Psychosocial approaches to substance abuse prevention: theoretical foundations and empirical findings

Substance abuse continues to be a major public health problem and a central policy issue throughout the United States. Interventions developed to reduce or prevent substance use have taken many forms including school-based education programs, mass media campaigns, and community-based movements. The extant research literature indicates that these interventions have frequently increased knowledge and awareness, and they have occasionally had an impact on attitudes and other substance use-related variables. However, rarely have any of these interventions had a measurable impact on actual substance use. A major exception is a class of school-based primary-prevention approaches that focus on the key psychosocial factors promoting adolescent substance use. These approaches include either resistance skills training alone or in combination with broader competence-enhancement interventions. The development of these intervention approaches and the evidence supporting their efficacy is an encouraging advance in a field replete with failures. Still, it is important to recognize the limitations of these approaches in their current form and the need to develop more comprehensive approaches combining school-based interventions with those impacting on the family, social institutions, and the larger community.