Partnership For Drug Free Kids, Revisited

continuing care parent teen addiction treatment

Back in February, I wrote a critique on the Partnership for Drug Free Kids (PDFK – formerly the Partnership for a Drug Free America). I was prompted to research PDFK and write the article after witnessing the empty testimony of an executive from the Partnership for a Drug Free NJ at a State Senate hearing. I mistook one Partnership for the other (if you are sufficiently confused, then you are now experienced with the problem of similarly named agencies within the same field). While I stand by the research and data from that article, I do want to clarify and expand upon it (eventually, I need to get around to examining the Partnership for a Drug Free NJ, but that’s a piece for another time).

In early March, I had a lengthy conversation with PDFK President Marcia Lee Taylor (noted marijuana policy expert and my friend Kevin Sabet told me she was a decent and well-meaning professional). During our talk, she stated that:

1) Partnership for Drug Free Kids is “completely separate from Partnership for a Drug Free NJ” and that they are often confused. She said that local programs often do the legwork to secure advertising on television and then both the local and national programs will put their names on public service announcement (PSAs).

2) The $100 million budget was made up of 80-90 million in donated advertising time and that it wasn’t “actual money” and that their operating budget was closer to $7M.

3) Ms. Taylor said that when the organization changed its name from Partnership for a Drug Free America to Partnership for Drug Free Kids in 2014, the focus changed to educating parents about drug problems and providing information and support to families. She was very clear that they are not an advocacy organization, but that people (like me) often confuse them for one based upon their history and PSAs.

4) “Everyone at PFDK is against marijuana legalization but studies show that 50% of parents are for legalization and we do not want to alienate them.” That is why, she said, that they do not take a hard stance against marijuana on their website or in their materials.

5) They use a news aggregator to report prevention and substance abuse issues on their site. They do this so people don’t spend lots of time each day hunting down different stories; rather, they can get their information in one place.

6) Ms. Taylor stated that the “families’ help” is the work they are most proud of. They have a toll free hotline that is staffed by bi-lingual licensed clinical social workers (LCSWs) during the work week. These LCSWs walk people through the website, provide them support, and refer them to volunteer parent coaches (who have been through this themselves). She reported that PFDK has over 80 parent coaches. These coaches have been trained by the Hilton Foundation.

 7) In an email correspondence a few days later, I asked Ms. Taylor about any metrics or evaluations that they had (or were aware of) about the effectiveness of their work. I will provide her full answer here:

Please note that proving a causal relationship between advertising exposure and a behavioral outcome is always difficult –there are so many variables that impact behavior- but a few of these studies have demonstrated a positive relationship between exposure to Partnership messaging and strengthened anti-drug attitudes as well as reduced substance use.

American Journal of Public Health (August 2002) – Evaluation of effectiveness of drug education messaging from PDFA from 1987 through 1990 – found that anti-drug advertising associated with a reduced probability of marijuana and cocaine / crack use among adolescents.  Team of researchers from Yale, NYU and elsewhere concluded that by 1990, “after three years of PDFA ads, approximately 9.25% fewer adolescents were using marijuana.”

Previously, the February 2001 issue of AJPH reported on a NIDA-funded study conducted by Philip Palmgreen at U of Kentucky that tracked impact of ad campaigns (mainly Partnership’s) running in selected counties in Kentucky.  Study showed a 26.7% decline in marijuana use among sensation-seeking teens exposed to the advertising.

In the same journal, in 1995, “The Impact of Anti-Drug Advertising” reported on a study by the Johns Hopkins University School of Medicine finding that teens’ perceptions of anti-drug advertising “suggest that anti-drug advertising serves as a deterrent to [middle and high school] youth substance abuse.”

Reporting on positive teen inhalant abuse data in Monitoring the Future (U of Michigan’s annual survey of teen substance use),  Dr Lloyd Johnston observed in 1996 that “the turnaround in inhalant use and beliefs about its harmfulness corresponds exactly with the start of the Partnership for a Drug-Free America’s anti-inhalant ad campaign… We are inclined to credit much of the improvement in inhalant use to that intervention.”

“Above the Influence” – the teen targeted program developed by the Partnership and ONDCP, has been shown in three separate studies (attached here) to be effective in reducing teens’ intention to use, and actual reported use, of marijuana.  (It should be noted that ATI was created initially, in 2005, as part of the National Youth Anti-Drug Media Campaign.  (The earlier incarnation of that campaign, “My Anti-Drug”, was evaluated independently between 1999-2004 and found to be ineffective.  I personally have never bought that conclusion –teen marijuana use declined dramatically over that period.  In any case,  ATI was developed after that evaluation was completed.)

