The NARCONON™ drug education curriculum for high school students: A non-randomized, controlled prevention trial

Richard D Lennox
Psychometrics Technologies, Incorporated, 2404 Western Park Lane, Hillsborough, NC 27278, USA

and

Marie A CecchiniIndependent Research Consultant, 10841 Wescott Avenue, Sunland, CA 91040, USA

Background

An estimated 13 million youths aged 12 to 17 become involved with alcohol, tobacco and other drugs annually. The number of 12- to 17-year olds abusing controlled prescription drugs increased an alarming 212 percent between 1992 and 2003. For many youths, substance abuse precedes academic and health problems including lower grades, higher truancy, drop out decisions, delayed or damaged physical, cognitive, and emotional development, or a variety of other costly consequences. For thirty years the Narconon program has worked with schools and community groups providing single educational modules aimed at supplementing existing classroom-based prevention activities. In 2004, Narconon International developed a multi-module, universal prevention curriculum for high school ages based on drug abuse etiology, program quality management data, prevention theory and best practices. We review the curriculum and its rationale and test its ability to change drug use behavior, perceptions of risk/benefits, and general knowledge.

Methods

After informed parental consent, approximately 1000 Oklahoma and Hawai'i high school students completed a modified Center for Substance Abuse Prevention (CSAP) Participant Outcome Measures for Discretionary Programs survey at three testing points: baseline, one month later, and six month follow-up. Schools assigned to experimental conditions scheduled the Narconon curriculum between the baseline and one-month follow-up test; schools in control conditions received drug education after the six-month follow-up. Student responses were analyzed controlling for baseline differences using analysis of covariance.

Results

At six month follow-up, youths who received the Narconon drug education curriculum showed reduced drug use compared with controls across all drug categories tested. The strongest effects were seen in all tobacco products and cigarette frequency followed by marijuana. There were also significant reductions measured for alcohol and amphetamines. The program also produced changes in knowledge, attitudes and perception of risk.

Conclusion

The eight-module Narconon curriculum has thorough grounding in substance abuse etiology and prevention theory. Incorporating several historically successful prevention strategies this curriculum reduced drug use among youths.

Background

Effective education is needed to address today's burgeoning substance abuse problem

Although the annual, benchmark study, Monitoring the Future (MTF) [1], has measured small declines in drug use during the past few survey years, the estimated 13 million youths aged 12–17 in the U.S. who become involved with alcohol, tobacco and other drugs annually remains high compared with the declining trend seen during the 1980's which ended in 1992 [2].

Problem areas include the estimated $22.5 billion that underage consumers spent on alcohol in 1999 (of $116.2 billion total) [3]; an alarming 212 percent increase in the number of 12- to 17-year olds abusing controlled prescription drugs between 1992 and 2003; and youth initiation of pain relievers estimated at 1,124,000 in 2001, second only to marijuana initiation at 1,741,000 [2]. Controlled prescription drugs (including OxyContin, Valium and Ritalin) are now the fourth most abused substances in America behind only marijuana, alcohol and tobacco.

When prevention efforts fail it is not at small cost. In 2005, lifetime prevalence rates for any drug use were 21%, 38%, and 50% in grades 8, 10, and 12, respectively [1]. Although it can be argued that not all students who try drugs will develop problems, in 2002 the alcohol abuse and dependence-related costs for lost productivity, health care, criminal justice, and social welfare were estimated at $180.9 billion [4].

For many youths, substance abuse precedes academic problems such as lower grades, higher truancy, lower expectations, and drop out decisions [5]. In fact, the more a student uses cigarettes, alcohol, marijuana, cocaine and other drugs, the more likely they will perform poorly in school, drop out [6,7] or not continue on to higher education [8].

Consistent with the goals and public health agenda of the Office of National Drug Control Policy (ONDCP) and the Department of Education, the Narconon program's ultimate goal is to prevent and eliminate drug abuse in society. Research has shown that preventing or delaying initiation of alcohol or other drug use during early adolescence can reduce or prevent substance abuse and other risk behaviors later in adolescence and into adulthood [9,10]. However, there is still much discussion regarding what policy and strategies to employ toward this goal.

For the past 30-years, Narconon drug prevention specialists have delivered seminars aimed at supplementing existing prevention efforts by further illustrating materials covered in school curricula. In 2004, Narconon International developed an eight-module drug education curriculum for high school ages based on the research and writings of L. Ron Hubbard as incorporated into the secular Narconon drug rehabilitation methodologies. Program developers analyzed post-program student feedback, surveys collected as a quality management practice that has been in place since program inception and continues today, in light of evidence-based practices and prevention theory to create a stand-alone, universal (all youths) drug education curriculum for high school ages aimed at addressing key problem areas.

The eight module Narconon drug education curriculum for high school ages incorporates a unique combination of prevention strategies with content addressing tobacco, alcohol, marijuana and common "hard drugs." Health motivation, social skills, social influence recognition and knowledge-developing activities address a number of risk and protective factors in the etiology of substance abuse and addiction. The aim of this study was to assess the program's ability to change drug use behavior, attitudes and knowledge among youths and evaluate the components of the Narconon drug prevention curriculum against prevention theory.

