2014

A Preventive Guide to Drug and Substance

Abuse in Schools

Jarrett Clifton, Rachel

Kwan, Cinthya
Hernandez, Beatriz
Montes

SDSU

CSP 662B

Table of Contents
Drug and Substance Abuse in Children ........................................................................... 2
What kinds of drugs are being abused ........................................................................... 2
Warning Signs ................................................................................................................. 2
National Association of School Psychology and American School Counselor Association
.......................................................................................................................................... 3
Working together ........................................................................................................... 3
Effective Programs ......................................................................................................... 3
Purpose of Interventions .................................................................................................. 4
D.A.R.E. ............................................................................................................................. 5
Implementation .............................................................................................................. 5
How Effective is it? ......................................................................................................... 5
Sample Counseling Session ........................................................................................... 5
Project Towards No Drug Abuse ...................................................................................... 6
Implementation .............................................................................................................. 6
Sample Counseling Session ........................................................................................... 6
Research ......................................................................................................................... 6
Positive Action .................................................................................................................. 7
Implementation .............................................................................................................. 7
Facts ............................................................................................................................. 7
Evidence ....................................................................................................................... 7
Resources.......................................................................................................................... 8
References ........................................................................................................................ 9
Appendix......................................................................................................................... 11

Drug and Substance

Abuse in Children
A guide to useful evidence based interventions and strategies for addressing
substance abuse in school age children.

Does it really happen?

Warning signs of
teenage alcohol
and drug use may
include:
Physical: Fatigue, repeated
health complaints, red and
glazed eyes, and a lasting
cough.
Emotional: personality
change, sudden mood
changes, irritability,
irresponsible behavior, low
self-esteem, poor judgment,
depression, and a general
lack of interest.
Family: starting arguments,
breaking rules, or
withdrawing from the family.
School: decreased interest,
negative attitude, drop in
grades, many absences,
truancy, and discipline
problems.

It DOES happen...
Experimentation with alcohol
and drugs during
adolescence is common.
Unfortunately, teenagers
often don't see the link
between their actions today
and the consequences
tomorrow. They also have a
tendency to feel
indestructible and immune to
the problems that others
experience.

Using alcohol and tobacco at

a young age has negative
health effects. While some
teens will experiment and
stop, or continue to use
occasionally, without
significant problems. Others
will develop a dependency,
moving on to more
dangerous drugs and causing
significant harm to
themselves and possibly
others.

Teenagers at risk for

developing serious alcohol
and drug problems include
those:
with a family history of
substance use
disorders
who are depressed
who have low selfesteem, and
who feel like they
don't fit in or are out
of the mainstream

Drug use is associated with a

variety of negative
consequences, including
increased risk of serious drug
use later in life, school failure,
and poor judgment which may
put teens at risk for accidents,
violence, unplanned and
unsafe sex, and suicide.

Social problems: new

friends who are less
interested in standard home
and school activities,
problems with the law, and
changes to less conventional
styles in dress and music.
Some of the warning signs
listed above can also be
signs of other problems.

What kinds of drugs are being abused?

Teenagers abuse a variety of
drugs, both legal and illegal.
Legally available drugs include
alcohol, prescribed
medications, inhalants
(fumes from glues, aerosols,
and solvents) and over-thecounter cough, cold, sleep,
and diet medications. The
most commonly used illegal
drugs are marijuana (pot),

stimulants (cocaine, crack,

and speed), LSD, PCP,
opiates, heroin, and
designer drugs (Ecstasy).
The use of illegal drugs is
increasing, especially among
young teens. The average
age of first marijuana use is
14, and alcohol use can start
before age 12. The use of
marijuana and alcohol in high
school has become common.

For more information visit

AACAP's Substance
Abuse Resource Center.

