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Why Drug Education Doesn't Work



Source: Vancouver Sun (CN BC)
Author: Dan Gardner, The Ottawa Citizen 
Published: Monday, November 25, 2002
Copyright: 2002 The Vancouver Sun
Contact: [email protected]
Website: http://www.canada.com/vancouver/vancouversun/

Anti-drug programs makes adults feel good, but all they're doing is digging a giant credibility hole.

Marsha Rosenbaum says it was "a nice Jewish girl, just like me" who showed her what's wrong with trying to scare kids away from illegal drugs. 

At the time, 25 years ago, Rosenbaum was interviewing women addicted to heroin for her doctoral dissertation. She met the nice Jewish girl in jail.

"She was just the straightest-looking, middle-class woman," Rosenbaum recalls. "But our lives had taken such different turns."

"What happened?" Rosenbaum asked. "And she said, 'We had these so-called drug education classes and they said if you smoke marijuana you'll get addicted to it. And they also said if we used heroin we'd get addicted to it. Well, most of us tried pot and nothing happened. So when heroin came along, I figured the whole message must be b.s. so I went ahead and tried it. And here I am, strung out and in jail.' " 

What to do about illegal drugs is hotly debated, but one thing everybody agrees on is the need to educate kids. "Everybody wants to do prevention. It's a buzzword," says Senator Pierre Claude Nolin, the Conservative chairman of the Senate's special committee on illegal drugs.

Unfortunately, that consensus has led to a near-total lack of scrutiny. Who is teaching our children about drugs? What are kids being told? What is it supposed to accomplish? And most importantly, is it working? None of these questions has received much public attention.

As a result, drug education in Canada is a mess -- "not properly planned, not properly delivered, and definitely not evaluated," Nolin says.

In the committee's final report in September, a call to legalize marijuana stole the headlines. But the report also called for a radical overhaul of drug education: Canada's largest program needs to be thrown out, the senators said. Police officers should stop teaching kids about drugs. Even the basic goal must change.

Most addiction education -- with the notable exception of alcohol -- preaches only abstinence: Just say no.

That's not good enough, the senators conclude. Almost half of all teenagers say yes at least once in their lives. So drug education must teach students how to minimize the risks.

The goal shouldn't be to stop all drug use, which is impossible, Nolin says. "They should try to prevent the abuse of drugs" -- use that is extreme, dangerous, or risks creating addiction.

In September's throne speech, the government promised to introduce a new national drug strategy, the first in 15 years. Education will undoubtedly be part of that strategy.

Perhaps the most astonishing fact about drugs in Canada is how few facts we know.

In 2001, Auditor-General Sheila Fraser reported that the federal government does not even know how much it spends on drug programs and enforcement; she estimated $500 million a year. That excludes money spent by the provinces and territories. When Nolin's committee added the cost of municipal and provincial policing, it estimated that enforcement of drug laws alone costs Canadians almost $1 billion a year. 

What does this spending accomplish? No one really knows, says the auditor-general. To figure it out would take good information on rates of drug use, but the data is "sparse, outdated, or not available."

And drug programs are almost never tested for efficacy. In fact, they generally can't be tested because, the auditor-general notes, the government has never set "clear and measurable expectations or objectives."

The fog surrounding drug policy is particularly thick around drug education programs. How much is spent? No one knows. However, Fraser estimated that 95 per cent of federal spending on drugs goes to enforcement, leaving perhaps $25 million for everything else. As a result, the Senate committee concluded, resources available for the prevention of drug abuse are "woefully inadequate."

A central player in prevention efforts is the drug awareness service of the RCMP, which provides a variety of education programs. By far the largest is Drug Abuse Resistance Education. Created in the U.S., DARE brings police officers to classrooms to tell kids about the dangers of drugs and to teach ways of saying no. DARE has curricula that cover kindergarten to Grade 12, but the core program is taught to Grade 5 or 6 students, one hour a week for 17 weeks.

Community service clubs pay for workbooks, pencils and other supplies, while the police pay for the officers' time. Community groups usually pay for police officers to be trained as DARE instructors; while Ottawa does not contribute, the U.S. government has given $750,000 to pay for the training of Canadian instructors.

In 2001, the RCMP and other Canadian police forces took DARE into 1,811 schools in 585 communities. About 65,000 kids were involved.

The RCMP runs several other drug education programs, some in which kids are encouraged to get involved in sports as an alternative to drugs, others for parents or aboriginal students. In all, RCMP officers make about 10,000 presentations a year. 

With the exception of DARE, no program has been seriously evaluated.

