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The Citizens' Drug Prevention Movement

The drug-prevention movement led by private citizens and nonprofit organizations began in the mid-1970s with parents who were concerned about the health and safety of their children. During this decade, drug use among American adolescents escalated from relatively low levels to the highest levels in the history of the world. Some young drug users were addicted and needed treatment. Others were in trouble with drugs but had not yet become addicted. Some were dying of drug overdoses and many were being killed in alcohol- and drug-related automobile crashes.

Many social and environmental factors appeared to contribute to the escalation in the use of alcohol and other drugs among the young. Parents organized to address these factors in order to prevent drug use among young people. In many cases, youth groups also formed to help parents prevent substance abuse among their peers.

Media groups soon organized in response to parents' concerns about the glamorization of drug use on television, in films and in song lyrics, and, more recently, on the Internet that influenced young people. A few years later, the advertising community initiated a campaign to design and air commercials with strong anti-drug messages targeted to children and adolescents.

A drug-related tragedy on the aircraft carrier Nimitz, in which many young servicemen were killed during routine practice maneuvers, brought the military into the prevention movement. It instituted universal drug testing to ensure that such an event would never happen again. The business community adopted drug-testing policies similar to those initiated by the military to prevent drug use in the workplace, particularly in jobs that involved public safety.

Educators and researchers concerned about drug use in primary and secondary schools and on college campuses developed school-based approaches to drug prevention. The law-enforcement community added its voice to the prevention effort through community-policing programs. It also joined forces with the education community through efforts such as DARE (Drug Abuse Resistance Education), in which police officers teach DARE's drug-education curriculum to students in elementary, middle and high schools, and to their parents.

Local, state, and national political leaders created policies and allocated resources to stem the flow of drugs into the country and to help people prevent substance abuse in their families and communities.

Specific ethnic and cultural groups created prevention groups as well. They focused on strengthening their communities through a renewed appreciation of their respective heritages and building on the resiliency that had enabled them to survive the long-term, debilitating effects of racism and poverty.

Seeing the opportunity to contribute its considerable strength and human resources, the faith community also initiated drug-prevention programs. When researchers established the links between substance abuse and the transmission of HIV/AIDS, the AIDS-prevention community joined hands with the substance-abuse prevention community.

Community partnerships and coalitions formed to bring all parts of the local community together to develop and implement substance-abuse-prevention strategies collaboratively.

The citizens' drug-prevention movement continues to expand at this writing. Each component that joins it seeks to create communities in which individuals and families can live healthy lives free of drug abuse and addiction and the problems they generate.

THE PARENT MOVEMENT

Parents initiated the prevention movement in response to the escalation of drug use among teenagers throughout the 1970s. Surveys conducted by the government indicate that in 1962, just seventeen years before drug use peaked at the highest levels in history, less than 2 percent of the entire U.S. population, and less than 1 percent of adolescents, had tried any illicit drug. By 1979, when the use of most drugs peaked, twenty-four million Americans used drugs regularly. Seventy percent of young adults (ages 18-25), 65 percent of high school seniors, and 34 percent of youth (ages 12-17) had tried an illicit drug. Even higher rates of use occurred with alcohol and tobacco. Ninety-five percent of young adults, 93 percent of seniors, and 70 percent of youth had tried alcohol, while 83 percent of young adults, 74 percent of seniors, and 54 percent of youth had tried cigarettes. One in nine seniors smoked marijuana daily.

Several social and environmental factors appeared to be contributing to this escalation in drug use among young people.

Between 1972 and 1978, eleven states decriminalized marijuana. The political rhetoric that accompanied the decriminalization effort tended to deny or minimize the harmful effects of marijuana and other drugs. State governmental action that equated penalties for marijuana possession with that of a traffic violation tended to reinforce this denial. Most people thought that state legislatures would not make marijuana more available through decriminalization if it were truly harmful.

