Research Supporting Alternatives to Current Drug Prevention Education For Young People

Widespread use of alcohol and illicit drugs by young people persists decades into a national campaign promoting universal abstinence. Media messages, prevention curricula, and punitive enforcement policies taken together have failed to bring about significant change. New ideas are needed.

Listening to Young People
America must establish a beachhead in the real world on this issue. Listening to young people is the way to start.  What can they tell us about substance use in their social world? What do they think about efforts to prevent use? Current drug prevention programs were developed without significant input from youth. Agencies sponsoring and using prevention programs seldom ask teens what they think about those programs. In addition, educators apply mandatory deterrent punishment to young offenders without finding out whether making examples out of those few who are caught really stops peers from experimenting.
Authentic dialogue with youth is required.  Honest and open communication can generate a renewed sense of purpose and hope among adults who care about young people.

Summaries of Relevant Research
The second step is to learn what research and related theory tell us about three questions. First, what is the evidence on the effectiveness of current prevention programs?  Second, what principles of youth development and socialization explain failure of current approaches and at the same time point to useful alternatives? Third, what educational principles must be incorporated into an alternative prevention practice?
To answer to the three questions brief summaries of pertinent research are offered. The studies have been selected for their quality and relevance, and in some cases because they are the most recent studies. Of course, summaries are never a substitute for consulting the originals. The studies selected comprise only a small part of the research relating to the questions.

I: Effectiveness of Current Prevention Programs
Empirical research relating to prevention as well as basic knowledge about human development during the teenage year and early adulthood provide a strong basis for rejecting most of current prevention education.    

Normalization of Substance Use
Using alcohol and other drugs, especially marijuana, has been incorporated into social world of ordinary American teenagers. This has happened despite a national commitment to “zero tolerance” toward youth substance use. Prevention messages and tactics that fail to take the implications of normalization into account are bound to fail.

Evidence

Newcomb, M., & Bentler, P. (1988).  Consequences of Adolescent Drug Use: Impact on the Lives of Young Adults. Sage.

This longitudinal study sponsored by the National Institutes of Drug Abuse (NIDA) assessed a large sample of adolescents at ages 12-14 and continued at regular intervals into early adulthood. In addition to drug use, family and social relationships, deviant behavior, mental health, work history, sexual behavior, and educational achievement were assessed. The authors concluded that experimental use of drugs, licit and illicit, “may be considered a normative behavior among United States teenagers in terms of prevalence, and (also) from a developmental task perspective.” (p. 214) This conclusion was drawn over a decade ago.

Skager, R. & Austin, G. (2001). Alcohol, Tobacco, and Other Drug Use among California Students in Grades 7, 9, and 11. Eighth Biennial Statewide Survey. Office of the Attorney General of California, Crime Prevention Center.

This statewide survey of youth in the nation’s most populous state regularly provides data consistent with the conclusion that drug use has long been normalized in the high school population. The latest survey shows that by age 16 substantial majorities of young people believe that marijuana use is common among their peers and that this drug is as easy to obtain as alcohol. Seven out of ten students in grade 11 believed that half or more of their age peers had tried marijuana. Eight out of ten reported that both alcohol and marijuana were easy or fairly easy to obtain.

Johnson, L., Bachman, J. & O’Malley, P. (1999). Monitoring the Future: National Results on Adolescent Drug Use Overview of Key Findings. (Washington, D.C.: NIDA, 2000, pp 3-6).

This long-established national survey out of the University of Michigan revealed that more than half of US students in 1999 consumed an illegal drug before they graduated from high school. In every year from 1975 to 1998 at least 82% of the high school seniors surveyed reported that marijuana was fairly easy or very easy to obtain. This figure rose to 90% in 1999.

Indoctrination Instead of Education
Information in anti-drug media messages and politically correct school-based prevention program lacks credibility for young people when compared to their own sources of information about drugs. Developers of these messages and programs made the fatal error of choosing indoctrination instead of education. This leads to false information, exaggerating dangers, and a biased presentation of the “facts.”  True education is credible because it is honest and tells the whole story. It respects the competence of learners and their right to decide for themselves. In contrast, when people realize they are being indoctrinated, they turn away from the messenger.
The core principle of drug indoctrination has been the “gateway theory.” This theory holds that use of marijuana is associated with a high probability of progression to use of “harder” drugs like cocaine and heroin, and thus dependency and addiction. This conclusion was never warranted by the research that ostensibly supported it. Common sense tells us that the theory exaggerated the problem, since approximately 80 million American adults have used marijuana at some time in their lives, yet the number heroin addicts is currently estimated at slightly less than one million, or millions less than would be predicted by the theory. (MacCoun and Reuter, below, p. 18). Recently the gateway theory has been discredited by definitive research.

