tag:theconversation.com,2011:/id/topics/youth-drug-use-41329/articlesYouth drug use – The Conversation2023-08-17T12:35:12Ztag:theconversation.com,2011:article/2097712023-08-17T12:35:12Z2023-08-17T12:35:12ZPotentially faulty data spotted in surveys of drug use and other behaviors among LGBQ youth<figure><img src="https://images.theconversation.com/files/541296/original/file-20230804-26-63jilc.jpg?ixlib=rb-1.1.0&rect=202%2C166%2C7737%2C5130&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A new study found that youth were providing extreme or untruthful responses to CDC surveys on LGBQ student health. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/female-hands-of-a-student-taking-a-test-royalty-free-image/1305362771?phrase=students+taking+a+survey&adppopup=true">FG Trade/E+ via Getty Images</a></span></figcaption></figure><p>Federal data on LGBQ student health <a href="https://doi.org/10.1111/cdev.13957">contain a significant amount of potentially exaggerated or untruthful responses</a>, raising questions about how they might skew people’s understanding of risky behavior among teens. These inaccuracies affect some responses more than others. That’s according to an analysis my colleagues and I did of high school surveys administered by the Centers for Disease Control and Prevention, better known as the CDC.</p>
<p>Without accounting for this invalid data, the CDC results suggest that for every heterosexual boy who uses steroids, three LGBQ boys use steroids. After accounting for the invalid data, neither group is shown to use steroids more. In contrast, disparities for being bullied or considering suicide were not affected by potentially invalid data.</p>
<p>Over 12,800 high school students during the 2018-2019 school year reported whether they identified as LGBQ – that is, lesbian, gay, bisexual or questioning – or heterosexual on the national <a href="https://www.cdc.gov/healthyyouth/data/yrbs/data.htm">Youth Risk Behavior Survey</a>. They also responded to items related to their health and well-being. </p>
<p>We first estimated what the risk disparities between LGBQ and heterosexual youth were before accounting for potentially invalid data. We then used a machine-learning algorithm to detect response patterns that suggested when youth were providing extreme or untruthful responses.</p>
<p>For example, we treated their responses with suspicion if they reported eating carrots four or more times every day and said they were impossibly tall. That means we gave less weight to their responses when we re-estimated all of the disparities. We then saw how the disparities changed after the potentially invalid responses were taken into account.</p>
<p>After accounting for invalid data, disparities in drug use – including steroids – injected drugs, cocaine, ecstasy and pain medication without a prescription were not as pronounced. LGBQ boys appeared to use injected drugs four times as often as heterosexual boys. But after accounting for the likely invalid data, neither group was more likely to use injected drugs. </p>
<p>Yet, while some outcomes were susceptible to invalid data, others were not. For example, LGBQ boys and girls were about twice as likely to be bullied at school and two to three times as likely to consider suicide. This shows that not all outcomes are equally affected by invalid data. </p>
<h2>Why it matters</h2>
<p>The Youth Risk Behavior Survey provides vital information on the health and behaviors of high school students. It informs research regarding <a href="https://www.cdc.gov/healthyyouth/data/yrbs/yrbs_data_summary_and_trends.htm">teen sexual behaviors, drug use and suicide risk</a>.</p>
<p><a href="https://doi.org/10.1111/cdev.13957">Our study</a> and others using different methods to account for invalid data <a href="https://doi.org/10.3102/0013189X11422112">consistently</a> <a href="https://doi.org/10.2105/AJPH.2018.304407">find</a> <a href="https://doi.org/10.1177/2332858419888892">that</a> LGBQ students are at a much higher risk for being bullied and for suicide, consistent with <a href="https://www.cdc.gov/healthyyouth/data/yrbs/yrbs_data_summary_and_trends.htm">CDC reports</a> on these outcomes. </p>
<p>It is critical to address the <a href="https://www.aclu.org/legislative-attacks-on-lgbtq-rights">ongoing stigmatization that LGBTQ+ people face</a> to reduce these mental health disparities. Yet, when researchers don’t check for invalid data, they might conclude that other differences are larger and more deserving of attention and resources than they are.</p>
<p>Policymakers and researchers must ensure that large-scale data collection efforts have safeguards for data quality.</p>
<p>We asked the CDC for a comment on our study’s findings. In response, they directed our attention to an <a href="https://www.cdc.gov/healthyyouth/data/yrbs/faq.htm">FAQ page</a> that discussed validity and reliability in a general sense. The CDC’s response did not specifically address the issue of how invalid data can have a disproportionate effect on minorities, which is a significant concern raised by our research.</p>
<h2>What other research is being done</h2>
<p>Other studies have found that invalid data can disproportionately influence <a href="https://doi.org/10.1111/cdev.13957">low-incidence outcomes like heroin use</a> and <a href="https://doi.org/10.1037/abn0000479">minority populations</a>, including <a href="https://doi.org/10.1300/J145v06n02_02">adoptees</a>, <a href="https://doi.org/10.1177/152822X06289161">disabled</a> <a href="https://doi.org/10.3102/0013189X14534297">individuals</a>, <a href="https://doi.org/10.1037/a0024824">racial or ethnic minorities</a>, <a href="https://doi.org/10.1177/152822X06289161">immigrants</a> and <a href="https://doi.org/10.3102/0013189X14534297">transgender individuals</a>.</p>
<p>Moreover, the issue of invalid data is not confined to youth surveys. Studies examining <a href="https://doi.org/10.1371/journal.pone.0287837">public health behaviors</a> during the COVID-19 pandemic and surveys on <a href="https://doi.org/10.1177/1948550617698203">sexual orientation among adults</a> have also encountered invalid responses, raising further questions about their accuracy.</p>
