Prevention Profiles: Take Five - Fran Harding (Former Director of the Center for Substance Abuse Prevention at SAMHSA)


Fran Harding

Audio file

Frances (Fran) Harding, who served as the Director of SAMHSA's Center for Substance Abuse Prevention for 11 years, joins us for this episode of Prevention Profiles: Take Five. During this, her second appearance on the podcast, Fran discusses her experience working on a college campus as a prevention professional early in her career, the challenges she faced trying to build a connection between law enforcement and prevention, and much more.

Rich Lucey: Hi, this is Rich Lucey in the Drug Enforcement Administration’s Community Outreach and Prevention Support Section.
Welcome to this episode of Prevention Profiles: Take Five.
I’m really excited about today’s episode and our guest, Fran Harding.
Let me tell you a little bit about Fran before she joins us and says hello.
Fran Harding served for eleven years as Director of the Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Prevention.
She is recognized as one of the nation’s leading experts in the field of drug misuse prevention.
Prior to federal service, Fran worked for the New York State Office of Alcoholism and Substance Abuse Services for 26 years, completing her tenure there as the Associate Commissioner for Prevention and Recovery.
Fran has held numerous state and national positions including serving as President of the National Prevention Network and receiving the Science to Practice Award from the Society for Prevention Research.
And in fact Fran was the first and to date only non-researcher to receive this award.
And with that, Fran, welcome to the podcast.

Fran Harding: Thank you.
It’s good to be speaking to you again.

Lucey: And of course, full disclosure, we’ve been doing these podcasts now for about two and a half years, and anybody who has listened to these podcasts knows that I often reference you, mainly because I worked for Fran in two different stents, once in New York State and once at CSAP.
And Fran’s more than a boss.
She’s a longtime friend and my mentor so it’s always a thrill for me to have Fran on the show.
So again, Fran, welcome.

Harding: Thank you.

Lucey: So I’m going to kick right in to our first question.
Since we post this episode series on our website,, your passion for preventing drug misuse among college students started early in your career when you took a job on a college campus.
Can you tell us a little bit about that experience and how did it shape your career going forward?
Harding: Thank you, good question.
It was quite the year.
It’s not what I expected.
I thought I was going to jump from this, the job that I had which was one of those beginner administrative jobs where I was a director for one of the dormitories, and I was part of Student Affairs.
That was the other half of my position.
And I thought that really was going to lead my career into college administration which I really wanted to do.
However it didn’t happen that way.
My biggest challenge was that the college had; the drinking age had just changed in the state I was working in to 19.
So with the one-year jump before, eventually all states as we know went to 21.
And they treated it like a joke.
When I say they, I mean everybody on the campus.
They pretended.
Both administration, security and especially the students just didn’t see that that was important.
So I learned that people really weren’t paying any attention to alcohol, and yet there were so many really bad things that happened to young people that were drinking.
Drinking too much, getting; they were dropping out of campus.
There were attacks on campus during dates, and all the things that we have read over the years.
I went to the law enforcement, which I’ll save for another question, but we had to; in this state we had to confiscate the beer when we saw it.
Most of it was beer back then.
And so I did.
Dutiful director, not very popular by some of the students, but confiscated the beer, put it in my office that I had on the first floor.
My apartment was on the second floor I believe.
One story short, one time I needed something in the office.
I went down.
It was about, I don’t know, midnight or so and I was doing some work.
And I opened my office door and found all of the security guards that were on duty that night drinking the confiscated beverage.
So that struck me as, no wonder we’re having such a difficult time with messaging, and nobody wanted to listen to having a program on campus for underage drinking and the dangers.
And it just opened my eyes that this job is going to be a lot harder than I thought.
I wish I could say it was a very happy ending.
It wasn’t.
I really got a little bit of a change going but not as much as I would’ve liked.
Another opportunity came up for the state of New York.
I went back to New York and then my whole career went a whole different way.

