Categories
Psychology

Drug Prevention: Rethinking the Model

Introduction

Society has consistently sought to address drug abuse in a proactive manner; namely, to educate younger students as to the dangers of drug use before they are usually exposed to opportunities to experiment.  It has long been felt that presenting the realities of the matter to children must translate to generating a point of view strong enough to withstand temptations, and consequently instill a healthy fear of drugs.  The logic is sound, certainly insofar as those realities are invariably grim.  It is reasonable to assume that, once children are made aware of the severe hardships and dangers to mind and body drugs bring about, they will be potently dissuaded from trying any recreational drugs.  Then, and commendably, more modern prevention programs take into account social elements, such as parental and community participation, to better provide a comprehensive base of support.

Regrettably, rates of success are by no means encouraging.  Increasing numbers of young people turn to drugs, and for a variety of reasons seemingly impervious to school and community efforts.  Part of this is due to the inevitable trait within adolescents to experiment, and to take part in activities perceived as daring or unacceptable.  This in turn promotes the insidious and traditional force of peer pressure, and a significant dilemma is then set in motion; the more adults discourage drug use, the greater becomes the forbidden attraction.  This being the case, and the sensible approaches of existing policies notwithstanding, a new model must be designed which incorporates within it a viable means of countering these contrary forces.  For drug prevention programs to succeed, the society must accept that only through acknowledging the attractions of drug use may discouragement be generated effectively.  In the following, such a new model will be presented, in which the very issues impeding drug prevention are turned into components aiding the processes.

Background and Current Models

That schools and communities have consistently sought to implement drug prevention is, unfortunately, more a matter of incentive than of recurring success.  The impetus for such programs is both clear and compelling, in that prevention instruction is relatively inexpensive, certainly compared to the costs of drug abuse to the society.  Even model programs, however, have not significantly impacted on drug usage.  No actual data may be known regarding how school programs have affected the adults later a part of the society, but estimates are that prevention programs reduce use of tobacco, alcohol, and narcotics by less than three percent (Caulkins, Pacula, Paddock, & Chiesa, 2002,  p. xix).  While any decrease is valuable, it is nonetheless plain that, particularly given the widespread applications of school programs, the approaches are not having the desired impact.

In terms of history, school drug prevention programs have veered in several directions since they became prominent in the 1970s.  This was a decade in which parents were deeply concerned by the new “drug culture,” which the media promoted as essentially emanating from the school playground or hallway.  Parents and communities became increasingly strident, and the different directions go to degree of intensity and approach.  In this period the prevalent model relied on educating children, in as dramatic terms as possible, of the dangers of experimenting with drugs.  Then, there was in the 1970s a growing pressure on the government; parents perceived the access to drugs something of a failure of governmental responsibility, so funding for drug education was virtually demanded (Mathison, Ross, 2007,  p. 208).  It may be said that, in these years, societal confidence was placed in disseminating knowledge to children, which was trusted to have sufficient force to discourage use.

The 1980s, however, would see a different course taken.  This commenced the period, still very much existing today, of focusing less on education and relying more on social imperatives.  School drug programs consistently had one message to convey: “just say no.”  This social influence model was widespread, and it also relied on scare tactics and cooperative efforts from other agents.  For example, the famous public service commercial of an egg in a frying pan, accompanied by the statement, “This is your brain on drugs,” became a watchcry for this prevention movement.  There was an unprecedented level of partnerships forming in parent/teacher coalitions and task forces (Mathison, Ross, 207,  p. 208).  At the same time, in this period also arose considerable resistance to the school drug prevention programs being initiated.  The schools were concerned as to lost class time in other studies, and many parents objected to the schools’ taking so active a role in what they perceived to be the parental domain of moral instruction.  Controversies aside, however, the dominant prevention message was essentially a vehement negation; with this pressure to refuse drugs acting in concert with frightening images, it was believed a sufficiently powerful prevention strategy was in place.

