Drug Education Programs Research Articles

Assessing the Impact of Drug Education Programs on Generation Z Tertiary Students' Knowledge

Aims: The Drug Education Program aims to impart knowledge about the dangers of drug abuse, especially among Generation Z tertiary students. Understanding the intricacies of drug abuse is imperative for personal well-being and catalyses the dissemination of critical information within the community. Despite the widespread existence of educational programs, there is an existing research gap regarding their effectiveness in improving the knowledge level of Generation Z tertiary students. Consequently, this study aims to assess the level of knowledge on drug abuse among Generation Z tertiary students.
 Methodology: This cross-sectional study involving 296 participants explores the knowledge levels of Generation Z tertiary students across seven drug categories. Participants engaged in student development programs were randomly selected, and a specially designed questionnaire was utilized for data collection through Google Forms. Descriptive data, presented as percentages, revealed gender-based disparities in knowledge and lack of knowledge about various drugs.
 Results: The analysis indicates that males generally possess a greater understanding of stimulants (30.16%) compared to females (15.9%), with marginal gender disparities in depressants (17.9% for males and 19.24% for females). Males exhibit slightly higher knowledge (17.64%) than females (14.34%) for hallucinogens, while knowledge levels about opium are comparable between males (35.55%) and females (33.52%). Moreover, males surpass females in understanding cannabis (27.3% to 19.46%), inhalants (33.88% to 29.82%), and kratom (15.3% to 9%).
 Conclusion: These findings highlight the overarching strategy recommends that educators adapt teaching methods by integrating real-life scenarios, grasping Generation Z's characteristics, and leveraging technology to establish an effective and resonant learning environment for this generation.

Prevalence and Causes of Drug Abuse among Youth-Recipients of School-Based Drug Education Programs: A Mixed-Method Study

This study investigated the impact of school-based drug education programs on drug use behavior through examining the prevalence and causes of drug abuse and addiction among youth-recipients (16-30 years) of drug education (DE) programs in Nigeria. A concurrent embedded mixed-method design was adopted for the study and data were collected with a questionnaire and an interview schedule on drug use behaviors. Results showed that drug abuse prevalence ranged from 3.8% for cocaine to 23.7% for alcohol, with daily addiction levels ranging from 1.3% to 5.0%. Depression, peer pressure, and social/economic hardships cause drug abuse. Drug education and gender influence drug use behavior. Drug abusers possess health, social, legal, and moral knowledges about drug use, with youth drug-abusers redefining responsible use by promoting the notion of “civilized use”. The study concluded that mainstream curricular drug prevention programs have little impact on drug use behavior since its recipients still abuse drugs. Drug education research, policy, and practice implications of the findings were discussed.

A pragmatic clinical effectiveness trial of a novel alternative to punishment for school-based substance use infractions: study protocol for the iDECIDE curriculum.

Adolescents who use alcohol and other drugs on school campuses are at heightened risk for adverse consequences to their health and wellbeing. Schools have historically turned to punitive approaches as a first-line response to substance use. However, punishment is an ineffective deterrent for substance use and may cause harm and increase inequities. iDECIDE (Drug Education Curriculum: Intervention, Diversion, and Empowerment) was developed as a scalable and youth-centered drug education and diversion program that can be used as a skills-based alternative to punishment. We aim to evaluate the effectiveness of the iDECIDE curriculum as an alternative to punishment (ATP) for school-based substance use infractions in the context of a large pragmatic clinical effectiveness study. We will conduct a Type 1, hybrid effectiveness-implementation trial. Using a stepped wedge design with approximately 90 middle and high schools in Massachusetts, we will randomly allocate the timing of implementation of the iDECIDE curriculum compared to standard disciplinary response over approximately 36 months. We will test the overarching hypothesis that student-level outcomes (knowledge of drug effects and attitudes about substance use; frequency of substance use; school connectedness) improve over time as schools transition from a standard disciplinary response to having access to iDECIDE. The secondary aims of this trial are to (1) explore whether change in student-level outcomes vary according to baseline substance use, number of peers who use alcohol or other drugs, age, gender, and school urbanicity, and (2) determine the acceptability and feasibility of the iDECIDE curriculum through qualitative stakeholder interviews. Substance use continues to be a major and rapidly evolving problem in schools. The importance of moving away from punishment to more restorative approaches is widely accepted; however, scalable alternatives have not yet been identified. This will be the first study to our knowledge to systematically evaluate an ATP for students who violate the school substance use policy and is well poised to have important implications for policy making.