Evidence

Beck, J. (1998). 100 years of “Just Say No” versus “Just Say Know.” Evaluation Review, 22(1), 15-45.

Exaggerating dangers of substance use and failing to tell the whole story discredits messenger and message when the targeted population has access to contrary information and experience. The use of “scare” tactics in prevention education originated in the “temperance” movement that led to national alcohol prohibition. Described at the time by a group of concerned scientists as “neither scientific, nor temperate, nor instructive,” this approach turned out to be ineffective if not counterproductive. Initially, concern about increasing illicit drug use among young people in the 1970s was addressed by NIDA with an emphasis on educating for responsible decision-making. This approach was soon countered by political pressure from the “Parent Power” movement, which demanded an abstinence-only message that, in Beck’s assessment, “practically insures an incomplete and biased presentation of the current knowledge regarding both legal and illegal drugs.”  Scare tactics have also been a common feature of media messages sponsored by the Partnership for a Drug Free America.

Golub, A., & Johnson, B. (2001). Variation in youthful risks of progression from alcohol/tobacco to marijuana and to hard drugs across generations. American Journal of Public Health, 23(2), 225-232.

This methodologically sophisticated study was based on data from the National Household Survey on Drug Abuse collected from 1979 to 1997. The authors concluded, “…youthful marijuana users may never progress to hard drug use…ethnographic studies have documented cultural norms that encourage marijuana use but strongly discourage use of hard drugs…” They go on to point out, “These findings suggest that the gateway phenomenon reflects norms prevailing among youths at a specific place and time and that the linkages between stages are far from causal.”(p. 229) In other words, using marijuana does not “cause” use of cocaine or heroin. Rather, whatever is perceived to be normal and desirable within a particular social context is the primary influence.

MacCoun, R.J. & Reuter, P. (2001). Drug War Heresies: Learning from Other Vices, Times, and Places. Cambridge University Press

This book provides a comprehensive analysis of drug policy in the US and several other nations, including prevention education policy and its results. They observe that current prevention programs are almost exclusively aimed at reducing overall prevalence. As a consequence, evaluations of prevention programs are “…preoccupied with establishing program effects on whether adolescents use, giving short shrift to the measurement of amounts and styles of drug use or the harmful consequences of that use.” They go on to point out,  “But the fact is that most adolescent drug users pass through a limited period of experimentation without experiencing any lasting effects or acute harms.” (p. 37) Of course, there is still the danger of dependency for some users. For the total US population, the percentage of marijuana users who have ever been dependent on that drug is approximately 10%, and more people are dependent on marijuana than on cocaine or heroin. (p. 19) These are examples of honest, unbiased kinds of information not provided in politically correct prevention, where the emphasis remains on the now discredited gateway theory.

Evaluations of Current Educational Strategies
Normalization of use of alcohol and marijuana among young people suggests that current approaches to alcohol, illicit drug, and tobacco prevention have been mainly ineffective. A large body of research supports this conclusion.

Evidence

National Research Council (2001). America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us. Committee on Data and Research for Policy on Illegal Drugs. Charles F. Manski, John V. Pepper, and Carol V. Petrie, editors. Committee on Law and Justice and Committee on National Statistics. Commission on Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.

This review of national drug policy identified 14 approaches to the prevention of drug use, but acknowledged that classroom instruction is the main strategy used in school-based prevention. This review concluded that there is at best limited evidence for the effectiveness of current school prevention programs, including social influence approaches, and that there have been serious design and measurement flaws in published research ostensibly supporting these programs.

Peterson, A.V., Kealey, K.A., Mann, S.L., Marek, P.M. & Sarason, I.G. (2000). Hutchison smoking prevention project: Long-term randomized trial in school-based tobacco use prevention—Results on smoking. Journal of the National Cancer Institute. 92(24), 1979-1991.

This study was cited for setting “a new standard of scientific rigor for prevention research.” (Richard Clayton, Ph.D., Professor of Health Behavior and Director of the Center for Prevention Research at the University of Kentucky School of Public Health). It reported on a 15-year smoking prevention study involving 8,400 students and over 600 teachers plus a rigorous research design comparing randomized experimental and control groups. Its purpose was to learn whether a “social influences” approach would reduce youth smoking through high school and beyond. The social influences addressed in the curriculum ran the gamut from peer pressure to tobacco advertising. Implementation by teachers was carefully monitored and found to be exemplary. The authors concluded, “There was a remarkable similarity between the control and experimental conditions, both for girls and for boys, for all smoking endpoints, and for all of the a priori subgroups.” “The lack of difference in smoking prevalence between the control and experimental conditions leads to the conclusion that the…intervention had very little or no impact on smoking prevalence.” (pp 1987-1988)

Rosenbaum, D., & Hanson, G. (1998). Assessing the effects of school-based drug education: A six-year multilevel analysis of project D.A.R.E. Journal of Research on Crime and Delinquency, 35(4), 381-412.

