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Parents, Schools and Communities: Working Together To Keep America'a Youth Drug-Free

The National Family Partnership's Red Ribbon Campaign, October 23-31, is a time to bring people together and make the drug-free message visible. The Red Ribbon Campaign, conducted annually since 1985 through local and nationwide volunteers, has made October a time to reinforce and introduce students throughout the country to the simple realization that they can choose to grow up drug-free.

The Red Ribbon media focus each October and the many in-school activities have helped to get this message across to our youngest children. School and parental involvement made a measurable difference throughout the 1980's. Great strides have been made in preventing our children from making damaging choices where schools, parents and communities have worked together.

But October is only one month in a full year of growing up with the peer pressures and the very tough realities of becoming a young adult in this country. Although we have made a difference at the earliest elementary school levels, success has been harder to achieve in the middle and high school levels, in large part due to a lack of parental involvement. In those crucial preteen and teenage years, parents are, in too many cases, missing from the equation that would equal greater success.

The lack of parental involvement has led to the beginning of an increase in drug use in the early nineties. This has been coupled with the casual acceptance by youth of drug use among their peers. It is a disturbing change that compels us to find new ways to effectively involve parents before we lose the ground we gained in the eighties.

For many of our young adults, drug and alcohol use has been the result of confused community norms and a low self-esteem. Coupled with peer pressure, wrong choices somehow become a "socially acceptable" behavior among peers. This peer group pressure can be counter-balanced by a strong, informed parental, school and community stand against the use of drugs and alcohol to cope with growing up. Without this crucial parental, school and community involvement, healthy societal and family norms break down.

We cannot afford to let this continue. We cannot let our young adults sacrifice their futures…or their lives. Parents, schools and communities must work together to prevent drug and alcohol abuse.

National Red Ribbon Week, a universal prevention program, sets the stage to deliver selected and targeted prevention programs. Informed Families, the Florida affiliate of the National Family Partnership, has developed two additional programs which allow schools, parents and the community to work together to prevent problem behaviors. The programs are Community Action Teams (CATs) and Safe Homes/Safe Parties.

A Community Action Team (CAT) builds a team within the school and a neighborhood coalition around a school. Members of the team within the school include- students, teachers, administrators, coaches, parents, grandparents, counselors, cafeteria workers, and bus drivers. Members of the team surrounding the school include police, civic and religious leaders, doctors, lawyers, business people, and representatives of all the community's service providers. Each CAT assesses the needs of their particular school, selects from a menu of programs, or designs programs to implement and involve the school and surrounding community in drug awareness, prevention and education efforts.

The goals of the CAT program are to:

• Increase parental involvement in their child's school
• Increase communication between and among parents, school administrators, teachers and students
• Create a sense of community belonging for parents, administrators, teachers and students
• Educate parents and other adults about the alcohol/drug problems and other detrimental issues facing our children today
• Involve everyone in drug prevention solutions

Each CAT offers training in their school/community including but not limited to:

• Workshops based on the Health Realization Model developed by Roger Mills, Ph.D.
• Recruiting
• Group dynamics
• Strategic planning
• Information about alcohol, tobacco and illegal drugs
• Family management
• Parent peer groups
• Refrigerator News

Informed Families' Safe Homes/Safe Parties is one example of a select and targeted program the CAT may decide to implement. Through the Safe Homes/Safe Parties program, parents and others learn to set guidelines for their children's behavior. Parents sign a pledge stating that they:

• Will set guidelines for their children's behaviors
• Will not allow underage youth to drink alcoholic beverages or use tobacco or other drugs in their home or place of business
• Will not allow underage youth to have unsupervised parties or gatherings in their home or place of business
• Will encourage alcohol-free and drug-free parties and activities for underage youth

Safe Homes/Safe Parties pledge drives take place in schools where a designated individual collects hundreds of parent signatures. With permission from parents who signed the pledge, names and telephone numbers are published in a school directory. Directories are distributed to parents who now have a fast and reliable means for contacting each other.

Once the school directory has been published, parent peer groups are formed. Parents meet four times with set agendas including the latest research on teenage brain development, the influence of the media upon adolescents, the need for setting norms, and most importantly, defining and setting guidelines. You can visit the Informed Families site for more information on these programs.