“They’re doing it anyway, let’s have a conversation about it”: exploring student and stakeholder attitudes towards drug education programmes for university students

Purpose Drug (including alcohol) use among UK university students is estimated to be widespread and associated with adverse social, physical, and mental health consequences. Drug Education Programmes (DEPs) may reduce drug-related harm although there is a sparsity of literature exploring their use in higher education settings; a gap our research aimed to fill. Materials and Methods We conducted semi-structured qualitative interviews with 20 university students and four individuals involved in the development and/or implementation of university drug education services. Interviews explored students’ experiences of drug use and the perceived barriers and facilitators for implementing university DEPs. Results Using reflexive thematic analysis, we developed the following five themes: (1) A culture of drug use; (2) Balancing risk and reward; (3) Drug use as a coping mechanism; (4) The current approach is failing students; and (5) A new approach. Conclusions While DEPs are a promising way of reducing harm, students’ fears of judgment, punishment, and criminalization may prevent them from fully engaging with them. Successful implementation of DEPs would therefore require structural changes to encourage students to access any future interventions.

Academic health services and health needs of college students around the era of the Covid-19 pandemic

Objective: The university medical services vary around the world (even within each university), but there are only a few publications on the utilization of these services by the students. The available on-campus services of public health care might include general health care, women’s centers, mental health care, disability services, wellness resource centers, career counseling, and alcohol and other drug education programs.
 Evidence Acquisition: This paper reviews the current literature on the overtime and current (due to Covid-19 pandemic) public health needs of college students based on studies that report the commonest specific diagnostic reasons for using the on-campus health care services.
 Results: Special reference is done on mental health problems among students generally and the students of health professions fields (a specific category themselves). Besides, other issues of interest are the substance-related problems among students and their perceptions about mental health problems and on- campus help- seeking services.
 Conclusions: It is unanimous that we need further educational and promotional campaigns to enhance the students; help-seeking behaviors, reduce stigmatizing behaviors and create more preventive public health services on campus, but also out-campus due to the Covid-19 pandemic.

How Did We Get Here? An Examination of Opioid Addiction from A Historical Perspective

America is facing a drug crisis that is rocking the nation at the cost of one trillion dollars since former President Richard Nixon declared war on drugs more than 40 years ago in 1971. This latest opioid crisis can be identified as the war on drugs 2.0. Research supports that the American public is not interested in fighting the war on drugs; it is interested in creating viable intervention programs that are effective in treating drug addiction and education programs for the drug prescribing medical community. Results revealed statistically significant differences between socioeconomic status and race, family status and criminal background, family status and criminal background related to a drug background, and family status and equally offering drug treatment options.

Positive Choices: Addressing the evidence-practice gap in alcohol and other drug prevention

Abstract Issue Alcohol and other drug (AOD) use during adolescence puts young people at risk of juvenile offending, poor educational outcomes, school dropout, and mental health issues. Since parents and school teachers are the primary source of contact for adolescents, it is important that they are equipped with accurate and up-to-date response strategies. There are a number of effective drug prevention strategies, however, they are not widely implemented. Description of the practice To address this evidence-practice gap, the Positive Choices initiative was launched in 2015. Positive Choices supports implementation of evidence-based and prevention strategies through provision of training and a centralised information and resources portal for young people, their parents and teachers. The portal contains information factsheets and webinars and was developed in consultation with AOD experts and target users. Drug education resources and curriculum programs meeting pre-specified criteria for relevance, quality and evidence-base are listed in the resources database. Results Positive Choices has been accessed by one-million Australian and international users. The most popular resources are videos, factsheets, webinars. In 2019, 71% parents and 65% teachers said that they would continue using the website. Half (54%) of school staff were not currently implementing evidence-based prevention strategies, of these 89% intended to shift to evidence-based practice after using Positive Choices. The majority of the users have said they would recommend the website to their colleagues and friends. Lessons Positive Choices is effective in changing users' intentions to implement evidence-based strategies. Drug education programs need to engage parents and teachers if they are to be effective. Key messages Positive Choices has increased users’ awareness of evidence-based prevention strategies. Positive Choices has increased users’ intentions to implement evidence-based prevention strategies.

Understanding the needs of local youth to inform drug and alcohol prevention and harm reduction services: A qualitative study.