Lucey: It certainly was an eye-opening experience for yourself as a new professional on campus and trying to do the work that you were being charged to do, and yet the positive that really did come out of that though (I of course know your story) was one of the very first assignments that you had in your new job working for the state of New York had to do with prevention on campus, right?
Harding: Yes, yes.
And it helped me by all of the somewhat very, some real negative, some just slightly annoying issues.
I was able to expand the original thought for my new administration that I was working for in the state of New York and expanded into the other areas that people didn’t talk much, particularly around date rape because the alcohol influence with that was very great.
And as you know, Rich, because you worked on the manual later on that came later to update it.
And we’ve had a lot of success.
And one of the things I’ll talk later on is around suicide, and it’s a health issue, that they weren’t even considered back then.
So I really; what it really did get for me though was the disrespect for and that people, parents, administrators, not to mention the students at the time, they just didn’t care because they didn’t see alcohol as dangerous as I did.
So I’m a fighter and so I was able to really look at the manual and start my learning in a different direction, which worked out for me and I hope a lot of the country.

Lucey: So before I go on to our second formal question, I’ll do a follow up.
Something you just said about there was a lack of respect among a variety of different audiences and stakeholders back then.
I mean you’ve been in the field for a while, and I kind of, as you and I kind of joke, I’m about ten years behind you, but I’ve been in the field for quite a while too.
Do you think that that issue around respect for the field, at least maybe not just around alcohol, maybe the other drugs as well.
But do you think that there has been at least positive change in that regard over all that time?
Harding: Oh, absolutely.
We don’t have time for this, but it’s a different thing maybe for a different podcast.
But the number of steps that this field; we really, we didn’t know it at the time when back in the early ‘80s we were just beginning to make this.
When we started working in; I’ll say I because I am ten years ahead of you.
But when I started, it wasn’t a field.
People just kind of looked at you kind of funny.
So yes, the respect has grown.
Although it has, it ebbs and flows, right?
Sometimes it’s very strong and you feel supported, and other times it’s like when we’ll be talking later on about opioids, and the opioid situation.
I felt like I was right back where we started from.
So it is.
Because of the fact that we were able to have funding to get communities involved very early on in the early ‘90s, that late ‘80s, early ‘90s, that made the world of difference because we had a group of people, professionals that were able to bring prevention programming.
And then the Society for Prevention Research broke out in the early ‘90s with their programming, and then you could feel the momentum growing.
So yes, it started off very scary because people said they’re in college.
Let them drink.
They were 18.
But then that little; you know, I was there just when everything started to change.
So yeah, I agree.
It comes and ebbs and flows.
Bur right now I think we have; I would suggest to anyone to go into the field because you’re not going to have to be the fighter that we used to be.
I think that path has already been paved.
I think right now it’s a matter of just learning all the exciting new things we can do to help prevent addiction and death and everything that might come with it.

Lucey: Well, I definitely want to come back to that concept in just a little bit.
I’ll move on.
Our second question, because you touched on it, it’s what had a bit of a negative impact on you in your first professional job regarding law enforcement.
So I’m often asked, why is the Drug Enforcement Administration?
It’s right there in our name.
Our primary mission is law enforcement.
Why is DEA involved in prevention efforts?
I know that you early in your career or maybe throughout have struggled with that.
What was the biggest challenge that you faced in trying to build a connection between law enforcement and prevention?
Harding: Outside of the program DARE, if everyone knows that program by now in elementary school, that both helped and didn’t help us because the DARE program for young people ignored alcohol, and they just talked about drugs, and they wanted to make sure that 5th and 6th graders did not do drugs.
Well, the biggest drug of choice back then, and I would challenge people to say it still is, was drinking and alcohol.
So it was very difficult to sit down with a group of law enforcement officers at the time (timing is everything) and get them to see that you needed to do more than what they were doing.
Thankfully the federal government came up with money to give states that we could pass onto communities that actually had law enforcement in the plan of the Strategic Prevention Framework.
And you might remember, Rich (I’m sure you do), when we decided in the state of New York that we would develop a community coalition first to sort of try it out, to see so we could role model for the rest of our state.
And every single time we met (we met once a month) I always went over to the police chief that was a representative; he was representing law enforcement with one of his staff people.
And I’d always check in.
Do you see where you fit yet?
 So to make a long story short, after; I think, Rich, you could correct me if I’m wrong.
I think it was the fourth month, the fourth meeting that finally he looks at me with a smile and he says I’m not 100% there yet but I’m almost there.
And it was all about helping him to see that those checkpoints that he does to ensure that people are not drinking and driving were all a part of community prevention.
Then we went from there and we kept finding little things that they do that was very important of the crashes and the deaths we were seeing in our state at the time with drinking and driving, particularly around the high school, 11th and 12th grades.
So the audience may be interested to find out when I grab onto something and we know we have the science behind us and I know that I can see in your eye that you’re at least listening, I’m going to go.
It’s a challenge for me to get you to see that you do belong.
So I cannot today imagine a community program or a school program in college, I can’t imagine any program without law enforcement.
It’s almost as though it’s incomplete.
One of the appendages has been taken off.
So we’ve come a long way in this field.
It’s very, very important to have the backup of your law enforcement in a community or a school setting.
Lucey: Well, I know that for me it’s been exciting over the last couple of years watching some of our Special Agents with DEA who actually co-presented on panels with you at different national conferences.
And these are Special Agents who, yeah, first and foremost again, enforcement is the mission, but they really value and understand the need for prevention.
And they might not speak the language as we know, prevention science.
But it’s been really nice to see when that connection happens.
And I think they encountered that a few times during presentations that you’ve done with us.

