Principles of Substance Abuse Prevention - PRACTICES 3
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3
GUIDE TO
SCIENCE-BASED
PRACTICES
Principles of Substance
Abuse Prevention
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Prevention
Division of Knowledge Development and EvaluationAcknowledgments This document was produced under the guidance of Stephen E. Gardner, D.S.W., pro- ject officer, and Paul J. Brounstein, Ph.D., Division of Knowledge Development and Evaluation, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention (SAMHSA/CSAP), through contract #282-98-0023 to ROW Sciences, Inc., Carol Winner, project director. Principles of Substance Abuse Prevention is based on A Guide to Science-Based Practices in Substance Abuse Prevention, a seminal monograph developed and written by Paul J. Brounstein, Janine M. Zweig, and Stephen E. Gardner, with substantial contri- butions from Maria Carmona, Paul Florin, Roy Gabriel, and Kathy Stewart. Special thanks go to a dedicated review panel composed of Eric Einspruch, Roy Gabriel, and Katherine Laws, RMC Research Corporation; Carol Hays, Illinois State Incentive Grant Program; Patricia Post, Central Regional Center for the Application of Prevention Technologies; and Mary Joyce Prudden, CSAP, who offered invaluable sug- gestions for improving the document. The Department of Health and Human Services (DHHS) has reviewed and approved policy-related information in this document but has not verified the accuracy of data or analyses presented in the document. The opinions expressed herein are the views of the authors and do not necessarily reflect the official position of SAMHSA or DHHS. DHHS Publication No. (SMA)01-3507 Printed 2001 For single copies of this document, contact SAMHSA’s National Clearinghouse for Alcohol and Drug Information (NCADI), P.O. Box 2345, Rockville, MD 20847-2345; 1-800-729-6686, 301-468-2600, or TDD 1-800-487-4889; or visit the Web site at www.samhsa.gov. ii Principles of Substance Abuse Prevention
Foreword
Although recent reports show a leveling or decrease in substance use among our nation’s
youth, drug abuse remains a problem in our country. There were 14.8 million current
users of illicit drugs in 1999. This figure represents 6.7 percent of the population ages 12
years and older. The 1999 National Household Survey also found increases in illicit drug
use among adults ages 18–25. Although the rates for those 26–34 years old and 35 years
and older have not changed significantly since 1994, overall statistics indicate that there
is still work to be done in preventing substance abuse.
The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center
for Substance Abuse Prevention (CSAP) developed this series of products in response to
the ongoing substance abuse problems. The three components in this series support
CSAP’s mission to provide resources that are based on science, with measurable out-
comes, and designed to help community and state leaders formulate targeted programs.
CSAP is committed to sponsoring, accumulating, and integrating knowledge regarding
scientifically defensible and effective prevention practices. The primary foci of each doc-
ument in this series is CSAP grantees, constituent organizations, and the communities
these groups serve.
We are pleased to release these findings on the risk factors for substance abuse in dif-
ferent domains and successful intervention strategies to prevent substance abuse, delay
its onset, and reduce substance abuse-related behaviors. These results show that sub-
stance abuse develops in response to multiple influences, including the individual, fami-
ly, peers, school/work, community, and society/environment. These domains interact
with one another and change over time.
The research confirms that there are a variety of proven approaches to substance
abuse prevention. The strategies highlighted in this booklet range from personal skill-
building and opportunities for family bonding to community awareness and youth-ori-
ented mass media campaigns. These findings provide an empirical knowledge base for
practitioners and a guide to State and Federal agencies, local governments, and private
foundations in their efforts to fund programs with measurable outcomes.
This booklet is one in a series of products developed to help key stakeholders struc-
ture and assess scientifically defensible programs. It is designed to serve practitioners,
researchers, and policymakers as we all work together to develop innovative and effec-
tive methods of substance abuse prevention that respond to the unique needs of our
individual communities.
Joseph H. Autry III, M.D. Ruth Sanchez-Way, Ph.D.
(Acting) Administrator Director
Substance Abuse and Mental Health Center for Substance Abuse Prevention
Services Administration Substance Abuse and Mental Health Services
Administration
iiiTable of Contents
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ii
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iii
Principles of Substance Abuse Prevention . . . . . . . . . . . . . . . . . . . . . . . . .1
Principles of Effective Substance Abuse Prevention . . . . . . . . . . . . . .1
Why Use Scientifically Defensible Principles? . . . . . . . . . . . . . . . . .4
Why Use This Booklet? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Prevention Interventions by Domain . . . . . . . . . . . . . . . . . . . . . . . .7
Additional Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
vPrinciples of Substance
Abuse Prevention
For more than a decade, the Substance ples appearing in this document have
Abuse and Mental Health Services been identified through expert or peer
Administration’s Center for Substance consensus efforts such as consensus pan-
Abuse Prevention (CSAP) has supported els and meta-analyses. Many have also
demonstration programs designed to iden- been published in peer-reviewed journals.
tify interventions that work with high-risk Appropriate use of these scientifically
populations to prevent substance abuse, defensible principles can assist prevention
delay its onset, and reduce substance providers in designing services that are
abuse-related behaviors. Research now both innovative and effective, and in
confirms that interventions aimed at modifying proven models to respond to
reducing the risk factors and increasing the specialized needs of individual
the protective factors linked to substance programs.
abuse and related problem behavior can
produce immediate and long-term posi- Principles of Effective
tive results.
Substance Abuse Prevention
This section provides a brief listing of the
Substance abuse prevention princi-
scientifically defensible principles that
ples are basic truths, standards, and
can help service providers design and
elements that effective interventions
implement programs that work. The more
have in common and that have been
detailed descriptions of each principle
identified through the careful evalua-
within each domain are contained in the
tion of substance abuse prevention
text that follows.
programs.
However, principles derive from
Individual Domain
programs and must be viewed in this
context. They are best used to modify I-1. Build social and personal skills.
or adapt program core philosophy and I-2. Design culturally sensitive inter-
content to specific situations or popu- ventions.
lations. The preventionist who con- I-3. Cite immediate consequences.
structs programs directly from I-4. Combine information dissemina-
principles without an eye toward con- tion and media campaigns with
tent may have little to show as a result. other interventions.
I-5. Provide positive alternatives to
Effective interventions share certain help youth in high-risk environ-
principles that guide prevention providers ments develop personal and
in structuring client services. The princi- social skills in a natural and effec-
tive way.
1Guide to Science-Based Practices
I-6. Recognize that relationships exist Peer Domain
between substance use and a vari-
P-1. Structure alternative activities and
ety of other adolescent health
supervise alternative events.
problems.
