America's "Just Say No" Addiction

Tell Me What I Want To Hear
by Jeff Elliott

Parents, educators, and lawmakers all bask in the satisfaction of a job well-done
"It's not only the Colombian cartel that's gotten rich off drugs," a Bush administration drug policy official once said. "A lot of the curriculum marketers are making out like bandits."
In the past ten years, drug education has become a major industry that reaches into every community. At least $1.25 billion are spent annually in federal dollars alone. Throw in an easy $750 million or so in the many state, corporate, philanthropic and other grants and the total is probably well over $2 billion -- and that's a very conservative estimate. The true figure could be twice that, or more. But it's worth every penny if it keeps our kids from the perils of drug addiction right? Sorry: there's little evidence that any of these programs do much of anything to stop kids from using drugs.
It's not that these programs are useless: most of them provide children with reasonably accurate information about drugs, tobacco, and alcohol. They may build up a child's self-esteem, teach him or her self-reliance, and have other benefits. Another thing these programs do: they make parents and teachers feel better. One analysis found that although the programs didn't do much to keep kids away from drugs, they did reassure "parents that the schools are at least trying to control substance abuse among students."
And it's not only parents who are told what they want to hear; most educators believe the drug education programs are effective. After all, every few weeks a new bulletin or newsletter arrives at the school, brimming with good news. A new study proves the programs work; a new federal or state initiative is launched; more money is available for the district to spend on anti-drug activities. And politicians of all stripes love the programs -- when the Clinton administration recommended eliminating drug education entitlements in March of 1994, the House killed the motion, 418 to 1. Parents, educators, and lawmakers all bask in the satisfaction of a job well-done. It has become an national obsession, a narcotic in its own right.
But studies show these programs have mostly small and temporary effects on drug, alcohol, and tobacco use by children. Close scrutiny finds all of these programs fail in one of four ways:

they have almost no effect on children most likely to abuse drugs
children return to experimenting with drugs when the program's over
positive effects fade away within a year or two after the program
all benefits vanish when children enter a transitional period of life, such as entering high school

"Nobody wants to be the bearer of bad news"
This, of course, is not the happy picture drawn by the educator and research advocates who support these programs. It's not unusual to hear dramatic claims of a 50 percent (or more) drop in marijuana, cigarette, or alcohol use. Are they lying to us? Not necessarily. They're simply putting a positive spin on bad news.
Sorry to say, it's not unusual to find drug-ed researchers cooking the numbers. Dr. Joel Moskowitz, Associate Director for the Center for Family and Community Health, explains why: "Generally, the agencies that are funding the programs are also the ones paying for the evaluation. There's a tendency by the evaluators to report back what they think the agency wants to hear rather than what's really going on. Nobody wants to be the bearer of bad news. It makes the program providers unhappy, and it makes the funding agencies unhappy. It puts enormous pressure on the evaluator to massage the data to produce positive results."
Moskowitz is far from alone in criticizing these programs: many scientists have been quietly insisting for years that the "just say no" emperor has no clothes. But the same Federal dollars that pressures evaluators to put a positive spin on the results also pressures independent scientists -- many of them dependent on grants from the same Federal agencies -- to keep their opinions to themselves. It's not hard to find examples of researchers threatened and critical reports suppressed.
Without expert analysis, it's almost impossible to interpret the claims of success made by the authors of these anti-drug efforts. The program evaluation may be skewed by bad data, poorly conducted experiments, or political pressure. And that's assuming the program has even had an evaluation: a 1988 review of 350 different programs found less than 10 percent had any valid evaluation at all.

"Teaching kids who want to say 'yes' how to say 'no' may be about as useful as teaching pyromaniacs how to use fire extinguishers"
Although drug education programs were common in the 1970's, the movement didn't gather steam until the Reagan administration, particularly after Nancy Reagan claimed the issue has her personal cause. Research grants from both the federal departments of education and defense began flowing to universities and colleges to find the cure for this national problem.
But when these early programs were evaluated, it was found that the news was anything but good. The positive impacts were small, and usually only on the kids who weren't likely to sneak a beer or try a joint anyway. Some evaluations even found that the programs had the dreaded "boomerang effect."
The boomerang effect is a teacher or parent's worst nightmare: the more you teach the kids about the evils of drugs, the more they're driven to try them. And that's what they found in some of the programs; high risk kids -- children who had smoked more than a couple of cigarettes in the year before the program -- were more likely to smoke afterwards.
"If kids are looking for a way to distinguish themselves from the more conventional kids who are doing well in school, then you might be stimulating their move to drug use," Moskowitz says.
Other researchers have suggested that even providing drug information to some of these children can be conterproductive. It can arouse their curiosity about forbidden substances, or give them tips on how to abuse familiar substances. Does this mean that troubled, high risk children should be given special intensive programs? Should they be further isolated from their more normal classmates? We don't know. But as one scientist has noted, "Teaching kids who want to say 'yes' how to say 'no' may be about as useful as teaching pyromaniacs how to use fire extinguishers."

