Youth Illicit Drug Use Prevention: DARE Long-Term Evaluations and Federal Efforts to Identify Effective Programs

The use of illicit drugs, particularly marijuana, is a problem among our nations youth. The adverse effects of illicit drug use play a role in school failure, violence, and antisocial and self-destructive behavior. A recent national survey1 showed that for 1996 through 2002, more than 30 percent of tenth and twelfth grade students reported using marijuana in the past year. Further, about 20 percent of high school seniors reported using marijuana within the past 30 days. In fiscal year 2000, the federal government spent over $2.1 billion on illicit drug use prevention activities for youth, according to the Office of National Drug Control Policy (ONDCP).

Many programs are designed to help prevent and reduce illicit drug use among youth. Often, these programs also address the use of other substances, such as alcohol and tobacco. Youth drug abuse prevention programs are implemented in school, family, and community settings. School-based prevention programs are the most prevalent because schools provide easy access to children and adolescents. The most widely used school-based substance abuse prevention program in the United States is the Drug Abuse Resistance Education (DARE) program,2 which is funded by a variety of sources, including private, federal, and other public entities. DAREs primary mission is to provide children with the information and skills they need to live drug- and violence-free lives through programs at the elementary school, middle school, and high school levels. The DARE program is usually introduced to children in the fifth or sixth grade. According to research literature, concerns have been raised about the effectiveness of the DARE fifth and sixth grade curriculum in preventing illicit drug use among youth. As agreed with your staff, this report contains information you requested on (1) the results of evaluations on the long-term effectiveness of the DARE elementary school curriculum in preventing illicit drug use among children and (2) federal efforts to identify programs that are effective in preventing illicit drug use among children.

To identify evaluations on the effectiveness of DARE at preventing illicit drug use among children, we searched social science, business, and education databases, which included the Department of Health and Human Services (HHS) National Institutes of Healths (NIH) National Library of Medicine, for evaluations of DARE published in professional journals. We identified articles published in the 1990s on six evaluations of the DARE elementary school curriculum that included illicit drug use as an outcome measure and that also met key methodological criteria for our review, such as a long-term evaluation design and the use of intervention and control groups for comparisons. The six long-term evaluations that we discuss in this report were conducted at different times up to 10 years after student participants were initially surveyed. The six evaluations are based on three separate studies in three states. We reviewed each of the six evaluations and summarized the results of our review. We also held discussions with the researchers who conducted the evaluations. We did not independently validate the research designs or verify the results of evaluations on the effectiveness of the DARE program. (Enclosure I contains citations for the articles on evaluations of the DARE elementary school curriculum that we reviewed and enclosure II describes the methodology we used to select the evaluations).

To determine federal efforts to identify programs that are effective in preventing youth illicit drug use, we interviewed federal officials and reviewed documentation on efforts by HHS and the Department of Education (Education) to recognize programs that demonstrate success in reducing illicit drug use among children and adolescents. We did not independently verify the results of prevention programs recognized by the federal agencies. We conducted our work from January through December 2002 in accordance with generally accepted government auditing standards.

In brief, the six long-term evaluations of the DARE elementary school curriculum that we reviewed found no significant differences in illicit drug use between students who received DARE in the fifth or sixth grade (the intervention group) and students who did not (the control group). Three of the evaluations reported that the control groups of students were provided other drug use prevention education. All of the evaluations suggested that DARE had no statistically significant long-term effect on preventing youth illicit drug use. Of the six evaluations we reviewed, five also reported on students attitudes toward illicit drug use and resistance to peer pressure and found no significant differences between the intervention and control groups over the long term. Two of these evaluations found that the DARE students showed stronger negative attitudes about illicit drug use and improved social skills about illicit drug use about 1 year after receiving the program. These positive effects diminished over time.

HHS and Education have identified several programs that show evidence of effectiveness in preventing youth substance abuse and promoted their use in schools and communities. The Substance Abuse and Mental Health Services Administration (SAMHSA) within HHS and Education use expert panels to review program information that the programs developers or others submit and rank the programs on several criteria, such as the scientific rigor of their evaluations and the overall usefulness of their findings for preventing substance abuse. Only those programs that produce a consistent pattern of positive results that have been verified scientifically are recognized as effective, according to SAMHSA. HHS has also identified other programs supported by HHS-funded research, that show evidence of effectiveness in preventing substance abuse among youth. Specifically, within NIH, officials from the National Institute on Drug Abuse (NIDA) and scientists who conduct NIDA-funded research identified effective drug use prevention programs that were scientifically evaluated and have demonstrated positive results over time. HHS and Education disseminate descriptions of effective programs to practitioners, schools, and the general public. In addition to the effective programs, each of the agencies also has identified programs that, based on initial results, show promise in preventing substance abuse among youth. However, the outcomes of these programs either have not yet been verified scientifically or have not consistently demonstrated positive results in preventing or reducing substance use, according to the agencies. The agencies also disseminate lists of these programs.

In response to HHSs comments on a draft of this report, we revised the reports title to better reflect the scope of our work. HHS and Education provided additional information about their efforts to identify effective substance abuse prevention programs that we incorporated as appropriate.