Experiential education is powerful and acknowledged as one of the most important and effective forms of educating and training. Isn't it time we learned to fight fire with fire, work together, and design holistic coordinated programs to influence the individual, the peer group, the school, the family, and the community? We possess the knowledge, but do we possess the spirit and the quality of relationships to work together to help kids grow up safe, healthy, and drug-free? The Red Ribbon Campaign, October 23-31, offers us a time to demonstrate our team spirit and showcase our message. Together, we can help America's kids grow up safe, healthy and drug-free!

Media Literacy: Saving Children From Self-Hate and Destructive Behavior

By Dr. Peter DeBenedittis for The Bureau For At-Risk Youth

In mid-March, my friend and I sat in the front row of a minor league ballpark in Tucson, Arizona, watching a spring training game between the Diamondbacks and the Rockies. A woman in her early twenties sat next to us. She asked my friend if he liked her shoes, a pair of bright orange suede Adidas with nifty white stripes. He told her they were all right. Even though he affirmed her, she replied, "I know, but at least my socks are Nike."

By age 18 the average child in America has seen 100,000 commercials on TV. Counting logos, signs, promotions, and all the other mass mediums, this figure soars to nearly twenty million. Behind each ad exposure is a simple message that every child internalizes - you're a loser because you don't own this. No advertising tells us we're okay and don't need to buy anything. Advertising tells us we're uncool, missing what's in style, too fat, too bored, or too boring.

Although our political leaders choose to ignore it, over 4,000 scholarly studies have found that mass media causes societal violence. The Surgeon General wrote in 1972, that "the debate is over." Recent research has found that higher amounts of television viewing is correlated with underage drinking. Teens that see R-rated movies are three times more likely to drink and smoke. And despite all the blame that alcohol and tobacco companies put on parents they depict as not doing enough in their so-called prevention spots, advertising influences children to smoke twice as much as does peer pressure. The same holds true with alcohol. Grube & Wallach (1994) found that children who are more aware of beer advertisements have more favorable attitudes toward drinking, and are more likely to report an intention to drink beer once they are adults.

Media literacy is a powerful tool to inoculate youth against the destructive values being sold to them. The National Office on Drug Control Policy (June 2001) reported that "because the(ir) Campaign's entire strategy acknowledges the power and influence of media on America's youth, it is important and appropriate for the initiative to help young people develop their critical thinking skills by further investing in media literacy."

Media literacy is the ability to "read" television and mass media. Media literacy education teaches people to access, analyze, evaluate, and produce media. Children who understand the motivations and production techniques of media are less likely to adopt the unhealthy attitudes or behaviors that mass media depict.

What makes media literacy a powerful prevention tool is that it takes children's natural tendency to rebel, and redirects it towards those selling them addictive lifestyles. Media education represents a new and exciting approach to protecting youth from the unhealthy effects of media -- an approach that is not dependent on Hollywood's or Madison Avenue's willingness to accept responsibility for its programming and advertising.

In conversations with some of the 50,000 students I give presentations to each year, I continually hear about the impact media literacy education can have. I've had young girls break into tears after seeing me show how actresses and models are computer enhanced in such ridiculously fake ways. I've gotten letters from ex-smokers expressing their gratitude for saving their lives by showing how tobacco ads can manipulate teens into addiction. The impact of media literacy on prevention is more than anecdotal. Post-tests from tobacco prevention talks I gave show that a third of teen smokers attending make an immediate attempt to quit their habit.

At the 2000 Alcohol Policy XII Conference, I presented the results of a study that found a single 45-minute presentation deconstructing alcohol advertising led to significant changes in the social expectancies middle school students had about drinking. Several peer reviewed studies have been published that found similar results with children as young as the third grade. While at Washington State University, Erica Austin (1997) published two studies showing a change in children's intention to drink alcohol after a media education program. Participating students were less likely to rate alcohol ads positively, were less attracted to alcohol promotional material, and showed greater disdain for alcohol commercials

As with alcohol prevention, researchers are beginning to find that media literacy is an effective tool in helping prevent and treat eating disorders. Stormer & Thompson (1995) found that very brief instruction in media literacy given to women in college produced significant pre-to-post program reductions in appearance- and weight-related anxiety. The students were less likely to idealize the slenderness embodied by fashion models and actresses. Irving, DuPen, & Berel (1998) found that high school girls viewing a media literacy film on body image and discussing it reported less internalization of a "thin" beauty standard and lower perceived realism of media images than did their comparison group.