Methods

Description of the sample

The Narconon program recruited 14 schools from two states. Schools were assigned to education or control groups based on similarity of school size, community size and general ethnicity. Schools also agreed to complete three testing points: Baseline, approximately one month later, and a six month follow-up. The full Narconon drug education curriculum was implemented either after completion of the baseline survey (education condition) or after completion of the final six month survey (control condition). Fidelity of curriculum delivery was verified by facilitator report.

After obtaining parental consent, there were 236 control group and 244 experimental group students in Oklahoma, with 295 control group and 220 experimental group students in Hawai'i. Voluntary assent and confidentiality were explained to the students. After the baseline survey, one charter school of 26 participants withdrew from the study for scheduling reasons. No provision was made to adjust representation by gender or potentially interesting ethnic or risk groups.

The study protocol and consent forms were reviewed and approved by Copernicus Group IRB (Protocol HI001). Human participant protections certified survey staff assigned each student a unique identification number based on a classroom roster. For confidentiality, students marked their answers on standard bubble answer forms labeled only with their unique identification number. The roster and identification code was used to give students the same identification number at each survey point, thus permitting comparison of answers given on each measurement occasion – a sampling strategy that provided the necessary statistical power to identify differences in tested variables among a universal classroom population, where the majority of youths do not use drugs. Completed answer forms were placed by each student into a security envelope, sealed, and returned to survey staff for mailing to the Principal Investigator for scanned data entry, data management, and statistical analysis.

Drug education intervention

The study design called for each of the schools recruited to the experimental conditions to receive the complete drug education curriculum. Professionally trained facilitators followed a codified delivery manual and completed a daily compliance report. Codified Narconon drug prevention curriculum materials help the facilitator implement the program according to specific standards, maintaining program fidelity.

Outcome measures

The primary outcome measure was last 30-day substance use using the Center for Substance Abuse Prevention (CSAP) Participant Outcome Measures for Discretionary Programs designed for outcomes evaluation in CSAP funded substance abuse prevention programs which is recommended for use in a pre-test/post-test design. (Form OMB No. 0930-0208 Expiration Date12/31/2005) [11]. Questions were directed to frequency of use of twenty two drugs of abuse including twelve questions from the Monitoring the Future Survey [1].

Secondary outcomes assessed by the CSAP instrument included perception of risk, attitudes and decisions about drug use including five questions from the Monitoring the Future Survey that ask about perceived harm from substance use; and four questions from the Student Survey of Risk and Protective Factors [11] that ask about drug use attitudes. In addition to calculating change in behavior and beliefs among individuals, these questions permit comparisons to state and national norms.

Additionally, the program developers recommended 25 questions that were appended to the CSAP survey for the purpose of assessing whether drug education concepts covered by the Narconon program are correctly understood by each program recipient, to what extent they are retained at follow-up points, and whether or not students could apply key program concepts. The program developer questions were designed to examine proximal effects including the ability of the program to educate by examining recall of program material, as well as give an impression of student capacity to apply program skills such as self-reported ability to communicate their beliefs on substance use, recognize and resist pressures to use substances, and make decisions.

Statistical analysis

The non-randomized design – where it cannot be assumed that groups assigned to experimental and control conditions will be equal – calls for a conservative analysis. For this reason the study utilized Analysis of Covariance (ANCOVA) of the change scores from baseline, controlling for initial drug use as well as changes in the school populations as covariates. The autocorrelation among the classroom clusters was statistically accommodated through use of a nested treatment effect, in which the treatment effect was nested within the classroom effect. Type III sum of squares deviations between the baseline characteristics of both groups were used in all post-treatment statistical comparisons of the treatment and control group, thus statistically controlling for any differences existing at baseline and removing any effects caused by pre-existing differences between the two test conditions that might confound the results. In this way, the analysis is aimed at establishing the statistical strength and reliability of assigning any measured differences at the six-month post-treatment follow-up to the drug education received by the experimental group rather than any attempt to quantify those changes.

Results

Evaluation of Narconon curriculum components

Table 1 outlines the eight curriculum sessions against key constructs used by many drug prevention programs. The interactive curriculum imparts science-based information from fields as diverse as toxicology, forensic science, nutrition, marketing, pharmacology, and many others. Program materials include audiovisual support and clear lesson plans that are to be delivered in their entirety combined with quality management tools such as anonymous student questionnaires for each session and a facilitator's log sheet to list any session problems and/or questions. Facilitator training emphasizes the importance of effective communication as well as creating an environment in which students may ask questions, discuss personal situations, and actively participate.

Table 1. Constructs in the Narconon Drug Education Curriculum for high school students.

