In 1982, a young girl asked Nancy Reagan what she should say if someone tried to offer her drugs. The First Lady’s response was simple and direct.
Those three words sparked a campaign that would last for decades, acting as a foundation for anti-drug prevention programs in the ’80s and beyond. Those programs have shaped our perception of illicit substances today, with schools around the country using education to discourage alcohol and drug use among children.
But have programs that use the “just say no” approach like D.A.R.E been effective in deterring the use of drugs?
We examined results from the National Survey on Drug Use and Health to chart youth drug knowledge and the impact of drug education programs and parental guidance.
A Timeline of Perceived Drug Risk in Children
From “Just Say No” to the development of inclusive educational programs, anti-drug campaigns have had a marked impact in reducing substance use.
During the 90’s, a number of programs were developed to teach drug education, awareness and prevention. The most widely adopted was D.A.R.E., however many schools developed their own curriculum to suit their student population. The next most popular programs were Alert, Here’s Looking at You, Life Skills Training, Lions Quest, and Too Good for Drugs II.
Drug prevention education continued to grow, leading to the Safe and Drug-Free Schools and Communities Act of 2002, designed to support school programs in decreasing violence and drug use. Beyond 2002, programs were gradually expanded to more middle school and high school students. This also led to more inclusive programs that addressed all forms of drug abuse while also emphasizing social confidence and competence (peer relationships, drug resistance skills, anti-drug attitude and academic support.)
Despite a “just say no” approach to drug use, data show that America’s youth don’t consider all drugs to be created equal. The perceived risk of drug use varies greatly. In 2014, 59 percent of individuals 12 to 17 years old believed trying heroin once or twice was a great risk, yet only 50 percent felt that using cocaine once a month was a risky choice. These beliefs have remained largely unchanged over the last 15 years, despite ongoing prevention programs and a nearly sixfold increase in deaths related to heroin between 2001 and 2014.
What’s more surprising is that minors have maintained the perception that alcohol presents a greater risk to their health than other illicit substances. This could stem from a variety of factors including youth prevention programs that emphasize long term health effects of drinking, repercussions of drunk driving, the impact of alcohol in their home environment, or perhaps the loss of a friend or family member as a result of alcohol.
Another standout point is the falling risk perception of Marijuana. From 2009 to 2014, the feeling of marijuana posing a “great risk” steadily fell from 30 percent to 23 percent. This could be traced to regular media coverage around the increased use for treating medical issues with prescription marijuana, as well as the growing legalization in several states in the U.S.
The Effectiveness of Prevention Programs on Substance Use
Programs like D.A.R.E. and “Just Say No” have made a visible impact on alcohol and marijuana use, but the data shows that drug programs have been less influential in discouraging illicit drug use among students. During certain years, illicit drug use among students who participated in drug prevention programs was actually higher than students who did not participate.
For all data sets the rates of substance use fluctuate almost identically for non-participants, indicating that drug-prevention programs are only part of the equation in deterring drug-use among adolescents. For example, illicit substance abuse fell from 12 percent in 2002 to 9 percent in 2015 among nonparticipants, this rate dropped identically among program participants from 11 percent to 8 percent.
Indeed, outside factors such as the availability of particular drugs play a substantial role in influencing youth. According to the National Institute on Drug Abuse, the availability of marijuana increased in 2009. The graph above shows a large spike in marijuana use among both participating and nonparticipating students around this time
How Perceived Substance Risk Can Influence Illicit Drug Use
The National Survey on Drug Use and Health looked at the correlation between perceived risks and substance use. The survey results showed that for certain drugs, when youth understand the perceived risk, they are less likely to use illicit substances. For example, 11 percent of youth who perceived weekly cocaine use to have “moderate to no risk” reported illicit substance use, while only eight percent of youth who believed cocaine was a “great risk” experimented illicit substances.
One concerning outlier in the survey results forces a moment of pause — why are youth who perceive a “great risk” for heroin use more likely to use illicit substances than those who report “moderate to no risk”? The answer may be related to the mind-altering effects of heroin which can impair one’s ability to resist the drug. Heroin is a highly addictive substance and dependency can override judgement and self-control. It’s imperative that drug education stresses the dangers of experimenting with highly addictive drugs such as heroin.
The results of this survey are both comforting and concerning when evaluating the current state of drug education programs. While stressing the risks of different substances does seem to have an impact on deterring use, drug education must take a unique approach for individual substances, especially for those that can grip an adolescent in addiction.
Perception of Availability
The survey results indicate that older students aged 16-17 are more likely to report that drugs are easier to obtain. The perception of availability grows as an adolescent ages and social circles expand. Youths discover the wide array of opportunities and sources for obtaining drugs and alcohol, such as friends, parents and relatives (with, and without, their knowledge), parties and social gatherings, dealers or suppliers, and co-workers.
The survey results indicate an opportunity for augmented drug education programs around the age of 17 when students recognize the availability of drugs and alcohol. High school seems to be a key moment for drug prevention efforts. The marked decrease in available, effective drug prevention programs at the high school level continues to be a concern and could be a key contributor to increased illicit substance use. In 2015, we see 2.6% of 12 to 13 year olds report to having used illicit substances in the past month. This figure jumps to 16.3% for 16 to 17 year olds. While programs do exist for high school students, most programs are targeted at the elementary and middle school level.
A review of drug and alcohol programs targeting the 11-18 age group (from youth.gov) showed only a few programs with promising results across the nation. This includes D.A.R.E., Communities That Care, Keepin’ it REAL, Project TND, and Teenage Health Teaching Modules. Other programs targeting the 11-18 group were noted as having little to no effect in the prevention of substance use. Many programs were simply limited in scope, reaching only to ages 11-15.
The most effective nationwide programs utilized classroom curricula that focus on cognitive behavioral treatment as well as prevention of drug use through health education.
Parental Impact on Preventing Substance Use
While educational programs like those discussed above are important in educating children on the risks of substance use, the role family can play in preventing youth drug use is equally important. According to the National Institute on Drug Abuse, risk of drug use among children can be reduced when parents work to develop strong family bonds, are consistent with discipline, and provide adequate support (emotional, cognitive, social and financial), allowing them to encourage more healthy decisions.
Conversely, a lack of nurturing, support, or significant relationships can increase the risk of drug use. The above study from the NIDA also found that increased or regular conflict between parents and their children resulted in a greater risk of children experimenting with or using illicit substances. It’s evident that positive parental guidance and nurturing relationships can help encourage children toward healthy decisions.
Nancy Reagan’s words led to the creation of dozens of research-based drug abuse prevention programs in schools. A combination of drug education programs in school and parental guidance is critical in protecting youth from drugs. Today, children and adolescents face countless risks; responding to these risks before they become a problem isn’t always easy. However, we’ve made great progress with prevention and intervention in recent years.
Still, there is work to be done. Many adolescents are still using drugs and fail to see the associated risks. Our resources at projectknow.com are designed to educate teens and parents and connect them to the resources and support they need to understand substance use disorders and the available treatment options. Visit our homepage at ProjectKnow.com to find resources to connect you, a friend or a loved one with the help they need.
Figures obtained from the 2014 and 2015 National Survey on Drug Use and Health were made available from samhsa.gov. Illicit drug use is defined by the study as the misuse of prescription psychotherapeutics or the use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Youths defined by studies as individuals of 12 to 17 years of age.