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The California Healthy Kids Resource Center is administered for
the California Department of Education (CDE) and the California
Department of Health Services (CDHS). This report does not necessarily
reflect the position or policies of the CDE or the CDHS. Questions
about this report can be sent to Deborah Wood, Ph.D., Executive
Director, California Healthy Kids Resource Center, 313 W. Winton
Ave., Hayward, CA 94544, 510-670-4581, dwood@acoe.k12.ca.us.
Cover Letter | Summary
| Agency Background | Drug
Abuse Prevention Program Description | Process
of the Evaluation | Medical and Scientific
Accuracy | Developmental Appropriateness
| Teaching Methods | References
| Endnotes | Appendix
Summary
Narconon is a secular program based on the research and writings
of L. Ron Hubbard, who also founded the Scientology religion.
The Narconon network provides drug rehabilitation, education and
prevention services, and professional training. Narconon Drug
Abuse Prevention Program (NDAP) consists of one to eight presentations
provided in elementary, middle, and high school classrooms. They
are designed to supplement schools' core health and drug abuse
prevention curricula. The NDAP presentations are usually provided
by trained, former drug addicts and graduates of Narconon's rehabilitation
program. The NDAP sessions address general drug information, specific
information on alcohol, tobacco and marijuana, the negative impact
of drug use on the body and mind, media and alcohol use, tobacco
and nicotine, drugs and emotions, and goal setting. A subset of
NDAP materials requested was provided for review. NDAP was evaluated
for accuracy, developmental appropriateness, and teaching methods.
Some drug-related information presented in the NDAP and supplementary
resources provided to schools—although aligned with the
Narconon drug rehabilitation methodology—does not reflect
accurate, widely accepted medical and scientific evidence. Some
information is misleading because it is overstated or does not
distinguish between drug use and abuse. The NDAP elementary, middle,
and high school presentation outlines are inadequately differentiated
to the developmental characteristics and cognitive levels of student
learners. Although the NDAP is ostensibly aligned with research-based
practice, the actual presentation outlines, delivery scripts,
and additional resources made available to schools are often inconsistent
with these standards. NDAP presentations are lecture-oriented
sessions that emphasize conveying information to students and
provide limited opportunities for students to exchange ideas,
interact with concepts, construct personally meaningful understanding,
and practice skills. Some NDAP teaching methods may undermine
the desired objectives of schools' research-based drug prevention
curricula: using ex-addicts to teach drug prevention in schools
may tacitly reinforce students' perceptions that drug use really
isn't risky and may also contradict efforts to teach students
to critically evaluate health information and its sources. Because
NDAP presenters are encouraged to be flexible and the presentation
materials leave a variety of content and suggested activities
with insufficient instructional direction, the standardization
and fidelity of implementation may not be high.
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Agency Background
Agency. Narconon is a secular program based
on the research and writings of L. Ron Hubbard, who also founded
the Scientology religion. The Narconon network provides drug rehabilitation,
education and prevention services, and professional training.
The Narconon network includes the Association for Better Living
and Education International (ABLE), which licenses groups to use
L. Ron Hubbard's drug rehabilitation and prevention methods and
ensures that the programs delivered under the Narconon trademark
are delivered in accordance with Mr. Hubbard's specifications,
Narconon International, individual Narconon detoxification centers,
Friends of Narconon, and the Foundation for Advancements in Science
and Education (FASE).
Narconon drug rehabilitation program. The Narconon
treatment program is described as a "social education"
model of drug rehabilitation. It is a four-to-six month, drug-free
rehabilitation program that includes a detoxification regimen
of aerobic exercise, dry-sauna sweating, hydration and nutrition
supplements; life skills trainings; and personalized plans for
after-graduation living.1-3
As a social education program it does not always require licensing
designed for medical, psychiatric or other models of drug rehabilitation.
1 The unique detoxification
component of Narconon's drug rehabilitation program is based on
the teachings of L. Ron Hubbard. 1
The premise of the detoxification regimen is that the activation
of drug residuals stored in the body can elicit drug cravings
in the former drug user thus tempting relapse.1,3
The Narconon detoxification regimen is designed to eliminate drug
residues from drug users' bodies and thus reduce the cravings
that may be caused by these residues. 1,3
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Drug Abuse Prevention Program Description
Narconon drug abuse prevention program (NDAP).
