Anti-Drug Programs Get Off Drugs

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Dando Furenza a la Familia: Only one session focuses on substance abuse and its effect on the body.

Every now and then an advertising image is so powerful that it becomes a cultural icon – like the frying egg that stood for your brain.

In 1987, the Partnership for Drug-Free America launched the now-famous TV ad that starred an egg sizzling in a frying pan, while a baritone voice intoned: “This is your brain on drugs. Any questions?”

That piece of fright came at the tail end of the “Just Say No” era, the anti-drug campaign launched by first lady Nancy Reagan. Both phrases live on today as the butts of countless jokes, while the anti-drug strategies behind them have been largely abandoned.

“Large-scale media campaigns generally reinforce attitudes that are already established,” notes Liz Robertson, chief of the prevention research branch at the National Institute on Drug Abuse. “They don’t change people’s attitudes.”

“By junior high, 95 to 99 percent of the kids are well aware of the dangers” of drug abuse, says Gilbert Botvin, director of the Institute for Prevention Research at Weill Cornell Medical College and developer of the widely used Botvin Life Skills Training (LST).

Not only have anti-drug programs moved beyond biologically based scare tactics and morality-based media campaigns, but they’ve also moved beyond drugs. Many of today’s efforts are based on holistic approaches that focus on life skills and decision-making.

The efforts build on research into the myriad factors behind youth drug abuse, such as peers, family members and the media. Botvin, for instance, conceptualized LST after considering what skills youth need to help them deal with those factors: recognizing negative influences, resisting peer pressure and advertising messages, and building self-esteem, assertiveness and independent thinking. Like many newer anti-drug programs, LST spends little time actually discussing drugs.

Such approaches make sense to Arlene Terras, who served as research psychologist and study coordinator for the Multimodal Substance Abuse Prevention Program at the Philadelphia-based Belmont Center, which operated from 1995 until its federal funding ended in 2001.

“It hits the right notes,” Terras says. “You don’t treat adolescents who use drugs the way you treat addicts who use drugs. … There’s very, very, very little addiction” among youths.

“Most of the [youths’] problems trace back to family and psychological issues.”

The Neighborhood Houses in St. Louis switched to the life skills-oriented Sathya Sai curriculum, which originated in India, when an earlier program called “Be A Star” became outdated. Time seemed to have passed by both the materials – the stories, the music, the method of delivery (binders in a box, rather than software) – and the “Just Say No” content, says Program Director Roxanne Crawford. She says leaders of neighborhood community centers that used the program increasingly told her, “We can’t get much out of this. Times have changed.”

Sathya Sai, she says, is about choices: “Where do you want to be in life? What do you want to pursue? Many of them [the youths] say, ‘I want to be somebody. I don’t want to go to jail like my mom.’ ”

A similar shift in emphasis compelled administrators to change the name of Preparing for the Drug Free Years, developed at the University of Washington, to Guiding Good Choices, says Kevin Haggerty, assistant director of the university’s Social Development Research Group.

“The name change partly signifies … where we were in the late ’80s compared to where we are now,” he says, from “much more concern on drug use, per se” to “overall healthy development and healthy outcomes for young people. The name change reflects the zeitgeist.

“It also reflects what the program was originally designed to do: to promote positive outcomes, not just the absence of negative outcomes.”

While the emphasis of many such programs has changed, getting funds to keep programs going is no easier than ever. State grants through the U.S. Department of Education’s Safe and Drug-Free Schools program, which funds implementation, dropped from $555 million in 1997 to less than $300 million last year.

“Funding has diminished from what it was in the late ’90s,” says Haggerty of the Social Development Research Group. “It’s becoming more and more competitive at the local level” to find funds for anti-drug programs.

What’s more, much of the Safe and Drug-Free Schools money has gone to drug-testing programs, which have a “very meager deterrent effect,” says Linn Goldberg, a physician who led the creation of programs that focus on athletes and steroids, based at Oregon Health and Science University.

In addition, funding for research through the National Institutes for Health has flatlined for about four years, “barely keeping up with inflation,” Robertson says.

Following are examples of promising programs that have survived in the current climate. All are included on the National Registry of Evidence-based Programs and Practices (, run by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). Due in part to funding cuts and to the shift in strategy away from pure anti-drug strategies, many of the programs on the list no longer exist.