Claiming that a revised program is entirely new is a well-known academic shell game
Many of those early programs faded, and now can only be found as academic footnotes. But one program thrived: Drug Abuse Resistance Education, better known as DARE.
Begun in 1983, DARE delivers a message substantially the same as other programs. But this program is also unique: DARE is taught only by uniformed police officers. DARE now reaches around 8,000 communities and more than 50 percent of of our schools. Six million children will receive DARE instruction this year, and another 19 million will have short, preliminary classroom visits from their local DARE officer to prepare them for the DARE curriculum, usually taught in 5th grade.
One reason DARE has thrived is because of its enthusiastic support from law enforcement professionals, from small town police departments to the highest levels of the Department of Justice. As recently as September, the government issued a "fact sheet" on the program that endorses the program without reserve.
DARE also flourished because it received the lion's share of the drug education money. The program has been mentioned in at least three funding bills, including last year's massive Crime Bill. All told, local DARE programs are currently eligible for a direct share of more than half a billion federal dollars annually. A random survey of cities with DARE programs also found a variety of other funding sources: city funds, corporate and private grants, even monies from drug seizures.
But the evaluations of DARE show the same dismal results as the other programs. When researchers last year completed a study that showed conclusively that it didn't work, DARE had a quick answer: we've completely redesigned the program, so all the old data no longer applies.
This position infuriates many researchers, who view it as a disingenuous attempt to deflect criticism; claiming that a revised program is entirely new is a well-known academic shell game. "There's not a new curriculum -- there's a slightly changed curriculum," argues Richard Clayton, Director of Center of Prevention Research. Clayton, who is now concluding a five year evaluation of DARE.
Clayton and other researchers were also dismayed to find that the Justice Department, which funded the comprehensive study, released only a terse summary of the report, and one that picked out only the small fragments of good news found in the study.

"The state can't endorse any study that says you can use an illegal substance"
Most schools use DARE to deliver the bulk of their anti-drug, alcohol, and cigarette message, but there are signs that may be changing. Parents groups have challenged their local school boards to drop the program in several communities nationwide, and this fall, the Oakland school district suspended the DARE program for a year, citing its $1 million annual cost and strong testimony against the program by Moskowitz and others.
California has the largest school population in the country, and the state reflects the national dilemma with drug education. Vast amounts of public and private dollars are distributed each year, with little accountability as to how the money is spent. While much of it goes to drug education as intended, researchers will say privately that some goes to relieve strained school district budgets.
With hundreds of millions of dollars annually at stake, it's no wonder that California is reluctant to accept criticism of its programs gracefully. In the same way that the Justice Department buried the report critical of DARE, the state Department of Education has quietly chosen to ignore a recent study showing failure. Among the reasons given was even the we've-got-a-new-program-now claim that DARE used to deflect criticism.
Department consultant Jana Slater has still another objection to the study: "We don't have a problem with many of the conclusions. There's no conspiracy, no suppression. It just contains recommendations that the state can't follow.
"The report concludes that the no-use message is alienating kids. At this time, the state can't endorse any study that says you can use an illegal substance carefully. It's not like AIDS education; that's abstinence based too, but information is provided about how to have sex safely. The difference is that sex is not illegal."
And this is the bottom line for California and all other states: all drug education programs must deliver the same message of "no illegal use of legal substances and no use of illegal substances," as demanded by federal guidelines. Vary from that theme -- such as by teaching that teenagers should have a designated driver when drinking at a party -- and schools don't get the drug education money from Washington.

