JUST SAY 'RESEARCH': ANTIDRUG PROGRAM STRESSES SCIENCE

A new program from the National Institute on Drug Abuse (NIDA), "Mind Over
Matter," is using neuroscience research results to teach, rather than
preach to, students about the dangers of addictive drugs. "People have
historically seen drug abuse as purely a social problem that results from
voluntary behavior and remains voluntary. But science has taught us that
addiction is expressed in a behavioral way [and] comes about from the
result that drugs have on the brain," says NIDA director Alan Leshner. The
program will help fulfill the December 1997 recommendation of the Institute
of Medicine's Committee to Identify Strategies to Raise the Profile of
Substance Abuse and Alcoholism Research that the science of addiction be
more prominent in curricula, from elementary school to medical school.

Neuroscience-based teaching about drug addiction uses imaging technologies
such as positron emission tomography (PET) and magnetic resonance imaging
(MRI) to show what happens when addictive drugs flood the brain. The
approach can work, according to Cathrine Sasek, science education
coordinator at NIDA, the project officer who developed the program. She
frequently talks to middle- and high-school classes. "If you even so much
as hint at giving an antidrug talk, you lose them," she reports. "You can,
however, talk about the brain-they pay attention to the neurobiology of
drug abuse."

The program's developers also hope it may spark interest in science. "Young
people are intrigued by their bodies, particularly at the middle-school
level. We know that science is interesting to them, and it is a vehicle to
teach about science and drugs," says Leshner.

But there's no guarantee that Mind Over Matter will either prevent drug
abuse or propel students onto a science career track. "Showing pictures of
a brain on drugs will interest those kids already interested in science,
but for the others, it won't mean much," predicts Godfrey Pearlson, a
professor of psychiatry at Johns Hopkins Medical Institutions. He uses PET
scans to study cocaine-induced binding of dopamine to receptors on brain
neurons (see accompanying story). Still, he adds, the approach is worth a
try.

Funding for Mind Over Matter came from NIDA, with about $50,000 used to
develop the written materials. These include six glossy magazines that open
out into posters and a long booklet for teachers on "The Biological Effects
of Drugs" that is packed with facts and figures. Ten NIDA staffers with
scientific expertise provided the information and reviewed the content of
the program, and several outside artists and writers contributed. Feedback
for the program, which was field-tested in classrooms, has been
overwhelmingly positive, according to Sasek. "We have taken the materials
to several teachers' meetings [National Association of Biology Teachers and
National Science Teachers Association], and the teachers have loved the
materials," she says. "In addition, the prevention community is also very
enthusiastic about the materials." Materials are free at these conferences
or available from the National Clearinghouse for Alcohol and Drug
Information.

Many drug-education efforts differ markedly from the science-based
approach. A fried egg sizzles on a television screen, with the message
"this is your brain on drugs." Celebrities and law-enforcement officers
tell classes that drugs kill, while teachers and parents urge students to
"just say no." But statistics indicate that these efforts are not effective
in reaching many young people.

Statistics On Teen Drug Use

Facts and figures on drug use are abundant. The National Longitudinal Study
on Adolescent Health, sponsored by the Department of Education's Safe and
Drug-Free Schools Program, queried 12,118 seventh- to 12th-graders in 1997.
The study found that 25.7 percent of respondents smoked cigarettes, 17.9
percent drank alcohol, and 25.2 percent smoked marijuana. These figures,
however, varied considerably among school districts.

Data on trends, while useful, sometimes send mixed messages. For example, a
survey by Atlanta-based Parents Resource Institute for Drug Education
(PRIDE) conducted in 1996 and 1997 of 141,077 junior and senior high
schoolers found a statistically significant increase in monthly drug use
among sixth- to eighth-graders but unchanged monthly use among high-school
students. And a United States Department of Education survey of 10,000
fifth- and sixth-graders as they progressed in school from 1991 to 1995
found a similar increase in drug use by eighth grade. Yet the 23rd annual
Monitoring the Future Survey, released Dec. 20, 1997, by the Department of
Health and Human Services (HHS), showed increased drug use among 10th- and
12th-graders, but a leveling off among eighth-graders. Leshner and HHS
Secretary Donna Shalala interpret the findings to reflect a glimmer of
success in drug abuse education programs, but all the studies conclude that
the absolute numbers on drug use remain alarming.

The National Center on Addiction and Substance Abuse, based at Columbia
University, found that from 1995 to 1996, the proportion of teens who said
that they would never try illegal drugs fell from 86 percent to 51 percent.
Several of the center's studies identified school as the most common place
to procure drugs-suggesting that this might also be the best place to
introduce drug abuse education programs such as Mind Over Matter.

Enter NIDA

Mind Over Matter targets grades five to nine, which includes youngsters
typically not yet tempted to try drugs as well as those in the highest-risk
age group. Program materials include six oversized brochures in which a
cartoon character, Sara Bellum, takes students on a guided tour of the
brain on drugs. (The original name, Nerve Anna, was rejected because
students would associate her with Kurt Cobain, guitarist and singer of the
band Nirvana who had a well-known drug abuse problem and died of a
self-inflicted gunshot wound in 1994.) The idea is that packaging science
information attractively will hold students' attention.