P-2. Incorporate social and personal
I-7. Incorporate problem identification
skills-building opportunities.
and referral into prevention pro-
grams. P-3. Design intensive alternative pro-
grams that include a variety of
I-8. Provide transportation to preven-
approaches and a substantial time
tion and treatment programs.
commitment.
Family Domain P-4. Communicate peer norms against
use of alcohol and illicit drugs.
F-1. Target the entire family.
P-5. Involve youth in the development
F-2. Help develop bonds among par- of alternative programs.
ents in programs; provide meals,
P-6. Involve youth in peer-led inter-
transportation, and small gifts;
ventions or interventions with
sponsor family outings; and
peer-led components.
ensure cultural sensitivity.
P-7. Counter the effects of deviant
F-3. Help minority families respond to
norms and behaviors by creating
cultural and racial issues.
an environment for youth with
F-4. Develop parenting skills. behavior problems to interact with
F-5. Emphasize family bonding. other nonproblematic youth.
F-6. Offer sessions where parents and
youth learn and practice skills. School Domain
F-7. Train parents to both listen and S-1. Avoid relying solely on knowl-
interact. edge-oriented interventions
F-8. Train parents to use positive and designed to supply information
consistent discipline techniques. about negative consequences.
F-9. Promote new skills in family com- S-2. Correct misconceptions about the
munication through interactive prevalence of use in conjunction
techniques. with other educational approach-
F-10. Employ strategies to overcome es.
parental resistance to family-based S-3. Involve youth in peer-led inter-
programs. ventions or interventions with
F-11. Improve parenting skills and child peer-led components.
behavior with intensive support. S-4. Give students opportunities to
F-12. Improve family functioning practice newly acquired skills
through family therapy when indi- through interactive approaches.
cated. S-5. Help youth retain skills through
F-13. Explore alternative community booster sessions.
sponsors and sites for schools. S-6. Involve parents in school-based
F-14. Videotape training and education. approaches.
2 Principles of Substance Abuse PreventionS-7. Communicate a commitment to C-15. Assess progress from an outcome-
substance abuse prevention in based perspective and make
school policies. adjustments to the plan of action
to meet goals.
Community Domain C-16. Involve paid coalition staff as
C-1. Develop integrated, comprehen- resource providers and facilitators
sive prevention strategies rather rather than as direct community
than one-time community-based organizers.
events.
C-2. Control the environment around Society/Environmental Domain
schools and other areas where S/E-1. Develop community awareness
youth gather. and media efforts.
C-3. Provide structured time with S/E-2. Use mass media appropriately.
adults through mentoring. S/E-3. Set objectives for each media
C-4. Increase positive attitudes through message delivered.
community service. S/E-4. Avoid the use of authority figures.
C-5. Achieve greater results with highly S/E-5. Broadcast messages frequently
involved mentors. over an extended period of time.
C-6. Emphasize the costs to employers S/E-6. Broadcast messages through mul-
of workers’ substance use and tiple channels when the target
abuse. audience is likely to be viewing or
C-7. Communicate a clear company listening.
policy on substance abuse. S/E-7. Disseminate information about the
C-8. Include representatives from every hazards of a product or industry
organization that plays a role in that promotes it.
fulfilling coalition objectives. S/E-8. Promote placement of more con-
C-9. Retain active coalition members spicuous labels.
by providing meaningful rewards. S/E-9. Promote restrictions on tobacco
C-10. Define specific goals and assign use in public places and private
specific responsibility for their workplaces.
achievement to subcommittees S/E-10. Support clean indoor air laws.
and task forces. S/E-11. Combine beverage server training
C-11. Ensure planning and clear under- with law enforcement.
standing for coalition effective- S/E-12. Increase beverage servers’legal
ness. liability.
C-12. Set outcome-based objectives. S/E-13. Increase the price of alcohol and
C-13. Support a large number of preven- tobacco through excise taxes.
tion activities. S/E-14. Increase minimum purchase age
C-14. Organize at the neighborhood for alcohol to 21.
level. S/E-15. Limit the location and density of
retail alcohol outlets.
3Guide to Science-Based Practices
S/E-16. Employ neighborhood antidrug accountability and will simultaneously
strategies. ensure that program participants receive
S/E-17. Enforce minimum purchase age the most effective services available.
laws using undercover buying
operations. The Role of Domains
S/E-18. Use community groups to provide Substance use is a complex problem that
positive and negative feedback to develops in response to multiple influ-
merchants. ences. These spheres of activity—typically
S/E-19. Employ more frequent enforce- called domains—include the individual,
ment operations. family, peers, school, community, and
society/environment.
S/E-20. Implement “use and lose” laws.
Characteristics and conditions that
S/E-21. Enact deterrence laws and poli-
exist within each domain of activity also
cies for impaired driving.
function as risk or protective factors that
S/E-22. Enforce impaired-driving laws. help propel individuals to or safeguard
S/E-23. Combine sobriety checkpoints them from substance abuse. As such,
with positive passive breath sen- each of these domains presents an oppor-
sors. tunity for preventive action.
S/E-24. Revoke licenses for impaired dri- Research indicates that as individuals
ving. develop, their interactions within and
S/E-25. Immobilize or impound the vehi- across domains of activity change over
cles of those convicted of time. The Web of Influence model (figure
impaired driving. 1) illustrates that these dynamic and
complicated relationships can result not
S/E-26. Target underage drivers with
only in substance abuse, but also in other
impaired-driving policies.
problem behaviors such as violent crime
and suicide.
Why Use Scientifically Risk and protective factors are drawn
Defensible Principles? from a large body of literature (Bry, 1983;
Prevention programs today must produce Hansen, 1997; Hawkins, Catalano, &
tangible results. State and federal agen- Miller, 1992; Newcomb & Felix-Ortiz,
cies, local governments, and private foun- 1992; Reynolds, Stewart, & Fisher, 1997).
dations are interested in funding programs As applied by CSAP and depicted in the
with measurable outcomes. The new Web of Influence, risk and protective fac-
emphasis on performance means that pre- tors function as an interactive model. A
vention practitioners must show that the risk factor such as delinquency, for exam-
programs they propose achieve the results ple, can also become an outcome if an
predicted. The prevention field now has intervention aimed at preventing or
an empirical knowledge base to assist changing the development of that behav-
practitioners in selecting proven ior fails to achieve its objective. In the
approaches for their programs. Using sci- same way, if an intervention succeeds in
entifically defensible principles will help strengthening a protective factor such as
practitioners respond to demands for
4 Principles of Substance Abuse PreventionFigure 1
Web of Influence
Teen School Substance Teenage Violent
Pregnancy Dropout Use Suicide Crime
Individual
Risk and
Protective
Factors
Society/
Peer
Environment* Family Community** School/Work
Association
Related Risk Risk and Risk and Risk and
Risk and
and Protective Protective Protective
Protective
Protective Factors Factors Factors
Factors
Factors
*Society/Environment: Refers to the total complex of external social, cultural, and economic conditions affecting a
community or an individual.