The Partnership is currently working with the Consumer Healthcare Products Association to prevent OTC cough medicine abuse among teens via “intercept” digital messaging and content.  Ongoing evaluation of the messaging by Hall & Partners (independent research company) has shown that target (“fence sitter”) teens exposed to the messaging have stronger anti-cough medicine attitudes and lower intent to use.

In 2011, an independent evaluation of our Parents360 community education program that found it was effective in increasing parent knowledge and self-efficacy to address their child’s drug use.

Lastly, I think it’s worth pointing out that in-market “effectiveness” (as opposed to a controlled test of a PSA), requires both media tonnage and strategic “rightness” – something that rarely happens in the real world.  We can point to the period between 1987 and 1992 when Partnership advertising was most strongly supported by the media (hitting $350 million in 1991) and teen drug use declined significantly –not just cocaine, which was the drug most often featured in our messages, but all drugs including marijuana.

I followed up the conversation with President Taylor with a long phone call and email exchange with Denise Mariano, a parent of a young person in long term recovery who has become an effective advocate in NJ. She was a 2013 NCADD-NJ Advocate Leader, is a naloxone trainer and a member of the Morris County Opiate Task Force. She was recognized at the White House last year as one of the 2015 Office of National Drug Control Policy (OCDCP) advocates. She has been a volunteer for the Partnership for Drug Free Kids for four years and credits them with changing her life. When her child was struggling with addiction, she said she called and emailed over 50 different programs/resources and only two responded to her – one was the Partnership. She is extremely proud of the Parent Support Network and was trained as a peer-to-peer coach in 2014. When pressed for measurable data that showed the effectiveness of the peer-to-peer program, she said it was still early but that she had personally seen it help a number of people.

After these phone calls and some further reading/study, I have refined my stance on the Partnership:

1) There is a name problem. The fact that there are multiple “Partnerships for a Drug Free …..” is extremely confusing. I don’t think changing their name for a second time in three years is the optimum solution, but the Partnership does need to differentiate themselves better. Additionally, keeping the name makes it harder to shake off the failures of the 1985-2014 Partnership for a Drug Free America’s work (which I went into detail in my previous piece).

2) The $80M to $90M a year in free advertising is extremely significant (one need only look at the Trump 2016 GOP primary to see how valuable free media air time is). I am still dissatisfied with the PSAs and would like to see that free advertising used more effectively.

3) While I understand the political nature of the Partnership’s public marijuana stance (so that they don’t alienate parents they might otherwise reach), part of leadership is setting the tone and changing public perception. The best public stewards are those that are willing to lead people in the right direction, even if it means taking unpopular positions and irritating other stakeholders and people in power. Ideally, I would like to see them change their position on their website and donate some of the airtime to anti-marijuana legalization groups like Smart Approaches to Marijuana (SAM).

4) By using a news aggregator to publish industry stories on their website, it gives off the appearance that they are supporting policies, programs, companies or industries when they may not be. For example, when they publish articles about the pharmaceutical industry, it can appear that they support them. I have urged them to clearly delineate what is news and what they support.

5) Each spring, I teach one to two senior seminars at the Rutgers School of Social Work. It is the last class before they graduate, and I spend much of the semester teaching them the importance of data, evaluations and how success is measurable. While I appreciate both President Taylor’s and Ms. Mariano’s answers regarding the effectiveness of the Partnership and the limited evaluations metrics they have, I stridently urge them to work harder on getting both internal and external measures on the effectiveness of the Partnership’s work. Anecdotal stories are wonderful and often touching, but they are not reasons to support a program. The Partnership has a prominent role in our national battle against substance addiction and receives a great deal of free advertising – for that, they need to invest in better evaluation tools.

6) It was evident that Denise Mariano’s life has been transformed by the help that the Partnership provided several years ago, and she has helped numerous families since then. I know of a few other parents who have also dedicated their time, energy and hearts to the Partnership – I am aware of how hard they work and how much they truly care (and how they do this all for free). The strength and value of the Partnership is obviously in their volunteers and in their parent support network. Their work is real and should be commended. For my part, I am sorry for concluding my previous piece with saying the Partnership “needs to go away.” It was a flippant remark from someone who tries to take a middle-of-the road approach and seeks nuance. I will do better.

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