Reducing drug and alcohol harm is a public health priority and the Australian government has adopted a harm minimisation approach to policy. Understanding the needs of local youth is necessary for the design of relevant prevention and harm reduction services. Using 5 unstructured focus groups and 10 interviews involving 30 participants recruited from different settings, this study explored youth perspectives around alcohol and other drugs and the psychosocial factors that influence their substance use. Three main themes were identified. First, young people perceived that drugs fell into a hierarchy related to the harm they cause and the stigma associated with use. Second, the importance of validating a young person's experience with using drugs (regardless of where they were placed on their substance-use trajectory) as a measure to increase the credibility of drug education programs. Third, the significant influence of peers on young people's drug attitudes and behaviours. Drug and alcohol education strategies must be more explicit regarding harm across all drug types, regardless of legal status or perceived social acceptability. Prevention services would benefit from including lived realities from young people's varied and changing experiences with using substances. Peer involvement in the design of preventive strategies (and involvement in participatory research to identify felt needs) is paramount to ensure teachings are grounded in a young person's social context and lived realities. SO WHAT?: This study provides information to guide the development of appropriate and authentic drug and alcohol prevention and harm reduction services for young people.

The Implemention of Preventive Drug Education Program Among Public and Private School

The program caters to public and private schools’ needs regarding implementing the preventive drug education program in curriculum and instruction, intervention program and services, learning and development activities, advocacy campaigns, evaluation, and research. The main purpose of this study was to determine the level of implementation of drug education programs among public and private secondary schools in Nasipit Agusan Del Norte. The researchers used a descriptive design comprising the survey method to collect relevant information for the study. Based on the finding, there is no significant difference in the level of implementation of preventive drug education program between public and private secondary schools in Nasipit Agusan del Norte, which were the following; curriculum and instructions, intervention program and services, learning and development activities, advocacy campaigns, and monitoring evaluation and research. The researchers would like to recommend that the public and private secondary schools continue implementing the preventive drug education program in Nasipit Agusan del Norte. Moreover, all personnel in-charge in the drug education program will attend any drug symposium and activities to have proper training: curriculum and Instruction.

A Pilot Evaluation of I'M HAPPY: An Interactive Module to Halt Abuse of Prescriptions in Preteens and Youth.

Objective: The purpose of this project was to create a web-accessible drug education program that would positively impact student knowledge and perceptions. Materials and Methods: An interactive computer module (Interactive Module to Halt Abuse of Prescriptions in Preteens and Youth [I'M HAPPY]) was created using a combination of e-learning and animation software. The module used narrated illustrations, animations, and games to explain what over-the-counter (OTC) and prescription drugs are, how they are used correctly, and what risks they carry. Animated drug refusal scenarios with user-determined outcomes were also incorporated. Sixth-grade students were asked to complete the module online and were given a 14-question pretest and posttest on the definitions, adverse effects, and proper use of OTC and prescription medicines. They were also asked to rank the perceived helpfulness of several drug refusal strategies. Student opinions about the computer module itself were collected on the posttest. Results: Students (n = 34) scored better on quiz questions following the module. They also showed increased favorability toward three of four drug refusal strategies after completing the module, with a greater proportion ranking these strategies "Very Helpful." Most students indicated they learned new things from the module (79%) and found it enjoyable (88%) and easy to use (97%). Conclusion: The I'M HAPPY program improved student knowledge of OTC and prescription drugs and enhanced perceptions of the helpfulness of certain drug refusal strategies. The computer module was considered enjoyable and easy to use, and can be easily disseminated to any student or classroom having internet access.

Self-Efficacy and Its Influence on Job Satisfaction Among Substance Abuse Prevention Program Teachers

Drug prevention and education program had been implemented in schools through special Substance Abuse Prevention Program (PPDa). The purpose of this study was to identify self-efficacy, job satisfaction and their relationships among PPDa teachers. This study also measured the differences in self-efficacy and job satisfaction based on gender and experiences in handling PPDa program. The researcher used snowball sampling technique to recruit 150 PPDa teachers in Malaysia. The translation version of 'General Self-efficacy Scale' and Job Descriptive Index (JDI) were used to achieve the research objectives. The findings showed that PPDa teachers are at the moderate level of self-efficacy and low level of job satisfaction. There was no significant difference in self-efficacy based on gender and experience in handling PPDa program. There was also no significant difference in job satisfaction based on experience in handling PPDa program. However, there was a significant difference in job satisfaction based on gender. The findings also revealed that there was a significant positive relationship between self-efficacy and the level of job satisfaction (rs=.277, p=0.01). The findings revealed that further enhancement could improve teachers’ self-efficacy and job satisfaction to combat substance abuse in school level.