**Community: Refers to the specific geographic location where an individual resides and to the conditions within
that particular area.
family bonding, improved family bonding Prevention education to teach partici-
can become a positive outcome. pants important social skills such as drug
resistance and decision making;
Substance Abuse Prevention and Alternatives to offer opportunities for
Treatment Block Grant Strategies participation in developmentally appro-
In the Substance Abuse Prevention and priate drug-free activities to replace,
Treatment (SAPT) block grant legislation, reduce, or eliminate involvement in sub-
Congress defined six strategies that pre- stance use-related activities;
vention programs can use to increase Problem identification and referral to
protective factors and reduce the impact recognize individuals with suspected sub-
of risk factors, as follows: stance use problems and refer them for
Information dissemination to increase assessment and treatment;
knowledge and change attitudes about Community-based processes to
substance use and abuse through activi- expand community resources dedicated
ties such as classroom discussions and to preventing substance use and abuse
media campaigns. through activities such as building com-
munity coalitions; and
5Guide to Science-Based Practices
Environmental approaches to promote ■ Although this booklet groups principles
policy changes that reduce risk factors by domain, planners and providers
and preserve or increase protective factors should not feel constrained by this
such as stepped-up enforcement of legal approach because many principles
purchase age for alcohol and tobacco work well in more than one domain.
products. ■ Principles identified in this booklet may
To obtain funding from CSAP through not relate to substance abuse problems
the SAPT block grant, States must identify directly. Instead, they may influence the
the strategies that will be used in their risk and protective factors that con-
proposed interventions. tribute to or guard against problems
(Hansen, 1997; Reynolds et al., 1997).
Why Use This Booklet? ■ Although CSAP recommends a compre-
Principles of Substance Abuse Prevention hensive approach to substance abuse
organizes scientifically defensible princi- prevention, increasing the number of
ples by domain and links them to the pre- principles used in a program does not
vention strategies identified in the SAPT necessarily increase its effectiveness. It
block grant. Service providers can refer to is important to select scientifically
it for ideas about what works, to identify defensible principles that best meet the
proven principles in a particular domain, needs of program participants, support
and to justify the use of one or more prin- program objectives, and complement
ciples in a program. Because each princi- one another.
ple is cited, it is relatively easy to locate ■ Likewise, while scientifically defensible
the full article for more detailed informa- principles may improve some out-
tion. Grant reviewers, evaluators, and fun- comes, they cannot compensate for or
ders may also find Principles of Substance salvage a poorly designed or imple-
Abuse Prevention useful as a quick mented program.
overview of the state of the art in preven- ■ Combining a series of substance abuse
tion programming and as a tool for deter- prevention principles does not neces-
mining whether a program is using sarily make for an effective prevention
scientifically defensible principles. program. Principles are best used to
modify and enhance existing prevention
Some Caveats programs and efforts, rather than create
Before one begins to use the principles new programs from scratch.
highlighted in this booklet, it is important ■ Successful, scientifically defensible
to remember that: interventions rely on strong implemen-
■ This list is not exhaustive, and it will tation and continuous, rigorous evalua-
grow as additional principles undergo tion to determine if benchmarks and
evaluation. CSAP encourages program standards have been met and if desired
planners and providers to build on the outcomes have been achieved. Such
information in this booklet to develop implementation and evaluation are, in
the foundation for new and innovative themselves, important for substantiating
approaches to substance abuse the scientific defensibility of prevention
prevention. principles (Morrissey et al., 1997;
Reynolds et al., 1997).
6 Principles of Substance Abuse Preventionties, influence attitudes, and pro-
Prevention Interventions by
mote behavior inconsistent with
Domain use. These interventions usually
include information about the
Individual Domain negative effects of substance use
Among the risk factors for substance (Bell, Ellickson, & Harrison, 1993;
abuse in the individual domain are lack Botvin, Baker, Dusenbury, Botvin,
of knowledge about the negative conse- & Diaz, 1995; Ellickson, Bell, &
quences associated with using illegal sub- McGuigan, 1993; Hansen, 1996;
stances, attitudes favorable toward use, Pentz et al., 1990; Schinke &
early onset of use, biological or psycho- Cole, 1995; Tobler, 1986, 1992).
logical dispositions, antisocial behavior, I-2. To be effective, interventions must
sensation seeking, and lack of adult be culturally sensitive and consid-
supervision (Bry, 1983; Hawkins et al., er race, ethnicity, age, and gender
1992; Scheier & Newcomb, 1991). Most in their designs (Botvin, Schinke,
interventions aimed at the individual are Epstein, & Diaz, 1994; Center for
designed to change knowledge about and Substance Abuse Prevention
attitudes toward substance abuse with the (CSAP), 1996).
ultimate goal of influencing behavior. I-3. Youth tend to be more concerned
about social acceptance and the
Linking Skills Development with immediate rather than long-term
Information effects of particular behaviors.
Life Skills Training (LST) Program Citing consequences such as
demonstrates that linking key skills stained teeth and bad breath has
development with information target- more impact than threats of lung
ing social influences to use, and rein- cancer, which usually develops
forcing these strategies with booster later in life (Flay & Sobel, 1993;
sessions, can produce durable reduc- Flynn et al., 1997; Paglia &
tions in use. Room, 1998).
I-4. Used alone, information dissemi-
Research shows that whether pro-
nation and media campaigns do
vided by trained teachers, health pro-
not play a major part in influenc-
fessionals, or peer leaders, research
ing individual knowledge, atti-
shows that LST can lower levels of
tudes, and beliefs, but they can be
tobacco, alcohol, and marijuana use
effective when combined with
among white, African American, and
other interventions (Flynn et al.,
Hispanic/Latino youth by 59 to 75 per-
1992, 1997; Flynn, Worden,
cent and reduce multidrug use by as
Secker-Walker, Badger, & Geller,
much as 66 percent (Botvin et al.,
1995).
1994, 1995).