Narconon developed the Narconon Drug Abuse Prevention Program
(NDAP) as an adjunct to its drug treatment program. 4
NDAP is designed as a supplementary activity to a school's drug
abuse prevention education curriculum. 1,4-5
The NDAP lecturers are generally former drug abusers. 4
Over 200 example educator thank you letters and student post-presentation
surveys (from 52,000 on file at Narconon) praise the NDAP presentations
in California. 6
An unpublished evaluation of a sample of 1,045 middle and high
school students who completed a written survey after a one-hour
NDAP presentation found positive drug knowledge and attitude results.
4
NDAP, as described in the Narconon Drug Abuse Prevention Specialist
Manual, consists of eight 30-45 minute presentations provided
in elementary, middle, and high school classrooms. 5
The eight sessions address general drug information, specific
information on alcohol, tobacco and marijuana, the negative impact
of drug use on the body and mind, media and alcohol use, tobacco-use
prevention, and goal setting. (See Appendix A for an overview
of the program objectives and content.) The Nacronon network also
provides schools with drug abuse prevention videotapes, booklets,
student worksheets, peer education program, and training workshops
to teachers (http://www.narconon.org,
July 2004). 1,5
The NDAP and other drug abuse prevention materials and resources
the Narconon network makes available to schools are the focus
of this evaluation.
Since 1972 Narconon has delivered 5,772 drug prevention presentations
to 447,400 students in California schools (C. Carr, PowerPoint
presentation, July 2004). Currently in California there are seven
NDAP presenters, of whom "about 50%" are graduates of
the Narconon drug rehabilitation program (C. Carr, discussion,
July 2004). b
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Process of the Evaluation
Scope of the program evaluation. The California
Healthy Kids Resource Center (CHKRC) c
evaluated the Narconon Drug Abuse Prevention Program (NDAP) at
the request of the California Department of Education (CDE) using
research-based evaluation forms (http://www.californiahealthykids.org)
and following written procedures discussed with CDE and Narconon
(July, 2004). The NDAP and other drug prevention materials made
available by the Narconon network to schools were evaluated for
medical/scientific accuracy, developmental appropriateness, and
teaching methods.
Materials evaluated. Narconon provided a subset
of the materials requested for evaluation. Requests were made
to Narconon for a complete set of prevention program materials,
including curricula, audiovisual materials, student handouts,
videotapes of classroom presentations, selection and training
of presenters, etc. Follow-up requests were made for these materials
and additional drug prevention materials identified as available
to schools in Narconon publications (Narconon website, newsletter,
and overview of services, July 2004). (See Appendix B for a list
of materials requested, received, and reviewed.)
Reviewers. The CHKRC prepared the NDAP evaluation
report with input from written independent evaluations from medical,
scientific, and health education exerts. The outside evaluations
were advisory to the CHKRC. Narconon program materials were independently
reviewed by fourteen reviewers and three CHKRC staff. Reviewers
included five doctors (M.D.s), four board certified in pediatrics
and adolescent medicine and/or with specific expertise in addiction
and substance abuse; two doctors (Ph.Ds) with expertise in child
and adolescent development; one doctor (Ph.D.) with expertise
in prevention research and program evaluation of substance abuse
programs. Reviewers also included nine school health education
specialists (with teaching credentials and/or masters level health
or education degrees) including elementary, middle, and high school
teachers, university faculty, and school district/county office
of education tobacco, alcohol, and other drug abuse prevention
education coordinators.
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Medical and Scientific Accuracy
NDAP instructional materials do not clearly identify authors,
their institutional affiliations or qualifications, or whether
the materials underwent content or pedagogical review; although
one material references L. Ron Hubbard as the source of its information.
d Some of the general
content presented in the NDAP is accurate, such as the information
on media and alcohol, tobacco and nicotine, achieving goals, and
possible effects of drug abuse on mental processing (e.g., memory).
Some drug-related information presented in the NDAP and supplementary
resources—although aligned with the Narconon drug rehabilitation
methodology—does not reflect accurate, widely accepted medical
and scientific evidence. Some information is misleading because
it is overstated or a distinction between drug use and abuse is
lacking.
