Prevention of Adolescent and Young Adult Alcohol and Drug Problems
- LAST REVIEWED: 24 July 2013
- LAST MODIFIED: 24 July 2013
- DOI: 10.1093/obo/9780195389678-0199
- LAST REVIEWED: 24 July 2013
- LAST MODIFIED: 24 July 2013
- DOI: 10.1093/obo/9780195389678-0199
Introduction
Prevention is an important element in the continuum of care for adolescent substance abuse. Therefore, significant time has been spent developing and implementing various prevention programs, as well as monitoring their effectiveness. Most programs are targeted at children and adolescents, as this is the time of life when most people initiate use of alcohol and other drugs. Readily understood is the fact that there is no need to treat something that has never occurred. However, examining the prevalence of use can help frame the urgency for these strategies. Each year, numerous studies are conducted in order to determine the prevalence of substance use across the United States. Each of these studies attempts to determine trends in drug use, and each helps identify specific prevention targets, particularly in adolescents. It has long been recognized that research on age of initiation (i.e., at first use) has shown that later onset can help lessen substance-related consequences. Students who had their first use of alcohol in high school or college typically have substantially lower alcohol/drug-related problems than those who began using earlier, such as in middle school or elementary school. Many in the substance abuse treatment field maintain that this is due to the fact that once an adolescent experiences substance use as a coping mechanism, other important social and problem solving skills are either not learned or fall by the wayside. Although there is agreement about the importance of delaying onset of first use, there is no consensus on the best strategy for prevention. However, there is agreement that the most successful prevention interventions have certain elements, including the following: current, evidence-based information (while this alone is clearly not enough); affect regulation skills; drug/alcohol resistance skills; social skills; and culturally grounded modes of delivery. Universal prevention interventions aimed at preventing initial use in younger children are one mode of prevention. Selective or indicated prevention interventions are designed to target at-risk groups. Many prevention interventions are now recognizing that abstinence models are problematic, particularly among older adolescents and emerging adults. Therefore, stage of change, recovery communities, and harm reduction models have taken their place in the prevention arena.
General Overviews
One cannot engage in prevention interventions without having a full understanding of substance use and abuse as it occurs in adolescence. The following texts give a broad and solid foundation on which programs can be built, clinical skills can be developed, and prevention interventions can be made effective. Abadinsky 2008, Doweiko 2012, and Dziegielewski 2005 provide general overviews. Fisher and Harrison 2000 have overview information directed specifically at counselors. Hilarski 2005 and Springer and Rubin 2009 focus in on assessment and treatment of addictions, while Straussner 2006 is frames as clinical work with addiction clients. Kelley 2006 looks through the lens of societal crime and related policies.
Abadinsky, H. 2008. Drug use and abuse: A comprehensive introduction. 6th ed. Belmont, CA: Thomson/Wadsworth.
This text provides overviews of drug legislation, history, physiology, drug effects, sociology, and psychology. It has brief chapters on treatment and prevention. It has several concluding chapters on the business of drugs, trafficking, law enforcement, policy, and possibilities of decriminalization/harm reduction. It is written specifically for course-work, with definitions, summaries, and review questions. It does not target clinicians and professionals.
Doweiko, H. E. 2012. Concepts of chemical dependency. 8th ed. Belmont, CA: Brooks/Cole.
This text has a detailed examination of substance use disorders, with an emphasis on the continuum of chemical use. It is a logical text, with questions and answers arising from previously noted information. It has several chapters on issues overlooked in other general texts, such as substance disorders and college students, infectious diseases, gender issues, and pharmacological interventions.
Dziegielewski, S. F. 2005. Understanding substance addictions: Assessment and intervention. Chicago: Lyceum.
This is not a prevention book, per se. However, it outlines (1) a substance-specific review of the various drugs and their impact (e.g., amphetamines, cocaine, caffeine, nicotine, alcohol, heroine, prescription drugs, cannabis, hallucinogens, and inhalants) and (2) such important issues as assessment, polysubstance disorders, and dual diagnoses. The book includes illustrative case histories.
Fisher, G. L., and T. C. Harrison. 2000. Substance abuse: Information for school counselors, social workers, therapists, and counselors. 2d ed. Boston: Allyn & Bacon.
This transdisciplinary overview of substance abuse for counselors speaks to drug classification, models of addiction, cultural groups, assessment, diagnosis, intervention (including the Johnson model of formal intervention, rare in many texts), treatment, twelve step and support groups, families of addiction, relapse prevention, HIV/AIDS, other addictions, prevention, and ethical issues. It has practical utility more than a scientific focus.
Hilarski, C. 2005. Addiction, assessment, and treatment with adolescents, adults, and families. Binghamton, NY: Haworth.
This book addresses some of the more recent evidence-based practices, including contingency management, motivational interviewing, non-abstinence-based treatments, couples and family therapy, and other relevant interventions. It is a compilation of articles about very interesting topics, including substance abuse counselor confrontations, twelve-step programs and faith-based recovery, potential iatrogenic effects in group treatment, screening and assessment instruments, and incarcerated juvenile offenders.
Kelley, M. S. 2006. Readings on drugs and society: The criminal connection. Boston: Pearson Education.
This text provides a research-based overview on drugs and crime and the many ways the two subjects overlap. Again, while this is not a prevention book per se, it is important that professionals working in the prevention arena have an understanding of the criminal and policy backdrop that so many drug and alcohol abusers engage in.
Springer, D. W., and A. Rubin. 2009. Substance abuse treatment for youth and adults. Hoboken, NJ: Wiley.
This text focuses on two approaches shared for adolescents, one for family intervention, and two techniques for working with adults. The text’s overview is good as a springboard for graduate learning, but this is more of a scientific compilation of techniques than a “how to” book.
Straussner, L. S. 2006. Clinical work with substance-abusing clients. 2d ed. New York: Guilford.
This text by Dr. Straussner, an expert in the field, covers a broad spectrum of issues, including prevention, but it gives a wider lens to adult and adolescent substance abuse clients and related clinical issues.
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