Perspective
The “Just Say No” drug prevention strategy is not enough to keep at-risk teens from experimenting with drugs. And the dangers of experimentation are high, particularly with methamphetamine, which is reportedly so addictive that just a few “hits” have the capacity to addict the user.
Rather than a hit-and-run message, a good-quality intervention must incorporate psychological, social, and cultural strategies to take youth out of the context that would lead to experimentation in the first place. This involves creating a tight-knit social fabric around the youth with clear expectations.
Such an intervention also requires helping young people cultivate a sense of connectedness to people and places, a sense of power and belief in themselves, the confidence that they can handle challenges and make good decisions, and a sense of their uniqueness and value.
A good-quality intervention also helps youth develop social skills; provide close monitoring to protect them from risk situations; minimize trauma, which often leads to risky behaviors; and provide state-of-the-art treatment for those who become addicted.
Toward this end, one key strategy is to provide activities that prevent boredom. Doing so not only occupies youth, but it also offers an opportunity to monitor youth behavior in a subtle way and teaches social skills necessary to develop and sustain positive relationships.
In all cases, interventions should be customized to best serve the population being targeted. Kids share certain universal developmental aspects to their lives. But kids are also unique individuals with varying cultural, racial, and ethnic perspectives, not to mention class and regional styles. Universal approaches that will reach all youth should be considered, but we also need to tailor the approaches so the messages are culturally relevant, recognizable, and not offensive to the target culture.
Finally, encouraging law enforcement efforts aimed at stopping the drug distribution system early–before youth have an opportunity to get in trouble–is critically important.
Family-Focused Strategies Can Work
When thoughtfully designed and carefully implemented, the methamphetamine prevention message is well received, new research supported in part by the National Institutes of Health's institute on drug abuse shows.
In an assessment of drug prevention interventions delivered to middle school students in rural Iowa, programs that relied on the development of strong partnerships among families, schools, and communities led to significant reductions in methamphetamine abuse in later years, according to Richard L. Spoth, Ph.D., and his colleagues at the Partnerships in Prevention Science Institute at Iowa State University, Ames (Arch. Ped. Adolesc. 2006;160:876–82).
In one of the studies, 667 families of rural Iowa sixth graders were randomly assigned to participate in one of two interventions–the Iowa Strengthening Families Project (ISFP) or the Preparing for the Drug Free Years (PDFY) program–or to a control group.
The ISFP is made up of seven 2-hour sessions, including 1 hour of separate, concurrent skills-building curricula for the child and the parents, and 1 hour of a joint family curricula. The goal of the project is to enhance family protective factors and to reduce family risk processes.
The PDFY program has a five-session design, only one of which requires the child's attendance. The goal of the program is enhance protective parent-child interactions.
At the 12th-grade follow-up, which included 457 of the original families, none of the students who had participated in the ISFP reported methamphetamine use within the past year, compared with 3.6% of the PDFY group and 3.2% of the controls.
In the second study, 679 families of seventh-grade students were randomly recruited to participate in one of three approaches: a school-based, goals-directed intervention called Life Skills Training (LST) combined with a modified version of the ISFP called the Strengthening Family Program for Parents and Youth; the LST program alone; or a minimal-contact control group. The LST program consisted of 15 sessions geared toward specific goals and taught to students during regular classroom periods, with five follow-up sessions 1 year later.
Of the initial study group, 597 families were available for 12th-grade follow-up evaluations, which showed that the adolescents who participated in the combined interventions had a relative reduction in lifetime methamphetamine abuse of 65%, compared with the controls.
In both studies, Dr. Spoth said, the most effective interventions were those that had strong family components and were delivered in a manner that was sensitive to local culture and conditions–factors that must be taken into consideration when designing prevention programs targeting at-risk adolescents.