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NASP Communiqué, Vol. 33, #4

A Reality-Based Approach to Teens and Drugs

By Marsha Rosenbaum

Like many parents, when my children entered adolescence, I wished "the drug thing" would magically disappear and my children would simply abstain. But as a drug abuse expert whose research was sponsored by the National Institute on Drug Abuse, and as a parent, I knew this wish to be a fantasy.

It comes as no surprise to school psychologists and counselors that despite federal expenditures for prevention “education” exceeding $2 billion per year (and five to seven times that at state and local levels), government surveys consistently show that half of American teenagers admit to experimenting with drugs by the time they graduate from high school, and 8 out of 10 have tried alcohol.

Today’s adolescents have been exposed, since elementary school, to the most intensive and expensive anti-drug campaign in history. Haven't they been told, again and again, to “just say no” by school-based programs such as Drug Abuse Resistance Education (DARE) and hard-hitting media campaigns? Why hasn’t the goal of teen abstinence been achieved? Where have we gone wrong, and what can we, as parents, counselors and school psychologists, do to ensure the safety of our teenagers?

The Context of Prevention

As a sociologist, I believe it’s important to look at the context of our prevention efforts. Though we urge our young people to be “drug-free,” the American public, including children, are perpetually bombarded with messages that encourage them to imbibe and medicate with a variety of substances. Alcohol, tobacco, caffeine, over-the-counter and prescription drugs seem to be everywhere. In fact, the Journal of the American Medical Association recently reported that 80% of adults in the U.S. use at least one medication every week, and half take a prescription drug (Kaufman, et al., 2002).  Nearly one in two American adults uses alcohol regularly; and more than one-third have tried marijuana at some time in their lives, a fact not lost on their children. 

An additional factor makes the “drug-free” mantra problematic. Today's teenagers have witnessed the increasing “Ritalinization” of their fellow (difficult-to-manage) students, and stimulants such as Adderal have become a drug of choice on college campuses. All of us have seen prime-time commercials for drugs to manage such ailments as “Generalized Anxiety Disorder,” with teenagers the most recent market for anti-depressants. Teenage drug use seems to mirror modern American drug-taking tendencies. Therefore, some psychologists have argued that given the nature of our culture, to define teenage experimentation with legal and illegal substances as “deviant” is inaccurate.

A common, though faulty, assumption driving our prevention efforts is that if teenagers simply believe that experimentation with alcohol or other drugs is dangerous, they will abstain.  As a result, many programs include exaggerated risk and danger messages. Although the old Reefer Madness-style messages have been replaced with assertions that we now have scientific “proof” that drugs are dangerous, critical evaluations, particularly of marijuana, pierce holes in the most common assertions and are inconsistent with students’ observations and experiences. Hence the cynicism we see in so many teenagers regarding the anti-drug messages they regularly receive.

Science-Based Education and School Policies

It’s time to dispense with messages designed to frighten students, and replace them with drug education based on solid science that will prepare them for lifelong decisions, such as appropriate dose levels and the effect of combinations, about a range of substances they might ingest. 

On the technical side, the subject could easily be integrated into a variety of high school courses and curricula, including physiology and biology (to learn how drugs affect the body), psychology (to learn how drugs affect the mind), chemistry (to learn what’s contained in drugs), history and civics (to learn how drugs have been handled by the government), and social studies (to learn who uses which drugs, and why).

Even the best education isn’t enough. It is important for students to have a safe place where they can talk honestly and openly, and share their fears and concerns without judgment.  Many conversations about alcohol and other drugs already happen in the offices of the trusted school counselor or psychologist, or as part of a growing number of student assistance programs.

But when dealing with students who are not abstinent, who say "maybe" or "sometimes" or "yes" to alcohol and other drug use, many professionals face an impossible dilemma. They want to help, to open honest conversations, but are strapped by abstinence-only, zero tolerance policies, rendering them unable to advise those students who need them most. It’s a long road from experimentation to abuse, and school psychologists, freed up from policies derived from politics rather than science, can make a real difference in keeping students safe.

Problems with punitive policies. There are no easy answers when it comes to teenage use of alcohol and other drugs, but it’s clear that increasingly punitive measures make the situation worse.

