Helping Our Children—Time to Try a New Approach | Pt. III

Last time we talked about a new attitude to take when dealing with young people’s drug use. But in practical terms, how should people charged with guiding and caring for youngsters put this attitude to work?

In order to implement an effective drug-education practice, Dr. Rosenbaum stresses, four key actions must be taken. First, adults should use science to inform young people about drug use. Many adults have forgotten what it was like to be young; their impulse is to shield kids from the realities of drug use. They routinely underestimate kids’ ability to analyze data, evaluate facts, and make responsible decisions based upon empirical facts them.

It is not difficult to include scientific evidence about drugs into traditional educational and mentoring settings. Such information that may be incorporated includes the psychological and physical effects of drug use, the chemical makeup and effects of drugs, social ramifications of use and abuse, and historical and political frameworks. This sort of information may be featured in a variety of school curricula and may be tailored to be culturally appropriate as easily as other material might be.

Secondly, Dr. Rosenbaum states, the importance of moderation should be stressed. Though drug experimentation is quite common and all manner of drug use pervades society, drug abuse should be resisted. “[Young people] should know how to recognize irresponsible behavior when it comes to place, time, dose levels and frequency of use.” It is clear that the scientific evidence in a drug education program can provide young people with the knowledge they need to make informed choices for themselves. Such consideration of moderate drug use should also be made, she writes, based upon information about the specific health consequences of excessive use. Such consequences do not necessarily arise from experimentation with drugs, but from repeated, excessive and reckless use of drugs in circumstances requiring full cooperation, stamina, or focus.

Third, drug policies must address the potential negative consequences of drug abuse for young people; these negative consequences involve situations that might otherwise be rewarding, such as academics and sports. Within this part of informational caretaking, authority figures should also discuss situations in which mere drug use, and not abuse, may bring unwanted results. Dr. Rosenbaum uses the rules and laws that govern drug use in various places as examples. “They need to know that if they are caught in possession of alcohol, marijuana, or other drugs, they will find themselves at the mercy of the juvenile and criminal justice systems.” In schools, it may be the case that “penalties for violating the rules present risks that often extend well beyond the health risks of drug use itself: expulsion from school, a criminal record, and social stigma – all of which make it harder to find employment in the future.” As Dr. Rosenbaum has maintained throughout her booklet, this type of information should be used in much the same way that accurate scientific information is to be used: to let young people know the facts that will allow them to make appropriate, informed choices—not to frighten them.

The fourth parameter listed is the overarching message of the entire booklet: to place safety first. It must be recognized that the concept of safety should be the cornerstone, indeed the purpose, of a good drug education policy, for it is the safety of vulnerable individuals that drug education is designed to protect. Dr. Rosenbaum uses alcohol as a simple example of a drug around which very straightforward safety measures can be taken. The use of a designated driver and the reservation of safe spaces to drink are two steps that may be taken to aid the actual safety of young people drinking, not merely to aid the enforcement of laws and rules.

Some may argue that such safety measures serve only to enable young people’s use. But the message of safety within realistic situations remains. Dr. Rosenbaum writes, “Will teens stop drinking as a response to crackdowns? Probably not. Too many say they will just move the party to the street, the local park, the beach or some other place where adults are not present. And they’ll drive to get there.”

The booklet outlined here provides an extremely useful model to help authorities such as parents, teachers and spiritual mentors to enact a policy of drug guidelines that works within the world in which young people live. Though it may be uncomfortable for older people to imagine drug use by those in their charge, Dr. Rosenbaum’s brochure promotes bravery in the face of those ideas. As our history has shown time and time again, drugs remain a fact of life. Young people’s experimentation with drugs will not stop because of the threat of harsher punishment or stricter penalties.

Given this unavoidable truth, it is far better to work toward the safety of young people using drugs than to attempt to eradicate drug use. Any program designed to work within a fantasized environment is bound to be unsuccessful. Far better is Dr. Rosenbaum’s guide, firmly geared toward what young people face when making personal choices about drugs.

If you, like many, support a more effective attitude toward drug education, talk to those you wish to help; tell them the whole truth; ask them for their own insights; listen to their experiences without judgment. And most importantly, when designing a class or modeling realistic behavior or simply having a talk with young people, interact with them on their own turf–meet them where they are.

