Challenging Dogma - Spring 2009

Wednesday, May 6, 2009

Failures in the War on Drugs and its Usage Among Teenagers and Young Adults: A Critique of Anti-Drug Campaigns-Enver Holder-Hayes

One of the biggest problems has been the possession, sale and usage of drugs and narcotics both here in the United States and around the world. This subject is just as relevant today as it was several decades ago when issues with drugs began to rise. Today, there is a huge issue taking place at the United States southern border with Mexico because of the war on drugs, which has spiraled out of control in the last few months causing many people to be killed (1). U.S. Secretary of State, Hillary Clinton essentially blamed the people of the America for the problems at the border, saying that Americans “…insatiable demand for illegal drugs fuels the drug trade (2).” While drug possession and sale has been a big driving force in the problem of the war on drugs at the border, the more pertinent issue domestically has been the usage of drugs, especially among teenagers and young adults. While the prevalence of some drugs such as stimulants, have been declining over the last few years, drugs such as marijuana and vicodin, have had a steady prevalence since the mid-1990s and there is an increase starting to occur (3). Drug abuse has also been a major problem among different racial groups, specifically marijuana when it comes to Blacks and Latinos and cocaine when it comes to Whites (4).

Certainly, with drug abuse being a major issue among young people there have been many anti-drug campaigns and interventions that have been put in place. This problem is also important to me personally because I come from a community in Brooklyn, NY where teenage drug use is very high. Despite those efforts, the amount young people utilizing drugs have not decreased much at all (3). One of the anti-drug campaigns put into place was the Partnership for a Drug Free America which is run privately in conjunction with the federal government. One of the main missions of this campaign is to “motivate and equip parents to prevent their children from using drugs and alcohol (5)” That statement alone helps to illustrate some of the fundamental flaws of this campaign and why it has not worked effectively to reduce the amount of drug use among youngsters in this country. Other popular campaigns similar to the Partnership for a Drug Free America, that have struggled to be effective in the anti-drug war has been the National Youth Anti-Drug Media Campaign and Above the Influence (6,7). There are three main criticisms that can be made about the anti-drug media campaign that is being waged here in the U.S. and why it has not worked. One reason why this campaign has not worked effectively is that it uses parents to send messages to their children about not using drugs. Another reason why this campaign has not worked effectively is because its messages are mixed, failing and very misleading. A third and final flaw of this campaign is that the messages that it tries to send does not relate to young people and alternative activities other than drug use are not proposed.

Parents Are Used to Deliver the Message

The main component of the Partnership for a Drug Free America campaign and others similar to it is to educate parents on the consequences of drug use and how to talk to their children about encouraging them not to use drugs. Some major social science and behavioral models that the anti-drug movement utilizes is the Health Belief Model, Social Cognitive Theory and Advertising Theory (8,9). However, the Health Belief Model is flawed in many ways and is part of the reason that using parents to send the message about not using drugs has had little effect (8,9). One flaw is that the Health Belief Model is an individual level model and uses individual level factors, which means that environmental or social factors are not considered (10). Another flaw is that the model assumes that a person’s behavior is planned and behavior does not happen spontaneously (10). A third flaw is that the model assumes that behavior is totally rational and that a cost/benefit analysis is used to by a person to exhibit a certain behavior (10).

A few years ago the National Institute on Drug Abuse (NIDA) did an assessment of how effective the National Youth Anti-Drug Campaign and the Partnership for a Drug Free America has been in reducing drug use among teens and youngsters (11). One of the areas that was assessed was the impact of the campaign on parents and if parents in turn had an effect on their children (11). The study finds that parents do a good job in talking to their children about the importance of not using drugs and doing activities that are fun with their children (11). However, when it comes to parents closely monitoring their children on what activities they are involved in and who they hang around the results are very poor (11). Most parents are not paying close enough attention to who may be influencing their children outside of the home which may be contributing to the ineffectiveness of the anti-drug campaign.