<p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work.</em></p><img src="https://counter.theconversation.com/content/209771/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Joseph Cimpian receives funding from the U.S. Department of Education Institute of Education Sciences and the National Science Foundation.</span></em></p>Potential inaccuracies in CDC high school surveys may have created an exaggerated perception that LGBQ youth engage in risky behaviors, new research shows.Joseph Cimpian, Professor of Economics and Education Policy, New York UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1325962020-03-09T19:01:01Z2020-03-09T19:01:01ZWild Butterfly film review: Claire Murray’s story gives a human face to trauma, drug use and blame culture<figure><img src="https://images.theconversation.com/files/318792/original/file-20200305-127951-37x764.jpg?ixlib=rb-1.1.0&rect=20%2C5%2C1973%2C1137&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Wild Butterfly/FanForce</span></span></figcaption></figure><p>Who deserves our compassion and medical care? Does a person who has used drugs deserve a liver transplant … and then a second? What if she’s 24 years old and a mother of small children? What if she had been prescribed the drugs initially for a mental health condition? What if she started showing mental-health symptoms after she was sexually assaulted and then mercilessly bullied? Would she be more deserving then?</p>
<p>These are some of the questions raised by <a href="https://fan-force.com/films/wild-butterfly/">Wild butterfly</a>, the story of Claire Murray, who died in 2010 at just 24 years old after complications from a <a href="https://www.perthnow.com.au/news/wa/liver-mum-claire-murray-reveals-i-dont-deserve-a-second-chance-ng-6753f9d062c04f37fb0f43ed4347004d">failed liver transplant</a>. Her search for a second liver was the subject of <a href="https://www.theaustralian.com.au/news/nation/claire-murrays-family-to-sell-home-to-pay-500000-liver-transplant-debt/news-story/5a0e6bdbf49da5ab73961313a53a6dd6">scathing media coverage</a>. “They had a poll on her life,” Claire’s mother says in the documentary. “[It asked] ‘Do you think she deserves to live or die?’” </p>
<p>The documentary also raises questions about how she was treated by some health professionals and the general public on social media, treatment that was underpinned by prejudice about people who use drugs and a lack of understanding about problematic use and relapse.</p>
<p>More broadly, it’s also a story of stigma and discrimination and a reminder of what can happen when the media mine trauma and drug use for clickbait.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/JsZ58j_2PNA?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Wild Butterfly is billed as a true crime documentary, but gives insights into the stigma faced by drug users and their families.</span></figcaption>
</figure>
<h2>More to the story</h2>
<p>Claire was subjected to trial by media, portrayed as an ungrateful “junkie” who wantonly wasted her first transplant opportunity. <a href="https://www.perthnow.com.au/news/wa/liver-mum-claire-murray-reveals-i-dont-deserve-a-second-chance-ng-6753f9d062c04f37fb0f43ed4347004d">Reports from the time</a> said Claire “admitted taking drugs after the first transplant” and was prevented from returning to the transplant waiting list by rules “that forbid persistent substance abusers from being eligible for donor organs”. In fact, the film tells us she had a rare clotting disorder that led to the rejection of her first liver.</p>
<p>The film describes how she was sexually assaulted at 12 years old while on a camp, and then subjected to unrelenting bullying and stalking, which led her down a path of drug use.</p>
<p>Exposure to trauma in childhood is <a href="https://dx.doi.org/10.1097%2FHRP.0000000000000014">linked</a> to a range of psychological, social, developmental and medical problems right through to adulthood. </p>
<p>We now know <a href="https://developingchild.harvard.edu/science/key-concepts/toxic-stress/">neglect and abuse</a> in childhood permanently rewires the developing brain. <a href="https://dx.doi.org/10.1097%2FHRP.0000000000000014">Emotional dysregulation</a> is the primary feature among people who have experienced trauma, and many people turn to alcohol or other drugs to help regulate these negative, often unbearable, emotions.</p>
<p>A large percentage of people who have experienced physical, sexual or other abuse as children or adults <a href="https://www.google.com/search?client=safari&rls=en&q=trauma+and+drug+use+epidemiliolgy&ie=UTF-8&oe=UTF-8">use alcohol and other drugs</a> to try to dampen the constant feelings of fear, anxiety and depression; and a large proportion of people <a href="https://www.google.com/search?client=safari&rls=en&q=trauma+among+people+in+drug+treatment&ie=UTF-8&oe=UTF-8">in treatment</a> for alcohol or other drug problems have a history of abuse.</p>
<p>We can never know someone’s circumstances or their motivations. Wild Butterfly is a sad reminder of how much additional damage can be done by people making assumptions and judging those who use drugs.</p>
<h2>Blame culture</h2>
<p>This film balances the sensitive and nuanced issues without doing further harm. It explains the issues of drug use and trauma, without laying blame on people who use drugs or their families – and it does it with humanity. In my view, this sense of empathy and humanity is too often absent from mainstream reporting on people who experience problems with alcohol and other drugs.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/318795/original/file-20200305-127877-5ns3v7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/318795/original/file-20200305-127877-5ns3v7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/318795/original/file-20200305-127877-5ns3v7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=800&fit=crop&dpr=1 600w, https://images.theconversation.com/files/318795/original/file-20200305-127877-5ns3v7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=800&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/318795/original/file-20200305-127877-5ns3v7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=800&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/318795/original/file-20200305-127877-5ns3v7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1005&fit=crop&dpr=1 754w, https://images.theconversation.com/files/318795/original/file-20200305-127877-5ns3v7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1005&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/318795/original/file-20200305-127877-5ns3v7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1005&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The public didn’t know that abuse and bullying played a role in Claire’s drug use.</span>