I-5. Alternatives such as organized
sports, involvement in the arts,
Research has shown the following:
and community service provide a
I-1. Social and personal skills-building
natural and effective way of
can enhance individual capaci-
reaching youth in high-risk envi-
7Guide to Science-Based Practices
ronments who are not in school
and who lack both adequate adult Use of Incentives To Promote
supervision and access to positive Program Participation
activities. Positive alternatives can
help youth develop personal and The Strengthening Families
social skills inconsistent with sub- Program, aimed at 6- to 10-year-old
stance use (CSAP, 1996; Tobler, children of substance abusers and their
1986). parents, used incentives such as
movie/sporting event tickets and
I-6. Effective programs recognize that
vouchers for groceries and other
relationships exist between sub-
household items as well as transporta-
stance use and a variety of other
tion to engage and retain parents in the
adolescent health problems—such
program. This approach spans cultures
as mental disorders, family prob-
and has been successfully adapted for
lems, pregnancy, sexually trans-
and evaluated with Hispanic/Latino,
mitted diseases, school failure,
Asian/Pacific Islander, African
and delinquency—and include
American, and white families (Kumpfer
services designed to address them
& Alvarado, 1995; Kumpfer, Molgaard,
(Compas, Hinden, & Gerhardt,
& Spoth, 1996; Kumpfer, Williams, &
1995).
Baxley, 1997).
I-7. Incorporating problem identifica-
tion and referral into prevention ture can also be a serious risk factor
programs helps to ensure that par- (Szapocznik et al., 1997). Research has
ticipants who are already using shown the following:
drugs will receive treatment
F-1. Interventions targeting the entire
(Brounstein & Zweig, 1996;
family—parents as well as chil-
Johnson et al., 1996).
dren—can be effective in prevent-
I-8. Providing transportation to treat- ing adolescent substance use
ment programs can encourage (Dent et al., 1995; Dishion,
youth participation (Brounstein & Andrews, Kavanagh, & Soberman,
Zweig, 1996). 1996; Hawkins et al., 1992;
Kumpfer et al., 1996; Pentz et al.,
Family Domain 1989; Walter, Vaughn, & Wynder,
Family domain risk factors include 1989).
parental and sibling drug use or approval F-2. Retaining parents in family-based
of use, inconsistent or poor family man- programs can also be difficult
agement practices—including lack of (Botvin et al., 1995; Dent et al.,
supervision, lack of parental involvement 1995). Helping to develop bonds
in children’s lives, family conflict, sexual among parents in a program
or physical abuse, economic instability, (Cohen & Linton, 1995; Creating
and lack of attachment to parents, often Lasting Family Connections, 1998;
called low family bonding (Hawkins & Resnik & Wojcicki, 1991); provid-
Catalano, 1992). For immigrant families, ing meals, transportation, and
problems adapting to the mainstream cul- small gifts; sponsoring family out-
8 Principles of Substance Abuse Preventionings; and ensuring that programs
are culturally sensitive can help to Interactive Techniques Help
improve retention (Kumpfer & Promote Family Communication
Alvarado, 1995).
Creating Lasting Connections’
F-3. Interventions that help minority Getting Real training for parents,
families respond to cultural and youth, and families emphasizes role-
racial issues can produce positive playing to help participants identify the
effects. Issues include the role of responses they use most in talking with
the extended family, influence of family members, improve their ability
immigration or circular migration, to express feelings and ideas clearly,
different language abilities within and establish new patterns of interac-
families, influence of religion and tions to enrich family relationships.
folk healers, influence of volun- Because adults and children respond
tary and social organizations, and differently to interactive techniques
stresses experienced by families as such as role-play, the program trains
a result of socioeconomic status parents and youth separately. It is also
and racism (Kumpfer & Alvarado, careful to limit the age range with
1995; Kumpfer et al., 1997; youth to a three-year span (e.g., ages 9
Szapocznik et al., 1997). to 11) and frequently separates groups
■ Family strategies that are effective by gender. Careful implementation
include the following: ensures that activities occur in a safe
F-4. Focus on developing parenting place, a condition important for suc-
skills rather than simply offering cessful interactive interventions
information about parenting (Bry (Brounstein & Zweig, 1996; Creating
& Canby, 1986; Kumpfer et al., Lasting Family Connections, 1998;
1996; Szapocznik et al., 1988). Johnson et al., 1996).
F-5. Emphasize family bonding
F-8. Train parents to use positive and
through opportunities for joint
consistent discipline techniques
parent-child participation in
and to monitor and supervise their
activities (Dishion & McMahon,
children (DeMarsh & Kumpfer,
1998; Szapocznik et al., 1988).
1986).
F-6. Offer sessions in which parents
F-9. Interactive techniques, including
and youth learn and practice
modeling, coaching, rehearsal,
skills both separately and togeth-
and role-playing, can help to pro-
er (Brounstein et al., 1996;
mote the development of new
DeMarsh & Kumpfer, 1986;
skills in programs aimed at
Dishion & McMahon, 1998;
improving family communication
Kumpfer & Baxley, 1997).
(Dishion & McMahon, 1998;
F-7. Train parents to both listen and Patterson & Chamberlain, 1994;
interact in developmentally Szapocznik et al., 1988; Webster-
appropriate ways with their chil- Stratton & Herbert, 1993).
dren (Brounstein & Zweig, 1996;
Kumpfer et al., 1997).
9Guide to Science-Based Practices
F-10. Recruiting parents for family- Peer Domain
based prevention programs can be
The principal risk factors associated with
difficult. Incentives that can help
the peer domain are peer use, peer norms
overcome resistance include pro-
favorable toward use, and peer activities
viding transportation and child
conducive to use. Research has shown
care, offering rewards for partici-
the following:
pation such as cash payments,
P-1. Structured alternative activities
and scheduling programs at times
and supervised alternative events
most convenient for parents
(e.g., sober prom and graduation
(Kumpfer & Alvarado, 1995).
parties) can offer peers an oppor-
F-11. With intensive support (at least 12
tunity for social interaction in set-
to 15 sessions of counseling and
tings antithetical to substance use
skills-building), substance-abusing
(CSAP, 1996; Williams & Perry,
parents can improve their parent-
1998).
ing skills and as a result improve
P-2. Alternative activities that incorpo-
their children’s behavior and
rate social and personal skills-
reduce both their own and their
building opportunities can be
children’s levels of substance use
effective with youth in high-risk
(Bry, 1994; Kumpfer et al., 1996;
environments who may not have
Olds, 1997).
adequate adult supervision or
F-12. For families of juvenile offenders,
access to a variety of activities, or
family therapy can improve family
who may have few opportunities
functioning, increase family skills,
to develop the kinds of personal
and reduce recidivism (DeMarsh
skills needed to avoid behavioral
& Kumpfer, 1986; Kumpfer et al.,
problems (Tobler, 1986).