These researchers reported that the nation’s most popular drug prevention education program “had no long-term effects on a wide range of drug use measures” and that there was some evidence for a boomerang effect among suburban youth in that students in this population exposed to DARE reported more use than students who had not been exposed. This is one of the latest of a series of studies confirming that the DARE program is ineffective and for some young people actually counterproductive.

National Household Survey on Drug Abuse: Main Findings. (1998). Office of Applied Studies, National Institute on Drug Abuse, SAMHSA, US Department of Health and Human Services, Rockwell MD, March 2000, p. 174.

This report concluded that “exposure to prevention messages outside school, such as through the media, was fairly widespread but appeared to be unrelated to illicit drug use or being drunk.” NIDA also reports, “Nearly 80% of youths who used illicit drugs and more than three-fourths of youths who were drunk on 51 or more days in the past year reported being exposed to prevention messages outside of school.”

Brown, J.H., D’Emidio-Caston, M., & Pollard, J.A. (1997). Students and Substances: Social power in drug education. Educational Evaluation and Policy Analysis, 19(1), 65-82.

This study is one of several from the California Drug, Alcohol, and Tobacco Education Study (DATE). This study is especially noteworthy because the authors interviewed both school personnel and students, the latter in focus groups. Most high school students reported that school-based drug information had little or no effect on their decisions about substance use and said the same about the teachers who taught such courses. The researchers pointed to the possibility of a negative fallout associated with doubts among teens about the credibility of their teachers: “…yet, much of our evidence suggests that drug education may facilitate the formation of negative effects ranging from a negative perception of educators to the boomerang effect.” The authors cite basic research in social psychology showing that, when people distrust or dislike someone who tries to influence them, they may “do exactly the opposite of what the influencing agent does or desires that we do.” (p. 79)

Gorman, D.M. (2002). The “science” of drug and alcohol prevention: the case of the randomized trial of the Life Skills Training Program. International Journal of Drug Policy, 13, 21-26.

Changes in drug policy have led to an increased emphasis on accountability as represented in the requirement that programs be “science-based” or “research-based.” A recent publication by Botvin, et al., (Addictive Behaviors, 2000) claim to have demonstrated reduction in alcohol, marijuana, and other illicit drug use six years after the original intervention. Gorman cites (p. 23) guidelines by the National Research Council Committee on Drug Abuse suggesting that follow up studies should assess at least 75% of the original samples. In contrast, Botvin reports results for selected subgroups. Only the “high-fidelity” sample was used and of that only a small group amounting to only 7.5% or the original. No information given on how this group was selected. While Botvin claimed that this group did not differ on demographics, Gorman pointed out that the original group was quite homogeneous and that any differences on the criterion measures could be due to self-selection or other factors operating on the initial elity group (p. 24)  as well as other extraneous confounding factors. The 6-year group numbered only 302 members does not come close to meeting the NRCC criterion and may reflect the influence of additional extraneous factors. There is not basis for drawing any conclusions from this research, in other words.

Gorman, D.M. (1996). Etiological theories and the primary prevention of drug use. Journal of Drug Issues, 26(2), 505-520.

This is a comprehensive review of current approaches to drug education and the causal theories that underlie them. Flaws in research ostensibly supporting life skills education (LSE), an approach currently favored by sponsoring agencies, are identified. In particular, the practice of shifting criteria of success from study to study depending on what appears to be significant in a given case is bad science.  Other flaws in research methods are discussed. LSE and similar programs are based on naïve assumptions in that they propose universal curricula for all groups and situations based on simplistic ideas about the reasons young people try drugs.

Failure to Implement Federally Approved Research Based Strategies
Despite informed criticism of research ostensibly supporting LSE and several other social influence curricula, the federal Center for Substance Abuse Prevention (CSAP) has anointed several such programs as “science-based” and thus suitable for use in schools. (DARE was not included in this list). Despite recommendations from this federal agency, such programs are not being widely implemented in schools. A recent study has added to similar findings from earlier research. These studies raise questions the ability of schools to commit time and resources to “add-on” curricula in a period of intense pressure to accomplish the traditional goals of public education.

