School-Based

Drug abuse prevention should be addressed as early as preschool. Preschool children can benefit from learning how to handle aggression, solve problems, and communicate better so that they can avoid putting themselves at risk for drug abuse later in life. Middle and high school programs should focus on peer relationships, communication, assertiveness, drug resistance skills, and developing anti-drug attitudes. School-based prevention programs should be repeated often for the best level of success.

Personal and Social Skills: Focused Education Characteristics***

Moving now to the school, are those interventions that focus on personal and social skills development.  The evidence for their effectiveness is good.

These programs provide opportunities to learn skills to cope with a variety of situations that arise in the daily lives of children.  They support the development of general social competencies and address normative beliefs and attitudes.

These are large programs that are delivered by trained teachers who use interactive methods to deliver the content.  The primary focus of these programs is on skills development with an emphasis on coping skills as well as personal and social skills.  These programs generally consist of a series of sessions and in many cases have booster sessions over the school years to reinforce and enhance these life skills.

Interventions that had no outcomes or negative outcomes generally were information or knowledge only, were focused on building self-esteem only or on emotional education only.  The use of teachers without specialized training and using non-interactive methods were also found not to have positive outcomes on substance use.

Classroom Environment Improvement Programs: Characteristics Linked to Positive Outcomes***

The school is a setting where the intervention curriculum can be delivered, as well as improve the school experience and enhance positive feelings about school and education. 

These programs strengthen classroom management competencies of teachers and support the socialization of children to successfully assume their role as students.

These programs are generally delivered by regular teachers who are trained in non-instructional strategies to respond effectively to inappropriate behavior and to reinforce appropriate behavior and to give feedback on what are the roles of students and what are expected behaviors.  These programs that improve both academic and socio-emotional learning are generally delivered in the first school years and actively engage students.

Policies to Keep Children in Schools**

Research shows that keeping children in schools has been linked to positive outcomes.  Evidence to support this policy’s effectiveness is adequate and most of the evaluation studies were conducted in low- and middle-income countries.

Policies to keep children in school are most effective for children who are at risk for a number of reasons related to their families but also to their communities.  Building new schools to replace run-down buildings and providing cash incentives to families to maintain children in schools are the chief characteristics of these policies.

Early Adolescence and Adolescence
(11-15 Years) Evidence-Based Strategies

There are many more evaluation studies of interventions that address the needs of this age group.  Parenting skills programs are shown in grey in this slide as they were discussed earlier but remain effective for this group as well as personal and social skills-based curricula, policies within the school both addressing the universal needs.

For the more at-risk population, interventions that provide individual attention such as those that address psychological vulnerabilities and mentoring have adequate evidence of effectiveness.

Parenting Skills: Characteristics****

Similar to middle childhood, the content of effective parenting skills programs for early adolescence includes the enhancement of family bonding and parenting skills particularly in setting rules, monitoring free time and friendship patterns, and continuing to be involved in the child’s educational experience. These have been found to have positive outcomes for early adolescents with very good supportive evidence of effectiveness.

Parenting Skills: Characteristics****

What is key about these programs is that the material, situations, and issues are relevant for older children. They include multiple group sessions that are highly interactive.  They require trained instructors and are organized to facilitate full participation.

Personal and Social Skills Education: Characteristics***

Personal and social skills education is also very relevant for this age group with adequate evidence of effectiveness.  However, early adolescence is a period when youth enter the at-risk years for substance use. These programs foster substance and peer refusal competencies to counter social pressures to use substances and cope with challenging life situations in healthy ways.  The additional components address perceptions of risk or harm associated with substance use with a focus on consequences that are particularly relevant to early adolescence.  At this time, youth hold misconceptions regarding the normative nature of substance use with many overestimating the number of their peers who they think smoke, drink or use drugs.  Without accurate information, they are unable to weigh consequences against perceptions of the expectations associated with substance use. 

This age group is particularly interested in being engaged in prevention activities and the effective methods for such engagement require trained teachers or instructors who act more as facilitators and coaches than lecturers.

School Policies and Culture: Characteristics**

The personal and social skills education programs generally consist of a manualized curriculum.  However, the school offers other opportunities for evidence-based prevention programming including addressing the policies relative to the use of substances and how to handle infractions to creating a more positive environment in which students feel safe, comfortable, and successful that have been found to be effective with adequate evidence.

In general, school policies regarding substance use must be specific as to what substances are being targeted, reducing or eliminating access to substances, and addressing infractions of these policies in a positive way with counseling or supportive services.  This approach was found to have a positive impact on substance use among all students as well as school staff. When infractions of these policies are negative perhaps through suspensions or expulsions, substance rates either remained unchanged or increased.

Furthermore, there is absolutely no evidence that drug testing deters substance use.

School Policies and Culture: Characteristics**

These effective substance use school policies are more successful with the participation of a range of stakeholders in developing the policies and how to handle infractions.  Often students and parents along with school staff are involved.  Finally, prevention policies in the school are most effective when they are implemented with other prevention interventions.  The policies and interventions deliver the same messages in different ways and support each other.

Individual Psychological Vulnerabilities Intervention: Characteristics Linked to Positive Outcomes**

During this period, children with psychological vulnerabilities such as sensation-seeking, impulsivity, anxiety sensitivity, or hopelessness have been found to be vulnerable to substance use, if not addressed in a positive way.  These youth begin to have problems in school, with their parents, or with their peers.  In general, those identified with these problems are screened by professionals using validated instruments. Interventions that provide these youth with the skills to positively cope with their emotions have been found to have positive outcomes. These interventions are delivered again by trained professionals and consist of 2 to 5 short sessions.

Mentoring: Characteristics*

Although the evidence-base mentoring programs particularly for youth at risk for engagement in problem behaviors are not strong, the research literature indicated that trained mentors delivering a very structured program of activities can result in positive outcomes. In general, youth are matched with adults who commit to supporting them on a regular basis over extended periods of time.

Late Adolescence and Adulthood: Evidence-Based Strategies

In addition to those EBIs and policies we just discussed (in grey), we have found that alcohol and tobacco policies have excellent scientific support for effectiveness.

Other than community-based multi-component initiatives which we will discuss lastly today, media campaigns that have limited evidence of support unless they are designed and delivered appropriately, workplace prevention programming with good evidence of effectiveness, interventions in entertainment venues also with limited evidence of support but quite promising, and brief interventions with very good evidence of effectiveness.

Tobacco and Alcohol Policies: Characteristics Linked to Positive Outcomes*****

As tobacco and alcohol use is more prevalent than other substance use and the associated global health burden is greater, delaying the use of these substances among youth can have a significant social impact. Furthermore, youth who use other substances often also use alcohol.

Evidence-based tobacco and alcohol policies are those that reduce access to underage children and adolescents and reduce the availability of tobacco and alcohol products.

Successful policies are those that increase the minimum age for sale of these products and increase their prices through taxation.  Banning advertisements of tobacco and restricting the advertisement of alcohol products targeting youth have also been shown to reduce their use.  Finally, active and consistent enforcement of these policies and involving retailers through educational programs are part of these effective approaches.

Below are two examples of School-Based Curricula That Work

Two examples of prevention programs that are considered evidence-based.  They are:

Click the links below for more Evidence-based programs to chose from;

https://oasas.ny.gov/system/files/documents/2020/05/ebps-detail-guidance-document_0.pdf

https://www.samhsa.gov/sites/default/files/20190719-samhsa-finding_evidence-based-programs-practices.pdf