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Substance Abuse: Treating the Addicted Teen Client
Prevalence of In-School Substance Use
Teachers and principals are aware that their schools are not drug-free zones. During the 1990s, the U.S. Department of Education conducted various surveys asking teachers and other school staff about the level of safety and discipline in their schools. In a 1991 survey, 10 percent of high school teachers indicated that students' substance use interfered with their teaching (Mansfield, Alexander, & Farris, 1991). In 1998, one-third of all principals surveyed regarded substance use as a significant problem in their schools (Heaviside, Rowand, Williams, & Farris, 1998).
Students are even more aware of the presence of drugs and alcohol in their schools. In a 2000 study, only 42 percent of public school students surveyed regarded their schools as free of drugs (Califano, 2001). Another study found that half of all high school students surveyed had observed their fellow classmates impaired by drugs or alcohol during school hours (Nolin, Vaden-Kiernan, Feibus, & Chandler, 1997). And a current national estimate shows that 29 percent of students in grades 9-12 reported that drugs were made available to them on school property (DeVoe et al., 2002).
Why Do Students Use Substances in School?
Weak attachments to school Some students turn to drugs and alcohol when their attitudes toward school begin to deteriorate. Research has shown that students who are less "bonded" to school are less likely to succeed academically and more likely to engage in disruptive or delinquent behavior, including substance use (Finn, 1989; Hawkins, Catalano, & Miller, 1992). Research has already shown that students with weak attachments to school are more likely to engage in substance use outside of school (Bucholz, 1990; Califano, 2001; Dryfoos, 1990). A recent study has now addressed the question of whether school belonging is associated with in-school substance use. Through surveys of more than 200 high school students, the study found that those who had little attachment to school and devalued its importance were more likely to use substances at school than were students who had an attachment to school (Voelkl & Frone, 2000).
Interviews with students revealed that students generally found it easy to indulge, unnoticed, in substance use in school. But they also said that the knowledge that they might be caught by school officials would serve as a strong deterrent. Thus, teachers must be more sensitive to possible student drug use in order to reengage students who have withdrawn from the learning process, and school administrators must reduce students' opportunities to buy, use, and sell drugs on school grounds.
Opportunity. Research shows that schools and students facilitate substance use at school. Schools, for example, often unwittingly provide both the venue and the opportunity for drug use. In one recent national survey, 36 percent of students between the ages of 12 and 19 reported that marijuana was easy to get in their school building, on school grounds, or on a school bus (Chandler, Chapman, Rand, & Taylor, 1998). According to the U.S. Departments of Education and Justice, 30 percent of students in grades 9-12 reported having drugs offered or sold to them on school property in 1999, an increase of 6 percent since 1993 (Kaufman et al., 2001).
School personnel may be unaware of the extent to which these substances are available. In 1997, the Center on Addiction and Substance Abuse reported that 41 percent of students surveyed had witnessed drug sales on school grounds, compared with a mere 12 percent of teachers (Califano & Booth, 1997). More recently, the Center found that 35 percent of teachers surveyed said that their schools were not free of drugs, compared with 66 percent of students (Califano, 2001). Are these differences surprising? Not really. Substance use and selling do not generally occur in classrooms or busy hallways. Building administrators do not always have time to patrol the corridors and public areas, and teachers are tied to their classrooms for most of the day. And students who are predisposed to use alcohol and drugs at school are most likely to do so when they believe that their acts will elude detection (Voelkl & Frone, 2000).