Examples of inaccurate information presented
to students in NDAP presentations and supplementary resources
include:
- drugs burn up vitamins and nutrients
- drug-activated vitamin deficiency results in pain which prompts
relapse
- marijuana-induced, rapid vitamin and nutrient loss causes
the "munchies"
- small amounts of drugs stored in fat are released at a later
time causing the person to re-experience the drug effect and
desire to use again
This information reflects hypothesized processes of drug metabolism,
bioavailability, and psychoactive impact, and is the premise for
the Narconon detoxification regimen. a This theoretical information
does not reflect current evidence that is widely accepted and
recognized as medically and scientifically accurate.
Examples of misleading statements and inferences
presented to students in NDAP presentations and supplementary
resources include:
- drugs are poisons
- the amount of a drug determines if it acts as a stimulant
or as a sedative
- anyone who takes drugs does so to avoid problems
- drugs ruin creativity and dull senses
This information is overgeneralized or exaggerated.
Inaccurate and misleading drug-related information is problematic
because it can confuse students and be perceived as designed to
arouse fear. It may also lead students to discredit the schools'
drug prevention program and distrust educators.
Inaccuracies and misleading inferences were not limited to a
single material, but were evident in NDAP elementary, middle and
high school presentation outlines and delivery scripts and in
the supplementary drug prevention materials available to schools
that were provided for this review. (See Appendix C for annotated
examples of inaccurate and misleading information.)
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Developmental Appropriateness
The NDAP materials lack attention to the developmental characteristics
and cognitive levels of student learners. The eight elementary,
middle, and high school presentation scripts are undifferentiated.
Presentation outlines and delivery scripts for students at different
developmental levels comprise the same content, terminology, and
presentations verbatim, with limited language and activity differences.
Although the introduction of the NDAP manual reviews possible
program content for children of different ages, the manual lacks
guidance, language, scripts, and examples that translate this
content into developmentally appropriate presentations or learning
activities. Presenters are directed to "use age-appropriate
terminology." However, with the exception of "THC,"
no examples were found for drug-related vocabulary to be provided
to learners of different ages. Nor are presenters provided with
definitions of terms to use with students at different developmental
levels. Differentiated learning support materials, such as visual
and overheads, to help explain concepts to younger students were
not evident. Similarly, guidance was not found for the appropriate
grade levels for the student videos, worksheets, or booklet. In
addition, guidance was not found for presenters regarding what
types of personal or observed drug-use anecdotes might be appropriate
or inappropriate, effective or ineffective for students of different
ages. (See Appendix D for terminology used in NDAP.)
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Teaching Methods
Research-based drug abuse prevention education.
School-based drug abuse prevention content areas that have demonstrated
effectiveness in the scientific literature include learning activities
that enable students to,
- recognize and assess risks and possible consequences of drug
use;
- understand and analyze external influences to use drugs (e.g.,
family, peers, media) and internal pressures to use drugs (e.g.,
desire for acceptance, perceptions of norms regarding drug use);
- learn and practice personal and social skills (e.g., decision
making) and drug-use resistance skills (e.g., refusal skills).
These content areas are most effective when taught using interactive
techniques (e.g., role-playing, cooperative learning, discussion,
and skills practice) in which students actively construct personally
meaningful understanding and learn skills. Ineffective practices
include information-only programs about the negative effects of
drugs, scare tactics, testimonials of ex-addicts, single-exposure
interventions, and non-interactive techniques that emphasize conveying
information to students. Non-interactive techniques are most likely
ineffective because they fail to accommodate the complex relationship
between health knowledge and behavior. The best known non-interactive
program is Drug Abuse Resistance Education (DARE), which has been
shown to be ineffective. 7-11
The NDAP is designed to supplement the school's core health and
drug-abuse prevention curricula. Nonetheless, its content and
strategies should be consistent with curriculum standards and
research-based practice. e Even though
the NDAP manual describes research-based practice, the actual
presentation outlines, delivery scripts, and additional resources
made available to schools are often inconsistent with these standards,
as described in the following sections.
Use of research-based interactive techniques.
NDAP presentations do not use research-based interactive techniques.
NDAP presentations are lecture-oriented sessions designed to verbally
convey information about the risks and dangers of drug use and
addiction, using concrete examples, as well as humor, and entertaining
moments. Some lectures are interspersed with student participation
(mostly in the form of presenter questions and group responses).
