which any person is identified as an individual at risk
for substance abuse. Universal prevention strategies
address the entire population (e.g., national, local
community, school neighborhood) with messages and
programs aimed at preventing or delaying the use of
alcohol, tobacco, and other drugs. Selective preven-
tion strategies target subsets of the total population
that are deemed to be at risk for substance abuse by
virtue of their membership in a particular population
segment—for example, children of adult alcoholics,
dropouts, or students who are failing academically.
Indicated prevention strategies are designed to pre-
vent the onset of substance abuse in individuals who
do not meet medical criteria for addiction but who are
showing early danger signs, such as truancy, falling
grades, and cigarette smoking.
Research shows that there are many risk factors
for drug abuse, each having a different impact de-
pending on the phase of development. Risk factors
can be associated with individual characteristics as
well as social contexts. Individual risk factors include:
genetic susceptibility to addiction, high sensation
seeking, impulsive decision making, conduct prob-
lems, shyness coupled with aggression in boys, rebel-
liousness, alienation, academic failure, and low
commitment to school.
Family risk factors include: substance abusing or
emotionally disturbed parents; perceived parent per-
missiveness toward drug/alcohol use; lack of or incon-
sistent parental discipline; negative communication
patterns and conflict; stress and dysfunction caused
by death, divorce, incarceration of parents or low in-
come; parental rejection; lack of adult supervision;
poor family management and communication; and
physical and/or sexual abuse. School risk factors in-
clude: ineffective classroom management, failure in
school performance, truancy, affiliations with deviant
peers, peers around deviant behaviors, and percep-
tions of approval of drug using behaviors in the
school, peer, and community environments.
Certain protective factors have also been identi-
fied. These factors are not always the opposite of risk
factors, and their impact varies along the develop-
mental process. The most salient protective factors in-
clude: strong bonds with the family; experience of
parental monitoring with clear rules of conduct with-
in the family unit and involvement of parents in the
lives of their children; success in school performance;
and strong bonds with prosocial institutions such as
the family, school, and religious organizations. Other
factors—such as the availability of drugs, alcohol, and
tobacco, and beliefs that substance use by young peo-
ple is generally tolerated—also influence a number of
youth who start to use drugs.
A young boy rolls a marijuana cigarette. Adolescents are most likely
to experiment with alcohol and tobacco before trying marijuana—all
are considered to be ‘‘gateway drugs.’’ (Joan Slatkin/Archive
Photos, Inc.)During the 1990s, the federal government made
a concerted effort to test and disseminate prevention
programs that met rigorous scientific standards for
effectiveness. For example, school districts had to se-
lect effective programs and evaluate their progress to-
ward specific goals for reduction of substance use by
students, in order to receive funding through the Safe
and Drug Free Schools program. Agencies such as the
National Institute on Drug Abuse and the Center for
Substance Abuse Prevention funded national and
local studies to test whether youth who participate in
prevention programs actually experience a reduction
in risk factors, an increase in protective factors, and/
or reductions in substance use. Federal agencies, sci-
entific societies, and private foundations developed
criteria for assessing the evidence about the effective-
ness of various approaches and programs, and many
provided recommendations to the public about par-
ticular programs and approaches through web sites
and print media. Changing behavior is exceedingly
complex, but informed efforts by parents, schools,SUBSTANCE ABUSE 393