Drug and Alcohol Prevention Programs

Abstract

This article discusses drug and alcohol prevention programs in K–12 public schools in the United States. The concept of prohibition (or abstinence), as enshrined in the Eighteenth Amendment to the US Constitution, was the seed of an idea that in the twentieth century blossomed into full-fledged drug and alcohol prevention programs aimed at young people. Programs such as DARE (Drug Abuse Resistance Education), with its "just say no" approach to drugs and alcohol, put aside messages of temperance and became embedded in the curricula of most American public schools by the 1980s. Several government-funded studies over the past two decades have concluded that nationally recognized programs such as Across Ages and CASASTART (Striving Together to Achieve Rewarding Tomorrows) are more effective than DARE, but DARE supporters continue to maintain that their program still offers the best hope of combating youth alcohol and drug abuse.

Overview

Drug and alcohol prevention programs have been a fixture in modern American public schools since the 1970s, but their roots go much deeper into American social, religious, and political history. In particular, their origins can be traced to the temperance leaders of the nineteenth century, who began to speak out against the social ills caused by alcohol and smoking. Beginning around 1800, a Protestant religious revival known as the Second Great Awakening swept across the United States, and the membership of groups such as the Methodists and Baptists grew immensely. These groups both revived and spread the view that alcoholism was immoral and sinful. The American Temperance Society was formed out of this religious fervor in 1826, and within a decade it had one million members—a staggering number when one considers that the entire non-slave US population in 1830 (including children) was less than 11 million.

Historical Background. Beginning in the 1820s, Protestant ministers in the United States began preaching against the evils of "demon rum," and by the 1830s many temperance leaders began to move from support of moderate alcohol use to calling for its outright abolition. In their view, it was impossible to fight the scourge of alcoholism when alcohol was freely available. Better to put temptation out of reach.

The first major victory for the prohibitionists came in 1881, when Kansas amended its state constitution to ban the sale of alcohol. Other states followed, and in 1920, the Eighteenth Amendment to the United States Constitution—which banned "the manufacture, sale, or transportation of intoxicating liquors within, the importation thereof into, or the exportation thereof from the United States and all territory subject to the jurisdiction thereof for beverage purposes"—went into effect.

The introduction of alcohol prevention programs into public schools began during this time. Beginning in 1880, this push was made by the Department of Scientific Temperance Instruction in Schools and Colleges, the educational wing of the Women's Christian Temperance Union. By the turn of the century, virtually every public school in the country had enacted a mandatory anti-alcohol education program, and most were carefully supervised by WCTU members. Prohibitionist leaders reasoned that if young people were shown the evil outcomes of alcohol use, not only would they be much less likely to take a drink themselves, but they also would support the organization's greater goal of national prohibition. As the passage of the Eighteenth Amendment a generation later attests, the prohibitionists were successful, though it is also true that average alcohol consumption increased between 1880 and 1920.

The repeal of Prohibition in 1933 had a chilling effect on alcohol prevention programs in the public schools. Because many Americans came to see that the cure for alcoholism among some—total abstinence—was worse than the disease for many others, and because of the national attention required by World War II and the Korean War, anti-alcohol programs in the public schools were largely neglected for several decades.

Political Intervention. In the 1960s, however, some young people formed a counterculture in which experimentation with alcohol, and especially hallucinogenic drugs, was the norm. The counterculture seeped into popular culture, too, and concerned parents and politicians began to renew the call for substance abuse education—but this time with an equal emphasis on illegal drugs. In 1970, President Richard Nixon declared that drug and alcohol education was a national priority, and by the end of the 1970s, most public schools had drug and alcohol prevention programs in place. Quickly the focus of these programs became total abstinence—summed up in the popular catchphrase "just say no"—and more moderate viewpoints were prohibited by 1977.

President Nixon commissioned several studies of the effects of federal drug education programs, and the conclusions reached were often negative toward the programs. In 1973, a second report from the National Commission on Marijuana and Drug Abuse stated that "no drug education program in this country, or elsewhere, has proved sufficiently successful to warrant our recommending it" and alleged that "the avalanche of drug education in recent years has been counterproductive" because it makes drug use more alluring. Instead, the commission recommended that drug education be focused less on abstinence and more on addressing the root causes of drug use and addiction, such as the social problems faced by adolescents. In 1977, the report from President Gerald Ford's Cabinet Committee on Drug Abuse Prevention, Treatment and Rehabilitation echoed those pragmatic sentiments, suggesting that drug education be "primarily focused on moderating the effects of drug taking."