– By Maggie Maurer,
SPW Policy Intern


Helping Our Children—Time to Try a New Approach | Pt II

II.
In 2014, Dr. Marsha Rosenbaum published a guide for parents and educators entitled Safety First: A Reality-Based Approach to Teens and Drugs. She begins the explication of her transformative, reality-based approach for dealing with teen drug use with a heartfelt letter to her own son. At the time of her writing, her son was about to enter high school where, she was certain, he would be presented with numerous opportunities for drug use. Because the booklet is geared toward the education of young people, the attempt to understand their perspective is crucial, as is the understanding that experimentation with drugs—by people young and old—is common, and always will be. “Drugs are an integral part of American life,” she writes.

In this letter, Dr. Rosenbaum outlines the key ideas established in the rest of her booklet. She presents reasons for her son to heed her advice, all of which have to do with negative consequences of doing drugs, including potentially diminished academic and personal performance, as well as legal and institutional consequences that may follow him beyond high school. Notably, these consequences are things that can harm him and not things that may affect authority figures like her. Dr. Rosenbaum keeps her focus on the actions and reactions of her son, for it is within his conscience that the struggles with decision-making will take place.

The reasons not to do drugs that she gives may seem at first glance typical, but there is an important message within her advice here, and indeed, throughout the entire booklet: her continued reassurance that she is not offering caution because she wishes to appear wiser than he (and thereby fulfilling her own inner need rather than his), but because she truly wants to offer her own experience and knowledge as useful assistance. She writes, “I choose not to try to scare you by distorting information because I want you to have confidence in what I tell you.”

The guide goes on to break down features of young people’s drug use and the attempts that have been made to curb it, followed by an explanation of alternative measures that should be taken. Throughout the entire booklet, the focus remains squarely on the single most important thing to do in a successful preventative strategy: to tell the plain truth. Though adults in positions of authority assert that they, too, have always told the truth in their warnings, it is unfortunately the case that many abstinence-focused learning strategies tend to embellish consequences in order to instill fear in those listening. For example, statistics are often overstated for dramatic effect, again to heighten fear in vulnerable youth.

But the most grievous distortion of truth that often occurs in abstinence-based education is the widely accepted idea that all drug use is the same. Just as a streamlined, uniform set of rules and consequences is ineffective when dealing with individuals, so too is the simplified description of individual drug use counterproductive.

Rosenbaum writes, “prevention messages often pretend there is no difference between use and abuse…[or] emphasize an exaggerated definition that categorizes any illegal use of drugs as abuse.” The interchangeable use of the ideas of drug use and drug abuse is harmful for several reasons. For one thing, common sense shows that all use of altering substances is not necessarily abuse. The world is filled with drugs that are both legal and used in moderation. Caffeine, Ritalin, Valium, alcohol—all of these substances have been determined to be safe in certain amounts, despite the fact that they affect mood and consciousness, much as substances such as marijuana, heroin and cocaine do.

Why make such a specious claim? Much in the same way that rules and regulations have been established to bind all individuals, so have standards concerning degrees and types of harm. It is a fundamental principle of reality-based drug education and of harm reduction that the parameters of moderation and excess vary from user to user.

Far more detrimental, however, is the effect that equating drug use with drug abuse has on young listeners. Rosenbaum states, “Teens often dismiss this hypocritical message because they see adults routinely making distinctions between use and abuse. Most observe their parents and other adults using alcohol without abusing it.” Small wonder that young people view adults’ abstinence-based messages as disingenuous; they are continually confronted with its opposite.

Though these are only two problems with abstinence-based drug education, they are vital flaws. Dr. Rosenbaum argues it is far better to approach the task with evidence-driven caution; personal safety should take precedent. Next we will discuss several of the ways she offers in her pamphlet that people can take this preferred approach when dealing with young people.

