Like millions of people in the United States, I participated in Drug Abuse Resistance Education (DARE), the iconic drug education program rooted in the abstinence-only, “just say no” message of the Reagan administration. DARE was run by police officers who made frequent visits to our fifth-grade classroom. It was the mid-90s, and the cops informed us that using drugs would surely ruin our minds, turning us into glassy-eyed zombies, turning us hopelessly addicted and leading us straight to jail. Marijuana was a dangerous “gateway” to this awful life. We pledged never to use drugs.
The contradictions were unavoidable by the time I entered high school. By then, medical marijuana was making headlines, and researchers had determined that illegal weed was less harmful than legal cigarettes and alcohol. Parents smoked pot, just like famous musicians. Adderall and other stimulants that can produce a long-lasting buzz were systematically overprescribed to teenagers and were readily available at school. Older students I looked up to used drugs, and their lives didn’t go down the drain. They were star athletes and honor students winning college scholarships. My friends joked about DARE as we popped pills and smoked cigarettes at the bowling alley, where a former DARE police officer got hammered at the bar.
Of course, illicit drug use can have consequences. Some of my friends were arrested or kicked out of school for days at a time, increasing the likelihood that they would be further criminalized and incarcerated. A few developed serious addictions, a problem I would see more and more as I grew older. I lost half a dozen friends to opioid overdoses before I was trained to administer the lifesaving overdose-reversal drug naloxone in my late 20s (to learn more about overdose prevention, click here). By that time, communities across the nation were facing a burgeoning overdose crisis that would claim hundreds of thousands of lives and begin to change the public conversation about drugs to one that focuses on addressing health needs — and not a moment too soon.
Learning about how to administer naloxone was one of the most important lessons of my adult life. That’s why I was excited to chat with Drew Miller, a health teacher at Bard Early College High School in New York City. Miller’s students learn about how to identify and respond to an overdose during a lesson on opioids, and they learn about naloxone. It’s part of Safety First, a drug education curriculum developed by policy reformers promoting harm reduction, a broad set of ideas and practices rooted in the understanding that some people — including youth — will encounter and possibly use drugs for a variety of reasons, even if drug use is discouraged or criminalized. Instead of “just say no” propaganda, harm reduction reduces risks by helping people make the healthiest choices based on evidence-based research, without judgement. Abstinence is the most direct choice to avoid drug risks, and the Safety First curriculum discusses abstinence and generally discourages drug use. But the program is also realistic.
“Drugs are not always great for you, but people who use them are not bad people and you will probably encounter them in your life,” Miller said in an interview.
Should Eddie eat another weed brownie?
At first glance, Safety First looks a bit like the drug education I remember from high school and middle school, except scare tactics have been replaced with useful facts about how drugs work and why the government made some of them illegal (hint: the history of drug prohibition is steeped in racism and classism). I took a close look at Safety First’s unit on marijuana, the most widely-used drug among teens after alcohol. Older adolescents are more likely to use marijuana, with 5 percent of eight graders reporting marijuana use in the past month, compared to 23 percent of 12th graders, according to a 2016 government survey.
With Safety First, students learn about different marijuana products, from raw buds to concentrates and edibles, along with their effects on the mind and body. This is important because the legal marijuana industry has made a number of different products more readily available. While some people use marijuana to treat medical conditions or just relax, cannabis is an “incredibly complex drug,” according to the curriculum, and anyone considering using it should learn about how the different strains and forms “impact the body and mind differently.”
Researchers are concerned that marijuana could harm developing teenage brains, and prolonged or habitual use could make mental health problems worse, according to the curriculum. In the harm reduction section of the unit, students learn that the best way to avoid these potential harms is abstinence — choosing not to use marijuana. However, Safety First recognizes some teenagers will make a different choice. So, students learn the difference between smoking marijuana and consuming edibles. The effects of smoking marijuana are felt immediately, but smoking can harm the lungs. Edibles don’t impact the lungs, but their effects are not immediate and last much longer.
Students are given a real-world scenario to consider: A friend named Eddie ate a weed brownie 15 minutes ago. He doesn’t feel high and wants to eat another. What advice should you give him? Eddie should know that edibles can take 45 to 90 minutes to kick in. He should wait at least two hours before consuming more to be safe. Anyone who has made the mistake Eddie was about to make knows that a marijuana overdose does not itself cause serious health problems, but can be extremely uncomfortable if not terrifying for several hours. Arming students with facts empowers them to educate people around them, whether they choose to use edibles or not.
