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Just say nonsense.

"I can't get caught in the middle here--I've got my job," the man whispers into the telephone, careful not to be overheard. "But I've seen data that this stuff doesn't make any difference at all." The "stuff' is an educational product sold by this guy's company. Is he peddling video games? Dumbed down textbooks? Nope: a Just Say No anti-drug curriculum taught in schools. Tums out that the effectiveness of the mantra of Nancy Reagan's first ladyship may be about as durable as a caffeine buzz.

In the past 10 years, drug education has become a $2 billion industry, with companies selling expensive teachers' seminars and anti-drug texts to schools across the country. At least $1.25 billion of that comes from federal block grants that schools can use for counseling, social work, and other "anti-drug" activities and paraphernalia--including posters, bumperstickers, t-shirts, and coffee mugs. At least an additional $750 million comes from local and state governments and corporate gifts. Money well spent if it keeps our children from inhaling, right? That's the catch: There's little evidence that these dollars do anything to keep kids from using chugs. It's a new alphabet soup, all acronyms for messages of abstinence: STAR, DARE, ALERT, and dozens more. The nation's schools have bought a bill of goods so large and so ostensibly worthy that it's difficult to acknowledge disappointing results. And the money, now that it' s flowing, is subject to the oldest fact of bureaucratic life: Once a government subsidy starts, it's virtually impossible to shut down.

Since the early eighties, Just Say No courses-classroom sessions, usually about a dozen, held over a few months in sixth, seventh, or eighth grade, sometimes supplemented by community and high school events--have quietly become commonplace. These programs have produced exorbitant claims of success: "More than 25 million kids will be impacted by the highly successful DARE program," reads one glowing press release. "DARE's impact on reducing drug use among young people is well-documented by numerous studies."

Drug bust

That, of course, sounds encouraging; the only problem is that it's not true. Perhaps the best that can be said of the Just Say No ideology is that it makes parents and teachers feel better. A 1988 analysis published in the Journal of Drug Education found that although the sessions probably didn't keep kids away from drugs, they did reassure "parents that the schools are at least trying to control substance abuse among students." Meanwhile, a new University of Michigan study finds that, after years of decline, marijuana, cocaine, and LSD use is actually rising among eighth graders.

Consider Project SMART: Founded in 1981, SMART was one of the earliest Just Say No programs taught in junior high schools. The approach seemed valid: Once a week for 12 weeks, kids would be taught to resist peer pressure, interpret ads for booze or cigarettes, and practice saying no through role playing. To evaluate how well the program worked, the children were tested one and two years later. The first follow-up found children still doing well, at least in resisting cigarettes. But at the end of the second year, almost all positive effects had faded, and kids in the study were now smoking cigarettes and marijuana to about the same degree as those who hadn't been in SMART.

Worse, the evaluators lost track of more than 50 percent of the kids before the follow-ups were completed. As a result, one reviewer of SMART says, "Even the modest effects reported by the investigators are debatable."

But through the magic of statistics, these small gains have been translated into tremendous victories in the war on drugs. In an evaluation of one program, ALERT, 1.4 percent of the kids who had been in the class had tried marijuana within 15 months of completing the course, compared to 3.7 percent of the kids

who hadn't participated--a difference of 2.3 percent. ALERT researchers, however, claimed a heartening 60 percent drop in marijuana use. Technically, they were right: 2.3 is about 60 percent of 3.7. And doesn't a 60 percent improvement sound so much better than 2 percent?

A better indicator of ALERT's success comes from a study by the Rand Corporation and the Conrad N. Hilton Foundation. The evaluators found that it had the strongest effects on kids that needed it least. Children who had puffed on just one or two cigarettes came out of the program with a strong distaste for l'air de Marlboro. While ALERT delayed many kids from trying marijuana and found modest effects on their use of alcohol, the benefits disappeared the next year. According to Dr. Phyllis Ellickson, the project's primary investigator, this shows that, "If you make even a little dent, it's hard to maintain it."

