Section Navigation. Facebook Twitter LinkedIn Syndicate. Minus Related Pages. Substance Use Among Teens The guide highlights the most commonly used substances and the extent of the problem, such as Alcohol, marijuana, and tobacco are substances most commonly used by adolescents. Risks of Substance Use The guide also highlights the risks of substance use among teens.
Substance use can do the following: Affect the growth and development of teens, especially brain development. Occur more frequently with other risky behaviors, such as unprotected sex and dangerous driving. Contribute to the development of adult health problems, such as heart disease, high blood pressure, and sleep disorders.
Guide for Pediatricians Pediatricians can help teens avoid and reduce substance use by talking with them about their use. More Information. The RHRD program uses five prevention components.
The first is reducing alcohol access, which is accomplished by helping communities use zoning and municipal regulations to control the density of bars, liquor stores, etc.
The second component is responsible beverage service, which involves training alcohol beverage servers and assisting retailers develop policies and procedures to reduce drunkenness and driving after drinking. The third component aims to reduce drinking and driving through increased law enforcement and sobriety checkpoints. The fourth component reduces underage alcohol access by training alcohol retailers to avoid selling to minors and those who provide alcohol to minors, and through increased enforcement of laws regarding alcohol sales to minors.
The fifth component provides communities with the tools to form the coalitions needed to implement and support the interventions that will address all RHRD prevention components.
To properly implement RHRD, project staff must assess community priorities and decide which interventions to use and how to adapt them. Typically, this involves working closely with local community organizations, opinion leaders, law enforcement, zoning and planning commissions, policy makers, and the public to collect this information. Recommended project staff for RHRD include a director who is responsible for developing the initiative, seeking funding, building coalitions, and hiring project staff, an assistant director who manages office operations and staff and implements the program, along with one or more data managers, administrative assistants and volunteers.
Training and consultation target the specific needs and problems of the individual community. Training manuals for RBS are available along with brochures that offer strategies and tactics for reducing alcohol use within the community.
One of the outcome studies reported on alcohol use outcomes. In the study, alcohol consumption was assessed via telephone surveys to randomly selected individuals from households in the intervention and comparison communities.
Findings indicated that individuals living in the intervention community sites had significant reductions in drinking quantities, rates of driving when having had too much to drink, and rates of driving over the legal limit, when compared to individuals living in comparison sites.
In addition, RHRD was found to produce effects on other outcomes, including alcohol-related traffic accidents and alcohol-related assaults. Prevalence rates of alcohol, tobacco, and other drug use increase rapidly during the years from early to late adolescence, and typically peak during young adulthood.
Prevention programs for adolescents have been developed and implemented in school, family, and community settings. The most effective programs are guided by relevant psychosocial theory regarding the etiology of substance abuse and target key risk and protective factors that have been shown to be associated with substance abuse behavior. Among adolescents, substance use involvement is typically a function of the negative pro-drug social influences in their social environment combined with individual psychosocial vulnerabilities to these influences.
The most effective programs are highly interactive in nature, skills-focused, and implemented over multiple years. Literature reviews and meta-analytic studies have shown that programs with these characteristics can reduce smoking, alcohol, and other forms of substance use in young people, compared to youth who do not participate in such programs. Several rigorous outcome studies of school-based prevention programs have demonstrated clear evidence of short and long-term effects on substance use behavior.
Those family interventions that combine parenting skills and family bonding components appear to be the most effective. Community-based drug abuse prevention programs include some combination of school, family, mass media, public policy, and community organization components.
Community programs present that present a coordinated, comprehensive message across multiple delivery components are most effective in terms of changing behavior. While there are a growing number of evidence-based prevention programs for adolescent substance use and abuse, it is important that prevention efforts remain flexible and responsive to changing trends in use. For example, the abuse of prescription and over-the-counter medications among adolescents is a growing problem that requires a coordinated and comprehensive response.
This is especially true because these medications are often readily accessible to teenagers, either from medicine cabinets at home, from friends or relatives, or for purchase at the local pharmacy or through the internet. Multiple stakeholders can address the issue of ready access. Parents can limit access by safeguarding medications in a secure location, keeping an inventory of medications in the home, and disposing of unused or old medications.
