Wed. May 25th, 2022

Stop teaching drug abstinence: Just say no to the era of ‘just say no’



It doesn't work.
It doesn’t work. (Doug Mills/AP)

At this time 30 years ago, we found ourselves in the midst of one of the worst public health crises in U.S. history, one that killed tens of thousands of people a year. Somehow today, we find ourselves at a similar juncture. The only question is: Will we repeat the mistakes of the past?

Yesterday’s crisis was AIDS, caused by a virus spread primarily through unprotected sex. Today’s crisis is drug overdoses caused as people who use illegal drugs increasingly find the drug supply adulterated with potent fentanyl.

And in both cases, education that emphasizes abstinence first, rather than pointing to pragmatic and realistic attempts to make behavior less risky, has proven to be counterproductive.

Even mortality numbers look eerily the same. More than 700,000 people have died from AIDS-related causes in the U.S., and 700,000 people died from accidental overdose in the U.S. between 1999-2016, with rates increasing in recent years.

Yet once again, instead of treating the problem with a public-health solution, the United States is investing more than a billion dollars each year in abstinence-only education that does little more than stigmatize and stymie our capacity to keep ourselves and each other safe.

The same stigma that originally referred to AIDS as Gay Related Immune Deficiency (GRID) and held people back from getting tested or using protection is now preventing people suffering with substance-use disorder from getting the treatment they need.

In order to get help, drugs users are forced to confront the stigma that has been culturally created and embraced by the over-criminalization of drugs in the U.S. and the people who use them.

These fears and stigmas extend into our educational system — telling students to “just say no” and begging them to remain abstinent for the rest of their lives. We project ignorance and ill-conceived wishes that they will never grow up or become one of “those people” in the commercials, images heralded especially during the height of the drug war.

We neglect the fact they themselves or a family member may use substances, and we conflate all drug use with abuse, leaving teens with a limited framework with which to understand theirs or another’s use of alcohol or other drugs as they become adults and navigate this all for themselves.

It’s time we reexamine these age-old philosophies in light of again-dire circumstances. What we have learned from the evolution of sex education in the United States is that by openly and honestly teaching youth about sex — and the associated risks — early on, we can reduce the occurrence of infectious diseases, stigma, teen pregnancy and even adolescent sexual activity.

It is our collective responsibility as advocates, parents, teachers, policymakers and public health officials to start teaching kids about drugs in a way that includes harm reduction. Through consulting with parents and educators, the Drug Policy Alliance has developed a new drug education curriculum called Safety First to teach high-school age students about drugs, how they work and their associated harms, so that they can make responsible, informed and most importantly, safe, decisions.

Some may say that drifting away from abstinence-only drug education is losing the battle, losing sight of what’s right or wrong. They say it’s a tacit endorsement of drug use.

Nonsense. Having a foundation of real, down-to-earth drug education earlier rather than later will ensure young people are prepared, and know how to keep themselves and others safe, as they inevitably encounter even more drugs progressing into adulthood.

Kids grow up. And the fact that we have a generation of adults who have not been provided sufficient drug education and were also students of abstinence-based models is evidenced in our mortality rates.

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