Prevention research in the early 1970s persuaded some that drug education did not reduce drug use, and government funding for drug education materials ceased. This created a vacuum that was filled by decriminalization advocates and those who stood to profit from increased illicit drug sales. A great deal of the educational materials available throughout the 1970s taught people how to "use drugs responsibly," rather than teaching them what scientists were learning about the harmful effects of drugs. These materials tended to promote drug use rather than prevent it.

As states decriminalized marijuana, an industry emerged to assist people in their drug-taking. This industry manufactured drug paraphernalia—toys and gadgets designed to enhance drug use—and sold it in "head shops," places where so-called "pot heads," "acid heads," "coke heads," and other drug users could go to buy implements to help them take drugs. Head shops also sold promotional materials and "starter kits" targeted to young aspiring drug users. By 1977, some 30,000 head shops were conducting business across the nation.

Each of these factors helped drive drug use up among children and teenagers. Parents organized to help young people who were using drugs stop using them through education, prevention, counseling, or treatment. They also sought to prevent nonusers from starting in the first place, and to reinforce those who decided not to use drugs by emphasizing the desirability of living drug-free lives. Groups that led this effort included the Parents Resource Institute on Drug Education (PRIDE), National Families in Action, the National Federation of Parents for Drug-Free Youth, the American Council on Drug Education and Committees of Correspondence, as well as state groups, such as Texans War on Drugs, Florida Informed Parents, Tennessee Families in Action, and Alaskans for Drug-Free Youth, to name a few, and thousands of local groups in cities, towns, and counties across the country.

Parent groups targeted the social and environmental factors they felt were contributing to the escalation in drug use among young people and developed strategies to address those factors. They did this by first establishing clear definitions. They defined drug abuse to include all illegal drugs and all legal drugs and substances used illegally. These latter included alcohol and tobacco for those under the legal purchasing age, as well as medicines, glue, gasoline, and other substances people abused. Then, parent groups set clear goals: To prevent use before it started, to persuade users to stop and to help those who couldn't stop, find treatment. For alcohol, the goals were slightly different: To prevent use before the legal drinking age, to persuade those who chose to drink when they reached the legal drinking age to follow low-risk drinking guidelines, and to help those who were addicted to alcohol find treatment.

To achieve these goals, parent groups developed several strategies. They mounted an intensive effort to obtain laws to ban the sale of drug paraphernalia. Over a four-year period they succeeded in getting such laws passed in several communities and states. By 2000, nearly every state had such laws. Challenges to the paraphernalia laws were brought by the National Organization for the Reform of Marijuana Laws (NORML), which argued that they were unconstitutional. Many of NORML's board members were also members of the drug-paraphernalia industry. However, in the early 1980s after several conflicting rulings issued by federal district and appeals courts across the nation, the United States Supreme Court upheld these laws as constitutional. This ended the joint effort between NORML and the paraphernalia industry to defeat the paraphernalia laws.

NORML also led the marijuana decriminalization movement. Between 1972 and 1978, the organization persuaded eleven states to decriminalize marijuana. The parent prevention movement stopped this effort: Parents prevented additional states from decriminalizing after 1978, and defeated a federal effort to decriminalize marijuana nationwide. In some decrim states, such as Alaska, parents worked to re-criminalize the drug, after surveys showed that marijuana use among young people was considerably higher in decrim states than in non-decrim states.

Parent groups placed primary focus on ensuring that drug-education materials convey a no-use message, rather than recommending the "responsible use" of drugs that were both illegal and harmful. They did this by going to the medical and scientific literature and insisting that drug-education materials reflect what was reported in that literature about drug effects.

These strategies seemed to have contributed to the peak and then steady decline in drug use among adolescents, young adults, and the entire population since parents first initiated the prevention movement. The Monitoring the Future Survey, conducted by the government annually since 1975, shows a direct correlation between rates of use and young people's belief that drugs are harmful. The more students who believe a specific drug will hurt them, the fewer students use that drug. Sadly, for reasons not yet fully understood, the steady rise of high school students who perceived drugs to be harmful leveled off and began to decline in the early 1990s. As a result, the steady decline in drug use over fourteen years reversed shortly after. Starting in 1993 student drug use once again began rising and doubled throughout the decade.

