SFMMS ADVOCACY CASE STUDY: Quality Drug Education in Schools

Steve Heilig, MPH

Drug abuse and addiction have long been one of our nation’s most prevalent health problems, too often resistant to efforts to reduce it. One aspect of “prevention” is drug education, especially of youth, but that too has long been mired in debates about impact and what works best. In 1999, SFMMS co-convened a major conference titled “Just Say Know: New Directions in Drug Education.” The meeting drew hundreds to hear learn from an expert faculty on all aspects of drug education, with a consensus that fact-based, non-“scared straight” or “just say no” approaches are best.

Within a couple years there was a notable postscript of the conference when the San Francisco Chronicle reported that a drug education program called Narconon was offered in many local schools. The program, not affiliated with the well-established recovery network Narcanon (Narcotics Anonymous, but the very slight difference in spelling seemed no accident), was part of the controversial “Church” of Scientology, even though they publicly deny the connection. It was offered for free, which made it attractive to cash-strapped school districts (and ironically reminded some of us of the old “first ones free” approach said to be used by drug dealers).

The Chronicle article spurred much concern and soon the San Francisco Superintendent of Schools, having sent multiple health education staff to our conference, was on the phone to the SFMMS, seeking peer review of the Narconon program. We agreed, and they sent over large binders of material. I farmed it out to five addiction medicine and drug education experts for review—which is where things got more interesting. Because the SFUSD is a public body, their communications are open to the public. Within days Narconon representatives began showing up at the SFMS offices, asking to meet with me. The first couple times I did speak with them briefly and took more of their material, but told them this had to be an impartial review with no “lobbying” (explaining to them what an IRB is, as an example). But they kept arriving, and demanded to know who the other reviewers were. I was glad that had been kept out of the correspondence with SFUSD, even if it left me the sole contact.

Our receptionist was “creeped out” by the continued efforts to get into the building. This came to a head when two strangers showed up at an SFMS board meeting, insisting on speaking to the group “as concerned citizens.” I had to forcefully tell them to leave, which they reluctantly did. I was also able to learn that one of them was a physician, with long affiliation with Scientology. Then a military psychiatrist I had met via other work, who was involved in surveillance of terrorist and “hate groups,” got in touch to tell me I was being angrily discussed by Scientologists around the nation, with one Narconon official saying he really wanted to punch me in the face. Now I was getting some feelings of creepiness too.

The expert review came in promptly, with the consensus that the “science” underlying Narconon didn’t reflect scientific or educational standards. I put this conclusion into a short letter, writing that the Narconon curriculum “often exemplifies the outdated, non-evidence-based and sometimes factually inaccurate approach, which has not served students well for decades.”

The school district took quick action and removed Narconon programs from their drug education efforts. Even better, the Chronicle reported “Heilig’s letter set in motion a chain of events, and California’s education department recommended that all public schools reject Narconon as unscientific, a claim that was unanimously backed the next month by the California Medical Association”—endorsing an SFMS policy resolution. The AMA soon followed suit. We’d “gone statewide and national”— something SFMMS often hopes to do in our policymaking work.

One unintended effect of this victory was that I was asked to “put my money where my mouth is” and volunteer for drug education in local schools. I gladly did this for years until I perceived I’d become too old to have credibility on this topic with adolescents. But also, the Chronicle eventually returned for another look at SFUSD drug education and found that Narconon had slipped back in somehow. That was soon remedied. It seems that eternal vigilance is the price of good education.