Tests for selection bias: Demographic representation and drug use characteristics of groups at baseline

A total of 995 students out of a possible 1106 were recruited based on informed parental consent. Of these 726 completed both the baseline assessment and the six-month follow-up. The main sources of attrition were students not available on the day of survey and students no longer enrolled at the study school at the six month follow up.

Although selection of sites for "no treatment" attempted to match the demographic composition at intervention sites with respect to residence state, age, and general economic group, this strategy does not guarantee that the two types of sites are free from selection bias. Table 2 presents demographics composition of the control and treatment groups. Students frequently indicated several ethnic categories. The ethnic make-up of this group is particularly interesting as the evaluation includes a number of typically under-represented groups; however, the size and scope of this study do not make analysis of individual ethnic groups feasible.

Table 2. Demographics.

The drug use portion of this questionnaire determines general usage levels for the various drugs (except for cigarettes and smokeless tobacco). For example, "On how many occasions during the last 30 days have you used marijuana ..." is answered on the scale: "1" = 0 occasions, "2" = 1–2 occasions, "3" = 3–5 occasions, "4" = 6–9 occasions, "5" = 10–19 occasions, "6" = 20–39 occasions, and "7" = 40 or more occasions. From this, Table 3 shows the means for both groups to be slightly higher than 1 or "0 occasions", indicating some degree of drug use but a high proportion of individuals not using substances, or that substance.

Table 3. Drug use at baseline: Comparison of means between treatment and control groups.

Comparison of the means on the drug use measures between the treatment and control groups prior to receiving any drug education, as seen in Table 3, show that the two groups do not differ significantly on any of the drug abuse measures, suggesting that any difference seen at follow-up was unlikely to be caused by pre-existing differences.

Effects of the Narconon drug education curriculum on drug use compared with sites that have not yet received the curriculum

At follow-up, as shown in Table 4, students in the drug education program, but not the control group, had moved toward less drug use for virtually all of the drug use types. Given the similarities of group drug use behavior measured at baseline, this pattern alone supports the reliability of the differences created by the drug education curriculum.

Table 4. Drug use at six month follow-up: Comparison of means between treatment and control groups.

A number of drug use reductions achieve statistical significance. Characteristics of the specific tests indicate the effectiveness of the program. The areas of alcohol, tobacco and marijuana use in the past 30 days are particularly relevant to high school populations: Amount of cigarette use showed the strongest effect (F = 3.89, df = 11, p < f =" 3.39," df =" 11," f =" 3.35," df =" 11," f =" 2.28," df =" 11," p =" 0.010" f =" 2.12," df =" 11," p =" 0.017," f =" 1.87," df =" 11," p =" 0.040" f =" 169," df =" 11," p =" 0.073,">

Among the "hard drugs," use of amphetamines was somewhat prevalent among these youths and was significantly reduced by the curriculum (F = 2.35, df = 11, p = 0.008). Reduction in use of amphetamines without a prescription approached significance (F = 1.59, df = 11, p = 0.098).

The differences between the drug education and control groups are consistent with the literature on universal, classroom-based types of intervention [12] where drug use data is obtained by self-report and levels of substance use are high among only a small subgroup of youths [13].

Influence of the Narconon drug education curriculum on perception of risk and attitudes about drugs or drug use compared with sites that have not yet received the curriculum

Survey questions for decisions regarding drug use, changes in perceptions of risk and attitudes regarding drug use and means of the answers for each group at follow-up along with the significance values are presented in Table 5. Corresponding percents of students answering in an anti-drug fashion are presented for each question in Tables 6, 7 and 8.

Table 5. Means of attitudes and beliefs responses at six month follow-up.

Table 6. Decisions regarding drug Use: Percent of students in each group who gave a "drug free" answer.

Table 7. Perception of "harmfulness" of drugs: Percent of students in each group who answered "great risk."

Table 8. Disapproval of drug use: Percent of students in each group who answered "wrong" or "very wrong."

Six months after participating in the program, controlling for baseline differences, there was a much greater tendency for the control group to plan to get drunk in the year following the six-month follow-up compared with the drug education program group (F = 1.65, df = 11, p = 0.003) as well as a stronger decision to smoke cigarettes among the control group. (F = 1.33, df = 11, p = 0.008) In comparison, the drug education treatment group stated a stronger commitment to a drug free lifestyle than the control group (F = 1.82, df = 11, p = 0.048).

At six month follow-up, four out of five questions assessing risk of harm were statistically significant. Significantly more students in the drug education group indicated great risk to the question "how much do people risk harming themselves (physically or in other ways) if they try marijuana once or twice (F = 6.55, df = 11, p < f =" 9.41," df =" 11," f =" 1.91," df =" 11," p =" 0.035).