– By Maggie Maurer,
SPW Policy Intern


Helping Our Children—Time to Try a New Approach | Pt I

“Today’s teenagers have been exposed…to anti-drug messages…designed to generate fear in young people and encourage them to abstain from alcohol and other drug use.”
–Dr. Marth Rosenbaum, Safety First: A Reality-Based Approach to Teens and Drugs

I.
Over 30 years ago First Lady Nancy Reagan popularized an anti-drug campaign best known by its catchphrase: “Just say no.” From a political standpoint, Mrs. Reagan couldn’t have more simply expressed “the” solution to drug issues. Not only was the action to be taken remarkably straightforward, the description of that action was, too. “Just say no!” A single word was all that was needed to vanquish the problem of drug use among our young people.

The simplicity of the solution strongly implied by extension that the problem itself was simple. Indeed, if a single action is truly the only thing necessary, perhaps people had made the problem entirely too complicated. America did not need to spend millions of dollars on law enforcement and treatment, or countless hours on education and mentoring. No, the problem was simply individual kids taking drugs based on their own choices. Very successfully, the anti-drug campaign sold the idea that making kids strong enough to say no was the best—and ultimately the only—answer.

Many Americans whose lives were not affected by the daily consequences of drug use, easily embraced this revolutionary step toward an end to the Drug War. These citizens began actively supporting abstinence-only education in schools, advertising on television, and programs in communities, youth groups, churches, and any other place where children were able to hear the message.

The result? After over 30 years of warning children to just say no, studies have shown no definitive correlation between drug-abstinence education and a reduction in the drug use of minors. Why did this program fail? And most importantly, after finding no documentable proof of any sort of success, why are we still using it?

Many people would argue that actions earn fitting results, and since those people understand drug use as a negative action, they reason that negative consequences must follow it. Furthermore, they believe that if the negative repercussions of drug use don’t happen consistently, kids will sense a weakness in the authority dictating proper behavior and morality; and that would make the problem of teen drug use even more out of control.

Moreover, many adults can remember a good deal about incidents in their own youth—times when they made foolish choices and suffered negative consequences for those choices. Since today those people are successful enough to have earned some degree of authority, their logic is that a set of rules that worked for them (and indeed, for many others like them) must necessarily be the most effective rule for everyone else.

One attitude rarely mentioned is the motivation that accompanies this abstinence-only instructional model. To be sure, many have been able to resist whatever temptations have befallen them: overeating, cheating financially, and using drugs, among other things. Inside many of us exists the sense that “proper” behavior is often the sacrifice of some sense of pleasure. The conviction that those who were not strong or brave enough to resist these pleasures should be punished: “Why should some people get to do the pleasurable things that we didn’t get to do?” they may think. The idea of unfairness often pulls at us and causes us to wish for punishments to others for getting away with something. But even within these deeply intrapersonal conclusions lies what has long seemed to be a given: that everybody on earth should live within and adapt to precisely the same framework as everyone else, no matter the differences in individual life circumstances.

One notable factor in all of these attitudes is that they focus more on the people unaffected by the repercussions of behavior than they do on those actively suffering those repercussions. Desires for swift punishment, for equality of constraint and predictable results stem from within those enforcing the rules. Such people are not the ones who will be directly affected by the policies they support; those affected are, ironically, overlooked.

This systematic uniformity has proven to be a colossal failure, as shown by the utter lack of effectiveness of abstinence-only drug education. And yet, in spite of this uselessness, the myth persists that, if one form of punishment proved to be utterly useless, surely a stronger form of that same punishment should do the trick. Albert Einstein once quipped that “The definition of insanity is doing the same thing over and over but expecting different results.” It seems that the policies of abstinence-only drug education have, over their years of repetition, entered the realm of insanity.

It is time for a new outlook on kids’ drug use. It is time for a factual accounting of effective strategies that may be used to best help out youth. It is time to meet kids on terms that are realistic for them, not terms that the rule makers find most comfortable. It is time for authorities to put aside their fears and to face the problem of young people’s drug addiction head-on. It is time to be brave enough to step into young people’s own territory; to meet young people where they are.

And how do we do that? In our next post we will delve deeper into Dr. Rosenbaum’s reasoning, and discuss views on drug education that should always remain in focus before beginning.

– By Maggie Maurer,
SPW Policy Intern


Sooner or Later, We All Intersect

Many of us remember when “running errands” was a bigger project than it is today. Even now, when most of us have free time to go and take care of stuff, there is a list a mile long: 1) Buy the week’s groceries 2) Make a deposit at the bank 3) Get a new pair of mittens [it’s December, and you’ll be darned if you don’t usually put the pair inside your pocket together] 4) Get the oil changed in the car 5) Stock up on thank-you notes.

