 Drug Prevention Makes a Difference By Mathea Falco
Americans are deeply concerned about drugs. Two-thirds of the public think that drug abuse is worse today than five years ago. Half say that they know someone who has been addicted to an illegal drug. Over the years, Americans have spent substantial amounts of money to combat drug problems. Since 1980, we have spent $290,000 million on federal, state, and local anti-drug efforts. This amount -- some $20,000 million a year -- is twice as much as the federal government spends annually for all biomedical research, including research on heart disease, cancer, and AIDS. Federal policy has been consistent: we have spent most of the money trying to reduce the supply of drugs in this country through enforcement, interdiction, and overseas programs to eliminate drug production. Unfortunately, this effort has failed. Despite a fivefold increase in federal expenditures for supply reduction efforts since 1986, cocaine is cheaper today than it was a decade ago. Heroin is sold on the streets for $10 a bag at purities exceeding 60 percent compared to less than 30 percent in 1990. The nation's chief drug enforcement official, Thomas Constantine, administrator of the Drug Enforcement Administration (DEA), told Congress in March 1995 that "availability and purity of cocaine and heroin are at an all-time high." And for the first time, arrests for drug possession reached the one million mark in 1994 -- a 30 percent increase over the past three years. Faced with these statistics, many have come to question whether supply can ever be reduced enough to affect drug abuse. Despite America's overseas efforts, worldwide opium and cocaine production has doubled in the last 10 years. The number of countries producing drugs has doubled as well, making drugs a truly global business. Pressure on one country only leads to increased production elsewhere. Since a single 25-square mile plot is enough to grow all the opium consumed in the United States, the likelihood that we can stop drug production becomes small. Nor are our borders easily sealed, when a single DC-3A flight can bring a year's supply of heroin into the United States and 12 trailer trucks can bring in a year's supply of cocaine. It is doubtful whether any policy to cut off the supply of drugs to America can ever succeed. But if supply cannot be curtailed, perhaps demand can be reduced. Such considerations have led to new interest in drug prevention, treatment, and community efforts to organize citizens against drugs. Drug use among young teenagers is climbing rapidly: marijuana smoking among eighth graders has more than doubled since 1991. Yet most children do not get effective drug prevention teaching, even though such programs can cut new drug use by half. In addition, one million prison inmates in this country have serious drug habits, regardless of the crimes for which they were convicted. Treatment for drug abuse is not readily available inside the criminal justice system or in many communities. Yet extensive research confirms that treatment is the most cost-effective way to combat addiction and drug-related crime. Polls show Americans strongly favor a balanced approach, which includes law enforcement, treatment, and prevention, and focuses anti-drug spending in their communities rather than overseas. Increasing Drug Use Illegal drug use cuts across all economic and ethnic groups. Of the 12 million Americans who admit they use drugs at least once a month, three-quarters are white and employed. Since 1992, adult drug use has gone up 12 percent, the first sustained increase since the 1970s. Among young adults ages 18 to 21, one in seven now reports using illicit drugs at least once a month. Marijuana remains the most widely used illegal drug, among both adults and teenagers. Because of more intensive cultivation and hybridization of potent strains, today's marijuana is much stronger than its 1960s counterpart. Heroin use is increasing, particularly among young professionals and those in the entertainment world. Because of its higher purity, the drug can be snorted or smoked, increasing its appeal to those reluctant to inject drugs. Methamphetamine abuse is also increasing. A synthetic stimulant that produces euphoria, high energy, and self-confidence, the drug may induce violent, paranoid behavior as well as stroke, seizure, and death. Methamphetamine-related emergency room episodes more than tripled between 1991 and 1994 nationwide, according to the Drug Abuse Warning Network (DAWN). Among medical professionals, the legal narcotic fentanyl -- 10 times more powerful than heroin -- is frequently abused. The overdose death in November 1995 of a young medical student in New York drew national attention to the usually hidden problem of drug addiction among doctors, nurses, and other health providers. In 1990, fentanyl sold on the streets as heroin was blamed for 17 deaths in the New York area. Teen Drug, Alcohol and Tobacco Use Drug use is rising dramatically among the nation's youth