more than a pilot program, Fighting Back has demonstrated remarkable success in reducing substance abuse among youth aged 12-17 in the Santa Barbara, Calif., county school system. The community-wide effort to build a safer, healthier, and drug-free community focuses on reducing the demand for alcohol and other drugs. It addresses issues contributing to substance abuse, rather than simply teaching denial skills. The community-wide strategies evolved into a long-term local intervention designed to reduce the problems associated with substance abuse through heightened public awareness, increased community outreach, and better institutional infrastructures (school, hospitals, etc.). Its long-term strategy aims at changing the way individuals and organizations think about substance abuse and at providing better responses to the various problems that it can cause.

For a more comprehensive list of model drug programs, visit www.modelprograms.samhsa.gov