The American School

Counselor Association (ASCA)
ASCA recognizes that
students unmet mental
health needs can be a
significant barrier to
students academic,
social, and career
development which could
possibly compromise
school safety.
ASCA Position Statement on Student Mental Health:
http://www.schoolcounselor.org/asca/media/asca/PositionStatements/PS_
StudentMentalHealth.pdf

The National Association of

School Psychology (NASP)
NASP recognizes that many
students are unable to
benefit fully from
educational experiences
when they are living with
adversities such as poverty,
violence, and/or substance
abuse and they could lead
to disengagement in school
activities.
NASP Position Statement of Mental Health Services:
http://caspsurveys.org/NEW/pdfs/nasp05.pdf

Working together
School psychologists and school counselors are at the forefront of mental health service
delivery in the schools. Mental Health includes drug and substance abuse. Throughout
the United States, school psychologists and school counselors provide mental health
services including the design of prevention programs, assessment, counseling, mental
health, case management, and behavioral consultation services and crisis intervention
in partnership with teachers, parents, school administrators, and other members of the
school community to assist in developing effective strategies to serve students in need
and to prevent mental health problems.

Effective Programs
Effective Programs should
have the following:
Programs should be
developed from identified
needs of students,
recognizing potential
contributions from all
stakeholders, including
students, parents, special
service providers, teachers,
administrators, and other
support personnel.
Effective programs
necessitate a
comprehensive approach,
including a focus on
developmental,

preventative, and remedial

activities that facilitate the
educational process for
students. (NASP Position
Statement: Ensuring High
Quality, Comprehensive
Pupil Services 1)
Effective programs
recognize that learning
takes place within
environmental and social
contexts, and they take
steps to assist schools in
maintaining safe
environments that support
teaching and learning.
Effective programs within
the school are best
delivered through
multidisciplinary mental
health teams that ensure
culturally competent
practice.

Effective programs
recognize that not all
services can be provided in
the school and include
effective linkages with
various community
resources.
Accountability through
consistent, continuing, and
effective program
evaluation is crucial in both
the development of
effective programs and the
ensuring of continuing
community support.

Resources
NASP Position Papers:
http://www.nasponline.o
rg/about_nasp/position_
paper.aspx
ASCA Position Papers:
http://www.schoolcouns
elor.org/schoolcounselorsmembers/about-asca(1)/position-statements
National Survey on Drug
Use and Health, Tables:
http://oas.samhsa.gov/N
SDUH/2k10NSDUH/tabs/
TOC.htm

Purpose of Interventions
D.A.R.E. STUDENTS

PROJECT
TOWARD
S NO
DRUG
ABUSE

POSITIVE
ACTION

PROCESS OF CREATING A MANUAL

Identify a crisis that is prevalent. Gather data
and research about specific evidence based
interventions.
The following interventions were selected due
to their target community. Each intervention
services a different set of population. All
interventions are evidence based.

STUDENTS

STUDENTS
PARENTS
COMMUNITY
DATA AND FOLLOW UP
Each intervention gathers data
through the use of self reports
(surveys), police data, and student
interviews.
Follow up would include more
intensive counseling services for
students (e.g., Solution-Focused Brief
Counseling).

35 mil.

D.A.R.E.
Students worldwide are taught to
live a drug free life by a series of
teaching lessons in the classroom.

D.A.R.E was founded in 1983, to help children from kindergarten

to teens become aware of the consequences of using drugs and
learns how to deal with peer pressure.

D.A.