Although a greater percent of students who received the Narconon drug education curriculum indicated great risk of harm from smoking one or more packs of cigarettes per day, and having one or two drinks each day, the mean answer for that group indicated slightly less risk than answered by the control group (F = 5.79, df = 11, p < f =" 2.27," df =" 11," p =" 0.010">

Among the questions assessing whether students believed drug use was "wrong" or "very wrong" for someone their age, the drug treatment group felt that dinking liquor, smoking cigarettes, and using LSD, etc., were more wrong at follow-up than did the control group (F = 3.15, df = 11, p < f =" 4.12," df =" 11," f =" 3.96," df =" 11,">

Competency in absorbing the material covered in the Narconon drug education curriculum compared with sites that have not yet received the curriculum

The ability of the intervention to impart knowledge was tested by examining students' ability to correctly answer nineteen items designed to assess assimilation of program content and six questions assessing their ability to apply program messages to drug use decisions and behaviors.

As shown in Table 9, six-months after receiving the drug education program, significantly more students who received the drug education curriculum were able to give answers consistent with the program content for all nineteen items, controlling for differences at baseline. Of interest, students in the drug education program improved their understanding that alcohol is a drug (F = 6.03, df = 11, p < f =" 4.24," df =" 11," f =" 8.79," df =" 11," f =" 3.53," df =" 11," f =" 5.73," df =" 11,">

Table 9. Percent of students who gave a correct answer to program content questions.

However, "addiction only happens once you can't stop," was scored "true" more often among the control group than among the treatment group (F = 2.95, df = 11, p <>

Of the six questions assessing student decisions and behaviors, three produced significant change. Students in the drug prevention group were more likely to indicate that they knew enough about drugs to make decisions (F = 2.77, df = 11, p = 0.002,). Interestingly, recipients of drug prevention indicated a greater current ability to resist pressures to take drugs (F = 2.77, df = 11, p = 0.002) although the question assessing past resistance to drug use pressures was answered similarly between both groups at all time points. There was also a larger shift in the number of students who indicated "false" to the statement "drugs aren't really that bad" (F = 1.91, df = 11, p = 0.035).

Because a rather large percent of students in both groups answered the questions correctly at baseline, no further analysis was done to separate groups based on competency.

Discussion

The purpose of this study was to evaluate the capacity of the Narconon drug education program to produce a long-term impact on students' drug use behaviors in a universal (all student) classroom setting. To a large degree, baseline survey responses were similar to drug use patterns seen in large national surveys. After controlling for pretest levels of use, at six months after receiving the drug prevention curriculum students in the drug education group had lower levels of current drug use than students in the comparison group. Significant reductions were observed for alcohol, tobacco, and marijuana – important categories of drug abuse for this population – as well as certain categories of "hard drugs" including controlled prescription drugs, cocaine, and ecstasy. The results in Table 4 show a clear and reliable tendency among every category tested for the drug education program to produce reductions in drug use behavior.

This is encouraging in light of the evaluation being designed to provide a "real world" test of the Narconon program under the normal conditions of operating a classroom based intervention. Inherent barriers to administering the program and evaluation while schools were in session, including assessing its effectiveness with self-report questionnaires, leads to modest measurable differences between the drug education groups and the control groups with relatively large error terms.

The use of the CSAT survey methodology does not make quantifying the reductions in drug use possible and that was not an aim of this evaluation. Importantly, by testing a universal audience, rather than selecting groups of high risk students, the mathematical differences between student responses in each category remained modest due to the majority of students indicating no drug use at baseline.

The CSAP questions testing the hypothesis that changes in attitudes and beliefs would be modified by the drug education program, argue for a mediating effect on substance use. Interestingly, the questions aimed at discerning whether new knowledge was obtained and retained over time, although indicating an overall pre-existing acquaintance with the data, nonetheless categorically produced the most statistically significant changes.

Primarily an education strategy (Center for Substance Abuse Treatment classification [14]), the Narconon program includes approaches that align with key prevention theories. Throughout the curriculum, persuasive communication is emphasized as the means to impart each component [15]. Competency enhancement is accomplished through student interaction [16] and after-school personal inspection of media and other environmental influences aimed at addressing social influences. Science based information is presented, and students complete exercises aimed at developing their ability to assess the correctness of messages presented as information from a variety of sources.

Originally researched on cigarette use by Evans and colleagues in 1976, social influence theory was one of the first strategies to produce an impact on drug use behavior. This theory posits that alcohol and other drug use among young people is primarily a social behavior strongly influenced by social motives, a complex and reciprocal interaction between both personal and environmental factors including both overt and covert pressure from friends and others to conform to what is depicted as the group norm. A major departure from previous approaches to tobacco, alcohol, and other drug abuse prevention; Evans work emphasized increasing awareness of the various social pressures promoting drug use, including media influences [17,18].

One well-popularized aspect of today's social influences model is the focus on social resistance skills training. However, programs based primarily on resistance training have shown mixed results [19,20]. While this is not a focus of the Narconon program, students who received the curriculum were more likely to say they could now resist pressures to use drugs compared with those who did not receive this program. Interestingly, both groups answered similarly about their ability to resist pressures in the past.