Hallfors, D & Godette, D. (2002). Will the ‘Principles of Effectiveness” improve prevention practice? Early findings from a diffusion study. Health Education Research, 17(4), 461-470.

This study of adoption and implementation of research-based drug prevention programs sampled 104 school districts in 12 states. While many districts appeared to select such programs, actual implementation was limited. Only 19% of school district coordinators reported, “…schools were implementing a research-based curriculum with fidelity. Common problems included lack of teacher training, lack of requisite materials, use of some but not all of the requisite materials, use of some but not all of the required lessons and teaching strategies, and failure to deliver lessons age appropriate groups.” The researches cited contributing factors such as lack of funding, inadequate infrastructure, decentralized decision-making and lack of program guidance.

Flawed Theories about Why Young People Use
As Gorman pointed out (last reference), the failure of current drug education is in part the result of basing prevention on untested, simplistic, or over-generalized notions as to why young people use drugs.
Two ideas about the causes of youth substance use have been most influential.  The first is that personal deficits such as low self-esteem, low sense of personal efficacy, or lack of social and life skills are the reasons young people try drugs. The other is that direct peer pressure is the cause. These two notions ignore research findings revealing that healthy, socially successful youth also use drugs and that modeling and spontaneous imitation are far more potent influences on drug use than is direct pressure from peers.

Assumption I:  Young People Try Drugs because They Have Personal Deficits
Despite almost universal acceptance of this apparently self-evident assumption, alcohol and drug use is by no means confined to youth who are “deviant,” lack social and life skills, or are emotionally disturbed. The assumption reflects the current “risk-factor” approach that orients prevention education to compensatory strategies or “fixing” what is wrong with young people.
Evidence

Shedler, J.S., & Block, J. (1990).  Adolescent drug use and psychological health.  American Psychologist, 45, 612-630.

Relationships between psychological characteristics and drug use at age 18 were obtained for participants in a longitudinal study that began in preschool at age 3.  Measures of quality of parenting were collected at age 5 and on personality characteristics throughout the study. The authors concluded that, “Adolescents who had engaged in some drug experimentation (primarily with marijuana) were the best-adjusted in the sample.”  Participants showing signs of problematic use by age 18 had exhibited behavior problems before initiation of use. Lifetime abstainers tended to be isolated socially compared to moderate or occasional users. The authors also observed that abuse of drugs (as contrasted with experimentation or occasional use) was not amenable to purely educational intervention. Other approaches are needed including treatment and change in environment. The authors were concerned that their conclusions would be misrepresented in the media as claiming that drug use would improve an adolescent’s psychological health. There was no evidence that this was the case. (When alcohol and marijuana use is perceived as a normal part of teen social life, then most popular, socially successful young people are likely to use at least occasionally.)

Skager, R. & Austin, G. (2001). Op. cit.

When asked why peers their own age tried alcohol or other drugs, senior high school students selected positive reasons much more frequently than negative. Two thirds of 16 year olds (67%) in the most recent survey cited “to have fun.” (Viewing alcohol and drug use as a form of recreation has been the dominant response throughout the history of the California survey.) Over half (57%) selected curiosity (“to see what it’s like”). About half (52%) selected an alternative implying group norms (“because their friends do”). These were the three most frequently endorsed responses. Negative motives such as boredom were selected by less than half of the respondents.

Evans, W.P., & Skager, R. (1992). Academically successful drug users: An oxymoron? Journal of Drug Education, 22(4), 353-365.

Analysis of data from the California Student Survey and an independently assessed sample in a Southern California county revealed that over 70 percent of academically successful high school students had engaged in some type of drug use. Moreover, these students were as likely to be classified as frequent drug users as students who were less successful academically. The authors suggested that, “…educators should be cautious of relying on poor school involvement as one of the most salient indicators of student drug use. Mediating factors such as high educational aspirations, parent educational level, and emotional stability appeared to have counterbalanced the negative effects of substance use for this group.”

Assumption II: Peer Pressure Forces Young People to Try Drugs
Direct peer pressure to drink or use is a minor influence in the initiation of drug use use. Spontaneous imitation is a much more significant factor as predicted by social learning theory.  Imitation is a fundamental proclivity in human learning and applies especially where children, adolescents, and adults find themselves in new social situations and want to fit in and belong. The current emphasis on training children and youth to avoid peer pressure (resistance skills training or RST) reflects a naïve and patronizing assessment of why most young people try drugs. Most teens that perceive drinking or using as a way to have fun, bond with friends, or satisfy their understandable curiosity about what drugs do are not likely to want to say, “No, thank you.”