<span class="attribution"><span class="source">Wild Butterfly/FanForce</span></span>
</figcaption>
</figure>
<p>Wild Butterfly tells the story of Claire largely from her parents’ point of view. It was her dying wish to set the record straight. You can feel their pain and it’s heartbreaking. What if it was your child? What would you do to ensure they had a chance at recovery? The parents’ story also demonstrates that families of people with alcohol and other drug problems need support.</p>
<p>It’s the people who judge others on their drug use who really need to watch this film and, sadly, they probably won’t. The film is a reminder that there’s more to people and their circumstances than meets the eye.</p>
<p>There are opportunities for reflection on the part of the media, the health profession and the general community. There are media guidelines on reporting on drug and mental health issues available from <a href="https://www.aodmediawatch.com.au/guidelines-for-journalists/">AOD Media Watch</a> and <a href="https://mindframe.org.au/alcohol-other-drugs/communicating-about-alcohol-other-drugs">Mindframe</a>.</p>
<p>We have come a long way in our understanding about other common mental-health disorders, like depression and anxiety, but we still have a long way to go when it comes to empathy and compassion for people who use alcohol and other drugs.</p>
<p><em>If you need information or support, contact the National Alcohol and Other Drug Hotline on 1800 250 015.</em></p>
<p><em><a href="https://fan-force.com/films/wild-butterfly/">Wild Butterly</a> is screening in cinemas nationally.</em></p><img src="https://counter.theconversation.com/content/132596/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicole Lee works as a consultant in the alcohol and other drug sector and a psychologist in private practice. She has previously been awarded funding by Australian and state governments, NHMRC and other bodies for evaluation and research into drug prevention and treatment. She is a member of board of directors of Hello Sunday Morning.</span></em></p>New Australian film Wild Butterfly is a story of stigma and discrimination directed towards people who use drugs. And a reminder of what can happen when trauma and drug use are played for click bait.Nicole Lee, Professor at the National Drug Research Institute (Melbourne), Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1221282019-10-23T04:59:37Z2019-10-23T04:59:37Z‘My friends are taking MDMA at raves and music festivals. Is it safe?’<figure><img src="https://images.theconversation.com/files/288664/original/file-20190820-123736-amjiz1.png?ixlib=rb-1.1.0&rect=77%2C59%2C3892%2C1916&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">No drug is 100% safe. </span> <span class="attribution"><span class="source">Wes Mountain</span></span></figcaption></figure><blockquote>
<p>My friends are taking ecstasy at raves and music festivals. Is it safe? — Anonymous</p>
</blockquote>
<h2>Key points</h2>
<ul>
<li>no drug use, including ecstasy, is 100% safe</li>
<li>festivals can present unique risks </li>
<li>look out for friends, know the risks and where to get help.</li>
</ul>
<p><a href="https://theconversation.com/au/topics/i-need-to-know-66587"><img src="https://images.theconversation.com/files/290837/original/file-20190904-175686-polw3q.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=90&fit=crop&dpr=2" width="100%"></a></p>
<h2>What is ecstasy or MDMA?</h2>
<p>Ecstasy is a slang term for drugs <em>meant</em> to contain 3,4- methylenedioxymethamphetamine (MDMA), a stimulant that can also cause mild hallucinations at high doses. While ecstasy was traditionally sold as tablets, it’s <a href="https://ndarc.med.unsw.edu.au/sites/default/files/National%20EDRS%20Interview%20Report%202018_1.pdf">increasingly sold in crystal, capsule and powder forms</a>. </p>
<p>According to the <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/2016-ndshs-detailed/data">most recent data</a>, only 1% of Australians aged 12-17 said they had tried ecstasy. However, studies suggest young Australians who attend music festivals are <a href="https://www.ncbi.nlm.nih.gov/pubmed/29304871">much more likely</a> to have tried it.</p>
<hr>
<p><iframe id="rsqsA" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/rsqsA/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<hr>
<h2>So, is it ‘safe’?</h2>
<p>There seems to be a common perception ecstasy is “safe”. But no drug use — legal or illegal — is completely safe. While drug experts <a href="https://www.ncbi.nlm.nih.gov/pubmed/31081439">rank</a> ecstasy as less harmful than other drugs, such as “ice” and alcohol, there are still significant risks involved:</p>
<ol>
<li><p>given ecstasy is illegal, the market is unregulated. As a result, drugs sold as “ecstasy” <a href="https://www.harmreductionaustralia.org.au/wp-content/uploads/2018/06/Pill-Testing-Pilot-ACT-June-2018-Final-Report.pdf">commonly do not contain MDMA</a> and may contain something far more dangerous. This means the effects can be unpredictable</p></li>
<li><p>even if your drugs contain MDMA, the dose or potency can <a href="https://www.acic.gov.au/sites/default/files/illicit_drug_data_report_2017-18.pdf?v=1564727746">vary hugely</a>. Recently, <a href="https://www.smh.com.au/national/nsw/tragic-reveller-told-friend-he-would-push-through-inquest-hears-20190716-p527lm.html">very high purity ecstasy</a> has been detected in Australia. This can significantly increase the risk of overdosing or having serious side-effects </p></li>
<li><p>even pure MDMA at normal recreational doses can be risky in the <a href="https://www.ncbi.nlm.nih.gov/pubmed/24899699">wrong conditions</a> (for instance, when it’s very warm)</p></li>
<li><p>common short-term effects also include <a href="https://www.ncbi.nlm.nih.gov/pubmed/16771886">increased heart rate and body temperature, teeth grinding and anxiety</a>. While evidence on the long-term effects of taking MDMA is still emerging, there may be lasting impacts on <a href="https://www.ncbi.nlm.nih.gov/pubmed/23881877">memory, mood, cognition and sleep</a>.</p></li>
</ol>
<h2>What are the risks when taking it at festivals?</h2>