A re-emergence of calls for drug decriminalization and legalization worries prevention advocates. This effort was being led once again by NORML and by other organizations that emerged from NORML, including the Drug Policy Foundation and The Lindesmith Center. Many leaders of these organizations were once active in NORML. The glamorization of drug use in song lyrics and films was also reappearing, as were claims by legalization proponents that people can use highly addictive drugs "safely." Whether these shifts in environmental conditions were contributing to the turnaround in drug use was not yet clear. Nor was it clear whether the rise in drug use among high school students was a temporary aberration or a permanent trend. Nonetheless, the prevention community has redoubled its efforts to ensure that drug abuse resumes and sustains it downward trend.

THE ANTI-DRUNK-DRIVING MOVEMENT

At the same time the parent drug-prevention movement was targeting illicit drug use and the problems it generated among young people, another group of parents and families took aim at the problem of drunk driving and the devastation it was creating on the highways, particularly among young people. At the time, deaths from alcohol-related crashes were so prevalent that drunk-driving crashes had become the leading cause of death among adolescents. Families of many young people whom drunk-driving crashes had killed organized groups such as Mothers Against Drunk Driving (MADD), Remove Intoxicated Drivers (RID), and Students Against Drunk Driving (SADD) (now Students Against Destructive Decisions) to stop the carnage on the highways. As with the parent-led, drug-free movement, parents who led the anti-drunk-driving movement first raised the nation's awareness about the problem and then developed strategies to address it.

Among the many contributions this movement has made, perhaps the most significant deals with the age at which young people may legally purchase and consume alcohol. For many years the legal drinking age in every state was twenty-one. During the Vietnamese War, however, when young men aged 18 and over were drafted into the military, most states lowered their legal drinking ages to eighteen in the belief that if young men were old enough to fight for their country, they ought to be old enough to drink. The unanticipated consequence of this action, however, was to further drive down the age at which young teenagers and even pre-adolescents were able to purchase alcohol, albeit it illegally. This led to the appalling rise in the number of young people who were killed in drunk-driving crashes.

As anti-drunk-driving groups tried to persuade state legislatures to return the legal drinking age to twenty-one, their efforts were consistently defeated, year after year, by the alcohol industry, which had considerably more dollars to spend lobbying against such an action. In many states, drug-free parents groups joined forces with MADD, RID and other parent-led, anti-drunk-driving groups, but to no avail. What broke the log jam was MADD's strategy of advocating for a federal bill that would deny federal highway funds to states that refused to increase the drinking age to 21. Although the alcohol industry also succeeded in defeating the federal effort for several years in a row, the anti-drunk-driving forces finally over-whelmed the industry, and Congress passed the federal bill.

Faced with the loss of federal highway funds, nearly all states have raised the drinking age to twenty-one. The U.S. Department of Transportation estimates changes to the drinking age laws have saved some 13,000 teenage lives to date. Furthermore, when MADD, RID, and similar groups first organized, some 52,000 Americans were killed on the highway each year. About half of those deaths, 26,000, were due to alcohol-related crashes. By the year 2000, both highway deaths and those caused by drunk-driving had been reduced considerably.

These groups continue to work to reduce drunk-driving and the problems it generates by advocating for better enforcement of existing laws, passage of new laws, and effective methods to mandate repeat DUI offenders into treatment.

THE MEDIA

In response to parental concerns about the glamorization of drug and alcohol use in films and on television, several groups organized to address these concerns. The family of actor Paul Newman founded the Scott Newman Center in memory of Mr. Newman's only son, Scott, who died of an overdose of alcohol and drugs. The Center bestowed awards to producers and writers who created television programs and films that contained strong no-use messages and that enhanced the public's understanding of substance-abuse issues and ways to deal with them successfully. The Entertainment Industries Council has advanced this strategy with its PRISM Awards, conducted in partnership with the National Institute on Drug Abuse. The Council also developed programs to work with film makers to educate them about the issue of substance abuse and to encourage them to de-glamorize drug use in movies. The National Academy of Television Arts and Sciences implemented strategies to enhance the industry's awareness of the impact it could have in reducing substance abuse through the power and reach of the mass media.