ALL ABOUT THIS SCHOOL-WIDE PREVENTION PROGRAM

IMPLEMENTATION
Grade Levels

The delivery of the lessons are given by police

officers that come to the classroom for 10 weeks;
one hour per week. Lessons include avoiding
peer pressure, safety, self-esteem building,
managing anger, gang prevention, drug effects,
and a lot more. Lessons vary by grade level and
school level; a kindergarten lesson plan would be
different from a fourth grade lesson plan, also a
middle school lesson plan would be different
from a high school lesson plan. Each lesson is
planned to a specific level to align with the
development of the students learning skills,
developmental stages, social stages, and their
school environment (ProCon.Org, 2014)

Kinder 4th Grade Lesson

The lessons given to Kindergarten
to fourth grade students are
designed to prepare student for the
Core Program in 5th grade and
help provide them with
information on how to be safe,
peer pressure, and self-esteem
(Watervliet police, 2002)
Junior High School Lesson
The 5th Grade CORE Program is
organized into seventeen 45-60
minute lessons taught by a certified
D.A.R.E. Instructor. The CORE
program focuses on problem solving
and peer pressure. The 6th Grade
Program is formatted into five 40-45
minute lessons focusing on Violence
Prevention and Conflict Resolution
(Watervliet police, 2002)
Senior High School Lesson
Five lessons are taught twice for a
two week period by a combined
effort from the D.A.R.E. Officer and
the Health Teacher. This curriculum
emphasizes on Social Skills and
Violence Prevention Strategies
(Watervliet police, 2002)
http://homepages.rpi.edu/home/40
/mcgras/public_html/dare1.htm

R.E.

D.A.R.E.

http://www.dare.org/

How effective is it?

There is research debating the efficacy of this intervention. However, we have included it due to the familiarity
that most people have with it (nation-wide recognized program). Considering this debate, use of this intervention
would best be tailored to fitting your school site's specific needs. According to the US Substance Abuse and
Mental Health Services Administration (SAMHSA), participants in the D.A.R.E. program report lower alcohol,
tobacco, and marijuana use than students who did not receive the program. 40% of participants who used alcohol
at the beginning of the program reported reductions in alcohol use after receiving the curriculum, and 32%
reported discontinuation of alcohol use altogether. Studies of D.A.R.E. by the Research Triangle Institute and in
the Journal of the National Medical Association found that D.A.R.E. graduates are five times less likely to
initiate smoking compared with non-D.A.R.E. control groups, and report lower levels of tobacco use in 5th and
6th graders in the one to two years following program graduation. However, there are studies stating the need to
revamp this intervention in order for it to be more positive. (http://dare.procon.org/)

Sample Counseling Session: During a 5th grade CORE lesson plan (Resistance Techniques)
Facilitator: Welcome back everyone,
todays topic is about peer pressure, Can
anyone tell me what peer pressure is?
Student 1: When your friends want you
to do something that you dont
Facilitator: Thank you, now can anyone
tell me about a time that they felt they
were peer pressured to do drugs?
(Students raise their hands) Manuel, can
you please tell me about a time you felt
peer pressured?
Manuel: My best friend has an older
brother who is in high school and he

says talks about smoking. About two

weeks ago, he offered me and his brother
some and i did not want to do it so I
pretended that it was already too late and I
needed to be home.
Officer: I am glad to hear that you did not
give in into peer pressure, can you talk
about how you felt at that moment?
Manuel: I felt embarrassed, I felt stressed,
I felt scared
Officer: Why did you feel like that?

Manuel: I felt embarrassed because I was going

to look like a nerd for not wanting to do it, and I
felt scared because I did not know what would
happen if I did say no, what would happen if I
did
Officer: Thank you Manuel, that is a great
example of why students do give into peer
pressure, students want to be accepted by their
friends and often give into doing things they do
not want to do. That is a huge part of peer
pressure, now today, we are going to learn some
techniques on how to deal with peer pressure.
Lesson continues.

