And the winner is… Cocaine: The US-Mexico drug war.

This post is based on an amazing broadcast I heard on KPCC, a local NPR radio-station; the story was part of Zocalo radio.

In the story, Dr. Josh Kun spoke about the struggles of the war on drugs and the recent massive casualties on the southern side of the border. I had talked about this violence in a past post, but hearing about it from the point of view of someone else made me realize all the more how desperate the situation is.

Drug smuggling, money, and reality

As Josh pointed out, drug-dealing and smuggling bring in so much money (billions of dollars annually) that it is at best naive, and at worse, stupid, to think that guns and enforcement are going to do the job. When there are tens of billions of dollars at stake in areas of the world that are deeply entrenched in severe poverty, the money is going to win.

I’ve had personal experience with this, with Mexican Federales bringing in cocaine in the tires of police cars. When faced with smuggling operations like that, all the sweeping governmental mandates won’t change a thing.

How do we fix the cocaine problem?

Given the fact that the US supplies the drug dealers not only with the money (we buy more than 50% of the world’s drugs), but also with the guns, it seems to me that there are only 2 ways to make a dent in the business:

1) We have to do a better job at treating, and preventing, the massive drug-abuse problem in this country. I’m working on this, and I haven’t failed at much in my life (yet), so hold on tight, I’m on it.

2) We have to do whatever we can to increase the standard of living in these places. That way, the deaths, the shootings, the violence, and the fear that permeate the border towns on both sides of the US-Mexican border affected by this are simply no longer worth it. If given a choice between starvation and a cocaine run, most of us would choose the cocaine; the choice is a lot simpler when there’s food on the table and soccer balls for the kids to play with.

That’s it, that’s our goal. This is how we make the world of drug abuse, smuggling, brain-damage, imprisonment, and death, better. We don’t do it with guns; instead we used common sense, we use our heads. We can’t beat out poverty with bullets, the human will to survive and thrive will keep producing soldiers.

The context of my addiction – Environmental effect on drug use???

When most people think about addiction, they imagine a person completely unable to control their cravings, always wanting the thing they’re addicted to. That was certainly my experience throughout most of my addiction.

So what happens when you just can’t have it? What happens when drug use is just not allowed? What happens if your life depended on it?

In a way, this question was at least partially answered recently in an article by a number of psychologists at the University of Tel Aviv. What the authors did was simple: They asked a group of heavy Orthodox smokersQuitting is smoking is difficult, at least in some contexts. about their cravings, irritability, and difficulty avoiding smoking on a regular workday, and random day in which they were not allowed to smoke, and the Sabbath (the Jewish day of rest), during which they’re not allowed to smoke for religious reasons. The simple finding was that the participants craved smoking a lot less, were less irritable, and found it a lot easier to avoid smoking on the Sabbath than on any of the other two day.

The moral of the story? Smoking may be really addictive, but when the choice is a cigarette or eternal damnation, it’s a pretty easy one to make…

In the future, I’ll talk about how this idea of addiction within specific contexts has been shown to also exist for the effect of the drug (or behavior) itself!

Take Charge of your Life: Another adolescent substance abuse prevention program that doesn’t work.

In a previous post we talked about the ineffectiveness of the school-based substance abuse prevention program called D.A.R.E. (Drug Abuse Resistance Education). We reported data from a meta-analysis of 11 studies which showed no significant effect of D.A.R.E. in reducing drug use. A recently published study examined the effectiveness of another school-based program called Take Charge of Your Life (TCYL)
TCYL was developed in 1999 as part of the Adolescent Substance Abuse Prevention Study (ASAPS). The ASAPS was a response to the criticism D.A.R.E. was receiving at the time. The goal of the study was to create a more effective program that could utilize D.A.R.E. funding and resources.
The TCYL curriculum consists of 10 lessons in the seventh grade and 7 lessons in the ninth grade which are all taught by trained D.A.R.E. Officers. The TCYL lessons inform students of the personal, social, and legal risks involved with drug use and provide accurate statistical data on drug use. The general philosophy of TCYL is to actively engage students and allow them to make a choice to not use drugs. Like D.A.R.E., the TCYL courses teach communication, decision-making, assertiveness, and refusal skills.
To determine the effectiveness of TCYL, 20,000 seventh graders were enrolled in the study and followed through the ninth grade. Roughly half of these students received the TCYL curriculum while the other half did not.
The results from the study show a negative effect, where TCYL actually increased alcohol and cigarette use among baseline nonusers, compared to students who did not receive TCYL. Clearly, this is not what the developers of TCYL were hoping to see. However, what is equally interesting from the results is a positive effect, where TCYL decreased marijuana use among students who were already using marijuana when the study began. This finding reinforces the idea that people can be affected by the same program differently.
Perhaps the lesson to be learned from the mixed results of TCYL is that prevention programs need to be designed to take into account people’s individual differences. The traditional “one size fits all” approach to prevention may not be the most effective
*D.A.R.E. has not adopted the TCYL curriculum and will continue to teach the relatively new “keepin’ it REAL” curriculum, whose effectiveness has yet to be determined.

Teen smoke

Contributing co-author: Andrew Chen

In a previous post we talked about the ineffectiveness of the school-based substance abuse prevention program called D.A.R.E. (Drug Abuse Resistance Education). We reported data from a meta-analysis of 11 studies which showed no significant effect of D.A.R.E. in reducing drug use. A recently published study examined the effectiveness of another school-based program called Take Charge of Your Life (TCYL).

TCYL was developed in 1999 as part of the Adolescent Substance Abuse Prevention Study (ASAPS). The ASAPS was a response to the criticism D.A.R.E. was receiving at the time. The goal of the study was to create a more effective program that could utilize D.A.R.E. funding and resources.

The TCYL curriculum consists of 10 lessons in the seventh grade and 7 lessons in the ninth grade which are all taught by trained D.A.R.E. Officers. The TCYL lessons inform students of the personal, social, and legal risks involved with drug use and provide accurate statistical data on drug use. The general philosophy of TCYL is to actively engage students and allow them to make a choice to not use drugs. Like D.A.R.E., the TCYL courses teach communication, decision-making, assertiveness, and refusal skills.

To determine the effectiveness of TCYL, 20,000 seventh graders were enrolled in the study and followed through the ninth grade. Roughly half of these students received the TCYL curriculum while the other half did not.

The results from the study show a negative effect, where TCYL actually increased alcohol and cigarette use among baseline nonusers, compared to students who did not receive TCYL. Clearly, this is not what the developers of TCYL were hoping to see. However, what is equally interesting from the results is a positive effect, where TCYL decreased marijuana use among students who were already using marijuana when the study began. This finding reinforces the idea that people can be affected by the same program differently.

Perhaps the lesson to be learned from the mixed results of TCYL is that prevention programs need to be designed to take into account people’s individual differences. In addition to previous drug use, developers need to understand how race, gender, personality, and other individual variables affect the success or failure of their program. Without this understanding, “one size fits all” programs like D.A.R.E. and TCYL can easily end up causing more harm than good.

*D.A.R.E. has not adopted the TCYL curriculum and continues to teach the relatively new “keepin’ it REAL” curriculum, whose effectiveness has yet to be determined.

Citation:

Sloboda, Z., Stephens, R.C. , Grey, S.S., Teasdale, B, Hawthorne, R.D., Williams, J., and Marquette, J.F. (2009) The adolescent substance abuse prevention study: A randomized field trial of a universal substance abuse prevention program. Drug and Alcohol Dependence. 102(1-3)