Section XIII Drug Education

In the Interim Report we made certain general observations concerning drug education. In particular, we suggested that it was necessary to tell the whole truth about drugs as far as humanly possible, that it was unwise to base drug education on a strategy of fear, and that drug education should be seen as part of general education for living. We said that the purpose of drug education should be to provide the basis for informed and wise personal choice. In a similar vein, we said that drug education, as part of general education, should have as its objective the kind of understanding that will permit an individual to live wisely, in harmony with himself and his environment.

Since the Interim Report we have attempted to learn about various efforts in Canada to develop programs in drug education and also to profit from experience elsewhere, particularly in the United States. In the last few years there has been a second look at drug education and the extent to which we can rely on it to achieve our objectives of social policy in relation to non-medical drug use. There has been difficulty in finding any broad measure of agreement on objectives, suitable content, and appropriate measures of effectiveness. In many quarters there has been severe criticism of current drug education efforts on this continent, and even scepticism about what we can hope to achieve with this form of social response.

The Commission conducted a survey of the drug education policies of provincial educational authorities and local school boards across Canada,1 made an in-depth study of the programs in certain schools,2 questioned students on their response to drug education,3 and identified some of the more innovative and promising programs' What the Commission learned from these studies is summarized here.

Provincial authorities provide general support and guidance for local school boards in the development of drug education programs, but programs are developed at the local level and vary considerably in their approaches. Programs are adapted to local circumstances and requirements. When the Commission made a survey of 584 local school boards in 1971 (of which 369 or 63% responded), less than half of the respondents said they had drug education programs or specific policies concerning drug use in the school.5 The proportion with drug education programs may be assumed to have increased considerably since then.

The two main goals of drug education programs, as reported by the local boards, were information and counselling. Approximately half of those replying said they wanted to provide students with sufficient information so that they could make their own decisions based on knowledge. Others said they wanted their students to know the dangers of drug use. About 20 per cent of the responding boards were interested not only in providing their students with information but in counselling them with respect to drug use, as well as general values and problems in living.

About two-thirds of the boards which provided drug education did so through the health education course of studies. About 20 per cent provided it in other subject areas, usually guidance, and the remainder presented it as a separate course of study.

As for methods, about three-quarters considered student counselling important. The same proportion favoured small discussion groups and information dissemination in the form of lectures and pamphlets.

With respect to selection and training of teachers for drug education, about half the boards which provided drug education thought in-service teacher training important and provided it. About half of these chose teachers on the basis of demonstrated empathy with students or because they volunteered, while the remainder simply designated certain teachers, usually those who taught the course of which drug education was a part. Resource personnel or materials used in teacher training, in the order of preference given by reporting boards, were the following:

1. physicians or other medical personnel;
2. printed or audio-visual materials;
3. law-related personnel, especially policemen;
4. a specialized agency, such as an addiction foundation;
5. former and current drug users;
6. students;
7. parents;
8, personnel from innovative services and street-workers.

With respect to evaluation, about one-third of the reporting boards said that they evaluated their drug education programs. The main method of evaluation was seeking the opinions of students as to the effectiveness of the program. About three-quarters of the boards considered their programs to be moderately effective or better. The degree to which certain criteria of evaluation were favoured by the boards was as follows: increase in students' understanding and awareness (94.1% ); increase in parents' understanding and awareness (64.7%) ; students with drug-related problems assisted (58.8% ); attainment of specified information level (47.1 % ); non-users deterred from starting use (41.2% ); overall decrease in drug use (29.4% ); overall decrease in harmful use of drugs (5.9% ).

The replies of the boards indicated that efforts in drug education were concentrated in grades seven to nine, although students in grades below and above this range were included by some respondents. Many of the drug education programs that came to the attention of the Commission were directed at junior high school students.