Media literacy education can also reduce children's susceptibility to violence. A study conducted with English 8- and 9-year-olds demonstrated changes in children's comprehension and awareness of media violence. In 1983, Huesmann, et al., found statistically significant changes in children's attitudes about media violence using media literacy. Their treatment simply consisted of two training sessions within a 2-week period where third graders wrote essays for a video about how harmful television violence can be.

Parents and teachers can take back control of the values being taught to our children. It doesn't take a lot of effort either to teach a child to be media literate. One study found that parents who talk back to their TV sets had children who were less likely to drink in their teens. The American Academy of Pediatrics has a wonderful website with tips for teachers and parents called Media Matters.

The beauty of teaching media literacy for prevention is that students love learning about media. Schools also embrace media literacy because, ultimately, students are being taught critical thinking skills. And if these are not reasons enough, the preventive value of media literacy is not substance or behavior specific. The media literacy skills used to deconstruct and build resistance to tobacco advertising are the same ones used to prevent underage drinking, violence, eating disorders and other risky behaviors. I encourage you to become a cultural revolutionary and begin to learn and promote media literacy.

Guidelines For Youth Tobacco Prevention

By Isabel Burk, M.S., CPP, CHES for The Bureau For At-Risk Youth

Smoking by minors continues to be a serous problem in America. Each day, approximately 6000 youth try a cigarette, and 3000 become daily smokers.

Are many students smoking? The University of Michigan's "Monitoring the Future" (MTF) school survey has been studying drug use of school-age populations for almost 30 years. The latest 2001 MTF data reported that 12.3 percent of 8th graders, 21.3 percent of 10th graders and 29.5 percent of high school seniors smoked cigarettes within the past 30 days. This is down from higher rates in the mid-1990s.

Cigarette smoking isn't a risk-free activity -- people who smoke cigarettes are more likely to engage in other risky behaviors. According to the John Hopkins School of Public Health, people who had been or were smokers were seven times more likely to have tried marijuana; seven times more likely to have tried cocaine; 14 times more likely to have tried crack; and 16 times more likely to have tried heroin, compared with nonsmokers. (Journal of Addictive Diseases, December, 2000.) These risks make it even more important to keep youth smoke-free through multiple prevention efforts.

Contrary to popular belief, a few cigarettes can affect an individual's entire life. Newly published research by the University of Massachusetts reveals that, for seventh graders, nicotine addiction can result from just a few puffs on a cigarette every other day for a couple of weeks. (Archives of Pediatrics & Adolescent Medicine, April 2002)

Tobacco prevention must start young and continue with consistent messages delivered through several modalities. Recent research demonstrates that fifth graders who knew about tobacco use by parents, siblings, and friends, and had easy access to tobacco in the home, were significantly more likely to be smoking by eighth grade. The strongest correlate of smoking in eighth grade was having a best friend who smoked. However, intention not to smoke in fifth grade predicted nonsmoking in eighth grade. (Journal of School Health, February, 2002.)

Parents are the first prevention educators, and the most effective, says the Partnership for Drug-Free America. Parental prevention messages should be simple and consistent, starting young. Pre-school is not too early to discuss your values related to tobacco and other drug use. Tell children that you value good health, and that tobacco can harm health. Make the point that smoking can compromise current and future goals, as well as impacting everyday activities by reducing lung capacity and increasing susceptibility to respiratory problems. For instance, a youngster who plays soccer should understand that smoking will make it more difficult to run and more difficult to play at peak performance.

Use television and movies as a good opportunity to bring up this issue. If a character smokes, that's a springboard for discussion. Remind youth that even if advertising and media depict smoking as glamorous and desirable, the reality is quite different. Negative points to include: most people do not smoke; high cost of cigarettes; helplessness of addiction; odor on breath, hair and clothes; prohibition of smoking in many places; impact on health, and quality of life.

Schools play an important role in tobacco prevention as well. Because youth look up to educators and counselors as role models, they are important allies and messengers. Schools and community agencies should have a clear policy on cigarette use and possession, enforced consistently. People on staff need training and periodic updates to help them implement and enforce the policies. When staff does not enforce the rules, this harms youth morale and undermines prevention, sending mixed messages.