Harding: Well, right, and the opportunity I would extend to everyone is to have a conversation so people know their lane.
How many times have you heard?
 I mean with some of your probably current colleagues, particularly anyone in the law enforcement.
Well, that’s not my job.
Well, that’s not my job.
Well, but it is because it’s all of our jobs.
And let me show you what you can do.
I don’t want you to go into the classroom and teach.
I don’t want you to be the one to have to sit down with parents and show them the good, the bad and the ugly about alcohol use.
I don’t want you to be the one to have to stand in front of young people, either in middle school, high school or in college, and give them all the what fors of what you can do, what you can’t do.
What I want you to do is your job because I want the community and the schools to understand that I have an education job to help you to be healthy and safe, but here’s the person who’s going to help you if you get in a bad situation.
And once law enforcement or anybody else, law enforcement, parent, teacher, older adult, it doesn’t matter.
Once everyone knows their lane and knows what they can do, they all don’t have to be experts.
I’ll be the one taking the heat from a parent or a college student who thinks I’ve gone too far.
I’ll stand there and take that and have that debate.
I don’t think it’s the law enforcement, but I wouldn’t go and slam down a door to get in to break up a fight.
So we all have different roles.
And as soon as you help people to see their role in staying safe and healthy, I think, Rich, that’s when we turned the corner, once we realized we all had our own specialty.