Evidence

Harris, J.R. (1995). Where is the child’s environment? A group socialization theory of development. Psychological Review, 102(3), 458-489.

In a review of research on the social origins of human personality this author stresses imitation as a basic process in human learning and development. Among the earliest cooperative behaviors in early childhood are “acts that imitate the acts of peers…Young humans strive to dress, speak, and behave like their same-sex peers.” Anthropological evidence reveals that children and youth in hunter-gatherer and tribal societies rarely learned through direct instruction or teaching. Rather, they were encouraged to observe and imitate adults.

Lightfoot, C. (1992). Constructing self and peer culture: A narrative perspective on adolescent risk-taking. In L.T. Winegar & J. Valsiner (Eds.). Children’s Development Within Social Context. Vol.2, Research and Methodology. Laurence Earlbaum Associates.

This chapter, written from the perspectives of constructivist and narrative psychology, reinterprets adolescent risk-taking as social behavior undertaken as a way of “creating both private experience and group shared knowledge” (p. 240). Peer pressure is “less a push to conform than a desire to participate in experience (that is) relevant to group identity” (p. 235). As applied to substance use, this means that motivation is not only internal to individual and directed at belonging, but also that using or drugs in a peer group creates shared experience enhancing the sense of connectedness among members and the special character of the group as contrasted with other groups.

Coggans, N., & McKellar, S. (1994). Drug use amongst peers: Peer pressure or peer preference? Drugs: Education, Prevention and Policy, 1(1).

This British review summarizes research on the influence of peer pressure and self-esteem on youth drug initiation. The conclusion is that overt peer pressure is not a significant factor and that youth with high self-esteem are as likely to use drugs as are those with moderate or low self-esteem. Drug use is thus more likely to reflect the “role of the individual in their own development… without assuming that motivation for drug use arises solely out of personal or social inadequacy” (p. 15).

Gorman, D.M. (1995). Are school-based resistance skills training programs effective in preventing alcohol misuse? Journal of Alcohol and Drug Education, 41, 74-98.

This review of research on resistance skills training (RST) focused on initiation and misuse of alcohol, the leading drug of abuse among young people. The author found little evidence that RST programs were effective.  “The majority of the studies reviewed show that such programs, while not detrimental, have little or no impact upon participants. In those studies reporting a positive effect, this is limited to sub-groups of the target-population.” The negative findings are the result of using a causal theory based on only two (peer pressure and media influence) of the many risk factors that relate to alcohol use among young people. His recommends abandoning the “universal approach to prevention, in which all students receive the same intervention, in favor of targeting specific high-risk groups.”

Deterrent Punishment Is a Counterproductive Strategy
Deterrent punishment is designed to discourage young people from using substances by making an “example” of the offender. In other words, teens that are caught are expendable, useful only as tools for making others fear the same fate. The majority of US schools have adopted mandatory deterrent policies, but there is no evidence that drug use has declined as a result. Instead, such policies engender cynicism and alienation among young people.

Evidence

Foster, S. E. & Richter, L. (2001). Malignant Neglect: Substance Abuse and America’s Schools. National Center on Addiction and Substance Abuse. Columbia University. Report

The great majority of US schools apply mandatory penalties to students who violate rules on substance use. The penalties are typically automatic expulsion, suspension, or transfer to an alternative school. The study reported that 88% of schools apply these policies for illicit drug violations, 87% for alcohol, and 79% for tobacco. According to the authors such disciplinary policies, while consistent with the principle of zero-tolerance, have two negative consequences. First, parents and peers who know that a youth is using are likely to remain silent in order to protect that individual from further damage resulting from punitive policies. Secondly, very few schools that have adopted deterrent punishment offer helping services for students whose use has become problematic.

Brown, J.H., & D’Emidio-Caston, M. (1995). On becoming “at risk” through drug education. Evaluation Review, 19(4), 451-492.
This study is also derives from the Drug Alcohol, and Tobacco Education or DATE study conducted in California. This report examined student views on school drug programs and policies. Students generally believed that school policies purged those peers who were most in need of help. The authors noted that the National Monitoring the Future Study had revealed “no evidence that students chose to alter their behavior rather than risk expulsion.” (p. 484) They also concluded from the focus groups that most students had decided, “to look elsewhere for credible drug information.” (p. 484) In their conclusion the authors criticized prevention programs for ignoring life experience students bring to the classroom, especially experience stemming from alcohol or other drug use by self or others. This practice undermines the credibility of school prevention personnel when their messages are in conflict with what students have personally seen or experienced.

