Analyzing drug abuse prevention efforts

Several decades of research on school-based prevention approaches have produced programs that help, to varying degrees, in reducing substance abuse among youths. American Behavioral Scientist devoted a recent issue to analyzing the results of the drug abuse prevention efforts.

But like a review of school-based drug programs published last December in the Journal of School Health, this study concludes that the programs used most frequently in schools in the United States are among the least effective.

The programs that have demonstrated lasting, meaningful reductions in drug use involve training in social resistance skills. Effective curricula also contain drug information that emphasizes the short-term and negative social consequences of use.

Social resistance training

It appears that extensive information about types and effects of drugs is not necessary and may even be counterproductive. The most effective programs identify the pressures to use drugs and give students the skills they need to resist peer pressure while maintaining their friendships.

Teaching adolescents that most people do not use drugs also appears critical to the long-term success of drug abuse prevention. There is evidence that broader-based programs that focus on decision making, goal setting, stress management, communication and assertiveness skills produce slightly larger reductions in drug use than social resistance training alone. The objective of such broad-based programs is to promote social and academic competence in order to prevent a variety of risky behaviors during adolescence.

In American Behavioral Scientist, Louise Ann Rohrbach, University of Southern California; Carol N. D’Onofrio, University of California/Berkeley; Thomas E. Backer, Human Interaction Research Institute; and Susanne B. Montgomery, Loma Linda University, evaluate why schools are not using the more effective programs.

They suggest that these programs involve teaching and learning techniques with which many teachers are not comfortable. Interactive teaching techniques include role-playing, small-group activities and peer-led discussions promote active participation that can change beliefs and behavior.

Inadequate testing

Most of the programs widely used in schools today have been inadequately tested. Of the three most popular programs — Dare, Quest, and Here’s Looking at You, 2000 — only Dare has been adequately evaluated, and results suggest that it is no more effective at reducing substance abuse than standard curricular approaches.

More promising results have been shown for STAR, Life Skills Training, the Seattle Social Development Program, Project Northland, the Alcohol Misuse Prevention Program and the Teenage Health Teaching Modules.

So why haven’t programs with better results captured a larger share of the school market? Despite inadequate testing or poor performance, write Rohrbach et al., popular programs successfully use attractive packaging, aggressive marketing with communities, and simple teaching approaches to get their programs widely adopted by schools.

Schools appear to focus on the practical characteristics of a program, such as whether it has clear instructions, how much preparation and training are required and how students and teachers respond to it. The complex, interactive teaching/learning activities of the more effective programs are less popular.

The challenge is to develop programs that are flexible yet robust, so that teachers can make modifications to meet their needs without jeopardizing the program’s effectiveness. These researchers urge further large-scale evaluation that includes pre- and post-tests, control groups and long-term outcome measures of substance use.

“Diffusion of School-Based Substance Abuse Prevention Programs” American Behavioral Scientist Volume 39, Number 7, June 1996 pp.919-934.

Published in ERN September/October 1996 Volume 9 Number 4


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