WHY DRUG EDUCATION DOESN'T WORK

Anti-Drug Programs Makes Adults Feel Good, But All They're Doing Is Digging
A Giant Credibility Hole

Marsha Rosenbaum says it was "a nice Jewish girl, just like me" who showed
her what's wrong with trying to scare kids away from illegal drugs.

At the time, 25 years ago, Rosenbaum was interviewing women addicted to
heroin for her doctoral dissertation. She met the nice Jewish girl in jail.

"She was just the straightest-looking, middle-class woman," Rosenbaum
recalls. "But our lives had taken such different turns."

"What happened?" Rosenbaum asked. "And she said, 'We had these so-called
drug education classes and they said if you smoke marijuana you'll get
addicted to it. And they also said if we used heroin we'd get addicted to
it. Well, most of us tried pot and nothing happened. So when heroin came
along, I figured the whole message must be b.s. so I went ahead and tried
it. And here I am, strung out and in jail.' "

What to do about illegal drugs is hotly debated, but one thing everybody
agrees on is the need to educate kids. "Everybody wants to do prevention.
It's a buzzword," says Senator Pierre Claude Nolin, the Conservative
chairman of the Senate's special committee on illegal drugs.

Unfortunately, that consensus has led to a near-total lack of scrutiny. Who
is teaching our children about drugs? What are kids being told? What is it
supposed to accomplish? And most importantly, is it working? None of these
questions has received much public attention.

As a result, drug education in Canada is a mess -- "not properly planned,
not properly delivered, and definitely not evaluated," Nolin says.

In the committee's final report in September, a call to legalize marijuana
stole the headlines. But the report also called for a radical overhaul of
drug education: Canada's largest program needs to be thrown out, the
senators said. Police officers should stop teaching kids about drugs. Even
the basic goal must change.

Most addiction education -- with the notable exception of alcohol --
preaches only abstinence: Just say no.

That's not good enough, the senators conclude. Almost half of all teenagers
say yes at least once in their lives. So drug education must teach students
how to minimize the risks.

The goal shouldn't be to stop all drug use, which is impossible, Nolin
says. "They should try to prevent the abuse of drugs" -- use that is
extreme, dangerous, or risks creating addiction.

In September's throne speech, the government promised to introduce a new
national drug strategy, the first in 15 years. Education will undoubtedly
be part of that strategy.

Perhaps the most astonishing fact about drugs in Canada is how few facts we
know.

In 2001, Auditor-General Sheila Fraser reported that the federal government
does not even know how much it spends on drug programs and enforcement; she
estimated $500 million a year. That excludes money spent by the provinces
and territories. When Nolin's committee added the cost of municipal and
provincial policing, it estimated that enforcement of drug laws alone costs
Canadians almost

$1 billion a year.

What does this spending accomplish? No one really knows, says the
auditor-general. To figure it out would take good information on rates of
drug use, but the data is "sparse, outdated, or not available."

And drug programs are almost never tested for efficacy. In fact, they
generally can't be tested because, the auditor-general notes, the
government has never set "clear and measurable expectations or objectives."

The fog surrounding drug policy is particularly thick around drug education
programs. How much is spent? No one knows. However, Fraser estimated that
95 per cent of federal spending on drugs goes to enforcement, leaving
perhaps $25 million for everything else. As a result, the Senate committee
concluded, resources available for the prevention of drug abuse are
"woefully inadequate."

A central player in prevention efforts is the drug awareness service of the
RCMP, which provides a variety of education programs. By far the largest is
Drug Abuse Resistance Education. Created in the U.S., DARE brings police
officers to classrooms to tell kids about the dangers of drugs and to teach
ways of saying no. DARE has curricula that cover kindergarten to Grade 12,
but the core program is taught to Grade 5 or 6 students, one hour a week
for 17 weeks.

Community service clubs pay for workbooks, pencils and other supplies,
while the police pay for the officers' time. Community groups usually pay
for police officers to be trained as DARE instructors; while Ottawa does
not contribute, the U.S. government has given $750,000 to pay for the
training of Canadian instructors.

In 2001, the RCMP and other Canadian police forces took DARE into 1,811
schools in 585 communities. About 65,000 kids were involved.

The RCMP runs several other drug education programs, some in which kids are
encouraged to get involved in sports as an alternative to drugs, others for
parents or aboriginal students. In all, RCMP officers make about 10,000
presentations a year.

With the exception of DARE, no program has been seriously evaluated.

"We've had anecdotal evaluation, but obviously that doesn't carry very far
in terms of looking at [whether] we are really meeting the needs," says
Corporal Mark Sorokan, one of 44 officers with the Drug Awareness Service.

