1. © Copyright 2011, Pearson Education, Inc. All rights reserved. Chapter 16 Substance-Abuse Prevention

2. © Copyright 2011, Pearson Education, Inc. All rights reserved. Levels of Intervention in Substance-Abuse Prevention Substance-abuse prevention efforts fall into three basic levels of intervention: primary, secondary, and tertiary. Primary prevention focuses on populations that have had only minimal or no exposure to drugs.

3. © Copyright 2011, Pearson Education, Inc. All rights reserved. Levels of Intervention in Substance-Abuse Prevention Secondary prevention focuses on populations whose drug experience has not yet been associated with serious long-term problems. Tertiary prevention focuses on populations who have entered treatment; the goal is to prevent relapse.

4. © Copyright 2011, Pearson Education, Inc. All rights reserved. Strategies for Substance- Abuse Prevention The U.S. federal agency specifically charged with prevention programs is the Center for Substance Abuse Prevention (CSAP), a division of the Substance Abuse and Mental Health Services Administration (SAMHSA), which is in turn a division of the U.S. Department of Health and Human Services.

5. © Copyright 2011, Pearson Education, Inc. All rights reserved. Strategies for Substance- Abuse Prevention The overall strategy for substance- abuse prevention is to minimize the risk factors in a person’s life with respect to drug-taking behavior and to maximize the protective factors.

6. © Copyright 2011, Pearson Education, Inc. All rights reserved. Strategies for Substance- Abuse Prevention The inclination to resist the effects of risk factors for drug-taking behavior through the action of protective factors is referred to as resilience.

7. © Copyright 2011, Pearson Education, Inc. All rights reserved. Strategies for Substance- Abuse Prevention In order to be “evidence-based,” primary and secondary prevention programs must be evaluated against a control group that did not receive the intervention. Positive change per se is not enough for a judgment of success.

8. © Copyright 2011, Pearson Education, Inc. All rights reserved. Strategies for Substance- Abuse Prevention The estimated costs of substance abuse in the United States exceed $1 trillion each year. The federal program Healthy People 2020 has set specific objectives regarding a wide range of health behaviors, including those that pertain to substance abuse.

9. © Copyright 2011, Pearson Education, Inc. All rights reserved. Figure 16.1

10. © Copyright 2011, Pearson Education, Inc. All rights reserved. Lessons from the Past: Prevention Approaches That Have Failed Several strategies have been largely unsuccessful in meeting the goals of substance-abuse prevention. They include the reliance on supply/availability reduction, punitive judicial policies, scare tactics, objective information, and affective education.

11. © Copyright 2011, Pearson Education, Inc. All rights reserved. Hope and Promise: Components of Effective School-Based Prevention Programs Effective school-based programs have incorporated a combination of peer- refusal skills training, relaxation and stress management, and training in social skills and personal decision making.

12. © Copyright 2011, Pearson Education, Inc. All rights reserved. Hope and Promise: Components of Effective School-Based Prevention Programs The Life Skills Training (LST) program is an example of a comprehensive program that incorporates several of these school-based components for effective substance-abuse prevention.

13. © Copyright 2011, Pearson Education, Inc. All rights reserved. Hope and Promise: Components of Effective School-Based Prevention Programs The Drug Abuse Resistance Education (DARE) program, in its original form, has been shown to have little effect in primary prevention, although later versions have incorporated many of the components that have been demonstrated to be effective.

14. © Copyright 2011, Pearson Education, Inc. All rights reserved. Community-Based Prevention Programs Community-based programs make use of a broader range of resources, including community leaders and public figures as positive role models, opportunities for alternative-behavior programming, and the mass media.

15. © Copyright 2011, Pearson Education, Inc. All rights reserved. Community-Based Prevention Programs Recent efforts by the media have had a major impact on the image of drug- taking behavior in both high risk populations and others in the community.

16. © Copyright 2011, Pearson Education, Inc. All rights reserved. Community-Based Prevention Programs CASASTART is an example of a community-based program that incorporates intensive community-wide components of substance-abuse prevention.

17. © Copyright 2011, Pearson Education, Inc. All rights reserved. Family Systems in Primary and Secondary Prevention Community-based prevention programs are increasingly mindful of the importance of the family, particularly parents, as the first line of defense in prevention efforts.

18. © Copyright 2011, Pearson Education, Inc. All rights reserved. Figure 16.2

19. © Copyright 2011, Pearson Education, Inc. All rights reserved. Family Systems in Primary and Secondary Prevention A major emphasis in primary and secondary prevention programs has been on the special roles of parents, grandparents, guardians, and other family members. Improved lines of communication within the family are crucial elements.

20. © Copyright 2011, Pearson Education, Inc. All rights reserved. Multicultural Issues in Primary and Secondary Prevention Cultural considerations are important when communicating about substance abuse with specific population subgroups, such as Latinos and African Americans.

21. © Copyright 2011, Pearson Education, Inc. All rights reserved. Substance-Abuse Prevention in the Workplace The 1988 Drug-free Workplace Act mandated that any company or business receiving U.S. federal contracts or grants provide a drug-free workplace. This is carried out through a comprehensive and continuing program of drug education and awareness.

22. © Copyright 2011, Pearson Education, Inc. All rights reserved. Substance-Abuse Prevention in the Workplace It is estimated that substance abuse costs as much as $60 billion–$100 billion each year. One element of most drug-free workplace programs is an employee assistance program (EAP), serving to help workers with abuse problems.

23. © Copyright 2011, Pearson Education, Inc. All rights reserved. Substance-Abuse Prevention in the Workplace Where unions exist, member assistance programs (MAPs) supplement and complement the work of EAPs.

24. © Copyright 2011, Pearson Education, Inc. All rights reserved. Yes, You: Substance-Abuse Prevention and the College Student On college campuses, substance-abuse prevention programs are incorporating features of both school-based and community-based approaches. There is a compelling need to change the culture of alcohol and other drug use in college.

25. © Copyright 2011, Pearson Education, Inc. All rights reserved. Yes, You: Substance-Abuse Prevention and the College Student Substance-abuse prevention programs should involve faculty and administrators, as well as students, in an overall comprehensive strategy. College fraternities have taken important strides toward banning alcohol in fraternity houses, even when members are of legal drinking age.