Another reason why using parents to deliver the message about not using drugs is ineffective is because most children see parents as the enemy. For the majority of teenagers and young adults, when a parent tells them not do something they will do the opposite and it will peak their interest about the issue even more. A 23-year old girl had this to say about the use of parents to send the anti-drug message in a recent article, “Teenagers seldom listen to their parents. To me, only someone who has in-depth knowledge of drugs or was once a drug-taker is persuasive (12).” This article also discusses how the lack of attention that they pay to their children about what behaviors they are carrying out contributes to the growing drug use problem. Ms. Koon Man-wai who is a registered social worker who encounter’s teenagers who use drugs daily had this to say, “Many parents are occupied by their work. As they have heavy workload, they can only contribute little time to anti-drugs programs (12).”

Misleading and Failed Messages

While using parents to send messages about not using drugs to their children has its problems, it is only a component of the broader problem of the National Anti-Drug Campaign. Another problem with the anti-drug campaign here in the U.S. is that it sends misleading and mixed messages to children. One example of how an anti-drug campaign can be misleading is the very famous fried egg ad which was put out by the Partnership for a Drug-Free America which implied that by using drugs you were frying and damaging your brain. This ad was negative and did little to stop teenagers from using drugs especially teenagers who had already been using drugs (13). Another problem with that advertisement is that it does not have a message that children can relate to and understand (13). Equating using drugs and frying an egg is very misleading and can easily turn many teenagers and even parents off as to its message. However, misleading advertisements are not limited to the U.S. An advertisement being run in Israel equates using drugs, specifically marijuana to terrorism (14). The ad talks about how using and purchasing drugs contributes to funding Hezbollah, a major terrorist group in the Middle East (14). Again, here you have a message that is totally off-track and sends a message that teenagers are not likely to take seriously.
The anti-drug campaign here in the U.S. is mainly effective in deterring teenagers who have never used drugs rather than those teenagers who have already experienced using them. That means that if teenagers are not exposed to interventions before they begin using drugs, the anti-drug campaigns are pretty much useless. Cho and Boster did a study which examined anti-drug campaigns and how both teenagers who have not used and used drugs both perceived the campaign and how effective they are (15). They found that teens who had already used drugs already perceived before they saw the ads that they would have little effect on stopping their drug use than those teens that had never used drugs.

As mentioned earlier, many of the anti-drug campaigns try to utilize social science theories as a blueprint for their overall approach, specifically the Health Belief Model, Social Cognitive Theory and Advertising Theory. The failure of the correct use of the Social Cognitive Theory has directly attributed to many of the misleading and failed messages that anti-drug campaigns have been sending (9). A good anti-drug campaign using SCT should build one’s self-efficacy and make teens believe that they should overcome the obstacle of not being tempted to use drugs and if using drugs being able to stop (9). Secondly, the anti-drug campaign should be able give teen’s incentives to change their behavior when it comes to drugs so that teens know that their life will be better if they are abandoning drugs (9). Sending messages that teenagers cannot understand or don’t take seriously does nothing to solve the drug abuse problem and just waste millions of dollars in funds.

Alternatives Are Not Proposed

Finally, the third critique that I have of the anti-drug campaign here in the U.S. is that alternatives are not given and proposed to teenagers about what they should be doing instead of using drugs. For some, selling drugs is a way of making money for their families. For others, life may be so stressful that they feel the only way to deal with the stress and relieve it is to use drugs. It should be no surprise then that drug use is very high among teenagers who live in inner-city communities or below the poverty line (16). A study published in 2004, looked at how drug use among inner-city teenagers was dependent on many factors such as peer involvement with drugs, protective factors, and emotional and behavioral problems (17). They found that teens who reported prior drug use had less protective factors, many emotional and behavioral problems and had peers with heavy involvement with drugs as well (17).