Policy should be clearly communicated and reinforced often. Signs and posters can be utilized, but staff should also take the opportunity to discuss tobacco policy with youth several times during the year. When there is a policy violation, schools and agencies can invoke a range of consequences to help educate and guide youth into supportive programs and, hopefully, to the decision to reduce or quit smoking.

Coordinated school health programs that incorporate tobacco prevention can be effective. Schools should help teach, practice and reinforce student skills of assertiveness, setting goals, and resisting pressures. Review and repetition are critical to help youth become confident in these skills and abilities. Many schools have professionals to help with counseling and/or referrals to education and smoking cessation programs. Schools can also prohibit tobacco advertising, symbols and/or paraphernalia, to reduce exposure to these messages.

Youth groups and peer leaders can be very effective in influencing youth to remain smoke-free. Peer groups and peer leadership programs provide healthy role models and they are well-received. Peers can deliver prevention messages in ways that adults can't. Non-smoking youth leaders who are credible send the message that tobacco-free is respectable, acceptable, and fun.

Tobacco control media campaigns financed through tobacco settlement funds play an important role in reinforcing family and school prevention efforts. These big-budget advertisements compete with the tobacco industry's well-funded media campaigns.

Modalities such as posters, bulletin boards, websites, jingles, public service announcements, and others can keep positive, pro-health messages in front of the public, and send the message that tobacco-free is the norm.

Effective prevention starts young and continues through the life span. Risks arise at many points in life, and prevention efforts can be supportive and affirming for individuals considering their options at any age.

RESOURCES

DiFranza, J; Savageau, J; Fletcher, K; Ockene, J; Rigotti, N; McNeill, A; Coleman, M; Wood, C. Measuring the Loss of Autonomy Over Nicotine Use in Adolescents: The DANDY (Development and Assessment of Nicotine Dependence in Youths) Study. Archives of Pediatrics & Adolescent Medicine, April 2002

Johnson, CC; Li, D; Perry, CL; Elder, JP; Feldman, HA; Kelder, SH; Stone, EJ;, Fifth through eighth grade longitudinal predictors of tobacco use among a racially diverse cohort: CATCH. Journal of School Health, February, 2002.

Lai, S; Lai, H; Page, J; McCoy, C. The association between cigarette smoking and drug abuse in the United States. Journal of Addictive Diseases, 2000.

Alcohol Prevention: Staying In Front Of The Wave

By Stacia Murphy for The Bureau For At-Risk Youth

Too many kids are drinking -- just look at the most recent statistics. By the 8th grade, 52% of youth have tried alcohol; by the 12th grade, about 80% have used alcohol; nearly 7 million, or 19%, of persons ages 12-20 are binge drinkers; people who begin drinking before age 15 are four times more likely to develop alcoholism than those who begin at age 21; 31% of U.S. college students meet criteria for alcohol abuse and 6% are alcohol dependent.

Yet many people refuse to take the problem of underage drinking as seriously as they should. After all, they say, isn`t getting drunk with your friends part of growing up in America?

Unfortunately, while the majority of kids who drink do grow up to become healthy adults, use of alcohol greatly increases the chances that they will be involved in a car crash, homicide or suicide -- the leading causes of death for teenagers and young adults. In fact, a 16-year-old is more likely to die of alcohol-related causes than any other.

Adults also may be ambivalent about underage drinking because they think kids are drinking to relax or have a good time with their friends. What`s the harm, they ask, if they`re not drinking and driving?

Kids, however, aren`t "social drinkers" who enjoy a glass of wine with their meal or go to cocktail parties. Nearly 60% say they drink when they`re upset and nearly 40% drink alone. By the time they get to college, a large percentage of them have become "binge drinkers," which means they have had five or more drinks in a row during the past two weeks.

Kids typically begin using alcohol around the age of 13, long before their minds and bodies are mature enough to handle the effects of a powerful drug. Research shows that the earlier kids start drinking, the more likely they will be to develop a problem with alcohol or other drugs later in life.

Once kids start drinking, their world suddenly becomes a more dangerous place. Girls are more likely to be forced into unwanted sexual activity, which can result in pregnancy. Boys get into more fights and commit acts of vandalism that may escalate into more serious crimes. The academic and athletic performances of both sexes can suffer.

In short, if we care about the health of our children, we must do everything we can to discourage them from drinking for as long as possible.