Though this list is scattered, it is fairly representative of what many have to do on errand day. We used to spend entire Saturdays criss-crossing town, from service station to clothing store to grocery store, to the optometrist, to the bank.

I’ll bet I’m not the only one who felt great relief at the emergence of a certain store which shall remain nameless, but that is in nearly every town in America, at which we became suddenly able to accomplish multiple errands in one stop. Suddenly, taking care of our lives became markedly easier.

I do not have enough space in this article to address the various arguments that have arisen about this store since its genesis. However I chose to focus on the store as a metaphor for a key ingredient in social improvement and harm reduction efforts: intersectionality.

Intersectionality is a phenomenon embodied by every individual. It is the unique combination of one’s (often involuntary) espousal of multiple identities including those that are socioeconomic, racial, geographical, gender-based, and healthcare-driven. Put simply: none of us have only one identity. We ourselves are intersectional, as we are a unique compilation multiple perspectives and multiple characteristics.

Okay, So I’m Multifaceted. So What?

One of the most harmful things to real social progress is the mistake many of us make: identifying ourselves only by to one facet of our intersectional selves. In our quest to protect the interests of the identity that we have deemed most important, we often overlook other parts of ourselves that also have contributing needs. For example, if I vote in an Arizona election, I may choose to think of myself primarily as a taxpayer, and vote for policies that best protect my interests regarding taxes. But if I am an environmentalist as well, I may choose to subsume that part of my identity in favor of my identity as a taxpayer. Because most policies cannot reflect our intersectional identities, we end up choosing to represent only the part of our identity that seems most important to us.

Unfortunately, as we attempt to whittle our own identities down to one dimension, we tend to begin viewing others around us as singular, as well. Moreover, in seeking to protect ourselves and our families, we tend to identify others according to their characteristics we view as most dangerous. Thus, someone who is a resident of Phoenix, a mother, and a user of intravenous drugs tends to get labeled by members of her community merely as an intravenous drug user. The other parts of her identity that need support? They get swept under the rug.

It is crucial for all of us, we members of the intersectional human race, to understand is that we all have multiple needs and multiple motivations. But others who may seem dangerous to us must be treated as residents of the communities that we share. In order to make our state safer, we need to keep safe all of the residents of our state. In order to protect my interests as a resident of Phoenix, I need to consider all of the residents of Phoenix as part of the equation. Just like the famous store, our communities are made up of many different sections, many of which do not affect us personally.

When we are able to see all lives as intersectional and having various needs, we are better equipped to support policies and programs that may affect some of our fellow Arizonans, but perhaps not us directly. We in the Harm Reduction community seek to remind our fellows that programs empirically proven to help members of marginalized social arenas, help all of us. If we want to make all of Arizona safer and healthier, we must seek to bring safety and health to all Arizonans. None of us has only one identity; we must focus on the parts of identity that we share.


What Would Jesus Do?

“And the King answering, shall say to them: Amen I say to you, as long as you did it to one of these my least brethren, you did it to me.”  --Matthew, 25:40

Many of us heard this quote often growing up, and many have unconsciously incorporated it into our daily outlook on life.  We try our best to be considerate to passersby, to those we meet in service positions, and perhaps most crucially, to those we feel have wronged us or those we love.  Regardless of personal religious affiliation, people would overwhelmingly argue that this idea, resting deep inside millions and millions of hearts, is a tool that helps us—all of us—live in a healthier, more peaceful world.

But some aspects of our world seem decidedly unhealthy, unpeaceful, and downright dangerous.  Such situations, circumstances and people are those that seem to have fallen victim to unspeakable evil; some things, we think, are so far gone that no effort, no matter how God-centered, will bring any aid or relief.  But a collective voice of religious conviction is rising, reminding all of us—all children of God, that we need to double down in tough times and translate our faith into works.

The opioid epidemic is running rampant across America.  People in positions of legal, medical and intellectual authority are testing any possible remedies for the opioid crisis that they can find.  Some relief has been found, but by and large the drug problem this country faces is still of epic proportions.