1996).
P-3. Effective alternative programs tend
F-13. Since schools in some communi-
to be intensive and include both a
ties may not be highly regarded or
variety of approaches and a sub-
accessible during nonschool
stantial commitment of time on
hours, exploring alternative com-
the part of their participants
munity sponsors and sites such as
(Schaps, DiBartolo, Moskowitz,
churches and community recre-
Palley, & Churgin, 1981; Shaw,
ation centers can enhance partici-
Rosati, Salzman, Coles, &
pation in family-focused
McGeary, 1997; Tobler, 1986).
interventions (Johnson et al.,
P-4. Alternative events can communi-
1996; Kumpfer et al., 1996).
cate peer norms against use of
F-14. Videotaped training and education
alcohol and illicit drugs and can
can be an effective and cost-effi-
serve as community statements in
cient tool to teach parenting skills
support of no-use norms (CSAP,
(Webster-Stratton, 1990; Webster-
1996; Rohrbach, Johnson,
Stratton & Herbert, 1993).
Mansergh, Fishkin, & Neumann,
1997).
10 Principles of Substance Abuse Preventionschool climate, and lenient school poli-
Exercise Caution When Grouping cies with regard to the use of some sub-
Very High-Risk Youth stances (e.g., tobacco). Many researchers
believe that student-based risk factors
Experience with the peer compo-
develop or become more pronounced
nent of the highly regarded Adolescent
when students are unable to experience
Transitions Program (ATP) suggests
some satisfaction from their academic
some caution in applying peer-oriented
efforts. For this reason, academic skills-
principles. ATP found that when very
building has become an important com-
high-risk youth are grouped together,
ponent of many after-school, alternative
even for a supervised intervention, a
activities (CSAP, 1996; LoSciuto, Rajala,
contagion effect can occur and prob-
Townsend, & Taylor, 1996; Tierney,
lem behaviors can increase. More
Grossman, & Resch, 1995). In much the
mixed or heterogeneous environments
same way, lack of attachment to school
may be needed to counter the impact
may relate to students’inability to set
of deviant norms and behavior
future-oriented goals, particularly those
(Dishion et al., 1996; Dishion &
that depend on education for their
McMahon, 1998).
achievement. Mentoring programs have
P-5. Involving youth in the develop- been designed, in part, to respond to that
ment of alternative programs can problem (CSAP, 1996; LoSciuto et al.,
increase the appeal of the activi- 1996).
ties offered and enhance partici- School climate is another factor con-
pation (Armstrong, 1992; Komro tributing to the lack of attachment to
et al., 1996). school. Together, teachers’ instructional
methods, classroom management tech-
P-6. Peer-led interventions or interven-
niques, class size, student-teacher ratios,
tions with peer-led components
classroom organization, and educators’
can be more effective than adult-
attitudes toward students affect the cli-
led approaches (Komro et al.,
mate in a particular school (Battistich,
1996; Tobler, 1986, 1992).
Schaps, Watson, & Solomon, 1996; Felner
P-7. Placing peers whose behavior is
et al., 1993; Flay, 1987). Drug testing and
deviant into the same group can
the use of drug-sniffing dogs are other
be problematic. More heteroge-
practices employed by some schools.
neous environments may be need-
However, those approaches have not yet
ed to counter the effects of
been extensively evaluated to determine
deviant norms and behavior
effectiveness in countering risk factors or
(Dishion et al., 1996; Dishion &
reducing levels of substance use at school
McMahon, 1998).
(Paglia & Room, 1998).
Research has found the following:
School Domain
S-1. When used alone, knowledge-ori-
The risk factors associated with the school ented interventions designed to
domain include lack of commitment to supply information about the neg-
education, poor grades or school failure, ative consequences of substance
lack of attachment to school, negative use do not produce measurable
11Guide to Science-Based Practices
and long-lasting changes in sub- S-4. Interactive approaches, such as
stance use-related behavior or cooperative learning, role-plays,
attitudes and are considered and group exercises that give stu-
among the least effective educa- dents opportunities to practice
tional strategies (Tobler, 1986). newly acquired skills (and that are
S-2. While interventions to correct characteristic of social skills and
misconceptions about the preva- peer-led interventions), help to
lence of use can change attitudes engage and retain youth in pre-
favorable toward use (Errecart et vention education programs
al., 1991; Hansen & Graham, (Botvin et al., 1994, 1995;
1991), they are most effective in Brounstein & Zweig, 1996; Komro
reducing substance use when et al., 1996; Walter et al., 1989;
combined with other educational Williams & Perry, 1998).
approaches such as fostering S-5. Booster sessions help youth retain
social skills (Shope, Kloska, skills learned in prevention educa-
Dielman, & Maharg, 1994). tion programs over time (Botvin et
S-3. Interventions for youth that are al., 1994, 1995).
peer led or include peer-led com- S-6. School-based approaches that also
ponents are more effective than involve parents can be effective in
adult- or teacher-led approaches preventing adolescent substance
(St. Pierre, Kaltreider, Mark, & use (Dent et al., 1995; Dishion et
Aitkin, 1992; Tobler, 1986, 1992). al., 1996; Kumpfer et al., 1996;
Pentz et al., 1989; Walter et al.,
1989).
Involving Parents in School-Based
Programs Fosters Effectiveness S-7. School policies that communicate
a commitment to substance abuse
The Child Development Project’ s prevention include formal no-use
Homeside Activities give parents a policies for students, teachers,
window into what their children are administrators, and other staff;
learning in school. This innovative training for teachers and adminis-
intervention introduces activities in the trators; and a health education
classroom that students complete at program based on validated prin-
home with parents and then incorpo- ciples (Paglia & Room, 1998).
rate into a follow-up classroom activity
or discussion. Parents are also con- Community Domain
nected to the school through Family
Community domain risk factors include
Read-Aloud and other activities
lack of bonding or attachment to social
designed to create an inclusive school
and community institutions, lack of com-
environment that, in turn, helps to pre-
munity awareness or acknowledgment of
vent or delay substance abuse and oth-
substance use problems, community
er problem behaviors (e.g., involvement
norms favorable to use and tolerant of
in gangs, carrying weapons) among
abuse, insufficient community resources
young people (Battistich et al., 1996).
to support prevention efforts, and inability
12 Principles of Substance Abuse Preventionto address the problem of substance Skogan, 1991; Eck & Wartell, in
abuse. Community institutions such as press; Gruenewald, Ponicki, &
churches, Boys and Girls Clubs, YMCA Holder, 1993).
