One day last summer, my seven year-old came home from day camp in tears. After much coaxing, she revealed that she'd seen an anti-drug presentation that day.
"They said drugs can kill you, and that wine is a drug," she wailed. "And Daddy drinks wine." She was convinced that her father was courting death when he downed his glass of Shiraz each night at dinner, and it took several days' worth of debriefing to convince her otherwise.
At the time, I tried to view the experience philosophically. The camp she was attending served kids with a variety of special needs -- physical disabilities, learning disabilities, emotional problems -- along with a sizable contingent of "at-risk" (i.e., poor, inner-city) kids. Overall, it was a fantastic, inclusive program, and while my child had never heard of drugs before that day, it's likely that some of her campmates had already confronted the issue, or would do so soon. So who was I to say that seven-year-olds didn't need to be preemptively scared straight?
But just a couple of months later, we were hit with a full-on anti-drug propaganda blitz. A notice came home from the counselor at the small private school my two daughters attend, announcing Red Ribbon Week: five solid days of "age-appropriate" drug abuse prevention activities that, the flyer promised, would build our children's self-esteem and educate them about the dangers of illicit substances. At the same time, little red ribbons began to appear on school fences, public and private, all across the city: Red Ribbon Week, I soon learned, is one of the most widespread anti-drug events in the country. One day, the kids at our school all wore funny hats. Another day, they came to school dressed as what they want to be when they grow up (the lesson being, I suppose, that if you get high, you'll never make it as a Disney princess). They learned anti-drug chants. The fifth-graders put on a play, "Little Red Ribbon Hood," in which the big bad wolf tries to get the protagonist to huff spray paint, smoke cigarettes and drink. And they all made handprint pictures inscribed with a solemn pledge: "These hands will never touch drugs."
Frankly, all this stuff made me squirm. But I tend to overcomplicate issues that seem perfectly straightforward to normal people, and I knew there was no way I could lodge a complaint with the school about this. I could just picture the hurt, shocked look on the counselor's face if I questioned her efforts. "But we're only trying to keep your children off drugs," she'd say. "Are you saying you want them to take drugs?" So I held my tongue. My kids seemed to enjoy the activities and to find the "Drugs are bad -- don't do drugs" message palatable enough, and my kindergartner was unperturbed. But my second-grader continued to get anxious if anyone said the word "drugs" around her. "Don't talk about that!" she'd shriek, covering her ears. Now, nearly a year later, she still harbors the fear that she will be one day forced to take drugs. For her, drugs have become just another childhood bogeyman. She doesn't quite believe me when I tell her not to worry about it.
But she hasn't yet asked any of the really hard questions -- unlike my friend's exceptionally bright kindergartner, who came home from his first day of Red Ribbon Week asking all manner of uncomfortably probing (but eminently reasonable) questions, like "If drugs kill you, Mommy, then why do people take drugs?" He's a persistent tyke, and because she doesn't like to flat-out lie to him, she found herself admitting that people take drugs to feel good, and that marijuana is actually legal in some countries. "He ended up asking me if I thought a close friend of our family, who is European, has ever smoked pot," she said. "What could I say? I've smoked pot. Our friend has probably smoked pot within the past month. And he's still alive. Does my son really need to work through that at age five?"
Like most of the thoughtful parents I know, my friend is a bit ambivalent about the whole anti-drug thing -- even as she worries that her authority-questioning kid will turn out to be a hopeless stoner one day. Certainly drugs are bad, and I will be quite content if my girls don't smoke pot, snort crushed-up Ritalin tablets, or binge drink when they're teenagers, just as I'll be pleased if they don't join Campus Crusade for Christ or get their tongues pierced. But all too often, these anti-drug programs seem to put parents in an impossible position: We must either agree with pronouncements and propaganda we know to be false or exaggerated, or we must engage our children in awkward conversations about complex subjects they are too young to understand. And while it's a simple matter to get kids under ten to accept black-and-white pronouncements like "Drugs kill you" or "Don't tell lies" or "Beauty is only skin deep," I wondered what would happen when they hit middle school, and the costumes and handprints are forgotten or despised as relics of childhood. And what happens the first time they meet someone who admits to having tried pot and is, miraculously, still alive?