Lucey: Well, I’m going to move on to the third question.
I’m going to loop back again to this concept that you brought up earlier about the ebbs and flows and the cycles that we often feel in the prevention field.
So when you and I worked together at CSAP, and now that’s more than four years ago, we talked about; we actually said this one time.
I don’t know if we were at lunch or we were traveling together.
It felt like all the planets were aligning in terms of prevention.
We actually called it a golden age of prevention.
We had a national prevention strategy.
That never existed before.
The agency we worked for had a strategic initiative that was solely focused on prevention.
And yet during the last five years or so, I mean it’s not related to any one factor but it just seems like the overall landscape of prevention has really morphed and changed.
And from my perspective it also feels like there’s an overall decline in focusing on primary prevention.
It all seems to be muddling together, both prevention and treatment and recovery.
And that’s not dismissing any one of those disciplines at all.
It just seems like it’s all really; the lines between those, the continuum if you will has gotten much fuzzier.
You know, both from your time within government and now that you’ve been out of that setting for a couple of years, from your observations do you think that’s true?
 And if so, what’s the likely impact of that?
Harding: Well, that’s a lot.
You made the sentences look much bigger after you described them.
I do think that what you’re saying is the correct observation.
And I have a lot of ideas of why that happened, and I’ll list them out, one in particular.
But I’ll start with the good news.
Well, I’ll start with the struggle.
The struggle is what it always has been.
I think that we tend; we meaning people who have been in the field more than five years, when you’re working and you’re feeling pretty comfortable, I think we forget that no matter how much we try, the world that we live in really just doesn’t want to hear what we have to say half the time.
They don’t want the outcomes, right?
They want us to do our job so they don’t lose their child to an overdose and alcohol.
They won’t lose their siblings to a car crash that’s damaging.
They won’t.
They won’t.
They won’t.
They don’t want any of that negativity, but they also really just kind of listen to us with that face of, wow, that’s pretty interesting.
And then I swear they go home and they say, thank God I’m not doing that.
So we still have that, even though we know it’s just; I don’t think I’m going to be able to express the excitement of being in this field and growing it and watching it grow and looking at our advancement.
Well, that all stopped for me when opioids came on the scene because when opioids hit and we were losing all these individuals to overdoses.
And then we got into, first of all it was just the usual safe opioids.
It was heroin and opioids together.
Then all of a sudden the oxys came in.
And then we started getting things like fentanyl and carfentanil and then et cetera, et cetera, et cetera.
And then of course we get the magic drug that’s able to bring you back from an overdose, thank goodness, in some particular cases.
So it took the country; you know, we have very short memories.
And the country went to almost like when we had Len Bias who died of crack cocaine.
It went way over there to the thing that they felt was far more important than worrying about my young person at the age of 13 starting to drink because it was real.
It was happening.
People were dying and it was on the news.
So one of the things that when I was looking at this question I was thinking of is this in a very strange and hopefully positive way, these lessons now will help the field that they can see that they can change.
Communities have changed the way people look at alcohol.
We do have laws now that will help them.
And you cannot ignore the drop in the percentage of young people under the age of 21 that actually don’t drink.
And that is a win-win.
And that’s what I try.
When I speak now, I always try to answer what people want to hear, but I always bring them back to the data.
And I always bring them back to look what we are doing together.
And I think that helps a little bit, I hope.
It’s not popular.
It’s not a popular field.
It probably never will be a popular field because we’re talking about things that people enjoy doing.
And saving lives.
But because we’re saving lives, it works.
But we’re struggling.
This is a challenge, a time of challenge.
But I’m seeing some interest.
I’m seeing people knowing how to pull together.
Thank goodness for evidence-based programs or science informed, however you want to call it these days.
But the fact that we know what to do, when to do it, how to do it, and we also know how to bring these other drug issues into the bigger fold of prevention in general.
I don’t know if that helps, but that’s my thinking.

Lucey: Yeah, and so hearing you talk, it just reinforces to me that in my 30-year career that’s been solely dedicated to drug misuse prevention, both at state government and federal government levels, I’ve seen those ebbs and flows, and I’ve gone through a lot of those ebbs and flows with you.
And the one thing that I totally admired about watching you react to this is, you know, at the end of the day; I mean certainly if we were in an ebb situation where it doesn’t seem like there’s enough focus on primary prevention, you can commiserate with the best of them, but at the very end, you always rise above that.
And I think you see it as a challenge, like you said.
And you are never defeatist about it.
You always find a way to rise above that and say, you know what, we will get back.
Harding: You know what though?
Yeah, the secret is for me anyway is you know, I think that the people that have decided to choose this as their career have been sort of blessed not to get all like you know in the clouds or anything.
But I think that it takes a certain person to be a surgeon.
It takes a certain person to every single day, and there’s so many of them out there that we have met, Rich.
How lucky we’ve been.
But it takes a certain person to get up every day knowing the messages that they’re going to give, 75% of the people don’t want to listen.
But they do it anyway, and they do it because we know that eventually it sinks in.
And we have saved lives, and we will save lives.
And there’s nothing better.
Especially look at what we’re living in right now.
I mean we know that.
Is this going to challenge?
Does this hold a candle to COVID-19?
Of course not.
But is it something we ignore and put all our eggs in one basket?
Absolutely not.
Because why?
Well, because during COVID-19 we’re getting a lot of depression.
We’re getting a lot of drinking.
In our state one of the essential, one of the essential businesses that were left open when we closed down our state were liquor stores.
Now think about that.
You don’t think that got me all into my prevention mode?
It’s like, well, isn’t that interesting?
And so there always is sometime.
I’m not expecting to save everybody.
I do hope that we have touched, and I will continue to try to give people the hope and the strength to move forward and giving messages that are not always received the first time, but they will be the second or third time, especially if they start to start seeing a little scare in their young person.