Instead of directly practicing resistance skills, the Narconon drug education curriculum provides an opportunity for youth to inspect a myriad of positive, negative and often conflicting messages regarding drugs and their abuse, messages that often include incorrect and conflicting information about drugs and their effects. Program developers believe that prevention effectiveness is currently compromised by the pervasiveness of conflicting messages, including popular prevention approaches that do not communicate a consistent message.

Attempts to promote abstinence contrast with other messages heard in and out of school. For example, the notion that "everyone will experiment" has lead to various, sometimes controversial, practices aimed at reducing harm [21]. Goodstadt argues that dichotomies such as "licit" versus "illicit" drugs, or simply "good" versus "bad" drugs, result in ambiguities and problems [22]. Petosa adds that legal definitions designating certain recreational drug as "licit" for adults but "illicit" for adolescents may encourage young people to use those drugs to demonstrate their transition to adulthood [23]. The current prevalence of media advertising for prescription medications sends another powerful message [24], one complicated by the fact that commonly prescribed medications are too often used in ways substantially inconsistent with diagnostic guidelines [25,26].

Although students may "know" a certain datum about drugs, conflicting messages such as these may cause that datum to be minimized or rejected entirely unless placed in correct context or inspected relative to other information. To address this, the program teaches about the often subtle pro-drug advertising and other environmental messages aimed at increasing tobacco, alcohol and other drug consumption; contrasting these pro-drug messages with true scientific facts about drug effects on the body, mind, emotions, and enjoyment.

Program facilitators purposefully encourage students to arrive at their own conclusions regarding the data presented based on each student's own observation of the topic under discussion. Facilitators do not tell students what to think, rather, they teach students how to observe.

Another environmental influence addressed by the Narconon program includes more accurate awareness of family and peer drug use patterns. The program includes modules to review and discuss personal observations and provide opportunity for youth to work out what are correct and pro-survival norms.

Media, family, peer and other environmental influences become the subject of competency enhancement activities included in the Narconon curriculum. Competency to observe is applied during after-school practicals and becomes subject of the subsequent group discussion. These take home assignments and classroom activities are also aimed at developing broader personal and social skills with peers, family and community members. Research supports the use of activities that improve interpersonal relations, self esteem, communication, and other skills as directly applicable to substance use as well as many other adolescent problems. Such activities appear to generally enhance program effects [27,28].

With respect to the importance of knowledge, while many early prevention programs gave individuals accurate facts about the harmful effects of alcohol and other drugs, theorizing that those individuals would reduce or avoid drug use because it was in their own best interest to do so, studies of this generic information-only or awareness model have led to one of the very few universally agreed-upon facts in the prevention field: That is, for the vast majority of individuals, simple awareness through passive receipt of health information is not enough to lead them to alter their present behavior or reduce their present or future use of drugs [29,30].

According to Botvin and Botvin [12,16]., inclusion of information remains a necessary component of substance abuse education, although information alone is not sufficient to reduce or prevent use. Evans stresses the importance of attention and comprehension of the contents of the message [15]. Narconon program developers posit that true information correctly communicated can lead to changed behavior by changing the perceived value or social acceptance of that information.

Since inception, Narconon prevention training materials have emphasized correct communication of information and interaction with the communicator. Facilitator training aligns with the five component communication persuasion model described by McGuire [31]. According to this theory, to be effective an educator must get and hold the listeners' attention, must be understandable (comprehension), must elicit acceptance on the part of the person exposed to the message (yielding), the acceptance must be retained over time (retention), and thereby be translated into action in appropriate situations. Testing the ability to choose a correct answer only begins to answer the question of the perceived value and usefulness of that information. To that end, the incorporation of persuasive communication into facilitator training and multi-media program components is suggestive. In theory, the communication of science-based information regarding the nature and effects of drugs can assist students in developing judgment and awareness, but only to the extent that the message sent is very real to youths and delivered in a way that students respect and can appreciate. Measurements of student satisfaction that include affective reactions (e.g. enjoyment, content value) should be further explored as they may reveal important shifts in perceptions about the information itself that would not be detected in simple "true/false" questions.

This theory is supported by a previous evaluation of 1045 post-program student surveys, published in 1995, with findings that the Narconon program format was engaging and appreciated by youths [32]. Participants also reported heightened perceptions of risk – including a shift in attitude among the borderline group of students who held the view that they might use drugs in the future. Eighty six percent of the students in this category stated that the session they had attended changed their mind; most stating that they were now more concerned about the effects of drugs or that they had not realized that drugs were so damaging.

In addition to analyzing elements of content and implementation, a recent synthesis of characteristics common to exemplary prevention programs by Winters, et al. [33] raises the issue of management structure and sustainability. Narconon International's corporate and regional offices provide centralized management and assistance to ensure that local prevention offices receive meaningful attention and support. In addition to the questionnaire used in this study, Narconon program staff continued to collect their own feedback evaluations for ongoing quality management. Staff interaction with teachers and community members helped the schools further reinforce the prevention messages.

