Three decades later, a mixed legacy for 'Just Say No'

SEATTLE -- For a generation of Americans, first lady Nancy Reagan was most closely associated with a single phrase: "Just Say No."

Three decades after the anti-drug campaign's heyday, its legacy is mixed. Experts say the slogan brought new attention to drug abuse and helped focus research on how to prevent it. But the motto also was part of a larger escalation of the drug war that relied on fear-based rhetoric, public moralizing and skyrocketing incarceration rates.

"Overall, the larger prevention community is thankful for large campaigns like 'Just Say No' for the broad, population-level awareness they raise," said Derek Franklin, who leads the Washington Association for Substance Abuse and Violence Prevention. "However, the sort of shaming attitude and questionable moral divide it created was something we wouldn't do today."

Further evidence of changing attitudes can be found in the movement to legalize marijuana, which is permitted for medical use in 23 states and for recreational use in Colorado, Washington State, Oregon, Alaska and Washington, D.C.

Reagan, who died Sunday at 94, made "Just Say No" the hallmark of her tenure in the White House. She said she first became aware of the drug problem when she learned the children of some of her friends were using drugs. Her daughter, Patti Davis, later wrote of experimenting with pills and cocaine.

As Reagan once recalled, the idea emerged during a visit with schoolchildren in 1982 in Oakland, California.

"A little girl raised her hand and said, 'Mrs. Reagan, what do you do if somebody offers you drugs?' And I said, 'Well, you just say no.' And there it was born."

At the time, Allan Cohen was the executive director of the Pacific Institute for Research and Evaluation, which had a federal contract to help states and local communities develop drug-abuse prevention programs. Cohen's organization had promoted and adopted the program the first lady visited in Oakland, called Oakland Parents in Action, which taught children skills for refusing drugs offered by their peers.

The message instantly resonated. By 1988, there were more than 12,000 "Just Say No" clubs around the country. Most were at least loosely based on the ideas developed in Oakland, Cohen said.

One of them was at Clyde Riggs Elementary in Portland, Tennessee. Helen Berry, the mother of a student there, was volunteering to help assemble a bulletin board one day in 1985 when a teacher showed her some "Just Say No" pamphlets.

"It was like a light bulb came on," Berry recalled. "I said, 'Wow, this is really important."'

She went on to lead the school's "Just Say No" club for 25 years, bringing in emphysema patients to warn about the dangers of smoking and quizzing pupils about how long marijuana can stay in the body.

"I just thought it was an outstanding program for kids to see what drugs can do," Berry said. "I've had kids come up to me today who are in their 30s and say, 'Mrs. Berry, I want you to know I never touched a cigarette.'"

Many researchers remain skeptical of the campaign's effectiveness, associating it with the first lady's calls to be intolerant of drug users or with the famous television commercial that featured an actor dropping an egg into a frying pan and saying, "This is your brain on drugs. Any questions?"

It's apparent now efforts to scare people into abstaining from drugs failed, they said.

"You think of 'Just Say No,' you think of eggs in a frying pan," said Caleb Banta-Green, a researcher at the University of Washington's Alcohol and Drug Abuse Institute. "Just because you remember it doesn't mean it worked. Addiction is a medical condition, but we still have a fundamental misunderstanding of what addiction is, and 'Just Say No' spread that misunderstanding."

Michelle Miller-Day, a professor at Chapman University in California, said the refrain might have been a simplistic message, but its popularity focused the attention of researchers on the social context of drug use and on developing programs that would help youngsters refuse drugs or at least delay experimentation.

She worked with a colleague from Penn State University, Michael Hecht, to develop "Keepin' It REAL" -- for Refuse, Explain, Avoid and Leave, a research-validated curriculum the popular anti-drug program DARE adopted in 2009 as it was under fire about its effectiveness.

Cohen said there's no way to quantify the effect of "Just Say No," but it's unfair to conflate the campaign -- a prevention effort aimed at middle or elementary school children -- with criticism of the larger drug war or mass incarceration. While the message may have seemed simple, the Oakland-developed curriculum was actually comprehensive, he said.

The issues "of criminal justice overreach or overstatement of the moral horrors of drug use were not much related to what the first lady was doing," Cohen said. "The greatest legacy was the promotion of preventive approaches, which at that point had almost been totally ignored."

These days, researchers have come up with better prevention programs, said Christopher Ringwalt, a prevention researcher at the University of North Carolina. But schools aren't necessarily using them. An emphasis on testing has squeezed prevention education out of many classrooms, he said.

"It's frustrating for people like me," Ringwalt said. "Attention has turned elsewhere."