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By Jonathan Caulkins

Within the struggle on medications, young children are at the entrance strains. is simply asserting no security adequate? The authors research the result of renowned university drug prevention courses to figure out how powerful they're at decreasing cocaine use and even if those courses are funds good spent, compared to drug-enforcement or drug-treatment courses.

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Extra info for An ounce of prevention, a pound of uncertainty: the cost-effectiveness of school-based drug prevention programs

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Additional support was provided by Carnegie Mellon University and by RAND's Drug Policy Research Center with funding from The Ford Foundation. Page ix Contents Preface vii Figures xiii Tables xv Summary xix Acknowledgments xxxiii Chapter One Introduction 1 An Analysis of Costs and Effectiveness 2 Beyond Cost-Effectiveness 5 An Issue Not Yet Examined 6 Our Focus 7 Chapter Two Effectiveness at Reducing Cocaine Consumption 11 Effect on Cohort Members Participating in Program 12 Proportion of Cohort That Would Otherwise Use Cocaine 13 Lifetime Consumption 15 Program Effect 17 Discount Factor 28 Summary 31 Multipliers 31 Social Multiplier 31 Market Multiplier 34 Qualifiers 35 Page x Integrating the Factors 37 Uncertainty 39 Sources of Effect 42 Chapter Three Cost-Effectiveness at Reducing Cocaine Consumption 45 Defining Program Cost 45 Estimating Program Cost 49 Estimating Cost-Effectiveness and the Implications of Uncertainty 51 Variation With the Passage of Time 56 Chapter Four Other Benefits 59 Estimating the Effect on Use of Drugs Other Than Cocaine 59 Simple Program Effectiveness 60 Other Factors 64 Comparison of Effects 65 Social Savings from Reduced Drug Use 68 Cocaine 69 Other Drugs 70 Benefits Unrelated to Reduced Drug Consumption 71 Chapter Five Nationwide Implementation 73 Implications for the Current Cocaine Epidemic 74 Implications for Future Epidemics 75 Implications for the Legalization Debate 78 Chapter Six Conclusions and Policy Implications 81 Model Prevention Programs Appear to Be Competitive With Enforcement 81 Great Uncertainty Remains About Prevention's Cost-Effectiveness 82 The Source of Benefits Is Not What Might Be Expected 83 Drug Use Prevention Has Benefits Other Than Reduced Cocaine Use 84 A National Program Is Affordable but Will Not End the Cocaine Epidemic 84 Page xi Drug Prevention Should Be Conducted Before It Is Perceived Necessary 85 Prevention Cannot Substitute for Enforcement in a Legalization Regime 86 The Bottom Line 86 Appendix A.

Expanding the mix of enforcement strategies used against dealers prosecuted at the federal level before the advent of mandatory sentencing. Treating heavy users with a program effective enough to keep the great majority off cocaine during treatment and cause a small minority to remain off heavy use after leaving treatment. Our best estimate of prevention's cost-effectiveness suggests that model school-based prevention programs can reduce cocaine consumption as much per dollar spent as some enforcement programs do.

This study was the "structured evaluation of different approaches . . L. 100-690) that was mandated by the Anti-Drug Abuse Act Amendments of 1988. It was intended to respond to policymakers' questions concerning the state of knowledge about prevention, but it did not address cost-effectiveness. The net result of these past efforts is that many scholars seem favorably disposed toward prevention generally. But skeptics are beginning to raise concerns about some of the evaluations that have been done and whether indeed prevention is cost-effective (or effective, for that matter) (Gorman, 1995; Moskowitz, 1993; Lynskey, 1998).

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