Researchers for the Commission conducted an in-depth study, by direct observation and discussion with teachers and students, of the drug education program in certain selected schools in a large metropolitan areas The study covered three high schools and one junior high school. The researchers concluded that drug education as a part of health education and physical education courses was a failure. The reasons given were that health education and physical education were regarded as "token" courses, and that the teachers were rarely found to be capable of dealing effectively with the topic of drugs and with the personal non-drug issues that surround drug use. The study was also critical of special programs of drug education in auditoriums with guest speakers and films, at which attendance was compulsory, and in which the tone was "strongly and naively anti-drug". Most teachers who were interviewed agreed that there was little chance of success with this approach. The study concluded that drug education should not be propaganda for the traditional culture nor be the indoctrination of a particular value position. Information in the form of short, free pamphlets was thought to be useful. The study stressed that drug education should be placed in a more general perspective, related to the other problems of personal adaptation with which students are more generally concerned.

The researchers were critical of certain aspects of the system of general education which, they felt, led to boredom and other states of mind conducive to drug use. In particular, they stressed that students should be given more free time to pursue study interests of their own, with assistance from the teaching staff. Emphasis was also placed on the need for a wide range of practical information. The study referred to this free period and the supporting organization for it as "The People's Period" and "The People's Department". It also suggested an "Information Rack" to provide information on such matters as drugs, birth control, family problems, personal counselling, welfare, legal aid, housing, venereal disease, and general medical clinics. Some of these suggestions were adopted and put into practice by a local school board during the course of the Commission's work.

A survey of the response of high school students to drug education revealed some interesting conclusions.? The first was that there was a low rate of response to (or interest shown in) questions about drug education as compared to questions concerning other matters, such as the students' backgrounds, their values, and their feelings about school life and their teachers. The main approaches to drug education reported by the students were special assemblies and films and lessons integrated into health or physical education classes. Only about six per cent of the responding students said that they were satisfied with their drug education programs, although about 48 per cent said they thought that drug education had increased their knowledge of drugs.

Students ranked drug education fourth as a source of information about drugs, well behind the first three choices: friends, television, and newspapers. The relative reliance on various sources of information differed according to the age of the students. More than 80 per cent of the students in junior high school grades relied on drug education to some extent, but only 25 to 30 per cent of the students in the senior high school grades mentioned it as a source at all. Almost 90 per cent of the senior high school students, but only about 60 per cent of the junior high school students, relied on their friends as one source of information. More of the younger students relied on their parents for information than did the older students, and more of the older students relied on their personal experiences for information than younger students did. (For a further discussion of this subject, see Section XIV The Mass Media.)

Almost three-quarters of the students said there was no teacher to whom they could, or would, go if they needed information about drugs. At the same time, about 70 per cent of the students thought drug information was available to them and that it would be useful. The kind of information that was most desired was information concerning the effects of drugs and the actual risks involved in various kinds of drug use.

As to the effects of drug education, slightly more than half of the students considered drugs other than cannabis to be more harmful after they had had drug education than they had thought before. The opinion of about a third remained unchanged, and the remainder considered the drugs less harmful than they had before drug education. Again there were variations according to the age of the students. Younger students were more likely than older students to consider the drugs more harmful than they had before drug education.

The most promising education programs which the Commission was able to identify in Canada place drug education in a broad perspective as part of the development of understanding about how to live effectively.8 There is emphasis on developing the capacity for finding viable alternatives to drug use. One program stresses the importance of "living skills". It suggests that the inability to avoid drug-related problems may be due in some measure to a poorly developed repertoire of the skills which enable the individual to fill free time with constructive alternatives to drug use.9

There has been little progress made with the problem of evaluation of drug education programs. Most of what is spoken of as evaluation consists of the impressions of a program's effectiveness from students and teachers. Indeed, there is some question as to how far there can be effective evaluation of drug education. We may test retention of information. We may test apparent effects of drug education on attitudes and behaviour. For this purpose, it would be optimal to conduct long-term follow-up studies with matched control groups, and even then we would be confronted with the very perplexing problem of assigning causal significance to the various factors which can influence or are otherwise associated with attitudes and behaviour. Although great emphasis is currently being placed on the necessity of evaluating drug education, adequate techniques for assessing its ultimate effects upon behaviour have yet to be developed and applied. In effect, we are presently acting on certain unverified assumptions concerning its efficacy with regard to various, often ill-defined goals and criteria.