Resnick, M.D., Beaman, P.S., Blum, R.W., Bauman, K.E., Harris, K.M., Jones, J., Tabor, J., Beuhring, T., Sieving, R.E., Shew, M., Ireland, M., Bearinger, L., & Udry, J. (1997). Protecting adolescents from harm. Journal of the American Medical Association, 278(10), 823-832.

Interviews conducted as part of the National Longitudinal Study of Adolescent Health found that only “connectedness” with parents-family and school were protective against health risk behaviors including substance abuse. There was no relationship between school disciplinary policies (nor any other school policies) and rates of tobacco, alcohol or illicit drug use. Only positive relationships between youth and their families and with their schools predicted positive behavioral indicators including lower levels of substance use.

II: Principles of Youth Development and Socialization
Findings from the behavioral and social sciences about the mental capacities of young people and how they are socialized in modern, complex societies do not support current approaches to prevention education. Three facets of adolescent development must be taken into account: (a) cognitive, or the ability to think like adults, (b) socialization and the critical role of the peer group, and (c) the construction of personal identity.

Adolescents Reason as Well as Adults
Adult reasoning and problem solving skills emerge during early adolescence. Teenagers detect inconsistencies in reasoning, ask penetrating questions about rules and regulations, and question the way the world works. Given the right information, they make decisions as rationally as adults do. When their own later experience contradicts what they were taught as children, they are likely to reject earlier beliefs. While adolescents can reason as well as adults, they often lack life experience. Lack of experience rather than lack of intelligence explains much of the impulsive, risk-taking behavior associated with being young.

Evidence

Moshman, D. (1999). Adolescent Psychological Development: Rationality, Morality, and Identity. Erlbaum.

This recent text on adolescent development draws the following conclusion. “For the most part, the distinction between adolescence and adulthood is a matter of cultural expectations and restrictions rather than a matter of intrinsic psychological characteristics. With the understanding that development is not limited to childhood, adolescence may best be construed as the first phase of adulthood.” This conclusion leads Moshman to characterize adolescents as “inexperienced adults” and suggest that an appropriate educational process for adolescents would be more like higher than elementary education.

Hine, T. (1999). The Rise and Fall of the American Teenager. Perennial.

This history of adolescence in the USA provides a different kind of evidence supporting Moshman’s conclusion. During the earlier history of the Republic most teenagers did not experience a period of life that we now identify as “adolescence.” On leaving elementary school the great majority of teens took on adult working and life roles. It was mainly the offspring of affluent families that continued schooling to the secondary and university level. They did so within restrictive institutional contexts that extended the period of childhood by means of controls inconceivable in the culture of the present. The term “adolescence” did not come into use until well into the 20th century.  The teenage culture we know today did not emerge until after World War II. 

Quadrel, M.J., Fischhoff, B. & Davis, W. (1993). Adolescent (in)vulnerability. American Psychologist, 48(2), 102-116.

The editor of the journal issue in which this research was published concluded that this study “challenges long-standing beliefs that adolescents are not competent to make good decisions about a variety of choices…(and) also questions the belief that adolescents’ feelings of invulnerability lead to…risky behaviors…(and) approaches to intervention with adolescents that are based on assumptions of adolescents’ incompetence and (feelings of) invulnerability (are to be avoided).” (Takanishi, R. P., p. 86, same issue) The authors conclude that assumptions of incompetence of adolescents lead to counterproductive paternalism that “disenfranchise and stigmatize adolescents.” (p. 114) As applied to prevention education, this suggests an educational process more appropriate to adult learners. 

Socialization in Peer Groups
Whether youth or adult, members of all peer groups compare and contrast themselves with members of other groups. This process promotes group solidarity. It also rewards individual members with a sense of being special and different, thus contributing to personal identity.  Peer groups are especially influential during adolescence when construction of a coherent sense of self is the key development process.
Developing a system of beliefs (ideology) is an important part of this identity project. Their social world often tells adolescents that substance use is fun and even beneficial. Further, using alcohol or drugs can be a way to demonstrate independence from adult control. This is especially likely when adults are perceived as against freedom and fun.
Adolescents also tend to be dogmatic about their newly acquired notions of right and wrong, partly because many of their beliefs have not been tested. They are resistant to messages that conflict with their own experience, the latter including what they learn from their friends. This is a rock on which conventional approaches to prevention education often crash and burn.

Evidence

Harris, J.R. (1995). Op cit. p. 16.