Physicians can limit access by documenting and monitoring prescription histories and refill requests for all patients and ensuring that prescription pads are secured. Pharmacists can limit access by identifying and addressing the issue of forged prescriptions. Of course, in addition to reducing access, each of these stakeholders can play a key role in raising awareness of the dangers of abusing medications.
As we move forward, it is important to address several factors that reduce the public health impact of effective prevention programming.
It is still the case that most schools use non-evidence based prevention programs, family-based prevention programs often do not reach the families in greatest need, and starting up community prevention programs requires substantial resources. It is clear that more research is needed to facilitate the wide dissemination of effective prevention programs into our schools, families, and communities.
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Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Kenneth W. Gilbert J. National Center for Biotechnology Information , U. Author manuscript; available in PMC Jul 1. Botvin , Ph. Author information Copyright and License information Disclaimer. Botvin, Ph. Griffin, Ph. Griffin is a consultant to NHPA.
Copyright notice. See other articles in PMC that cite the published article. Synopsis Substantial progress has been made in developing prevention programs for adolescent drug abuse. Keywords: prevention, substance abuse, adolescence, school, community, family.
Epidemiology and Progression of Use National survey data demonstrate that the prevalence rates of alcohol, tobacco, and other forms of substance use among adolescents peaked during the period of the late s and early s. Risk and Protective Factors In many respects, substance use and abuse can be considered developmental phenomena. Social Influence Factors One of the most consistent findings in research on the etiology of adolescent substance use is that social influences are central, powerful factors that promote experimentation or initiation of use.
Developmental Factors A developmental perspective on the etiology of substance use is instructive in our understanding of how best to prevent early experimentation with alcohol, tobacco, and other drugs. Multiple Levels of Influence Risk and protective factors contribute to the initiation, maintenance, and escalation of alcohol, tobacco, and illicit drug use, and these factors can be identified and addressed at the level of the individual, family, school and community.
Individual Factors Individual level factors encompass cognitive, attitudinal, social, personality, pharmacological, biological, and developmental factors Family Factors One central risk factor within families is the role that social learning processes play in terms of the modeling of behaviors and attitudes regarding substance use.
School and Community Factors Findings show that environmental factors and degree of bonding to conventional institutions are associated with adolescent substance use Prevention Terminology Contemporary terminology for classifying interventions, initially proposed by the Institute of Medicine in 16 , incorporates a continuum of care that includes prevention, treatment, and maintenance.
Evidence-Based Prevention Programs In the following sections, contemporary evidence-based approaches to drug abuse prevention for children and adolescents at the school, family, and community levels are described. School Based Prevention Schools are the focus of most attempts to develop and test evidence-based approaches to adolescent drug abuse prevention. Normative Education Normative education approaches include content and activities to correct inaccurate perceptions regarding the high prevalence of substance use.
Competence-Enhancement Competence-enhancement programs recognize that social learning processes are important in the development of drug use in adolescents. Model School-Based Programs In the following section, the authors review three model school-based substance abuse prevention programs for adolescents Table 1.
Table 1 Sample school-based drug abuse prevention programs. Open in a separate window. Program Components The LST program consists of three major components that address critical domains found to promote substance use. Program Providers and Training Requirements The LST program is implemented either by a trained classroom teacher, counselor, or health professional. Evidence of Effectiveness In support of the quality of research on LST, the NREPP web site lists seven peer-reviewed outcome papers from four demographically diverse cohorts of students, along with ten replication studies.
Program Components Project TND was developed to fill a gap in substance abuse prevention programming for senior high school youth. Program Providers and Training Requirements A one- to two-day training workshop conducted by a certified trainer is recommended for teachers prior to implementing Project TND.
Brief Alcohol Screening and Intervention for College Students The Brief Alcohol Screening and Intervention for College Students BASICS program is an indicated prevention program for college students who drink alcohol heavily and have had or are at risk for alcohol-related problems including poor class attendance, missed assignments, accidents, sexual assault, or violent behavior.
Program Components BASICS is based on principles of motivational interviewing, a directive, client-centered counseling style that is focused on eliciting behavior change by helping clients to explore and resolve ambivalence. Program Providers and Training Requirements Providers are counselors and other college personnel proficient in motivation interviewing techniques. Evidence of Effectiveness In support of the quality of research on the BASICS program, the NREPP web site lists four peer-reviewed outcome papers representing three cohorts of students with study populations consisting of primarily White youth, along with four replication studies.
