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    Malignant Neglect: Substance Abuse and America’s Schools

    Published: September 2001

    Drugs in schools are an enormous problem in the U.S., with fatal consequences. This report is a comprehensive analysis of available data on substance use in our schools and among students. It is designed to clarify how tobacco, alcohol and illicit drug use affect schools and to suggest what it will take to make our schools and our children substance-free.

    Key Takeaways

    Each student’s choice of whether or not to use substances is related to two factors: availability and perception of risk. The more available tobacco, alcohol and other substances are, the more likely students are to use them. Further, students are more likely to use substances when they believe that the harm associated with their use is low. Additional findings include the following:

    • Almost 5 million middle school students (30 percent) and 9.5 million high school students (60 percent) reported attending schools where illegal substances were used, kept and sold. These students were twice as likely to smoke, drink or use illicit substances as students who reported that their schools were substance-free.
    • Researchers found that substance use and addiction will add at least $41 billion (10 percent) to the costs of elementary and secondary education due to class disruption and violence, special education and tutoring, teacher turnover, truancy, children left behind, student assistance programs, property damage, injury and counseling.
    • Each year, there were 13 million incidents where a 12-to-17-year-old tried tobacco, alcohol, marijuana, ecstasy or some other illicit substance.
    • A high proportion of students who experimented with illicit substances continued using them throughout their years in high school.


    For schools:

    • Strive to prevent all forms of substance use, not just illegal substance use.
    • Train all administrators, teachers, counselors and other staff to spot the signs of substance use and know how to respond.
    • Provide strong non-substance use messages every year from preschool through the twelfth grade, tailored to the age of the child.
    • Provide access to treatment and education without penalty for students who voluntarily request help with a substance use problem.


    For parents:

    • Be hands-on in their parenting (for example, eating dinner with their children most nights of the week, being very aware of their children’s academic performance, and monitoring what their children watch on TV and do on the Internet).
    • Make clear that they would be extremely upset if their children used substances.
    • Impose a curfew.
    • Know where their children are after school and on weekends.


    For government policy:

    • Fund research to develop treatment programs designed to meet the needs of youth.
    • Strengthen and enforce laws prohibiting the sale of cigarettes and alcohol products near school boundaries.

    Research Methods

    The data in this report was based on focus groups and national surveys with teens, parents, teachers, and school administrators; an analysis of national data related to youth substance use; a panel of experts in education and psychology; an examination of school-based programs designed to prevent and treat substance use; and a review of more than 1,000 publications related to substance use and education.

    Last Updated

    November 2023