Source: Centre Daily Times Author: Natalie Croll. Natalie Croll is the assistant director of the Office of Health Promotion and Education at Penn State. Andrew Bills, health promotion specialist, contributed. Pubdate: Sunday, January 18, 1998 Contact: Note: Please indicate whether your comments may be considered for publication. Website: http://www.centredaily.com/ SEND ONE STRONG MESSAGE, AND SHARE THE RESPONSIBILITY Choice 2: Change attitudes about illegal drugs: Since government cannot significantly reduce the supply of illegal drugs, we must reduce the demand for them -- by changing tolerant attitudes. Parents, schools and the entertainment media must say, with one voice, that illegal drugs are dangerous and socially unacceptable. The link of substance abuse with negative consequences, such as the loss of employee productivity, poor school performance, increasing health-care costs, increasing acts of violence and death, has been the focus of media attention throughout the past decade. Prevention messages and programs such as "Just Say No" and others have become prolific throughout the United States, and yet we see little change in the cost to society caused by the abuse of alcohol, the use of tobacco and the prevalence of illegal drugs. To address this crisis, a shift is under way in the way we think about alcohol and other drug-abuse prevention. No longer is prevention the job of just the local health education teacher or prevention specialist hired by a school district, county or college. The community as a whole is seen as a catalyst for the prevention of alcohol and other drug problems. Prevention, therefore, is a multidisciplined approach of multiple strategies that affect the entire community and that strive for environmental change. Dr. Richard Keeling, director of University Health Services at the University of Wisconsin-Madison, has noted the prevention messages we have used for decades -- such as "Know when to say when," "Drink responsibly" and "Know your limits" -- place all the responsibility on the individual, and none on the community. This isolation of individual responsibility supports the broader misperception that bad things happen to bad people; that the individual didn't know enough or was irresponsible. And the community's role in this is merely to mourn the individual's misfortune or loss, and move on. There is rarely a community response that involves identifying cultural norms, practices, principles, values, institutions and beliefs that support continued consequences of use, misuse or abuse. Current thinking in prevention asserts that alcohol and other drug abuse is not the problem of a troubled few, but is a reflection of the nature of the communities we create. We must identify where and how our communities directly and indirectly support misuse and abuse, where behaviors and messages are inconsistent with our desires for a safe, caring community. This needed approach to prevention is no longer one of mere information-sharing; it is a community public health approach. It will not occur in a classroom or lecture, but rather in daily living. There will be a shift in strategies from those which focus only on the individual to those that address the environment. No longer will use be OK, laughed at, glorified by the media or approved of within our stories. Mixed messages and behaviors inconsistent with the values of the community will be challenged. It is a process of changing the context in which we all make our decisions for use. Prevention does not compete with but relies upon and supports the continued rigorous enforcement of current policies and laws. It supports ongoing treatment for those who suffer from the effects of the disease of addiction and builds upon intervention programs to identify those at risk for dependency. The National Issues Forum, which will provide an opportunity for public talk on public politics, is an example of prevention in action and practice. Through this forum individuals will be able to come together as a community to engage in conversation and debate this critical issue. This is a long-term, communitywide process of change requiring us to engage in difficult conversations and to take action. It is time for us to change our beliefs about prevention from "know your limits" to embracing our collective responsibility, as Keeling says, to notice, care and act. © 1998 Centre Daily Times