“We modeled this very much after the comprehensive sex ed approach,” said Sasha Simon, an educator who developed the Safety First curriculum with the Drug Policy Alliance, in an interview. “You give kids the information and treat them with a level of maturity by letting them know how drugs work, their associated risks, and how they can mitigate those risks if and when they were to encounter them.”
As a result, students are more likely to recognize the level of maturity required to make decisions about whether and how to use drugs. As Simon notes, medically accurate sex education often follows the same philosophy. This stands in sharp contrast to abstinence-only education, which provides students with only one strategy for staying safe. In reality, people use all sorts of strategies to make drugs and sex safer. Short on facts, abstinence-only drug education must rely on scare tacticssuggesting drug use inevitably leads to harm and suffering. This fails students in two major ways. When students who do use drugs discover that they are not necessarily horrible and can provide relief and pleasure, abstinence-only education immediately loses credibility. Scare tactics also reinforce stigma about drug use. A teen experiencing stigma is more likely to hide problematic drug use from adults instead of asking for help and seeking treatment. Stigma is also at the heart of the failed drug war policies that created school-to-prison pipelines and set the stage for the overdose epidemic.
Harm reduction rising
“‘Just say no’ doesn’t work — it shames people,” Miller said. “If anything, this curriculum has made my students less likely to use drugs because they know the honest truth about how they work. And should they or their friends encounter these substances, I feel better knowing I did everything I could to equip them with the basic understanding to keep them safe.”
Rates of teenage drug use (including cigarettes and alcohol) are shaped by a variety of factors, but have dropped since the late 1990s when DARE was at its height. Since then, funding for DARE and its style of drug education dried up as study after study found it was ineffective. DARE trafficked in the idea that teens turn to drugs to be “cool,” but even if that were the case, DARE didn’t provide a solution: There’s nothing cool about cops providing kids with “facts” that don’t reflect the real world and quite possibly their own lived experience. Today, the federal government still spends millions of dollars on drug “prevention” education through grants for local programs, but these programs are supposed to be “evidence-based” and shown to work.
Harm reduction encourages healthier choices based on scientific evidence, and as the opioid crisis challenges society to embrace more humane drug policies, these policies may well make their way into more classrooms.
Simon and I are in our early 30s, both products of the DARE era. Reading her curriculum on opioids and the overdose epidemic, I can’t help but wonder how our generation might be different had we learned about drugs through the lens of harm reduction. I’m sure a lot of us could have avoided an unpleasant experience with weed brownies. And how many opioid overdose victims might still be alive?
“In DARE, you promise to a police officer that for the rest of your life you won’t do drugs, forever and ever. Just look at the number of drug overdoses — that was so ineffective,” Simon said.
Simon and other researchers use focus groups and individual interviews with students to evaluate the Safety First curriculum’s effectiveness, and so far the results are promising. Miller is teaching Safety First for the second year in his health class, and five schools in San Francisco began teaching the curriculum over the past school year. What are the students saying?
“Overwhelmingly, they appreciated the fact that they were given honest information that was not fear-based, and they appreciated the fact that they were given honest information not only for themselves, but for others,” Simon said.
Miller said his students are engaged, and Safety First has prompted classroom discussions that affirm students who have used drugs or know people who do, rather than stigmatizing them into forced silence. Under the harm reduction model, learners know they won’t be judged or punished for sharing their personal experiences and speaking their minds. This keeps the conversation honest and combats stigma. Parents are also happy with Safety First, Simon and Miller said. Members of the Bard PTA even suggested a harm reduction workshop for parents. The curriculum aligns with National Health Education Standards and Common Core Learning Standards, so it can be used by any school or youth program.
The harm reduction movement has been around since the 1980s but is now becoming mainstream, thanks in part to the overdose epidemic. Social conservatives may push back against harm reduction in the classroom, just as they have fought medically accurate sex education. However, as I and many others have written, it’s only a matter of time before harm reduction becomes central to public policy. As opioid addiction spread into whiter and wealthier communities, policymakers have been forced to reckon with the decades-long drug war that cast drug users as criminals and social failures, rather than human beings who may have medical needs. Communities of color have been challenged by opioids for years, but that it took a steady stream of headlines about otherwise successful white people becoming addicted to opioids and dying to push the conversation in the direction of public health is proof that the war on drugs upholds white supremacy. This progress is also undermined by the government’s fixation on arresting people who sell drugs, which ensures the drug war will continue.
Attitudes toward drugs are shifting, most certainly among teens, who are less likely to use drugs now than they were two decades ago. Still, some of them will choose to use drugs, and some won’t. They all deserve to be as safe as they can be.
Copyright © Truthout. Reprinted with permission.