In her comprehensive review of research on peer groups Harris observes that the behavior of adolescents in complex societies (those in which youth are not allowed to classify themselves as adults once physical development is complete) results in self-classification into contrasting groups: teenagers vs. adults. One consequence of this distinction is that delinquent acts among adolescent are extremely common in Western societies and violators include young people who have been model children and who will later be law-abiding adults. Harris concludes that, “Adolescents are not aspiring to adult status—they are contrasting themselves with adults. They adopt characteristic modes of clothing, hairstyles, speech, and behavior so that, even though they are now the same size as adults, no one will have any trouble telling them apart.”

McAdams, D.P. (1993). The Stories We Live By. Guildford Press.

This text follows the development of identity from early childhood into maturity. Identity is viewed as a “personal myth” constructed from elements laid down in successive periods of life. The two milestones in adolescence are (a) attaining formal or abstract reasoning and (b) developing a set of personal beliefs or ideology. The author follows Erik Erickson in viewing ideology as “a systematic body of ideas about humankind and the world” that unfolds during adolescence once the ability to reason abstractly about “what is and what ought to be” is attained. (p. 312) Ideology is a “setting” for identity that locates one’s personal myth “within a particular ethical, religious, and epistemological ‘time and place’. “(p. 81) In other words, beliefs have a social origin and are an integral part of personal identity. (This makes them hard to change; especially in adolescents who have not have experienced the consequences of some of their beliefs).

III: Adolescent Drug Prevention Programs Should Emphasize Participation and Respect for Young People
Prevention education must address young people in ways that acknowledge their need to participate actively. Research has shown positive results for interactive learning and virtually none for sequenced, “factual” curricula in which teachers recite information about the dangers of drug use. In true interactive learning relationships between teacher and learners, learning process, and timing come first. The right kind of relationship involves trust—learners know that the teacher cares about them and is always honest with them. It involves respect—the teacher acknowledges the intelligence, personal experience, and active contributions of the learners. It involves flexibility—the learners have an equal opportunity to set the agenda and the teacher recognizes the importance of the “teachable moment,” the time when learners want to know something. Finally, It involves responsibility—learners as well as teachers are responsible for making the experience worthwhile.

Research Supports A Different Kind of Learning Process
Secondary education in general has been criticized for failing to address adolescents in ways appropriate to their level of mental development. Since young people possess cognitive abilities equal to those of adults, they are able to evaluate prevention messages in the light of their own sources of information. As a result they readily detect half-truths and exaggerations. They resent being treated as if they did not have the ability to make their own decisions. They are resistant to lectures about making personal choices when only one choice is presented as acceptable. They want open discussion and to be treated with respect by adults.  

Evidence

Eccles, J.S., Midgley, C., Wigfield, A., Buchanan, C.M., Reuman, D., Flanagan, C., & Mac Iver, D.  (1993). Development during adolescence. American Psychologist, 48(2), 90-101.
These authors present the evidence for a mismatch between the needs of developing adolescents and opportunities typically afforded in social environments of home and school.  They argue that adolescents entering middle school are often confronted with a “regressive” environmental change. Their relationships with teachers become impersonal, there is less opportunity to participate in classroom decision-making, and they experience decreasing autonomy at a time in which developmental changes associated with adolescence demand the opposite. While amounting to a general critique of US middle and high schools, the authors’ diagnosis and conclusions fit most prevention education especially well.

Tobler, N.S. & Stratton, H. (1997). Effectiveness of school-based prevention programs: A meta-analysis of the research. Journal of Primary Prevention, 18(1), 71-128.

This landmark research combined the results of 120 scientifically valid evaluation studies of alcohol/drug prevention education programs into an overall analysis that related program characteristics to outcome measures. Use of interactive learning strategies was the only program characteristic that differentiated between programs that had positive effects vs. those that did not. Non-interactive programs increased knowledge about alcohol and drugs, but did not change attitudes nor decrease substance use. Interactive programs showed positive outcomes on all three measures: knowledge, attitudes, and use. The authors concluded that group process was the factor that most distinguished interactive from non-interactive programs.