He agrees that "evaluation is key to any type of programming." But, he
says, the Mounties just can't afford it.

DARE's efficacy has never been studied in Canada, either. But it has been
evaluated in the U.S. The Senate committee reviewed that research and
concluded that it's a flop.

DARE was developed in 1983 by Darryl Gates, then the controversial chief of
the Los Angeles police department. (Gates later offered a more
unconventional idea for drug policy when he told a U.S. Senate committee
that casual drug users should be shot.) The program ballooned during the
drug panic of the late 1980s. It's now taught in 80 per cent of U.S. school
districts and has spread to 40 other countries.

That growth isn't based on a record of success. In 2001, a report by the
U.S. National Research Council commissioned by the top White House official
on drug policy -- the "drug czar" -- surveyed the extensive research on
DARE and concluded the program has "little effect" on kids' drug use. That
same year, a report from the U.S. surgeon-general's office concluded DARE
had "little or no deterrent effect on substance abuse." In 1997, a report
on crime prevention commissioned by the U.S. Congress was even more blunt:
"DARE does not work to reduce substance abuse."

DARE's failure in the U.S. is well known among Canadian researchers. A 2001
report prepared for Health Canada noted that the American studies have
"been consistent in showing that the program does not prevent or delay drug
use, nor does it affect future intentions to do so."

When Canada's Senate committee reviewed the research, it was appalled.
"This information is in the public domain," the committee report said. "It
has been available for many years. Considering the limited resources
available for the prevention of drug abuse in Canada, federal authorities
and the RCMP ought to have looked at that information" before they brought
DARE to Canada.

But DARE officials insist their program is not a failure. They point to
research that shows students given DARE know more about drugs and have a
more positive attitude about police. Surveys also show that parents,
teachers and school administrators also tend to be satisfied with the
program. DARE was recently given an award for making an "outstanding
contribution to education" by the British Columbia School Superintendents
Association, Sorokan notes.

"Almost any program makes adults feel good because they feel like they're
doing something," says Marsha Rosenbaum, who is director of the San
Francisco office of the Drug Policy Alliance, a non-government organization
critical of American drug policy. But the point of DARE is not to spread
good feelings but to reduce drug use, which it doesn't do.

DARE's defenders blame the schools. William Alden of DARE America says
that, although the program has a full kindergarten-through-Grade 12
curriculum, "most of the communities in the United States and around the
world only had the resources to implement the elementary school curriculum"
in Grades 5 or 6. "Certainly, 17 one-hour lessons are not going to
inoculate anybody" against drug use.

Critics don't buy the argument that there just isn't enough DARE.

"The problem isn't the extent of it, it's the content," says Rosenbaum.
Both the original DARE and the pilot project have just one message: "Drugs
are bad, you shouldn't do them, and here's how to refuse."

That message is a mistake, Rosenbaum says. For one, relying on the
"badness" of drugs to scare kids encourages adults to exaggerate the
dangers. Then, when kids see peers use drugs without falling to pieces,
everything adults say about the subject becomes suspect.

"We have dug ourselves into a giant credibility hole." That's dangerous, as
Rosenbaum found when she interviewed the heroin addict who figured "the
whole message must be b.s."

And kids will see other kids using drugs. In the U.S., slightly more than
half of high school seniors admit to having used at least one illegal drug.
A 2001 survey of Ontario students found 43.5 per cent of teens in Grade 12
had used marijuana; 26.8 per cent had used some other illegal drug.

There are two main explanations for the failure of the Just-Say-No
approach, Rosenbaum says. First, it bears no resemblance to reality.

"Adults regularly use alcohol," she notes. "We gobble pharmaceutical drugs
as well as over-the-counter substances. Kids understand that coffee is a
drug -- they know what happens in the morning when their parents get up and
they've got to have that cup of coffee before they can speak." Children
also see growing numbers of their peers being prescribed "kiddie cocaine"
- -- Ritalin and other stimulants. So rhetoric about living drug-free seems
hollow, even silly.

Then there's the problem of adolescence itself. "It's a time in our lives
when we're most amenable to experimentation, to taking risks, to pushing
the limits. You tell a 15- or 16-year-old boy that something, anything, is
physically dangerous and you're almost setting up a challenge," Rosenbaum
says. Not surprisingly, drug use peaks in the late teen years.

To parents, this may sound hopeless and frightening. But research
consistently finds that such experimentation is not likely to end in disaster.

