Mental Health Matters; ‘Just Say No’ just a form of lip service? (opinion)
Mental Health Matters
Last week I had the good fortune to sup with my son in San Francisco. He was in town on business, and I told him I was writing a column on the Drug Abuse Resistance Education (D.A.R.E.) Program.
“Oh yeh,” says he, “that program.” (My son grew up in Marin County, California in the 1980s). As he recalled it, the programs “Just Say No” approach to alcohol, tobacco and drugs seemed to goad teens to try the stuff, knowing full well that most of their parents partook of one or more of the substances, and seemed to be doing just fine.
D.A.R.E., a national and later international substance abuse prevention program for school-age youth, was founded in 1983 as a joint initiative of the Los Angeles Police Department and the L.A. Unified School District.
Students sign a pledge not to use drugs and are taught by local police officers about the governments thoughts regarding the dangers of illegal drug use.
The program has grown into a behemoth organization that has paid 70,000 police officers to teach 200 million kids world-wide, and 140 million in the United States about the dangers of substance abuse.
At its peak, it’s estimated that the program cost $1 billion annually, about $200, per student, per year. Not bad.
You would think that a program initiated to decrease substance abuse would be scientifically validated on a small sample before billions of dollars are spent implementing it nationally. You would be wrong.
Parents like the program because their children are taught that illegal drugs are all highly addictive and dangerous. Parental support is mistaken for program effectiveness. Money flowing to school districts proves irresistible.
Unfortunately for D.A.R.E. and 200 million student participants, almost all reputable research concluded that the program has no influence on decreasing subsequent substance abuse, and, in some studies, even seemed to increase substance abuse.
Psychologists call this latter effect “psychological reactance,” namely attempts to restrict a person’s freedoms can produce an anti conformity boomerang effect.
As a 2014 article in Scientific American points out, “Just Say No” programs exemplified by D.A.R.E. are largely ineffective, because only instructing students that substance abuse is bad has no behavioral impact.
In 2009, in response to mounting criticism and diminished financial support, D.A.R.E. Program content was altered to include interactive learning and is now said to be more effective.
Recently, the FBI and the Drug Enforcement Administration have produced a raw and dramatic story aimed principally at high school students. Entitled “Chasing the Dragon-The Life of an Opioid Addict,” this 45 minute video and companion study guide are being made available to schools and the nation.
The film will garner a wide audience. There is little to offend conventional wisdom; Illegal drugs are deemed highly addictive, marijuana is portrayed as a “gateway” drug, and jail is a natural, rather than a political, consequence of getting caught.
Like the D.A.R.E. Program, the “Just Say No” tone of the video will earn parental support.
But will it work? Will this new effort to decrease substance use in youth accomplish its goals? Unfortunately, like D.A.R.E., this program is being rolled out at a national level in the absence of research proving its effectiveness.
For my money, a more objective, balanced and informative look at drug abuse is offered in the new Frontline program, “Chasing Heroin,” first aired on February 23, 2016.
This documentary, like the FBI/DEA movie, focuses on the physical and soul-destroying impact of drug addiction. But it also describes the problem in a social and political context, correctly noting that, “we can’t arrest our way out of this problem,” and highlighting the innovative ways that beat cops in the Seattle area, together with social service agencies, are dealing with drug use on their streets.
This story argues that traditional criminal justice approaches simply don’t understand the nature of drug addiction, thus multiplying the very agonies they want to diminish.
The program challenges the viewer to understand the logic of treatment on demand rather than incarceration, and harm reduction strategies like providing clean needles to addicts.
Moreover, it discusses the controversies surrounding Drug Courts (Washoe County recently increased its budget for Drug Courts), and the nationwide need to improve treatment services for addicts.
If, as an informed citizen, you want to better understand drug addiction, I recommend both of these on-line videos for your consideration.
Incline Village resident Andrew Whyman, MD, is a clinical and forensic psychiatrist. He can be reached for comment at email@example.com.
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