When President Bush took office, drug use had been on the rise over much of the previous decade and had reached unacceptably high levels. The Administration set out a bold agenda to counter these trends, and the Nation is seeing results: drug use is down, particularly by young people.

At the heart of the Administration’s success in reducing drug use is a change in perceptions about the acceptability of using illicit substances. Education programs and outreach activities, backed up by scientific studies, have worked to spread the word that illicit substance use can be harmful to a person’s health and wellbeing, as well as a detriment to society as a whole. Drug addiction can also be seen as a threat to individual freedom in that it can reduce people to a single, destructive desire. Given the harmful effects of substance abuse, the National Drug Control Strategy has made healing drug users a priority—a testament to the fact that America is the land of second chances.

The three charts below show Trends in Cigarette Use, 1900–2004 (left), Trend in Illicit Drug Use, 1974–2004 (middle), and Trends in Alcohol Use, 1850–2002 (right)

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The greatest pressure on young people to start using drugs does not come from drug pushers but from their peers. It is, therefore, important to continue to educate young people about the dangers of drug use and build a cultural norm that views illicit drug use as unacceptable. This culture, and the attitudes that support it, works as a bulwark against the spread of drug use.

Attitudes start at home—and parents and caregivers play the most influential roles in the lives of children. Children who have parents and caregivers who are engaged, loving, and supportive are more likely to grow up to be healthy, productive adults. Engaging young people directly about drug use has been shown to reduce the chances of drug initiation. Also, research shows that if teens can make it to adulthood without experimenting with drugs, they are far less likely to begin using drugs later in life. The community also plays an important role in establishing a culture that promotes healthy choices. Through their actions and attitudes toward drug use, teachers, coaches, faith leaders, employers, and community organizations show young people how to lead their lives. If these role models treat drug use as a rite of passage, young people will take the cue and experiment with dangerous, addictive substances. On the other hand, if they highlight the dangers of drug use and set out clear guidance that drug use is not tolerable, then they help build a culture that promotes drug free lives.

Trends in cigarette, illicit drug and alcohol use illustrate this point. The use of these substances has ebbed and flowed, reflecting cultural changes regarding perceptions of risk and the social acceptability of substance use, as well as the impact of effective policies that affect the availability of, and demand for, harmful substances (see chart above). As substance abuse became socially acceptable in the 1970s, use increased. Likewise, when social norms changed and people became more aware of the dangers of substance abuse, use declined.

The Bush Administration has worked to change a culture of acceptance of drug use by providing information about the dangers of drugs to users and the costs to society. The Administration is working with parents, faith leaders, and community organizations to help young people make the decision to avoid illicit substances. Last year, First Lady Laura Bush launched the Helping America’s Youth Initiative, which is intended to help young people avoid risky behavior. At the Helping America’s Youth conference in October 2005, Mrs. Bush and five members of the President’s Cabinet were joined by more than 600 parents, caregivers, civic leaders, faith-based and community service providers, researchers, and other interested parties to highlight the challenges young people face and identify ways to help young people grow to live successful, productive lives (see Community Guide to Helping America’s Youth).

	Community Guide to Helping America’s Youth During the 2005 State of the Union Address, President Bush announced that First Lady Laura Bush would lead a new initiative, known as Helping America’s Youth. The Helping America’s Youth Initiative focuses on ways to help young people avoid risky behavior such as alcohol, tobacco, and drug use, engaging in early sexual activity, and gang involvement. The initiative works to bring Federal, state, local and nonprofit resources together to encourage public-private partnerships and to inspire caring adults to join the armies of compassion to help our Nation’s youth. The aim is to create an environment that promotes healthy decisions so that young people can become productive citizens. To help local communities better identify the challenges they face and the resources available to address those challenges, Mrs. Bush announced the creation of a web-based community guide. The Community Guide to Helping America’s Youth, located at www.helpingamericasyouth.gov, provides an array of data to local communities on poverty, out-of-wedlock births, drug use, underage alcohol use, sexually transmitted disease rates, and other issues. It then gives a program-by-program list of services available in the community to help meet these challenges. The Community Guide also gives insight into ways to create stronger community partnerships, from locating resources to finding individuals to serve as members on the board of directors for a service provider. Communities will be able to add to the site through their own secure community network and share best practices with other organizations around the country.

To help bolster cooperation among Federal, state, local, and non-governmental sectors, the Bush Administration launched the Strategic Prevention Framework (SPF). The framework develops data-driven comprehensive strategies that effectively reduce factors that put communities at risk for drug abuse, while strengthening protective factors that can result in healthy outcomes for individuals of all ages—particularly our Nation’s youth.

The framework creates an infrastructure that ties together prevention efforts at Federal, state, and local levels and within communities. Each participating state develops a prevention strategy that is tailored to local needs and works to implement new policies, programs, and practices that leverage existing community resources while working to build new ones. The framework has two primary components: an evidenced-based five-step planning process to guide the development of a comprehensive prevention strategy and a data-driven methodology that states and communities can use to plan and implement strategies that best serve their communities. Since the framework was announced in October 2004, the Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded 26 SPF State Incentive Grants.

