Challenging Dogma - Spring 2008

...Using social sciences to improve the practice of public health

Wednesday, April 23, 2008

The Truth About D.A.R.E.: Unsuccessful Application of Public Health Models Led To An Increase In Drug Use Among Adolescents – Nisha Bhinde

The Drug Abuse Resistance Education (DARE) program is an effort to provide children with the information and skills they need to live drug-free and violence-free lives. The program exists in nearly 80% of the school districts in the United States, in 54 countries around the world, and reaches approximately 36,000,000 students each year (1). Since the program’s inception in 1983, studies conducted by the U.S. General Accounting Office (GAO), the U.S. Department of Education, and many others concluded that DARE is ineffective in reducing the use of alcohol and drugs and is sometimes even counterproductive (2). Early DARE evaluations, from 1987-1989, were generally favorable, showing decreased alcohol, tobacco, and other drug use. The majority of the recent evaluations of DARE, however, show increased use of these substances (3, 4). These studies suggest that the DARE program has no significant long-term effect on preventing illicit drug use among adolescents.
According to GAO’s 2003 report, numerous studies found no significant differences in illicit drug use among students who received the DARE curriculum and those who did not. A few of the studies found that the DARE students showed stronger negative attitudes about using illicit drugs approximately one year after receiving the program. Unfortunately, these attitudes diminished over time and many students increased drug use after several years (5). In response to these results, the U.S. Department of Education now prohibits schools from spending federal money on DARE (6).
Nevertheless, DARE is still one of the largest education-based drug control programs taught in school districts nationwide. The program spends over $1 billion dollars annually to provide students with trained police officers, educational resources, and materials and supplies needed for the curriculum (7). Unfortunately, the benefits of the DARE program do not outweigh these costs. The DARE curriculum attempts to use the scare tactic to deter students away from drugs, yet the program’s supply of DARE paraphernalia actually increases students’ curiosity and experimentation. Additionally, presenting trained officers to teach the curriculum creates a disconnect between the instructor and the student because adults cannot easily relate to the adolescent world (8). DARE also focuses on completely refraining from drug use, which decreases many students’ level of self-efficacy and increases their likelihood of creating self-fulfilling prophecies. DARE’s approach to provide effective drug abuse resistance education has failed to impact its young audience through unsuccessful application of public health models.
DARE glamorizes and demonizes drugs at the same time
DARE attempted to convey the seriousness of drug use and violence by utilizing uniformed police officers and promotional paraphernalia, such as buttons, bumper stickers, t-shirts, and the program’s mascot, Daren the bear. Inadvertently, the students directed most of their focus on the police officers’ guns, seized drug vehicles, and all of the free DARE materials. The students were attracted to the glamour rather than the content of the presentations, illustrating the “forbidden fruit” syndrome (9,10). This effect refers to indulgence or pleasure in something that is tempting but dangerous (10).
Even though the DARE curriculum teaches students about how dangerous drugs are, curiosity tempts many students to try them anyway. This is not surprising because adolescence is a time when many choose to experiment. It is a time when teens start to listen to new music, try new sports and activities, read new books and magazines, and even try drugs and alcohol (11, 12). In fact, curiosity is accepted as the most common motive for initially trying drugs. Research indicates that many adolescents want to know how it feels to lack inhibitions; they believe it will help them to better understand who they are (13). Accordingly, the DARE officers were unsuccessful in preventing the students’ increased awareness and curiosity from being translated into illegal use. The evidence suggests that by exposing young impressionable children to drugs, the program was encouraging and nurturing drug use (14).
Aside from curiosity, the increased drug use among students may be a result of adolescents’ risk-taking characteristics. Studies show that the onset of puberty is related to an increase in risk-taking, sensation-seeking, and reckless behavior (15). Many youths feel the need to expose themselves to unsafe environments and new and exciting experiences (13). Often times, students discover these experiences through drug-resistant education programs such as DARE. The name DARE itself also encourages risk-taking behavior. The word “dare” often means a challenge to do a hard, dangerous, or rash thing, especially as a test of courage. Therefore, adolescents often dare to go against what they learn in classroom, which is “just say no” to drugs. The main lesson students learn is the concept of rejection, which they reinforce by challenging the entire DARE program (9).
The method used to teach the students about drugs involves the scare tactic. The strategy here is to induce fear into the students by telling horror stories of junkies, crackheads, and other drug users who spend a majority of their lives supporting habits that they cannot control (16). Additionally, DARE lumps all drugs together into one category: Marijuana, cocaine, heroin, LSD, PCP, ecstasy, and even cigarettes and alcohol are all equally dangerous (17). Such categorization demonizes all drugs and exaggerates the dangers of the less harmful substances. DARE believes this tactic will scare young people into refraining from drugs. Research suggests that scare tactics are not only ineffective, but they can be counterproductive. As young students mature, they realize the fallacy of the myths that were once presented to them as fact, which causes the officers to lose credibility (18).
Many other public health campaigns have also used this fear-arousal approach to attempt behavior change. Fear messages increase the severity of the perceived threat, which motivates the recipient to change his or her behavior to reduce that threat (19). However, if an individual doubts that the recommended behavior change will be effective, then he or she will focus on eliminating the fear through denial or reactance (19). Communication theory suggests that using tactics that induce fear have the opposite intended effect because they cause a complete denial of the message (20). Thus, students should not hear that all drugs taken in any amount will lead to the path of destruction. Once youths actually begin experimenting, their experiences differ from what they learned. As a result, the entire prevention message is lost and increased drug use results.
DARE officers cannot relate to students’ situations