Since the, the movement has been toward more intuitive prevention tactics, possibly because the “say no” strategy was less than successful.  What is occurring today is that the field continues to expand, and drug prevention at all school levels is the societal norm.  There remain concerns that such programs may trigger interest in drugs previously not present, just as conservative movements still resist the schools as taking on a role not believed to be in their purview (Mathison, Ross, 2007, p. 210).  New approaches, nonetheless, continue to be implemented.  Among the more interesting is that developed for middle school children in Arizona by the Southwest Interdisciplinary Research Center (SIRC), applied under the banner of, “Keepin’ It REAL.”  This region of the country is noted in terms of its children being particularly vulnerable to drug abuse, and for specific reasons.  An enormous percentage of students are of Mexican backgrounds, and many are first-generation Americans.  Discrimination issues render this population of children far more susceptible than whites to alcohol, cigarette, and drug usage, just as discrimination is seen as fostering these trajectories in the Latino/American culture and homes.  The “REAL” model was then developed to both address minority factors in drug prevention and build upon lessons learned from failed efforts, as in the inadequacy of superficially addressing culture in drug prevention.  The model essentially incorporates motivation and respect approaches to support the acronym of, “Refuse, Excuse, Avoid, and Leave,” each of which is a denial tactic for students (Marsiglia, 2013).  The key is utilizing cultural awareness here, and operating from the position that multicultural perceptions are infusing the students’ feelings regarding drug use.  A recent study based on 2, 487 Mexican-American students undergoing the school program report consistently favorable results, with student self-efficacy, or the incentive to refuse drugs, rising across the sampling, and alcohol refusal was most significant (Marsiglia, 2013) . It is crucial to note, however, that such results may serve only as estimated predictors of future usage, just as the study primarily relies upon self-reporting.

The National Institute for Drug Abuse reports that most students experiment with drugs in early adolescence (Griffin et al, 2003), and this supplies the foundation for another prevention model, “Life Skills Training” (LST).  The approach here is to foster personal development in the adolescent to such an extent that they will be better equipped to make informed, healthy decisions.  This is about the totality of the student, rather than a focus on the negative aspects of drugs, and the goal is the development of a non-substance usage norm.  In several studies, the LST has revealed considerable success, with lessened rates of smoking, drinking, and the use of other drugs in both minority and predominantly white adolescent samplings.  Moreover, it is estimated that the training creates prevention effects lasting up to six years (Griffin et al, 2003).  As with the REAL program, however, this apparent success must be tempered by the fact that LST, as with virtually all school prevention programs, relies on self-reporting.  Then, even as lessened usage was reported across the spectrum, percentages of difference are typically modest.

Proposed New Model

       In establishing a new school drug prevention program, it is essential to regard past models in terms of both approach and success.  To begin with, the famous “just say no” core of earlier models is valuable in affirming the lack of substance in any approach that so relies on a social imperative.  This failure is, in fact, hardly surprising; if it may be said that anything defines the adolescent state of mind, it is an unwillingness to conform to social parameters in place.  New models comprehend this to a degree, but it is held here that this knowledge must be a cornerstone in an effective program.  This inherently creates a dilemma; how can the school, which is an institution of authority, successfully send a message to a population inherently resistant to authority?  This, however, will be addressed in the following.

Secondly, it is critical to determine at what school age such programs are likely to be effective.  As noted, the evidence indicates that early adolescence is the period in which students either initiate drug use or consider it.  Consequently, it seems reasonable to begin prevention training earlier.  The new model, however, comprehends that children at these ages do not necessarily conform to trajectories as adults do.  More exactly, the drug prevention strategies employed on pre-adolescent children may well be wasted efforts, simply because children at that age are wholly uninterested in learning about that which has no meaning whatsoever to them.  Applicable here is Piaget’s theory of formal operation as emerging in children between the ages of 11 and 13.  This is when the child first perceives themselves as interacting with the world in ways mutually experienced.  In a sense, previous concepts of reality are stretched, and vast possibilities are opened (Slee, Campbell, & Spears, 2012,  p. 445). Then, older students in high school are usually developed to the extent of being less compliant with instruction that goes to behavior and, importantly, their social relations. The proposed model then determines middle school or pre-adolescence as the crucial arena in which prevention should be taught.