Interactive Learning, Connectedness and Resiliency
The National Longitudinal Study of Adolescent Health cited earlier (Resnick et al., 1997) found that the most significant protective factor against every health risk behavior associated with being young (with the single exception of pregnancy) was connectedness with school and family. “Connectedness” means relationships, not with abstractions like the family or the school, but with caring
Beck’s (1998) review cited earlier on the history of prevention education in the USA suggests that young people will use drug information if it is accurate, honest, and delivered by people they trust. The author questions the wisdom of premature rejection of the informational approach because the effectiveness of earlier programs was not confirmed by research. When teachers who lack credibility provide biased or inaccurate information, the outcome is likely to be nil or even counterproductive for learners privy to other sources of information. Earlier informational programs failed because they attempted to indoctrinate rather than educate. 
Young people are acutely sensitive to the quality of their relationships with adults. Some kinds of relationships work against connectedness. Teachers that ignore what their students already know about drugs and are not interested in what they have to say will fail to connect. Young people interpret such behavior as uncaring and demeaning.
Creating positive connections between young people and adults is the cornerstone of the youth development approach. Youth development programs stress the enhancement of resiliency—the capacity to function successfully despite obstacles and trials. Resiliency shifts prevention from compensating for youth defects (the current “risk factors” approach) to the development of positive assets and strengths. How principles of resiliency can be applied to drug prevention education is described in a recent article. 

Brown, J.H. (2001). Youth, drugs, and resilience education. Journal of Drug Education, 31(1), 83-122.

Current research in cognitive neuroscience demonstrates that feeling or affect is a vital component of human learning. A sense of meaning and relationship with a subject promotes learning and links it to behavior. This process is facilitated by a sense of rapport (connectedness) between teacher and learner.  “When young people believe that adults are listening to them regarding their affective issues—needs, fears, curiosities about drug use—rapport is built.” (p. 105) “Good drug information distinguishes between drugs, levels of use, and various contexts in which drug use occurs. (p. 106) In other words, “no-use” messages required by zero-tolerance, risk-factor prevention treats all drugs as if they were the same and shuns information that would promote safety among those who choose to experiment. For a youth population in which alcohol and other drug use is normalized, this approach provides convincing evidence that adults neither understand the world in which they live nor care about their welfare.

Tobler, N.S. (1992). Drug prevention programs can work: Research findings. Journal of Addictive Diseases, 11(3), 1-28.

This study compared prevention programs with different types of leaders. Mental health professional and counselors were most effective, followed by peers. Regular teachers produced the most negligible effects. (This finding does not reflect general incompetence on the part of teachers, but rather that approaches suitable for academic subjects are not effective for education addressed to personal choice and development.) Tobler concluded that, leaders should be people who are “competent in group process, who can enhance the interactional process and simultaneously focus and direct the group. Successful leaders have the ability act as guides, as opposed to being dominant. They are able to tolerate ambivalence, and know when to remain silent to facilitate true dialogue. They are able to empower adolescents to make conscientious decision and to encourage freedom of choice and individual self determination.” (p. 20-21)
This leads back to the beginning—that adults must listen. This point is made eloquently at the end of a book that, while not based on research in the strict academic sense, is a stellar example of what can be learned if one is willing to talk with young people rather than to them.

Hersch, P. (1998). A Tribe Apart: A Journey into the Heart of American Adolescence.  Fawcett-Columbine.

“The turbulence of adolescence today comes not so much from rebellion as from the loss of communication between adults and kids, and from the lack of a realistic, honest understanding of what the kids’ world really looks like. The bottom line: we can lecture kids to our heart’s content but if they don’t care what we think or there is no relationship between us that matters to them, or they think we are ignorant of the reality of their lives, they will not listen.” (p. 365)
Prevention education is an enterprise in which adults attempt to influence the life choices of young people. It is not an academic subject like algebra or even history. Authenticity and trust on both sides must be established if positive outcomes are to result. Relationship and process come first. Curriculum content follows only when these prior requirements are met.

The following are four characteristics of interactive learning.
• Adults provide information when it is asked for rather than in a predestined order. This is the principle of the “teachable” moment. Learners also participate in setting the agenda. Open discussion and dialogue encourage active participation.
• Adults recognize that many if not most teens have had their own encounters with drugs (even abstainers) and that information and questions arising from that experience must be allowed to surface.
• Adults must be a credible source of information and pertinent experience. Honesty and a non-judgmental approach are essential in establishing credibility. The learners must be confident that the adult’s overriding concern is for their health and safety.
• An open interactive learning process will inevitably promote self-identification by problematic users and questions about how to approach a friend who has a problem. Intervention and associated helping services must be coordinated with interactive prevention programs.

Final Note
Young people already know that they can try drugs. They are aware that drugs are readily available and can easily find out where they can be obtained. They know that only a relatively few users of marijuana go on to use of other illicit drugs. Most important, they are aware that the choice between using and abstaining is theirs to make.
Young people do not ask adults for permission to try drugs, nor does an honest and open learning process give permission. Experiences shared by participants in such a process will not differ from what youth hear in private conversations among themselves. The difference is in the presence of a wise and informed teacher or facilitator plus engagement in a positive educational process.