These recommendations were largely ignored by legislators. In the 1980s, the focus of drug and alcohol prevention programs remained the abstinence approach, and under federal law, no federal grants would be awarded to any drug and alcohol education program that deviated from this message. "Today, material that describes low-risk and responsible drinking for those who choose to consume alcoholic beverages is difficult to find" (Engs, 1991). The slogan "just say no" was championed by First Lady Nancy Reagan, and it was the central message of an aggressive television campaign featuring many celebrities.

DARE. Most public schools implemented this abstinence-only approach in the form of the Drug Abuse Resistance Education (DARE) program:

“DARE was founded in 1983 in Los Angeles and has proven so successful that it is now being implemented in 75 percent of our nation's school districts and in more than 43 countries around the world. DARE is a police officer–led series of classroom lessons that teaches children from kindergarten through 12th grade how to resist peer pressure and live productive drug and violence-free lives” (DARE, 2007).

At the beginning of the twenty-first century, abstinence-based K–12 drug and alcohol programs like DARE were continuing to find enthusiastic supporters, but whether such support is borne out by the data on adolescent drug and alcohol abuse is still an open question. There continue to be critics who suggest that the time has come to try alternate approaches that accept that a percentage of adolescents will experiment with alcohol and drugs. As far as these critics are concerned, inculcating responsible behavior in young people begins with education and ends with trust.

Further Insights

How Parents & Communities Can Make a Difference. The research on adolescent drug and alcohol use indicates that the level of parental involvement in a child's life is one of the most reliable predictors of youth drug and alcohol abuse. This involvement includes knowing a child's friends and schedule, talking to them about the dangers of drugs and alcohol, and not allowing young people to be in an environment where risky behavior is likely to take place.

One illustration of this comes from the 11th National Survey of American Attitudes on Substance Abuse conducted by the National Center on Addiction and Substance Abuse (CASA) at Columbia University:

“Teens who say parents are not present at the parties they attend are 16 times likelier to say alcohol is available, 15 times likelier to say illegal drugs (including marijuana, cocaine, ecstasy, prescription drugs) are available, and 29 times likelier to say marijuana is available, compared to teens who say parents are always present at the parties they attend” (CASA, 2006, p. ii).

But, the CASA report adds, there is still a need for parents to pay more than lip service to the idea of supervision:

“Ninety-eight percent of parents say they are normally present during parties they allow their teens to have at home. BUT a third of teen partygoers (33 percent) report that parents are rarely or never present at parties they attend. Ninety-nine percent of parents say they would not be willing to serve alcohol at their teen's party. BUT 28 percent of teen partygoers have been at parties at a home where parents were present and teens were drinking alcohol” (CASA, 2006, p. ii).

Viewpoints

The Effectiveness of Drug & Alcohol Prevention Programs. In terms of the numbers of adolescents using drugs and alcohol over the past several decades, the evidence indicates that usage levels fluctuate on both macro and micro levels. Depending on the variables one uses—such as the substance, time period, age group, location, frequency of use, race and gender—the numbers and trends can be either encouraging or discouraging.

For example, Susan Cohen (1998) noted what appeared to be some sobering trends:

“The news in the '90s is not that American teenagers drink in high school. The real news is that they drink in middle school or younger, and that both binge drinking and frequent drinking are increasing. It's also no longer a matter of boys will be boys. The girls are catching up. … Buried in annual news reports about the War on Drugs is the fact that alcohol, not cocaine or marijuana, remains the drug of choice for kids ages 12 to 17. At the same time, mounting scientific evidence has found a correlation not just between alcohol and automobile accidents, but between alcohol and violence, alcohol and sexual assault, alcohol and adolescent drowning, alcohol and teenage suicide, alcohol and unprotected sex, and between drinking in the teen years and later alcoholism.”

"Monitoring the Future" Surveys. Conducted each year since 1975 by the Institute for Social Research at the University of Michigan, the "Monitoring the Future" (MTF) survey is a long-term study of substance use by young Americans. The survey is given to some 50,000 8th, 10th, and 12th graders nationwide. In its 2012 overview, the survey reported:

“In the late 20th century, young Americans reached extraordinarily high levels of illicit drug use by U.S. as well as international standards.... In 1975, when MTF began, the majority of young people (55%) had used an illicit drug by the time they left high school. This figure rose to two thirds (66%) in 1981 before a long and gradual decline to 41% in 1992—the low point. After 1992 the proportion rose considerably to a recent high point of 55% in 1999; it then declined gradually to 47% in 2007 through 2009, and stands at 49% in 2012” (Johnston et al., 2013, p. 10).

