“Generational forgetting”: A year-end reflection

As 2012 comes to a close, there are a few drug- and alcohol-related stories I’d like to forget. But forgetting isn’t always the best way to cope with the unpleasant repercussions of US drug policy. For several generations, social psychologist Lloyd Johnston’s statistics have quantified the adage that those who cannot remember the past are doomed to experiment with bath salts (more on that in a minute).

In 1975, Johnston and his colleagues at University of Michigan began conducting the nationwide survey, Monitoring the Future. By pairing these results with the National Household Survey on Drug Abuse (initiated in 1971), we have been able to get a fairly accurate annual look at drug use prevalence for almost four decades. Both surveys were inspired, in part, by the increase in youthful experimentation with psychoactive substances (especially marijuana) in the 1970s. While substance use trends come and go, academic interest in youthful drug use has remained stable.

The good thing about studying high schoolers: We get older, they stay the same age

In examining trends in drug use over the course of several decades, Johnston and his colleagues noticed a pattern: among adolescents, trends in substance use correlated with the perceived risk that particular substances posed. As teens came to view a particular substance as dangerous, fewer would experiment with it. The inverse was also true: an overall decrease in the perception of a drug’s riskiness sometimes predicted an uptick in use. Because teens are more likely to take social cues from peers than from elders, Johnston suggested that this pattern of receptivity and hard-learned revulsion reflected a process of “generational forgetting.” Experiencing—or witnessing—the negative effects of substance use are often the most compelling evidence that a substance is actually harmful. Younger generations have no memory of the negative consequences of earlier addiction epidemics that justified the regulation of particular substances. According to Johnston, they re-learn these “harsh lessons” for themselves.

As perceived risk and disapproval go up, use goes down (Bachman, Johnston & O'Malley, American Journal of Public Health, June 1998)

As perceived risk and disapproval go up, use goes down (Bachman, Johnston & O’Malley, American Journal of Public Health, June 1998)

Historian David Musto argued that the pattern holds true for policymakers as well (Points authors will elaborate on this in 2013). The relaxation of regulations surrounding psychoactive substances leads to an increase in use, which leads to an increase in harms, which inspires a reversal of lax policies. Musto offers the example of cyclical approaches to opiate prohibition to illustrate this claim. Johnston provides another example: after the passage of the 26th amendment in 1971, 29 states lowered the minimum drinking age. But the lower drinking ages were associated with alcohol-related accidents, and federal dis-incentives caused most states to raise the drinking age from 18 to 21 in the 1980s.

These instances of generational forgetting raise a perennial public health problem: is there a good way to prevent amnesia-induced epidemics of substance use? Scare tactics and grotesque images are time-honored tactics, but the efficacy of these strategies is questionable. Furthermore, Johnston argues, “the attitudes and beliefs young people hold about drugs tend to be drug-specific. Simply because they come to see one drug as more dangerous does not mean that they will see all drugs as more dangerous.” So substance-specific scare campaigns don’t have a halo effect; for example, in recent years, youth are more likely to perceive smoking cigarettes as dangerous. They’ve adopted hookah as a cigarette alternative, despite the health consequences.

Because substance use trends shift, substance-specific health campaigns have to adapt to historical circumstances. In addition to the problems associated with population-level memory lapses, new drugs emerge, inspiring new studies, media campaigns, and policy responses. For example, 2012’s Monitoring the Future press release identifies a marked drop in bath salts-related calls to poison control centers, “likely due to the DEA scheduling some of the chemicals in bath salts and also to widespread publicity about the dangers they carry.”

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Those chemicals got plenty of publicity: enough for the Hollywood Reporter to classify the un-glamorous concoction as the “designer drug of 2012.” But just as the bath salt scare of 2012 may have reversed the upward trend in the drug’s use, the folks at Monitoring the Future warn that the second big drug story of the year—the legalization of marijuana in Colorado and Washington—could further encourage the upward trend in marijuana use among youth (currently holding steady after a four year long increase).

Along with bath salts and pot history, Points has covered other drug-related headlines: butt-chugging, the presidential campaign, the Lance Armstrong doping scandal, and the cultural and historical relevance of numerous drug-using celebrities.

Taking an historical perspective, Points contributors try to remember that the stories we tell ourselves about psychoactive substances haven’t necessarily been continuous throughout the ages. Like the cycles of drug trends, some narratives persist, while others become antiquated and seemingly irrelevant. A few get new-media makeovers.

It’s too soon to say with certainty which of 2012’s stories will have long-lasting political and historical impact (and I doubt we’ll try to measure whether our coverage has changed teenage health beliefs). But I’m all for speculation: Which stories do you think will stick around this year? What should Points contributors remember to discuss in 2013?

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