<p>In recent years, there have been more reports of <a href="https://www.smh.com.au/national/nsw/music-festival-deaths-inquest-set-down-for-july-20190228-p510sz.html">drug-related deaths at festivals</a>. While the media typically describes deaths involving ecstasy as “overdoses”, most ecstasy-related deaths are <a href="https://www.tandfonline.com/doi/abs/10.1080/14659891.2018.1436607?journalCode=ijsu20">not</a> the result of simply taking too much. </p>
<p>Drug experiences can be influenced by <a href="https://www1.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-front12-fa-toc%7Edrugtreat-pubs-front12-fa-secb%7Edrugtreat-pubs-front12-fa-secb-2%7Edrugtreat-pubs-front12-fa-secb-2-5">lots of different things</a> and music festivals can sometimes result in a “perfect storm” of risk factors. For example, an experienced male taking an ecstasy pill at a quiet gathering at home is likely to have a very different experience to an inexperienced female taking her ecstasy pills at a crowded festival on a 35°C day. </p>
<p>Females, those with lower body weight, and/or those who haven’t used ecstasy before, and therefore haven’t built up any physical tolerance, should use a smaller dose.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=559&fit=crop&dpr=1 600w, https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=559&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=559&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=702&fit=crop&dpr=1 754w, https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=702&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=702&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Drug experiences can be affected by lots of different things.</span>
</figcaption>
</figure>
<p>Some key risks at music festivals include:</p>
<ul>
<li><p><strong>hyperthermia aka heatstroke:</strong> MDMA <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008716/">affects the body’s ability to regulate temperature</a> (it can increase body temperature and also make it harder to cool down). Environmental factors at festivals such as warm weather, crowds and dancing can significantly increase the risk of overheating (see <a href="https://dancesafe.org/heatstroke/">tips</a> for staying cool)</p></li>
<li><p><strong>hyponatremia aka water intoxication:</strong> MDMA can <a href="https://www.ncbi.nlm.nih.gov/pubmed/23476039">disrupt the body’s water/electrolyte balance</a> (can make your body <a href="https://cjasn.asnjournals.org/content/3/6/1852">retain water</a>). While you need water to avoid dehydrating, drinking too much can also be dangerous. Read up on these <a href="https://drugaware.com.au/getting-the-facts/staying-safe/#Dehydration-and-overhydration">guidelines</a> on dehydration and overhydration for more information</p></li>
<li><p><strong>dodgy on-site sellers:</strong> <a href="https://www.ncbi.nlm.nih.gov/pubmed/30541674">UK research</a> found people buying drugs on-site (inside the festival grounds) were more than twice as likely to buy drugs that did not contain what they thought. There have been cases where festival goers thought they were buying MDMA but actually bought N-ethylpentylone (a riskier stimulant linked to psychosis and <a href="https://www.dea.gov/press-releases/2018/08/31/dea-acts-against-dangerous-deadly-designer-synthetic-drug-linked-151">deaths</a>)</p></li>
<li><p><strong>policing or legal problems:</strong> festivals often have a heavy police presence with sniffer dogs and being caught with drugs can lead to possession or supply charges. However, it’s very important not to panic and swallow your drugs if you see sniffer dogs. This has been linked to at least three <a href="https://www.pedestrian.tv/news/defqon-1-drugs-death-reignites-sniffer-dogs-debate/">festival deaths</a> in Australia.</p></li>
</ul>
<h2>Worried about your friends?</h2>
<p>If you’re going to a rave or festival and suspect some of your friends might take illicit drugs, it’s important to be aware of the risks, look out for your friends and know where to get help. Here are some tips:</p>
<ol>
<li><p><strong>make emergency plans with friends:</strong> download the festival map, have a meeting point, make sure mobiles are charged, stick together and know where on-site support services are </p></li>
<li><p><strong>look out for <a href="https://drugaware.com.au/getting-the-facts/staying-safe/#Signs-someone-needs-immediate-help">red flag symptoms</a></strong> (for instance, feeling hot, unwell, confused or agitated) and never be scared to seek help from on-site medical or support services. They’re there to help you, not judge or arrest you</p></li>
<li><p><strong>be informed:</strong> <a href="https://drugaware.com.au/getting-the-facts/staying-safe/">Drugaware</a>, <a href="https://www.dancewizensw.org.au/patron/#block-yui_3_17_2_1_1524198824688_25530">Dancewize</a> and <a href="http://www.boomtick.com.au/listen-out-perth-save-a-mate-training/">Boomtick</a> all have great information about drugs and how to keep safe.</p></li>
</ol><img src="https://counter.theconversation.com/content/122128/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jodie's doctoral research was funded by a scholarship from the Australian Government Department of Health. The National
Drug Research Institute at Curtin University is supported by funding from the Australian Government under the Drug and Alcohol Program.</span></em></p>A person’s drug experience can be influenced by many different things, such as heat, access to water and dosage.Jodie Grigg, Research Associate at the National Drug Research Institute, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1115252019-02-11T19:16:07Z2019-02-11T19:16:07ZI Need to Know: ‘My friend is using ice and smoking pot. What do I do?’<figure><img src="https://images.theconversation.com/files/258149/original/file-20190211-174861-sgjkf9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">It can be tricky to know what to do when someone you care about starts taking drugs.</span> <span class="attribution"><span class="source">www.shutterstock.com</span></span></figcaption></figure><p><em><a href="https://theconversation.com/just-so-you-know-the-conversation-launches-a-qanda-service-for-teens-103432">I Need to Know</a> is an ongoing series for teens in search of reliable, confidential advice about life’s tricky questions.</em></p>
<hr>
<blockquote>
<p>My friend is using ice and smoking dope. He says it makes him feel good like his medication doesn’t. His parents know but don’t know what to do. I am worried, as he has stopped being chatty and is not going out or doing anything. He is changing, but worse.</p>
<p>– Anonymous</p>