If someone could demonstrate that these scare tactics and charades will do any good when the time comes for my daughters to actually turn down their friend's mom's OxyContin, I would find them more palatable. But as Red Ribbon Week crescendoed to the "Red Ribbon Rally" (skits, poems, raps, and songs), I had a gloomy suspicion that in the long run, its message might turn out to be worse than useless. After all, I'm a member of the "Just Say No" generation, and all I remember about that reprogramming effort was having a good laugh at it while feeling rather ... merry. I wanted to know if anti-drug programs had become any more effective -- or any less ridiculed by their youthful targets -- than they had been when I was coming up. I wanted to know if there was any good reason to start lecturing kids about dope in kindergarten (and if there mightn't be a way of doing so that would generate less fear and confusion). And I did, despite my crotchety attitude, genuinely want to know if there was anything I, the school, the government, or anyone else could do to prevent my kids from becoming hard-core drug addicts one day.
To be sure, most parents wouldn't deny we have a problem with drug use among teens. By twelfth grade, 48.2 percent of American kids will have tried illicit drugs (including alcohol) at least once, according to 2006 data gathered by the University of Michigan's Monitoring the Future project, a government-funded study that has tracked rates of youth substance abuse for more than thirty years. That's a decrease from 1999, when that number was 54.7 percent, but (barring some sort of massive social upheaval) it is a near certainty that a significant proportion of grade-schoolers will one day break their sweet handprint promises. Not to pursue a life of hopeless addiction, necessarily, but perhaps to smoke pot a few (or a few dozen) times, and, if current trends continue, to use prescription drugs cadged from the family medicine cabinet to get high (a new pastime known as "pharming"). Some of them will try terrifying adolescent stunts like huffing or the "choking game," in which you asphyxiate yourself to the point of getting a head rush (and, in a few horrible instances, to the point of death).
But mostly, they will drink. Despite the hype over marijuana, ecstasy, and meth, alcohol remains by far the most common mood-altering substance used by adolescents: in 2006, about 45 percent of twelfth graders and 17 percent of eighth graders had taken a drink in the previous thirty days, according to Monitoring the Future data; the corresponding numbers for marijuana use are 18 and 6 percent. Twelfth-grade lifetime usage figures for hard drugs like cocaine, ecstasy, and methamphetamine are in the 1 and 2 percent range, and even lower for heroin. Even at the height of the crack epidemic of the late 1980s, only 5.4 percent of seniors had tried it. Just like my daughter's camp counselors told her, alcohol is a drug -- and it is far more likely to get her in trouble one day than any other substance (except perhaps, in the long-term, nicotine, the other state-sanctioned drug). Youth drug prevention as we now know it got its start in the 1980s, with Nancy Reagan's "Just Say No" campaign, a response to a rate of teenage drug use that reached an all-time high in 1981, when 65.6 percent of high school seniors reported on Monitoring the Future surveys that they had tried illicit drugs. Hard on the heels of Just Say No was the founding in 1983 of D.A.R.E. (Drug Abuse Resistance Education), a national nonprofit organization that now sends trained police officers into 75 percent of the nation's school districts to teach kids, usually fifth and sixth graders, about the dangers of drugs. Three years later, in 1986, came the Partnership for a Drug-Free America, a coalition of advertising people interested in using their marketing skills pro bono to discourage youth drug abuse. The Partnership made its first big splash with the "This is Your Brain on Drugs" spots -- which, of course, gave rise to endless ironic jokes made while sucking on a bong -- and followed up with classics like the ad that depicted a girl diving into an empty swimming pool and the one in which the actress Rachael Leigh Cook smashes up a kitchen to demonstrate the proposition that "this is your brain on heroin."
While incorrigible stoners may have giggled at such excesses, from the point of view of the nascent drug prevention movement, these efforts seemed to be working. By 1991, the number of high school seniors who had tried illicit drugs dropped to 44.1 percent. Marijuana use declined from 60.4 percent in 1979 to 32.6 percent in 1992. And a couple of years later, when television stations became increasingly reluctant to donate the airtime needed to show Partnership ads, rates began to creep back up again, with marijuana use climbing to 49.6 percent in 1997, and general illicit substances to 54.7 percent in 1999. Both the initial drop and the subsequent rise seemed to indicate that the ads and the in-school programs like D.A.R.E., Project ALERT and Red Ribbon Week, which got its start in 1985, had worked.