Project Towards No Drug Abuse

in both universal prevention for the entire
high school population, as well as selective
prevention for students at high risk of drug
abuse.
Project Toward No Drug Abuse targets
three predictors of drug or alcohol abuse.
Motivation factors include attitudes,
beliefs, desires, and expectations of drug
use. Decision making is explored, teaching
students how to make decisions that
influence their lives in positive ways.
Lastly, skills such as self control, social
skills, and coping skills are taught to
students in order to give them tools to turn
away from drug abuse. Effectiveness of
Project Towards No Drug Abuse is an
this program can be measured by doing pre
interactive program that aids the prevention
and post tests of: drug use in the past 30
of drug abuse in high school aged students.
days, knowledge tests about consequences
Project Towards No Drug Abuse integrates
of drug use, or skill scales in the areas of
drug prevention and treatment methods with coping, self control, and stress
cognitive behavioral therapy and skills based management.
training in individual counseling sessions. Its
http://tnd.usc.edu/tobuy.php
efficacy has been shown
1)
2)
3)
4)

8)
9)

IMPLEMENTATION
The Project Towards No Drug Abuse
program is delivered by teachers or
health care professionals in twelve
sessions 40 minutes in length, over the
course of three weeks. Each session
has a specific theme to address
substance abuse or positive life skills.
The emphasis is not necessarily on the
lesson material itself, but rather the
interactions between facilitator and
student; the facilitators questioning is
to lead the student to generate their
own answers.
The following are summaries of the 12
sessions:
Look below

1. Communication and Active Listening: Introduction to the program, discussion about effective communication skills
2. Stereotyping: Discuss common stereotypes in high schools and how they may lead to self fulfilling prophecies
3. Myths and Denial: Identify myths and facts about drug abuse, discussion on how beliefs can justify drug use
4. Chemical Dependency: Discuss negative consequences of drug abuse in different areas of the students life (family, social, emotional,
physiological)
5. Talk Show: Acting out or talking about past events where the student has had negative consequences caused by drug abuse
6. Marijuana Panel: Acting out or talking about past events where the student has had negative consequences associated with marijuana specifically,
discussion on other possible negative consequences of use
7. Smoking Cessation: Discuss negative consequences of tobacco use specifically
8. Stress, Health, and Goals: Talk about strategies to deal with stress, identify the life goals of the student, and discuss the value of health
9. Self Control: Discuss contexts where self control is necessary. Talk about consequences of lack of self control. Identify the students use of self
control
10. Positive and Negative Thought and Behavior Loops: Give examples about how thoughts, choices, and behaviors are linked
11. Perspectives: Identify examples that demonstrate perspectives on social issues, including drug use
12. Decision Making and Commitment: Discuss and practice decision making steps. Students end therapy by making a personal commitment about
drug use

Sample Counseling Session

For this sample session, the example will be based on lesson
five, Talk Show. In this excerpt, the facilitator will map out
the negative influence on drugs in the students life by evoking
a narrative to act out.
Facilitator: Can you tell me about a time where using drugs or
being around others who were using drugs had a negative
impact on your life?
Student: Well... this one time I was at a party and someone
brought some weed. I wasnt expecting to smoke that night, but
I didnt want to turn down free weed. In the end we got so high
that none of us could drive home. I had to stay the night. I
forgot to call my parents and tell them, so they were really
worried.
Facilitator: So it sounds like you got high and couldnt get
home, which worried your parents because they werent sure
where you went. I think you made a smart choice by not driving
home when you were high, but I see that getting high in the first
place caused some trouble with your parents.
Student: Yeah... When I got home they could smell the pot on
my clothes. They got really mad and took away my phone for
two weeks.
Facilitator: In your opinion, what about that situation made
you feel the most uncomfortable?

Student: I didnt like not being able

to do what I wanted to do. Like, I
wanted to go home, but I just
couldnt. I also felt really bad about
making my parents worry about me
like that.
Facilitator: Would you say that you
regret smoking weed that night?
Student: Yeah, I do.
Facilitator: If its okay with you, Id
like for us to act out the conversation
you had with your parents when you
came home the next day. Ill be your
parents, and you be you, okay?
Student: Okay.

