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Your Drug Prevention Program Probably Isn't Working

Too many popular school-based substance-abuse prevention programs lack grounding in science, the Los Angeles Times reported back in 2006. The situation is probably not much different today. Past studies have shown that only 35 percent of public schools and 13 percent of private schools are implementing prevention programs with demonstrated effectiveness, despite the fact that No Child Left Behind requires schools receiving federal funding to use evidence-based programs.

Time-honored but ineffective programs include one-time events, or presentations that simply explain the dangers of various substances (these can actually increase young people’s interest in trying alcohol and drugs). Other common offenders include “scared straight” approaches that feature crashed-car displays, guest speakers in recovery from addiction, and people who've lost friends and relatives to drunk driving. Sure, kids will tell you these experiences were meaningful and that they liked them, but there’s no evidence that liking a program or experiencing an “emotionally powerful” presentation leads to changes in youth behavior.

Similarly, trying to curb substance abuse with punitive “zero-tolerance” policies may work for the police, but is generally ineffective and counterproductive in a school setting. Research tells us that schools should have clear and consistently enforced no-use policies, but should not suspend students without considering the context of the situation, providing support services and offering opportunities to re-connect to the school community. (See the report Zero Tolerance, Zero Evidence.) Here’s another message that research sends loud and clear: Having law enforcement deliver classroom sessions is a wonderful tool for building youth-police relationships, but has little impact on kids’ actual substance use. (See a review of the effectiveness of the DARE program.)

Health class does not equal prevention

It’s tempting to think that telling kids “drugs are dangerous and bad” will somehow convince them not to use. We often approach drug prevention with the same assumptions that underlie history or math class—if we give them the knowledge, they'll be able to apply it, or at least remember it on test day. The problem is that kids use alcohol, tobacco and other drugs based a complex set of psychological and sociological motivations and influences. For some, using substances is viewed positively within youth culture and is also strongly linked to personal identity, the wish to feel like an independent adult, and the desire for social status among peers.

“Oversimplification is just one reason most school-based drug-prevention programs don’t work,” said researcher David Hanson, of the University of North Carolina at Chapel Hill, in the article “Popular prevention programs lack nuance, research.” “The decisions kids face are more nuanced than most drug programs make them appear.”

Knowledge about dangers is certainly a factor in prevention, and youth need to receive this message from both school and home, but that's only one piece of the puzzle. After all, isn't the danger of alcohol and drugs part of the reason they're so attractive to teens? Young people, feeling invincible, routinely underestimate risks. And don’t we hear youth saying, after hearing of a case of serious harm from alcohol or drugs, “Yes, but that won’t happen to me?” This is why “information” approaches aimed directly at kids are the least effective type of prevention strategy. (See “Don’t Do It! Ineffective Prevention Strategies.”)

So if one-time guest speakers, sad or scary stories, zero-tolerance policies and lectures about substance-abuse dangers aren’t that effective, why do many schools continue to invest time and money in these strategies? Part of the confusion may be that these types of activities do help to raise general awareness, and also reinforce the behavior of kids who already plan to steer clear of substances. “Preaching to the choir” is not the same thing as prevention, however—prevention efforts should strive to lower the risk of harm within the youth population as a whole. For some youth this means getting them to avoid ever trying substances; for others this means helping them stop use, reduce use to a less dangerous level, or begin experimentation at a later age. In order to accomplish these goals, prevention approaches must try to counter the powerful social and cultural contexts that encourage kids to use alcohol and drugs.

Yes, it is possible to influence young people so that they are more likely to make the right choices. There are a few types of strategies that have been around a while, yet might be just the breath of fresh air that your school's alcohol, tobacco and other drug (ATOD) prevention efforts need. You’ll notice that these ideas don't even really address substances—at least not via lectures or lesson plans—and that’s the whole point. As Cindy Wakefield and James Campain, the authors of “Don’t Do It,” note, “Our time and energy is best used to teach positive, healthy behavior, rather than fruitlessly trying to stop dangerous behavior through manipulation and punishment.”

Remember that any strategy, effort or program in your school should be regularly evaluated to determine whether it is effective. Sometimes even “model programs” from federal registries can fall flat, especially if your school lacks the infrastructure for full-strength implementation, or if the program is not a good cultural match for your student population. At the very least, you will need to administer a youth “risk behaviors” survey annually or every other year to track changes in student substance use. (If your state already requires you to do this, you’re in luck.) Among other things, survey questions should assess (1) past 30-day or past-year use of various substances, (2) the age at which student first used various substances, (3) whether students believe these substances are harmful, and (4) whether students believe parents and peers disapprove of use of these substances. One such survey is the Search Institute’s Profiles of Student Life: Attitudes and Behaviors. Consult your state’s public health department for recommendations regarding other high-quality surveys.  

Three proven strategies to keep in mind:

Idea # 1- Build “developmental assets” and student strengths/skills that are incompatible with substance use.

Developmental assets are strengths both internal and external to students that when present, markedly reduce the likelihood of a young person engaging in risky behaviors, including alcohol and drug use. Assets include things like experiencing a caring, encouraging school environment; having a useful role in the community; and spending three or more hours per week in sports, clubs, or organizations at school and/or in community organizations. There are many ways in which schools can help build assets—with no purchased programs, high-priced trainers or guest speakers required.

Life Skills, a federal model program, is proven to reduce the risks of alcohol, tobacco, drug abuse, and violence by targeting the major social and psychological factors that promote the initiation of substance use. Rather than merely teaching information about the dangers of drug abuse, the program promotes healthy alternatives to risky behavior.

Idea # 2Make sure that every student is connected to at least one caring adult who serves as a positive role model.

Even when caring adults don’t directly discuss substance use with youth, their emotional support and positive example can speak volumes. Schools can provide informal mentoring by pairing students up with staff members (even non-teaching staff can make excellent mentors). More formal youth mentoring programs, such as those that follow the national Elements of Effective Practice guidelines, are more intensive and can provide even greater benefit.

While you’re at it, consider helping students make positive connections with each other—try mixing up cliques and providing structured interactions among groups of students who typically wouldn’t connect. (See a research review on School Connectedness.)

Idea # 3Short-circuit typical peer norms so that students view avoidance of alcohol, tobacco and other drugs to be “cooler” than using these substances.

Social norms marketing can be applied within a school to help students develop accurate perceptions of levels of peer substance use. Since youth often overestimate levels of peer use, once students recognize that “not everyone is doing it,” they will be less motivated to use substances themselves.

Rescue Social Change Group has developed an innovative method of social norms marketing that takes into account the unique influence of culture, youth identity and social environments on youth risk behaviors within a particular school community. The company uses “social branding” (a subtle approach that makes very little direct mention of substances and avoids preaching and scare tactics) to make substance-free lifestyles an appealing choice for students. Instead of “preaching to the choir,” the approach actively engages higher-risk students who may be experimenting with substances, since these often-popular students are in the best position to market ideas to their peers.


Article by Celine Provini, EducationWorld Editor
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