Cover image for An ounce of prevention, a pound of uncertainty : the cost-effectiveness of school-based drug prevention programs
An ounce of prevention, a pound of uncertainty : the cost-effectiveness of school-based drug prevention programs
Caulkins, Jonathan P. (Jonathan Paul), 1965-
Publication Information:
Santa Monica, CA : Drug Policy Research Center, Rand, 1999.
Physical Description:
xxxiii, 194 pages : illustrations ; 23 cm
Reading Level:
1430 Lexile.
Format :


Call Number
Material Type
Home Location
Item Holds
HV5824.Y68 O94 1999 Adult Non-Fiction Central Closed Stacks

On Order



America is spending billions of dollars on school-based drug prevention programmes. But how effective is prevention? How much does it cut drug use? This is an examination of the evidence from programmes, including Project ALERT and Life Skills in order to answer these questions.

Table of Contents

Prefacep. vii
Figuresp. xiii
Tablesp. xv
Summaryp. xix
Acknowledgmentsp. xxxiii
Chapter 1 Introductionp. 1
An Analysis of Costs and Effectivenessp. 2
Beyond Cost-Effectivenessp. 5
An Issue Not Yet Examinedp. 6
Our Focusp. 7
Chapter 2 Effectiveness at Reducing Cocaine Consumptionp. 11
Effect on Cohort Members Participating in Programp. 12
Proportion of Cohort That Would Otherwise Use Cocainep. 13
Lifetime Consumptionp. 15
Program Effectp. 17
Discount Factorp. 28
Summaryp. 31
Multipliersp. 31
Social Multiplierp. 31
Market Multiplierp. 34
Qualifiersp. 35
Integrating the Factorsp. 37
Uncertaintyp. 39
Sources of Effectp. 42
Chapter 3 Cost-Effectiveness at Reducing Cocaine Consumptionp. 45
Defining Program Costp. 45
Estimating Program Costp. 49
Estimating Cost-Effectiveness and the Implications of Uncertaintyp. 51
Variation With the Passage of Timep. 56
Chapter 4 Other Benefitsp. 59
Estimating the Effect on Use of Drugs Other Than Cocainep. 59
Simple Program Effectivenessp. 60
Other Factorsp. 64
Comparison of Effectsp. 65
Social Savings from Reduced Drug Usep. 68
Cocainep. 69
Other Drugsp. 70
Benefits Unrelated to Reduced Drug Consumptionp. 71
Chapter 5 Nationwide Implementationp. 73
Implications for the Current Cocaine Epidemicp. 74
Implications for Future Epidemicsp. 75
Implications for the Legalization Debatep. 78
Chapter 6 Conclusions and Policy Implicationsp. 81
Model Prevention Programs Appear to Be Competitive With Enforcementp. 81
Great Uncertainty Remains About Prevention's Cost-Effectivenessp. 82
The Source of Benefits Is Not What Might Be Expectedp. 83
Drug Use Prevention Has Benefits Other Than Reduced Cocaine Usep. 84
A National Program Is Affordable but Will Not End the Cocaine Epidemicp. 84
Drug Prevention Should Be Conducted Before It Is Perceived Necessaryp. 85
Prevention Cannot Substitute for Enforcement in a Legalization Regimep. 86
The Bottom Linep. 86
A. Estimating Average Lifetime Cocaine Consumptionp. 89
B. Prevention's Effectiveness at Reducing Marijuana Initiationp. 97
C. Relationship Between Age of Marijuana Initiation and Lifetime Consumption of Cocaine and Marijuanap. 105
D. Estimating the Magnitude of the Social Multiplierp. 115
E. How Prevention's Cost-Effectiveness Varies Over Timep. 131
F. Estimating the Magnitude of the Market Multiplierp. 139
G. Estimating the Magnitude of the Causation/Correlation Qualifierp. 143
H. Estimating the Magnitude of the Scale-Up Degradation Qualifierp. 155
I. Prevention's Effect on Heavy Alcohol Use and Cigarette Smokingp. 163
J. Accumulation of Prevention's Effect Nationwidep. 177
Referencesp. 185