Health and life concepts

Adolescent Substance Abuse

Alcohol is the drug of choice among adolescents in the United States. Rates of use are more than double those of cigarette smoking. Because alcohol use is so prevalent, it is more resistant to change than the use of marijuana or other illegal drugs, which are used by adolescents with far less frequency than alcohol (Stigler, Neusel, and Perry, 2011, p. 160).

Schools can play an important role in interventions aimed at preventing alcohol use and abuse by adolescents. As demonstrated in a 2006 report by the Surgeon General, alcohol use typically begins during adolescence (Stigler, et al., p. 157). Schools are an essential component of prevention programs because of their mission to educate and their status as the community institution with the greatest continuous and intensive contact with underage youth. Several school-based programs are discussed. Evidence-based examples show where further research is needed.

The Drug Abuse Resistance Education (DARE) program is widely used in the United States. Studies have consistently shown that it has little if any impact on alcohol and drug use (Ennett et al., 1994, cited in Stigler, p. 160). A modified program, DARE Plus, has been successful in reducing tobacco and alcohol use among boys, probably because of the "plus" components such as peer leadership, parental education and neighborhood involvement.

Stigler et al. studied the efficacy of alcohol use and abuse prevention programs by examining data collected at least six months after implementation. They looked across three developmental periods, including under ten years of age, between ten and fifteen years of age, and age sixteen and older. Although the most successful programs were either school-based exclusively or included a large school-based component, the researchers found that making the intervention a school-based program was not automatically a guarantee of success. The researchers identified nine elements essential to the effective development and implementation of school-based alcohol prevention interventions.

The first element focuses on the social-influences model, which emphasizes helping students identify and resist social influences such as peers and media. Second, successful interventions address social norms around alcohol use. Third, successful interventions build personal and social skills that help students resist pressure to drink. Fourth, small-group activities and role plays are used to engage students and give them the opportunity to practice saying and doing the right things. Fifth, peer leaders help deliver the intervention programs, making them more relevant and engaging for students. Sixth, successful interventions integrate other segments of the community. These can include parents, community leaders, and others whom students respect. Seventh, successful interventions are not "one-off" programs, but continued over multiple sessions and multiple years to ensure students keep hearing the message. Eighth, successful programs provide training and support to facilitators. Finally, the interventions that are most successful are those which are culturally and developmentally appropriate for the students they serve.