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Boundaries · 1983

D.A.R.E. — Drug Abuse Resistance Education

Prevention is entrusted to information, abstinence norms and skills for resisting peer pressure.

D.A.R.E. —Drug Abuse Resistance Education— was a school prevention programme created in Los Angeles in 1983 through collaboration between the Los Angeles Police Department and the Los Angeles Unified School District. Its classic format used standardised lessons delivered mainly by uniformed police officers and combined education about alcohol, tobacco and other drugs with abstinence messages, decision-making, the identification of peer pressure and practice in refusal responses. It achieved massive expansion in the United States and other countries, but evaluations of the classic curriculum found null or very small preventive effects on substance use. It is a universal prevention programme and not a psychotherapy, because it intervenes with school groups regardless of any individual request for help, does not formulate clinical cases and is not systematically adapted to a specific psychological problem.

Theory of change

The programme assumes that preventive knowledge, abstinence norms and refusal skills reduce the likelihood of use in the face of peer pressure.

Core ideas

  1. D.A.R.E. is school prevention, not psychotherapy

    D.A.R.E. is aimed at groups of students regardless of whether they present a psychological problem, a substance use disorder or a subjective request for help. Its format consists of standardised preventive education and not of an individualised interpersonal treatment based on clinical assessment, case formulation and adaptation to a specific form of suffering. Wampold and Imel explicitly place initiatives of this kind among prevention programmes and not within their definition of psychotherapy. (Wampold & Imel, 2015).

  2. The classic curriculum relies on information and interpersonal resistance

    The central logic of classic D.A.R.E. holds that pupils will reduce their risk of use once they know the consequences of substances, adopt abstinence norms and can resist peer pressure through refusal responses and decision-making. The programme is built around this combination of psychoeducation, resistance skills and behavioural commitment. (Ennett, Tobler, Ringwalt & Flewelling, 1994; Clayton, Cattarello & Johnstone, 1996).

  3. The police presence is part of the programme's historical identity

    One of the most recognisable features of classic D.A.R.E. is that the lessons were delivered by uniformed police officers. This configuration sought to lend authority, visibility and institutional legitimacy to the preventive message, integrating school, police and community within a single prevention strategy. (Rosenbaum & Hanson, 1998).

  4. Institutional dissemination does not guarantee preventive effectiveness

    The massive expansion of D.A.R.E. illustrates that a programme's public popularity, ease of implementation, institutional authority and political acceptance do not amount to robust preventive results. The accumulated evaluations of the classic curriculum called into question whether its spread reflected any real, sustained reduction in substance use. (Ennett, Tobler, Ringwalt & Flewelling, 1994; West & O'Neal, 2004).

  5. The overall preventive effect of classic D.A.R.E. was virtually null

    West and O'Neal reviewed eleven D.A.R.E. studies with comparison groups and assessments of alcohol, tobacco or illicit drug use before and after the intervention. The overall effect was d = 0.023 in favour of D.A.R.E., an extremely small magnitude indicating that the classic programme produced no relevant, consistent preventive reduction in substance use. (West & O'Neal, 2004).

  6. Ineffectiveness and harm are distinct empirical conclusions

    A programme may lack preventive effectiveness without necessarily producing a general increase in the problem it aims to prevent. Wampold and Imel stress that the classification of D.A.R.E. as a harmful intervention has sometimes rested on isolated negative results, when the body of available studies showed an aggregate effect close to zero. This distinction requires that harm and ineffectiveness be assessed on the basis of the complete corpus of evidence and not through the selection of particular adverse findings. (Wampold & Imel, 2015).

  7. Isolated adverse evidence did not justify a general classification of harm

    Wampold and Imel note that Werch and Owen found only one D.A.R.E. study with indications of a negative result, limited to a subgroup of suburban schools and reduced once exposure to other drug education programmes was controlled for. In West and O'Neal's later meta-analysis, only one of eleven studies showed a negative effect, d = −0.117, while the aggregate result was virtually null. (Werch & Owen, 2002; West & O'Neal, 2004; Wampold & Imel, 2015).

  8. Preventing substance use requires a broader formulation than individual resistance

    The onset and maintenance of substance use may be related to trauma, psychopathology, social exclusion, violence, family use, availability of substances, community norms, attachment relationships and social reinforcement. A programme centred mainly on information and interpersonal refusal may prove insufficient when these factors organise the risk, so the needs for prevention, harm reduction and treatment must be distinguished clinically. (Wampold & Imel, 2015; West & O'Neal, 2004).

Influences

  • Universal school-based prevention
  • Health education
  • Training in resistance to peer pressure
  • Community policing
  • The anti-drug policies of the War on Drugs

Key references

  • Wampold, B. E., & Imel, Z. E. (2015). The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work (2nd ed.). Routledge.
  • Werch, C. E., & Owen, D. M. (2002). Iatrogenic effects of alcohol and drug prevention programs. Journal of Studies on Alcohol, 63, 581–590. [https://doi.org/10.15288/jsa.2002.63.581](https://doi.org/10.15288/jsa.2002.63.581)
  • West, S. L., & O'Neal, K. K. (2004). Project D.A.R.E. outcome effectiveness revisited. American Journal of Public Health, 94(6), 1027–1029. [https://doi.org/10.2105/AJPH.94.6.1027](https://doi.org/10.2105/AJPH.94.6.1027)
  • Ennett, S. T., Tobler, N. S., Ringwalt, C. L., & Flewelling, R. L. (1994). How effective is Drug Abuse Resistance Education? A meta-analysis of Project D.A.R.E. outcome evaluations. American Journal of Public Health, 84(9), 1394–1401. [https://doi.org/10.2105/AJPH.84.9.1394](https://doi.org/10.2105/AJPH.84.9.1394)
  • Clayton, R. R., Cattarello, A. M., & Johnstone, B. M. (1996). The effectiveness of Drug Abuse Resistance Education (Project D.A.R.E.): 5-year follow-up results. Preventive Medicine, 25(3), 307–318. [https://doi.org/10.1006/pmed.1996.0051](https://doi.org/10.1006/pmed.1996.0051)
  • Rosenbaum, D. P., & Hanson, G. S. (1998). Assessing the effects of school-based drug education: A six-year multilevel analysis of Project D.A.R.E. Journal of Research in Crime and Delinquency, 35(4), 381–412. [https://doi.org/10.1177/0022427898035004002](https://doi.org/10.1177/0022427898035004002)
  • Lynam, D. R., Milich, R., Zimmerman, R., Novak, S. P., Logan, T. K., Martin, C., Leukefeld, C., & Clayton, R. R. (1999). Project D.A.R.E.: No effects at 10-year follow-up. Journal of Consulting and Clinical Psychology, 67(4), 590–593. [https://doi.org/10.1037/0022-006X.67.4.590](https://doi.org/10.1037/0022-006X.67.4.590)