When it comes to alcoholism, primary prevention is a little like surfing. It`s important to stay ahead of the wave if you want to reach the shore safely. Similarly, getting -- and staying -- out in front of the wave of substance abuse problems facing this country is the primary objective of prevention.

Primary and secondary prevention programs and policies are usually far more effective than tertiary prevention (treatment) in reducing the level or prevalence of a problem in society. Nonetheless, without effective and affordable treatment programs that reduce the suffering of individuals and make the costs of alcohol problems and alcoholism to individuals and society more widely known, society is often uninterested in prevention. Clearly, both prevention and treatment are needed.

Primary prevention actions are directed toward prolonging life and promoting health for the general public by helping the public reduce or prevent the incidence of new cases of alcohol-related problems and alcoholism. The goals of health promotion, risk reduction and disease prevention include:

• Changing social norms regarding drinking and intoxication.
• Educating the public, specific populations and individuals about the health risks and social consequences associated with alcohol consumption.
• Reducing the risk of alcohol-related problems and alcoholism among groups at high risk (e.g. adolescents, children of alcoholics, underserved and/or disadvantaged populations, groups with minority status, and people with limited economic resources and limited access to a range of health-care options).
• Reducing drinking in high-risk situations (e.g. drinking and driving, drinking and sports, drinking during pregnancy, drinking in combination with other drug use, drinking to alleviate stress, etc.).
• Delaying the age of onset of drinking.
• Acknowledging abstinence as a drinking choice among all groups.
• Increasing public awareness that alcohol is a drug.

Secondary prevention focuses on early detection of alcohol-related problems or alcoholism and intervention to arrest or interrupt the progression. In order to achieve these objectives, the following strategies have proven to be effective:

• Identify individuals for intervention and treatment.
• Identify high-risk groups for education and intervention (e.g. adolescents, children of alcoholics, underserved and/or disadvantaged populations, etc.).
• Promote community-based, culturally-relevant, age and gender-specific education and intervention programs and coalitions (e.g., schools, parents, media, clergy, health clinics, DUI).
• Support twelve-step programs with AA, Al-Anon, Alateen or Children of Alcoholics groups.
• Encourage educationally sound training programs for service providers (e.g., physicians, nurses, psychologists, social workers, teachers, clergy).
• Further the availability of Employee Assistance Programs and Student Assistance Programs.
• Promote research and evaluation of education and intervention approaches based on outcome among individuals, specific populations and the general population.
• Support research to determine biological and psychological markers.
• Advocate for referral services for those in need of intervention.
• Promote education to alert the public, particularly specific at-risk populations or groups, about early signs of alcohol problems and alcoholism and of services available.

While the issue of underage drinking is a complex problem, one that can only be solved through a sustained and cooperative effort between parents, schools, community leaders, and the children themselves, there are three areas which have proven to be effective in prevention of underage drinking: curtailing the availability of alcohol, consistent enforcement of existing laws and regulations, and changing norms and behaviors through education. In addition, the alcohol beverage industry has a responsibility to discourage underage drinking and to curtail advertising and marketing that appeals to underage youth.

As a society, we`ve got to do a far better job persuading our citizens and our young people that alcohol use is a dead end, that they are playing Russian roulette, not only with their own lives, but with the lives of friends, neighbors, and loved ones. Education and strong parental supervision are the ways to head off and heal the devastating consequences of underage and excessive drinking

To Test Or Not To Test

By Isabel Burk, M.S., CPP, CHES for GuidanceChannel.com

Over the past decade, schools have implemented new policies and procedures in an effort to prevent or reduce student drug use. On June 27, 2002, the Supreme Court ruled 9-4 in favor of a school district in Tecumseh, Oklahoma that required students to consent to random tests for drugs as a condition for participation in interscholastic extracurricular activities. This legal precedent has spurred many other districts to consider drug testing. This article will discuss some of the factors that schools should take into account as they deliberate this issue.

Before taking any action, schools should request a written opinion from the school attorney. Ask for a summary of relevant legal decisions, as well as any guidelines or additional information to keep in mind. For instance, the attorney can advise on confidentiality of results and record-keeping related to the drug testing of students. New federal rules on health records should be investigated to see how a drug-testing program might be impacted. In fact, if a drug testing protocol is adopted, policies and procedures should be reviewed by the school's attorney.