Many of the anti-drug advertisements talk about the dangers of using drugs but then don’t give any positive messages about what alternative may be available. Let’s take the Above the Influence campaign as an example. This is probably one of the most popular anti-drug campaigns that target teens in the U.S. today. Most of their ads talk about how using drugs may cause certain consequences such as stealing, decreased motivation and certain health risks (7). However, they don’t show ads that talk about some of the positive things that people who not using drugs can do. I think if more ads were showing some positive role models that teens look up such as athletes, actors and professionals (doctors, lawyers), it would have more of an effect changing teens behaviors, especially those who already began using drugs.

The final main social science theory that is used in anti-drug campaign is of course, advertising theory. It fits perfectly into the problem of advertisements not showing positive alternatives to using drugs rather than just showing the negative consequences. The goal of advertising theory is to change a mass of people’s behavior at the same time by making them a promise in two ways, by providing certain benefits and by hitting at their core values (10). While most of the anti-drug advertisements talk about the long-term benefits of not using drugs, many teenagers think in the short-term and so it is imperative that the advertisements show the short-term benefits of not using drugs as well. An article in the American Journal of Public Health, looks at the impact of the National Youth Anti-Drug Media Campaign on a group of teenagers between the ages of 12 and 18 (18). The results found were remarkable in that the campaign had no effect on drug use and even may have increased the chances of teens using drugs (18). This type of result is unacceptable and provides more evidence that the types of advertisements that are being constructed by various anti-drug campaigns are wasteful and ineffective.

Conclusion

As illustrated, the use of drugs by teenagers has been a major problem over the few years. Consequently, millions of dollars have been put into anti-drug campaigns targeted at teenagers and young people. Unfortunately, they have for the most part been unsuccessful and have had some fundamental flaws. Three flaws that I saw with the anti-drug interventions were that parents are being used to deliver the message, many of the messages are misleading and do not relate to teens and there are no alternatives given to teens in the anti-drug ads about what other things they can be doing besides drugs. Social science research and theory such as the Health Belief Model, Social Cognitive Theory and Advertising Theory have been used to shape how many of the anti-drug interventions are constructed. However, many of these social science theories also have flaws that are contributing to why the anti-drug campaign among teens has largely been a failure. There is also another issue that the anti-drug campaigns are not considering. Stopping drug trafficking is very important in succeeding in the effort to lower teen drug use and drug use overall. If the amount drugs coming into the U.S. are limited, teenagers will have to work harder to obtain drugs and therefore they will be less inclined to use them. As mentioned earlier, poverty also plays a key role in the failure of the anti-drug campaign as well. While many of these tasks will not be easy to accomplished, they must be implemented for the United States to have any shot in putting a dent in drug use among teenagers and people overall.

REFERENCES

1. Lacey, M. (2009, March 29). In Drug War, Mexico Fights Cartel and Itself . New York Times , p. A1.

2. Sheridan, M. B. (2009, March 26). Clinton: U.S. Drug Policies Failed, Fueled Mexico's Drug War. Washington Post , p. A01.

3. NIDA Info Facts. (2008). High School and Youth Trends. National Institute on Drug Abuse.

4. National Institute on Drug Abuse. (2003). Drug Use Among Racial/Ethnic Minorites. U.S. Department of Health and Human Services.

5. About the Partnership . (2009). Retrieved April 1, 2009, from Partnership For a Drug Free America: http://www.drugfree.org/Portal/About/

6. National Youth Anti-Drug Media Campaign. (2009). Retrieved 1 April, 2009, from National Youth Anti-Drug Media Campaign: http://www.mediacampaign.org/

7. AbovetheInfluence. (2009). Retrieved April 1, 2009, from AbovetheInfluence: www.abovetheinfluence.com

8. Rice, R.A. (2000). Public Communication Campaigns. Sage Publishers.

9. Hencken, R. (2007). Why Won’t Teenagers Just Accept Our Anti-Drug Messages? The Folly of the National Youth Anti-Drug Media Campaign. NCA 93rd Annual Convention , 1-30.

