Can the Military Help Prevent Drug Use Among Youth?

Illegal drug use is a major problem confronting the United States today, and the Congress, in an effort to marshal additional resources to address this problem, directed the Department of Defense (DoD) to establish pilot outreach programs designed to reduce drug use among youth. Congress also directed the Secretary of Defense to report on the effectiveness of these programs and to recommend whether they should be continued. Researchers from the National Defense Research Institute and the Drug Policy Research Center in RAND's Domestic Research Division assisted in the evaluation, documenting the results of their efforts in Preventing Drug Use Among Youth Through Community Outreach: The Military's Pilot Programs. The following are the five central policy issues investigated and the results obtained.

• How well suited is the military for running drug prevention programs for youth? The military has a number of attributes that allow it to fill a niche within an overall, multiagency prevention strategy. The National Guard's close community ties may allow it to play a larger role.
• How effective were the programs and what did they cost? The only real measure of effectiveness is reduced drug use, and the nature of the programs did not allow that measurement. However, the programs were generally well run and followed credible models. Cost per youth varied by program but was generally between $100 and $600 per year or iteration.
• Did the programs affect readiness? The programs, which relied heavily on volunteers and required only an hour or so per week, had minimal effect on readiness.
• How many youth could such programs reach? Military drug prevention programs cannot reach more than a small fraction of the youth at risk.
• What are the desirable attributes of outreach programs using the military? Modest programs that rely on volunteers and are designed locally but operate under a central leadership hold out the highest promise for effectively using military personnel. Direct contact between youth and military personnel tends to exploit the military's comparative advantage. Programs should target high-risk youth but not the most troubled.

The Programs

DoD funded 12 programs across the four services and the National Guard. The programs varied considerably in size, location, format, intensity, and funding. Staff size varied from 50 to 500 and locations from a single installation to a nationwide network. Formats ranged from individual mentoring programs, to adventure camps, to physical fitness programs, to funding civilian programs. Some programs met for an hour a week and others up to nine hours per week. Funding ranged from $70,000 to just over a million dollars annually. All programs, however, concentrated on either preventing first drug use or precluding those who may have experimented from moving to regular use. An important finding is that for most of the programs the military demonstrated a good capability for working well with the communities, a key to success for these programs.

How Well Suited is the Military?

Those interviewed for the study identified a number of advantages the military has in running youth drug prevention programs for youth. Commonly cited were institutional characteristics, such as organizational skills, discipline, and a drug-free image. The people in the military are another strength: young, ethnically diverse, and enthusiastic. They also have the skills required to support programs such as outdoor adventure experiences. And military facilities are valuable assets, particularly National Guard armories, because they provide convenient places to conduct activities.

However, interviewees identified some comparative disadvantages that must be considered when using the military to support such programs. Members of the military are not trained in community outreach, so most of their specialized skills do not apply. And military organizations have a certain rigidity that may impede implementing nontraditional programs. Furthermore, members of the military are not as experienced in working with youth as schools and social service agencies. Finally, military personnel move frequently, hampering continuity.

But, on balance, the military can apply its strengths and fill an important niche in a wide set of programs. The National Guard may be able to fill an even broader role than active forces because of its close community association.

How Effective Were the Programs and What Did They Cost?

The best measure of effectiveness is reduced drug use. Unfortunately, the programs lacked some of the basic aspects of experimental design, such as random assignment and control groups, necessary to draw causal inferences. We did estimate how effective the programs would have to be in terms of reduced drug initiation for a projected savings in social costs to outweigh program costs. We were deliberately conservative in our estimates. Using this approach, a program that cost $100 per participant would be cost-effective if it

• prevented 0.6 percent of the participating youth from starting to use cocaine, or 3 percent from using marijuana
• delayed for four years 2.5 percent of the participants from initiating cocaine use or 15 percent from starting to use marijuana.

On average, a year of cocaine use costs society about seven times as much as a year of marijuana use. Thus, programs should focus on those at risk for using hard drugs. Comparing thresholds of effectiveness with what is known about comparable programs suggests that a number of military programs are cost-effective, particularly those involving mentoring, which have a modest dollar cost.

Did the Programs Affect Readiness?

The funds spent on the pilot program could have been used to increase readiness. But the programs were small (reaching only about 10,000 youth and using less than 0.002 percent of the defense budget), and most of the service participants were volunteers. The time given by most volunteers was modest, usually an hour per week or a weekend per year. Facilities were used only when it did not interfere with military activities. Also, the programs had positive effects on morale and community relations. And preparing for military-relevant subjects, such as first aid or physical training, may have benefited those military personnel involved. However, both positive and negative effects on military readiness appear to be modest.

How Many Youth Could Such Programs Reach?

As mentioned, the programs were small, reaching only 10,000 or so youth. How many more youth could they reach? Certainly, there are many at-risk youth. The primary constraints to expanding the program are the number of volunteers, the number and locations of sites, and funds. Rough estimates are possible based on the number of volunteers, sites, and funds likely to be available. Without changing their fundamental character, DoD programs could reach only about 200,000 at-risk youth, a small fraction of the number at risk.

Desirable Attributes of Programs Using Military Personnel

Future programs using military personnel should emphasize the following six attributes:

• Rely on volunteers. This focus will keep program costs low, draw on the military's comparative strengths, and minimize the effect on readiness.
• Keep program size modest. Limiting size will also help limit the effect on readiness.
• Design programs locally. A local focus allows the programs to address the most pressing needs in the community and to take advantage of local resources.
• Provide central leadership. Although the programs should be designed locally, central leadership can provide model programs, facilitate sharing of information, and supply technical advice and training.
• Target programs at youth who are at high risk for drug abuse—but not the most troubled. Military programs can reach only a fraction of the youth who need help, and thus they should focus on youth who have the greatest need. These would generally be youth who are wavering over hard drug use. But few military volunteers have the professional training necessary to deal with extremely troubled young people, so they should not be the focus of these programs.
• Do not rule out short programs. All other things being equal, sustained programs have more effect than short ones. However, short programs can have some effect and may be all that is feasible for units of military people who move frequently.