and YWCA, and Boy and Girl Scouts C-3. Mentoring programs that provide
often provide individuals with opportuni- structured time with adults can
ties to develop personal capacities and increase school attendance and
interact with prosocial peers in construc- positive attitudes toward others,
tive endeavors (Brounstein & Zweig, the future, and school and can
1996; CSAP, 1996; St. Pierre et al., 1992; reduce substance use (Brounstein
Tierney et al., 1995). Workplaces within & Zweig, 1996; CSAP, 1996;
the community, media, and community LoSciuto et al., 1996).
coalitions are other vehicles for address- C-4. Community service can increase
ing and reducing community domain risk positive attitudes toward others,
factors. Specifically, research has found the future, and the community
the following: and can provide youth with
C-1. One-time community-based sub- opportunities to give back to their
stance abuse prevention and edu- community (Brounstein et al.,
cation events alone are unlikely to 1996; CSAP, 1996; LoSciuto et al.,
affect participants’behavior, but 1996).
they can be effective as part of an C-5. Highly involved mentors usually
integrated, comprehensive pre- achieve greater positive results
vention strategy. In that context, than those who are less commit-
such events show that a commu- ted (Brounstein et al., 1996;
nity supports no-use norms, draw LoSciuto et al., 1996).
public and media attention to sub-
C-6. Emphasizing the costs to employ-
stance use issues, and help
ers of workers’substance use and
increase awareness and support
abuse can encourage companies
for other important prevention
to become more active in preven-
efforts (Paglia & Room, 1998;
tion efforts. Costs include lost pro-
CSAP, 1996).
ductivity and increased health
C-2. Controlling the environment care premiums to cover sub-
around schools and other areas stance-abusing employees and
where youth gather helps to rein- their dependents (Cook, Back, &
force strong community norms Trudeau, 1996; Frankish, Johnson,
against substance use. Controls Ratner, & Lovato, 1997).
include restrictions on the number
C7. Communicating a clear company
of alcohol and tobacco outlets,
policy on substance abuse can
required setbacks for alcohol and
help change workplace norms
tobacco outlets, restrictions on
about substance use and abuse
advertising near schools including
(Ames & Janes, 1987; Cook et al.,
billboards, and the designation of
1996).
drug-free zones that set standards
for adult as well as youth behav-
ior (Davis, Smith, Lurigio, &
13Guide to Science-Based Practices
C-8. Community coalitions that work
Mentoring Can Increase Positive include representatives from every
Attitudes and Reduce Substance organization that plays a role in
Use fulfilling coalition objectives. For
example, if comprehensive service
Across Ages: An Intergenerational
coordination is the objective,
Approach to Drug Prevention careful-
community agency leadership
ly matches adult mentors, ages 55 and
needs to be involved (Christenson,
over, to sixth-grade African American,
Fendley, & Robinson, 1989;
Asian, Latino, and white students in
Edelman & Springer, 1995;
three Philadelphia middle schools.
Warren, Rodgers, & Evers, 1975).
Recognizing the importance of conti-
If the objective is raising commu-
nuity, Across Ages encouraged mentor-
nity awareness and stimulating
ing relationships that encompassed
community action, grassroots
parents and teachers as well as stu-
activists and community citizens
dents and extended past the school
must be involved (Chavis &
year and throughout the summer.
Florin, 1990; CSAP, 1997a,
Across Ages’ multidimensional
1997b; Warren et al., 1975).
approach to mentoring brought com-
Community linkage coalition
munity residents into the schools and
models require a mix of both
improved school attendance. Students
types of community members
with deeply committed mentors
(CSAP, 1997b).
changed their attitudes toward older
C-9. Effective coalitions retain active
people, school, and the future and
members by providing meaningful
developed increased capacity to resist
rewards for participation such as
peer pressure to use drugs (Brounstein
opportunities for organizational
& Zweig, 1996; CSAP, 1996; Johnson
leadership, distribution of
et al., 1996; LoSciuto et al., 1996).
resources to home agencies, and
accomplishment of highly valued
personal, organizational, and
community goals (Join Together,
1996; Nistler, 1996).
C-10. Effective coalitions define specific
goals and assign specific responsi-
bility for their achievement to sub-
committees and task forces, rather
than spending time on elaborating
organizational structures and pro-
cedures (Christenson, 1989; Join
Together, 1996; Rohrbach et al.,
1997).
C-11. Planning is critical to coalition
effectiveness and begins with a
clear understanding, drawn from
14 Principles of Substance Abuse Preventionvalidated empirical evidence, of based perspective and make
the substance-related problems it adjustments to the plan of action
seeks to change (Armstrong, 1992; to meet their goals. Success is a
Gabriel, 1997; Join Together, function of strategies and activi-
1996; Reynolds & Fisher, 1997). ties, not a reflection of a coali-
C-12. Effective coalitions set outcome- tion’s organizational structure or
based objectives that are used to design (CSAP, 1997b, 2000;
develop specific strategies and Forster et al., 1992; Gabriel,
subsequent activities (Forster, 1997; Join Together, 1996; Keay,
Hourigan, & McGovern, 1992; Woodruff, Wildey, & Kenney,
Join Together, 1996; Reynolds, 1993).
Stewart, & Fisher, 1997). C-16. Paid coalition staff can function
C-13. Effective coalitions support a large more effectively as resource
number of prevention activities, providers (such as communica-
rather than focusing on a single tions, coordination, and adminis-
project (CSAP, 2000). trative expertise) and facilitators
C-14. Residents are more likely to par- than as direct community organiz-
ticipate in community partnership ers (Join Together, 1996). It is
activities if they are organized at important for paid staff members
the neighborhood level, where to serve as catalysts for action and
volunteers can see how they will ensure that community partici-
affect their own situations (CSAP, pants receive credit for program
2000). success (CSAP, 2000).
C-15. Effective coalitions routinely
assess progress from an outcome-
Society/Environmental Domain
Risk factors in the society/environmental
domain include norms tolerant of use and
Planning Is Essential to Coalition abuse, policies enabling use and abuse,
Effectiveness lack of enforcement of laws designed to
prevent use and abuse, and inappropriate
The Day One Community
negative sanctions for use and abuse.