</blockquote>
<p>Working out what to do when you are worried about a friend who is using drugs can be tricky. Just asking the question shows what a supportive friend you are and that’s a very good start.</p>
<p>There’s not one right way to approach it. There are many ways to help and support your friend.</p>
<p>Remember, they might not see their drug use as a problem (from what you have said it sounds like they view it as a solution rather than a problem). </p>
<p>You can’t force your friend to do anything they don’t want to do. In the end, it needs to be their decision to change, but there’s lots you can do to support and encourage them.</p>
<h2>How do you know if it’s a problem?</h2>
<p>One thing to remember is that most <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/ndshs-2016-detailed/contents/table-of-contents">people who use drugs</a> only use occasionally for a short time in their lives and won’t develop a serious issue.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/many-people-use-drugs-but-heres-why-most-dont-become-addicts-35504">Many people use drugs – but here’s why most don’t become addicts</a>
</strong>
</em>
</p>
<hr>
<p>People take drugs for lots of <a href="https://theconversation.com/in-debates-about-drug-use-fun-is-important-110696">different reasons</a>, including because it is fun or it makes them feel good, to “escape” from problems, and to make physical (like pain) or emotional (like anxiety) problems go away (sometimes referred to as “self-medicating”).</p>
<p>If your friend is using drugs regularly it’s more likely they’ll be having negative effects. <a href="https://au.reachout.com/articles/how-to-tell-if-you-have-a-drug-problem">Signs</a> that drug use is becoming a problem include: </p>
<ul>
<li>using weekly or more</li>
<li>giving up activities they used to enjoy to use or recover from drugs</li>
<li>missing school or work or becoming unreliable</li>
<li>needing to use more and more to get the same effect.</li>
</ul>
<h2>Raising the issue</h2>
<p>One of the best pieces of advice anyone has given me came from a person who was supporting a family member who was using drugs. She said, “think about what you would do if drugs weren’t involved”. How would you approach your friend if they were doing anything else that worried you?</p>
<p>Also think about what you would like your friends to do or say if you were doing something they were worried about.</p>
<p>Find a time to talk when you’re both clear headed, you’re somewhere private and you have plenty of time. You don’t need to make it formal, just make sure the setting is good for a sensitive chat when you raise the issue.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/258134/original/file-20190211-174861-1dsex1e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/258134/original/file-20190211-174861-1dsex1e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/258134/original/file-20190211-174861-1dsex1e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/258134/original/file-20190211-174861-1dsex1e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/258134/original/file-20190211-174861-1dsex1e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=425&fit=crop&dpr=1 754w, https://images.theconversation.com/files/258134/original/file-20190211-174861-1dsex1e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=425&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/258134/original/file-20190211-174861-1dsex1e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=425&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Just raising the issue and listening is helpful.</span>
<span class="attribution"><span class="source">from www.shutterstock.com</span></span>
</figcaption>
</figure>
<p>Think about what you want to say beforehand so you are prepared.</p>
<p>It doesn’t usually <a href="https://www.ncbi.nlm.nih.gov/books/NBK64353/table/A56963/">help</a> to plead, persuade, preach, bribe, guilt-trip or threaten (for example, “if you keep using, I will…”). Try not to speak in a judgemental or critical tone of voice, it usually just creates resistance.</p>
<p>Give them time to talk and don’t cut them off. A rule of thumb I use is they should be talking half the time or more. Ask questions that show your concern rather than telling them what to do. You might say something like: </p>
<blockquote>
<p>You don’t seem to want to go out much anymore. We really miss hanging out with you. Is everything ok?</p>
</blockquote>
<p>Or more direct: </p>
<blockquote>
<p>I know drugs make you feel better when your medication doesn’t but I’m really worried about you and want to make sure you are OK.</p>
</blockquote>
<p>If your friend doesn’t want to talk about it, it doesn’t help to take it personally or to argue the point with them. It can be a hard thing for people to talk about and they may need some time. </p>
<p>Let them know that you’re there to listen and support if they need it. If they know you’re open, they’re more likely to talk later. Just raising the issue and listening without judgement is helpful.</p>
<h2>Other things you can do</h2>
<p>How and how much you help is up to you. You might try to help your friend in practical ways, you might decide to just provide support and listen, or you might decide to step back and have less contact with them.</p>
<p>It’s OK if helping them becomes too much for you. You also need to look after yourself. It can be very hard seeing someone you love with problems. At times you might feel frustrated and helpless, like it’s impossible to get through to them. You might need to be patient because it can be <a href="https://theconversation.com/health-check-what-makes-it-so-hard-to-quit-drugs-69896">hard to give up</a> drugs once they have become a habit.</p>
<p>If you choose to provide a lot of help and support, you might want to talk to someone, such as a psychologist or counsellor, yourself.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/258135/original/file-20190211-174864-1rjxz9k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/258135/original/file-20190211-174864-1rjxz9k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/258135/original/file-20190211-174864-1rjxz9k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/258135/original/file-20190211-174864-1rjxz9k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/258135/original/file-20190211-174864-1rjxz9k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/258135/original/file-20190211-174864-1rjxz9k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/258135/original/file-20190211-174864-1rjxz9k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Encourage your friend to participate in drug and alcohol-free activities.</span>