The government, at least, was convinced enough of a cause-and-effect relationship that the Office of National Drug Control Policy (ONDCP) -- the Drug Czar's office -- teamed up in 1998 with the Partnership for a Drug-Free America to create the National Youth Anti-drug Media Campaign, which would slot Partnership ads into airtime bought with public money -- some $1.4 billion over the next eight years. And presto: today, youth drug use is once again trending down. Data from 2006 showed lifetime marijuana use at 42.3 percent among twelfth graders and "any illicit drug" at 48.2 percent, continuing a decline that began around 2000.
So, good news, right? We're on the right track: we just need more and better ads, cop lectures, and skits and we can rest assured that our kids won't end up burnouts.
If only it were so simple. While massive, long-term surveys like Monitoring the Future and the Department of Health and Human Services' National Survey on Drug Use and Health are considered a reliable measure of trends in drug use, it's not so easy to definitively identify the causes behind the shifting numbers. As with the steep drop in the violent crime rate that began in the early 1990s, which has been chalked up to everything from tougher sentencing laws to legalized abortion, changing rates of youth drug use could be due to any number of causes: economic, cultural and political trends; geopolitical events affecting drug pricing and availability; the coming of age of the "echo boom" generation; or a combination of factors.
As it turns out, numerous university and government studies have found D.A.R.E. -- by far the country's most widespread school-based drug education program -- useless in preventing youth drug use in the long-term. A six-year University of Illinois study released in 1998 reported that suburban kids who had taken part in D.A.R.E. had "significantly higher levels of drug use" than those who hadn't.
And in 2005, a five-year, $42.7 million, government-funded study by the University of Pennsylvania and Westat, Inc., a Rockville, Maryland, research corporation, concluded that the Youth Anti-Drug Media Campaign was totally ineffectual at preventing drug use by teens.
The Westat study, which surveyed between 2,000 and 4,000 nine- to eighteen-year-olds each year for four years, found that exposure to the ads led to higher rates of marijuana initiation among non-users, a result known as the "boomerang effect." While self-reporting has obvious limitations for pinpointing the number of kids using drugs at a given time (kids reported their attitudes and drug use on in-home touch-screen surveys; they can easily lie) it is considered more reliable as a measure of change in use over time, because if they are lying, they are likely to do so with some consistency on each year's survey, unless there's a major cultural shift.
Robert Orwin, Westat's principal investigator on the study, says that he and his colleagues were surprised to find that the Media Campaign produced a boomerang effect, but they "couldn't make it go away." He offered a theory on why it might be so. "The message was that drugs are bad for you; don't do drugs," he says. "The meta-message was that a government agency is spending all this money and all this effort to tell me how bad drugs are, so everybody must be using drugs."
Orwin is also critical of the "Reefer Madness"-style hysteria of some of the ads. (For the record, he believes that it is dangerous for kids to smoke pot.) Particularly memorable was the ad in which one tween blows another away with his father's gun after the two are seen smoking pot. In another TV spot, some stoned kids in an S.U.V. run over a little girl on a tricycle. Orwin suspects that many teenagers, who "aren't stupid," viewed much of this rhetoric as pure comedy. "The ONDCP and the Partnership claimed that they copy-tested the ads with kids, trying to get their near-term reactions, and that the kids liked the ads," he says. "I found that hard to believe. If the kids said they found the ads persuasive, those kids were goofing on you. Because they couldn't possibly have believed that."
At the heart of this debate is the question of whether the advertising industry's well-oiled system of marketing theory and research methodology can convince kids not to buy something -- in this case, drugs -- as successfully as it can convince them to buy toys or breakfast cereal.
Tom Hedrick, senior communications officer and a founding member of the Partnership for a Drug-Free America, says yes. "The people that started the Partnership believed that while drug abuse was a very complicated psychosocial issue, that at the very front end of the problem a choice to use was involved, and that the choice to use was not unlike that for products and services," he says. "And that the science and art of marketing and communications, which had been used for many years to sell products and services, could be inverted and used to help un-sell the product to the American public and to kids."
Public service ads directed at kids have, in fact, convinced them to refrain from doing things they're attracted to, such as smoking. A study in 2002 found the "Truth" anti-smoking campaign effective. The campaign was created by the American Legacy Foundation, a group underwritten with tobacco settlement money. But the same study found that Philip Morris's "Think: Don't Smoke" ads increased the likelihood that kids would take up smoking. Clearly, not all "un-selling" is created equal.
"In the case of [the anti-smoking ads], kids were more heavily involved in the design," says Orwin. "And the target, in terms of who was in a sense the bad guy, was Big Tobacco. If you quit smoking, you're not only doing something for yourself: you're also doing a rebellious, antiestablishment act. With drugs, there isn't anything like Big Tobacco you can put up there as the enemy."
