Albia Dugger • Miami Dade College

Chapter 16 Drug Prevention

and Education

Approaches to Prevent Drug Abuse

• What should be the goals of drug education and prevention?

• When should drug education and prevention efforts be initiated?

• What education and prevention efforts are effective?

• Who should be responsible for drug education and prevention?

Funding Drug Prevention

• In the US, most funds for drug prevention come from the federal government

• 2012 National Drug Control Budget: $1.7 billion was allocated to drug prevention out of a budget of $26.2 billion

• Most community leaders favor spending a larger portion on reducing demand rather than supply of drugs

Agencies

• Substance Abuse and Mental Health Services Administration (SAMHSA) is responsible for:• Center for Substance Abuse Prevention (CSAP)• National Institute on Alcohol Abuse and Alcoholism

(NIAAA), • National Institute on Drug Abuse (NIDA)• Office of Treatment Improvement• National Institute of Mental Health (NIMH)

Drug Prevention in Retrospect

• 1970s: Primary focus was to reduce the supply of drugs by stopping their importation, sale, and manufacture

• Interdiction remains a popular strategy but now is complemented by other measures

• 1980s: Some drug experts began to contend that prevention should be directed toward the underlying factors that contribute to drug abuse

Drug Prevention in Retrospect

• Society was concerned primarily with hard drugs such as heroin, LSD, cocaine, crack, and PCP

• Soft drugs such as alcohol, tobacco, and marijuana are known as gateway drugs

• The primary strategy of CSAP is to keep young people from experimenting with drugs at all

Effectiveness of Prevention Programs

• Problems in assessing effectiveness of programs:• Absence of control groups• Poor data collection• Groups that are too small• Inappropriate statistics• Lack of followup to determine how long any change in

drug use persisted

School-Based Programs

• Five essential criteria:1. Adequate hours of curricula, over at least three years2. Peer involvement3. Emphasis on social influences, life skills, and peer

resistance4. Change in perceived norms5. Involvement of parents, peers, and the community in

changing norms

Goals of Drug Prevention

• To prevent the individual from beginning drug use• To minimize the risks of drugs to the user• To reduce the risks of drug use to society• To prevent drug dependency• To teach responsible drug use• To stop drug use after patterns have been established• To delay the onset of drug use

Levels of Drug Prevention

• Primary prevention: • Strives to reach people before they start using alcohol,

tobacco, or other drugs• Should be initiated at a young age because most children

already have tried drugs, especially alcohol, by the time they get to high school

• Includes drug education, mass media campaigns, community-oriented programs, drug testing, and legislation

Levels of Drug Prevention

• Secondary prevention: • Attempts to minimize potential damage resulting from drug

use by targeting people who have experience with drugs.• Considered an early intervention stage

• Tertiary prevention: • Geared to heavy drug users and those whose patterns of

drug use are well established• Basically refers to drug treatment

Drug Prevention Continuum

Identifying High Risk Youth

• High risk behaviors include:• Delinquent behavior, self-destructive behaviors, and

dropping out of school

• Risk factors include:• Individual behavioral factors• Individual attitudinal factors• Individual psychosocial factors• Family factors• Community environmental factors

Drugs and Delinquent Behavior

Resilient Children

• Many children from impoverished backgrounds display resiliency despite the presence of major life stressors

• Characteristics of resilient children:• Flexible, responsive, adaptable, and active• Have positive relationships • Empathetic, caring, persistent, competent problem-

solvers, success oriented, and educationally motivated• Able to disengage from dysfunctional family environments

At-Risk Factors

• Hereditary and Familial Factors:• Sons of men with alcohol problems are more likely to have

alcohol problems• Rates of dependence are greater if siblings are dependent• Family history of antisocial behavior or criminality

increases the risk of drug problems• Lack of supervision of children after school is related to

drug use

At-Risk Factors

• Psychosocial Factors:• Peer pressure• Low self-esteem• Low self-efficacy• Sensation seeking• Lack of social skills• Rebelliousness against authority• Lack of commitment to school• Attraction to deviance• Unfavorable attitudes toward adult behavior

At-Risk Factors

• Biological Factors:• Different amounts of pleasure derived from drugs• Different amounts of self-control

• Community Factors:• Communities where people move often• Extreme poverty and deprivation• Communities that lack social support and controls

regulating behaviors, including drug use

Preventing High-Risk Behavior

• Education:• Poor school performance and low expectations for school

are strong predictors of drug use• School alternative programs focusing on community and

recreational activities, physical activities, and job training help youths at risk to stay off drugs