Effectiveness of a brief information, motivation and behavioral skills program on stage transitions and lapse for individuals who use ketamine

ObjectiveChronic ketamine use is a significant public health and social problem in East and South East Asia and may lead to impairments in health and cognitive functioning. The study evaluated effects of an information, motivation and behavior skills (IMB) program on changes in motivational stage and ketamine use. MethodsKetamine using individuals residing in the City of Taipei were recruited (N = 395): 279 selected an IMB program consisting of a 1-day workshop of six 50-minute interactive sessions provided in small groups. The remaining 116 participants selected an education-as-usual (EAU) program consisting of a 1-day workshop of six 50-minute didactic lectures provided in a large group format. Motivational stage of change and ketamine knowledge were assessed before and after the interventions. Participants were followed one year later to assess their ketamine use status. ResultsNo significant difference in knowledge increase between the IMB and EAU groups (p = .59). The proportion of participants who transitioned from the contemplation to preparation motivational stages was greater in the IMB group than in the EAU group (p < .01). A significant difference in the rates of ketamine lapse during a one-year post intervention follow up was observed between the IMB (50%) and EAU (75%) groups (p < .01). ConclusionsInterventions based on IMB principles may be more effective in supporting motivational stage transition and in prevention of lapses to ketamine use as compared to currently offered standard drug education programs. Policy makers should consider including IMB interventions in their rehabilitation programs addressing ketamine use problems.

Knowledge, attitudes and behaviours on tobacco, alcohol and other drugs among Nigerian secondary school students: Differences by geopolitical zones.

Nigeria is composed of six geopolitical zones plus one Federal Capital Territory. Differences between zones can differentially influence the adoption of risk behaviours by adolescents. This paper aims to describe the knowledge, attitudes, beliefs, risk perception, skills and substance use among Nigerian secondary school students highlighting the differences by geopolitical zone. The population size of each zone was taken into account in extracting the 32 schools for the survey. The characteristics of the social environment, tobacco, alcohol and substance use, knowledge, beliefs, risk perception, attitudes, personal skills and school climate were investigated through an anonymous questionnaire. A total of 4078 adolescents participated in the survey: 5.1% reported they had smoked cigarettes at least once in their life, 33.6% drank alcohol, 13.1% experienced drunkenness, 7.5% used cannabis and 11.6% other drugs. The highest rates of alcohol use were observed in the South, whilst the use of tobacco, cannabis and other drugs was higher in the North. Knowledge about tobacco, alcohol and marijuana was quite low across all zones. Scores for self-esteem, decision-making and refusal skills, risk perception and beliefs were lower in the North. This study shows a high prevalence of adolescent alcohol and substance use in Nigeria. There is a need for planning and implementing evidence-based drug education and prevention programs across the country. Prevention activities targeting adolescents could help to reduce the later life burden of disease related to use of tobacco, alcohol and other drugs.

Prioritizing HIV/AIDS prevention strategies in Bandung, Indonesia: A cost analysis of three different HIV/AIDS interventions.

BackgroundIndonesia has one of the fastest growing HIV epidemics in Asia, which mainly concentrates within risk groups. Several strategies are available to combat this epidemic, like outreach to Men who have Sex with Men (MSM) and transgender, Harm Reduction Community Meetings (HRCMs) for Injecting Drug Users (IDUs), and Information, Education and Communication (IEC) programs at Maternal & Child Health Posts (MCHPs). Reliable cost data are currently not present, hampering HIV/AIDS priority setting. The aim of this study thus is to assess the societal costs of outreach programs to MSM and transgender, HRCMs for IDUs and IEC at MCHPs in Bandung, Indonesia in 2016.MethodsThe societal costs were collected in Bandung from April until May 2017. Health care costs were collected by interviewing stakeholders, using a micro-costing approach. Non-health care costs were determined by conducting surveys within the target groups of the interventions.ResultsThe societal costs of the outreach program were US$ 347,199.03 in 2016 and US$ 73.72 per reached individual. Moreover, the cost of HRCM for IDUs were US$ 48,618.31 in 2016 and US$ 365.55 per community meeting. For the IEC program at MCHPs, US$ 337.13 was paid in 2016 and the cost per visitor were US$ 0.51.ConclusionThis study provides valuable insights in the costs of outreach to MSM and transgender, HRCMs for IDUs and IEC at MCHPs. Policy makers can use these results in setting priorities within Indonesia. Data on effectiveness of interventions is necessary to make conclusive statements regarding cost-effectiveness and priority of interventions.