The Partnership's Hedrick points out that no industry has ever been able to show a strict causal link between advertising and an increase in business. He suggests that a new standard be used for evaluating anti-drug ads' effectiveness. "Common sense and observation suggest that during the campaign, there has been a more than twenty-five percent decline in illicit drug use among teens," he says.
The government, at least, seems to buy that argument. President Bush has requested a $30 million increase in funding for the Media Campaign in his 2008 budget. (The new Democratic chairman of the House subcommittee that oversees the Drug Czar's office, Rep. Dennis Kucinich of Ohio, is an outspoken critic of the War on Drugs, however, so that appropriation will no doubt be scrutinized closely.)
Though government-funded anti-drug advertising seems set to continue full steam ahead, heavy-handed ads of the flattened trike variety probably won't reappear anytime soon. A new crop of ads, created by the Portland, Oregon, firm Wieden + Kennedy for a new campaign called "Above the Influence," takes a different approach. One series depicts wry little animated scenes, like a dog expressing disappointment at his stoner master asking him to walk himself. Another spot, in faux-documentary style, reveals a made-up fad called "Slomming," an acronym for "Sticking Leaches On Myself." Adolescent actors display leeches they've attached to their bodies and talk about the practice as something that's "hard not to get into" because everyone does it, and the final tagline is "What could you be convinced to do?"
My personal favorite, "The Conversation," depicts a boy receiving a phone call from a friend with whom he'd been partying the night before. We only witness one side of the conversation. "How did she get home?" he asks, then offers, "Man, I was so high, I didn't. ... Are we cool?" And after a pause, a quietly anguished, "Tim, you know me. That's not me." We don't know what awful thing he's done -- did he hook up with his best friend's girlfriend and then abandon her in a 7-11 parking lot? -- but the ad is hard-hitting and haunting in a totally insidious way, far from the browbeating and threats of ads past. Kids are not being told that they'll die if they get high, just that there may be unpleasant consequences.
The new ads' relative subtlety is more likely to strike a chord with kids than over-the-top scare tactics, says Mark DiMassimo, creative director of the advertising agency DiMassimo Goldstein, and a former member of the Partnership's creative review committee.
"The fact is that the light touch works," he says. "The government is not going to fund anything that encourages anything illegal, obviously. But on the other hand, a savvier approach, a soft touch dealing with social fear rather than mortal fear -- ultimately, what we're selling is a kind of self-actualization."
Kids may respond well to these ads, as DiMassimo suggests. Certainly, they are good entertainment. But according to Westat's data, kids approved of the earlier Media Campaign ads, too. According to Orwin, it was the later, more highly-rated spots -- the "Marijuana Initiative" ads that began in late 2002 -- that were found to have the greatest boomerang effect. Perhaps the kids in the focus groups weren't "goofing" on the Partnership, as Orwin surmised. Perhaps they really did find the ads insightful and persuasive. But maybe kids' immediate response to an ad has little relation to its ultimate effectiveness -- unless, perhaps, it's an inverse one. Maybe what the ads accomplished was simply "substantial recognition" of the brand "Pot."
Because of drug ads' apparent risk of backfire, it may be school-based drug education that offers the best hope of steering kids away from addiction, even though sitting in a gym listening to a police officer or teacher talk about drugs can't rival the glamour of slick ad campaigns produced by the country's top agencies. A face-to-face program can offer more nuanced information than a thirty-second TV spot, along with the chance for kids to ask questions and discuss the issues, and an opportunity for teachers to gauge their students' knowledge, attitudes and risk level. However, much like other anti-drug efforts, school-based prevention programs have had something of a checkered past.
One has managed to build a near-monopoly. Founded in 1983 by the Los Angeles Police Department, under the leadership of former Police Chief Daryl Gates, the D.A.R.E. program consists of seventeen weekly lessons aimed mostly at fifth- and sixth-graders. The participating officers focus on "resistance education": telling kids about the dangers of drugs, building their self-esteem, giving them positive alternatives to drug use, and arming them with ways to say "No" to peer pressure.
After a 1986 study by National Institute of Justice (NIJ) found that D.A.R.E. produced positive outcomes, the program started receiving federal funds, supplemented by private contributions, merchandising royalties, and the willingness of local communities to donate police officers' time. By 2000, according to a Government Accountability Office report published that year, D.A.R.E. was operating in 80 percent of school districts in the United States and receiving a share of the Department of Education's $439 million in drug prevention grants. Although no one (including the GAO) seemed to know how large a share of the federal prevention budget went to D.A.R.E., a 1993 USA Today story reported that the nonprofit was taking in $700 million a year in public and private funds.