Family-Based Prevention There are a variety of effective family-based prevention approaches for adolescent substance abuse. Model Family Based Prevention Programs In the following section, the authors review three model family-based substance abuse prevention programs for adolescents Table 2. Table 2 Sample family-based drug abuse prevention programs. Help families improve parental monitoring, family support, rule-setting, and communication Enhance family bonding and communication skills among parents and youth and other skills for personal growth.
These effects were maintained at 3 and month follow-up assessments, although effect sizes were small Compared to youth in the comparison group, CLFC children reported less frequency alcohol use in the previous three month period; As family pathology decreased, CLFC reduced the frequency of alcohol and other drug use at the 12 month assessment; CLFC parents used more community services when a personal or family problem arose A series of randomized trials showed that participation in BSFT produced reductions in youth marijuana use and overall substance use, compared to control group participants; A study of adolescent girls showed significantly greater reductions in substance use at posttest and at the one year follow-up compared to similar girls in the control group.
Family Matters Family Matters is a universal prevention program designed to prevent tobacco and alcohol use in children 12 to 14 years old. Program Components The Family Matters booklets contain readings and activities designed to get families to identity and address family characteristics, behaviors, and attitudes that can influence adolescent substance use.
Program Providers and Training Requirements The health educators who conduct follow-up telephone calls after each mailing can be paid staff or volunteers. Evidence of Effectiveness In support of the quality of research on Family Matters, the NREPP web site lists two peer-reviewed outcome papers with study populations consisting of primarily White youth no replication studies were listed. Creating Lasting Family Connections Creating Lasting Family Connections CLFC is a selective intervention that is designed to prevent substance abuse and violence among adolescents and families in high-risk environments.
Program Components A coordinator planning to implement CLFC trains a small staff of volunteers to recruit and retain participating families from high-risk environments, and then identifies, recruits, and selects the relevant community collaborators for the program.
Program Providers and Training Requirements It is recommended that two or more facilitators run each of the parent and youth sessions in order to facilitate a team approach that enhances learning. Evidence of Effectiveness In support of the quality of research on CLFC, the NREPP web site lists two peer-reviewed outcome papers reporting results of one cohort of youth and parents no replication studies were listed.
Brief Strategic Family Therapy Brief Strategic Family Therapy BSFT is an indicated family-based prevention program that aims to decrease individual and family risk factors through skills building and by improving and strengthening family relationships. Program Providers and Training Requirements One full-time BFST counselor can provide the program to 15 to 20 families for in-office sessions and 10 to 12 families for in-home sessions. Community-Based Prevention Evidence-based drug abuse prevention programs delivered to entire communities typically have multiple components.
Program Providers and Training Requirements Recommended project staff for RHRD include a director who is responsible for developing the initiative, seeking funding, building coalitions, and hiring project staff, an assistant director who manages office operations and staff and implements the program, along with one or more data managers, administrative assistants and volunteers.
Summary Prevalence rates of alcohol, tobacco, and other drug use increase rapidly during the years from early to late adolescence, and typically peak during young adulthood. Footnotes Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. Contributor Information Kenneth W. References 1.
Newcomb MD, Locke T. Health, social, and psychological consequences of drug use and abuse. In: Sloboda Z, editor. Epidemiology of drug abuse.
Springer; New York: Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychol Bull. Reviewing theories of adolescent substance use: Organizing pieces in the puzzle. Monitoring the Future national survey results on drug use, Volume I: Secondary school students. Kandel D. Stages and pathways of drug involvement: Examining the gateway hypothesis.
Cambridge University Press; New York: Drug abuse: Origins and interventions. Multilevel modeling of direct effects and interactions of peers, parents, school, and community influences on adolescent substance use. J Youth Adolesc. Villani S. Impact of media on children and adolescents: A year review of the research. Tobacco advertising and consumption: evidence of a causal relationship. J Public Health Policy. Swadi H. Individual risk factors for adolescent substance use.
Drug Alcohol Depend. Khantzian EJ. The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harv Rev Psychiatry. Drugs of abuse and stress trigger a common synaptic adaptation in dopamine neurons. Lochman JE, van den Steenhoven A.