"Drug educators need to switch from a get-tough mentality found in the drug war"
The federal government's insistence on a "no-use" message is seen a major stumbling block in designing a drug education program that really works. Most kids do experiment with some these substances -- particularly alcohol. Over 90 percent of adolescents try alcohol before leaving high school. As some psychologists point out, drug use is so commonplace in some communities that "we might as well ask why some adolescents abstain, rather than why most do not."
So what's the solution? "It's not clear to me what we ought to be doing with prevention," Moskowitz says. "As a society, we have largely ignored our underlying social problems, claiming that we do not have the economic means to address them. Moreover, we lack the political will to implement the more promising prevention policies and programs that we can afford."
Moskowitz is right: some programs do seem to work. But he's also right that these programs would be enormously expensive to implement nationally, making our current $2 billion annual bill for drug education seem like chicken feed.
"I think the targets ought to be delay and focus on abuse rather than just focus on use. Most kids who try something don't get in trouble," says Dr. Michael Newcomb of the University of Southern California. "We've got to deal with the bigger picture, with people's attitudes in general and not just drugs. The 'just say no' program created a problem by oversimplifying it and acting as if there was a simple answer to the complex problem of drug abuse."
Many researchers, including at least one author of a no-use program, readily admit they would like to junk the strict "just say no" dogma and incorporate a responsible-use approach into the programs. "I think to be honest, that's the only realistic approach -- at least for alcohol," says Newcomb. "I don't think we can say there's responsible use of marijuana or cocaine. But alcohol is legal is society, and adolescents are probably going to use it at some point. Since car crashes with drunk teenagers are a leading cause of death for that age group, I think we're really missing the boat if we don't attack that realistically."
Dr. Joel Brown, principal author of the study ignored by the California Department of Education, also thinks we need to change our attitude towards troubled kids, offering help and counseling instead of expulsion -- or even arrest.
"Drug educators need to switch from a get-tough mentality found in the drug war toward active and honest engagement with students," says Brown. "This includes an education in which drug use is not advocated, but at the same time one in which students can confidentially share their drug experiences with one another and educators without fear of punishment.
"Another educational goal becomes one of providing enough interaction and honest information so that risky behaviors like drinking and driving do not kill students. Those who have a problem must get help rather than punishment; their peers must see that they are getting such help."

So what should we do? Given that we're spending about $5.5 million per day on drug education, should we change our course? And if so, do we have the collective will to mobilize our entire society into a single-minded campaign against drugs, alcohol, and tobacco? Do we have the money to invest in promising -- but enormously expensive -- programs? Do we have the courage to admit that, while wrong, children actually do experiment with drugs, alcohol, and cigarettes?
But this much is apparent: we definitely need to improve the existing programs. Or scrap them altogether. Or increase law enforcement. Maybe.
The sad truth is: we simply don't know what the hell to do.