after a decade of decline. From 1993 to 1994, marijuana use among young people aged 12 to 17 jumped 50 percent. One in five high school seniors smokes marijuana daily. Monitoring the Future, which surveys student drug use annually, reports that negative attitudes about drugs have declined for the fourth year in a row. Fewer young people see great risk in using drugs. Mood-altering pharmaceutical drugs are gaining new popularity among young people. Ritalin, prescribed as a diet pill in the 1970s and now used to treat hyperactive children, has become a recreational drug on college campuses. A central nervous system stimulant, Ritalin can cause strokes, hypertension, and seizures. Rohypnol, produced in Europe as a legal tranquilizer, lowers inhibitions and suppresses short-term memory, which has led to some women being raped by men they are going out with. When taken with alcohol, its effects are greatly magnified. Rock singer Kurt Cobain collapsed from an overdose of Rohypnol and champagne a month before he committed suicide in 1994. In Florida and Texas, Rohypnol, known as "roofies" and "rope," has become widely abused among teens, who see the drug as a less expensive substitute for marijuana and LSD. Glue, aerosol sprays, lighter fluid, and paint thinner are inhaled by growing numbers of children to get a quick but potentially lethal high. These volatile solvents and gases can cause brain damage, paralysis, and even death. Both adults and youngsters are generally unaware of the terrible risks posed by inhalants; many parents do not know which of these household products can be misused in this way. In 1995, one in five 13-year-olds reported using inhalants, an increase of 30 percent since 1991. Inhalants kill as many as 1,000 people each year, most of them still in their teens. Alcohol and tobacco use is increasing among teenagers, particularly younger adolescents. Each year, more than one million teens become regular smokers, even though they cannot legally purchase tobacco. By 12th grade, one in three students smokes. In 1995, one in five 14-year-olds reported smoking regularly, a 33 percent jump since 1991. Drinking among 14-year-olds climbed 50 percent from 1992 to 1994, and all teens reported substantial increases in heavy drinking. In 1995, one in five 10th graders reported having been drunk in the past 30 days. Two-thirds of high school seniors say they know a peer with a drinking problem. Preventing Drug Use Extensive studies have documented that drug prevention programs work. Life Skills Training, a program for junior high students, can reduce new tobacco and marijuana use by half and drinking by one-third. With booster sessions in 9th and 10th grade, these results are sustained through high school. Effective prevention programs are not expensive, compared to the costs of prison construction, high-tech interdiction equipment, and health care for diseases related to tobacco, alcohol, and illegal drugs. Life Skills Training, for example, costs about $7 per pupil per year, including classroom materials and teacher training. Successful prevention efforts reach beyond the classroom to include the larger world that shapes attitudes toward drugs -- families, neighborhoods, businesses, and the media. The Carnegie Council on Adolescent Development, which recently completed a landmark study of children aged 10 to 14, concluded that a comprehensive approach is needed during these critical years when drug use and other problem behaviors begin. The essential "protective factors" that help children move successfully through adolescence include educational achievement, social skills, strong bonds with family members, teachers, and other adults as well as clear rules for behavior. Parental disapproval of substance abuse is also an important protective factor. The 1995 PRIDE survey found that parental involvement can significantly deter drug use, even among older teenagers. Positive options that create optimism about the future also reduce children's vulnerability to drugs. The Carnegie Council recommended the creation of middle schools small enough to respond to children's developmental needs, "family friendly" workplaces that encourage greater parental involvement, education in health and decision-making, and strong community support as steps to help raise resilient, productive teenagers. The influences on a child's decisions to smoke, drink, and use illegal drugs are complex, including anxiety, stress, peer values, and the desire to fit in socially. Advertising is a particularly powerful influence. A recent California study found that children were twice as likely to be influenced to smoke by cigarette advertising than by peer pressure. In 1993, the tobacco industry spent $6,000 million for advertising and promotions. Preventing teen smoking is critically important: 90 percent of all adult smokers began smoking before the age of 19. Programs That Work Helping Children at Risk. Project HighRoad brings together parents, schools, community organizations, housing authorities, local