"We've had anecdotal evaluation, but obviously that doesn't carry very far in terms of looking at whether we are really meeting the needs," says Corporal Mark Sorokan, one of 44 officers with the Drug Awareness Service. 

He agrees that "evaluation is key to any type of programming." But, he says, the Mounties just can't afford it.

DARE's efficacy has never been studied in Canada, either. But it has been evaluated in the U.S. The Senate committee reviewed that research and concluded that it's a flop.

DARE was developed in 1983 by Darryl Gates, then the controversial chief of the Los Angeles police department. (Gates later offered a more unconventional idea for drug policy when he told a U.S. Senate committee that casual drug users should be shot.) The program ballooned during the drug panic of the late 1980s. It's now taught in 80 per cent of U.S. school districts and has spread to 40 other countries.

That growth isn't based on a record of success. In 2001, a report by the U.S. National Research Council commissioned by the top White House official on drug policy -- the "drug czar" -- surveyed the extensive research on DARE and concluded the program has "little effect" on kids' drug use. That same year, a report from the U.S. surgeon-general's office concluded DARE had "little or no deterrent effect on substance abuse." In 1997, a report on crime prevention commissioned by the U.S. Congress was even more blunt: "DARE does not work to reduce substance abuse."

DARE's failure in the U.S. is well known among Canadian researchers. A 2001 report prepared for Health Canada noted that the American studies have "been consistent in showing that the program does not prevent or delay drug use, nor does it affect future intentions to do so."

When Canada's Senate committee reviewed the research, it was appalled. "This information is in the public domain," the committee report said. "It has been available for many years. Considering the limited resources available for the prevention of drug abuse in Canada, federal authorities and the RCMP ought to have looked at that information" before they brought DARE to Canada.

But DARE officials insist their program is not a failure. They point to research that shows students given DARE know more about drugs and have a more positive attitude about police. Surveys also show that parents, teachers and school administrators also tend to be satisfied with the program. DARE was recently given an award for making an "outstanding contribution to education" by the British Columbia School Superintendents Association, Sorokan notes.

"Almost any program makes adults feel good because they feel like they're doing something," says Marsha Rosenbaum, who is director of the San Francisco office of the Drug Policy Alliance, a non-government organization critical of American drug policy. But the point of DARE is not to spread good feelings but to reduce drug use, which it doesn't do.

DARE's defenders blame the schools. William Alden of DARE America says that, although the program has a full kindergarten-through-Grade 12 curriculum, "most of the communities in the United States and around the world only had the resources to implement the elementary school curriculum" in Grades 5 or 6. "Certainly, 17 one-hour lessons are not going to inoculate anybody" against drug use.

Critics don't buy the argument that there just isn't enough DARE.

"The problem isn't the extent of it, it's the content," says Rosenbaum. Both the original DARE and the pilot project have just one message: "Drugs are bad, you shouldn't do them, and here's how to refuse."

That message is a mistake, Rosenbaum says. For one, relying on the "badness" of drugs to scare kids encourages adults to exaggerate the dangers. Then, when kids see peers use drugs without falling to pieces, everything adults say about the subject becomes suspect.

"We have dug ourselves into a giant credibility hole." That's dangerous, as Rosenbaum found when she interviewed the heroin addict who figured "the whole message must be b.s."

And kids will see other kids using drugs. In the U.S., slightly more than half of high school seniors admit to having used at least one illegal drug. A 2001 survey of Ontario students found 43.5 per cent of teens in Grade 12 had used marijuana; 26.8 per cent had used some other illegal drug.

There are two main explanations for the failure of the Just-Say-No approach, Rosenbaum says. First, it bears no resemblance to reality.

"Adults regularly use alcohol," she notes. "We gobble pharmaceutical drugs as well as over-the-counter substances. Kids understand that coffee is a drug -- they know what happens in the morning when their parents get up and they've got to have that cup of coffee before they can speak." Children also see growing numbers of their peers being prescribed "kiddie cocaine" -- Ritalin and other stimulants. So rhetoric about living drug-free seems hollow, even silly.

Then there's the problem of adolescence itself. "It's a time in our lives when we're most amenable to experimentation, to taking risks, to pushing the limits. You tell a 15- or 16-year-old boy that something, anything, is physically dangerous and you're almost setting up a challenge," Rosenbaum says. Not surprisingly, drug use peaks in the late teen years. 

To parents, this may sound hopeless and frightening. But research consistently finds that such experimentation is not likely to end in disaster.

"Most adolescents who try alcohol or other drugs do not become frequent or problem users," notes a report of the Canadian Centre for Addiction and Mental Health. And most teens grow out of it quickly, with rates of drug use dropping off dramatically when they reach their early 20s.