As for cigarette smoking, the MTF survey measures "30-day prevalence," referring to the proportion of respondents who have smoked cigarettes within the past thirty days. The 2012 overview reported:

“Smoking peaked in 1996 for 8th and 10th graders and in 1997 for 12th graders before beginning a fairly steady and substantial decline that continued through 2004 for 8th and 10th graders (12th graders increased a bit in 2004). Between the peak levels in the mid-1990s and 2004, 30-day prevalence of smoking declined by 56% in 8th grade, 47% in 10th, and 32% in 12th. It is noteworthy, however, that this important decline in adolescent smoking decelerated sharply after about 2002. There was some further decline after 2004 in all grades, but the declines appeared to end in the lower two grades in 2010. In both 2011 and 2012, however, declines occurred in all three grades. An increase in 2009 in federal taxes on cigarettes (from $0.39 to $1.01 per pack) may have contributed to this resumption of the declines in use” (Johnston et al., 2013, p. 40).

According to results from the 2017 MTF survey, between 48 and 50 percent of young people had used an illicit drug by the time they left high school since 2011.

Centers for Disease Control and Prevention (CDC). The US Centers for Disease Control and Prevention (CDC) reported in 2012 that the use of any illicit drug by young people aged twelve to seventeen had declined slightly from 11.6 percent in 2002 to 10.1 percent in 2010; the use of marijuana specifically had declined from 8.2 to 7.4 percent. Binge drinking declined from 10.7 to 7.8 percent for this age group, and cigarette smoking declined from 13 to 8.3 percent. In 2023, the CDC reported continued declines, finding that the percentage of high schoolers who reported drinking alcohol in the past month had dropped from about 34 percent in 2013 to 22 percent in 2023. Marijuana use decreased from about 23 percent in 2013 to 17 percent in 2023, and the use of illicit drugs such as cocaine, heroin, and hallucinogens decreased from approximately 16 percent in 2013 to 10 percent in 2023.

Given the fluid nature of the statistics, it's hardly surprising that survey data on the use of drugs and alcohol by adolescents has been subjected to much interpretation by scholars and other experts in the field. In terms of alcohol (and even marijuana) use, those who support the right of teenagers to drink or smoke in moderation see the statistics as evidence that prevention programs have been an expensive exercise in futility. Others, especially youth advocate groups and the US government, read the surveys as showing steady, incremental progress toward the goal of complete adolescent abstention from tobacco and alcohol until the age of twenty-one—an age they perceive to be the beginning of a more responsible season of life.

Questioning DARE & the Abstinence-Based Approach. Since its founding in 1983, DARE has become by far the leading drug and alcohol education program in the United States and around the world. But the program has its share of critics. Gonnerman (1999) observed that DARE takes an all-or-nothing view of the drug and alcohol landscape:

“In DARE's worldview, Marlboro Light cigarettes, Bacardi rum, and a drag from a joint are all equally dangerous. For that matter, so is snorting a few lines of cocaine. DARE's student workbook features an eighth-grade alcoholic named Robert on page seven, Wendy the pot-smoking eighth-grader on the next page, and by page 10 a ninth-grader named Laura is trying to score some cocaine. After reading these tales, students are supposed to list what they learned about each drug” (Gonnerman, 1999).

Critics also argue that DARE has put forth an overly simplistic view that fails to draw the important distinctions between these substances that many adolescents already understand from experience. The result, critics say, is that the truly important message—that young people should act responsibly toward drugs and alcohol—is lost:

“'It really is irresponsible to place all drugs in the same category,' says Marsha Rosenbaum, who heads the West Coast office of the Lindesmith Center, a drug policy reform organization. 'What I don't want kids to hear is that all drugs and any amount you do will be the road to devastation. Once kids get to an age where they're experimenting … they know that is not true, so they throw away the entire prevention message. It isn't really education. It's indoctrination.'”

In response, DARE and its supporters argue that their approach is sound. A teenager can begin drinking alcohol, they argue, and then graduate to marijuana and cocaine, and the slope is far too slippery for the fine distinctions urged by critics.