To help with the decision, form a committee of stakeholders to explore the issue. The committee might be composed of some school staff, parents, students, medical professionals, law enforcement, and community members. Work with the committee to determine the specific purpose of establishing a student drug-testing program. For instance, people may be concerned about student safety if participating in sports when under the influence. Or the school may wish to set up the program as a deterrent for students who want a specific reason to abstain from drugs. For example, the program will enable students to say, "We can't smoke pot because we'll get kicked off the team if we test positive." Articulating the goals in writing helps keep the committee on track.

Does random, suspicionless drug testing reduce student drug use? Only a few studies have examined this issue. The Office of National Drug Control Policy's guide, What You Need to Know About Drug Testing in Schools, summarizes some data and school experiences.

As with any important educational or health issue, data informs the decision. The committee should gather and review data to get a picture of student drug use. Look at the school's most recent student drug survey, noting which substances are the most commonly used and the ages of those who use. Many surveys also ask students where they use substances and at what time of day. Some surveys correlate drug use with participation in sports or other activities. If possible, compare the current survey with surveys from past years to see what trends are developing.

To get a more complete picture, contact local law enforcement and juvenile justice services to find out what substances have been most problematic. Hospitals and drug treatment centers can also be helpful. Sifting through this information can help the committee get a feel for which substances are most likely to be selected by the school population subject to drug testing. In light of the fact that drug tests look for specific drugs, it is helpful to know which drugs to look for -- and which methodologies can find these drugs.

Once drug patterns have been determined, it is time to investigate various types of drug testing. Contacting several vendors can help compare methodologies, costs, procedures and effectiveness. Urine tests are often utilized in the school setting. Note that urine screens don't tell if the individual is currently "under the influence" but a positive result indicates the individual probably used a specific drug within a day or two.

Urine tests are most often configured to check for use of marijuana, heroin/opiates, cocaine, amphetamines and PCP. Alcohol, the drug most used by youth of school age, leaves the system quickly, so standard urinalysis won't be able to detect it. If your student survey indicates widespread alcohol usage and very little other drug use, urinalysis might not be the most effective methodology for your school. Also remember that urine screening must be conducted in a specific manner to avoid tampering or contamination, requiring training of personnel and careful collection, handling, and transport.

Saliva testing is another drug screening methodology to consider. Compared to urine screens, collecting a specimen is less embarrassing for both the students and supervising adults. The 2002 U.S. Supreme Court decision involved urine testing, so it is best to check with the school attorney regarding saliva testing because court decisions, education law and other precedents may vary from state to state.

Discuss which groups of students would be included in the random testing program. Students who engage in athletics are often included, but some school drug testing programs also include students who enroll in extracurricular activities. Some schools even require random drug testing for anyone who wants a permit to park on campus.

Look at the big picture: would the drug testing take place every week, or twice a month, once a month, quarterly? Approximately how many youth would be tested at one time? In what manner will the students be randomly selected? How will consent be obtained? Who will be responsible for administering the program? Some vendors will conduct the entire procedure -- from selection to testing to reporting results -- as part of contracted services. Ask vendors about false positives or false negatives, and find out how they would verify tests to re-check any screen that shows positive. Medical consultation can be an important part of this process.

What happens if a student's drug test comes back positive? Step-by-step procedures should be developed for this event, including a process for appeals. Who informs the parent? Who informs the student? What records are kept and how is confidentiality assured? This is a sensitive issue that must be handled carefully.

The committee can work with school administrators to discuss the consequences resulting from a student testing positive. Some schools use this opportunity to confer with the parent regarding counseling or assessment for drug dependence. In some cases, the student is barred from participating in the activity for a period of time. In other cases, a school will allow the student to take additional drug tests to regain privileges if the results are negative. The entire process should be written out to eliminate gaps and ensure continuity.

After working through the decision-making process, the committee is ready to answer two questions:

• Is student drug testing appropriate for our needs, in our community?
• Is student drug testing a solid financial investment as compared to other strategies?

If random, suspicionless student drug testing is determined to be a viable strategy for your school, it must be approved by the Board of Education. A period for public comment may be helpful before the Board makes its final decision. A program that affects students should be well-publicized and carefully initiated so that everyone is aware of the goals, parameters, and implications. Schools should consider beginning with a pilot program, the refine the program and procedures as needed.

