‘Just Say No’ Called Too Simplistic : UCLA Study on Drug Use Rekindles Debate on Risk

Two decades after experimentation with drugs emerged as something of a rite of passage into American adulthood, the first studies of the long-term consequences of teen-age substance use are rekindling an emotional debate over the true risks of drugs.

The research, including a massive UCLA study published in July and ongoing research at Rutgers University, documents the severe damage suffered by chronic users and the apparent absence of measurable long-term harm experienced by many occasional users.

Critics have balked at accepting some of the findings, fearing that to do so could be taken as an endorsement of recreational drug use. But some researchers say the findings illustrate the limitations of current substance-abuse prevention efforts, many of which emphasize heading off all drug use, including occasional experimentation.

“What we see is that the problem is a complex one and that there is no single type of drug user,” said Beatrice Rouse, the National Institute on Drug Abuse official overseeing much of the research. “There is no single type of prevention or intervention that will work for everyone.”

The debate was triggered in July when UCLA released what was hailed as one of the most comprehensive studies ever of the effects of adolescent drug use. The study, published in book form, tracked 739 Los Angeles County youths from junior high school into young adulthood.

The researchers, two psychologists who have worked extensively in the field, found that heavy drug use had altered nearly every aspect of personal and social development. It disrupted relationships, jobs and education. It impaired physical and mental health.

But the majority of those studied who used drugs less frequently had suffered fewer scars. There was a “linear relationship” between the amount of drug use and the amount of damage. And among infrequent or experimental users, as with non-users, the researchers found no appreciable impact.

In the study and in interviews, the authors questioned the prevailing “just say no” approach, suggesting that emphasis be placed not simply on thwarting first-time use but also on reducing “abuse, regular use and misuse.”

“The typical youngster who has a beer or some marijuana at a party is not the one who is going to develop long-term damage as a result of their drug use,” the UCLA study said. “It is those teen-agers who develop a life style of drug use to relieve emotional distress and other life stressors . . . that will suffer long-term, negative consequences of their use.”

Spawns Fierce Reaction

News of the study’s findings touched off a fierce reaction.

Dozens of queries poured into the National Institute on Drug Abuse, the federal agency that had paid for the research. In addition, White House officials and some parents’ groups questioned the study’s methodology and cautioned against misinterpretation.

“Parents are furious about it,” said Sue Rusche, executive director of the National Drug Information Center of Families in Action and a member of the advisory board of the federal agency that oversees the National Institute on Drug Abuse.

Among other things, Rusche and others said the researchers lost contact with more than half of the original 1,600 participants who enrolled in the study in 1976. That fact, Rusche said, calls into question the validity of their findings.

Rusche also expressed concern that the findings about experimental use might lull parents into a dangerous sense of security. If parents choose to overlook signs of social drug use, a child’s drug problem may quickly become more serious, she said.

Finally, Rusche and others challenged the researchers’ reservations about “just say no”--an approach Rusche’s group credits for the drop in marijuana use. According to federal figures, daily use among high school seniors has dropped from 11% in 1978 to 3% in 1987.

Abstinence Favored

The best approach, critics contend, is to insist on abstinence.

“We don’t know if an infrequent user is going to become a frequent user,” a White House official who asked to remain anonymous said in an interview. “Does society take that chance with a human being’s life? Do we play that kind of Russian roulette?”

UCLA, too, received dozens of requests for information from the public. One of the researchers, Michael Newcomb, gave 25 media interviews within days after the study’s release. The university was prompted to issue an amended summary of the findings, punctuated with caveats and disclaimers stressing the researchers’ opposition to drugs.

“Note: This study measured the factual consequences of drug use,” the revised summary stated. “The researchers themselves are strongly opposed to drug use by teen-agers and consider their study a strong indictment of the use of drugs.”

Others in the field are familiar with the type of response that greeted the UCLA study.

“Drug use is a very emotional issue,” said Robert J. Pandina, a Rutgers University psychologist doing a comparable federally funded study. He added later, “When you provide an unpopular message in a political process, you’re likely to get hammered for it.”

‘It Will Churn Waters’

“It will churn up the waters again,” Bonnie Benard, a research specialist at Illinois’ Prevention Resource Center, said of the study. The UCLA researchers, she added, have “done really solid research for years. It’s not something you can ignore.”

