Prevention Research

The adoption of effective drug abuse prevention programs by communities nationwide will significantly reduce the toll of drug abuse and addiction on our society, especially our nation's youth. In the coming years, research advances in the following areas will significantly enhance our nation's prevention efforts:

• Understanding of the genetic and environmental risk and protective factors that can prevent or lead to drug abuse and addiction.

• Enhancement of the assessment of drug problems at a local level by providing communities with effective research-based tools.

• Translation of research-based prevention principles for the specific needs of local communities.

Risk Factors

Understanding what determines vulnerability to substance abuse is crucial to the development of effective prevention programming. At this point, there is no evidence that a single, unique factor determines which individuals will abuse drugs; rather, drug abuse appears to develop as the result of a variety of genetic, biological, emotional, cognitive, and social risk factors that interact with features of the social context. Thus, both individual-level factors and social context-level factors appear to make an individual more or less at risk for drug abuse and influence the progression from drug use to drug abuse to drug addiction.Studies supported by NIDA and SAMHSA have already identified many risk factors associated with the development of drug problems. These factors typically have been organized into categories that represent individual, familial, and social risks. For example, we now know that individual-level risks include shy, aggressive, and impulsive personality traits and poor academic achievement; and family-level risks include poor monitoring by parents and exposure to substance use by parents and siblings. School-level risk factors include a pro-drug-use norm and availability of drugs on or near the school campus; and community-level risks include lack of positive academic and recreational programming for children and adolescents after school hours and on weekends, as well as low levels of law enforcement with respect to minors' use of licit and illicit substances. This sampling of risk factors illustrates the breadth and complexity of the risks that can confront any one person.

Protective Factors

For many years, our focus was on discovering the factors that put people, particularly children, at risk for drug use, abuse, and addiction. We now know that there are also protective or resiliency factors that protect individuals from developing drug-related problems. NIDA-supported research has already uncovered many such protective factors that operate at the individual and contextual levels through the family, peer group, school, community, workplace, and the media, among others. Examples of protective or resiliency factors include a stable temperament, a high degree of motivation, a strong parent-child bond, consistent parental supervision and discipline, bonding to pro-social institutions, association with peers who hold conventional attitudes, and consistent, community-wide anti-drug-use messages and norms. An accumulation of protective factors may counteract the negative influences of a few risk factors.The challenge for the future is to understand how risk and protective factors interact to make individuals more or less vulnerable to trying drugs, abusing drugs, and/or becoming addicted to drugs. Additionally, we must understand the unique risk and protective factors that contribute to drug abuse among minority populations. This knowledge will allow prevention researchers and providers to design programs that can be more effectively tailored to individual needs.

Effective Research and Community Needs

To give communities the science-based tools to prevent drug abuse, we must have research in several emerging areas of prevention. Strategies that can help communities better determine their own local needs and their readiness for interventions are needed. For example, communities must be given the epidemiological tools to assess their needs. Research is needed also to aid understanding of the organization, management, financing, and delivery of prevention services. In the treatment arena there are established systems such as clinics, hospitals, outpatient centers, HMOs, and clinician training and certification systems. However, there are no defined systems for provision and financing of prevention services or training and credentialing of providers. Thus, it is difficult to determine how decisions are made about prevention implementation. A full understanding of these issues will help integrate prevention strategies and programs into existing community-level service delivery systems and sustain them.

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