The impact of gender, socioeconomic status and locality on the development of student patterns of alcohol consumption and harm

Purpose The consequences of problematic alcohol consumption fall heavily on Australian adolescents, with this population at increased risk of death, serious injury and other harm. Research regarding whether gender, socioeconomic status (SES) or locality play a role in young people’s alcohol consumption and related harm is limited in Australia. The purpose of this paper is to determine whether Victorian students’ patterns of alcohol uptake, consumption and related harm differed between gender, SES and locality. Design/methodology/approach The study involved secondary analysis of student data from the Drug Education in Victorian Schools harm minimisation drug education programme, undertaken in 21 Victorian government schools over three years The initial cohort of 1,752 students was followed during Years 8, 9 and 10, when their average age would have, respectively, been 13, 14 and 15 years. Findings There were no gender differences in drinking uptake, consumption or harm. Students with low SES were more likely to have consumed a full drink of alcohol and also experienced more alcohol-related harm. Students living in a regional/rural area were more likely to have engaged in high alcohol consumption. Originality/value The findings of this study highlighted that different student demographics have an impact on patterns of alcohol consumption, vulnerability and harm. Students with low SES, living in a regional/rural area, are more at risk than students with higher SES living in a fringe metro/major regional or metro area. Future school harm minimisation drug education programmes should consider the needs of students with demographics that make them more susceptible to higher consumption and harm.

Potential of an Interactive Drug Prevention Mobile Phone App (Once Upon a High): Questionnaire Study Among Students.

BackgroundIn recent years, drug prevention networks and drug education programs have started using Web-based or mobile phone apps as novel prevention tools, testing their efficacy compared with face-to-face prevention.ObjectiveThe aim of this study was to assess the potential of an interactive app called Once Upon a High (VoltEgySzer).MethodsThe app approaches drug prevention from 6 different aspects, and it addresses youngsters with 6 different modules: (1) interactive comics/cartoons, telling stories of recovery; (2) quiz game; (3) roleplay game; (4) introduction of psychoactive drugs; (5) information on the somatic and psychological effects of psychoactive substances; (6) list of available treatment units, rehabs, and self-support groups in Hungary. Students of 2 vocational schools and 2 high schools filled out a questionnaire at a baseline (T0) and a 2-month follow-up (T1) data collection session. Students of 1 vocational school and 1 high school downloaded the Once Upon a High app (app group), whereas students from the other vocational school and high school did not (nonapp group). The time points of T0 and T1 questionnaires contained demographic variables, items with regard to substance use characteristics for both legal and illegal substances, including novel psychoactive substance, exercise habits, knowledge about psychoactive substances, attitudes toward substance users and validated instruments measuring the severity of tobacco (Fagerström Test for Nicotine Dependence), alcohol (Alcohol Use Disorder Identification Test), cannabis (Cannabis Abuse Screening Test), and synthetic cannabinoid consumption. Beliefs about substance use (Beliefs About Substance Abuse) and perceived self-efficacy (General Perceived Self-Efficacy) were also measured. At T1, members of the app group provided additional evaluation of the app.ResultsThere were 386 students who participated in the T0 session. After dropout, 246 students took part in T1 data collection procedure. Alcohol was the most frequently consumed psychoactive substance (334/364, 91.8% lifetime use), followed by tobacco (252/386, 65.3%, lifetime use) and cannabis (43/323, 13.3% lifetime use). Decreased self-efficacy (beta=−.29, P=.04) and increased daily physical exercise frequencies (beta=.04, P<.001) predicted higher frequencies of past month energy drink consumption, whereas elevated past month alcohol consumption was mainly predicted by a decrease in negative attitudes toward substance users (beta=−.13, P=.04) in the regression models. Once Upon a High was found to be effective only in reducing energy drink consumption (beta=−1.13, P=.04) after controlling for design effect, whereas perceived utility of the app showed correlation with a decreasing alcohol use (rS(44)=.32, P=.03). The roleplay module of the app was found to be the most preferred aspect of the app by the respondents.ConclusionsThe Once Upon a High app can be a useful tool to assist preventive intervention programs by increasing knowledge and self-efficacy; however, its efficacy in reducing or preventing substance use needs to be improved and further studied. Additional potential impacts of the app need further testing.