• Teachers may be role models for helping children to develop resilience

Head Start

• Preschool programs such as Head Start help at-risk children

Preventing High-Risk Behavior

• Role of parents:• Parental drug use greatly increases the likelihood of

children’s drug use• Parents who have high expectations for their children

foster academic success and resilience

• Community efforts:• Drug use is prevalent in impoverished, urban

neighborhoods• Jobs have been shown to help curb drug use

Preventing High-Risk Behavior

• Barriers to community prevention efforts:• Leaders’ lack of perceived empowerment to continue

prevention work• Insufficient preparation for adopting successful programs • Public resistance to spending more money on drug

prevention programs after ineffective programs• Idea that programs that are effective in one community will

not necessarily work in other communities

Drug Education

• Evolution in Drug Education:• 1970s: Information about the dangers of drugs• Mid 1970s: Values clarification focused on the underlying

values contributing to drug use• Alternatives approach substitutes a positive addiction for

the negative addiction• More emphasis on health in general and less emphasis on

the pharmacology of drugs• Current education emphasizes developing resilience skills,

learning peer-refusal techniques, and gaining life skills

Limitations of Drug Education

• Problems with Drug Education:• Teachers often do not keep up with latest information• Students sometimes know more about drugs than

teachers do• Some teachers are judgmental or moralistic• Goals of drug education are often unclear• Goals of drug education are often unrealistic

Goals of Drug Education

• Possible goals:• To impart knowledge• Reducing drug abuse or dependency• Preventing or delaying first-time drug use• Curtailing students’ drug use• Teaching responsible drug use

One-Size-Fits-All Drug Education

• What Works: Schools Without Drugs Objectives1. Valuing and maintaining sound personal health and

understanding the effects of drugs on health2. Respecting laws and rules that prohibit drug use3. Recognizing and resisting pressure to engage in drug-

taking behavior4. Promoting activities that reinforce a positive, drug-free

lifestyle

Current Approaches to Drug Education

• Personal and Social Skills Training:• Young people who rate high in self-efficacy are more

likely to avoid harmful patterns of drug use• Skills training: A drug prevention program in which one

learns skills to prevent drug use• Includes skills for resisting media and interpersonal

influences, problem-solving and decision-making, relieving stress and anxiety, relaxation, self-control, self-esteem, interpersonal relations, and assertiveness

Current Approaches to Drug Education

• Social Norms Approach:• Goal is to correct misperceptions of students and reduce

alcohol use

• Resistance Skills Training:• Involves recognizing, managing, and avoiding situations

that may encourage drug use

Current Approaches to Drug Education

• Drug Prevention Programs:• Project ALERT has been shown to reduce weekly alcohol

and marijuana use, at-risk drinking, and alcohol use resulting in negative consequences, as well as attitudes and perceptions conducive to drug use

• Life Skills Training (LST): students are taught how to avoid being persuaded by others, to manage anxiety, to communicate more accurately, to be assertive, and to enhance their self-esteem

Current Approaches to Drug Education

• Drug Abuse Resistance Education (DARE):• Police officers go to classrooms and teach elementary

students about drugs and personal safety• Had little impact on drug use

• Just Say No!• Adequate for some students, but not for others• Some students do not recognize peer pressure or have

the skills to refuse drugs

DARE improves relationships between police, children, and schools

Effectiveness of Drug Education

• Components of Effective Programs:• Based on an understanding of theory and research• Information is developmentally appropriate; short-term,

negative social consequences are emphasized• Emphasize social resistance skills training • Includes normative education• Teachers use interactive teaching techniques• Teachers receive training and support• Time devoted is sufficient and continued• Programs are culturally sensitive.• School programs include family, community, and media• Evaluation is necessary to determine effectiveness

Health Education

• Drug education at the secondary level typically is taught in health education classes

• Sequential health education from K through 12th grade had a positive effect on knowledge, attitudes, and behaviors

• Administrative support and teacher training are important to the success of health education

Peer Programs

• In some, older students teach younger students about drugs

• In other programs, peers facilitate discussions about drugs with others of the same age, or peers counsel peers

• Besides acting as role models, peer leaders have to be able to communicate effectively

• Peer programs were most effective with the average student; for at-risk students, alternative programs were most effective