As with many sensitive issues, there is no one right answer. Each school and community must work through the process, examining the issues to discover what would be most effective for their particular situation.

RESOURCES

What You Need to Know About Drug Testing in Schools

National Federation of State High School Associations

The Center for Drug Free Sport

Drug-Free Workplace Programs (U.S. Substance Abuse & Mental Health Services Administration)

The Drug and Alcohol Testing Industry Association

Drug Testing News

The Truth About Club Drugs

By Isabel Burk, M.S., CPP, CHES for GuidanceChannel.com

In the 1980s the term club drugs was coined to label the drugs most often used at social sites such as late night dance clubs and raves. The drugs would typically be stimulants or hallucinogens, used by older teens and young adults to keep up their energy for partying all night. The term itself implies cachet, as if usage of these drugs constitutes entrée into a club, appealing to young people on several levels.

These exotic-sounding drugs burst into our national consciousness, prompting increased media coverage, increased abuse and increased parental concern. The increased attention spurred demand, which led to imitation drugs, lowered prices and widening availability. In turn, use of club drugs spread from the late night city club scene to wider availability at social venues and finally to gatherings at private homes, even in rural areas. Club drugs are used almost exclusively at night and on weekends, but the demographics and dangers have changed, as younger teens have easier access and more money to try drugs.

The US Substance Abuse and Mental Health Services Administration currently lists Ecstasy, LSD, GHB and Ketamine in the club drug category. (The Drug Abuse Warning Network Report, July, 2004) Their effects couldn`t be more dissimilar, but they are included in this category because they are often found on the club or social scene.

How widespread is the issue? The National Survey on Drug Use and Health reports that in 2002, 1.1 million people over the age of 12 tried Ecstasy for the first time, of which one third (371,000) were under age 18. Good news: new users decreased from the 1.8 million who first tried the drug in 2001. Bad news: mean age of first time users declined from 21.7 years to 20.7 years, the lowest mean age of initiation of Ecstasy recorded since the survey first reported Ecstasy use in 1976, revealing the ever younger age of beginners.

First time use of LSD is way down, too, dropping to 170,000 new users under 18 years old in 2002, almost half of the number who tried LSD in 2001. Again, mean age of first time users dropped for the third year in a row, to 17.1 years, the lowest mean age since the survey began in 1965.

The combination of stimulant, euphoric and psychedelic properties makes Ecstasy dangerous, but these same properties are desirable to youth. The small pastel colored tablets frequently sport cartoons stamped into the top, appealing to younger prospects as well. Fifteen percent of high school students and 15% of college students reported having used it at some time in their lives (University of Michigan Monitoring the Future/NIDA, 2001, 2003). Effects commence in about 30 minutes, can last 4-6 hours, and include increased energy, distortion of time and perception, muscle tension and/or spasms, increased blood pressure, increased heart rate, faster respiration, increased body temperature, and more. Ecstasy promotes Seratonin, the "feel good" brain neurotransmitter, so users get a powerful surge of euphoria. Dangers include problems with heat exhaustion, heart disturbances and stroke; in 2002, more than 4000 people ended up in the emergency room with Ecstasy-related problems. And after the drug effects wear off, users can experience disturbances with mood and memory that may linger.

Some Ecstasy users smoke marijuana, drink alcohol or use other drugs in an effort to modulate the intense effects of the drug. These polydrug users face increased risks of drug interactions and other unwanted effects. In fact, many users who buy club drugs may be unwittingly ingesting a variety of drugs. Drug trafficking has become more hazardous and expensive as a result of post-9/11 security measures, so the price of pure Ecstasy has increased, spurring adulteration and/or use of substitutes that mimic its effects.

Although Ecstasy grabbed the headlines, LSD use has held steady for half a dozen years, finally showing a definite decline in usage in 2003 among school-age youth as well as college students. Still, 14-15% prevalence confirms the continuing challenge of LSD. Onset of effects within 30 minutes and duration of effects up to 8 hours combines to make LSD a serious risk to health and safety, changing sensorial perception and interpretation, increasing heart rate, blood pressure and body temperature. LSD often enters the bloodstream via paper tabs rubbed on the skin as well as in liquid form. These tabs are commonly decorated with brightly colored images. In 2002, almost 900 emergency room visits were precipitated by LSD use, overwhelmingly by the young (76% were under age 26) and male (87% of patients were male).