Random drug testing, the “silver bullet” promised and promoted by the federal government, has many pitfalls.  First, the largest-ever national survey (76,000 students) to measure drug testing reported in 2003 that there is no difference in illegal drug use among students from schools with or without drug testing (Yamaguchi, Johnston, and O’Malley, 2003). Drug testing alienates students, who must be observed by a school official while urinating to be sure the sample is their own. The collection of a specimen is a humiliating violation of the most basic privacy, and especially embarrassing for an adolescent. Testing can have the unanticipated effect of keeping students from participating in extracurricular programs—activities that would fill their time during the peak teenage drug-using hours of 3-6 PM. Finally, drug testing is expensive.  School administrators in Dublin, Ohio, for example, calculated that their $35,000 per year program was not cost-efficient. Of 1,473 students tested at $24 each, 11 tested positive, for a total cost of $3,200 per “positive” student. They canceled the program and, with the savings, were able to hire a full-time counselor (Gunja, Cox, Rosenbaum, and Appel, 2003, see Figures 1 and 2).

In general, “zero tolerance” policies simply push students away, though research from the National Longitudinal Study of Adolescent Health (McNeely, Nonnemaker, and Blum, 2002) shows that school connectedness has a direct relationship to lowered health risk behaviors such as drug use.  That’s why last year the California State PTA passed a resolution to “support in-school suspension, after school interventions, positive behavior mentoring, student assistance and other programs that offer counseling and education as a preventive disciplinary response to student drug abuse.” (California State PTA Resolution C, 2003) Most recently, the National Institutes of Health reported that “get tough” youth programs, as well as boot camps and DARE, are ineffective. The report cited various forms of counseling as most effective (National Institutes of Health, 2004).

Safety First

Similar to comprehensive sex education, reality-based drug education, coupled with counseling when needed, has the promise of increasing students’ knowledge, awareness and safety.

Although parents today are strongly encouraged to have “the drug talk” with their teens, many are uncomfortable with the subject. Some don’t know enough; others know too much; they’re embarrassed—so the talk falls into the lap of the school psychologist or counselor. That’s why the Drug Policy Alliance (www.drugpolicy.org) created the Safety First project in 1999, as a drug education program for educators and parents looking for balanced information and alternatives to failed “just say no”-style approaches, as well as ways to talk with teens about drugs. We provide free, easily digestible written materials, including the 17-page booklet, Safety First: A Reality-Based Approach to Teens, Drugs, and Drug Education, a take-action brochure (Getting Real About Teens and Drugs), a website (www.safety1st.org) containing balanced fact sheets about a variety of drugs, a Q & A column, news and more; and a video (Let’s Talk) of teens talking about drug education. We are now an allied agency of the California State PTA, and have distributed over 120,000 packets to parents and educators all over the world. We are pleased to make these resources available (through our website) to members of the National Association of School Psychologists.

A popular sample of our materials is a letter I wrote to my own son, published in the San Francisco Chronicle when he started high school. I received dozens of e-mails from school counselors, who in turn gave the letter to concerned parents looking for a way to talk with their own teens. Perhaps you can use it, too.

Dear Johnny,

This fall you will be entering high school, and like most American teenagers, you'll have to navigate drugs. As most parents, I would prefer that you not use drugs. However, I realize that despite my wishes, you might experiment.

I will not use scare tactics to deter you. Instead, having spent the past 25 years researching drug use, abuse and policy, I will tell you a little about what I have learned, hoping this will lead you to make wise choices. My only concern is your health and safety.

When people talk about "drugs," they are generally referring to illegal substances such as marijuana, cocaine, methamphetamine (speed), psychedelic drugs (LSD, Ecstasy, "Shrooms") and heroin. These are not the only drugs that make you high. Alcohol, cigarettes and many other substances (like glue) cause intoxication of some sort. The fact that one drug or another is illegal does not mean one is better or worse for you. All of them temporarily change the way you perceive things and the way you think.

