Prevention of Drug Use and Harm

Prevention of Drug Use

• Prevention refers to measures that prevent or delay the onset of drug use, as well as measures that protect against risk and reduce harm associated with drug supply and use.

What Are We Trying to Prevent?

• Drug use, or at least delay its initiation
• Harm associated with drug use, including:
  • Route of administration risks
  • Overdose/excessive use risks
  • Avoidance of help seeking due to legal concerns
  • Risks of associated problems (e.g. accidents)
  • Harm to others (e.g. laws prohibiting smoking in public places)

Prevention Strategies

• Prevention levels:
  • Primary level: prevent initial drug use (e.g. supply reduction methods, education on harms to developing body, school-based and parent education programs)
  • Secondary level: prevent harm (e.g. education on risks of addiction, advice on route of administration options)
  • Tertiary level: reduce harm (e.g. needle and syringe programs (NSPs), controlled drinking, drink driving campaigns)
• Prevention targets:
  • Universal: targeting whole populations (e.g. national campaigns, advertising programs)
  • Selective: targeting subgroups with above-average risk (e.g. school-based programs, alcohol-free communities)
  • Indicated: targeting individuals with detectable symptoms (e.g. counseling, advice lines, educational pamphlets)

Clarifying Prevention Objectives

• Timing for intervention: as early as possible in the developmental pathway
• Goals and purposes: targeting attitudes, knowledge, expectancies, and behaviors associated with drug use (risks)
• Specific risk factors: targeting specific risk factors such as peer influences and educational involvement
• Combination approach: the best approach involves a combination of factors

Research Support for Prevention

• Adolescent interventions:
  • Support for classroom-based education programs
  • More effective if interactive, time-intensive, and led by students
  • Life skills training programs and family-based interventions
  • Support for regulation of price and availability of tobacco to young people
  • Lack of support for effectiveness of alcopop price increases
• Interactive programs (e.g. role-play, discussion, games) are a key factor in effectiveness
• "Peer" needs to be carefully chosen and supported

Examples of Interventions

• Parent education programs and family interventions (e.g. Triple P)
• Home visits to high-risk mothers from before birth to age 2 years

Australian Public Service (APS) and Binge Drinking Campaign

• APS: "While the 'alcopop' tax is an example of a targeted measure aimed at reducing the attraction of young people into an alcohol-soaked culture, such legislation—by itself—will not change Australia's drinking culture."
• Binge drinking campaign (2009): Risky single occasion drinking (RSOD) needs targeted and population-relevant strategies to reach those most vulnerable to the risks associated with frequent RSOD

Universal Interventions for Illicit Drug Use

• Diversion programs
• Prohibition: may reduce drug use among non-users (primary), but not much evidence it affects current users