There were other prevention programs out there, but D.A.R.E. was the most widespread, the richest, and, with its iconic red and black bumper stickers, by far the most visible. Parents, politicians, and school officials loved D.A.R.E.: it made them feel that something was being done about the drug problem (and it didn't hurt that a substantial proportion of its budget came from private donations). The kids enjoyed the logo-emblazoned booty and the contact with personable police officers. Over the years, the core curriculum was periodically updated to include new drugs (tobacco, inhalants) and new issues (conflict resolution, gangs).
But amid the accolades, there was just one little problem: after the NIJ's initial positive findings (later criticized for poor design), study after study by university researchers and government agencies began to show that D.A.R.E. simply didn't work. In 2000, the Department of Education announced that it would no longer let schools spend their federal drug prevention funds on D.A.R.E. Finally, after a decade of dismissing negative scientific studies (D.A.R.E. Executive Director Glenn Levant once quipped, "Scientists will tell you bumblebees can't fly, but we know they can."), D.A.R.E. unveiled a brand-new curriculum in 2001, aimed at seventh- and ninth-graders instead of fifth- and sixth-graders, and announced a five-year longitudinal study of its effectiveness to be carried out by researchers at the University of Akron.
The new curriculum, called "Take Charge of Your Life," designed to be less preachy and more interactive than the old D.A.R.E. model, is patterned after less widely used but more effective programs that employ peer group discussions, games, and role playing. Preliminary findings, released last year, seemed cautiously optimistic, announcing that the program "may be effective in reaching those adolescents who are at elevated risk for substance abuse." No conclusions have yet been offered as to whether the program decreases those kids' drug use, though; final results will be released later this year.
The study's principal investigator, Zili Sloboda, spent years as a National Institute on Drug Abuse researcher, evaluating the efficacy of prevention programs and coauthoring a government pamphlet on effective programs for schools and parents (D.A.R.E. is conspicuously absent from the list of "science-based" programs). She says the original D.A.R.E. was too didactic, with a police officer at the front of the room delivering content to a passive audience. "The programs that have been demonstrated to be effective are based on getting kids to use critical thinking skills," she says. "That's how kids learn." Take Charge of Your Life presents the instructor (still a cop) as a guide or coach, not as a lecture-giving heavy. It also helps students develop problem-solving skills by presenting them with drug or drinking scenarios and asking them to discuss how they would react.
Reading through the NIDA booklet Sloboda helped to research, I was struck by how much emphasis the approved programs place on issues other than drugs. In fact, none of the four elementary-level programs the booklet endorses seem to mention drugs at all. They focus instead on encouraging positive relationships between kids and their environments -- schools, teachers, families, and peers -- and helping them achieve a sense of academic and social competence. The goal of recognized programs, such as the Caring School Community Program, SOAR, and PATHS, is to enhance the "protective factors" believed to reduce a student's future likelihood of drug abuse, not to provide young children with information about drug risks and peer pressure. (Nor, I couldn't help noting, to require "pledges" about their future behavior).
"When kids fail in school, especially early on, this puts them on a trajectory that puts them at risk for substance abuse later on," Sloboda says. "In elementary school, one important component is that you want academic programs introduced so that kids can succeed. Another is to help them develop prosocial attitudes, and to get them involved in prosocial activities" -- drama, sports, music, art.
But she cautions that the research on why kids do drugs is far from definitive, and that different kids try drugs for different reasons. "More kids initiate than get dependent and continue use," she says. "A very high percentage -- between 80 and 90 percent -- tend to initiate and stop." This group, she says, tries drugs as a social thing, and because it's fun. The 10 to 20 percent that develop a problem usually have more deep-seated emotional or psychological problems.
I asked Sloboda if a successful prevention program for older kids should at least own up to the existence of the "fun" side -- in addition to the self-destructive or self-medicating aspects -- of drug use. "I think a lot of these programs are very realistic in that regard," she says. "I did observe the delivery of [the new D.A.R.E.] in the classroom, and one thing that was very striking to me was the fact that kids are actively engaged in conversations about these very issues."