Some people will tell you that drugs feel good, and that's why they use them. But drugs are not always fun. Cocaine and methamphetamine speed up your heart; LSD can make you feel disoriented; alcohol intoxication impairs driving; cigarette smoking leads to addiction and sometimes lung cancer; and people sometimes die suddenly from taking heroin. Marijuana does not often lead to physical dependence or overdose, but it does alter the way people think, behave and react.

I have tried to give you a short description of the drugs you might encounter. I choose not to try to scare you by distorting information because I want you to have confidence in what I tell you. Although I won't lie to you about their effects, there are many reasons for a person your age to not use drugs or alcohol. First, being high on marijuana or any other drug often interferes with normal life. It is difficult to retain information while high, so using it, especially daily, affects your ability to learn.

Second, if you think you might try marijuana, please wait until you are older. Adults with drug problems often started using at a very early age.

Finally, your father and I don't want you to get into trouble. Drug and alcohol use is illegal for you, and the consequences of being caught are huge. Here in the United States, the number of arrests for possession of marijuana has more than doubled in the past six years. Adults are serious about "zero tolerance." If caught, you could be arrested, expelled from school, barred from playing sports, lose your driver's license, denied a college loan, and/or rejected from college.

Despite my advice to abstain, you may one day choose to experiment. I will say again that this is not a good idea, but if you do, I urge you to learn as much as you can, and use common sense. There are many excellent books and references, including the Internet, that give you credible information about drugs. You can, of course, always talk to me. If I don't know the answers to your questions, I will try to help you find them.

If you are offered drugs, be cautious. Watch how people behave, but understand that everyone responds differently even to the same substance. If you do decide to experiment, be sure you are surrounded by people you can count upon. Plan your transportation and under no circumstances drive or get into a car with anyone else who has been using alcohol or other drugs. Call us or any of our close friends any time, day or night, and we will pick you up, no questions asked and no consequences.

And please, Johnny, use moderation. It is impossible to know what is contained in illegal drugs because they are not regulated. The majority of fatal overdoses occur because young people do not know the strength of the drugs they consume, or how they combine with other drugs. Please do not participate in drinking contests, which have killed too many young people. Whereas marijuana by itself is not fatal, too much can cause you to become disoriented and sometimes paranoid. And of course, smoking can hurt your lungs, later in life and now.

Johnny, as your father and I have always told you about a range of activities (including sex), think about the consequences of your actions before you act. Drugs are no different. Be skeptical and, most of all, be safe.

Love, Mom

References

California State PTA, Resolution C (Zero Tolerance) (2003).  Available at:  http://www.capta.org/sections/convention-2003/downloads/ResolutionC.pdf

Gunja, F., Cox, A., Rosenbaum, M., & Appel, J. (2003).  Making sense of student drug testing: Why educators are saying no.  New York: ACLU Drug Policy Litigation Projection in partnership with Drug Policy Alliance.

Kaufman, D. et al. (2002).  Recent patterns of medication use in the ambulatory adult population of the United States.  Journal of the American Medical Association, 287, 337-344.

McNeely, C.A., Nonnemaker, J.M., & Blum, R.W. (2002).  Promoting school connectedness: Evidence from the National Longitudinal Study of Adolescent Health. Journal of School Health, 72 (4),138-46.

National Institutes of Health (2004).  Preventing violence and related health-risking social behaviors in adolescents: An NIH state-of-the-science conference.  Conference overview presented at Natcher Conference Center, Bethesda, MD, October 13-15, 2004.  Available at: http://consensus.nih.gov/ta/023/preventviolenceintro.html

Yamaguchi, R., Johnston, L.D., & O’Malley, P.M. (2003).  Relationship between student illicit drug use and school drug testing policies.  Journal of School Health, 73 (4), 159-164.  Available at: http://www.moitoringthefuture.org/pubs/text/ryldjpom03.pdf

© 2004, National Association of School Psychologists. Marsha Rosenbaum, PhD, is a medical sociologist and the director of Safety First, a reality-based drug education program for educators, parents and counselors. She is author of the project’s booklet, Safety First: A Reality-Based Approach to Teens, Drugs, and Drug Education. Dr. Rosenbaum will be a speaker at the 2005 NASP Annual Convention.