Pubdate: Fri, 16 Feb 2001 Source: Salon (US Web) Copyright: 2001 Salon Contact: 22 4th Street, 16th Floor San Francisco, CA 94103 Fax: (415) 645-9204 Feedback: http://www.salon.com/about/letters/index.html Website: http://www.salon.com/ Forum: http://tabletalk.salon.com/ Author: Dawn MacKeen JUST SAY NO TO DARE America's School-Based Drug Prevention Program Gives In To Critics' Pressure For nearly two decades, the majority of schoolchildren in the United States have been required to memorize three little words: "Just say no." They have been taught that dabbling with drugs even once can harm you, that peer pressure to use drugs is a lurking menace to be dodged and rejected at all costs. They have written thousands of essays decrying drug use, and worn T-shirts, hats, ribbons and badges to ward off the encroaching threat of narcotics. But the days of "Just say no" may just be over. Leaders of the nation's largest drug prevention program, Drug Abuse Resistance Education, announced on Thursday that they were changing DARE's approach, admitting that the vastly expensive program appears to be ineffective. Indeed, research has indicated that DARE may actually have contributed to greater drug use by high school students. DARE administrators announced that the program will adopt a new strategy for school-based drug prevention, and begin testing it in 80 high schools and 176 middle schools in the fall. Around 50,000 students will be involved. "The new curriculum gives students the skills to make positive, quality-of-life decisions," reads DARE's press release. "It also discusses the conditions leading up to violent behavior, how to identify potentially violent situations, and some basic ways to avoid or defuse such situations." Critics of DARE say the time is long overdue to dismantle the program and make sure, before exposing children to it, that it is not only effective but, most important, not harmful. They also worry that these changes, like much-heralded changes in the past, will not be significant enough to completely revamp the failing program. Joan McCord, co-chairwoman of the National Academy of Sciences panel that issued a stinging report on DARE this week, is one of the people who is concerned about the program hurting the children who participate. "It's a mistake to assume that you can simply design a program and know in advance whether it will be harmful," says McCord. "I think of those who created thalidomide. They had good intentions, and look what happened. The harm comes from the failure of programs and programs must be evaluated for safety." She and others assert that politics is what has kept the much-criticized program around for so many years, despite a mountain of evidence contesting its efficacy. Don Lynam, who issued a report two years ago questioning the effectiveness of DARE, feels vindicated after Thursday's announcement. But he fears that the new DARE program won't depart enough from its old curriculum. Over a decade, Lynam and his colleagues at the University of Kentucky compared children who had participated in DARE with those who had not. They followed more than 1,000 students from sixth grade, when they initially heard DARE's message, to age 20. Salon spoke with Lynam about the nature of drug abuse, the failure of the DARE program and why so many parents, politicians and police officers blindly believed the program was working. What was the major finding of your study? In the end, we found that DARE did not affect individuals' drug use behavior or attitude about drugs. It also didn't affect things that DARE purports to influence, like peer pressure resistance or self-esteem. Was there any benefit of being in the DARE program? Initially, we found DARE had influenced kids' attitudes toward drugs. So if you asked them questions about what they thought about drugs and what they expected from drugs a couple of months after they received DARE, the kids were more negative about drugs. But [the effect] was really short-lived, and disappeared after about a year. It seems your study came to the same conclusion as many other studies -- that DARE simply wasn't working. I think pretty much any well-controlled study that involved randomization of DARE [programs in schools] found the same thing. And none of them came out with evidence in support of DARE's efficacy. So why has this program continued for so long? I think the police like it a lot, not just for its potential influence on preventing drug abuse but also because they get a chance to go out and talk to kids (while they're not busting them) and build a good relationship with the community they police. The other reason is that people are not good scientists about this stuff. The parents look around and don't think their kids are using drugs -- and the kids probably aren't using drugs -- but they say, "Oh, my kid went through DARE. See, DARE works." Did you find other examples of this blind-faith approach? You get it a lot from the editorial writers in our local paper or even from some of the police who go through these programs. They say, "You know the studies may not show it, but I can see it in the kids' faces that I'm making a difference and this is important." And the bottom line is that you can't see it in their faces because you're only seeing kids who went through DARE, and you may