Parents, educators, and lawmakers all bask in the satisfaction of a job well-done	"It's not only the Colombian cartel that's gotten rich off drugs," a Bush administration drug policy official once said. "A lot of the curriculum marketers are making out like bandits." In the past ten years, drug education has become a major industry that reaches into every community. At least $1.25 billion are spent annually in federal dollars alone. Throw in an easy $750 million or so in the many state, corporate, philanthropic and other grants and the total is probably well over $2 billion -- and that's a very conservative estimate. The true figure could be twice that, or more. But it's worth every penny if it keeps our kids from the perils of drug addiction right? Sorry: there's little evidence that any of these programs do much of anything to stop kids from using drugs. It's not that these programs are useless: most of them provide children with reasonably accurate information about drugs, tobacco, and alcohol. They may build up a child's self-esteem, teach him or her self-reliance, and have other benefits. Another thing these programs do: they make parents and teachers feel better. One analysis found that although the programs didn't do much to keep kids away from drugs, they did reassure "parents that the schools are at least trying to control substance abuse among students." And it's not only parents who are told what they want to hear; most educators believe the drug education programs are effective. After all, every few weeks a new bulletin or newsletter arrives at the school, brimming with good news. A new study proves the programs work; a new federal or state initiative is launched; more money is available for the district to spend on anti-drug activities. And politicians of all stripes love the programs -- when the Clinton administration recommended eliminating drug education entitlements in March of 1994, the House killed the motion, 418 to 1. Parents, educators, and lawmakers all bask in the satisfaction of a job well-done. It has become an national obsession, a narcotic in its own right. But studies show these programs have mostly small and temporary effects on drug, alcohol, and tobacco use by children. Close scrutiny finds all of these programs fail in one of four ways: they have almost no effect on children most likely to abuse drugs children return to experimenting with drugs when the program's over positive effects fade away within a year or two after the program all benefits vanish when children enter a transitional period of life, such as entering high school
"Nobody wants to be the bearer of bad news"	This, of course, is not the happy picture drawn by the educator and research advocates who support these programs. It's not unusual to hear dramatic claims of a 50 percent (or more) drop in marijuana, cigarette, or alcohol use. Are they lying to us? Not necessarily. They're simply putting a positive spin on bad news. Sorry to say, it's not unusual to find drug-ed researchers cooking the numbers. Dr. Joel Moskowitz, Associate Director for the Center for Family and Community Health, explains why: "Generally, the agencies that are funding the programs are also the ones paying for the evaluation. There's a tendency by the evaluators to report back what they think the agency wants to hear rather than what's really going on. Nobody wants to be the bearer of bad news. It makes the program providers unhappy, and it makes the funding agencies unhappy. It puts enormous pressure on the evaluator to massage the data to produce positive results." Moskowitz is far from alone in criticizing these programs: many scientists have been quietly insisting for years that the "just say no" emperor has no clothes. But the same Federal dollars that pressures evaluators to put a positive spin on the results also pressures independent scientists -- many of them dependent on grants from the same Federal agencies -- to keep their opinions to themselves. It's not hard to find examples of researchers threatened and critical reports suppressed. Without expert analysis, it's almost impossible to interpret the claims of success made by the authors of these anti-drug efforts. The program evaluation may be skewed by bad data, poorly conducted experiments, or political pressure. And that's assuming the program has even had an evaluation: a 1988 review of 350 different programs found less than 10 percent had any valid evaluation at all.
"Teaching kids who want to say 'yes' how to say 'no' may be about as useful as teaching pyromaniacs how to use fire extinguishers"	Although drug education programs were common in the 1970's, the movement didn't gather steam until the Reagan administration, particularly after Nancy Reagan claimed the issue has her personal cause. Research grants from both the federal departments of education and defense began flowing to universities and colleges to find the cure for this national problem. But when these early programs were evaluated, it was found that the news was anything but good. The positive impacts were small, and usually only on the kids who weren't likely to sneak a beer or try a joint anyway. Some evaluations even found that the programs had the dreaded "boomerang effect." The boomerang effect is a teacher or parent's worst nightmare: the more you teach the kids about the evils of drugs, the more they're driven to try them. And that's what they found in some of the programs; high risk kids -- children who had smoked more than a couple of cigarettes in the year before the program -- were more likely to smoke afterwards. "If kids are looking for a way to distinguish themselves from the more conventional kids who are doing well in school, then you might be stimulating their move to drug use," Moskowitz says. Other researchers have suggested that even providing drug information to some of these children can be conterproductive. It can arouse their curiosity about forbidden substances, or give them tips on how to abuse familiar substances. Does this mean that troubled, high risk children should be given special intensive programs? Should they be further isolated from their more normal classmates? We don't know. But as one scientist has noted, "Teaching kids who want to say 'yes' how to say 'no' may be about as useful as teaching pyromaniacs how to use fire extinguishers."
Claiming that a revised program is entirely new is a well-known academic shell game	Many of those early programs faded, and now can only be found as academic footnotes. But one program thrived: Drug Abuse Resistance Education, better known as DARE. Begun in 1983, DARE delivers a message substantially the same as other programs. But this program is also unique: DARE is taught only by uniformed police officers. DARE now reaches around 8,000 communities and more than 50 percent of of our schools. Six million children will receive DARE instruction this year, and another 19 million will have short, preliminary classroom visits from their local DARE officer to prepare them for the DARE curriculum, usually taught in 5th grade. One reason DARE has thrived is because of its enthusiastic support from law enforcement professionals, from small town police departments to the highest levels of the Department of Justice. As recently as September, the government issued a "fact sheet" on the program that endorses the program without reserve. DARE also flourished because it received the lion's share of the drug education money. The program has been mentioned in at least three funding bills, including last year's massive Crime Bill. All told, local DARE programs are currently eligible for a direct share of more than half a billion federal dollars annually. A random survey of cities with DARE programs also found a variety of other funding sources: city funds, corporate and private grants, even monies from drug seizures. But the evaluations of DARE show the same dismal results as the other programs. When researchers last year completed a study that showed conclusively that it didn't work, DARE had a quick answer: we've completely redesigned the program, so all the old data no longer applies. This position infuriates many researchers, who view it as a disingenuous attempt to deflect criticism; claiming that a revised program is entirely new is a well-known academic shell game. "There's not a new curriculum -- there's a slightly changed curriculum," argues Richard Clayton, Director of Center of Prevention Research. Clayton, who is now concluding a five year evaluation of DARE. Clayton and other researchers were also dismayed to find that the Justice Department, which funded the comprehensive study, released only a terse summary of the report, and one that picked out only the small fragments of good news found in the study.