But a nuanced, engaging approach to drug education -- not to mention all those music, art, and drama programs -- can be costly and complex. Many of the more successful programs are intensive: you have to train teachers, use classroom time, invest in materials. Even then, they often require booster programs to maintain their effectiveness in the long-term. The website of LifeSkills Training, a widely praised program developed at the Weill Medical College of Cornell University, cites research demonstrating that graduates of its middle-school program remained less likely to use drugs six years later, in twelfth grade -- but that's after fifteen sessions in seventh grade, ten booster sessions in eighth grade, and five in ninth grade.
If there is any long-term benefit to be gained from exposing elementary school children to explicit talk of drugs, though, I have yet to find it. Some of the research on the original D.A.R.E. program for fifth- and sixth-graders pronounced it useless even in the short-term, hence the recent shift to seventh and ninth grades. And Red Ribbon Week, the program my children have been through, has never been subjected to an evaluative study of any kind, according to Peggy Sapp, executive director of the National Family Partnership, its parent organization. Indeed, experts like Sloboda say that the basic research on how younger kids respond to drug prevention hasn't yet been done. "My opinion is that we don't really know how to deal with this issue with younger kids," Sloboda says.
For teens and tweens, scientifically validated programs like those in the NIDA pamphlet (and, maybe, the new D.A.R.E.) may offer a good deal more in the way of useful skills and positive attitudes than "Just Say No" or even "Slomming." But they nonetheless adhere to the bedrock ideology that has defined anti-drug programs since the federal government began to fund them in the 1980s: abstinence only. No reputable prevention researcher would suggest telling kids that it's okay to break the law "just a little bit," but some experts do believe drug education has been in a decades-long state of denial about the fact that many kids are going to try drugs no matter what you tell them, and that while total abstinence is an admirable goal, an important corollary should be the reduction of risk and harm for those kids who don't achieve it -- and helping those who dabble to be part of the 80 to 90 percent that don't go on to dependency.
"Abstinence is the best choice regarding drugs. To me that's a no-brainer," says Marsha Rosenbaum, director of Safety First, which bills itself as "a reality-based approach to teens, drugs, and drug education." (It is an arm of the Drug Policy Alliance, a group devoted to ending the "War on Drugs.") "However, what is also true in America today, is that if you define drugs broadly as any substance that changes the way you think, feel, and perceive the world, drugs are everywhere. Legal and illegal drugs, alcohol, pharmaceuticals, over-the-counter substances that are mind-altering. Drugs are part of American culture, whether we like it or not."
Rosenbaum is a medical sociologist who spent eighteen years researching drugs like crack, heroin, and methamphetamine as a NIDA grantee. She says she had an awakening of sorts when her daughter, then in fifth grade, came home from a D.A.R.E. presentation announcing that she "knew everything" about drugs. "She drew a picture on the chalkboard, a big circle with a lot of little circles inside," Rosenbaum says. "She said, 'The big circle, that's your brain. The little circles are your brain cells.'" Then Rosenbaum's daughter picked up an eraser and proceeded to wipe away half of the little circles. "'When a person smokes marijuana,' she said, 'half of their brain cells get erased forever.'"
Rosenbaum was dismayed. "I worried that kids would learn that they had been lied to," she says. "And that the kids would throw the baby out with the bath water, and not listen any more to anything adults told them about drugs. It's the problem of cynicism, which I had encountered in my research with heroin addicts" -- many of whom, she says, had tried marijuana, found that it did not cause the dire harm they'd been warned against, and as a result had dismissed the entire anti-drug message.
Rosenbaum strongly advocates abstinence, but also recommends a "fall-back strategy" for teenagers (and parents) who choose not to abstain, an approach she says is nowhere to be found in conventional drug education. She believes drug prevention programs should provide scientifically accurate facts about drugs, refrain from scare tactics, and outline strategies for risk reduction to those who need them, particularly with regard to alcohol (don't drink and drive, for example, and be aware of the signs of alcohol poisoning) and marijuana (don't smoke pot every day or before school).
Some prevention groups dismiss views like Rosenbaum's as part of a hidden "legalization agenda." Other drug researchers and educators may very well share some of her beliefs in private, but if they need federal funding to do their work, they can't voice such radical notions, and their curricula can't include risk-reduction provisions for kids who use drugs. "In order to get federal funding, the [sole] message has to be that drugs are harmful and wrong," she says. "That language is in the federal statute."