These assumptions have been increasingly challenged in recent years, particularly in the United States, where, it is fair to say, there have been signs of growing disenchantment and even disillusionment with drug education. It is difficult to know how far the criticisms of drug education in the United States would be true of drug education in Canada. Our own impression is that there has not been in Canada anything comparable to the American proliferation of drug education materials, ranging in quality from apparently excellent efforts to obviously inadequate and possibly harmful programs. From all accounts, there has been in the United States such a great outpouring of inferior materials and programs that many have called for a halt or a "moratorium" on drug education efforts to give time for the selection of good materials and the development of wider agreement on objectives and methods. Characteristically, Americans appear to have embarked on a great variety of drug education programs with greater gusto than Canadians, with the inevitable excesses that such enthusiasm brings. Because of Canada's smaller population and fewer jurisdictions, it is easier for good drug education programs to gain in influence through imitation.

In addition to criticism of the quality of drug education materials and programs in the United States,1° there have been doubts raised about the efficacy of drug education as an influence on behaviour.11 Critics have said that we have placed too much reliance on it. They point out that information concerning the dangers of cigarettes has failed to bring about a significant decrease in the amount of cigarette smoking. These critics say that people's behaviour is not as much influenced by information as we might like to think. They point to more significant and longer-lasting influences in the personality and social background of the individual. There is also a suspicion that people may, by a process of "selective attention", avoid the impact of information that does not support their choice of behaviour. In other words, we cannot even be sure that the information reaches those for whom it is most appropriate. It has been observed, however, that we have not seriously begun to make use in drug education of existing scientific knowledge concerning the techniques of influencing behaviour.12

Apart from these questions concerning the positive efficacy of drug education, there is concern that it may often serve to arouse an unhealthy curiosity or interest in individuals who might not otherwise be attracted to particular forms of drug use. This is undoubtedly a danger in all discussion of forbidden things, particularly with young children. There is also the fear that while persons who are familiar with drug use are likely to have more credibility and therefore more effective educational impact than non-users, they may in many cases reinforce attitudes that are favourable to drug use.

Notwithstanding these doubts concerning the efficacy of drug education and these fears that it may sometimes produce harmful results, we believe that we should persist with it as one of several means of helping to develop the understanding and the capacity required to enable the individual to deal effectively with the personal challenges presented by drugs. As with any other kind of human problem, we have more to fear from ignorance than from knowledge in the field of non-medical drug use. Even if drug education is more effective in conveying information than in influencing attitudes or behaviour, its informational function is essential. Individuals cannot be said to be adequately equipped to make wise choices if they do not have the requisite informational basis. Helping our young people to develop an adequate understanding of the phenomenon of non-medical drug use in its essential implications for personal welfare is a duty that we owe to them.

At the same time, we must see the process of drug education in a much broader context than the formal program in the school system. We must not expect drug education in the schools to be able to overcome the lack of other constructive influences. Parents must be involved in drug education as well as teachers. Much of the knowledge about ourselves and how to live that is relevant to the ability to cope effectively with the challenges presented by drugs can only be imparted effectively in the home. This is the subject-matter of a later section of our report.

Perhaps a final word about fear is in order. When we said in our Interim Report that we did not think drug education should be based on a strategy of fear we had in mind a program that started out with the stimulation of fear as its objective. The notion of a strategy of fear implies that one will set out to inspire fear and to shape the message accordingly. Obviously, one should not distort the facts to produce fear, but if the facts objectively stated give rise to fear this is not a consequence to be avoided. We did not mean to suggest that fear resulting from a consideration of the objective facts was a bad thing.