Cooking the numbers like this is not unusual. "Generally, the agencies that are funding the programs are also the ones paying for the evaluation," says Dr. Joel Moskowitz, principal investigator for the Western Consortium for Public Health, a nonprofit attached to the University of California at Berkeley and at Los Angeles. "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."

Another program benefitting from massaged data is Project STAR. According to Mathea Falco's enthusiastic 1992 book, The Making of a Drug-Free America, the nine-year old STAR program is "one of the most effective prevention programs in the country." STAR's results in Kansas City, for instance, did seem remarkable: an across-the-board, 30 percent drop in alcohol, marijuana, and cigarette use by kids. But when they tried to reproduce STAR in Indianapolis, the results weren't nearly as dramatic. In the most recent follow-up, Indiana children were only 3 percent ahead of average for cigarettes, and less than 1 percent for cocaine use. :

No program, however, illustrates the folly be- hind Just Say No as DARE, the most widely ! taught program nationwide. Founded in 1983, ' DARE, which grew from an idea proposed by i then-Los Angeles Police Chief Daryl Gates, now reaches five million schoolchildren. Although the message it delivers is substantially the same as the others, this one is unique: DARE is taught only by uniformed police officers. Official DARE estimates peg the program's cost at $12 per child, which would make it the cheapest drug education program in the country. (STAR and its cohorts cost between $15 and $25 per child.) But how well does that $12 figure stand up to scrutiny? According to a Justice Department report, nearly 10,000 police officers have had the two-week DARE training sessions. Assuming officers are paid $35,000 per year (including benefits), that's at least $14 million spent for weekly salaries during training. And if only three-quarters of these trained cops are working for DARE half-time, the total would be over $125 million just for annual payroll. If these estimates are even close, DARE is easily the nation's most expensive drug prevention program. And more important, as even Falco notes, "DARE does not reduce tobacco, alcohol, or drug use," a conclusion other studies have reached.

Who pays for DARE? You, in part. The Drug Free Schools and Communities Act of 1986 requires that 10 percent or more of the state grants to governors go only to projects that include "classroom instruction by uniformed law enforcement officials" and meet other criteria met only by programs "such as Project Drug Abuse Resistance Education." There's nothing nationwide that meets these standards--except DARE. In the 1992 appropriation, its share of the pie came to almost $10 million. The rest of the money comes from city funds, corporate and private grants, and drug seizures, bringing in rivers of money to police departments to win public relations points in their jurisdictions and time off from more difficult crime fighting.

And while the managers of programs like DARE and STAR are eager to fill their coffers, no one is really sure what happens to all the drug education money once it trickles down to the schools. A California program, CADPE, tried to find out by making the schools accountable. Supervisors didn't expect the schools to prove the drug programs worked; they merely wanted to make sure the drag war money went to the fight place. Administrators were astonished when schools asked if they could use the money for football teams and bus trips. The schools claimed these expenses were justified because they offered kids drug-free activities. CADPE held firm, demanding that they prove every dollar was spent as intended. It'll be worth it, CADPE told the schools, because we're in this for the long haul. They were wrong. Three years after CADPE kicked off, California red-lined it out of its 1992 budget.

CADPE had one advantage, however, over most Just Say No programs: At least it was evaluated. A 1988 review found that only 10 percent of 350 different school programs had been assessed at all. Evaluation is difficult work: Because follow-up takes years, many children are lost to researchers as families move away and kids drop out of school or fail to return questionnaires. In some studies, more than half the children are lost. Except for DARE, which is run by police officers, all school programs are presented by school faculty or health educators. We have no idea how well or how much of any curriculum is actually delivered. One isolated study found that less than 70 percent of the material was presented as intended.