NDAP presentations offer limited opportunities for students to
meaningfully interact with the concepts, construct their own understandings
for themselves, and learn and practice skills. With few notable
exceptions (e.g., session on media and alcohol), the presenter's
questions tend to ask students to confirm the presenter's conclusions
rather than critically reflect, exchange ideas and generate their
own conclusions. Examples:
- "'...When a healthy person takes drugs, the drugs
can make them sick. . .So if a person is not sick, is there
any good reason to take a drug?' (No!)" (1.3)
- "Tell them: '...who know somebody who smokes cigarettes?
(Every hand goes up.) Alright, who knows someone who smokes
cigarettes and wishes that they could quit? (Almost all of the
same hands go up.) That is a good example of addiction. Do you
think those people, when they tried their first cigarette, WANTED
to become addicted? ('No!') I don't think so. And, do you think
that that person, who ever it might be, started out by using
twenty cigarettes per day? ('No!') Probably not. Most people
begin by using just a cigarette here, and a cigarette there,
and if they don't stop, they can very soon be using 5 or 10
per day. People don't decide to become addicted to a drug. Nobody
goes home at the end of a school day and says, 'What am I going
to do tonight? Wash my bicycle . . . and become a drug addict.'"
(4.1)
Similarly, activities that could provide meaningful student interaction
with the concepts often lack sufficient concept development or
detail for effective implementation. Examples:
-
"Get students to give examples of varying types
of drug use and ask them 'Is this a responsible use of drugs,
or is it irresponsible?'" (1.4)
-
"Activity: Role-playing to demonstrate the meaning
of addiction." (4.5)
-
"Activity: Students name various commercials they've
seen to demonstrate their ability to use critical thinking
skills and to identify pro-alcohol messages." (5.4)
-
"Activity: Students give examples they've seen of
how powerful the addiction to nicotine can be." (6.4)
Accurate information without the use of scare tactics.
Strategies designed to frighten students into avoiding drugs do
not work, and can be counterproductive. Statements presented to
students in the NDAP are indicative of scare tactics. These include
failure to clearly distinguish between drug use and abuse and
overstating risks. Example:
-
"...'Even coffee can cause some serious problems
if someone takes too much of it. In fact enough coffee in
a short period of time could potentially kill a person. Now,
I've never heard of anyone dying from an overdose of Starbucks.
But I have heard of people dying from an overdose of caffeine.
Usually that's from taking caffeine in pills. . . . Other
drugs do the same thing. Have you ever seen someone go to
a party and the first thing they do is drink beer? . . . if
he keeps drinking, he could kill himself.'" (2.1)
Normative perceptions. Most drug education curricula
include normative education strategies designed to correct misperceptions
that many students are abusing drugs. In contrast, the NDAP delivery
scripts suggest presenters ask students about personal experiences
and expect shared responses that may reinforce perceptions that
drug abuse is common. This questioning strategy may undermine
the normative education components of the school's research-based
drug prevention curriculum. Examples:
- "Tell them: 'Raise your hand if you know someone
who drinks too much alcohol.' (Most hands will go up.) Ask if
they know someone who has trouble with some drug. (Some of the
hands.) Ask, 'Who knows someone who smokes cigarettes?' (Every
hand will go up.) 'Great. Who knows someone who smokes and wishes
they could quit? Alright, you all know someone who has a drug
problem then, don't you?'" (0.3)
- "'Who here has seen someone who just has to have
a cup of coffee every morning? (Every hand is up.) . . . Have
you ever seen someone go to a party and the first thing they
do is drink beer? (Most hands up.) . . . Have you ever seen
someone drink so much alcohol that they actually passed out?'"
(Almost every hand up.) (2.1)
- "Discussion: Ask students, 'Have you observed the
differences in a person between the time before he started using
drugs and the time after he started using drugs?' Get them to
discuss this with a partner." (3.2)
In addition, there may be student and family privacy concerns
about using this questioning strategy.
Using reformed drug addicts in drug prevention education
. NDAP presenters include former drug addicts. As noted
above, the use of testimonials of former drug abusers is not a
research-based strategy, either as core instruction or as a supplementary
activity. Authorizing ex-addicts to teach drug prevention in schools
may tacitly reinforce student perceptions that drug use really
isn't risky. Similarly, educational institutions may compromise
their ability to teach students how to critically evaluate the
credibility of health information and its sources 4,
f if they afford drug prevention education
authority to ex-addicts who do not possess legitimate credentials,
degrees, or medical training.
