A submission by Students Against Addiction: Drug Prevention in Schools: A Review of What Works.

Drug Prevention in Schools: A Review of What Works

Schools have traditionally been a place where, more often than not, youth are first exposed to the world of drugs. Despite the exposure and availability of drugs in these institutions, drug use is typically left to a minority of students; alcohol being an exception (“Nida infofacts: High,” 2014). Until 1987, the federal government dedicated little effort and resources to drug prevention in schools. It was not until congress passed the Drug-Free Schools and Communities Act (DFSCA) that a national effort, championed by the US government, was made to reduce drug use in schools. The idea of the program was to give funding to every school district in the country to be used solely on the development and implementation of drug prevention programs (Silvia & Thorne, 1997); however, this act did not specify what programs’ schools were to spend their money on, and how policies should be enforced. This paper will outline various programs that have been implemented in schools over the years, such as zero tolerance, randomized suspicion-less drug testing (RSDT), and other prevention programs, as well as examine their overall support and efficacy.

Zero tolerance is a common enough policy name, a number of schools have something resembling this in their books. However, the actual term “zero tolerance” is not specific to any one type of program or institution. The idea of “zero tolerance” is simple; it creates a uniform, usually fairly harsh, punishment for any behavior that violates a rule or policy. The idea of zero tolerance can trace its roots back to the mid-80s when it was used to reduce drinking and driving. In this regard, this policy was used as a way of keeping individuals under the age of 21 from having any sort of alcohol in them and driving; if they were caught, even if under the legal .08 limit, they received the same penalties as someone of age with a BAC above .08 (“History of zero,” 2011). Soon after, schools began adopting similar policies for their students. By the early 1990s school districts in California, New York, and Kentucky set a standard expulsion policy for any activities related to drugs, fighting, or gang involvement. It only took 3 more years for similar policies to pop up in schools across the country (Skiba, 2000). Finally in 1994 the Clinton administration followed suit and signed into law a zero tolerance policy that required a one year expulsion for gun possession (American Psychological Zero Tolerance Task Force, 2008). Part of the popularity of this policy could be associated with its low cost. Despite school and community desires to eradicate drugs from schools, it is a pricey process. The federal grants given to school districts for drug prevention, as established by the DFSCA, is relatively little and comes out to approximately $10 per student (Silvia & Thorne, 1997). Thus, a policy where a student who uses drugs is kicked out for free is much more appealing than other programs that will be discussed later which involve outside resources. Despite its seeming popularity, zero tolerance policies carry quite a bit of controversy with them. Since its nationwide passage, the media has spotlighted situations where students have been suspended for extended periods of time for miniscule offenses, such as bringing a toy gun to class, sharing an inhaler with fellow student suffering an asthma attack, or a five year old turning in a razor blade to a teacher that he found at his bus stop (Skiba & Peterson, 1999). Also, there is a growing body of literature suggesting that there is a racial bias in the execution of zero tolerance (Skiba, Eckes & Brown, 2009). This latter finding was held consistent when controlled for SES level (Skiba, Eckes, & Brown, 2009; Skiba & Peterson, 1999).

Despite the controversy associated with zero tolerance policies, it is still a widely used practice for reducing weapons, drugs, and fighting in schools. Unfortunately, this does not mean it is an effective policy. Research on this topic suggests that zero tolerance is an overall ineffective program that does not decrease the behaviors it bans (American Psychological Zero Tolerance Task Force, 2008; Skiba, 2000). In fact, a survey monitoring drug and alcohol use since the early 90s, shows that drug use amongst students between 8^th and 12^th grade reached an all-time high in the late 90s. At this point, approximately 54% of 12^th graders reported using at least one illicit-drug being surveyed. That year, the same sample also reported that approximately 80% of students had experimented with alcohol (Johnston, O’Malley, Bachman, & Schulenberg, 2013). These In the report by the American Psychological Zero Tolerance Task Force (2008), they discuss certain modifications to the zero tolerance policy that may make it a more effective policy. One of the first things discussed in the article is the blind application of the policy in most schools. They discuss that punishments should not be rigid in application but rather should be left up to teacher or principal discretion; this way factors of the situation can be assessed in the punishment. They also discuss the idea that the extreme punishments of zero tolerance (i.e. expulsion and long-term suspension) should only be used under extreme cases that could put individuals in danger. Due to the scrutiny of the zero tolerance policy, other programs are beginning to be examined that may be more effective alternatives. One that is gaining more support is the use of randomized suspicion less drug tests (RSDT).