The report by Winters, et al. [33] points out the broad lack of programs aimed at high school years and, interestingly, the need for multiple sessions in future years to reinforce the message. The Narconon high school curriculum helps fill this need. Existing materials for younger ages should also be developed into an age appropriate curriculum to provide a continuum of educational resources. As the program further develops its training materials for professional facilitators it may consider also making them appropriate for peer leader groups who may particularly benefit through improved communication skills. The program should also develop appropriate universal booster sessions and provide educator consultation.

Project findings may have policy implications regarding both setting goals and objectives for prevention programs as well as evaluating their success. For example, the Safe and Drug-Free Schools and Communities act of 1994 includes "slow recently increasing rates of alcohol and drug use among school-aged children by 2000" among the six performance indicators chosen for assessing program accomplishments. It also expects prevention to "realize continuous improvement in the percentage of students reporting negative attitudes toward drug and alcohol use between now and 2002". Further, this act is subject to requirements of the Government Performance and Results Act of 1993 (GPRA) in requiring local and state education agencies to monitor program effectiveness, for which the CSAT instrument is a recommended tool sanctioned by the National Institute on Drug Abuse (NIDA), and the Substance Abuse and Mental health Services Administration (SAMHSA). Unfortunately, the instrument is unable to quantify change in drug use and does not assess completely the factors that might lead to such a change, factors that may include change in knowledge and the perceived value of that knowledge.

As current youth drug use levels remain high, it is clear that much more remains to be learned regarding effective drug abuse prevention. What works best; what goals additional to reduction in youth drug use – if achieved – constitute an effective program; how to measure achievement and the extent to which a school-based implementation strategy can counter other influences remains under discussion.

Conclusion

As an intensive, eight-module, educational curriculum, the Narconon program has thorough grounding in theory and substance abuse etiology, incorporating several important and historically successful prevention components. This supports the prediction that participants in this classroom-based program would change their behavior regarding drugs of abuse. Further, the Narconon network provides a strong organizational structure to foster sustainable and high fidelity program implementation.

In this evaluation, the Narconon drug education curriculum produced reliable reductions in drug use a full six months after completion of the drug education program and in every category of drug use tested. A third of these questions – those assessing the drugs most commonly used by youths; alcohol, tobacco and marijuana as well as "hard drugs" – showed statistically significant reductions in use. The reductions achieved with both amphetamines and non-prescription use of amphetamines are important given recent increases in availability and initiation of these drugs. The reliability of the reductions measured in drug abuse behavior provide the most relevant support for the Narconon drug education curriculum.

The program's ability to produce reductions in drug use behavior appears to be through correcting prevalent but false messages while empowering youth to observe, draw their own conclusions, and potentially also improves interpersonal skills contributing to the development of appropriate group norms. These changes may result in shifts in perception of risk and corrected attitudes as individuals and as a group. However, the mechanisms of action for this program should be further explored using sensitive instruments and analyses designed to test this hypothesis. Although the CSAP questionnaire underwent an extensive development process, isolating effective components of drug prevention programs may require a more robust methodology, particularly in light of the theory constructs of this program.

The Narconon drug education curriculum for high school grades shows clearly positive results and sends an important and powerful message promoting abstinence. Given the significant reductions in drug use behavior, the scientific content and social influence theory underlying the program materials and their implementation, and the strong, centralized management by Narconon International, this program is very promising and fills a vital need in substance abuse prevention.

Competing interests

M Cecchini wishes to disclose that between 2000–2002 she was the Executive Director of a Narconon center engaged in delivering substance abuse prevention programs; familiarity with program operations made it possible to coordinate independent field data collection with ongoing prevention efforts and assisted in describing the history and development of the program.

Authors' contributions

RL is Principal Investigator and developed the study design, statistical analysis and interpretation, and drafted sections of the manuscript.

MC coordinated the independent field data collection staff with scheduled drug education program delivery, ensured compliance with procedures to protect human subjects, and drafted sections of the manuscript.

Both authors read and approved the final manuscript.

Please send all reprint/proof correspondence to Marie Cecchini, 10841 Wescott Avenue, Sunland CA 91040.

Acknowledgements

The authors acknowledge the Association for Better Living and Education, Narconon International, Narconon of Hawai'i and Narconon of Oklahoma for project support.

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Source: substanceabusepolicy.com

What To Expect In Detox

By: Joe Gardener

Detoxification is ridding the body of sustained drug and/or alcohol addiction. It is most often the first step in getting your life back on track. There are people who have had to go through detox alone but that should not have to be the case. Drug detox and alcohol detox can be done in a caring and supportive environment with people who either have been through the process themselves or are trained in detoxification. For alcohol and most drug addictions, there is also medication that can help ease the symptoms of withdrawal.

While in detox, people are able not only to rid their bodies of the harmful drugs but also to discover what triggered the addiction in the first place. Ridding your body of the drugs or alcohol will be useless if you return to the same lifestyle as before you entered detox, so you must learn to change your behaviors. At first, none of it may make sense, but that is the affects of the drugs and alcohol. It does begin to make perfect sense and you see that by changing your behaviors you can get your life back on track.