But beyond pure methodology, the question remains: Does DARE work? Not very well, at least according to much of the relevant literature:

“In 1991, a U.S. Justice Department study determined that kids who had gone through a DARE program used drugs as often as kids who had not. A 1993 Government Accounting Office report criticized bureaucrats for restricting drug education funding to programs that hewed the "Just Say No" line. And a 1998 U.S. Department of Education analysis of over 10,000 public school students found that other programs had better outcomes than DARE. More than 15 university and government studies have concluded that DARE doesn't reduce drug use or abuse” (Newman, 1998).

Supporters of DARE counter that even though some studies may at first appear to cast doubt on the effectiveness of the program, what they instead reveal is that young people need even more exposure to DARE, not less.

Alternatives to DARE. Hanson (2007) discusses several viable alternatives to DARE that have a proven record of success. He writes that fortunately, schools are not faced with the choice between DARE and no program. A federal agency, Substance Abuse and Mental Health Services Administration (SAMSHA), part of the US Department of Health and Human Services, has identified several model programs, any of which would be viable alternatives to the DARE program. Two of the many programs SAMSHA recommends include:

• Across Ages: A mentoring program that pairs young people (ages 9 to 13) with adults over 55 who serve as mentors and role models. It seeks to strengthen community bonds through service programs and family bonds through family activities.
• CASASTART (Striving Together to Achieve Rewarding Tomorrows): This program, run by the National Center on Addiction and Substance Abuse (CASA) at Columbia University, does not assume that young people will not experiment with drugs or alcohol, but it seeks to put social and emotional supports in place to prevent continued use.

These and other anti-alcohol and anti-drug programs take a holistic approach to drug and alcohol prevention among young people by enlarging the discussion to include substance abuse counselors, family therapists, and community leaders. They strive to make drug and alcohol abuse less appealing by helping adolescents understand the positive and negative power of peer pressure and giving them alternative strategies for coping with the angst that is part of an adolescent's journey to adulthood.

Terms & Concepts

Alcohol Abuse: According to abstinence-based programs, the use of alcohol by those under the legal drinking age. More broadly defined as an unhealthy use of, and dependence upon, alcohol.

Across Ages: A nationally recognized drug and alcohol prevention program that pairs young people (ages 9 to 13) with adult mentors over 55 to teach young people life skills and strengthen community bonds through service programs.

CASASTART (Striving Together to Achieve Rewarding Tomorrows): Another nationally recognized drug and alcohol prevention program that does not assume that young people will not experiment with drugs or alcohol, but seeks to put social and emotional supports in place to prevent continued use.

Drug Abuse Resistance Education (DARE): A school-based program designed to convince young people not to use drugs (including tobacco) and alcohol.

Drug Abuse: The use of illegal drugs or tobacco products, especially by minors.

Eighteenth Amendment: An amendment to the US Constitution that outlawed the sale of alcohol in the United States. It was in effect from 1920 to 1933, when it was repealed by the passage of the Twenty-First Amendment.

Prohibition: A period from 1920 to 1933 in the United States in which it was illegal to purchase or make most types of alcohol.

Temperance Movement: A movement, begun in the early 1800s, whose supporters advocated moderate use of alcohol. Many early temperance advocates became prohibitionists by the end of the nineteenth century.

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Suggested Reading

Hedrick, J. D. (1997). Drink and disorder in the classroom. In D. S. Reynolds and D. J. Rosenthal (Eds.), The serpent in the cup: Temperance in American literature (pp. 205–228). Amherst: University of Massachusetts Press.

Kanof, M. E. (2003). Youth illicit drug use prevention: DARE long-term evaluations and federal efforts to identify effective programs. Washington, DC: General Accounting Office.

Knopf, A. (2016). Childhood trauma heightens risk for teen drug misuse. Brown University Child & Adolescent Behavior Letter, 32(9), 1–6. Retrieved February 13, 2018 from EBSCO Online Database Education Source.

West, S. L., & O'Neal, K. K. (2004). Project DARE outcome effectiveness revisited. American Journal of Public Health 94, 1027–1029. Retrieved June 18, 2007 from EBSCO Online Database Education Research Complete.

Workman, J. W., Huber, M. J., Ford, J., Mayer, T., Moore, D., Wilson, J. F., & Kinzeler, N. (2012). The PALS prevention program and its long-term impact on student intentions to use alcohol, tobacco, and marijuana. Journal of Drug Education, 42, 469–485. Retrieved December 10, 2013 from EBSCO Online Database Education Research Complete.