Education about substance abuse

DEFINITION: The methods for substance abuse education vary widely. Education can be as informal as a community-based health fair to practitioner-oriented education sessions and workshops at conferences. Colleges and universities offer highly formal and structured education and instruction. Media messages are often used to educate the public on the multiple issues related to substance abuse.

Overview

Throughout recent history, efforts have been developed to educate the public on the dangers of substance abuse. Much of this work has targeted youth populations, especially in school settings. Substance abuse prevention educators have assumed that educating people on the dangers and harmful nature of substance abuse alone will prevent drug use and addiction. However, many studies have questioned the effectiveness of this approach.

Traditionally, a common technique was to invite an individual in recovery from alcohol or drug addiction into the classroom to talk about drug use and its negative impact. This approach was thought to be effective in preventing substance use. Another approach was for a teacher to show a film on substance abuse, a film that often included a number of scare tactics believed to deter youth from drug experimentation. Generally, the teacher would follow the film with a discussion of the dangers of drugs.

Another common method once believed to prevent substance abuse was for substance abuse educators to attend health fairs and simply hand out brochures to passersby. Health educators believed that if people knew about the negative effects of drug use, they would not use drugs. Much money and resources were spent in the hopes that educational brochures would deter people, primarily young people, from using tobacco, alcohol, or other drugs.

However, studies showed that these educational efforts were mostly ineffective. Substance abuse education is informative but is not effective as a single, stand-alone approach to preventing substance use. Practitioners who began to question their approach also began to explore the nexus between substance abuse education and the prevention of drug abuse. In some cases, popular approaches to prevention education, such as the original Drug and Alcohol Resistance Education (D.A.R.E.) program and other singularly focused educational curricula, were shown to be expensive and have adverse outcomes. For this reason, the National Institute on Drug Abuse (NIDA) substantially changed the D.A.R.E. curriculum. D.A.R.E. keepin’ it REAL was created in the late 2010s by substance abuse and prevention specialists. Unlike the old program, keepin’ it REAL receives its funding and is updated based on its efficacy in reducing substance use, according to science-driven studies. While longitudinal research is necessary to appropriately measure the program's impact, early evaluations found the program to be successful.

Substance abuse education can be effective if the goal is to inform people of the facts of drug use and to train students of health care about the best practices associated with the substance abuse profession. Different disciplines offer their own perspectives on the issue of substance abuse. Some courses in substance abuse counseling, for example, teach student therapists how to work with clients who abuse substances.

Center for Substance Abuse Prevention

The Center for Substance Abuse Prevention (CSAP), part of the US Substance Abuse and Mental Health Services Administration (SAMHSA), created six strategies that many US states use to channel funding to their respective regions, counties, and community groups that conduct prevention programs. One of these areas is prevention education. This strategy includes two-way or multidirectional communication about substance abuse topics, including prevention programs that cover parenting techniques, social skills, and peer resistance skills.

Prevention education is one of six overall strategies that CSAP attaches to The Substance Abuse Prevention and Treatment Block Grant (SABG). The other five strategies include information dissemination, alternative activities, community-based processes, environmental approaches, and problem identification and referral.

The focus of prevention education is to provide substantive information. Simply passing out a brochure, for example, is considered information dissemination only. Adequate prevention education occurs in settings with interactive communication that leads, for example, to programs such as Life Skills Training (LST), which has been replicated nationally. This program has proven effective across multiple sites and is among the most cost-effective drug prevention programs.

The LST program is a school-based program that prevents substance abuse and violence by targeting risky behaviors. The curriculum includes multiple sessions over time, with interactive role-playing scenarios that engage the students in the program. A number of evidence-based educational programs in substance abuse exist on the National Registry of Evidence-based Programs and Practices (NREPP), which is sponsored by SAMHSA.

National Institute on Drug Abuse (NIDA)

NIDA, part of the National Institutes of Health, also provides some definitions and descriptions on substance abuse education and dissemination efforts. NIDA has two critical focuses. The first is the strategic support and conduct of research across a broad range of disciplines. The second is ensuring the rapid and effective dissemination and use of the results of that research to significantly improve prevention, treatment, and policy as it relates to drug abuse and addiction. Specifically, NIDA funds education and dissemination efforts that inform adults and youth about the neuroscience of addiction. Youth-focused curricula include Brain Power and NIDA Goes Back to School, which are programs with a substance-abuse educational component.