Yet the barest glimmer of hope has begun to shine, as research has begun to show unequivocally that syringe service programs (SSPs: Mobile networks that provide users of intravenous drugs with clean needles) are helping to markedly reduce the spread of bloodborne infections (including Hepatitis C and H.I.V.) in places where they have been legally sanctioned. SSPs are not only helping reduce harm among those who actively use drugs, but also among members of the larger community, including law enforcement officers and medical technicians. SSPs help benefit the fellowship of men and women in which we all live.

Of course, at first glance the idea of offering clean needles to people using intravenous drugs seems counterintuitive.  After all, wouldn’t giving people the tools needed to use drugs in effect say to them, “Using drugs is okay! You have society’s blessing to carry on in your misery”?  And because overdoses, infections and deaths from injectable drug use continue, it seems to many that SSPs aren’t accomplishing anything apart from spreading drug use. And spreading drug us is not helpful at all.  Indeed, it seems rational to declare a War on Drugs; to declare a war on a phenomenon that has declared war on our world, and left many of us for dead.

But as people of faith, this is precisely the time to put our convictions to the test.  We must momentarily set aside the fact that research shows SSPs to be an effective weapon against the harms perpetuated by intravenous drug use, and answer a deeper call.  Even though our own struggles may not on the surface resemble those of millions of people grappling with intravenous drug use, we must remember how we have felt in our own darkest hours.  We must remember our own yearning, our own defeated pride, our own crushed confidence. Most importantly, we must remember what it was like to feel the constant weakening of our last hope: that God would send His mercy our way, no matter the form that mercy might take.

We are all members of the same human family. We must recall the ways in which family members can cause us grief; many of us and those we hold dearest may have been devastated by opioid use. As Jesus advised, we must turn the other cheek.

Many religious leaders have begun to echo the sentiment that when fighting the spread of drug use, our pervasive spirit of punishment is wrong.  Instead, they argue, the highest motivation should be “our religious principles of compassion, healing, forgiveness, reconciliation, and love.”

Syringe Service Programs show us at least one way to adopt such attitudes while still effectively fighting drug use and the harm it brings.  By supporting legislation allowing SSPs to operate legally in Arizona, we of earnest faith are doing something to help those who are suffering.  Just as God’s laws seek to save people from their own misguided behavior, so should our laws here on Earth seek to help—not to condemn.

As people of faith, our highest calling in this lifetime is to act according to the examples of best model yet to appear.  To live a satisfying life that is orchestrated by God, we must remember to follow His teachings. To offer our support to those who desperately need our helping hands.


Florida Expands It's Miami-Dade Needle Exchange Program

On May 1, the Florida legislature voted 40-0 to expand a pilot needle-exchange program from Miami-Dade county to
all Florida counties.  The measure will allow Syringe Service Programs (SSPs) to operate statewide, widening the distribution of unused needles, Naloxone, H.I.V. testing and treatment referrals.

We here at Sonoran Prevention Works fully support this measure, and we applaud the efforts of the lawmakers and advocates who have worked to bring about this legislation.  Like Arizona, Florida is a conservative state; the similarities between the two states give us great hope that the evidence-based, lifesaving steps taken in Florida are possible in Arizona, as well.

Florida’s lawmakers wisely examined the data related to SSP use in various areas, including in Miami-Dade county, where they elected to run a test SSP program.  Unsurprisingly, in areas where SSPs have been put in place, rates of H.I.V. infection have dropped dramatically, the presence of improperly-discarded needles has decreased, and opiate overdoses have been sharply curtailed by the distribution of Naloxone (Narcan) and its use by people who use drugs.

Arizona and Florida are two of the states reported to have had the greatest increase in overdose deaths between 2016 and 2017.  But while Florida’s increase was a mere 5.9%, Arizona’s increase was 9.4%.  With no further steps taken in Arizona to slow the effects of the opioid epidemic, we can expect the death rate to continue to increase.

We at Sonoran Prevention Works wish to re-assert our evidence-based, data-driven support for the legalization of SSPs, the implementation of which is the single most effective weapon we Arizonans can wield against the deadly drug problem that grips our whole country, and our state in particular.