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.