Preventing Substance Abuse

Primary Prevention: Programs aimed at young people who haven't tried substances.
- Pros: Encourages abstinence by educating about drugs and their influence.
- Cons: May create curiosity about drugs.
Secondary Prevention: Programs for those who have tried substances.
- Goal: Prevent the use of more dangerous substances and prevent dangerous forms of use of substances they are experimenting with.
Tertiary Prevention (Relapse Prevention): Follow-up programs.
- Goal: Help individuals with substance use disorder enter treatment.
Universal Prevention: Programs for an entire population (e.g., all school children).
Selective Prevention: Strategies for high-risk groups within the general population (e.g., students doing poorly in academics).
Indicated Prevention: Strategies targeted at individuals showing signs of developing problems (e.g., a child who started smoking at a young age).

Traditional anti-drug programs relied on police officers sharing "horror stories" about illicit drugs (scare tactics).
These programs assumed that providing information would increase knowledge, change attitudes, and decrease drug use.
1971 study and 1973 report showed this model was ineffective and may have increased drug use.

Values Clarification Approach: Focuses on the ability to make appropriate decisions rather than factual information.
- Involves discussing reactions to moral and ethical dilemmas.
- Teaching students to analyze and clarify their own values in life.
Teaching Alternatives to Drug Use: Offering activities to produce "natural highs".
- Relaxation exercises, meditation, vigorous exercise, sports.

In the mid-1980s, concern grew that effective education lacked emphasis on resisting interpersonal pressures to use drugs.
In 1986, the federal government launched a program to support drug use prevention in schools and communities.
Aimed to shift values, emphasizing that society does not condone drug use or underage alcohol use.

Evans (1976) introduced the psychological inoculation approach based on the social influence model in a smoking prevention paper.
Key elements for effective prevention:
- Training refusal skills.
- Public commitment.
- Countering advertising.
- Normative education.
- Use of team leaders.

Based on the social influence model of smoking cessation.
Delivered by police officers in uniform, originally in 5th and 6th grade classrooms using interactive techniques.
Components:
- Refusal skills.
- Team leaders.
- Public commitment not to use drugs.
- Self-esteem building.
- Alternatives to drug use.
- Decision making.
Impact on drug use was marginal, with limited evidence of long-term reductions in self-reported drug use.

Project Alert:
- Cigarette experimenters were more likely to quit or maintain lower rates of smoking.
- Experimental groups drank less alcohol soon after the program.
- Effects diminished over time.
Life Skills Training Program:
- Long-term positive results with a three-year program.
- Based on the social influence model.
- Teaches resistance skills, normative education, and media influences.

Occur in school settings and youth-oriented community service programs (e.g., YMCA).
Focused on straight youth by using them in group community service projects
Two main aspects:
- Peer influence: Understanding that peer opinions significantly influence adolescent behavior and emphasizes an open discussion to combat it.
- Peer participation: Involving young people in making important decisions and doing significant work.
Data on whether peer programs significantly alter drug use is either unavailable or inconclusive.

Four main approaches:
- Informational Programs: Provide parents with basic information about alcohol, drugs, their use, and effects.
- Parenting Skills: Teach communication, decision-making, goal setting, limit setting, and how to say no.
- Parent Support Groups: Regular meetings to discuss problem-solving, parenting skills, and their perceptions of the problem.
- Family Interaction: Families work as a unit to examine, discuss, and confront issues related to alcohol and drug use.

Allow for coordinated approaches from schools, parents, and civic organizations, increasing impact.
Community support and engagement are crucial due to the controversial nature of drug abuse prevention and education.
Bring resources together (e.g., enlisting public media to reinforce information).

The federal government encourages private employers to adopt policies to prevent drug use (e.g., random urine screens).
Goal is not to catch and fire drug users, but to prevent drug use by making it not condoned.

Most states require drug and alcohol abuse prevention education as part of a health curriculum.
A sensible, balanced approach combines factual information with social skills training, integrated into health, personal values, and decision-making themes.
Avoid inadvertently demonstrating how to do things one would not want students to do.
Inform without leading into temptations to use and abuse substances.