There is a danger that in raising too great expectations or in being excessively critical about drug education we may inhibit or paralyse very worthwhile efforts. The same stimulation of self-doubt by a host of experts has played havoc in the field of child-rearing. It would be a pity if teachers were made unduly self-conscious or discouraged by all these second thoughts about drug education. It is very easy to set unreal standards. Only good can come from a teacher who sympathetically assists students to develop a greater understanding of themselves and the problems of effective living, of which drugs are only one aspect. What is important in the long run is not the detailed, technical knowledge (although this should be imparted as accurately as possible) but the understanding of self and the role which drugs play in our lives. We have to come to this understanding by ourselves; drug education is only one of several means by which we may acquire it. With all its limitations it can play a useful role if it is carried out with candour and an awareness of the extent to which our individual values will inevitably determine our choices. As we said in our Interim Report the goal cannot really be more than to assist the individual to see where his true personal interest lies. In the final analysis we have no alternative but to place our faith in the value of this kind of understanding.

Reference has been made in the preceding section to the federal role in relation to drug education.

NOTES
1. Fred Walden and Barbara Myers, "An Analysis of Resources and Services Provided by School System Drug Education Programs," Commission Research Project, 1970-71.
2. Jeff & Hadie Solway, "Drug Education, Information, and Services in Selected Toronto Schools," Commission Research Project, 1970-71.
3. Fred Walden and Barbara Myers, "Students and Drug Education," Commission Research Project, 1971.
4. Fred Waldon and Barbara Myers, "Analysis of Courses of Study in Drug Education in Elementary and Secondary Public Schools in Canada," Commission Research Project, 1970-71.
5. Barbara Myers, "Drug Education in Canadian Schools: Results of a Survey of School Boards," Unpublished Commission research paper on the Project referred to in note 1 above.
6. Jeff and Hadie Solway, "Report on High School-Based Drug Information, Education and Services," September 1970 and "The Crisis in Our Schools," April 24, 1971, Unpublished Commission research papers on the Project referred to in note 2 above.
7. Barbara Myers, "Toronto Students and Drug Education," August    1971,
Unpublished Commission research paper on the Project referred to in note 3 above.
8. Christine Lohoar and Barbara Myers, "Background Papers on Drug Education in the Schools," Unpublished Commission research papers (May 1971) on the Project referred to in note 4 above. The program Moods Substances People of the Toronto Board of Education has been adopted by several other Boards. Two of the most interesting programs have been introduced by the Calgary and North York (Toronto) School Boards; Kenneth Low, "Intoxicant Problem Avoidance Capability, Instructions (Living Skills)," Calgary, Alberta; M. H. Coffeng, "A Submission to the Commission on Approaches in Education to Drug Concerns," Borough of North York Board of Education, Ontario, summer 1972.
9. Kenneth Low, see note 8 above.
10. Peter G. Hammond, "Why Drug Abuse Education is Failing in America," Paper delivered at the 30th International Congress on Alcoholism and Drug Dependence, Amsterdam, September 1972.
11. Amitai Etzioni, "Human Beings Are Not Very Easy to Change, After All," Saturday Review, Vol. 55, No. 23 (June 3, 1972), reprinted in Grassroots (September 7, 1972, supplement); Richard H. Blum, "A New Perspective on Drug Education," Address to the National Coordinating Council on Drug Education, reprinted in Grassroots (August 1972, supplement); Seymour Halleck, "The Great Drug Education Hoax," The Progressive, 1970, Vol. 34, reprinted in Grassroots, (January 1972, supplement); John D. Swisher and Richard W. Warner, Jr., "A Study of Four Approaches to Drug Abuse Prevention," Final report on Project No. OB083, U.S. Department of Health, Education and Welfare, July 31, 1971.
12. Reginald G. Smart, "Factors in the Effectiveness of Drug Education," Paper delivered at the 30th International Congress on Alcoholism and Drug Dependence, Amsterdam, September 1972.