In fact, Pandina and others said their findings support those from UCLA.

Pandina is tracking drug use among 1,400 New Jersey youths. Over the past decade, he has been examining effects of drugs on physical, psychological and social development during the transition to adulthood.

His research group has also identified a small minority of chronic drug users whose lives have been profoundly altered. At the same time, they have found that many others have been occasional or erratic users, many of whom stopped using drugs and suffered no long-term damage.

“In many studies, the findings, I think, are fairly consistent,” Pandina said in a telephone interview. “While there may be occasional problems, those problems are really episodic. They are not of the same nature as those of chronic users.

“Not that it’s not risky behavior. But there’s a lot of risky behavior. It’s not the rapid, escalating use leading to heroin abuse. We’re just not finding that.”

Other Problems Involved

Pandina said he is also finding that those people who become chronic users have problems that predate their drug use. Their drug use exacerbates those problems, which in turn accelerates their drug use.

“So it’s a little more complicated than ‘use causes dysfunction,’ ” he said. “. . . It’s much more likely that dysfunction is a key (causative) factor in triggering and maintaining higher level of use.”

Denise Kandel, a Columbia University sociologist also studying the effects of teen-age drug use, has also found a relationship between the extent of drug use and the extent of damage. But she said one cannot draw a line between lesser and greater risk.

“I have come to the conclusion that there is no clear-cut threshold,” said Kandel, also a researcher at New York State Psychiatric Institute. “. . . You find a linear relationship. The detriment in performance really increases regularly with each increase in drug use.”

Kandel has found that consistent drug use disrupts the transition into traditional social roles, leading to delayed marriage and child rearing. She has also found links between drug use and job and marital instability, as did Newcomb and Peter Bentler at UCLA.

Related to Initial Use

Kandel has also found that drug users may differ depending upon when they began using drugs: The earlier in one’s life one begins using drugs, including cigarettes and alcohol, the more likely one is to continue in later life.

Others in the field are not surprised by the growing body of research.

Karst Besteman, executive director of the Alcohol and Drug Problems Assn. in Washington, said experts have long suspected that occasional use leaves no measurable long-term effect. “It’s one of those things that we always knew,” he said, “and now it’s better documented.”

“It will be hard for a lot of groups to accept that kind of finding,” said Benard, whose state-funded center advises prevention groups. “But there has never been any research that I know of that has shown that occasional or experimental use does any kind of long-term damage.”

As a result, some researchers are challenging the emphasis on simply resisting peer pressure and avoiding initial use. They say the “just say no” approach is too simplistic to address all the reasons for drug use surfacing in the long-term studies.

Pandina, who works in drug-abuse prevention with young athletes, said young people are alienated by exaggerated reports of the effects of drug use. Prevention programs risk losing credibility if they do not accurately portray the risks.

Comprehensive Approach

He and others argue in favor of a more comprehensive approach that addresses the needs of those users at high risk of becoming chronic abusers--for example, children of broken homes or alcoholic parents who have lacked support and guidance.

Prevention programs should take into account the many causes of drug use and extend beyond the schools into the entire community, Benard said. Drug-abuse prevention should be just one part of broader efforts to encourage health and success.

“Prevention, in order to be truly successful, is a whole life-style effort,” said Besteman, formerly a federal drug official. “It doesn’t just home in on, ‘Don’t take drugs.’ It has to do with a lot of other parts of growing up--decision making, self-image, et cetera.”

Even so, he and others said, “just say no” has some practical--and political--value.

“It’s a bind that we’re all in,” said Dr. Edward Kaufman, chairman of the Committee on Drug Abuse of the American Psychiatric Assn. “Because I think it’s really true that the average adolescent . . . can leave his drug use behind as he enters into adulthood.”

But Kaufman, director of a UC Irvine chemical dependency service, added: “At this point, given the political climate and what we know about treatment. . . . I think that given my druthers the ‘just say no’ approach is the most effective for the most people.”

“Its greatest efficacy is that it says, ‘This is our social expectation,’ ” Besteman said. “. . . We knew from the beginning it was just a simple slogan. Like ‘an apple a day . . .’ or ‘brush your teeth after every meal.’ Have you ever known a kid who does that? But that’s what we tell kids in hopes they will brush once a day.”