In the mid-1980s, advertising and public-relations agencies formed the Partnership for a Drug-Free America. These agencies volunteer their talent and time to create and produce anti-drug commercials targeted to young people. The Partnership originally solicited free air time and space in the electronic and print media in which to place these commercials and ads, securing several billion dollars worth of media placement for the anti-drug messages it created. In the late 1990s, after media interest in drug abuse waned and coverage of the issue plummeted, the Partnership and the federal government joined forces. Congress appropriated $195 million over five years to purchase time and space in the media to conduct a public-education campaign to prevent drug use among young people. The campaign appeared to be working, driving drug use down 21 percent among adolescents between 1997 and 1999.

ETHNIC AND CULTURAL GROUPS

The introduction of crack in the mid-1980s made cocaine cheap and plentiful and brought illicit drug use and addiction into poverty-stricken communities that had heretofore succeeded in avoiding massive use of illicit drugs. Members of African American, Hispanic and Latino, native American, and Asian American communities organized to prevent drug use, drug addiction, and drug-related crime in their communities. The passage of the first Anti-Drug Abuse Act of 1986 assisted this effort. With it, Congress made demonstration grants available to local groups to prevent substance abuse among youth at high risk of becoming involved with illicit drugs.

The resulting movement mounted intensive efforts to confront the consequences of poverty and racism. One consequence was to have made poor communities more vulnerable to drug use and the health and social problems it created. Ethnic and cultural groups organized to confront these problems, helping addicts find treatment and reclaiming their communities from drug dealers. They also address other environmental factors, taking aim at the tobacco and alcohol industries' efforts to target ethnic communities for increased consumption of their products. They have defeated the introduction of new brands of cigarettes and alcoholic beverages targeted to African Americans and Hispanics and Latinos. Campaigns to eliminate the disproportionately high numbers of alcohol and tobacco billboards located near schools and churches in inner-city neighborhoods have resulted in outright bans of such advertising in at least two American cities, Baltimore and Cincinnati.

COMMUNITY PARTNERSHIPS

In 1989, the Robert Wood Johnson Foundation invited communities to submit proposals to establish Community Partnerships, bringing together all segments of the community—parents, young people, schools, ethnic and cultural groups, religious institutions, businesses, local governing bodies, and social and civic organizations—to reduce substance abuse. So many communities responded to the foundation's invitation that the government arranged for $100 million in assets seized from drug smugglers to make even more funds available to communities to establish partnerships to prevent substance abuse and related problems.

As the community coalition movement grew, the Foundation funded Community Anti-Drug Coalitions of America (CADCA) to lead it and join together, to provide technical assistance to coalitions and others. The Foundation also funded the Center on addiction and Substance Abuse at Columbia University to conduct research on substance-abuse issues.

Most authorities credit the activities of this sustained grass-roots, drug-prevention effort, as well as strategies implemented by federal, state, and local governments, with contributing to the reduction in drug abuse, drug addiction, and drug- and alcohol-related deaths that have occurred since the late 1970s. While drug use has increased since 1992, these increases in most cases are still below the levels of 1979. Reductions since then include the following:

• The number of Americans who are current users of illicit drugs was cut in half, from 24.0 million in 1979 to 11.0 million in 1992. The 1999 National Household Survey on Drug Abuse shows that current drug use rose to 14.8 million by the end of the decade. Current cocaine use, which peaked in 1985, dropped from 5.8 to 1.3 million in 1992, and rose to 1.5 million in 1999. Daily marijuana use by high school seniors dropped 500 percent: from 10.7 percent in 1979 to 1.9 percent in 1992, and rose to 6.0 in 1998. Alcohol-related traffic deaths have been reduced from 26,000 to 15,935 per year.
• Table 1 shows drug use among young adults (18-25), high school seniors, and adolescents (12-17) in the peak year (1979), the lowest year (1992), and in 1999.

SUE RUSCHE