Prevention of Drug Abuse

Clayton, et al (1996)
Botvin, et al (2004)
 The Evolution of DARE
 Gottfredson (1997):
 Reviewed all credible studies of DARE up to 1997
 Concluded it did not work, made suggestions
 Up to 1997 extensive research showed it
 didn’t work to reduce use, but
 did improve drug attitudes & knowledge about drugs
 Around then, DARE changed it’s curriculum (10, etc)
 Then claimed all the old research was no longer valid
 They also changed the stated goals of the program
 Not to reduce drug use, but improve attitudes/knowledge
 Always successful at these, but doesn’t lead to reduced use
 A DARE Evaluation Example
 Clayton (1996): strong research design, credible
 Study of the original DARE, funded by NIDA, not DOJ
 Published in Major Medical Journal (Preventive Med.)
 Looked at Long-term effects of DARE (5 Yrs)

 Randomly Assigned 31 Schools (DARE or Not)

 DARE in 6th Grade, Surveyed thru 10th, 2071 Students
 Asked about Alc, Tob, MJ use in last year, attitudes, etc.
 7th grade: Some better attitudes about drug use (7th only)
 No differences in Drug Use in 7th grade or any later years
 Overall increases in drug use over time of this study
 DARE may have slowed the increase, but not by much & not
for long
 Informal Student Survey
If DARE doesn’t work, why do we still have it?
Parents often support the program, don’t want it removed from schools

64 students in one of my prior classes

 76% had been in DARE in school
 94% knew someone who used drugs after being in DARE
 9% thought DARE had helped them avoid drug use
 Asked about when they were kids…
 42% thought it would help them avoid using drugs
 52% would have told their parents it was a good program
 39% said they would have told their parents it was good, even if they
didn’t really think it was
Illicit Drug Use Prevalence Rates for U.S. High
School Seniors in 2006

Over the previous 12 months:

Marijuana: 32% Cocaine: 6%
Ecstasy: 4% LSD: 2%

Copyright © Allyn & Bacon 2008

 Botvin & Griffin: Life Skills Training
 Despite declines since 1970s, some recent increases in
adolescent drug use point to need for prevention
 Alc, Tob, MJ are most widely used; May be Gateway drugs
 1/3 of HSS report being drunk/smoking, 1/2 used MJ
 Experimental use does not always lead to abuse, but
 Early onset is a risk factor for later crime, addiction, MH problems

 Prevention is important for several reasons

 Treatment is hard to make work, not 100% effective
 Other things like deterrence/interdiction don’t work

 Policy makers are coming to realize these facts

 Background on Life Skills Training
 Research shows many risk factors for Drug Use
 Cognitive, Social, Personality, Biological, etc
 These are good targets for prevention programs
 Esp. Drug-related behavior/attitudes of peers, siblings, pts
 Other factors include attitudes to drugs, self control, negative
feelings, sensation seeking
 Gateway theory suggests even delaying use could help
 Prevention programs often School-based (DARE)
 Best ones are based on accurate Psycho-Social theory &
they target actual risk factors (not common sense ideas)
 LST is a comprehensive program
 There are others that work too. Check out
 http://www.blueprintsprograms.com/
 The LST Program
 Resistance Skills & General Personal/Social Skills
 “most evaluated and evidence-based prevention prog.”
 Over 20 years of research supports it in various forms
with different samples and for different drug types
 50+% reductions in use of Tobacco, Alcohol & MJ

 3 Major Parts
1.General Self-Management Skills
2.General Social Skills
3.Drug-Specific Information & Skills
 Examples: Decision-Making, Problem Solving, Self-Control,
Social/Interpersonal Skills, Resistance Skills
 Examples of LST Effectiveness
 Program has been found effective for:
 Short-term reductions in smoking among White students
 When provided by teachers or peers
 With or without “Booster Sessions”
 Creating reductions in Alcohol & MJ use
 Long-term effects on Tob, Alc, MJ in NY State White students &
among Minority students in NYC
 Similar effects on Binge Drinking too

 Mediating Effects (How does it work?):

 Increases overall psychological health of person
 Reduces positive expectations (rewards) for drug use, &
 Increases assertiveness in refusing drugs
 Conclusion
 “Good” Prevention works (LST)
 Can have relatively large impacts (50+% reductions in USE)
 Generally seen as Cost-effective, esp. over the long-term
 So the benefits outweigh the costs of the program

 Problems
 Most of Federal Money spent on Prevention had gone to DARE,
despite consistent evidence of little or no effectiveness
 It’s not that we don’t know what else might be better…
 Other things work, but they are not as well known or widely
implemented (“Flashy”, feel-good programs dominate)
 We could probably get more preventative effect by spending
what little prevention money we do on something that works,
like Life Skills Training
Franklin County, FL: “BUSTang”