The NDAP materials are equivocal about presenters sharing their
personal drug-use experience. The presenter's manual advises that
what is most relevant is "your observation of what happens
to other people who abuse drugs, not your personal history."
If asked, presenters are instructed to be truthful but brief,
and "to make it clear that the fact that you are now able
to stand in front of a group and deliver an effective presentation
is in spite of your experiences," and to practice this with
an experienced Narconon presenter. g
Despite these cautions, no published scientific evidence was found
indicating that either describing the consequences of another's
drug use (instead of their own) or cautioning students from drawing
inappropriate conclusions is effective or relieves the problems
associated with using rehabilitated drug addicts in school-based
drug prevention.
In the Marijuana the Myth video— "viewed
by over 500,000 students!" (Narconon newsletter, 2004), and
which apparently is also used to train NDAP presenters (Narconon
Drug Abuse Prevention Specialist Training DVD of 2 Narconon video
properties, 2004)—a Narconon presenter voluntarily (not
in response to a student question) describes his personal initiation
to drug use to a classroom of students, adding, "I almost
died four times from drugs." Also in this video, five young
adults, each identified as "Former Drug User—Narconon
Graduate" describe their personal experiences with drug abuse.
(See Attachment E for video statements of former drug users—Narconon
graduates.)
Dosage and duration. As noted above, a one-time
presentation to students is not a research-based strategy. NDAP
includes eight 30-45 minute sessions on different drug prevention
topics that could be presented as one-time presentations or sequentially
over multiple sessions. Although Narconon has presented hundreds
of thousands of NDAP presentations to California students, no
evidence was provided that these are typically more than one-time
presentations to students. h
Fidelity of implementation. Standardization
of NDAP presentations was not reflected in the materials provided
for review. First, NDAP presenters are encouraged to be flexible
to accommodate the developmental differences, drug experiences
and concerns of pre-teens and teenagers. 12
Second, even though delivery scripts are provided for a great
deal of content and the NDAP manual directs presenters that "the
factual content points are to be adhered to very closely,"
a significant amount of NDAP content lacks scripts, and activities
lack implementation instructions—indicating that many of
these elements must be developed by individual presenters. Similarly
the NDAP presenter's manual only provides instructional content
and delivery scripts for alcohol, tobacco, and marijuana. No instructional
content or delivery scripts were found for the seven other drugs
listed in the General Developmental Guidelines, suggesting little
standardization of content and activities if these drugs are presented.
i (See Appendix F
for General Developmental Guideline.) No videotapes of live, complete
NDAP presentations to California students were provided for assessment
of fidelity and standardization of implementation.
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References
- Narconon Drug Rehabilitation and Prevention
Services for Over Three Decades: An Overview of Results.
Los Angeles, CA: Narconon International; 2002.
- Schare DW, Denk G, Shields M, Brunton S.
Evaluation of a detoxification regimen for fat stored xenobiotics.
Med Hyp. 1982;9:265-282.
- Beckmann S. Narconon: An overview of
the drug rehabilitation program. Los Angeles, CA: Narconon
International; May 1995. Unpublished manuscript.
- Beckmann SL, Chapman SL. Narconon drug
education program preliminary analysis. ERIC. 1989.
Accession number ED312602.
- Narconon Drug Abuse Prevention Specialist
Manual. Los Angeles, CA: Narconon International; 2004.
- NDAP Examples of educator responses
and NDAP Student responses: Elementary, middle and
high school. Los Angeles, CA: Narconon International;
2004. Compilation of sample letters and surveys.
- Strategies for prevention. In: Getting
Results (Part I): California Action Guide to Creating Safe and
Drug-Free Schools and Communities. Sacramento, CA: California
Department of Education; 1998: chap 4.
- Ringwalt CL, Paschall MJ. Substances, Adolescence.
In: Gullotta TP, Bloom M, eds. Encyclopedia of primary prevention
and health promotion. New York, NY: Kluwer Academic/Plenum
Publishers; 2003:1065-1073.
- Roona M, Steke A, Marshall D. Substances,
Adolescence (Meta-Analysis). In: Gullotta TP, Bloom M, eds.