Lucey: Well, you brought up COVID-19 and it wasn’t a specific question that I had intended to ask, and goodness knows we could dedicate an entire episode just to what’s been going on in our country.
But one of the messages that I’ve been continuing to promote over the last three to four months has been; and you just mentioned it.
We know that drug misuse, and not to ignore mental health conditions, but since we’re focused on the drug issues, we know that drug misuse goes up during stressful periods and following traumatic events and certainly COVID-19 qualifies.
And if ever there was a time to not put prevention on the back burner, now would be the time.
Now would be the time to focus on prevention.
Harding: And you know how I’m, the times that I’m able to have conversations with individuals is that, isn’t this just the best time to be able to?
You’re with your families.
Many of us have older children or grandchildren move in with us for a while so that they can stay away from the dangers that are out there with COVID-19.
And the skill sets that we have passed on and the science that was passed onto us to send out to communities and states is exactly what people are relying on right now.
Instead of, we know how to talk about wearing a mask.
We know, I mean, I’m putting together a presentation right now doing an overlay with this.
I mean look at all the prevention messages.
So prevention that we learned 20 or 30 years ago is now come back to us in a different format.
So we’re not forgetting about the alcohol because you have to talk about that.
You have to talk about we want your child to be alive to be able to be an adult, but you also look at all the value of helping people see the parallels  of what we’ve been teaching them about, of cases of what you can do for prevention.
How do you prevent COVID?
You wash your hands.
And even if we change, how many times has the data made us change and look at drug use a little differently?
I mean that’s just normal living.
So yeah, I think this has energized me all over again of being able to show how health and underage drinking and abuse of adult drinking and making sure that we’re healthy and safe when we go out the door.
And what’s the message?
The message is it’s not saving me.
The message is I’m saving you by wearing a mask.
And I’m not getting into that political fight.
I’m just saying that this is our time.
And if people are sitting back because they don’t have work right now, and I totally; my heart goes out to them.
But you can do work in your communities of putting together messaging and doing the same messaging that we’re doing.
It’s almost been a role model for the future.
Lucey: Well, those are some great parallels.
And in fact it’s a great segue into my fourth question because you just started to allude to it, and it’s having to do with parents.
You are a really strong supporter and advocate of parents and their role in preventing drug misuse.
What advice do you have for parents who have young adult children in college?
 And of course COVID-19 has changed a lot of what that looks like.
What advice do you have for parents?
Harding: Keep up the messaging, that when you get a young person, particularly if you’re talking college, and they’re at the college age, you can’t worry about them liking you anymore, right?
I mean if you’ve done your job as a parent, you don’t have to worry about the child running away from home because they’re angry with you.
It is more important right now, even when, even if; I would even say it might even be more important when we were trying to help parents and people on campus and the campus community and the administration who run the campuses, that alcohol is so dangerous in so many ways, particularly with all the date rapes and people falling off of, you know, during parties falling out of windows and these senseless deaths, et cetera, et cetera, et cetera.
Well, we as parents have to let our young person know that we do not agree with what you do.
Now does that mean that that inoculates a young person who goes to college, that they’re not going to drink because they’re not 21 and my parents told me not to do it?
No, it might not.
Mostly likely the data is showing that it doesn’t necessarily.
However when the message is put in my head, I’m going to be thinking about it.
So when I’m on a college campus and my college campus is telling me you can’t live in this dorm anymore, unless if you’re drinking, or we have rules, or whatever the thought is, now you’ve got two messages that are saying the same thing.
I think parents need to be strong.
I think that they need to give messages.
And if you’ve been giving them since they went to the DARE program in 6th grade, then they become a very natural part of life, right?
That doesn’t mean; so that you can make healthy and safe choices.
And I think that’s what I come down to is healthy and safe choices.
That’s how I mix the two with health, health issues, safety issues, just making sure of the drinking because as I’ve said a thousand and one times that if we do not talk about the dangers of underage drinking and the dangers of alcohol, abusing alcohol, who is going to do it?
And that is the, that’s why; I always felt like that’s why I’m in this field.
I do not mind talking about this.
I love talking about it because we have a ton of success stories.
And the senseless deaths really get to me, and I think they get to everyone.
And you and I, Rich, have personally been with too many parents that have lost their children to a drinking overdose or most likely drinking and driving crashes.
And I want to try to do everything I can till I have no more breath to be able to help people to understand that.
And I will talk about mixing it with the latest problems and everything else as well.
But the bottom line, the anchor is all about the prevention messages and understanding what prevention means and all the great resources that we have so that we can prevent alcohol use, which is still the easiest drug to buy and the less expensive drug to buy and the easiest affordability, and it’s right there in your home most likely or next door.