The Mind Over Matter magazines discuss marijuana, inhalants, opiates,
hallucinogens, steroids, and stimulants. A seventh magazine on nicotine
will be available soon. Each magazine opens into a poster that is a real
image of a neuron. The writing is vibrant. The narrative on opiates, for
example, describes the Cowardly Lion and Dorothy succumbing to the effect
of poppies in The Wizard of Oz. The neurobiology is presented in
easy-to-understand language, such as: "These cells grow so used to having
the opiate around that they actually need it to work normally." A cartoon
story introduces neurons, synapses, neurotransmitters, and receptors, and a
teacher's guide provides background. Success will be determined by how
quickly the initial 2,000-copy print run is depleted and from teacher
feedback.

Scientific Approach Not New

Using science to teach about drug abuse is not a new idea. The American
Council for Drug Education, based in New York City, has used information on
the nervous system in its publications since its inception in 1977, says
director Martha Gagné. Plus, the council's Web site features exercises to
demonstrate the effects of particular drugs on the brain and other organs.
"The Web site offers scientifically accurate data on substances and their
abuse to counteract the often-misleading material that now clogs up traffic
on the information highway," she adds. The site has been active since June
1997. According to Gagné, several hundred teachers access it monthly,
mostly to retrieve lesson plans and curriculum tips.

The College on Problems of Drug Dependence (CPDD) is a Philadelphia-based
professional organization of about 400 scientists who research drug abuse
and addiction. According to the group's mission statement, CPDD "serves as
an interface among academic, governmental, and corporate communities,
interacting with regulatory and research agencies as well as with
educational, treatment, and prevention facilities in the drug abuse field."
The organization has a journal and an annual meeting; its members provide
consulting services and expert witness testimony and sponsor programs to
attract young investigators to drug abuse research, says president Linda
Dykstra, William Rand Kenan Jr. Professor of Psychology and Pharmacology at
the University of North Carolina in Chapel Hill.

Television also is embracing a scientific approach to drug abuse education.
On March 29, PBS stations will present the first installment of "Moyers on
Addiction: Close to Home," a five-part documentary exploring social,
political, and scientific aspects of drug addiction. The second part, "The
Hijacked Brain," will feature the work of Anna Rose Childress, a clinical
associate professor in the department of psychiatry at the University of
Pennsylvania School of Medicine and a clinical psychologist with the drug
dependence treatment unit of the Philadelphia Department of Veterans
Affairs Medical Center. In their research, she and her coworkers show
participants videos of cocaine-related scenes while their brains are being
PET scanned. "We have confirmed that limbic structures indeed activate in
response to signals which trigger cocaine craving in humans; this does not
happen in response to viewing nature videos or in control subjects who have
no cocaine history," Childress says. Such signals include people,
locations, objects, sounds, sights, and smells that are associated with the
drug, she adds.

The Neuroscience Approach

Some drug-education programs may backfire because inquisitive students do
not believe the information given. Threats that marijuana use inexorably
leads to heroin use do not ring true to students who know this is not
always the case. "We learned in the '70s and '80s that hyperbole and
exaggeration do not work," says Leshner.

Lynn E. Zimmer, a professor of sociology at Queens College in New York and
coauthor with John Morgan of Marijuana Myths, Marijuana Facts: A Review of
the Scientific Evidence (New York, The Lindesmith Center, 1997), agrees
with Leshner. "It is hard to scare kids away from anything. I am concerned
that massive exposure to antidrug messages is counterproductive. How could
they possibly believe all the bad things about drugs?" she asks.

Zimmer does not believe that any current drug education programs work. The
Partnership for a Drug Free America, she maintains, overloads kids from
preschool age with antidrug messages. The D.A.R.E. (Drug Abuse Resistance
Education) program, in which police officers teach fifth- and sixth-graders
drug-resistance skills, has also had mixed results. "Kids exposed to the
program have a stronger antidrug attitude during that time, when they are
not really thinking about drugs, and you can get them to respond. But there
is no benefit once kids pass that age," Zimmer says.

The Mind Over Matter approach may penetrate typical adolescent arrogance
because it is not judgmental. But some researchers think this might not be
enough to overcome human nature. "We have known for years that cigarettes
are bad, and that has had no effect," Pearlson points out.

The best way to cut drug use among youth, suggest Zimmer and Pearlson, is
to take a variety of approaches. But the key to any program, Zimmer
maintains, is to provide information, not a guilt trip or fear. "Many
places in Europe have a more harm-reduction form of drug education. Young
people are given more information about how at one point, drugs go from
potentially dangerous to quite risky. This is not done in the U.S.," she
contends. If a student in the U.S. asks a teacher what a dangerous dose of
a particular drug is, Zimmer says, the teacher must refer the student to a
drug counselor.

A science-based view of drug abuse education is most effective, according
to Gagné, when it follows other programs that begin in preschool. "The best
approach to preventing drug use is to start as early as possible and
instill life skills in children that allow them to accept drug prevention
education as they get older," she says. Children need to learn ways to
build self-esteem, coping strategies, and decision-making abilities. "Then,
if scientific facts are presented-unlike media dramatization and scare
tactics-children and youths get a sense of truthfulness and reality, and
they are more likely to believe what they hear," she concludes.

Copyright © The Scientist, Inc.