PROTECTED DRUG ROUNDS AND RED TABARDS

Protected Drug Rounds And Red Tabards



Protected Drug Rounds And Red Tabards

Introduciton

Prevention efforts against substance use have focused primarily on children and adolescents because initial substance use is most likely to occur during adolescence and young adulthood. Primary prevention efforts include planned actions that help adolescents prevent predictable problems, protect existing states of health as well as healthy functioning, and promoting desired goals. This entry focuses on evidence-based prevention programs, which by definition have been developed and evaluated using well-controlled scientific methods.

Prevention Efforts

Although there are many substance use prevention programs, few have been evaluated in controlled experiments. The Substance Abuse and Mental Health Services Administration (SAMHSA) maintains a list of prevention programs that have been evaluated in the National Registry of Evidence-based Programs and Practices (NREPP). The NREPP defines evidence-based programs as those that (a) are conceptually sound and internally consistent, (b) have activities related to the conceptualization of the program, and (c) are reasonably well implemented and evaluated. The NREPP divides programs into three categories: promising, effective, and model programs. Promising programs have some positive outcomes but have not been fully evaluated or proven effective across replications. Effective programs have consistently positive outcomes and have been strongly implemented and evaluated. Model programs are those that are widely effective and have provided SAMHSA with materials, training, and technical assistance for nationwide implementation.

The Office of National Drug Control Policy (ONDCP) also provides guidance on evidence-based prevention programs. These guidelines include (a) addressing appropriate risk and protective factors for substance abuse in a defined population, (b) using approaches with demonstrated efficacy, (c) intervening early at important stages and transitions, (d) intervening in appropriate settings and domains, and (e) managing programs effectively. Taken together, federal guidelines indicate that prevention programs should be theoretically based, have demonstrated efficacy, and be tailored to specific factors, including risk, age, and sociocultural status. In the following section, a number of evidence-based substance abuse prevention programs are reviewed, the key attributes are identified, and recommendations for best practice in terms of substance abuse prevention efforts are provided.

Prevention Efforts With Demonstrated Efficacy

Recent research and reviews of the literature have identified characteristics that are associated with effective prevention programs that target low- and high-risk youth. Excellent reviews in this area are listed in "Further Readings" at the end of this entry. A number of risk and protective factors for substance use and abuse have been identified that vary along a continuum of individual, family, school, and community characteristics. Individual factors associated with risk for substance abuse include comorbid psychiatric disorders and impul-sivity. Living in a single-parent home, parental drug use, and lax parenting style represent family factors that are associated with substance abuse risk. School factors that are associated with greater risk for substance abuse include poor performance or lack of engagement in school activities. Positive peer attitudes toward substance abuse and cultural norms that do not prohibit drug use represent community factors that contribute to substance abuse ...