Communication theory also states that in order to develop a persuasive message, the audience must see the messenger as a credible source of information. This means that the messenger must display honesty and similarity to the receiver (20). With time, the instructors begin to lose credibility when the students compare their experiences outside of the classroom to what they learned in school. Students observe their peers and older siblings to find that what they see is often less serious than the experiences of the police officers. Such discrepancies lead to a loss of trust in the authoritative figures because it appears as though the instructors are lying to the students.
In addition to falsified information, many of the police officers who advocate for restraint have themselves previously used or currently use tobacco, alcohol, and/or drugs. For example, an Iowa DARE officer who was caught stealing drugs, trafficking methamphetamine, and making pornography was returned to teach in the classroom (9). There have also been several other cases reporting DARE officers who take smoke breaks in plain view of the students (21). This leads students to perceive the instructors as hypocrites, and in turn rebel against what they are teaching. As with fear messages, studies suggest that if students have negative perceptions of influencing agents, in this case the police officers, they will do the opposite of what the influencing agent desires (22). This is a case of an unsuccessful application of the social learning theory.
Social learning theory states that people learn from one another through observation, imitation, and modeling, which then leads to behavior. Two of the necessary conditions for effective modeling include attention, or selectively concentrating on a specific stimulus, and motivation, or having a good reason to imitate (23). With the DARE program, the students attention shifts away from the intended stimulus, the drug information, toward another stimulus, the drug paraphernalia. In the case of the students and the hypocritical police officers, there also does not appear to be a good reason to imitate. In fact, the students seem to have good reasons to not imitate the officers because they lied. Therefore, DARE does not create an environment conducive to effective modeling.
While there is distrust of information received about drugs and alcohol, there is also a lack of information for those students who have previously tried drugs or alcohol. The DARE officers focus on completely refraining from use and tend to ignore the important distinction between use and abuse. They make the mistake of treating any use as abuse. Students are not offered information on how to distinguish the differences between various alcoholic beverages, on the importance of having something to eat when consuming alcohol, or on how to pace one’s self when drinking (18). Thus, the current approach of DARE stigmatizes drugs and scares youths into refraining from these substances, rather than providing them with information on how to reduce the risks of drug and alcohol use.
DARE decreases self-efficacy and increases self-fulfilling prophecies
By focusing on complete risk-elimination, meaning to prevent all of one’s risk of a bad health outcome from occurring, rather than risk-reduction, meaning to merely reduce a person’s risk, DARE’s message sets unrealistic goals for the students (24). According to the social cognitive theory, a person’s decision to engage in a particular behavior is influenced by the person’s perception that he or she can successfully complete the behavior and achieve the desired outcome. This perception is reflective of the individual’s level of self-efficacy (23). Thus, when students who have previously said yes to drugs or alcohol hear the message “just say no,” they lose confidence that they can overcome the obstacles that led them to say yes in the first place. DARE portrays a negative attitude toward those who have tried illegal substances, which discourages students and sets them up to fail. Essentially, DARE decreases the youths’ level of self-efficacy by insinuating that they can never be redeemed for their actions (23).
Social cognitive theory also suggests that changing a behavior is a function of individual characteristics, including their level of self-control (23). As previously mentioned, puberty is a peak stage for seeking out risk-taking behaviors, thus a student’s level of self-control is lower at this age. Additionally, recent brain science suggests that teens’ brains may in fact be partly to blame. Imaging studies have shown that brain development of the frontal lobe, which is the center for planning, understanding cause and effect, foreseeing consequences, and controlling impulses, is still occurring during adolescent years (25).
In addition to decreasing self-efficacy, DARE also increases students’ creation of self-fulfilling prophecies. A self-fulfilling prophecy is a prediction that directly or indirectly causes itself to become true (26). This concept is a feature of the labeling theory, which states that an individual’s behavior is influenced by how he or she is characterized by other people in his or her society and the ‘label’ he or she is given (27). In many societies, adolescents who have tried drugs or alcohol before are often labeled as “bad” or “tainted.” Thus, these youths have no other choice but to conform to the essential meaning of such judgments, fulfilling their own prophecies.
Labeling theory also incorporates the concept of stereotypes. People tend to generalize that if a person does one drug, they probably do other drugs, and they are labeled as “druggies.” This is parallel to the concept of the gateway theory, which holds that using one substance, such as alcohol or tobacco, leads to the use of other substances. However, years of government research have failed to produce any evidence that using one substance causes the use of another (17).
Conclusion
While the DARE program proved to be effective in reducing alcohol, tobacco, and other drug use in the short-run, its impact diminished as the recipients of the program grew older, unintentionally leading to increased drug use. DARE’s attempt to increase drug awareness in order to prevent youths from trying drugs resulted in increased curiosity and experimentation of different substances. Additionally, DARE’s implementation of the scare tactic and its attempt to utilize communication theory had a boomerang effect. DARE fails to address the idea that the audience must see the messenger as a credible source. The instructors teach lessons that differ from their own lifestyles as well as from what the students actually experience, thus the officers’ trust is lost. Finally, DARE decreases self-efficacy and increases self-fulfilling prophecies by focusing on temperance rather than risk-reduction. In order to make DARE more successful, the program must appropriately apply social and behavioral health models such as communication theory, social learning theory, social cognitive theory, and labeling theory.
REFERENCES
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1 Comments:

  • At April 27, 2008 at 8:44 PM , Anonymous Anonymous said...

    I really felt as though I could connect with your paper as a child who grew up with the DARE program. I especially connected to the glamorization of drugs that you mentioned. I remember being being enthralled with the idea of getting one of the "cool" T-shirts.

    I also thought that your point about the use of the word "Dare" by the program as being counterproductive to their ultimate goal was very intriguing.

    Good job!
    -Tara

     

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