<span class="attribution"><span class="source">from www.shutterstock.com</span></span>
</figcaption>
</figure>
<p>Encourage them to engage in activities with you and your other friends that don’t involve alcohol or other drugs. <a href="https://adf.org.au/about/prevention/">Staying connected</a> with friends who don’t use drugs can help prevent the problem from getting worse.</p>
<p>Try to keep them as safe as possible. Don’t leave them alone in a potentially dangerous situation (like walking home late at night or at a party) because you’re frustrated or angry at them for using drugs. Call an adult you trust to help if you need to, or an ambulance if they look unwell.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/ice-age-who-has-used-crystal-meth-and-why-23031">Ice age: who has used crystal meth – and why?</a>
</strong>
</em>
</p>
<hr>
<p>If things are getting worse it’s OK to suggest professional help. If they’re open to getting help, ask them what they want to do. You could say something like, “what do you think would be most helpful to you?”, or “would it help to speak to a trusted adult/school counsellor/doctor?” You could offer to go with them for support.</p>
<p>You could also see if the parents need some professional advice, and give them some of the numbers below. It might be helpful for your friend or their parents to talk to the doctor who prescribed their medication – the dose and effects might need to be reviewed.</p>
<h2>Where to get help</h2>
<p>There are many options for both you or your friend to talk to someone about your worries. Here are some of the main ones:</p>
<p><a href="https://www.counsellingonline.org.au">CounsellingOnline</a> is a free online chat for concerns about alcohol and other drug. Anyone can use it – people using drugs and people wanting to help friends or family using drugs.</p>
<p><a href="https://headspace.org.au/eheadspace/">headspace and eheadspace</a> provide face to face and online/telephone support for mental health issues for people aged 12-25.</p>
<p><a href="https://kidshelpline.com.au/?gclid=EAIaIQobChMI8ILJr7Sy4AIVjSQrCh0dEgIsEAAYASAAEgLFUvD_BwE">Kids helpline</a> is a free telephone counselling service on any issue for children and young adults aged between 5 and 25. They can be reached at 1800 55 1800.</p>
<p>YSAS (<a href="http://www.ysas.org.au/">Youth Support and Advocacy Service</a>) is a youth alcohol and other drugs support organisation in Victoria. They have face to face and telephone services and a good info on their website. Their number is 1800 458 685.</p>
<p><a href="https://campaigns.health.gov.au/drughelp/resources/images/infographic-national-alcohol-and-other-drug-hotline">National Alcohol and Other Drug Hotline</a> is a free telephone information and counselling service similar to CounselingOnline, but on the phone. They can be reached at 1800 250 015.</p>
<p>Family helplines are telephone counselling services for friends and families of people who use drugs. Alcohol, prescription and other drug family support (<a href="https://apod.org.au/">APOD</a>) can be reached at (03) 9723 8000, <a href="http://www.fds.org.au/">Family Drug Support Australia</a> at 1300 368 186, and Family Drug Help at 1300 660 068.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-does-ice-use-affect-families-and-what-can-they-do-41186">How does ice use affect families and what can they do?</a>
</strong>
</em>
</p>
<hr>
<p><em>This article has been updated since publication to correct an incorrect hotline number for the National Alcohol and Other Drug Hotline.</em></p><img src="https://counter.theconversation.com/content/111525/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicole Lee works as a paid consultant in the alcohol and other drug sector, and as a psychologist in private practice. She has previously been awarded grants by state and federal governments, NHMRC and other public funding bodies for alcohol and other drug research.</span></em></p>It can be really tricky to know what to do when someone you care about starts using drugs. Raising the issue and listening without judgement is a good place to start.Nicole Lee, Professor at the National Drug Research Institute (Melbourne), Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/816022017-07-28T03:06:57Z2017-07-28T03:06:57ZThe D.A.R.E. Sessions wants is better than D.A.R.E.<figure><img src="https://images.theconversation.com/files/180105/original/file-20170727-11584-2hqdvk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Has D.A.R.E. moved beyond the "just say no" days of the '80's and '90's?</span> <span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Watchf-Associated-Press-Domestic-News-Californi-/981a4164f44143b1aaf907a3ed7fba02/4/0">AP Photo/Nick Ut</a></span></figcaption></figure><p>Americans of a certain generation will remember this mantra from the 1980s: Just say no.</p>
<p>This simple phrase was the cornerstone of Nancy Reagan’s drug abuse awareness initiative, rolled out in response to perceptions of sharp increases in youth drug use from the <a href="http://monitoringthefuture.org/data/16data/16drfig1.pdf">late 1970s and into the early 1980s</a>. It was also the cornerstone of D.A.R.E., the controversial youth substance abuse prevention program.</p>
<p>Recently, Attorney General Jeff Sessions announced that he would like to <a href="http://www.nydailynews.com/news/national/ag-jeff-sessions-bring-back-anti-drug-program-e-article-1.3318619">reinvigorate D.A.R.E.</a>, a move that was met with considerable skepticism in the media.</p>
<p>As a professor of psychology and director of the <a href="http://youthviolence.rutgers.edu/">Center on Youth Violence and Juvenile Justice</a> at Rutgers University-Newark, I welcome any and all efforts to support positive youth development and prevent youth substance abuse – but only if those efforts are in line with evidence from scientific research. Does that include D.A.R.E.?</p>
<h2>‘Just say no’</h2>
<p>The origins of “Just say no” are by now apocryphal, with potential attributions to a California elementary school student during a <a href="https://reaganlibrary.archives.gov/archives/speeches/1989/010489a.htm">school drop-in from the first lady</a> or a New York City <a href="https://www.nytimes.com/2016/06/23/business/media/robert-cox-man-behind-the-just-say-no-antidrug-campaign-dies-at-78.html">advertising executive</a>.</p>
