DARE TO CHANGE

The American Public Supports A Tough Stance On Drugs, Even Though It Doesn't Work.  The Only Way Things Can Change Is If The Media Start Confronting Some Unpalatable Facts, Says Maia Szalavitz.

TO OUTSIDERS, it will seem shockingly narrow-minded.  At a conference on drug abuse last year, sponsored by the US government's Center for Substance Abuse Prevention, a speaker was shouted down and told to "Shut the fuck up".  Her crime? Simply saying that government anti-drugs funds should go only to programmes based on methods that have been shown to work, and for suggesting that a popular scheme called Girl Talk wasn't one of them.  Only the conservative media thought the incident worth mentioning: the woman who had been silenced was a noted conservative.

But for anyone following the debate over US drugs policy, intolerance of dissent will be depressingly familiar.  Lack of respect for research is an endemic problem in this area.  It is not helped by the media, whose uncritical support for anything that claims to be "anti-drugs" only encourages the proliferation of ineffective and expensive programmes.

Girl Talk promotes the idea that helping girls achieve more in traditionally "masculine" areas makes them less likely to use drugs.  Yet since boys are at least twice as likely to use drugs as girls, this notion is questionable, and there isn't a shred of independent research to back it up.

The DARE ( Drug Abuse Resistance Education ) programme is an even bigger scandal, if only because it operates on such a large scale.  DARE is conducted by police officers in 80 per cent of American schools.  Children are taught that all drugs - including alcohol and tobacco - are equally harmful and given tips on the best ways to "just say no".  In the past Glenn Levant, the programme's founder, regularly demonised researchers for faulting his programme, calling their work "voodoo science" and accusing them of "kicking Santa Claus" and "setting out to find ways to attack our programmes".

But a year ago he changed his tune.  The government, embarrassed over the absence of any sound data supporting DARE, threatened to withdraw funding.  No published, peer-reviewed study has found that DARE reduces drug use among adolescents, while several have indicated increased use among participants.  Yet it took more than 18 years and a dozen solid negative studies of thousands of children before the point hit home.

More remarkable still, at the same time that Levant was reflecting on the ineffectiveness of his programme, he announced that he'd received a $13.7 million grant from the Robert Wood Johnson Foundation to revamp it.  DARE is so deeply entrenched in so many schools, that the foundation decided it would be better not to start from scratch.

The media's ambivalent attitude towards DARE surely influenced its decision.  Just weeks before Levant's announcement, a reporter from the Long Island-based tabloid Newsday, one of the largest local newspapers in the US, summed up the DARE debate in the following way: "Different camps cite conflicting studies, some indicating that DARE is effective and some that it isn't." If Newsday had done a five-second Web search to check both sides' citations, it would have found that the real data supports only one position.

Most newspapers treat research as just another partisan voice.  One Iowa paper wrote in September: "Most of the studies that have questioned DARE's effectiveness show that the message does not last - that those students who receive DARE as their only lesson on drug abuse have forgotten the message by the time they hit high school.  That doesn't mean it isn't effective as a starting point." Sounds like addict logic to me: if it's not working, try more.

It gets worse.  Consider DARE's basic premise - that police officers should teach children about drugs.  Teenagers mistrust authority figures on this subject, and are more likely to heed peers or adults whom they know - something social scientists have understood for years.  DARE is now taught to 10 and 11-year-olds, who compete eagerly for DARE shirts and praise from its officers.  But the revamped DARE will run in high school, where teenagers' interests in DARE paraphernalia is more likely to be ironic.  It's sure to raise a laugh at raves.  Yet a major foundation has agreed to fund yet more research - and still no one asks why.

There's a deeper problem here.  The government's position that drug use is always harmful is scientifically dubious.  Unfortunately, a 1994 law lays down that federally funded prevention programmes must have a strict "no use" message.  This effectively blocks any significant change of tactics even outside DARE.  Political change will be needed before anti-drugs efforts can begin to improve.  To stimulate this change there needs to be better research and reporting.  The quality British press, for example, has been far more sceptical of anti-drugs crusaders; and Britain has better drugs policies to show for it.  The British government has been funding needle-exchange programmes for drug addicts since 1988, as a way to limit the spread of HIV.  The US government has still not managed to do anything similar, despite scientific support from every major concerned body.

What sounds good isn't necessarily what works.  Two major reviews of existing data on drugs prevention programmes - one American, one British - have found that there is no known programme that actually cuts illegal drug use.  After billions of dollars and over three decades, not one has had a significant and lasting effect.  So why not test alternatives?

It may be time to try programmes aimed at reducing the harm drugs do, rather than their use.  It may be possible to cut addiction and overdose rates.  But we'll never know unless American journalists hold the largest funder of drugs research in the world - the US government - accountable.  So here's an appeal to American reporters: start to confront your biases and those of your audience, and make the effort to understand the science.  Dare to follow the data, not the crowd.

Maia Szalavitz is co-author of "Recovery Options: The Complete Guide" ( Wiley, 2000 ) and writes regularly on science and drugs policy.