Ironically, it may be the nation's poorest, most drug-ridden schools that can serve as laboratories in which innovative approaches to drug education can be developed, flying under the radar of federal law. UpFront is a San Francisco Bay Area initiative that got its start in one such urban school, Oakland High, nine years ago. Charles Ries, UpFront's director, says that he doesn't run an anti-drug program -- or, at least, not one whose prime directive is to convince kids not to do drugs. "We're more about supporting the students," he says. "What we believe is that having a genuine conversation with young people about what they believe and know about drugs, and why they believe it, is the only way to reduce the risk and harm connected to adolescent drug use."
UpFront developed its approach by asking Oakland High students, who live in an area that serves as a regional drug market, what type of drug education they would find most helpful. The kids asked for small, confidential discussion groups. That's what they got: workshops focusing on open communication, risk reduction, and complete and honest information about what Ries, in a locution that would probably send a conventional prevention expert screaming for the hills, calls the "pros and cons" of drugs. Topics for discussion include alcohol overdose prevention and intervention, distinguishing between casual and harmful use, and the fact that while people may initiate drug use out of curiosity, they continue to use because the drug delivers some sort of benefit to them. "We discuss what this benefit might be, the cost of achieving it, and whether it is worth it," Ries says. His students' questions, he adds, are often driven by their desire to understand a personal drug experience.
For this struggling student population, Ries says, this was the only approach that had a prayer of working. "As soon as we opened our doors, folks started showing up, and they continued to come, I think because we didn't really push any anti-drug agenda down their throats," he says. Although abstinence is not the program's main goal, Ries says that it has produced decreases in drug use at the school. "It's self-reported, but the students absolutely say that the program makes them less likely to use drugs," he says.
Despite the fact that its message is anathema to the feds, UpFront's funding initially came from the U.S. Department of Education's Office of Safe and Drug-free Schools. (Now, with the school district in bankruptcy, funding comes from other sources.) In a less chaotic district, Ries says, the program probably never could have gotten off the ground.
"There was not a lot of close oversight," he says. "But the money continued to come, because the outcomes we were able to capture were really good. We never really talked about anything we did that was out of the ordinary, until the district decided that our school would be one of the schools they'd use for a federal evaluation. We told them exactly what we did, they talked to the faculty and students, and they rated our program exemplary. Then we felt like we could really come out and talk openly about our approach and why it was successful."
UpFront now offers training and workshops for other schools -- including elementary schools -- and may soon be implemented in the San Francisco school system. In workshops for younger kids, Ries says, the approach is similar, emphasizing information and discussion. "We ask students to talk about whether they've already had a drink, who gave it to them and why, and how confusing those messages can be when the person who gave us our first drink is the person telling us we shouldn't do it," he says. "We help them tease out the mixed messages they will have gotten about drugs, alcohol, and smoking. It's more of an exploration of what they believe, their experiences, with a little health education thrown in, than an attempt to convince them that something in and of itself is harmful or wrong."
As for "I will never do drugs" pledges, he says, "I think it's crap. You don't want to ask people to be perfect. It's just a set-up, especially for young folks."
Meanwhile, the Bush administration is pushing a new approach to the youth drug problem that circumvents education altogether: random drug testing for public middle and high school students, a program that is already up and running in more than a thousand schools. If kids at those schools want to participate in extracurricular activities, they must submit to the tests. The program is set to expand, with the Department of Education offering grants to schools interested in starting or expanding drug testing. The Drug Policy Alliance -- the group that wants to end the War on Drugs -- calls testing "an easy anti-drug sound bite for the White House," and says it won't work. This claim was confirmed by a 2003 University of Michigan study of 76,000 students that found drug use to be just as common in schools with testing as in schools without it. In any case, if "prosocial" activities like sports and music are among the most important protective factors against drug abuse, it seems counterproductive to drive already troubled kids away from them.
Mainstream prevention experts also have reservations about testing. Zili Sloboda, the D.A.R.E. researcher, told me that she recently attended a parent meeting at her local middle school, at which school staff and police officers presented information about heroin and other drugs. "The law enforcement officers and prevention staff spoke to the parents about the availability of home [drug testing] kits that can be purchased at Wal-Mart and local drug stores," she says. "The parents wanted the schools to do the testing. My concern, shared by the prevention specialists, is what do parents do when they find that their children test positive? I don't think most people think about the post-testing phase, the most challenging of all."