With alcohol detox as well as drug detox, your body is likely going to go through withdrawal symptoms that can range from mild to severe. This is why there are often medications to help ease the discomfort of withdrawal. The most effective detox centers will incorporate several methods to help your mind and body recover from alcohol and/or drug addiction. Holistic treatment centers offer detox that helps physically, mentally and spiritually to help you gain control over your addictions and your life.

Most people fear the worse about detox but the process has come a long way over the years. There is so much known now about addictions and detoxification that just wasn’t known in the past. Medication use in detox used to be unheard of as well but now it is commonly used. While no one says it will be easy, it probably is not what you imagine it to be. There are many people leading happy lives now that they have rid their bodies and minds of drugs and/or alcohol. You can be one of them. Years of addiction take a toll on a person’s body and their mind. Only once you are rid of the addiction can you see the affects it has had on your life and the lives of others. Detox is a necessary part of obtaining a better life.

By talking to a professional at a detox center, you can gain more detailed information. Since no two people are alike, it is impossible to say exactly what your detox experience will be. The fear of detox, however, is often more frightening than the actual detox experience. This is part of the addiction; scaring yourself into not getting the help you need to rid yourself of drugs and alcohol. Detox should be done in a caring and professional environment with all of the tools available to help you overcome your addiction.

Article Source: http://www.bigfreearticles.com

Detoxification is ridding the body of sustained drug and/or alcohol addiction It is most often the first step in getting your life back on track

About the Author:
Joe Gardner has years of experience working with Alcohol Detox and Drug Detox. Visit his site to learn more.

Drug Rehabilitation Does It Really Works

Drug rehabilitation is not an easy task for the patient but it really works. It can transform one’s life. Drug rehabilitation programs can really help an individual to start a new life. Patient starts the rehabilitation program by going under a series of tests. The patient has to answer various questions each and every day. The goal of a rehabilitation center is to make the person free from addiction.

Everything starts from commitment. The treatment does not work if the patient is unable to recognize his problem. The patient should have desire to change his life. Many times the patient is forced to go under the treatment procedure. But the true healing starts from the patient’s mind.
The first step of the treatment is most difficult. First of all the physician have to deal with the drug remains ion the body. This step is known as detoxification. Withdrawal symptoms are also seen during this step of treatment.

As the detoxification step precedes the patient have to work with different types of counselors. The counselors try to find out the reason for taking the drug. The family should regularly visit some of the counseling sessions. According to some reports and statistics the patients with a supportive family recover fast as compared to others.

The patient should have detailed information about each and every step of the treatment before the program starts. This will help the patient to prepare himself before the initiation of the program. Patient should visit the physician regularly. It is a good idea to discuss all the doubts, fears and expectations.

The job of the family members is to find the best rehabilitation center. A center should have a skilled staff with a 24 hour emergency service. You should find lot of information related to the drug and alcohol rehabilitation programs. There are several sources of information which provide useful details. One of the useful forms of information is internet. It is a good idea to spend some time on the internet. You can go through the websites of the centers. This will help you to compare the facilities and cost of the programs they are offering.

If you want to know more about Alcohol Treatment then it is a good idea to visit Drug Treatment .

About Amit Chakraborty

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TREATMENT

Treatment, in this context, means active participation in the process of recovery from alcohol or drug abuse. Drug and alcohol treatment is the therapeutic and educational process which is usually the first step in recovery from alcohol or substance abuse.

Drug and alcohol treatment covers a wide range of options and variables.

Drug or alcohol treatment is a general term for the processes of medical and/or psychotherapeutic rehabilitation for dependency on alcohol or drugs. The intent of treatment is to enable the patient to cease using alcohol and or mood altering substances. Most people are steered into treatment as the result of some psychological, legal, financial, social, and physical consequences that their drinking or drug use has caused.

Through treatment tailored to individual needs, people with alcohol and drug abuse can recover and lead productive lives.


Scope of treatment

In today's recovery world treatment is very broad term. The overall scope of alcohol and drug treatment is two-fold:

1. Teaching the individual about alcohol and or drug abuse and what lifestyle changes will be necessary to maintain long term abstinence.
   


2. Behavior modification

Goal of treatment

the primary goal of treatment is achieving lasting abstinence from alcohol and or drug use. The immediate goals are to reduce physical and psychological abuse, improve the patient's ability to function and minimize the medical and social complications. Like people with other life threatening diseases such as diabetes or heart disease, people in treatment and recovery will also need to change their behavior to adopt a more healthful lifestyle.

Effective Treatment Approaches

Medication and behavioral therapy alone or in combination are aspects of an overall therapeutic process that begins with detoxification. It is followed by treatment and relapse prevention. Easing withdrawal symptoms is important in the initiation of treatment. Relapse prevention is necessary. And sometimes, as with other chronic conditions, episodes of relapse may require a return to prior treatment components. A continuum of care that includes a customized treatment regimen, addressing all aspects of an individual's life, including medical and mental health services, and follow-up options (e.g., community- or family-based recovery support systems) can be crucial to a person's success in achieving and maintaining an alcohol, drug-free lifestyle.