Partnership devised the Alcohol
Since long-lasting effects should
Sensitive Information Planning System
accrue from changing school, family, and
(ASIPS) to assess the extent to which
societal norms that promote and maintain
local criminal activity was alcohol
drug abuse in youth, many prevention
related and to provide a foundation for
specialists are trying to incorporate a
community planning activities. As one
focus on both individual change and
outgrowth of this assessment effort,
changes in the systems or environmental
Day One was able to marshal the data
contexts that promote or hinder use. This
needed to convince the city to use city
expansion will have a positive impact on
zoning to regulate retail availability of
larger numbers of people than has our
alcohol and tobacco and to conduct a
reliance on more individually targeted
decoy purchase program (Rohrbach et
programs that focus more on persons with
al., 1997).
a greater likelihood of becoming problem
15Guide to Science-Based Practices
Figure 2
Program Targets and Potential Impacts
abusers. The impact of this environmental also recognize that audience per-
focus on society as a whole may be sub- ceptions and capacities to under-
stantial, and societal/environmental sys- stand media messages may vary
tems change efforts may form an based on gender, culture, and
important first line of defense in fighting stage of cognitive development
the spread of substance abuse. (Figure 2) (Flynn et al., 1992, 1997).
Research has found the following: S/E-3. Effective mass media campaigns
S/E-1. Community awareness and media set objectives for each message
efforts can be effective tools for delivered; for example, to
increasing perceptions regarding increase positive expectations for
the likelihood of apprehension nonuse or to correct assumptions
and punishment for substance- about the number of youth who
related violations and can reduce use (Flynn et al., 1997).
retailer noncompliance (Lewit, S/E-4. Youth-oriented mass media cam-
Coate, & Grossman, 1981; paigns that are effective with
Schneider, Klein, & Murphy, youth in high-risk environments
1981). avoid the use of authority figures.
S/E-2. Appropriate use of mass media Instead, they use young models
can enhance community aware- who appeal to the target group
ness and influence community (Flynn et al., 1992).
norms about substance use (Paglia S/E-5. Effective campaigns broadcast
& Room, 1998). Effective, youth- messages frequently over an
oriented mass media campaigns extended period of time. For
identify target audiences. They example, an effective media cam-
16 Principles of Substance Abuse PreventionGrossman, 1996; Flynn et al.,
Changing the Community 1992; Wallack & DeJong, 1995).
Environment Can Reduce S/E-8. The limited research on alcohol
Underage Use of Alcohol warning labels suggests that while
they may affect awareness, atti-
Responsible beverage-server train-
tudes, and intentions regarding
ing for retail outlets and bars and com-
drinking, they do not appear to
pliance checks of age-of-purchase laws
have a major influence on behav-
(coordinated with local police depart-
ior (Barlow & Wogalter, 1993;
ments and sheriffs’offices) were among
Hilton, 1993; Laughery, Young,
the many integrated components of
Vaubel, & Brelsford, 1993).
Project Northland, the largest random-
Studies have suggested that more
ized community trial ever conducted
conspicuous labels would have a
for the prevention of adolescent alco-
greater effect on awareness and
hol use. Project Northland confirms the
behavior (Laughery et al., 1993;
importance of applying long-term envi-
Malouff, Schutte, Wiener,
ronmental interventions as well as
Brancazio, & Fish, 1993).
interventions oriented to individuals to
reduce underage alcohol use. It also S/E-9. Restrictions on tobacco use in
showed that it is possible to mobilize public places and private work-
community support for norms reinforc- places (also known as clean
ing the unacceptability of underage use indoor air laws) can be effective
(Williams & Perry, 1998). in curtailing cigarette sales
(Chaloupka & Saffer, 1992) and
paign in Vermont aired 540 televi- tobacco use among adults and
sion broadcasts of 36 different youth (Chaloupka, 1992;
spots and 350 radio broadcasts of Chaloupka & Pacula, 1997;
17 different spots per year over Evans, Farrelly, & Montgomery,
four years (Flynn et al., 1997). 1996; Ohsfeldt, Boyle, &
Capilouto, 1999; Wasserman,
S/E-6. Mass media messages that are
Manning, Newhouse, & Winkler,
effective are broadcast through
1991).
multiple channels at times when
members of the target audience S/E-10. Clean indoor air laws can reduce
are likely to be viewing or listen- nonsmokers’exposure to cigarette
ing (Flynn et al., 1992, 1997). smoke and help to alter norms
regarding the social acceptability
S/E-7. Counteradvertising campaigns that
of smoking (DHHS, 1994).
disseminate information about the
hazards of a product or the indus- S/E-11. Education and training programs
try that promotes it may help teach beverage servers about
reduce cigarette sales (Chaloupka alcohol-related laws, the penalties
& Grossman, 1996; Flay, 1987; for violation, the signs of intoxica-
Flynn et al., 1992) and tobacco tion and false identification, and
consumption (Chaloupka & techniques for refusing sales.
However, when used alone, these
programs usually do not produce
17Guide to Science-Based Practices
substantial and sustained shifts Wagenaar, 1991; Wagenaar,
toward compliance with the law 1993), particularly beer consump-
(Altman, Rasenick-Douss, Foster, tion (Berger & Snortum, 1985),
& Tye, 1991; DiFranza & Brown, and in reducing alcohol-related
1992; DiFranza, Savageau, & traffic crashes (General
Aisquith, 1996; Skretny, Accounting Office, 1987;
Cummings, Sciandra, & Marshall, National Highway Traffic Safety
1990). Administration, 1995; Safer &
S/E-11. Combining beverage-server train- Grossman, 1987; Toomey,
ing with enforcement of laws Rosenfeld, & Wagenaar, 1996;
against service to intoxicated Wagenaar, 1993).
patrons and against sales to S/E-14. Increasing the minimum purchase
minors is much more effective age for alcohol to age 21 is asso-
than training alone in changing ciated with reductions in other
selling and serving principles alcohol-related problems, includ-
(Cummings & Coogan, 1992; ing suicide, pedestrian injuries,
Feighery, Altman, & Saffer, 1991). other unintentional injuries (Jones,
S/E-12. Increasing beverage servers’legal Pieper, & Robertson, 1992), and
liability for alcohol-related crashes youth homicide (Parker &
can reduce injuries and fatalities Rebhun, 1995).
(Wagenaar & Holder, 1991). S/E-15. Limitations on the location and
S/E-13. Increasing the price of alcohol density of retail alcohol outlets
and tobacco through excise taxes may contribute to reductions in
can be an effective strategy for
reducing the prevalence of use
and the amount consumed Neighborhood Antidrug Strategies
(Chaloupka & Grossman, 1996; Can Disrupt Illicit Drug Markets
DHHS, 1989, 1992; Edwards et and Reduce Alcohol and Tobacco
al., 1994; Evans et al., 1996). Sales to Minors
S/E-13. Price increases can reduce alco-
The Community Coalition for
hol-related problems, including
Substance Abuse Prevention and
motor vehicle fatalities (Cook,
Treatment in South Central Los
1981), driving while intoxicated,
Angeles fought successfully to control
rapes, robberies (Cook, 1981;
the rebuilding of liquor stores in neigh-
Cook & Moore, 1993; Cook &
borhoods scarred by civil unrest. Its
Tauchen, 1984), cirrhosis mortali-
Neighborhoods Fighting Back project
ty (Cook & Tauchen, 1982), and
also forced absentee landlords to
suicide and cancer death rates
board up an abandoned house used
(Sloan, Reilly, & Schenzler, 1994).
for cocaine trafficking. Other partner-
S/E-14. Increasing the minimum purchase ship efforts led to a new ordinance that
age for alcohol to age 21 has levies financial penalties on those sell-
been effective in decreasing alco- ing tobacco to underage youth (CSAP,
hol use among youth (O’Malley & 2000).