Many of the early programs identified by NREPP were funded partly by NIDA, which also published the book Preventing Drug Use among Children and Adolescents (1997). This work highlights much evidence-based substance abuse prevention programs, many of which have an educational focus. Several programs have since been created and are being studied for effectiveness. The contributions and research funding that NIDA provides are crucial. Research results are interpreted and transferred to the field to influence educational practice.

NIDA’s publication also highlights the risk-and-protective-factor approach to prevention. This approach, which has been adopted by most in the field of substance abuse prevention as the framework for programming, argues that there are multiple risk and protective factors in a person’s life that can influence each stage of youth development. These factors operate across a number of domains, some of which include substance abuse. The implication for prevention specialists is that these factors must be assessed and understood before implementing a prevention program or a strategy designed to decrease risk factors and increase protective factors. This is exciting research, and NIDA was one of the first federal agencies to disseminate information on this approach.

The NIDA’s longitudinal study, Adolescent Brain Cognitive Development, has rendered data concerning negative neurodevelopmental factors of drug use, as well as factors that help identify those individuals at greatest risk, including socioeconomic class, discrimination, technology use, and social media use. The NIDA-sponsored HEALthy Brain and Child Development (HBCD) study aims to expand this research.

Guiding Principles and Best Practices

As prevention knowledge continues to grow, new findings are being presented that have a role in guiding decision-making about funding and implementing prevention programs. Early findings on prevention education include the following:

• Providing information and educating people on the harms and risks associated with substance abuse is not an effective strategy when used in isolation from other approaches. Skill development in combination with education is preferred.
• Didactic approaches are not effective at preventing substance abuse. Interactive educational approaches are encouraged.
• When educating youth, peer approaches are preferred but require training and oversight.
• When implementing education programming in schools, lengthy curricula, including booster sessions, are preferred to short-term or one-time-only types of events.
• Social skills programs that include numerous risk-and-protective-factor approaches are preferred.
• Booster sessions are encouraged after the prevention education session has concluded.
• Role-playing components to substance abuse education programs are recommended.
• Educational programs that include parents and students are recommended.

This early work helped to guide the field of substance abuse prevention. Much of the early work of the Center for the Application of Prevention Technology, under the CSAP contract, was to coordinate with states, jurisdictions, and tribal entities to transfer evidence-based information on substance abuse prevention programs and best practices to state leadership. It is within this context that education about substance abuse is often discussed. Communication covers what is effective and ineffective in this area.

College and University Education

Substance abuse education is growing. Colleges and universities offer many educational courses in substance abuse prevention and treatment, and the content of these courses varies widely. Some focus on substance abuse prevention, others focus on pharmacology, and still others focus on substance abuse treatment. Courses cover the sociology of substance abuse, criminal justice solutions to substance abuse problems, the medical implications for patients with substance abuse disorders, and substance abuse counseling. Courses are being taught traditionally, in the classroom but also online.

Substance abuse certification and licensure requirements have driven much of this increased activity in substance abuse education. Professional education in substance abuse prevention could not happen without careful pedagogical approaches and scientific findings to guide effective practice in the field.

National Youth Anti-Drug Media Campaign

The National Youth Anti-Drug Media Campaign is an educational vehicle for substance abuse messages in the United States. Millions of dollars are spent annually to create, distribute, and broadcast messages across the country. The campaign is part of the Office of National Drug Control Policy (ONDCP) in Washington.

A number of messages are offered as part of a comprehensive media campaign. Although the vast majority of these messages are one-way communication episodes, substance abuse organizations use the material, too. Also, the ONDCP and state authorities discuss how media messages can support substance abuse services regionally.

From 1998 to 2004, the media campaign received over $1.2 billion in federal funding, but in 2006, researchers found the program failed to reduce adolescent drug use. Congress began progressively reducing the program's funding beginning in 2007. The program adapted its approaches several times but remained either minimally funded or not funded in each fiscal year. In 2018 and 2019, the campaign’s Truth About Opioids initiative, a collaboration with the Ad Council and Truth Initiative, aimed to reduce opioid use among American youth.

Bibliography

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