Before the model is set out, two other factors are pertinent.  The first is that, while parental cooperation is helpful, the initiative should be primarily school-based.  On one level, the interaction between parents and schools inevitably enables innumerable potential conflicts.  The program’s assertion, for example, that alcoholism may be generated through an excess of social drinking may be contradicted by a parent’s behavior, so the parent’s input within the program would be an additional issue.  There is no discounting the importance of the family in guiding a child, yet it is as well unrealistic to rely upon a kind of parental template when the reality exists that parental values typically differ in large and small ways from the greater cultural.  Rather than depend upon an illusory, shared ideology between parents and schools, it is far more logical that, in the program itself, the diversity of the family be emphasized, which in turn will encourage the child’s growing sense of individual identity.  Maintaining the program as school-based allow promotes in the child the awareness that, when drug use is the issue, individuals are essentially acting individually, and may not count on external supports of any kind.

The second factor goes to an element virtually ignored in most prevention programs, save in dramatic ways revealing the dire consequences of drug use: physical well-being.  While it is true that programs emphasize the dangers of tobacco and alcohol to the body, the reality remains that healthy physicality is grossly ignored in middle and high schools.  The School Health Policies and Programs Study determined that low percentages of schools offer physical education, with only 7.9 percent of middle schools and 2.1 percent of high schools providing such classes. Students are far more encouraged to engage in interscholastic sports at these schools, but the nature of such sports is to attract only those teens already committed to the activities (Wilson, Kolander, 2011, p. 156).  Put another way, students most in need of developing their bodies and gaining awareness as to health are increasingly distanced from these classes and sports.  This goes to a critical component in any effective drug prevention program, in that students must be far more encouraged to participate in fitness, and in ways that both defy traditional, “clique” school associations and reinforce the connection between the brain and the body.

These components set out, then, the new prevention program operates in the following manner.  Middle schools set up classes each semester, timed to accommodate existing class schedules and populations, and not exceeding one class per two weeks.  This type of schedule is prompted by the conviction that less direct addressing of the subject, rather than more, will be more effective, as students will then not perceive themselves as inundated with unwanted information.  Then, at no point is the word “prevention” to be applied to these classes, a condition arising from the core concept.  It is based on a concept contrary to virtually all programs, in that it is felt that disregarding the attractions of drugs, or at best merely referring to such attractions randomly and as insignificant, only increases the appeal.  In simple terms, it is essential that schools confront the reality perceived by children (and adults), in that cigarettes, alcohol, and narcotics are associated with extremes of pleasure.  There is absolutely no point in a pretense that these perceptions are false or unfounded, because evidence to the contrary in the media surrounds the child.  When programs dismiss the appeal of drugs, they inherently devalue their own integrity, and likely render more attractive that which they seek to condemn.  This ideology in place, then, the new program commences in a teacher-led discussion on how drugs are seen by the children.  Complete candor is encouraged by the teacher relaying individual feelings had in the past, or still in place, regarding the inescapable appeal of drugs.  In simple terms, closing one’s eyes to the power of the enemy is not likely to lessen that power, so it is past time that prevention strategies openly addressed the subject, and turn a crippling disadvantage to an asset.