Effects of In-School Substance Use
But what do we know about the specific effects of in-school substance use on academic performance? First, substance use at school clearly interferes with the learning process. Students who are impaired by substances during school are less able to pay attention, take notes, participate in group tasks and class discussions, and take tests. And in-school substance use is likely to have a ripple effect, beginning with inappropriate classroom behavior that impedes learning and extending to attendance problems and, in extreme cases, to violence. In fact, adolescent substance users are two to three times more likely to be involved in physical fighting than are nonusers (Dukarm, Byrd, Auinger, & Weitzman, 1996). Fagan notes, Among contemporary explanations of violence and aggression, few have been more enduring than the presumed effects of intoxication from drugs or alcohol. (1990,p. 241)
In an ongoing study, we are exploring the connection between two types of alcohol use--"general" and "school-related"--and two types of aggression in school--interpersonal aggression and vandalism. The study is based on the responses of 208 students in grades 11 and 12 in public high schools. Twenty-four percent of the students reported using alcohol at school during the past year, and 75 percent had used alcohol outside of school. Overall, 63 percent of the students surveyed reported fighting with fellow students and 45 percent reported fighting with teachers; almost 25 percent claimed that they had damaged or stolen school property during the past school year. Preliminary results show that whereas alcohol use outside of school is not related to either interpersonal aggression or vandalism at school, in-school alcohol use is associated with both (Finn & Frone, 2002). Clearly, schools must address these special problems to function effectively.
First, educators need to become aware of and respond to disaffected students. Teachers and other school staff should look for warning signs--for example, frequent class-skipping and poor academic performance--and intervene when necessary. Researchers must also identify ways to increase students' attachment to school and their classes. These strategies may include classroom activities that increase student participation, schoolwide programs that encourage student involvement in extracurricular activities or school governance, and individual and group counseling activities. These programs will help students feel invested in their schools and education.
Second, school personnel must limit the opportunity for substance use through increased monitoring of places where students traditionally sell and use drugs and through more effective intervention. Current interventions to control substance use range from assemblies that highlight the dangers of drinking and driving to motivational speakers who encourage students to "just say no" to drugs, to more systematic programs that educate students about the dangers associated with substance use. Some school-based prevention programs have shown positive results, but many have had only limited success. For example, the Drug Abuse Resistance Education (D.A.R.E.) program has recruited law enforcement officials to help educate 5th graders on the dangers of drugs and to help students develop the skills and self-confidence to reject drugs. The program has thus far had a limited impact, however, and D.A.R.E.'s own Web site admits that
It is probably unrealistic to expect one "dose" of any primary prevention program to prevent an outcome as complex as drug use.... The impact of D.A.R.E. on long-term drug-use prevention is not well supported. And according to one national report, about half of school-based prevention activities are of such poor quality that they cannot reasonably be expected to make a difference in levels of problem behavior. (Gottfredson, Gottfredson, & Czeh, 2000, p. 15)
At the same time, schools have effectively implemented some research-based programs, such as the Life Skills Training Program, a three-year classroom program at the middle and junior high school level, and the Reconnecting Youth Program, which targets students in grades 9-12 who show signs of poor achievement and the potential to drop out. The National Institute on Drug Abuse has identified these programs as showing positive results and reports that they effectively promote resistance, self-management, and social skills training (2001).
More research is necessary to support effective programming and help schools improve their drug prevention curriculums. Courses that span multiple grade levels and make use of respected role models are more likely to be effective, as are education programs that target at-risk students more intensely during the high-risk transition periods between elementary and middle school and between middle and high school.
Research on the broader effects of disciplinary codes, including zero-tolerance policies, is also a must. The severity of zero-tolerance policies may have the unintended effect of exacerbating substance use because offending students do not receive drug treatment or counseling. Students who are removed from school are often not rehabilitated and have little motivation to return to school. And students who know about their peers' drug use are often reluctant to approach school personnel for help because they fear their own expulsion, for good reason. One New York State high school recently suspended 15 students for having attended parties where marijuana was present, regardless of whether they used it or simply saw others using it (Cervantes, 2002).
Finally, educators and researchers need to pay special attention to the impact of in-school substance use on students who abstain from using drugs or alcohol at school but may be confused or frightened when exposed to those substances at school. They may have difficulty concentrating on class-work, be less motivated to succeed in school, or be reluctant even to come to school. The only way to ensure that all students enjoy a safe and drug-free school environment is to pay serious attention to both the direct and indirect effects of in-school substance use and then to use those Findings to develop realistic and effective solutions.
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