"Most adolescents who try alcohol or other drugs do not become frequent or
problem users," notes a report of the Canadian Centre for Addiction and
Mental Health. And most teens grow out of it quickly, with rates of drug
use dropping off dramatically when they reach their early 20s.

For many, these facts suggest a Just-Say-No approach should be junked.

"The goals of any alcohol and drug prevention program for youth should be
realistic," says a paper prepared by the Centre for Addiction and Mental
Health. "The main goal should be preventing or reducing harms associated
with drug use."

"It's a bit like safe-sex education," says Eugene Oscapella, an Ottawa
lawyer and a founder of the Canadian Foundation for Drug Policy. "You could
say we're not going to tell people how to do it safely because we just
don't want them to do it. Well, you may not want them to do it, but are you
going to abandon them to serious health consequences, or even death, if
they do it improperly?"

This approach is sometimes called harm-reduction education. As an example,
Oscapella mentions heroin. Students should be taught that heroin is
powerfully addictive and should be avoided, he says. But they should also
be told that someone who uses the drug can dramatically reduce the danger
if they know a few simple facts, such as taking heroin while drinking
alcohol dramatically increases the chance of a fatal overdose.

For most students, that extra information about heroin makes no difference:
Heroin use has always been rare among teenagers -- just one per cent of
Ontario teens in 2001 had ever touched it, according to a Centre for
Addiction and Mental Health survey.

But for a few, Oscapella says, this information might mean the difference
between life and death. He cites the story of Peter Randell, a bright
19-year-old from Victoria. Peter was an avid reader and discovered that
some of his favourite authors had used drugs. One night, he was drinking
beer with friends when he decided, for the first time, to try heroin like
his literary heroes. The combination of drugs killed him.

Would harm-reduction education have saved him? Perhaps. For certain, the
Just-Say-No message did not.

Shifting drug education to focus on harm reduction requires a controversial
change. "Police officers," says the Senate report, "should neither develop
the programs nor deliver them."

In part, that's because police aren't the experts they think they are.

"The police are qualified to talk about the law, but they're not
pharmacologists," says Oscapella. There are a lot of myths surrounding
drugs, and police officers are just as likely to believe the myths as
anybody else.

For example, a recent PBS documentary featured a police expert solemnly
warning viewers that heroin can be instantly addictive -- simply not true.
The DARE America Web site (www.dare.org) says snorting heroin is "just as
dangerous" as injecting it -- again, not true. And Oscapella recalls a
police drug specialist who told an audience "all drugs are equally
dangerous" -- an absurd statement.

Still, Sorokan insists police officers make up for their lack of training
in pharmacology by working on the street. "We're qualified based on our
experience," he says.

But according to Patricia Erickson, a drug researcher at the Centre for
Addiction and Mental Health, that experience leaves police officers with a
distorted picture of drugs.

"There's no question that there's casual, moderate, spasmodic use of
heroin, cocaine, any drug you want to think of," she says. But the police
almost never see that sort of drug use because it goes on privately and
doesn't cause problems. The police only see the worst manifestations of
drug use -- homeless junkies, criminals, "crack whores," and overdose
victims. From this, they conclude that illegal drug use is likely to lead
to addiction, misery and death.

Thus police officers are bound to favour the Just-Say-No approach -- one
reason they're the wrong people to deliver harm-reduction education. And
police officers are sworn to enforce the law, which makes it awkward or
impossible for them to teach how to, in effect, break the law more safely.

In addition to ditching the police and the Just-Say-No approach, Rosenbaum
would like to drop something else from drug education. "Stop trying to send
messages," she says.

"We are so focused on the message we're sending to kids that it gets in the
way of just providing the science. The kids know we are trying to send them
a message. They get that part. They know we want them to abstain. And they
also know we will say just about anything to get them to abstain. They
tolerate us, but you know, they turn around, they roll their eyes, and they
go ahead and do it."

The same conclusion is drawn by Health Canada's Best Practices report:
"Fear-arousing messages accompanied by incorrect or exaggerated information
are not effective, and can generate skepticism, disrespect and resistance
toward any advice on substance use or other risk behaviour." Most
critically, drug information should always be "scientifically accurate,
objective, non-biased and presented without value judgment."

What's needed is honesty, Rosenbaum says. She would like to scrap
stand-alone drug classes whose explicit purpose is to manipulate behaviour.
Instead, factual information about drugs -- not just illegal drugs but all
- -- would be interwoven with other classes, like science and civics
education. (Examples can be found at her organization's Web site,
www.safety1st.org.)

"Just give them the information," she says. "They're going to make
decisions for themselves anyway."