Medication and Treatment

Medications can be used to help re-establish normal brain function and to prevent relapse and diminish cravings throughout the treatment process. Currently, we have medications for opioid (heroin, morphine) and tobacco (nicotine) addiction, and are developing others for treating stimulant (cocaine, methamphetamine) and cannabis (marijuana) addiction.

Behavioral Treatment

Behavioral cognitive therapies help patients engage in the treatment process, modify their attitudes and behaviors related to drug abuse, and increase healthy life skills. Behavioral treatments can also enhance the effectiveness of medications and help people stay in treatment longer.

Buprenorphine treatment

Buprenorphine is a relatively new and important treatment medication. NIDA-supported basic and clinical research led to its development (Subutex or, in combination with naloxone, Suboxone), and demonstrated it to be a safe and acceptable addiction treatment. While these products were being developed in concert with industry partners, Congress passed the Drug Addiction Treatment Act (DATA 2000), permitting qualified physicians to prescribe narcotic medications (Schedules III to V) for the treatment of opioid addiction. This legislation created a major paradigm shift by allowing access to opiate treatment in a medical setting rather than limiting it to specialized drug treatment clinics. To date, nearly 10,000 physicians have taken the training needed to prescribe these two medications, and nearly 7,000 have registered as potential providers.

addict-help.com

Drug And Alcohol Rehabilitation: The Facts

Drug rehab is a term that refers to psychotherapeutic and medical treatment for substance abuse, or a dependence on a harmful substance. These harmful substances include not only illegal street drugs like cocaine, heroine, or other amphetamines, but also prescription drugs and alcohol. Since the abuse of drugs and alcohol can have far-reaching consequences - social, physical, mental, legal, and financial - the main aim of drug and alcohol rehab is to break that dependency and to enable the patient to cease using the substances and to find a new drug-free way of life.

What does rehab do?

Drug and alcohol rehab tends to focus on the dual nature of substance abuse and dependency, which is both physical and psychological. Dealing with the physical dependency can result in severe withdrawal symptoms, so rehab centres help clients go through what is known as a 'detoxification' process to help cope with the physical withdrawal from drugs and / or alcohol.

Dealing with the psychological aspect of drug and alcohol abuse is also a major part of the rehabilitation process, and it generally focuses on helping an individual learn how to interact and react to situations and stresses on a daily basis, in a drug-free environment. Patients are encouraged to make changes to their life, which may include changing their group of friends, particularly those who are still using drugs or alcohol. In early recovery this can be an important factor in relapse prevention. Certain rehab programs take the client through a 'twelve-step programme', which challenges addicts and alcoholics to accept that they need help from others in order to beat their addiction, that they must make changes to their life in order to recover, and that they must lead a life which is based upon total honesty with themselves and others.

Often, rehab centres will recommend complete abstinence from legal substances, such as alcohol. Quitting the substance completely is the preferable option, even in cases where alcohol had not been a perceivable problem for the client before. This is because of the fact that most addicts, if their drug of choice is removed, will turn to another drug instead. Alcohol is a mind-altering drug, which will soon become a dependence in people who have been addicted to other drugs in the past.

What forms of rehab are there?

Other than the general treatment centres and twelve-step programmes that are available for substance abusers, a variety of alternative drug and alcohol rehab programmes have emerged over the past few decades. Programmes include residential treatment, extended care centres, sober living houses and local support groups.

Sometimes antidepressants are prescribed for rehab clients in the early stages of treatment, as a temporary measure, as they can be used as part of the detoxification process. However, This must be closely monitored to ensure the client does not develop another addiction to the prescribed substance. In most cases, however, when the client stops using drugs and alcohol, symptoms of depression will diminish and disappear over time. This is because symptoms of the addictive disorder very closely mirror those of clinical depression, with individuals suffering low moods, mood swings, irritability, restlessness, malaise, trouble sleeping and changes in appetite, as a direct result of their drug use. Many addicts are surprised and heartened to find that this is the case as they continue with their recovery.

While in most cases clients will check themselves into drug or alcohol rehab, often attendance and treatment at a rehab centre is ordered by the criminal justice system. Those who are convicted of minor drug or alcohol offences are often referred to a drug and alcohol rehabilitation centre instead of prison, and offenders who have a dependence upon alcohol are sometimes ordered to attend a number of Alcoholics Anonymous meetings to help overcome their addiction.

While traditional rehab treatment is based on counselling, a number of studies have shown that there are many occasions where individuals who suffer from addiction have a chemical imbalance that needs to be addressed along side physchological issues. Chemical imbalances can be helped through making changes to diet, other nutritional supplements, and working toward a healthy lifestyle, which helps to correct the imbalance and also releases the patient from the grip of drug or alcohol addiction.

Source: articlesbase.com