Of course, some reviewers of Just Say No have tried in recent years to show that the emperor has no clothes. But the same federal dollars that pressure evaluators to put a positive spin on the resuits also pressure independent scientists--many of them dependent on research grants from federal agencies--to keep their opinions to themselves. And if they do have the courage to speak out, they need only remember what happened to their colleague, Dr. Michael Newcomb. Newcomb's 1988 book, Consequences of Adolescent Drug Abuse, had an innocent enough conclusion: There was, he wrote, no evidence that most people who experiment with drugs get hooked. But this was big news in the last summer of the Reagan administration, when "use" and "abuse" were synonymous. The story made the front page of The New York Times, and provoked a fierce, kneejerk reaction from parents' groups and White House officials which led Newcomb to believe that his federal funding was in jeopardy.

Up in smoke

In the muddle of Just Say No, one program seems to have succeeded: the High/Scope Curriculum, funded by the foundation of the same name. According to its most recent follow up evaluation, more than 70 percent of the inner city kids in the program stayed away from drug dealing compared to peers who hadn't participated. Even better, the benefits continued well into adulthood. And, amazingly, it isn't even a new breakthrough in dealing with troubled teens--it's a preschool project for children 3 to 4 years old that began in 1962.

What went fight? It seems doubtful that preschool training would have much influence on behavior a quarter century later. One factor may have been the weekly 90-minute home visits from counselors who met with the children's parents. These meetings focused on the child's development--in essence, teaching parents how to parent. Another factor is the social and educational value of preschool. If high risk children start on an even footing with the rest of their classmates, they're less likely to drop out or slip into drug use. These explanations match the risk factors identified by Dr. Denise Kandel of Columbia University, who has studied the topic for 20 years. Kandel says that children's depression and poor relationships with parents are greater threats than peer pressure. Children who do well in school are less likely to be depressed, and better trained parents translate into a more stable home life for the children. The cost of such outreach now is staggering, unless a broad national service program were in place in which volunteers were doing the work on a large scale that the High/Scope did on a small one.

So what can we do about adolescent drug abuse? Ignore the problem? Jail every kid that sips from a can of beer? "I think the targets ought to be delay[ing use] and focusing on abuse rather than just focus on use. Most kids who try something don't get in trouble," says Newcomb, who is now a professor of counseling psychology at 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 were a simple answer to the complex problem of drug abuse."

One alternative is called responsible use. Like the Just Say No approach, it does not condone alcohol, cigarette, or drug use by children. It differs in recognizing that most kids do experiment with some of these substances--particularly alcohol. Over 90 percent of adolescents drink before leaving high school. The no use vs. responsible use debate was part of a 1991 General Accounting Office (GAO) report that criticized the single-minded position taken by the government: "Current research evidence has not demonstrated the general superiority of one prevention approach over any other, nor have any evaluations isolated the effects of a no use approach.'' The GAO concluded that "the search for effective drug abuse prevention programs will be most effective . . . if their policies are broadened to permit review of any type of promising program." Some researchers readily admit they would like to junk the strict Just Say No dogma and incorporate the responsible use approach. "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 in 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."

Realistic or not, responsible use is not a message that the feds want delivered. Department of Education guidelines demand a firm stance of "no illegal use of legal substances and no use of illegal substances." This eliminates many worthy organizations, such as SADD (Students Against Drunk Driving). Despite a proven record in reducing drunk-driving deaths, SADD's recognition that teenagers drink means it doesn't qualify for any drug war money. That ought to change.

So what's the solution? Schools the paying customers-ought to hold the Just Say No companies to the fire, demanding genuine evaluations before investing money in curricula that are just going to absorb valuable class time and whose results go up in smoke. At the same time, state education departments which are doling out drug education money need to make certain the money's reaching the classroom and not financing, as it did in California, bus rides, ball games, and other boondoggles. Just saying no to ineffective educational gimmicks is one informed decision grown-ups ought to be making.
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Title Annotation:Nancy Reagan's drug education programs
Author:Elliott, Jeff
Publication:Washington Monthly
Date:May 1, 1993
Words:2558
Previous Article:Mr. Break-It: the not very reassuring past of Ira Magaziner, the brains behind the Health Care Task Force.
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