The Science of Prevention

Substance abuse prevention seems like a simple idea. You prevent substance abuse. Of course I was taught in third grade never to define something using the same word (i.e. prevention is preventing something) because it doesn't add to the conversation and doesn't help us understand what that word really means. So, what does substance abuse prevention really mean? What are we trying to prevent?

The most obvious answer is that we are trying to prevent first use of a chemical substance. In fact, that's a great goal. But then does that mean we forget about the kids that have already tried something? And why do we care about preventing some 14 year old kid from trying beer or marijuana? After all you might say, "I did that and I turned out just fine."

The answer to why we want to keep that young person away from alcohol and other drugs is simple. We now know that children who try or use alcohol, tobacco, or marijuana before the age of 21 increase their chances of becoming addicted by many times over compared to the young person that we hold off from trying anything before he or she turns 21. In fact, people that don't try any alcohol or drug before age 21 rarely become addicted.

That doesn't solve the problem, though, because chemical addiction is a very complex issue and has many, many causes. Only one of those causes and contributing factors is an early initiation to use of an addictive substance. But it is key to emphasize, especially in a place like Nevada, that early drinking, smoking, or drug use is not a rite of passage and not a prerequisite for growing up properly.

Consider this: When JTNN compared the information provided by middle and high school students in school based surveys in 2005 we found that over 30% of 17 year olds that tried alcohol at age 8 or less had tried methamphetamine by the time they were 17. Those who tried alcohol at older ages had less involvement with methamphetamine. The numbers double for those who tried marijuana by age 8 with over 61% who did so also using meth by the time they were 17. This alone is huge in that much of our prevention efforts need to be spent in helping young children learn the value of and make the decision not to try even the so called "gateway" drugs of alcohol, tobacco, and marijuana.

But there's more. This doesn't mean that a child who has tried something is destined to a life of addiction. Our prevention efforts should still be geared to help that child make healthy decisions and to help him or her decide not to use again. We may even need to offer some of our youth strong education, sanctions, and even treatment, when the situation calls for it.

What are we trying to prevent? I think the picture is clear that we need to work toward preventing the decision to use a chemical substance. But we also need to help those who have started to make a decision to stop. The real prevention item here can be stated in a more positive way which is that we want to help youth make the best decisions that will ensure a life that is not impacted or destroyed by chemical substances.