Spotlight On: Substance Use Prevention Month

Highlighting The Goals of Prevention

As we enter October, we recognize Substance Use Prevention Month—a time to reflect on the importance of preventing substance misuse in our community. Prevention efforts are crucial in addressing substance use issues before they begin and mitigating their impact on individuals, families, and society. This article explores the three main goals of substance use prevention with examples of evidence-based practices that have proven effective in achieving these objectives.

Goal 1: Prevent Initiation of Substance Use (Primary Prevention)

The first goal of substance use prevention is to delay or prevent the initial use of substances, particularly among youth. This is crucial as research consistently shows that early substance use significantly heightens the risk of developing substance use disorders later in life. More than 90% of individuals with a substance use disorder began smoking, drinking, or using other substances before the age of 18, and over 96% initiated use before the age of 21 [1].

Prevention programs targeting youth have shown significant success in delaying substance use initiation. The CATCH My Breath vaping prevention program, for instance, has demonstrated effectiveness in reducing youth e-cigarette use. This school-based program educates students about the dangers of vaping and provides them with refusal skills. Another promising initiative is the TINAD (This Is Not About Drugs) program by Overdose Lifeline, the first youth-focused educational program addressing the opioid public health crisis. TINAD educates youth about prescription drug misuse risks, addiction, overdose recognition, and healthy coping strategies, equipping them to make informed decisions about substance use. Additionally, the One Circle program effectively prevents and reduces substance use by fostering belonging and support through inclusive peer circles. Its gender-responsive, trauma-informed approach empowers participants to develop healthy coping strategies and resilience, leading to improved attitudes toward substance use and a decrease in risky behaviors.

Goal 2: Prevent Progression of Substance Use (Secondary Prevention)

For individuals who have already initiated substance use, the second goal is to prevent the progression to more frequent use or the development of a substance use disorder. According to the 2024 Monitoring the Future survey, by 8th grade, about 20% of students have used alcohol and 18% have used a vaping device containing nicotine or marijuana. Additionally, most 12th grade students do not perceive significant risks associated with the experimental use of narcotics, increasing their likelihood of engaging in this harmful behavior [2]. Early intervention is key to addressing this concern.

Several evidence-based interventions have shown promise in preventing the escalation of substance use. SBIRT (Screening, Brief Intervention, and Referral to Treatment), for example, incorporates motivational interviewing techniques to encourage individuals to reflect on their behaviors and consider the benefits of reducing or ceasing substance use. The INDEPTH (Intervention for Nicotine Dependence: Education, Prevention, Tobacco and Health) program, developed by the American Lung Association, is an alternative to suspension or citation for students who violate school tobacco-use policies. This program addresses the teen vaping epidemic by helping students understand nicotine dependence, establishing healthy alternatives, and moving towards cessation. Another effective initiative is the Safety First program, which takes a reality-based approach to drug education for teens. Instead of using scare tactics, Safety First provides science-based information and emphasizes safety, encouraging critical thinking and responsible decision-making. This approach has been shown to reduce harmful behaviors associated with drug use and prevent the progression to more serious substance use issues.

Goal 3: Prevent and Reduce Harms Associated with Substance Use (Tertiary Prevention)

The third goal of prevention focuses on reducing the negative consequences associated with substance use, both for individuals who use substances and for the broader community. This approach, known as harm reduction, acknowledges that some people will use substances despite prevention efforts, and seeks to minimize the potential harms. In 2023, over 107,000 people in the United States died from drug-involved overdoses [3]. The CDC estimates that excessive alcohol use is responsible for about 178,000 deaths in the United States each year [4]. These sobering statistics underscore the critical importance of harm reduction strategies.

Harm reduction encompasses a wide range of evidence-based strategies and programs. One of the most prominent is the distribution of naloxone, a medication that can rapidly reverse opioid overdoses. Naloxone distribution programs have been associated with a 14% reduction in opioid overdose deaths [5]. These programs not only provide the medication but also train individuals to recognize and respond to overdoses, potentially saving lives in critical moments. Syringe services programs (SSPs), such as those offered by HIV Alliance, represent another crucial harm reduction strategy. These programs provide clean needles and syringes to people who inject drugs, helping to prevent the spread of bloodborne infections such as HIV and hepatitis C. Moreover, these programs often serve as a bridge to other health services, including substance use treatment and mental health care.

For alcohol-related harms, community-based programs that combine education, policy changes, and environmental strategies have proven effective. These might include initiatives to reduce drunk driving, such as designated driver programs or increased availability of late-night public transportation. Such comprehensive approaches have reduced alcohol-related car crashes by up to 20% in some communities [6].

Lastly, efforts to reduce stigma surrounding substance use and addiction are a critical component of harm reduction. Stigma can prevent individuals from seeking help or accessing harm reduction services. Public education campaigns and training for healthcare providers and law enforcement can help create a more supportive environment for individuals struggling with substance use.

Conclusion

Substance use prevention is a critical public health strategy that can save lives and improve community well-being. By focusing on preventing initiation, progression, and harm associated with substance use, and by implementing evidence-based prevention programs, we can significantly reduce the impact of substance use disorders on our society. This Substance Use Prevention Month, let’s commit to supporting and expanding prevention efforts in our community.

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