<p>The command, however, is carved deeply into the foundation of over 30 years of U.S. drug prevention policy.</p>
<p>The idea of just saying “no” to drugs emanates from a simplified view on “<a href="http://criminal-justice.iresearchnet.com/criminology/theories/rational-choice-theory/">rational choice theory</a>,” which contends that people choose their behaviors in order to maximize rewards and minimize costs.</p>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/180095/original/file-20170727-9209-86ljn2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/180095/original/file-20170727-9209-86ljn2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=757&fit=crop&dpr=1 600w, https://images.theconversation.com/files/180095/original/file-20170727-9209-86ljn2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=757&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/180095/original/file-20170727-9209-86ljn2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=757&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/180095/original/file-20170727-9209-86ljn2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=951&fit=crop&dpr=1 754w, https://images.theconversation.com/files/180095/original/file-20170727-9209-86ljn2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=951&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/180095/original/file-20170727-9209-86ljn2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=951&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">D.A.R.E. originally operated on the premise of teaching kids to simply ‘say no’ to drugs. It proved ineffective.</span>
<span class="attribution"><a class="source" href="http://clipart-library.com/clipart/pTqdzM7Bc.htm">Clipart-Library.com</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>It was also the central concept of the D.A.R.E. (Drug Abuse Resistance Education) program, when it was initiated in 1983. The goal was to help youth see that the costs of drug use far outweighed any rewards, and could be avoided by refusing to use drugs. This original model of D.A.R.E. seemed to rely on just a few key points: 1) drugs are bad; 2) if kids knew how bad drugs were, they would never choose to use them; and 3) this would be especially true if police officers were the ones telling kids about drugs.</p>
<p>Very simply, D.A.R.E. was a program that rested on the premise of training kids how to say “no.”</p>
<p>Of course, anyone who has ever been a parent knows that kids already know full well how to say “no.” But D.A.R.E. developers and interventionists knew they were laboring against <a href="https://www.aacap.org/aacap/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Peer_Pressure_104.aspx">peer pressure</a> and a popular culture that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805125/">glorified recreational drug use</a>.</p>
<h2>Where D.A.R.E. failed</h2>
<p>By now, it’s fairly well-known that the first version of D.A.R.E. was a <a href="http://content.time.com/time/nation/article/0,8599,99564,00.html">failure</a>: Studies of the program found that not only did D.A.R.E. <a href="https://doi.org/10.1006/pmed.1996.0061">fail to prevent</a> students from using drugs, in some cases it actually <a href="https://doi.org/10.1177/0022427898035004002">increased the likelihood</a> that students would use drugs.</p>
<p>Part of the difficulty with any substance use prevention program is that experimentation and risk-taking are <a href="https://doi.org/10.1111/j.1467-8721.2007.00475.x">part of youth development</a>, and providing students with more elaborate information about the effects of different substances could pique their interest even more, <a href="https://www.scientificamerican.com/article/why-just-say-no-doesnt-work/">particularly if the information is not presented appropriately</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/180096/original/file-20170727-27682-l8plys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/180096/original/file-20170727-27682-l8plys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/180096/original/file-20170727-27682-l8plys.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/180096/original/file-20170727-27682-l8plys.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/180096/original/file-20170727-27682-l8plys.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/180096/original/file-20170727-27682-l8plys.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/180096/original/file-20170727-27682-l8plys.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Substance abuse prevention programs like D.A.R.E. must contend with a popular culture that often glamorizes drugs, alcohol and tobacco.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/markjsebastian/2752162749">Mark Sebastian</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<h2>Bringing back D.A.R.E.</h2>
<p>Regardless of how the first D.A.R.E. program fell short, its failure was acknowledged. According to D.A.R.E. publicity materials, the program is still in place in approximately <a href="http://www.dare.org/about-d-a-r-e/">75 percent of American school districts</a>, but D.A.R.E. has fallen from grace and is no longer as central to U.S. anti-drug policy as it once was.</p>
<p>D.A.R.E. developers revised the program in the late 1990s and early 2000s, attempting to bring the program in line with scientific research and theories on youth drug use prevention. Yet these changes appeared unconvincing and failed to bring D.A.R.E. back to its former prominence.</p>
<p>When Jeff Sessions announced that he would like to revitalize D.A.R.E., reporters and pundits alike seemed troubled: Does Sessions want to return to implementing a verifiably ineffective program? In his announcement, Sessions seemed to paint a picture of the early glory days of D.A.R.E., and those in the media who have been <a href="http://www.huffingtonpost.com/entry/jeff-sessions-dare_us_596648c2e4b005b0fdca6695">covering</a> and <a href="https://www.washingtonpost.com/news/wonk/wp/2017/07/12/a-brief-history-of-d-a-r-e-the-anti-drug-program-jeff-sessions-wants-to-revive">writing</a> about the announcement are justifiably concerned.</p>
