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Drug use prevention - school programming and protective factors

Visit us (http://www.khanacademy.org/science/healthcare-and-medicine) for health and medicine content or (http://www.khanacademy.org/test-prep/mcat) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Brooke Miller.

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Video transcript

- [Instructor] One very important topic in any conversation about drug abuse is drub abuse prevention, or whether or not anything can be done to prevent drug abuse before it starts. So let's start off by talking about the government. The government tries to prevent drug abuse by making certain substances illegal. And by doing so, they are attempting to limit the availability of those substances, which is a form of prevention. The government also tries to prevent use and abuse by punishing those who use and sell substances. And the idea here of course is that people don't like to be punished, so they're not going to use and abuse substances if that leads to punishment. Another way that people try to prevent drug use and abuse is through a number of programs that are aimed at children, preteens, and teens. And these programs are often presented in schools, religious groups, and youth groups, and their aim is to stop drug use before it starts. You might be familiar with some of these programs. You might have gone through them yourself when you were in elementary school or middle school. But two very popular ones are D.A.R.E, which stands for Drug Abuse Resistance Education, and another program called Just Say No. These types of programs might be taught by teachers and integrated into existing curricula, or they might be taught by someone who is brought in from outside the school, which could include guest speakers or even police officers. And these types of programs, though all somewhat different from each other, tend to focus on three main things. The first is factual information about drugs. And this information is usually followed by stories of bad things that happened to people who used these substances, and they also typically include training that aims at boosting children's self-esteem with the goal of helping them resist peer pressure that might lead them to use drugs later on. A lot of time and money has been spent implementing these programs, and they certainly have good intentions, but over 20 years of evaluation into these programs have shown that these programs are not effective. Individuals who participate in these programs are just as likely to use substances as those who do not participate. In fact, some studies have shown that these programs might actually be counterproductive. That sometimes there's actually a higher rate of substance abuse among individuals who participate in these programs. And if there is any effectiveness, that effectiveness is very limited, and it only works for a short period after the intervention. It doesn't usually have an effect in the long-term. And I've mentioned all three possible conclusions here, and I don't mean to confuse you. So just to be clear, while there are some studies that show increased or decreased drug use in individuals who participate in these programs, a vast majority of them show no difference. And so now you might be wondering, why in the world these very well-intentioned programs have such a high failure rate. One reason might be that these programs are targeting kids who are just too young to really understand these messages. And there are a large number of these programs that focus on kids before they reach their teenage years. Maybe it's really easy for them to say that they will say no to drugs before they can really understand the pressures and social implications that can surround that decision. But at the same time, there are also programs that focus on individuals in their teenage years, and it's possible that teens might be too old for these messages. Maybe kids in this age range have already learned about substance use from their peers, and so they can't be inoculated against drug use. And as you might have noticed, these two things kind of contradict each other, so what really might be driving this is content. It might be the case that information that works well with younger kids doesn't work for older ones, and vice versa. There are probably some messages that we can give teens that would be meaningless to elementary school students. And so the key here might be finding the right balance of information. And maybe these programs don't have that balance figured out yet. And this reminds me of another point that I wanted to bring up about content. And that's that programs that rely on scare tactics are generally ineffective. And we don't totally understand why this is. It might be that even though kids and teens and preteens understand the messages of these programs, they may not think that the consequences apply to them. And so while they might be receptive to scare tactics in the short-term, it isn't going to affect their long-term decision-making. What about programs that just provide the facts about drug use and leave out any scare tactics or moralistic messages? Well it turns out that unfortunately, these programs aren't effective either. What about programs that boost self-esteem, programs that have students take an oath that say that they're gonna say no to drugs? As you might have guessed from following this pattern, these programs don't seem to influence drug use either. What about those studies that actually showed an increase in drug use? The studies that show that participants in these programs use substances more than non-participants. In this case it's possible that participating in these programs might lead students to think that substance use is actually more popular than it really is. And by accidentally transmitting this message, it might actually make these students more likely to use drugs. It's also possible that by telling students about drugs, by making them aware of them and by giving them general knowledge about them, it might lead them to be more curious about some of the drugs that they learn about. So we've talked a whole lot about things that don't work, and now I want to shift gears for a bit and talk about some things that do. Programs that use peers or older adolescents to teach drug prevention programs might be mildly more effective than programs that use adults. Although I will say that this is not supported by all studies. Because in general it's less about who teaches and more about what is taught. Programs that focus on developing social skills more broadly as well as teaching things like self-control and stress management have had some success. And that doesn't mean that programs shouldn't include factual information about substances or include messages about self-esteem and peer pressure. It just means that these things should be presented alongside other content. And I know that there tends to be a lot of focus on in-school programming about drug prevention, but it turns out that there are also some social factors that can decrease drug use. Things completely outside of typical drug prevention programming. And so I want to take a minute to talk about families and the way that the family structure can influence drug use. And I know that teenage viewers aren't going to like this at all, so I apologize in advance, but some studies have shown that when parents are involved in their children's social lives, when they know their friends and monitor their activities and know their whereabouts, this seems to decrease drug use. Thankfully there are also a number of other things that families can do that don't involve being involved in their children's business. One is making sure that the family has a close bond, making sure that family members are supportive of one another, and making sure that the home is a nurturing environment. Parents can also have clear and consistent expectations about not only drug use and alcohol use but also for things like schoolwork and chores. It might be helpful to make sure that the child feels like they are really part of the family and not just being controlled by it. So letting kids be involved in family decision-making, even for very small decisions, could have a strong influence. Before I go on and talk about anything else, I want to point out that most of the research that has been done in this area is correlational. We're not actually able to determine cause and effect. So it might be that being supportive of children leads them to use fewer substances, or it could be that children who do not use substances naturally feel more supported by their parents. Or there could be a third variable. Maybe doing well in school leads students to feel more supported by their parents, but also leads them to use fewer substances. And because these studies don't give us a clear understanding about directionality, it means that we can't draw any firm conclusions. But even with all of these problems, these studies are still important. For one thing, there have been a number of experimental studies that support this, studies that do show cause and effect. Also, keep in mind that some of these things just don't lend themselves to experimental studies. We can't just take a bunch of children and put half of them in a nurturing home and half of them in a not nurturing home and see what happens. I'm sure you would agree that that would not be ethical. And so even though correlational studies on this topic might not be perfect, they're still informative. But it isn't just parents that can have a role in reducing drug use, the whole community can play a role as well. Some studies have shown that children who have supportive relationships outside of their immediate family tend to use fewer substances. Teachers, neighbors, religious figures can all play an important role. Also having things like access to healthcare and childcare and family programming and drug-free recreational options, all of these things either correlate with decreased drug use or have been shown to do so experimentally with targeted family and community interventions. And this implies that schools can play an important role outside of providing specific drug prevention programming. They can also offer extracurricular programming, and sponsor social events. Basically they can serve the important role of giving children, teens, and preteens things to do that don't involve using substances. But these things don't affect all children equally. It seems that having a supportive community and family seem to be more important for younger children, while school and peer groups tend to be more important for older adolescents. So to summarize everything that we've been talking about in this video, there is no magic bullet that can prevent individuals from using and abusing substances. We don't currently have the ability to sit children down in a room for a few sessions, and expect them to be able to change their long-term views. That said, there has been a lot of research looking into new drug prevention strategies, and it's very possible that we'll have more effective programming in the future. But focusing only on this type of programming doesn't give us the whole picture because family and community can have a huge influence. Having a strong and nurturing family, school, and community seems to act as an important protective factor against drug use and abuse.