R
e
s
e
a
r
c
h

Another study was done on

immediate outcomes of Project
Towards No Drug Abuse (Nadra,
Sun, Rohrbach, Spruijt-Metz, Unger,
and Sussman, 2012). Results
indicated that students who received
Program Towards No Drug Abuse
scored significantly higher on the
program-specific knowledge test.
Students who completed the program
also had significantly lower intentions
for drug use in the next twelve
months. These results indicate that
students who complete the program
gain knowledge about drugs and have
lower intentions to do drugs.

The long term efficacy of Project No Drug Abuse has been explored by Sun, Skara, Sun,
Dent, and Sussman (2006). Results of the study indicated that long term effects were
significant in reduction of hard drugs, but not in smoking, alcohol, or marijuana use.

POSITIVE ACTION
A program aimed to improve school attendance and academic performance,
while also reducing disciplinary problems, substance use,
and violence. In addition to benefits for the students, PA
incorporates resources for families, school personnel, and
community members which encourages colloboration of
these stakeholders to promote a more effective learning

environment.

Sample Session
Counselor: Why do you
think people use
Marijuana?
Student: Probably
because it helps them
relax and its cool. I
mean, thats why I
smoke.
Counselor: How do you
feel about smoking?
Student: I feel like it
mellows me out and
helps me stay calm.
Counselor: What else
can you think of that
helps mellow you out
and stay calm?
Student: I dont know,
listening to music,
exercising, eating. Stuff
like that I guess.
Counselor: So youre
saying that doing those
things might keep you
calm, just like smoking
does?

The Positive Action

program (PA) has three
core components
necessary for successful
implementation.
The first component is
the self-concept theory;
which states that peoples
perceptions of themselves
are shaped by their
actions more than
thoughts or feelings.
Therefore, more positive
behaviors lead to a better
sense of self-worth.

The unique organization of PA has been recognized as a program

designed to teacher comprehensive Skills for Successful Learning
and Living; meaning, students develop personal, behavioral,
academic, and social skills that support them in the classroom as
well as other social contexts throughout life (Flay & Allred,
2010).

PA: Implementation

https://catalog.positiveaction.net/secondary-kits/

In regards to drug abuse, students are provided the opportunity to explore

their motivations for their actions and asked to critically think about the thoughts
prior to their actions, the action itself, and how they feel after the action (Flay &
Allred, 2010). Positive Action demonstrates effectiveness with a diverse group of
youth including middle school-aged students in low-income, minority, urban
school settings (Lewis, Schure, Bavarian, DuBois, Day, Ji, Silverthorn, Acock,
Vuchinich, & Flay, 2013). Decreased numbers of disciplinary referrals and
suspensions resulted from the implementation of the PA program; furthermore,
these positive results were sustained despite the absence of the community aspect
of PA (Lews, et al., 2013) which suggests the significant that is possible when the
intervention is provided with fidelity. Also, PA is an intervention that
encompasses social skills as well as personal development which has been found
to a decrease in student-reported substance use and other maladaptive behaviors
(Beets et al., 2009).

Student: Yeah. Maybe.

Counselor: How does it
feel to know that
smoking isnt the only
way to keep you mellow
and calm?
Student: Its nice to
know that its not the
only option.
*Student comes to the
realization that drugs are
not the only way to
remain calm.
Figure 1 shows the theoretical model for the Positive Actions
program along with expected outcomes.

Secondly, PA requires the

ThoughtsActionsFeelings
about self circle where
facilitators encourage
participants to see that their
thoughts influence their actions
which influences how they feel
about themselves,and the cycle
begins again with positive
feelings leading to positive
thoughts and so forth. The third
core component is the program
content:
1. Self-Concept
What it is, how it is formed, and
why it is important?
2. Positive actions for body and
mind.
Nutrition (including not using
harmful substances), exercise,
sleep, hygiene, thinking skills,
problem solving, decisionmaking, creativity, and study
skills.
3. Managing yourself
responsibly
Self-control managing personal
resources like time, talent,
energy, thoughts, actions,
feelings, money, and possessions.
4. Building Social Relationships
Treating others the way you like
to be treated; showing respect,
empathy, kindness, fairness,
cooperation.
5. Being honest with yourself
and others
Taking responsibility for telling
self and others the truth,
admitting mistakes, not blaming
others or rationalizing, doing
what you say you will do,
knowing your strengths and
weaknesses.
6. Continually improving
yourself
Setting and achieving goals,
believing in potential, having
the courage to try, turning
problems into opportunities,
persisting, and broadening
horizons.