For many, these facts suggest a Just-Say-No approach should be junked.

"The goals of any alcohol and drug prevention program for youth should be realistic," says a paper prepared by the Centre for Addiction and Mental Health. "The main goal should be preventing or reducing harms associated with drug use."

"It's a bit like safe-sex education," says Eugene Oscapella, an Ottawa lawyer and a founder of the Canadian Foundation for Drug Policy. "You could say we're not going to tell people how to do it safely because we just don't want them to do it. Well, you may not want them to do it, but are you going to abandon them to serious health consequences, or even death, if they do it improperly?"

This approach is sometimes called harm-reduction education. As an example, Oscapella mentions heroin. Students should be taught that heroin is powerfully addictive and should be avoided, he says. But they should also be told that someone who uses the drug can dramatically reduce the danger if they know a few simple facts, such as taking heroin while drinking alcohol dramatically increases the chance of a fatal overdose.

For most students, that extra information about heroin makes no difference: Heroin use has always been rare among teenagers -- just one per cent of Ontario teens in 2001 had ever touched it, according to a Centre for Addiction and Mental Health survey. 

But for a few, Oscapella says, this information might mean the difference between life and death. He cites the story of Peter Randell, a bright 19-year-old from Victoria. Peter was an avid reader and discovered that some of his favourite authors had used drugs. One night, he was drinking beer with friends when he decided, for the first time, to try heroin like his literary heroes. The combination of drugs killed him.

Would harm-reduction education have saved him? Perhaps. For certain, the Just-Say-No message did not. 

Shifting drug education to focus on harm reduction requires a controversial change. "Police officers," says the Senate report, "should neither develop the programs nor deliver them." 

In part, that's because police aren't the experts they think they are.

"The police are qualified to talk about the law, but they're not pharmacologists," says Oscapella. There are a lot of myths surrounding drugs, and police officers are just as likely to believe the myths as anybody else. 

For example, a recent PBS documentary featured a police expert solemnly warning viewers that heroin can be instantly addictive -- simply not true. The DARE America Web site -- http://www.dare.org  -- says snorting heroin is "just as dangerous" as injecting it -- again, not true. And Oscapella recalls a police drug specialist who told an audience "all drugs are equally dangerous" -- an absurd statement.

Still, Sorokan insists police officers make up for their lack of training in pharmacology by working on the street. "We're qualified based on our experience," he says. 

But according to Patricia Erickson, a drug researcher at the Centre for Addiction and Mental Health, that experience leaves police officers with a distorted picture of drugs.

"There's no question that there's casual, moderate, spasmodic use of heroin, cocaine, any drug you want to think of," she says. But the police almost never see that sort of drug use because it goes on privately and doesn't cause problems. The police only see the worst manifestations of drug use -- homeless junkies, criminals, "crack whores," and overdose victims. From this, they conclude that illegal drug use is likely to lead to addiction, misery and death. 

Thus police officers are bound to favour the Just-Say-No approach -- one reason they're the wrong people to deliver harm-reduction education. And police officers are sworn to enforce the law, which makes it awkward or impossible for them to teach how to, in effect, break the law more safely.

In addition to ditching the police and the Just-Say-No approach, Rosenbaum would like to drop something else from drug education. "Stop trying to send messages," she says. 

"We are so focused on the message we're sending to kids that it gets in the way of just providing the science. The kids know we are trying to send them a message. They get that part. They know we want them to abstain. And they also know we will say just about anything to get them to abstain. They tolerate us, but you know, they turn around, they roll their eyes, and they go ahead and do it."

The same conclusion is drawn by Health Canada's Best Practices report: "Fear-arousing messages accompanied by incorrect or exaggerated information are not effective, and can generate skepticism, disrespect and resistance toward any advice on substance use or other risk behaviour." Most critically, drug information should always be "scientifically accurate, objective, non-biased and presented without value judgment."

What's needed is honesty, Rosenbaum says. She would like to scrap stand-alone drug classes whose explicit purpose is to manipulate behaviour. Instead, factual information about drugs -- not just illegal drugs but all -- would be interwoven with other classes, like science and civics education. 

Examples can be found at her organization's Web site -- http:// www.safety1st.org

"Just give them the information," she says. "They're going to make decisions for themselves anyway."

Note: DARE in the classroom: It's awkward or impossible for police to teach how to, in effect, break the law more safely. 


CFDP
http://www.cfdp.ca/

Drug Policy Alliance
http://www.drugpolicy.org/

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