"The state can't endorse any study that says you can use an illegal substance"	Most schools use DARE to deliver the bulk of their anti-drug, alcohol, and cigarette message, but there are signs that may be changing. Parents groups have challenged their local school boards to drop the program in several communities nationwide, and this fall, the Oakland school district suspended the DARE program for a year, citing its $1 million annual cost and strong testimony against the program by Moskowitz and others. California has the largest school population in the country, and the state reflects the national dilemma with drug education. Vast amounts of public and private dollars are distributed each year, with little accountability as to how the money is spent. While much of it goes to drug education as intended, researchers will say privately that some goes to relieve strained school district budgets. With hundreds of millions of dollars annually at stake, it's no wonder that California is reluctant to accept criticism of its programs gracefully. In the same way that the Justice Department buried the report critical of DARE, the state Department of Education has quietly chosen to ignore a recent study showing failure. Among the reasons given was even the we've-got-a-new-program-now claim that DARE used to deflect criticism. Department consultant Jana Slater has still another objection to the study: "We don't have a problem with many of the conclusions. There's no conspiracy, no suppression. It just contains recommendations that the state can't follow. "The report concludes that the no-use message is alienating kids. At this time, the state can't endorse any study that says you can use an illegal substance carefully. It's not like AIDS education; that's abstinence based too, but information is provided about how to have sex safely. The difference is that sex is not illegal." And this is the bottom line for California and all other states: all drug education programs must deliver the same message of "no illegal use of legal substances and no use of illegal substances," as demanded by federal guidelines. Vary from that theme -- such as by teaching that teenagers should have a designated driver when drinking at a party -- and schools don't get the drug education money from Washington.
"Drug educators need to switch from a get-tough mentality found in the drug war"	The federal government's insistence on a "no-use" message is seen a major stumbling block in designing a drug education program that really works. Most kids do experiment with some these substances -- particularly alcohol. Over 90 percent of adolescents try alcohol before leaving high school. As some psychologists point out, drug use is so commonplace in some communities that "we might as well ask why some adolescents abstain, rather than why most do not." So what's the solution? "It's not clear to me what we ought to be doing with prevention," Moskowitz says. "As a society, we have largely ignored our underlying social problems, claiming that we do not have the economic means to address them. Moreover, we lack the political will to implement the more promising prevention policies and programs that we can afford." Moskowitz is right: some programs do seem to work. But he's also right that these programs would be enormously expensive to implement nationally, making our current $2 billion annual bill for drug education seem like chicken feed. "I think the targets ought to be delay and focus on abuse rather than just focus on use. Most kids who try something don't get in trouble," says Dr. Michael Newcomb of the University of Southern California. "We've got to deal with the bigger picture, with people's attitudes in general and not just drugs. The 'just say no' program created a problem by oversimplifying it and acting as if there was a simple answer to the complex problem of drug abuse." Many researchers, including at least one author of a no-use program, readily admit they would like to junk the strict "just say no" dogma and incorporate a responsible-use approach into the programs. "I think to be honest, that's the only realistic approach -- at least for alcohol," says Newcomb. "I don't think we can say there's responsible use of marijuana or cocaine. But alcohol is legal is society, and adolescents are probably going to use it at some point. Since car crashes with drunk teenagers are a leading cause of death for that age group, I think we're really missing the boat if we don't attack that realistically." Dr. Joel Brown, principal author of the study ignored by the California Department of Education, also thinks we need to change our attitude towards troubled kids, offering help and counseling instead of expulsion -- or even arrest. "Drug educators need to switch from a get-tough mentality found in the drug war toward active and honest engagement with students," says Brown. "This includes an education in which drug use is not advocated, but at the same time one in which students can confidentially share their drug experiences with one another and educators without fear of punishment. "Another educational goal becomes one of providing enough interaction and honest information so that risky behaviors like drinking and driving do not kill students. Those who have a problem must get help rather than punishment; their peers must see that they are getting such help."
	So what should we do? Given that we're spending about $5.5 million per day on drug education, should we change our course? And if so, do we have the collective will to mobilize our entire society into a single-minded campaign against drugs, alcohol, and tobacco? Do we have the money to invest in promising -- but enormously expensive -- programs? Do we have the courage to admit that, while wrong, children actually do experiment with drugs, alcohol, and cigarettes? But this much is apparent: we definitely need to improve the existing programs. Or scrap them altogether. Or increase law enforcement. Maybe. The sad truth is: we simply don't know what the hell to do.

Albion Monitor December 3, 1995 (http://www.monitor.net/monitor)

Contact rights@monitor.net for permission to reproduce.

America's "Just Say No" Addiction

Tell Me What I Want To Hear

by Jeff Elliott

Parents, educators, and lawmakers all bask in the satisfaction of a job well-done

"Nobody wants to be the bearer of bad news"

"Teaching kids who want to say 'yes' how to say 'no' may be about as useful as teaching pyromaniacs how to use fire extinguishers"

Claiming that a revised program is entirely new is a well-known academic shell game

"The state can't endorse any study that says you can use an illegal substance"

"Drug educators need to switch from a get-tough mentality found in the drug war"

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