<p>But given the history of D.A.R.E., it’s hard to imagine that we’ll be seeing “Just say no” redux anytime soon.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/180098/original/file-20170727-8525-559zl7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/180098/original/file-20170727-8525-559zl7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/180098/original/file-20170727-8525-559zl7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/180098/original/file-20170727-8525-559zl7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/180098/original/file-20170727-8525-559zl7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/180098/original/file-20170727-8525-559zl7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/180098/original/file-20170727-8525-559zl7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Jeff Sessions wants to bring D.A.R.E. back to classrooms, but the program will likely be very different from its previous incarnation.</span>
<span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Pence/33f8e4fe7dbe47c09e73838a4227c9a9/9/1">AP Photo/Jacquelyn Martin</a></span>
</figcaption>
</figure>
<h2>New D.A.R.E. isn’t D.A.R.E.</h2>
<p>You might be surprised to learn this, but the contemporary version of D.A.R.E. isn’t really D.A.R.E. at all – it’s a D.A.R.E.-branded adaptation of a highly successful, evidence-based substance use prevention program that rests on a body of scientific research documenting its effectiveness.</p>
<p>The program is called <a href="http://kir.psu.edu/index.shtml">“Keepin’ It REAL”</a> and was developed originally by prevention scientists at Penn State University. On its face, KIR looks like another “just say no” program: It relies on the acronym REAL, applied as “refuse,” “explain,” “avoid” and “leave.”</p>
<p>But while the theme of KIR rests on refusal and avoidance (i.e., just saying no), the curriculum addresses many of the issues that contribute to drug use in the first place, by <a href="http://kir.psu.edu/curriculum/">teaching and working with youth</a> on communication skills, self-regulation, cognitive problem-solving and emotion knowledge.</p>
<p>This approach to substance use prevention is in line with other, similar programs such as <a href="https://lifeskillstraining.com/">Life Skills Training</a> (developed by Cornell University researchers) and <a href="http://tnd.usc.edu/">Toward No Drug Abuse</a> (from scientists at the University of Southern California). These sorts of substance use prevention programs have been proven to reduce the likelihood of <a href="http://www.blueprintsprograms.com/factsheet/project-towards-no-drug-abuse">substance use</a>, but also the likelihood of <a href="http://www.blueprintsprograms.com/factsheet/lifeskills-training-lst">problem behavior and violence</a> – with the added benefit of improving positive behavior and interpersonal skills.</p>
<p>The new D.A.R.E.-branded KIR program hasn’t yet been subjected to formal evaluation: The biggest question is that we don’t yet know whether KIR can be delivered effectively by police officers. But KIR has <a href="http://kir.psu.edu/research/publications.shtml">passed muster</a> through a variety of prior adaptations, and the track record of the Penn State research team for implementing effective programs is promising.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/180115/original/file-20170727-8486-1szfj5e.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/180115/original/file-20170727-8486-1szfj5e.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/180115/original/file-20170727-8486-1szfj5e.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/180115/original/file-20170727-8486-1szfj5e.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/180115/original/file-20170727-8486-1szfj5e.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=505&fit=crop&dpr=1 754w, https://images.theconversation.com/files/180115/original/file-20170727-8486-1szfj5e.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=505&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/180115/original/file-20170727-8486-1szfj5e.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=505&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The D.A.R.E. you remember from the ‘80s or '90s is very different from what’s taught in classrooms today.</span>
<span class="attribution"><span class="source">Photo Courtesy of Michael Hecht</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<h2>The future of D.A.R.E.</h2>
<p>When Sessions called for renewed, large-scale implementation of D.A.R.E., many in the media <a href="http://www.dare.org/flawed-faulty-and-wrong-media-reports-on-2017-d-a-r-e-curricula/">seem to have missed</a> that he’s talking about the current configuration of the program – a new methodology that’s a <a href="http://www.dare.org/wp-content/uploads/2017/07/Curriculum-Support-Sheet.pdf">more likely recipe for success</a> than the infamously ineffective original D.A.R.E. What’s more, the D.A.R.E. folks have made it clear over the years that they will not be going back to the approach that was proven at best ineffective and at worst harmful.</p>
<p>In fact, the biggest obstacle to D.A.R.E.’s efficacy may be the D.A.R.E. brand itself, which has clearly been tarnished after decades of research criticizing the program.</p>
<p>If they can overcome that obstacle, the D.A.R.E. delivery system is optimal for large-scale substance abuse prevention. Schools are great venues for the delivery of health promotion programming, and police officers can convey the seriousness of the topic. </p>
<p>Fortunately, there have been <a href="http://monitoringthefuture.org/pubs/monographs/mtf-vol1_2016.pdf">notable declines</a> in underage tobacco and alcohol use in the last several years. However, with <a href="https://theconversation.com/the-opioid-epidemic-in-6-essential-reads-79243">opioid abuse on the rise</a> and students still engaging in relatively high rates of <a href="http://monitoringthefuture.org/pressreleases/16ESPADpr.pdf">other illicit drug use</a>, there is good cause for a new commitment to D.A.R.E.</p><img src="https://counter.theconversation.com/content/81602/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Paul Boxer does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Jeff Sessions was met with considerable skepticism when he announced his desire to revive D.A.R.E. But it turns out that the current program is nothing like the ineffective D.A.R.E. of the ‘80’s and '90’s.Paul Boxer, Professor of Psychology, Rutgers University - NewarkLicensed as Creative Commons – attribution, no derivatives.