This SPF program is built on the idea that states and local organizations are in the best position to identify the challenges they face and to take action to overcome them. Indeed, communities across the country have formed local anti-drug community coalitions that coordinate prevention and intervention efforts. These coalitions bring together community leaders and professionals in health care, law enforcement, and education to provide local, grassroots solutions to the challenges drug and alcohol abuse pose to their neighborhoods. Coalitions work to develop a model for all sectors to work together to change community norms and send the same no-use messages to young people. The Administration supports the efforts of many of these coalitions by providing $79.2 million in the President’s FY 2007 Budget through the Drug Free Communities (DFC) program. Through the establishment of community coalitions, the DFC program is designed to complement the development and implementation of the SPF in communities across America.

	One Voice for Volusia Drug use is a local problem that demands local solutions. Drug Free Community (DFC) coalitions bring together a wide range of stakeholders to tackle substance abuse on the local level. Their efforts focus on the prevention of youth alcohol, tobacco, drug, and inhalant use. When united, these coalitions of representatives from various community systems become a strong force for positive change in the Nation. Community coalitions assess local strengths and needs and then design their strategies around these findings. One Voice for Volusia is a DFC located in Daytona Beach, Florida. The coalition has been in existence since 1997. In 2004, One Voice for Volusia brought together local stakeholders to define a common vision for youth in their area. They identified 26 local organizations that work with or on behalf of youth. One Voice then worked to develop a plan to ensure that existing service programs run more efficiently. The group performed a local needs assessment to determine which youth issues they should prioritize. The assessment also provides a baseline by which progress can be measured. “We're working on improving the community systems in Volusia County to create a healthier environment for all of our youth,” says Executive Director Carrie Garnett. Currently, the project covers both Volusia County and neighboring Flagler County. Key goals include building stronger families, promoting wellness and health, and creating a brighter future for children and youth.

Currently, there are over 700 funded DFC coalitions, which exist in every state and form the backbone of the Nation’s community prevention system. Under this program, each grantee receives up to $100,000 annually for up to five years to develop a comprehensive community plan to address substance abuse problems.

Drug use is a particular concern for those who are leaving prison, and the Administration is supporting local organizations that help prisoners transition to independent, drug- and crime-free life outside prison walls. Recently, 30 organizations were awarded grants as part of a proposed four-year, $300 million initiative that the President announced in his 2004 State of the Union Address.

Parents, caregivers, and community leaders play an important role in promoting healthy decisions, but ultimately young people must choose for themselves to stay away from drugs. Recognizing this, ONDCP’s National Youth Anti-Drug Media Campaign, working with the Partnership for a Drug-Free America, launched a new advertising and online campaign for teens ages 14–16 that encourages them to live “above the influence” and to reject the use of illicit drugs and other negative pressures.

Above the Influence, launched in November 2005, features a series of television, print, and web-based interactive advertisements that tap into the power teens gain when they resist negative influences that compromise their values and aspirations.

Teens in high school today face competing pressures that can contribute to risky behaviors. These behaviors are positioned as “under the influence,” and the brand calls on teens to rise above them. The aim of this new campaign is to speak directly to the aspirations of young people. Staying away from drugs is not just what their parents and caregivers want for them—it is a way to be true to themselves and their potential.

Promoting a culture that supports healthy, drug free choices requires providing disincentives to using drugs as well. Screening for drugs is an important way to send the message that drug use is unacceptable—in the workplace, in schools, or as a condition for participating in extracurricular activities (see Student Testing to Maintain Safe Schools). Screening for drug use gives young people an “out” to say no to drugs. If they want to play on the volleyball team and know that they will be tested as members of the team, they can cite their desire to play as a reason not to use drugs when pressured by a peer.

In addition to creating a culture of disapproval toward drugs, drug testing also achieves three public health goals: it deters young people from initiating drug use; it identifies those who have initiated drug use so that parents and counselors can intervene early; and it helps identify those who have a dependency on drugs so that they can be referred for treatment.

Many schools across the country have instituted student testing as a way to maintain drug free schools and ensure that students who use drugs get the help they need. In his 2004 State of the Union Address, President Bush announced a new initiative to support communities that want to include drug screening as part of their efforts to maintain drug free schools. The program is optional—communities must apply for the grants—and it is not tied in any way to Federal education funding. Furthermore, testing cannot result in referral to law enforcement agencies or adversely affect the student’s progress in academic programs. Instead, the program is designed to help students make healthy choices and provide support for those who may have become addicted to illicit drugs. As the President said in his 2004 State of the Union Address, “The aim here is not to punish children, but to send them this message: We love you, and we don’t want to lose you.”

Student Drug Testing Sites

* Department of Education grantees ** School districts and private schools that identified themselves as conducting student drug testing in a 2003 survey conducted by the Office of National Drug Control Policy. *** Schools that were identified in media reports as conducting student drug testing. Source: Office of National Drug Control Policy (2005).