think that they don't use drugs, but you don't know that because they won't use them in front of you. And you don't know what these kids would be doing if they didn't do DARE. The only way to find out is through the controlled-study approach. Has drug war politics kept this program going? Yes. I do think it would be a politically unpopular thing for a politician to say, "I think we're going to defund DARE." I imagine that it would not sit well with the majority of the voters. You also sound like you are in favor of drug use if you do that. Do you feel vindicated with Thursday's announcement? I think it's a good step, but I'm waiting to see what the details look like. DARE has supposedly gone through changes before. The big difference between what's happening now and what has happened in the past is there's an evaluation component tagged onto this curriculum change -- to see whether or not it is effective. Because one of the things that DARE people say in response to my study is, "Well, that was the old version of DARE. We're using a new and improved version of DARE." In other words, curriculum changes are a nice way of getting around the fact that your old program didn't work. You just promise that the new one will. You seem a little skeptical about how big of a change it will be. I think the curriculum changes that have taken place previously have been more cosmetic than real. DARE continued to be administered by police officers to all kids regardless of the kids' risk, focused on peer pressure resistance and included a zero-tolerance policy -- and it's been that way with every incarnation of DARE until now. What was specifically wrong with the program? What made it ineffective? The first thing is that DARE is an untargeted program and assumes all kids are at risk for using drugs, so it aims its message at all of them. But there's actually good evidence that not all kids are at equal risk. If you want to reach kids at the highest risk, you might need to do something different. There are a couple of studies going on, some here at University of Kansas, which look at public service announcements targeted at people who are at high risk for drug use. They have found that this kind of targeted campaign is much more effective than an untargeted one. One thing you might hope DARE will do is try to design its program to better influence those who are most at risk. The other thing that has been problematic in the past is that DARE has this strong zero-tolerance policy for any drug use at all. But that gets undermined a lot by the popular culture. It might be a hard message for kids to buy into or believe because their favorite rock stars or friends are using these drugs, and their heads aren't blowing up. They don't see a whole lot of negative consequences accruing. Are you advocating an approach that teaches kids that doing drugs one time isn't that bad, but continuing use is? That could be an alternative -- or at least getting away from the whole "if you use drugs, your head is going to blow up" [approach]. DARE's longtime target of intervention has been peer pressure resistance. But the image you get from that is that good kids use drugs because bad kids pressure them. I think kids use drugs because they're available and kids are curious. It's not the case that there are all these bad kids lurking around in the corners, trying to get the good kids to try drugs. DARE may be targeting the wrong mechanism. How would one go about targeting the kids most at risk? You might design programs that would be more appealing to that group of kids. So if you think that one of the individual risk factors for drug use is high-sensation seeking, then you might work to make your presentations or your program more appealing to that group of kids. But do you think that the targeting of specific kids -- calling them aside - -- could have negative effects? I don't know that I would advocate identifying those kids and bringing them in and only treating them. But you could get at them in a universally delivered message that was just more appealing to them. Public service announcements are a good example. They don't select certain kids to see them, but they try to make the announcements more appealing to those at risk of using drugs. Did you ask the kids what they thought of DARE? No, the DARE program was only a small part of what we did. We wanted to see if there was any effect of DARE after a decade. We thought about not even publishing [the results] because everybody already knows that DARE doesn't work; people in the prevention community already know that. Why do you think DARE has been kept alive for so long? I think DARE America had a lot strong advocates in a lot of different places, and we as prevention scientists haven't done a particularly good job of getting the message out to the people on the street, where the decisions are really made. If I could convince my neighborhood that DARE doesn't work, it would have a lot of impact, probably more than me publishing another paper on it. After your report came out, were you criticized? Actually, I was. Glenn Levant, the head of DARE America, called it "voodoo science." What do you say to him and the other critics now? Just that they're simply wrong, and that none of their criticisms held any water. - --- MAP posted-by: Keith Brilhart