Do you remember the public service announcement video titled “This Is Your Brain on Drugs?” This ad series, like others in the 1980s, begins with a man holding an egg (your brain) and dramatically cracking the egg-brain into a sizzling hot frying pan as an ominous-sounding voice-over explains “this is your brain on drugs”. These ads were all in the spirit of substance use prevention and educating youth to make sure that they wouldn’t use substances. This ad series, like any others in the 1980’s relied heavily on scare tactics and an absolute belief that drug use is always a choice, with abstinence being the only solution. October is National Substance Use Prevention Month, and I would like to challenge old models of prevention.
Last year, I traveled around the state working with harm reductionists and talking to churches about substance use disorders and the overdose crisis in North Carolina. Immediately, all of my ideas about drug use, and how I developed those ideas, was challenged. I have had to rethink the effectiveness of prevention, from what we consider legal drugs like alcohol or caffeine and illegal drugs like heroin or marijuana. Like many, growing up with the DARE (Drug Abuse Resistance Education) program and the public service ads mentioned above, I thought that drug use was a dichotomy; you were either using drugs, or you weren’t. But through my work, I have learned and realized that drug use is a spectrum. I’ve personally met people who abstain from drug use, people who use drugs, people who are medically dependent on drugs, people experiencing active substance use disorder, and people who have been lost to substance use disorder. I’ve come to realize that drug use is a spectrum, that our previous methods of abstinence-only prevention do not work.
When I started this work, I read everything I could on substance use and addiction. One of the books that helped me challenge my perceptions of drug use was Johann Hart’s book Chasing the Scream. He did a condensed version of the book in a TED talk called Everything You Know About Addiction Is Wrong. In it, he explains that our views of addiction are outdated and that we have based a whole system on the wrong data. He describes the famous rat study where a rat is given two water bottles, one with water in it and one with water and cocaine. In this study, each time the rat will eventually end up addicted to the cocaine water. However, a scientist named Bruce Alexander thought this study was flawed because the rat was completely isolated in the cage. He had no one to play with and nothing to do other than drink the cocaine water. Alexander decided to redo the study. Instead of keeping the rat alone in the cage, he built a rat park, a kind of paradise for rats. In the study, there were lots of other rats to play with, toys, and mental stimulation. Alexander found that the rats did not prefer cocaine water after all. Johann Hart argues that Alexander’s study shows that the opposite of addiction is not sobriety, but connection. That statement has stuck with me and has been formational to my work.
What if we reframed prevention around beloved community instead of abstinence-only? Instead of telling people to “just say no,” we all engaged in saying “yes” to building community. If instead of using education to incite fear, we used to teach kids about mental health, adverse childhood experiences, and community building. This prevention month I ask you to join me in challenging how we can expand our definitions of substance use prevention, and think about the opportunity for connection available to people in your community.
For information about Prevention resource alternatives to DARE
For articles and research on the ineffectiveness of DARE