Family-based approaches to substance abuse prevention. J Prim Prev. J Adolesc Health. Community risk and protective factors and adolescent substance use. Institute of Medicine. Reducing risks for mental disorders: Frontiers for preventive intervention research. Science-Based Prevention Programs and Principles.
DHHS Pub. SMA Botvin GJ. Preventing drug abuse in schools: Social and competence enhancement approaches targeting individual-level etiological factors. Addict Behav. Support Center Support Center. External link. Please review our privacy policy. Life Skills Training. Project Towards No Drug Abuse.
Being aware of these risk factors can assist families, health professionals, schools and other community workers with identifying at risk youth and aid in reducing or eliminating risk factors through prevention and treatment programmes. Botvin et al 6 cited several key factors required in prevention programmes to make them effective.
These factors include a need to address multiple risk and protective factors, provide developmentally appropriate information relative to the target age group, include material to help young people recognize and resist pressures to engage in drug use, include comprehensive personal and social skills training to build resistance, deliver information through interactive methods and cultural sensitivity that includes relevant language and audiovisual content familiar to the target audience 6.
Successful prevention programmes should incorporate all of these characteristics and can then be provided through the family, school, community or healthcare community. The NIDA Report 4 emphasizes both the role of family and community prevention programmes as vital to deterring child and adolescent substance abuse. Their findings are summarized below:. Family prevention programmes: The NIDA Report emphasizes strengthening protective factors through the family, including increasing family bonding and using appropriate discipline.
Once these risk factors are identified, families may benefit from formal prevention programmes that can focus on enhancing family bonding, parenting skills including communication, rule-setting, appropriate disciplinary actions and changing parental behaviours that may place a child at risk for later abuse 4.
This is a comprehensive family-based outpatient or partial hospitalization day treatment programme for substance-abusing adolescents and those at high risk for continued substance abuse and other problem behaviours. MDFT focuses on helping youth develop more effective coping and problem-solving skills for better decision-making and helps the family improve interpersonal functioning as a protective factor against substance abuse and related problems.
Liddle et al 7 compared multi-dimensional family therapy with individual cognitive behavioural therapy CBT and found that although both treatments were promising, MDFT was more efficacious in treating substance use problem severity, in addition to creating more long lasting effects than standard CBT.
Community and school prevention programmes: In addition to family programmes, NIDA emphasizes school and community programmes as being beneficial in substance abuse prevention. One of the many examples of school prevention programmes cited in the NIDA Report 4 is Reconnecting Youth RY ; a school-based prevention programme for high school students with poor school achievement and a potential for not completing their education.
Participants may also show signs of multiple problem behaviours, such as substance abuse, depression, aggression, or suicidal behaviours. Students are screened for eligibility and then invited to participate in the programme. The programme goals are to increase school performance, reduce drug use, and learn skills to manage mood and emotions. RY blends small group work students per class to foster positive peer bonding, with social skills training in a daily, semester-long class.
Role of healthcare providers in prevention: It is believed that less than 30 per cent of primary care providers perform any screening for substance abuse and as many as 69 per cent do not offer any type of counselling Hallfors et al 11 cited the following barriers affecting the screening and prevention services in primary care: lack of tested screening tools, lack of knowledge, skills and confidence, financial disincentives third party services for covering prescription abuse vary widely ; and lack of follow up services and resource limitations.
Efforts from paediatricians and primary care providers to overcome these barriers can assist in identifying substance abusers and eventually lead to their treatment. The abuse of alcohol and drugs has resulted in significant morbidity and mortality among adolescents worldwide.
Many of these youth will lose their lives to drugs and alcohol and a significant number are likely to grow up to become problem drug users. Although, the substance abuse problem is complex and large in magnitude, there is a substantial amount of evidence-based research available to physicians, community leaders and schools to implement interventions that can decrease adolescent substance abuse rates.
Because this issue is not peculiar to any one community or culture, we recognize that individual interventions may not be universally effective. Therefore, we emphasize the NIDA strategy of targeting modifiable risk factors and enhancing protective factors through family, school and community prevention programmes, as a generalized framework for healthcare and community activists to use when researching programmes and strategies best suited for their own community.
National Center for Biotechnology Information , U.
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