National surveys of drug abuse have brought disturbing news in the last few years: Drug use has increased among our Nation's youth. While some news media speculate about a possible return to the high levels of adolescent drug use that the Nation witnessed in the 1970s, they are missing an equally important and more hopeful story. NIDA-supported prevention research has made great strides in developing both the knowledge and the tools that can stem the tide of drug abuse and curb its devastating effects on our Nation's young people.
A growing of scientific information shows that many factors can protect young people from drug use while other factors put them at risk of abusing drugs. Strong parent-child attachment, appropriate parental supervision, commitment to school, academic success, and friends who have conventional values are some protective factors. Chaotic family environments, ineffective parenting, poor academic performance, and deviant peer influences all put youths at risk. We also know that the impact of specific risk and protective factors may diminish or increase as young people develop, and their circumstances change.
Because risk and protective factors for drug use are found in the home, the school, and the community, NIDA has supported research on prevention programs in each of these domains. As a result, prevention practitioners now can select from a broad array of effective family-, school-, and community-based prevention programs to meet the needs of different groups in their communities.
Successful drug abuse prevention programs fall into three categories - universal, selective, and indicated - that describe their intended audience. "Universal" programs are meant for everyone in a school, a community, or a similar group and can reduce the overall prevalence of drug use. Our research indicates that universal community programs need to be comprehensive with well-coordinated components for the individual, the family, the school,the media, and community organizations. One such universal community-based program, developed by NIDA-funded researchers at the University of Southern California in Los Angeles, has reduced drug use over a 5-year period among middle-school students in Kansas City, Missouri. In this comprehensive program, a classroom curriculum teaches students how to resist influences to use drugs. In addition, schools, parents, mass media, and community organizations work together to promote consistent antidrug messages, attitudes, and policies in the community.
Although universal drug abuse prevention programs can work with general populations, they may not meet the special needs of groups within those larger populations who are particularly at risk of drug abuse. NIDA-funded researchers have been identifying these at-risk groups and individuals and developing "selective" and "indicated" programs to meet their complex needs. A special section in this issue, "Children on the Brink: Youths at Risk of Drug Abuse," highlights some of the remarkable results of this research.
"Selective" drug abuse prevention programs target groups who are exposed to factors that place them at greater-than-average risk of future drug abuse. Such programs are tailored to reduce the identified risk factors and strengthen appropriate protective factors in these individuals' lives. Research shows that children of substance abusers make up one such at-risk group.
Armed with this knowledge, NIDA-supported researchers at the University of Utah in Salt Lake City have developed a selective prevention program for these children and their parents. The family-focused program works to improve interactions within families. As a result, the program has reduced family conflicts, youth problem behaviors such as aggression and delinquency, and substance abuse. (See "Multifaceted Prevention Programs Reach At-Risk Children Through Their Families")
NIDA also has supported research to develop "indicated" drug abuse prevention programs for adolescents who already are exhibiting early signs of drug abuse and other problem behaviors such as school failure, antisocial behaviors, and psychological problems. Research shows that youths with these characteristics are at high risk of continued drug abuse. Successful indicated programs address these youths' specific problems, enhance protective factors, and reduce their substance use. A high school-based indicated program developed for such troubled youths by NIDA-supported researchers at the University of Washington in Seattle has reduced their problem behaviors, increased their academic performance, and reduced their drug involvement. (See "Specialized High School Prevention Programs Target At-Risk Adolescents")
While NIDA research shows that drug abuse prevention can work, we need to expand the range of effective prevention approaches and strategies. In one such effort, NIDA's Division of Epidemiology and Prevention Research is emphasizing the development of family prevention programs that intervene in early childhood to improve family functioning and parenting skills. Such early childhood programs could reduce risk factors and build resistance to drug use even before children enter school. Current studies also are testing new school-based programs that begin as early as kindergarten and extend through the primary grades. Several of these programs are aimed at children with conduct disorders, a known risk factor for later drug abuse.
We also are seeking and supporting research on the special needs of older children and adolescents who have dropped out of school, run away from home, become homeless, or been placed in juvenile court detention programs. This comprehensive research program will help us develop targeted interventions to meet the specific needs of diverse groups of youths at risk of drug abuse. (See "Drug Abuse Among Runaway and Homeless Youths Calls for Focused Outreach Solutions")
The increased drug use we have seen among America's youth in recent years is a warning signal that it is time for new and effective solutions to address the problem. NIDA's prevention research program is providing the knowledge, guidance, and tools to States, communities, families, and individuals as they work to ensure that young people remain firmly on the road to healthy and productive lives.