Recognizing the vital role that student drug-testing programs can play in reducing drug use in our Nation’s schools, the Administration has hosted a series of student drug-testing summits nationwide. These summits are designed to equip community leaders and local school officials with the tools they need to construct a successful student drug-testing program. Summit attendees learn from national and regional experts in the field about current technology, research, and legal issues surrounding the program and receive practical advice from those who have run successful programs and found innovative ways to fund them. The Administration will build on these successes and host several more summits in 2006.

	Drug Free Workplace American employers pay a high price for substance abuse, including increased employee absences from work, a higher potential for accidents and errors, low employee morale, and high illness rates. To ensure a healthy and safe environment, employers across the country have enacted drug free workplace programs. These programs are an effective way for both large and small employers to prevent substance abuse and provide assistance to those who have developed a problem. It also sends an important message to both prospective and current employees: if you want to work and stay healthy, you can't use drugs. Recognizing the need for a high level of conscientiousness and integrity in its staff, the human resources department for a nursing facility in Kingman, Arizona, decided to set up a drug free workplace program. The program they designed consists of a written policy that clearly outlines employer expectations regarding drug use, training for supervisors on the signs and symptoms of drug use, education for employees about the dangers of drug use, and drug testing to deter and detect use. It also includes an Employee Assistance Program (EAP) to provide counseling and referral to employees with drug problems. The center’s 200 employees accepted the program from the beginning, recognizing its value to them as employees and as caregivers to the residents. Since its implementation, there have been reductions in absenteeism, overtime, and workers’ compensation costs. “The center provides quality living by people who care, and our drug free workplace program ensures that the caring people are always at their best,” said Reva J. Sorber, human resources manager of the facility. “Because the center is a drug free workplace, employees feel safer and more secure, and families know that their loved ones are in the best of hands.” Every business is unique, and drug free workplace programs should be tailored to match a company's individual needs. Good programs generally include five elements: A written drug free workplace policy, that explains why the policy is enacted and provides a clear description of prohibited behaviors, as well as an explanation of the consequences for violating the policy. Supervisor training that ensures managers understand the workplace policy and provides information on how to recognize employees who have performance problems that may be related to substance abuse. It also explains how to refer employees to professional help. Employee education programs that provide information on company policy, how to comply with the policy, the consequences of violations, and general information on the dangers of substance abuse. Employee assistance programs that help prevent, identify, and resolve issues relating to substance abuse. These programs can include counseling and referral to professional help, which can be an alternative to dismissal. Drug testing that deters and detects drug use and provides concrete evidence for intervention. The Department of Labor has a website, www.dol.gov/workingpartners, that provides information on setting up a drug free workplace program. Employers should seek legal counsel when setting up a drug free workplace program to ensure company policy is in accordance with applicable local, state, or Federal laws and regulations.

Screening for drug use in school also helps prepare students for the workforce. Students must prepare for being part of a workforce that is increasingly insistent on maintaining a drug free environment. Employers cite safety, absenteeism, and health-related problems as key reasons why positive tests can result in serious sanctions for employees. Student testing prepares young people for this reality.

For adults, drug screening helps prevent initiation of use by sending a clear message that in order to work, one must be drug free. Furthermore, because the vast majority of American adults work, and most of these workers are parents, the workplace is an effective setting for prevention messages that have the power to spread exponentially to America’s families, schools, and communities. Perhaps most importantly, drug screening also keeps people who use drugs away from positions that can affect the safety of others, such as operating public transportation vehicles or caring for children and the elderly.

In all cases, the purpose of screening is twofold: send the message that drug use is unacceptable, and identify those who use drugs so they can receive appropriate intervention and treatment.

	Student Testing to Maintain Safe Schools A pioneer in student testing, Winston-Salem/Forsyth County Schools in North Carolina have used the It's My Call/It's Our Call random drug-testing program since 1998. In this program, high school students who participate in extracurricular activities agree to be randomly tested for drugs and alcohol. Other high school students and all middle school students also may volunteer for the program. Parent permission is required. The program has demonstrated its effectiveness. Since the 2000 school year, the percentage of students testing positive for alcohol and other drugs has declined steadily. It’s My Call/It's Our Call is designed to be therapeutic rather than punitive. Students who test positive are invited to be evaluated and treated for addiction problems at the school system's expense. If students agree to evaluations and treatment, their positive results are not reported to school officials. The program was started at Carver High School in 1992 before it was adopted system wide 6 years later. With almost 90 percent of the students participating in the program, Carver has won a trophy the past 3 years for having the highest percentage of student involvement. System wide participation in the program is a solid 55 percent. “When so many students participate, they feel positive peer pressure to join the program,” said Carol Montague, the principal of Carver. “It's helped create a very positive environment where you're expected to be drug and alcohol free.”The program is a collaborative effort by the school system, the Forsyth County Sheriff’s Office and the Partnership for a Drug-Free NC.

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