10. Edberg, M. (2007). Essentials of Health Behavior: Social and Behavioral Theory in Public Health. Sudbury, Massachusetts: Jones and Bartlett Publishers.

11. Walters, J., Johnston, L., & Hansen, G. (2004, January 23). Review Finds Anti-Drug Campaign Works on Parents (Sort Of) But Not Kids -- Findings Contradict Drug Czar's Rosy Views. Retrieved April 1, 2009, from Stop the Drug War: http://stopthedrugwar.org/chronicle-old/321/ads.shtml

12. Hok-Yee, E. T. (2008, October 27). Teens blame parents for drug abuse . Retrieved April 1, 2009, from The Young Reporter: http://tyr.journalism.hkbu.edu.hk/index.php?option=com_content&view=article&id=188:teens-blame-parents-for-drug-abuse

13. Dudukovic, N. (2008, May 15). This Is Your Brain...On Anti-Drug Campaigns. Retrieved April 1, 2009, from Psychology Today: http://blogs.psychologytoday.com/blog/remember-the-alamo/200805/is-your-brainon-anti-drug-campaigns

14. Immanuel, M. (2008, June 18). New anti-drug campaign equates smoking pot with terrorism . Haaretz .

15. Cho, H., & Boster, F. J. (2008). First and Third Person Perceptions on Anti-Drug Ads Among Adolescents. Communication Research , 35 (2), 169-189.

16. The Inner-City Anti-Drug Campaign. (2003). Retrieved April 1, 2009, from Advertising Educational Foundation: http://www.aef.com/exhibits/social_responsibility/pdfa/2416/:pf_printable

17. Lindsey, R., Weist, M. D., Smith-Lebeau, L., Rosner, L., Dixon, L. B., & Pruitt, D. D. (2004). Significance of Self-Reported Drug orAlcohol Use Among Inner-City Teenagers. Psychiatric Services , 55 (7), 824-826.

18. Hornik, R., Jacobsohn, L., Orwin, R., Piesse, A., & Kalton, G. (2008). Effects of the National Youth Anti-Drug Media. American Journal of Public Health , 98, 2229–2236.

The “Stay Focused” Campaign-An Alternative to the Current Failing Anti-Drug Campaigns-Enver Holder-Hayes

Every year, more than 17,000 deaths in the United States are caused directly and indirectly by illicit drug use (1). The evidence of drug use is startling among teenagers and young adults, with 41.9% of 12-25 year olds surveyed reporting ever using drugs and 55.6% of 18-25 year olds reporting ever using drugs, 31.9% of them within the past year (2). With this huge use of drugs among teenagers and young adults it has become clear that the anti-drug campaigns here in the U.S. have failed us (3). In the previous paper, three flaws of these campaigns were critiqued, using parents to deliver the message about not using drugs, misleading and mixed messages being provided about drugs and adequate alternatives to drug usage not being proposed.

A successful anti-drug intervention should address all of these flaws as well as building on aspects of those interventions that have worked. An alternative anti-drug intervention that will be addressed in this paper is called the “Stay Focused” campaign. The main objective of this campaign is having young adults helping other young adults to stay focused on their life goals and not letting drug usage get in the way. This intervention will have several components. The first is that teenagers will be used to deliver the message about not using drugs to other teenagers, in addition to parents. The second is that the message will be targeted so that teenagers and young adults not only understand the long term consequences of drug usage but how it can impact them in the short-term. The final component is to provide teenagers with a variety of resources to discuss their drug problems, if they are already using drugs; and how to stay away from using drugs if they are not already using them. The “Stay Focused” campaign will incorporate three types of social science theory, Theory of Planned Behavior, Social Cognitive Theory, and Advertising Theory.