Lucey: Well, now that we’ve talked a little bit about the parents, it brings us to our final question and a little bit of a pivot here.
For now I’d like you to talk a little bit.
What would you like to say to encourage the professionals on campus and in the communities who are working to prevent drug misuse among college students as well as the students themselves who are listening to the podcast?
Harding: I would say know your facts.
I also would say think about what messages that you are most comfortable giving.
You may not want to jump into to be the only person there talking about, oh, you’re 20?
You shouldn’t be drinking.
But there are other messages.
Have you thought of intoxication?
I mean intoxication and drinking too much or drinking and driving at the same time is a very dangerous level.
And young people and all the great minds and the talent that younger people today have is wonderful.
Do you really want to lose it?
If you’re not careful for a party that you very desperately want to attend for a lot of other social reasons.
I mean go to all the parties you want to, but also do you have to drink at the same pace that some who are ahead of you?
Do you have to drink at all?
Do you go to the party until it gets too, the pressure gets too much?
And when does the pressure get too much?
When you stay at the party too long.
So it’s a very natural thing.
I think that people should feel free to talk about alcohol and drinking.
I think that not to make it like you have a sign on your shirt saying I do not drink until I’m 21, but there’s nothing wrong with just saying no thanks, not tonight.
I’m not really into drinking right now.
And I think that is happening on college campuses more and more.
I just saw some stats.
It was a bar chart.
It really didn’t have numbers on it, and showing the comparison between what’s happening here between the three big issues.
Alcohol and drugs of course was one issue.
COVID was the second issue.
And social injustice was the third issue.
And this was all on a campus that I’ve been working with that were trying to decide who’s going to, is this going to be a virtual campus for the fall or will it be a mixed campus or whatever it is.
And I started thinking about all of the strength that young people now have.
I mean you get to choose which part.
You’re taking control of your health and your safety far earlier than I think some of the young people.
Lucey: Well, as expected, by having you on the episode, I just, you know, you’ve given our listeners so much to think about and some terrific advice and takeaways.
And that’s always a goal for the episodes of this podcast is for the professionals who are listening is to come away with something new.
It might be one thing.
It might be four things.
 But you know, and that’s something else I got from you in this last question about know your facts.
It’s something that I know that you’ve always said to the professionals that you work with is to know your craft.
I mean we have a valid science in our field, and that science is always evolving, and it’s really incumbent upon each of us to continue to learn and to know that science.
And I got that from you.
You drove that in my head, and I try to do the same thing with others.

Harding: But I like the way you said that though, Rich, because that is so very important.
And I think that’s the difference between prevention of, especially of underage drinking and dangerous drinking, risky drinking, and what we knew when we first began.
So yeah, it is the science.
Go and look up your science and choose.
If there’s a list of seven, choose two messages you’re comfortable with within your own skin.
Don’t choose the ones I tell you.
Choose the one that’s most comfortable for you.

Lucey: Absolutely.
So that brings us to the conclusion of this episode of the podcast.
Again Fran, thank you so much for joining us and for sharing with us your experiences and your wisdom and your guidance.
I think people still have a lot to learn from you so I appreciate it and thank you again.

Harding: Thank you.
Thank you, everyone.

Lucey: So for our listeners, with that, thank you for listening to this episode of Prevention Profiles: Take Five.
I encourage you to tell your stakeholders and your partners in prevention about the podcast.
We were recognized a couple of months ago by the National Association of Government Communicators with a 2nd Place award in their Blue Pencil and Gold Screen Awards competition for audio communications so we are extremely proud of that.
So we’re obviously doing something right in getting this information out to all of you.
And of course as we continue to all deal with the national pandemic in which we find ourselves, I say that I hope you are doing what you need to do to keep yourself, your family and friends and your community safe.
And so with that, I will say thanks for listening and have a great day.