The presence of drug testing has been around in schools since the beginning of schools’ war on drugs. It has been a controversial way of attempting to enforce the zero tolerance policy that so many schools have adopted (Yamaguchi, Johnston, & O’Malley, 2003). Unfortunately, just as is the case for the zero tolerance policy, the use of RSDT is under fire about whether or not it is an effective means for reducing drug use in schools. It is also equal too if not less favorable in the eyes of the general public as being a fair way to enforce drug policies. Two major complaints against RSDT, disregarding whether it is effective or not, that circulate through the literature is the cost and the rights of students (Beger, 2003, Evans, Reader, Liss, Wiens, & Roy, 2006, Silvia & Thorne, 1997, & Yamaguchi et al., 2003). The cost of a standard drug test range in price from $14-$30; in instances where schools are using RSDT on students involved in competitive athletics, prices can reach up to $100 in order to test for the use of anabolic steroids (Yamaguchi et al., 2003). As mentioned earlier in this paper the federal government, through the passage of DFSCA is only able to fund school districts enough to cover up to $10 per student (Silvia & Thorne, 1997). Another argument surrounding the use of RSDT centers on the rights of students. In an article by Beger (2003), it discusses students’ rights to privacy as well as students constitutional protection from unreasonable search and seizure. He highlights in his article various instances when students invasion of fourth amendment rights was caused by zero tolerance policies and there right to privacy is violated by the mere act of participating in a drug screening, “on a personal level, the testing is intrusive because it requires school children to urinate in the presence of a monitor and reduces their privacy only on the basis of their student status (344).” Despite the resistance from the public about the use of RSDT in schools, government action over the past two decades has further increased the legality and availability of drug testing in schools.  Two Supreme Court cases, Vernonia School District v Acton and Earls v Tecumseh School District, supported school districts rights to use RSDT on students who were engaged in extracurricular activity (Evans et al., 2006). Then in 2006 the federal government gave a 7.2 million dollar increase in funding to schools districts specifically for use on drug testing (Bensen, 2007). All of this has occurred despite any empirical evidence supporting the effectiveness of RSDT in reducing drug use in schools (Evans et al., 2006, Velasquez, 2010, Yamaguchi et al., 2003).

It is apparent that support and belief in the effectiveness of RSDT exists at the government level; however, studies that examine support at a school level paint a more ambiguous picture.  According to Yamaguchi et al. (2003) about 80% of school superintendents say they do not desire to have drug testing in their schools. In contrast, approximately 74.1% of students in their sample viewed drug testing as an effective way of reducing the drug problem, despite only a small minority of these students actually viewing drug testing as a good idea. Few researchers have looked specifically at the effects of RSDT in schools, but the ones that have, have determined the effectiveness to be inconclusive at best (Velasquez, 2010). In another study conducted by Evans et al. (2006), their findings strongly support the opponents’ side and demonstrate that RSDT is an ineffective way of reducing drug use in schools. In their study, the researchers used data from over 250 schools that examined drug usage in 8^th, 10^th and 12^th graders, as well as those same schools’ use of drug testing (information used was gathered from the Monitoring the Future (MTF) study and the Youth, Education and Society (yes) study). Results showed no significant correlations between the presence of drug testing and drug usage. Also, the punitive measures used with drug testing do not match up with the zero tolerance policy they are so often coupled with (Evans et al., 2006). Drug testing in schools was introduced at around the same time that zero tolerance was making its big scene in schools, and provided additional ways of cracking down on drug problems. Despite this, today these two seem to be growing a part. Students that test positive today rarely receive the harsh punishments that one would expect from zero tolerance. Rather, punishments usually focus on deterring the student from reengaging in drug behaviors. This is done through various forms of required drug classes and suspension from extracurricular activity (Velasquez, 2010). This is not to imply that these forms of punishment are a bad way to handle the situation, but these punishments may make policy towards drugs unclear to students, thus losing their preventative powers.