Evaluation of a drug and alcohol safety education program in aviation using interrupted time series and the Kirkpatrick framework

Compliance with drug and alcohol regulations are required by 14 CFR Part 120/ and 49 CFR Part 40. These regulations affect approximately 7200 aviation-related companies and their associated services. Consequences for noncompliance can include loss of revenue from imposition of civil penalties, suspension, or revocation of the company’s certificate to conduct business. Front End Analysis (FEA) was conducted to determine specific performance problems and provide five tailored educational interventions to address them. Program evaluation was conducted using Interrupted Time Series (ITS) modeling. Results showed significant (p < .05) decreases in nonconformities across all five models with small to moderate effect sizes. Based on the relative effects, values for reductions in civil penalty costs between 16% and 47%, were predicted. Actual sanction reductions from the pre-to-post-intervention periods were confirmed to be 24.21%. The study supported the efficacy of the ITS approach for implementation of level four Kirkpatrick evaluation.

First Time Cannabis Use and Sexual Debut in U.S. High School Adolescents

PurposeUse of illicit drugs by adolescents might facilitate or trigger other risky behaviors, including early sexual initiation (ESI), multiple partners, and unprotected sex. This study examines whether the age at which adolescents initiate cannabis use is associated with the age of their first sexual intercourse in the U.S. in 2015. MethodsA secondary analysis of data from the 2015 Youth Risk Behavior Surveillance Survey, a cross-sectional, nationally representative survey, was conducted (n = 7,664). Exposure of interest was age of initiation of cannabis use (never used cannabis, age 12 or younger, 13–14 years of age, and age 15 or older) and outcome was ESI (14 years old or younger). Unadjusted and adjusted odds ratios (OR) and their 95% confidence intervals were computed. ResultsPrevalence of ESI was 15.3%. The proportion of cannabis use was 39.9%. Adolescents starting cannabis use before the age of 15 had higher adjusted odds of ESI (OR ranged 4.2–6.7). This association is modified by sex: while in boys using cannabis before 13 years, the OR is 9 (95% CI 5.2–15.6); in girls, it is 2.8 (95% CI 1.7–4.7). ConclusionsOur findings suggest that there should be sex and drug education programs instituted before the age of 12 ideally, and no later than by age 15 since this time represents a critical period of initiating both behaviors.

An Examination of Universal Drug Education Programming in Ontario, Canada’s Elementary School System

School-based drug education initiatives are designed and marketed to prevent substance use and misuse. Over the past several decades, school-based drug education has evolved from delivering only information about drugs and the negative outcomes of their use to a multi-faceted, interactive approach, with several programs now using a combination of information, decision-making, social competency and to a lesser extent, harm minimization. Our study using a case study of a sample of Ontario, Canada elementary schools, found that the majority of programs that are being offered are selected less by empirically supported outcome studies than popular belief and marketing. Based on our findings we recommend that a consistent set of criteria be established based upon best practices to assist educational decision makers select prevention programs rather than allowing marketing or ideological positions govern what is delivered.

The Legalization of Medical/Recreational Marijuana: Implications for School Health Drug Education Programs.

More than half of US states have legalized medical marijuana. Several states have also legalized it for recreational use. In spite of states' actions, marijuana remains illegal under federal law. It remains to be seen, however, if the Trump administration will enforce federal law in states that have legalized marijuana. For now, it appears the move toward state legalization of marijuana will increase. Because of its legal status, research concerning the medical benefits of marijuana has been limited. We reviewed the literature pertaining to medical use and legalization of marijuana. Available research shows that marijuana can benefit some conditions. There are also concerns about harmful effects on both individual and public health and whether legalization will lead to increased marijuana use among youth. Each of these elements has implications for school-based drug education programs. Researchers have shown that the 10 states with the highest rate of past month marijuana use by youth all have legalized recreational and/or medical use of marijuana, whereas none of the 10 states with the lowest rate of past month marijuana use by youth, has legalized marijuana. In the debate over legalization schools can potentially serve as a community resource, providing accurate information concerning marijuana. Teachers and parents should continue to discourage young people from using marijuana (as well as alcohol, tobacco, and other drugs).