Discussion, moreover, is the central component to this model, and this then assists in overcoming the obstacle of teaching prevention from an authority position to a population resistant to authority.  The classes consist of no strategized lessons, and the relating of information is to be minimal.  The model, in fact, may be viewed as a kind of proactive support group; as the children are free to engage in talk and share experiences and impressions, they will gain the sense of solidarity substance abuse recovery programs offer.  They will understand, for instance, that the temptations they feel are felt by their peers, and in this way the potentially damaging force of peer pressure is redirected.  Equally importantly, each class will reinforce the environment as non-authoritarian.  The teacher must be provided with accessible information to correctly respond to inquiries made, but the general atmosphere must be cooperative, and to the extent that the children feel empowered as contributing individuals.

As this occurs, the teacher then may sway discussion to specific areas.  Several classes, for example, would focus on physicality, and without the typical scare tactic of informing the student that drugs will destroy their brain and health.  Instead, physical activity as a “drug” will be gently promoted, and this is further enabled by the evidence clearly reflecting the pleasurable effects of being fit.  Nothing here, as elsewhere, is to be “instructed”: rather, the open forum will then allow for students to compare such experiences and devise for themselves ways of promoting their own health.  As may be expected, this is also a model completely removed from grading or evaluations.  As noted, even the most careful studies on prevention programs rely on self-reporting, a dubious instrument in an arena in which confessions of substance use is central.  The idea instead is to empower through a passive encouragement of the development of the self, and at the most critical age.  The model here does indeed borrow conceptually from LST, but does not incorporate its more regulated procedures, nor any form of name or language designed to appeal to adolescents, as in, “Keepin’ It REAL.”  This is a necessarily unstructured framework, for the history of prevention programs and common sense together indicate that only a non-aggressive, inviting, non-threatening and non-tutorial approach is likely to generate student interest.

Conclusion

As the history and current status of school drug prevention programs reveal, this remains very much a difficult terrain.  On one level, enough has been learned through trial and error to

eliminate older models of outright negation reliant on societal influence.  New approaches are what may be termed holistic, in that they at least acknowledge the complex variables intrinsic in urging drug prevention on so volatile a population as children, and some success has been recorded.  Nonetheless, the key to an effective school program lies in finally acknowledging what corrupts the children to begin with: the enormous appeal of drugs.  When this is permitted to be explored in an open discussion format, it is reduced in power, and this is vital in preventing children from experimenting with drugs.  Important to the new model presented as well are the components of focusing on early adolescents, minimizing parental interaction, and reintroducing to the children the tangible pleasures and keenly felt benefits of fitness, howsoever they seek to attain them.  While lacking in a means to determine efficacy, this new school drug prevention program is offered as a rational and promising approach.

 References

Caulkins, J. P., Pacula, R. L., Paddock, S. M., & Chiesa, J.  (2002).  School-Based Drug             Prevention: What Kind of Drug Use Does It Prevent?  Santa Monica: RAND Corporation.

Griffin, K. W., Botvin, G. J., Nichols, T. R., & Doyle, M. M. (2003). Effectiveness of a Universal          Drug Abuse Prevention Approach for Youth at High Risk for Substance Use Initiation.            Preventive  Medicine, 36 (1), 1-7.  Retrieved from

http://weill.cornell.edu/ipr/PDF/Griffin-et-al-2003-PM.pdf

Marsiglia, F. F.  (2013).  Behind the Scenes of “Keepin’it REAL,” a Model Substance Abuse     Prevention Program for Middle School Students: Lessons Learned through the Process.        School of Social Work, University of North Carolina, Chapel Hill.  Retrieved from

http://ncace.web.unc.edu/files/2012/06/SLIDES-NC-ACE-02-25-13.pdf

Mathison, S., & Ross, E. W.  (2007).  Battleground: Schools.  Westport: Greenwood Publishing             Group.

Wilson, R., & Kolander, C. (2011). Drug Abuse Prevention: A School and Community    Partnership (3rd ed).  Boston: Jones & Bartlett Publishers

Slee, P. T., Campbell, M., & Spears, B. (2012).  Child, Adolescent and Family Development.      New York: Cambridge University Press.