The vast majority of literature does condemn the use of RSDT in schools, pointing to either its ineffectiveness or ethicality; yet there is a small glimmer of hope for it. There are some studies that point to positive aspects of drug testing, and if new programs evolve from this literature, drug testing may become an effective policy in the future. First, one article points out that the presence of RSDT programs can provide youth with a scapegoat when faced with peer pressure (Evans et al., 2006). Rather than turning down drugs due to personal reasons (i.e. saying they don’t want to use) they now have a legitimate excuse to turn down drugs; one that will leave them less subject to verbal abuse.  Also, another article used a RSDT program in a slightly modified form and it produced statistically significant success. In this study, the researchers found that when a RSDT program was paired with an incentive program, it increased effectiveness. Researchers worked with local businesses in a community and developed a discount card that had several deals to local restaurants, movie theatres, golf courses, etc.; this card was then given to students whose tests came out clean on a twice yearly drug screening (Office of National Drug Control Policy, 2002). Unfortunately programs like this then bring up the issue of cost-effectiveness. Not only would the school district have to pool a fair amount of its monetary resources to fund this, it also requires participation with local businesses, making this difficult to put together in larger cities. Yet programs like this and other non RSDT based programs that are emerging in schools across the country have received the most empirical backing in their effectiveness at reducing drug use amongst students (Office of National Drug Control Policy, 2002).

After reviewing other programs that have been used in the battle against drugs in schools there are two that seem to emerge as the leader, Life Skills Training (LST) and the NARCONON program. Although the NARCONON program is relatively new and not as empirically tested as LST it still has significant empirical support (Botvin & Eng, 1980, Botvin & Griffin, 2005, Evens et. Al., 1976, , Griffin, Botvin, Nichols, & Doyle, 2003, Lennox & Cecchini, 2008). Perhaps the main reason that these two programs both seem to be so effective is because they are both developed with the social influence theory of drug use in mind. This theory was first explored by Evans et al. in 1976 who found that this theory is effective at reducing cigarette smoking behaviors in teens. The theory hypothesizes that the reason youth experiment with drugs is largely due to the pressures and complex nature of social interactions (as cited in Lennox & Cecchini, 2008).

The LST program was originated by Botvin and Eng in 1980. They designed it to reduce tobacco use in adolescents (as cited in Lennox & Cecchini, 2008). The idea of LST is to teach kids various skills and knowledge that can help them resist the influence of drugs and the individuals who offer it to them (Griffin, et al., 2003). An extensive review of the literature shows that the LST program has received large support in its effectiveness in reducing drug use in youths (Botvin & Griffin, 2005). Perhaps the research that best supports the LST program as an effective program in combating youth involvement in drugs was performed by Griffin et al. (2003). The researchers aim was to test the effectiveness of the LST prevention program on at-risk youths for getting involved in drugs. At-risk youths were those with low grades and who hang out with peers who engage in drug use. The results of the study showed that at a year follow up, at-risks youths who were involved in the variable group showed a significantly lower level of drug use than their counterparts in the control group. This study is important because it focuses on a demographic of students who may be less receptive to drug prevention programs or may receive less positive support from parents and/or teachers.

