Each year, substance abuse and addiction contribute to the death of more than 120,000 Americans and cost taxpayers nearly $300 billion in preventable health care, law enforcement, crime, and other costs, according to the U.S. Department of Health and Human Services. For NIDA, the key word in this assessment is "preventable." The best approach to reducing the tremendous toll substance abuse exacts from individuals, families, and communities is to prevent the damage before it occurs.

The science of drug abuse prevention is still in its early stages. Yet it has already made great strides. Twenty-five years ago, drug abuse prevention programs, where they existed, were based primarily on ideology and good intentions. Today, we have effective prevention programs anchored solidly in a base of empirical knowledge about fundamental factors that can promote or reduce substance abuse. These research-based programs have demonstrated that we can modify individual, family, peer, and community factors that we know to be risk factors for drug abuse and, in this way, steer many young people away from abusing drugs. Two NIDA-sponsored National Prevention Conferences and a research-based guide on preventing drug abuse by children and adolescents synthesize key findings, detail fundamental prevention principles, and describe programs that have successfully applied these principles.

Buoyed by our successes and encouraged by our ongoing research, we know that science can do more to make drug abuse prevention more effective.

While recognizing these accomplishments, we are also compelled to do better to protect our children and adolescents. Buoyed by our successes and encouraged by our ongoing research, we know that science can do more to make drug abuse prevention more effective. The most urgent need is to make better use of what we already know. Recent research indicates that only one in seven of the Nation's public and private schools offers prevention programs that incorporate proven elements and deliver them in the most effective way (see "Few Middle Schools Use Proven Prevention Programs," NIDA NOTES, Vol. 17, No. 6). These findings underscore the need for additional research focused on accelerating the faithful adoption and application of research-based prevention approaches in communities across the Nation.

The difficulties inherent in translating precisely structured research-based programs into the culture and operations of diverse communities require that the scientists who develop programs and the practitioners who deliver them work together effectively to improve drug abuse prevention. Toward this end, NIDA has been promoting a working alliance between research and practice to identify programmatic, organizational, and local circumstances that foster or forestall the adoption and effective implementation of research-based programs by communities, schools, and service delivery organizations. A primary goal of this partnership is improved delivery of currently available interventions.

Our recently launched National Prevention Research Initiative (NPRI) has fast-forwarded this research-practice partnership with four large-scale community trials of programs that have been shown to prevent drug abuse on a smaller scale. In these trials, scientists and practitioners are delivering a research-tested intervention to populations in urban, suburban, and rural sites. Each trial examines specific implementation factors, such as how different training methods affect a program's delivery or how accurately the staff of a community service program delivers an intervention to different groups in various settings. Results of these studies should reveal systemic, structural, and other barriers to implementation and strategies to overcome these barriers. Ultimately, this information will enable many more communities to adopt research-based programs and use them effectively to prevent drug use. (For more information on NPRI, see "NIDA National Prevention Research Initiative Begins Broad Range of Studies".)

Blending the knowledge gained from research with the realities of the community practitioner should do more than accelerate the adoption of current prevention programs. It also should foster the development and testing of the next generation of prevention programs. Data from our field studies will inform the new prevention approaches that flow from NPRI's expanded basic and transdisciplinary prevention research and make them more feasible. Thus, tomorrow's prevention programs will more closely reflect the practical circumstances of the practitioners, the community settings in which programs are delivered, and the children, youths, and families who will take part in them.

Tomorrow's prevention programs will more closely reflect the practical circumstances of the practitioners, the community settings in which programs are delivered, and the children, youths, and families who will take part in them.

Because our schools play such a central role in preventing drug abuse, NIDA is particularly interested in bridging gaps between the researchers and practitioners who develop and deliver drug abuse prevention programs in our Nation's public and private schools. In April, NIDA took an important step toward this goal by bringing together educators, researchers, and representatives of Federal and State funding agencies to discuss school-based prevention at a 2-day meeting in Bethesda, Maryland. More than 100 meeting participants explored the many challenges to and opportunities for conducting prevention research in schools and in integrating research-based programs into the school curricula and operating environment. Meeting these challenges and seizing these opportunities will be key to improving the feasibility and effectiveness of school-based prevention programs and increasing their impact on young people's drug abuse.

The final step in getting effective approaches working in the community is communicating the latest scientific findings on preventing drug abuse to those who are in a position to apply them. To accomplish this, we are building on the success of our first research-based guide to preventing drug abuse among children and adolescents. An updated version of the guide synthesizes the significant advances in prevention science during the last 5 years and makes them accessible to parents, teachers, and community leaders. (See Tearoff, "Education in Action: NIDA Goes Back to School").

Our National Prevention Research Initiative, our conferences and meetings, and our dissemination of the latest prevention information demonstrate NIDA's strong commitment to closing the gaps between prevention research and practice. This blending of science-based knowledge with community realities will result in wider adoption of more effective programs and major progress toward the ultimate goal: that far fewer of our Nation's children and adolescents become snared in the destructive web of drug addiction.

Volume 18, Number 3 (October 2003)