police, and clergy to create comprehensive substance abuse prevention programs in three New York inner city schools and related housing projects: in the South Bronx, on Manhattan's Lower East Side, and in the Astoria section of Queens. Project HighRoad provides continuous support -- family group sessions, school health clinics, tutoring programs, after school and weekend enrichment programs, youth leadership training, and crisis intervention -- for almost 2,500 primarily black and Hispanic young people. At one school drug use among eighth graders declined 25 percent, while eighth grade drug use rose nationally between 1993 and 1995. Smoking declined by half; binge drinking declined at all grade levels. Building Bridges to the Future. Started in San Francisco in 1978, and recently expanded to 30 cities in the United States and Hong Kong, Summerbridge serves more than 2,000 students recruited each year from inner city schools. The program provides tuition-free intensive summer sessions after sixth and seventh grades, as well as year-round tutorials, counseling, and family advocacy that continue through high school. Rigorous academic classes, sports, field trips, art, theater, and photography classes are taught by outstanding high school and college students, many of whom attended Summerbridge themselves. Eighty-four percent of recent Summerbridge graduates have gone on to college preparatory high schools and 64 percent of its summer teachers have continued into the teaching profession. More than half of the Summerbridge teachers are from ethnic minorities, compared to 10 percent nationally. Summerbridge costs $1,330 per student annually. Options for Portland Youth. "Life Has Options" is the motto of Self Enhancement, Inc. (SEI), a program in Portland, Oregon, that has served more than 12,000 inner city school students since 1981. SEI offers classroom instruction, extracurricular activities, cultural enrichment, career counseling, and summer outreach for 450 high-risk children every year. Paid SEI staff work with participants in their schools, tutoring, encouraging, and handling crises. They provide after-school supervision and guidance with homework. They also work with families and help parents obtain counseling or find jobs when needed. A 1994 study found that school attendance improved and disciplinary referrals dropped dramatically among participants. Students in elementary school raised their grades by 47 percent; middle school students by 70 percent. SEI costs $1,800 a year per child. Oregon residents pay $21,375 a year in taxes to lock up one juvenile. Volunteers Fight Against Drugs. Since 1990, the American Bar Association (ABA) has found ways to engage lawyers, judges, and local bar associations in anti-drug efforts across the country. With close ties to many segments of the community -- business, professional, and government -- lawyers are in a unique position to pull together local and national support to combat drugs. Volunteer programs involve lawyers in teaching legal rights and responsibilities to first-time offenders and their families; in working as mentors for juveniles arrested for drug abuse or drug-related crime; and in helping communities fight street drug markets. Through the active participation of judges and lawyers, the ABA Standing Committee on Substance Abuse has also led to reform of the justice system, including the development of local drug courts. Communities Drive Out Street Drug Dealers. Through strong partnerships with police, government agencies, businesses, and non-profit institutions, citizens in Baltimore, Maryland, are dismantling the drug trade one city block at a time. Baltimore's Comprehensive Communities Program aims to retake public spaces from dealers and to replace drug markets with youth activities. Baltimore received a Bureau of Justice Assistance grant of $1.9 million to combine community policing, alternatives to incarceration, drug courts, and anti-gang initiatives, part of a national pilot program to create coordinated strategies against drugs. The Boyd Booth community of West Baltimore is once again a livable neighborhood. Citizens boarded up vacant houses, fenced off drug dealers' get-away alleys, pursued nuisance abatement against drug houses, and prevented apartment rentals by out-of-state dealers. Cleaning up trash, replacing street lights, removing public telephones from drug routes, and planning community social gatherings on drug corners have dramatically decreased open drug dealing on street corners. Since the program began in 1993, violent crime in Boyd Booth has dropped 52 percent and overall crime 40 percent. At the same time, fewer police resources are consumed by crime in the neighborhood, with calls to police dropping to one-fifth their 1993 rate.
__________ Mathea Falco, president of Drug Strategies, a non profit policy institute in Washington, D.C., was assistant secretary of state for international narcotics matters from 1977 to 1981.
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