Despite the level of support this program has received in the scientific community, organizations are constantly trying to find other programs that may help reduce drug use with students. One of these programs is the NARCONON program. NARCONON is an international drug rehab and prevention agency. In 2004 they developed a prevention education program that targets high school students. The education is very broad focusing on a number of items including health impacts of drugs, social skills that reduce drug exposure, ways to handle situations involving drugs, and other skills that help kids resist the strains of social pressures (Drug education programs, 2010). The NARCONON program is designed off of various other theories and programs that have shown success in the past. Two areas that they stress in their program is having sound scientific content in the education and an emphasis of LST in their prevention portion (Lennox & Cecchini, 2008). The NARCONON program has also shown similar findings to the LST program when empirically tested. Research conducted on over 1000 high school students shows that at a six month follow up screening, students who received the NARCONON program versus a regular drug education program showed reduced drug behaviors in every category. Along with this, students also showed an increased knowledge about the dangers of drug use (Lennox & Cecchini, 2008).

The two programs listed above are shown to be effective combatants in the war against drugs in schools. However, programs like these are not cheap; even though they probably receive some grant support and federal funding it is still going to cost the tax payers and local governments’ money to implement these programs in schools. That is why it is important to also look at simpler answers that may help reduce drug use in schools. One such answer was proposed by Evans-Whipp, Bond, Toumbourou, & Catalano (2007); they discuss the importance of schools addressing drug policy with students. In their research, the authors examined schools in Washington state and Victoria, Australia. The reason for the two locations was the difference in drug policies between the two countries.  Over the course of the study the authors examined how well schools delivered their drug policies to students. The results showed that when schools delivered their policies effectively to the students there was a reduction in drug use over the course of the year. One interesting difference that was pointed out in the article was that when policies stressed abstinence it was more effective at reducing drug use than when the policy stressed harm-minimization. The authors suggest that this is due to the more ambiguous nature of a harm-minimization policy. This article is one that should not be overlooked when looking for effective drug reduction techniques. Simple solutions like this cannot stand alone in schools but can be effective and more cost efficient than some of the more advanced programs.

After looking at the level of control schools have put in place over the past two decades, it would seem pretty obvious that drug use in schools has declined. Yet, against logical thought, this is not the case (“Drug education programs,” 2010; Johnston et al., 2013; “Nida infofacts: High,” 2014). Unfortunately drug prevention programs are struggling in the war on drugs. Despite the long decline in substance abuse that has been occurring since the 70s, more recent years have shown an increase in use of marijuana, heroin, ecstasy, oxyContin, and hallucinogens amongst 8^th, 10^th and 12^th graders; while conversely there is a decline in alcohol and tobacco use (“Drug education programs,” 2010; Johnstong et al., 2013; “Nida infofacts: High,” 2014). Interestingly enough students overall knowledge of the harm of drugs has increased slightly and their disapproval rates of peers using these drugs have decreased slightly over the same time frame (Johnston, O’Malley, Bachman, & Schulenberg, 2010; “Nida infofacts: High,” 2014). Statistics like this make it difficult to develop effective programs to reduce drug use, because it is hard to say why students are using. The statistics imply that students are absorbing the drug education information, but it does not seem to be impacting students the same. These statistics also seem to lend support to the social influence theory that was developed so many years ago. Perhaps students are simply engaging in drugs because that is what their peers are doing. This only reinforces the idea that implementing programs such as LST and NARCONON, or other programs that are based on the social influence theory may be the answer needed for this growing epidemic in our schools.

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References

Bensen, J. (2007). School drug testing: What is the role of intervention. Brown University Child & Adolescent Behavior Letter. 23(1), 1-6.

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Beger, R. R. (2003). The “worst of both worlds”: School security and the disappearing fourth amendment rights of students. Criminal Justice Review, 28(2), 336-354.

Drug education programs (2010). Retrieved from https://www.narconon.org/drug-education/

Evans, G. D., Reader, S., Liss, H. J., Wiens, B. A., & Roy, A. (2006). Implementation of an aggressive random drug-testing policy in a rural school district: Student attitudes regarding program fairness and effectiveness. Journal of School Health, 76(9), 442-458

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