Within the last five years, nonmedical prescription drug use has skyrocketed among high school students and young adults, many of whom illegally secure opioids and painkillers from friends and relatives. The recent phenomenon has sparked questions among parents, educators, and lawmakers about how to best address what has become a significant public health issue.
The answer may be in the form of new drug prevention programs — including one titled Narcotics Overdose Prevention & Education (NOPE) — that are popping up across the country. These programs aim to challenge popular but dangerous messages that encourage drug use with tangible information about the dangers of prescription painkillers, as well as the stories of parents and students who suffered the consequences of poor decisions.
The Downingtown Area School District in Chester County, PA counts among the school systems planning to use NOPE this year. More than 500 students there recently listened to a recording of a mother’s frantic 911 call moments after she found her 17-year-old son’s lifeless body in the aftermath of his overdose. Members of the group later took turns holding the dead teenager’s urn and skimming through photos of other teenagers who died of overdoses.
“All of these kids were around our age. It felt personal,” Michael Senn, an 18-year-old senior at Downingtown High School East, told the Associated Press.
Lawrence Mussoline, the district’s superintendent, has also been meeting with local leaders and parents to discuss the best ways to combat drug abuse and peer pressure among high school students. He told Daily Local News that community input, as well as survey data from local adolescents about their drug use, will help school district officials implement programming that best equips young people with the information that will compel them to think twice before taking part in harmful activities.
This focus on opiate addiction via graphic, in-school presentations — which have so far taken place in schools in Pennsylvania and Illinois — signals educators’ and parents’ newest campaign against the ever-evolving threat of drug addiction. Lawmakers in New Jersey, New York, and Wisconsin have also proposed measures that require public schools to teach students more about opioid drugs.
After alcohol and marijuana, prescription and over-the-counter medication like Vicodin, Adderall, Valium, and Xanax are the most commonly abused substances among young people, according to the National Institute on Drug Abuse (NIDA). People who take these drugs at high dosages for nonmedical purposes risk health complications — including breathing issues and brain damage — and, in many cases, death, especially when they mix the substances with alcohol and other drugs. In 2013, prescription opioids caused more than 16,000 deaths nationally across all age groups, according to the Centers for Disease Control and Prevention (CDC).
Cindy Grant, the director of the Hillsborough County Anti-Drug Alliance in Tampa, FL, says that teens can easily access these medications because they don’t need to go through a dealer.
“It’s your mom’s medicine cabinet, your grandmother’s medicine cabinet, an ill family member,” Grant, whose son overdosed on prescription medication, told ABC Action News in 2013 during the rollout of the NOPE program in a local school district. “These kids are getting the prescription drugs from their own houses and having what they call ‘skittle parties’ in some instances. That’s when kids bring different prescription pills and then they put everything in a bowl and just take pills from it.”
The opioid abuse problem has gone beyond the medicine cabinets. As states have started to crack down on prescription drug abuse, some young people have turned to heroin as a cheaper and easier substitute. A National Institutes of Health survey found that nearly half of young people who use painkillers — particularly by crushing and sniffing them — eventually move on to heroin as their drug of choice. It isn’t any less harmful of an alternative: Heroin deaths increased by nearly 40 percent between 2012 and 2013, according to data collected by the CDC. The national death rate has been on the rise for nearly three years.
While educators and lawmakers across the country acknowledge the need for drug prevention programs, efforts have been stalled by an ongoing debate over how to effectively educate young people.
A large body of research has confirmed that the drug prevention programs of the 1980s and 1990s were ineffective, partly because the curricula relied on scare tactics that don’t convince people to avoid using drugs. The Drug Abuse Resistance Education, also known as DARE, was implemented in schools across the country for years despite the evidence that it does not lower the rate of drug use among young adults. In 2001, the U.S. Surgeon General designated DARE as an ineffective prevention program. The U.S. General Accountability Office later found that rates of illicit drug use didn’t change among students who underwent the 10-week DARE course.
Proponents of NOPE tout the program’s strategies as centered on the science of addiction, and less reliant on the scare tactics that fueled the “Just Say No” message of the Reagan and Bush eras. It tracks more closely with NIDA’s recommendations. That group defines an effective drug-prevention program as one that addresses all forms of drug abuse, tailors itself to specific populations, and includes family members and other support systems.
Students who enroll in NOPE learn about the dangers of prescription drugs through interactive computer programs in combination with presentations that have been approved by licensed psychologists, prevention professionals, and parents who lost children to drug and alcohol-related incidents — a total deviation from what DARE has offered. NOPE instructors also teach students about the symptoms of a drug overdose so they can recognize when to seek medical attention.
That may please critics of previous anti-drug programs who have previously spoken out against the strategies employed under DARE.
“Often, administrators adopt school-based drug-prevention programs and continue to use them as long as they are funded, with little attention paid to their long-term effectiveness,” Lisa L. Sample and Crystal Fuller wrote in a 2013 article in which they stressed the need for more student self-reported surveys and program evaluation. Sample and Fuller, who are public policy and substance abuse experts respectively, say a “one size fits all’ solution to drug addiction won’t work.
“What all of this means is that if we wish to take a truly effective approach to drug use prevention, we need to be mindful of the variations and changes over time in children’s drug-use behavior and continually alter program components to address emerging trends,” they continued. “School-based drug-prevention programs are needed. As resources for prevention programs in schools decrease, it is imperative that the resources that remain be used effectively rather than allowing existing programs to continue unchanged or creating new one-size-fits-all programs based on local anecdotes and myths.”