Encyclopedia of primary prevention and health promotion.
New York, NY: Kluwer Academic/Plenum Publishers; 2003:1073-1079.
- Robertson EB, David SL, Rao SA. Preventing
drug use among children and adolescents: A research-based guide
for parents, educators, and community leaders. 2 nd ed.
Bethesda, MD: National Institute on Drug Abuse; 2003. U.S. Department
of Health and Human Services publication NIH 04-4212(A).
- Health Framework for California Public
Schools: Kindergarten Through Grade Twelve. Sacramento,
CA: California Department of Education; 2003.
- Carr CRN, Smith GW, Cecchini MA. The
Narconon drug abuse prevention program. Los Angeles, CA:
Narconon International. Unpublished manuscript.
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Endnotes
- The theoretical basis of the Narconon
detoxification regimen is described as,
The detoxification component of the Narconon program is based
on the premise that these adverse consequences of drug abuse
arise from small amounts of drugs or their metabolites stored
in the fatty tissues of the drug user. When fats are mobilized
during times of stress or hunger, the drug residuals are mobilized
as well. This may lead to reactivation of drug effects, a 'flashback'
type experience or, in the case of the recovering drug abuser,
this may lead to reactivation of the craving for his original
drug of abuse. This hypothesis is supported by the results from
treatment with the detoxification program...3
- The majority of the 150 example
thank you letters from California educators refer to one presenter:
Tony Blysma. One letter each refers to two other presenters:
Nathan Johnson and Garry Marshal. Typically the letters praise
the presentation and express gratitude for the external funding
that made it possible. Some of the letters describe the presenter
as a former drug abuser and remark on the personal stories of
drug abuse shared during the presentation.
- The CHKRC is administered for
the California Department of Education and the California Department
of Health Services to review research and health instructional
materials for use in California schools, provide technical assistance
and training in health education, and to provide a library of
reviewed resources for loan to California schools, professional
development programs, and other youth-serving programs. For
more information see the Center's website at http://www.californiahealthykids.org.
- The student booklet, "10
Things Your Friends May Not Know About Drugs" (2004) includes
the citation,
Narconon centers utilize the drug-free methods of American author
and humanitarian L. Ron Hubbard. The information in this booklet
is based on the works of L. Ron Hubbard.
- Regarding the involvement of
other health experts, the California Framework for Health Instruction
11 advises schools,
When planning a health education curriculum, leaders should
keep in mind that many professionals with special health-related
expertise and interest are available in schools and communities.
Potential human resources include health care providers; public
health educators in tobacco, alcohol, and drug prevention; public
health nurses; juvenile justice staff; environmental health
specialists; mental health counselors; and nutritionists...
When guests are invited to participate in the classroom, school
policies should be considered and adequate precautions taken
to ensure student safety and the guests' adherence to curriculum
standards and practices. (p. 48)
- Some reviewers raised a related
question as to whether the display of the Narconon logo, which
may also represent rehabilitation centers and services, on the
student materials (e.g., worksheets, surveys, videos), created
a possible an infringement of social compliance requirements
for classroom materials.
- The NDAP manual notes that Narconon
presenters apprentice under a mentor until the mentor and an
experienced presenter attest that the aspiring presenter is
qualified to work alone. Full certification is granted when
a presenter provides clear evidence of consistent success with
students in a variety of educational contexts over a period
of several months. Similarly, Narconon reports that NDAP presenters
are trained so that they can cogently present material regarding
a wide range of drugs. 12 While this attention to training is
admirable, no documentation or evidence of presenter training
was provided.
- Some records on dosage were provided
by Narconon New England for the period Aug. 1999— March
2000. Although the records were short term (less than a year)
and may be incomplete, they indicate that students at most schools
received one Narconon presentation. At some schools presentations
were given to more than one grade. If these data are extrapolated,
it might be inferred that some students may have received one
Narconon presentation per year over several years. Nonetheless,
conclusions about dosage for California students cannot be made
from New England data.
- Similarly, it was noted that
the program materials lacked guidance for schools or presenters
regarding how to help students who may be living in environments
where drugs are abused or chemical dependency exists, or to
help students who are using. Given the topics raised by the
NDAP presenters, it is likely that students with these troubles
might self-identify and be receptive to assistance if it was
offered.
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