1-888-299-5213
Drug/alcohol
addiction recovery
hotline

1-800-662-HELP
(4357)
National Institute
on Alcohol Abuse
& Alcoholism

1-888-425-2666
Al-Anon/Alateen

1-800-784-6776
The National Alcohol
and Substance Abuse
Information Center

San Diego County Services

http://www.sdcounty.ca.gov/hhsa/programs/bhs/alcohol_drug
_services/adolescent_treatment_services_nonresidential.html
http://www.sdcounty.ca.gov/hhsa/programs/bhs/alcohol_drug
_services/adolescent_treatment_services_residential.html
San Diego Police Resources

http://www.sandiego.gov/police/services/units/juvenileservices
/resources.shtml#drug
San Diego Youth Organization

http://www.sdyouth.org/
Teen Health and Wellness Hotlines

http://www.teenhealthandwellness.com/static/hotlines#Alcohol

A Critical Look at the D.A.R.E. Program and Effective Youth Programs (1999, July 26).
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J. (2009). Use of a social and character development program to prevent substance use, violent
behaviors, and sexual activity among elementary-school students in Hawaii. American Journal of Public
Health, 99, 1438-1445.
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http://www.colorado.edu/cspv/publications/factsheets/positions/PS-001.pdf
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http://dare.procon.org/
D.A.R.E (2014). In Watervliet Police Department. Retrieved April 10, 2014, from
http://homepages.rpi.edu/home/40/mcgras/public_html/dare1.htm
D.A.R.E Curriculum (2014). In Auburn Police Department. Retrieved April 10, 2014, from
http://www.auburnpolice.com/programs/dare/curriculum/
DARE Student Worksheet (n.d.). Retrieved April 15, 2014, from
http://www.kydare.com/pdf/worksheet.pdf
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2014, from http://www.crimesolutions.gov/ProgramDetails.aspx?ID=99
Drug abuse trends change DARE America responds (2013, May 10). In D.A.R.E. Retrieved
March 22, 2014, from http://www.dare.org/drug-abuse-trends-change-dare-america-responds/
Flay, B. R. & Allred, C. G. (2010). The Positive Action program: Improving academics,
behavior, and character by teaching comprehensive skills for successful learning and living. In T. Lovat,
R. Toomey, & N. Clement (Eds.), International Research Handbook on Values Education and Student
Wellbeing, pp. 471-503. New York: Springer.
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Prevention. Retrieved April 5, 2014, from http://www.alcoholfacts.org/DARE.html
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from http://www2.potsdam.edu/alcohol/YouthIssues/1059145293.html#.U1bguvldWSp
Lewis, K. M., Schure, M. B., Bavarian, N., DuBois, D. L., Day, J., Ji, P., Silverthorn, N., Acock, A., Vuchinich,
S., & Flay, B. R. (2013). Problem behavior and urban, low-income youth: A randomized controlled trial
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9

Logic/theoretic model of the expected effects of the Positive Action program [PDF document].
Retrieved from Blueprints Program web site:
www.blueprintsprograms.com/resources/logic_model/PositiveAction.pdf
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Drug Abuse (TND) dissemination trial. Preventive Medicine: An International Journal Devoted To
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448384/

10

Appendix
Figure 1. Projects Towards No Drug Abuse

11

Figure 2: D.A.R.E.

12

Figure 3: D.A.R.E. http://www.kydare.com/pdf/worksheet.pdf

13

Figure 4: Positive Action

14