Use a Combination of Peer and Parental Influence

The first component of the “Stay Focused” campaign is focused on getting teenagers to deliver the message about not doing drugs and other illegal activities to other teenagers. One of the key flaws of the current anti-drug campaigns is that many of them are based on parents telling them not to use drugs but do not recognize the influence of peers on drug usage as well (4,5). It is clear that strategy has not worked as many teenagers rebel against things that they parents say about what they should not be doing (4,5). A good way to make this component work is to apply the Theory of Reasoned Action. The three parts of this theory is a person’s attitude towards a particular behavior; followed by subjective norms that surround that particular behavior, which in turn will decide a person’s intention to actually produce that behavior (6).

Most teenagers attitude towards using drugs is that they know that using it is wrong and illegal but since their peers are doing it they still want to do it to “fit in”. In the “Stay Focused” campaign the aim will be to change the social norms. Teenagers who do understand the importance of not using using drugs will be used to convince other teenagers why it is important to not use drugs. This will not be done simply by advertising, but by having forums take place in both schools and community centers in which teenagers of the same age will have a discussion about the impact of drugs in their daily lives. In addition, parents will also be used to reinforce those ideas about drug use in the home. The National Institute for Health and Clinical Excellence, based in the United Kingdom, agrees that this is a part of a successful drug intervention. In the results of a study they did looking at ways drug interventions can be effective, they say “Peer approaches appear to be particularly beneficial for the peers themselves, providing positive experiences and a potential path to career or personal development (7).” The National Institute on Drug Abuse also thinks that a drug intervention focused on the use of teenagers’ family and friends is the best approach to design an intervention that combats drug abuse (8).

Send Clear Messages about the Long and Short-Term Consequences of Drug Use

The second component of the “Stay Focused” campaign is to send messages to teenagers and young people about the long and short-term impacts of drug use that are clear to them, with an emphasis on the short term. The best way to approach this part of this intervention is to apply Advertising Theory. Advertising Theory main goal is to change a mass of people while making a promise based on two provisions, providing benefits and reaching their core values (6). In the previous paper, it was noted that many of the advertisements send mixed and misleading messages to teenagers who made the anti-drug intervention flawed. In the “Stay Focused” campaign, two advertisements would be set up to target separate audiences. The first would be targeted to teenagers who may love to play sports and see that as a career decision. The second would be targeted to teenagers who see college and professional career as a goal.

For example, the first ad would show two healthy teenagers playing basketball, one beginning to use drugs and the other not using drugs. Then a timeline of how is game deteriorates over time will be presented, maybe 6 months, to where the teenagers is not as crisp and skillful as he was before he started using drugs. At the end of the advertisement, the message would read, “Using drugs made this teenager lose their skills, now they will not get recruited to play college basketball. Do you want that to be you? Stay focused on not using drugs and you can achieve anything!” The second ad would be similar in its structure, in the end the teenager using drugs will receive a letter stating they did not get into college while the teenagers not using drugs would be accepted. The White House Drug Policy office points out that in order for an anti-drug campaign to be effective it must be clear and direct in its messages to teenagers and young adults (9). An article written by Crain and colleagues points out how the pro-drug advertisements show more of an upside in the short-term than anti-drug advertisements that are targeted in the long-term which could be contributing to the spike in drug usage among teens (10).

Target Teenagers Who Are Already Using Drugs and Provide Alternatives

The last component of the “Stay Focused” anti-drug campaign is to take into account teenagers who have been using drugs and not using drugs, providing alternatives for them and a variety of resources to deal with their problem. Social Cognitive Theory is probably one of the best social science theories to focus on for this component. The reason why is because it takes into account external, social and internal factors that may influence a person’s behavior (6). It also targets the concept of self-efficacy, which is a person actually believing in themselves and that they can actually make the behavior change (6).