18 Principles of Substance Abuse Preventionalcohol consumption feedback to merchants can also
(Gruenewald, 1993), traffic crash- increase retailer compliance
es (Gruenewald & Ponicki, (Biglan et al., 1995; Lewis,
1995b; Scribner, MacKinnon, & Huebner, & Yarborough, 1996).
Dwyer, 1995), and other alcohol- S/E-19. More frequent enforcement opera-
related problems, including cir- tions can reduce retailer noncom-
rhosis mortality (Gruenewald & pliance (Lewis et al., 1996;
Ponicki, 1995a), suicide Preusser et al., 1994).
(Gruenewald, Ponicki, & Mitchell, S/E-20. “Use and lose” laws, which
1995), and assaultive offenses allow suspension of the driver’s
(Scribner et al., 1995). license of a person under age 21
S/E-16. Neighborhood antidrug strategies following a conviction for any
such as citizen surveillance and alcohol or drug violation (e.g.,
the use of civil remedies, particu- use, possession, or attempt to pur-
larly nuisance abatement pro- chase with or without false identi-
grams, can be effective in fication), can increase compliance
dispersing dealers, reducing the with minimum purchase-age laws
number and density of illicit drug among youth (Preusser, Ulmer, &
markets, and possibly reducing Preusser, 1992).
other crimes and signs of physical S/E-21. Deterrence laws and policies for
disorder within small geographical impaired driving can reduce the
areas (Davis et al., 1991; Eck & number of alcohol-related traffic
Wartell, 1998; Green-Mazarolle, crashes and fatalities among the
Roehl, & Kadleck, in press; general population and particular-
Lurigio et al., 1993; Rosenbaum & ly among youth. Reducing the
Lavrakas, 1993; Smith, Davis, legal blood-alcohol content (BAC)
Hillenbrand, & Goretsky, 1992). limit to 0.08 or lower can reduce
S/E-17. Enforcement of minimum pur- the level of impaired driving
chase-age laws against selling (Kloeden & McLean, 1994) and
alcohol and tobacco to minors by alcohol-related crashes (Hingson,
using undercover buying opera- Heeren, & Winter, 1994; Johnson,
tions (also known as decoy or 1995).
sting operations) can substantially S/E-22. Enforcement of impaired driving
increase the proportion of retailers laws can increase public percep-
who comply with such laws tion of the risk of being caught
(Cummings & Coogan, 1992; and punished for driving under
Feighery et al., 1991; Forster et the influence of alcohol (Voas,
al., 1998; Jason, Billows, Schnop- Holder, & Gruenewald, 1997).
Wyatt, & King, 1996; Jason, Ji,
S/E-23. Used alone, sobriety checkpoints
Anes, & Birkhead, 1991; Preusser,
are not effective in detecting large
Williams, & Weinstein, 1994).
numbers of drinking drivers
S/E-18. Undercover buying operations (Ferguson, Wells, & Lund, 1995;
conducted by community groups Jones & Lund, 1985).
that provide positive and negative
19Guide to Science-Based Practices
S/E-23. Combining sobriety checkpoints Heeren, Howland, & Winter,
with passive breath sensors that 1993; National Transportation
allow police officers to test a dri- Safety Board, 1993; Sweedler,
ver’s breath without probable 1990).
cause can substantially increase
the effectiveness of sobriety Additional Resources
checkpoints (Ferguson et al.,
CSAP has developed a series of products
1995; Jones & Lund, 1985).
to assist program planners, evaluators,
S/E-24. Administrative license revocation administrators, and policy makers in
for impaired driving, which allows designing and assessing scientifically
an arresting officer to confiscate a defensible programs. In addition to this
driver’s license if the driver is publication, Principles of Substance
arrested with an illegal BAC or if Abuse Prevention: A Domain-Based
the driver refuses to be tested, can Approach, products include the
reduce the number of fatal traffic following:
crashes (Hingson, 1993; Klein,
■ Defining Science-Based Substance
1989; Ross & Gilliland, 1991;
Abuse Prevention: An Evaluators’
Zador, Lund, Fields, & Weinberg,
Guide, a technical description of the
1989) and also reduces recidivism
CSAP methodology for identifying sci-
among driving-under-the-influ-
entifically defensible programs.
ence (DUI) offenders (Stewart,
■ Promising and Proven Substance Abuse
Gruenewald, & Roth, 1989).
Prevention Programs, a comprehensive
S/E-25. Immobilizing or impounding the
compilation of both proven and promis-
vehicles of those who have been
ing interventions in an easy-to-scan grid
convicted of an impaired-driving
organized by risk factor and domain
offense can significantly reduce
that also includes information on target
DUI recidivism rates for multiple
age, Institute of Medicine (IOM) preven-
DUI offenders (Voas, Tippetts, &
tion classification, program outcome,
Taylor, 1997, 1998). Deterrence
and CSAP strategy.
effects from marking license plates
CSAP also maintains a Web site and
of DUI offenders have been mixed
publishes materials to help prevention
(Voas, Tippetts, & Lange, 1997).
practitioners replicate proven model pro-
S/E-26. Impaired-driving policies targeting
grams. The Web site includes download-
underage drivers—particularly
able versions of Promising and Proven
zero-tolerance laws setting BAC
Substance Abuse Prevention Programs,
limits at 0.00 to 0.02 percent for
one of the publications described above.
youth and graduated driving privi-
It also provides the most up-to-date infor-
leges, in which a variety of dri-
mation available about CSAP’s model
ving restrictions are gradually
programs for replication.
lifted as the driver gains experi-
■ The Web site for CSAP model pro-
ence and maturity—can signifi-
grams is www.samhsa.gov/csap/model-
cantly reduce traffic deaths among
programs.
young people (Blomberg, 1993;
Hingson et al., 1994; Hingson,
20 Principles of Substance Abuse PreventionYou can also read