Whether widespread drug testing will reduce drug use remains to be seen, but I am pretty sure I don't want to see my girls have to pee in a cup to be in the school play. Regardless of what kind of drug education or interdiction they are subjected to, though, I will still wonder when, if ever, it will be okay for me to be honest with them -- about their experiences, and about my own -- and whether honesty, as Ries suggests, might be more helpful, in the long run, than an abstinence-only stance.
But even faced with numbers that are, on some level, encouraging -- a lot of kids may try drugs, but 80 or 90 percent of those kids don't become addicts -- drug authorities usually advise us to take a firm, unequivocal stand against all drugs, all the time. Theantidrug.com, the National Youth Anti-drug Media Campaign site for parents, recommends that parents "state clearly to their pre-teens and teens that they would be very disappointed if they started using marijuana" (emphasis theirs). If your child asks you about your own checkered past, the website recommends that you be honest -- but emphasize the negative consequences of your drug use. One suggested response: "When I was a kid I took drugs because some of my friends did. I wanted to in order to fit in. If I'd known then about the consequences and how they would affect my life, I never would have tried drugs. I'll do everything I can to help keep you away from them."
Far superior to "Just Say No," as far as it goes. But does it go far enough? What if you took drugs a few -- or a bunch of -- times and there were no major consequences? What do you say when they press you: "What kind of consequences, Mom?" Just how big of a web of lies are we expected to spin?
When I was seventeen and about to go off to college, my parents found out that I had dabbled in drugs, and all hell broke loose. They screamed at me for several hours, banned me from seeing my friends or leaving the house except to go to work for the rest of the summer, and sent me to a drug counselor (who, quite reasonably, concluded that I was an experimenter, not a budding addict). I think they were pretty shocked: I was an excellent student, held down a job, and was fairly obedient, overall. In any case, none of this drama did a thing to prevent my going off to college and trying nearly every drug known to humanity (and then getting into an Ivy League Ph.D. program, lest you think I spent years in the gutter as a result). This is not something I'd recommend to any teenager, and my actions most definitely contained significant risks, but were I to use the "negative consequences" gambit, I'd be hard-pressed to come up with any.
Years after my adolescent drug drama, after I had become a mother myself, my mom told me that she used to smoke pot occasionally when she was in her forties and I was still living at home. "I had to hide my stash from you," she said, laughing. "Everyone my age has at least tried pot. I'm not sure I'd want to be friends with someone who hasn't."
I must confess that even all those years later, I was not amused by this revelation. The memory of that struggle session was still painful. But I had to ask myself: in ten years, will I be screaming my head off after one of my kids comes home with bloodshot eyes? If I do, it will be for the same reason she did it: the clawing, clutching, debilitating fear that my child will come to some horrible end. It seems to me that for parents, all of this -- the lectures, the role-plays, the pledges, and the pee cups -- comes down to one all-important, all-consuming question: how can you tell if your kid will be a harmless dabbler or a hopeless junkie?
I decided to call up a friend who has two small children and a history of serious drug addiction -- who did suffer negative consequences, big ones, as a result of drugs -- for more insight. She's been sober for a long time, and though her toddlers won't face handprint pledges for another few years, she has already started thinking about how she'll talk to them about drugs when the time comes -- and about how she herself was taught about drugs during her own formative years. Surprisingly, she seemed calmer, when confronted by these questions, than many of the non-former addicts I know.
"I remember having a drug education course, in sixth grade," she says. "It was before the days of 'Just Say No.' It was more informational. By the end, I knew everything there was to know. And I felt both unrealistically confident that I'd never try drugs, and also unrealistically terrified, because it seemed like in junior high you'd have people coming up to you in the halls, poking you with needles full of drugs." Eerily, she chose to do her class report on heroin, the very drug she would become addicted to fifteen years later. In other words, she was a boomeranger, of sorts. "I do think I got a little interested in it," she says. "I found out how it made you feel, and that sounded appealing. Unlike something like LSD, which sounded horrible."
It's not drug experimentation, per se, that my friend blames for her addiction. She says that for her, heroin addiction was the culmination of a series of grim struggles: depression, anorexia. She worries that her own children may have inherited her addictive and depressive tendencies, and would like to keep them far from drugs for that reason. But she says she believes that kids will, inevitably, experiment, and that "abstinence only" is beside the point.
"You can't just say don't do it," she says. "Like with sex, you need to teach them to how to be responsible. But I don't know if you can teach a kid not to be a drug addict. I was self-medicating for depression, and I think [my addiction] could have been avoided. But probably not with a drug education program."
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