This component will have more of a hands-on approach. One approach is to get teenagers together who are currently using drugs and not using drugs to interact. By seeing physical examples of people who have been in their position and overcome it, it will help to drive their self-efficacy higher, therefore making them more likely to change their behavior and stop using drugs. A study looking at the effectiveness of anti-drug PSA’s pointed out that it is very important to take into account a person’s self-efficacy when designing an anti-drug intervention (11). A group called Common Sense for Drug Use Policy criticized the Office of National Drug Control Policy for using a set of anti-drug ads for the 2008 Super Bowl, because it ended up lowering the self-efficacy of teenagers rather than raising it (12).

The second goal is to help change the environment around the communities that many of the teenagers live in so that they have alternatives to not using drugs. A good example is the environment that minorities may face. Many neighborhoods that minorities live in are run down with little parks and recreational facilities for teenagers to utilize. Having infrastructure and activities in place may make teens too busy or become turned off by using drugs. One article pointed out that targeting and making changes in environment can be very effective in changing behavior (O'Connell, 2004). The example they used was with tobacco smoking, where taxes where raised on cigarettes and restrictions were placed on where people could smoke (13).

Conclusion

As illustrated, the “Stay Focused” campaign goal is provide teenagers with as much power and resources as possible to change their behaviors, particularly when it comes to using drugs. The three main components of this intervention is utilize both peer-to-peer intervention jointly with parent to teen intervention to change individual behavior and social norms, emphasize the short-term consequences of drug usage and providing resources by advertising effectively and alternatives for teenagers who are using and not using drugs to change one’s self efficacy and environment. The “Stay Focused” campaign may not totally eliminate the problem of drug use but will reduce it by acknowledging previous interventions weaknesses.

References

1. DrugWarFacts.org. (2009, January 9). Annual Causes of Death in the United States. Retrieved 25 April, 2009, from Get the Facts: www.drugwarfacts.org

2. Lloyd, J. (2002). Drug Use Trends. Washington, DC: Office of National Drug Control Policy.

3. Hencken, R. (2007). Why Won’t Teenagers Just Accept Our Anti-Drug Messages? The Folly of the National Youth Anti-Drug Media Campaign. NCA 93rd Annual Convention , 1-30.

4. Walters, J., Johnston, L., & Hansen, G. (2004, January 23). Review Finds Anti-Drug Campaign Works on Parents (Sort Of) But Not Kids -- Findings Contradict Drug Czar's Rosy Views. Retrieved April 1, 2009, from Stop the Drug War: http://stopthedrugwar.org/chronicle-old/321/ads.shtml

5. Hok-Yee, E. T. (2008, October 27). Teens blame parents for drug abuse . Retrieved April 1, 2009, from The Young Reporter: http://tyr.journalism.hkbu.edu.hk/index.php?option=com_content&view=article&id=188:teens-blame-parents-for-drug-abuse

6. Edberg, M. (2007). Essentials of Health Behavior: Social and Behavioral Theory in Public Health. Sudbury, MA: Jones and Barlett Publishers.

7. Louise Millward, D. W. (2004). Evidence for effective drug prevention in young people. Wetherby, Yorkshire: Health Development Agency.

8. Mathias, R. (1997). National Conference Showcases Effective Drug Abuse Prevention Programs. National Institute on Drug Abuse.

9. Office, W. H. (2008). What Works: Effective Public Health Responses to Drug Use. Washington DC.

10. Crain, R. (1996). Ad biz needs to reinvigorate once-strong anti-drug message. Advertising Age , 67 (36), 17-17.

11. Barrett, D. W. (2007). Measuring the Effectiveness of Anti-Drug Public Service Announcements. International Communication Association, (pp. 1-29). New Orleans, LA.

12. ONDCP Spends Millions On Ads In Spite Of Federal Research Proving Campaign Is A Failure. (2008, February 1). Retrieved April 25, 2009, from Common Sense for Drug Policy: http://www.csdp.org/news/news/ondcpads.htm

13. O'Connell, M. E. (2004). Reduding Underage Drinking. National Academies Press.

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