Gamma hydroxybutyrate(GHB) morphed from an underground drug for bodybuilders to a predatory drug for potential rapists or robbers, and now includes users who want to modulate other drugs` effects. For decades, bodybuilders looked to GHB to put themselves into a deep sleep, thinking their bodies would secrete additional human growth hormone to make them stronger with bigger muscles.

At small doses, GHB reduces social inhibitions, similar to alcohol, and an increased libido. At higher doses, GHB`s pronounced sedative effects plus intoxication and mild euphoria are the desired counterpoint for those already under the influence of Ecstasy or stimulants. Effects are felt within 15 minutes of ingestion, lasting up to four hours.

Predators also rely on this combination of effects to disable victims. The odorless, colorless, almost tasteless powder is mixed into liquid (usually water) for drinking. Unwitting victims may not even notice the slightly thick consistency or slightly salty/bitter taste especially if they are already high from alcohol or other drugs. This used to be called "date rape" but is now termed "drug facilitated rape," a more accurate label.

It is possible to formulate GHB from inexpensive ingredients following recipes found on the internet. As with any illicit substance, GHB can contain dangerous substances introduced during development or trafficking, posing additional dangers to users.

Rates of prevalence of GHB abuse in the mainstream population have remained steady at under 2% for high school students since 2000, the first year NIDA included questions about GHB on its Monitoring the Future survey. But GHB dangers persist. In 2002, more than 3000 patients arrived in emergency rooms as a result of GHB complications. Doctors found multiple drugs in more than 2500 of these people, which can be deliberate (drinking while using drugs, for example) or inadvertent (purchasing adulterated drugs or being drugged without your knowledge.)

However, no reliable data exists to determine the prevalence of involuntary (predatory) incidents. Urine tests on victims may fail to find GHB because it clears the system rapidly. In fact, victims may not understand what happened to them, coming back to themselves hours later with fuzzy memories and woozy, disoriented feelings, and may never seek medical assistance at all.

A legal drug used for anesthetic or sedative purposes, Ketamine Hydrochloride, has been on the club drug scene for about a decade. Best known as "Special K" or "Vitamin K" when abused, this prescription drug (Ketalar®, Ketaset®) is legally used for pediatric anesthesia or by veterinarians for sedation of small animals. Ketamine can be swallowed, snorted, smoked or injected. So why would it be used in a social setting? First, perception that a legal drug might be safer and more potent than a street drug. Second, the unusual combination of effects: visual/auditory hallucinations and dissociation, resulting in users’ feeling detached from their body and senses, floating. And, as with most drugs, the thrilling feeling of taking risks.

The drug works quickly, as most anesthetics do, with effects in about 10-15 minutes, lasting up to about 90 minutes. Ketamine also facilitates rape, as it is somewhat easy to administer to an unsuspecting person, rendering the victim helpless for more than an hour.

The 2002 emergency room report listed 260 visits related to Ketamine, a significant decrease from the 679 reported cases in 2001. More than 68% of patients were under age 26, Only 20% of emergency room patients had a single drug in their body, with 80% having ingested multiple drugs.

Club drugs present unique challenges for prevention. Their wider availability, perceived prestige, and association with social/party behaviors appeal to an even younger target audience. Reinforcement of healthy family values, coupled with increased vigilance by parents, maintain positive expectations and guiding principles for youth. More than ever, parents need to become familiar with the local social scene, know the whereabouts of their children, and supervise gatherings. Settings and conditions of drug abuse continue to change, so we need to continue to learn and share knowledge about trends and risks in our neighborhood and community.

Parents can form informal networks to exchange information, discuss issues and work with community officials on drug prevention issues.

Since club drugs appear in headlines frequently, parents can use the news as an opportunity to open a conversation, discussing safety issues and family rules. Discuss the unglamorous side of club drugs: emergency room visits, victimization, etc. Note that drugs of abuse may pose significant danger when taken by a person with a medical condition, either exacerbating health issues or by interacting with prescription medications.

Club drugs will undoubtedly be a continuing threat, so we must keep ourselves positive and informed, in order to protect all our youth.

References

National Survey on Drug Use and Health, 2003

The Drug Abuse Warning Network Report, Club Drugs 2002 Update

Monitoring the Future 2003 from the National Institute on Drug Abuse