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SAMHSA News - Volume X, No. 2, Spring 2002

Prevention Programs Reduce Drug Use Among High-Risk Youth

A nationwide study of federally funded substance abuse prevention programs for youth at high risk for substance abuse found that the programs yielded reduced rates of alcohol, tobacco, and marijuana use according to a SAMHSA report.

Reported first-time use of cigarettes, alcohol, and marijuana was 12 percent lower at program exit than for comparison youth, and 6 percent below comparison youth 18 months later. Substance use by youth who had already begun to use substances was 10 percent lower at exit than among comparison youth; and 18 months later, use levels were 22 percent below comparison youth.

The 5-year study, the National Cross-Site Evaluation of the High-Risk Youth Demonstration Program, involved more than 10,500 youth in 48 communities that are characterized by high levels of risk, such as poverty, crime rates, and ambient substance use.

"This study provides an unprecedented opportunity to learn about preventing and reducing substance abuse among high-risk youth," said SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W. "We will use the findings on what works and why to provide a benchmark and help strengthen prevention programs in communities across the Nation."

The study identified six program components that can help reduce the likelihood of substance use. Among the successful programs were those emphasizing life skills development, connectedness to constructive peers and adults, and self-examination.

Program design and implementation also had an effect. Favorable results were more likely when programs had a clear purpose and evidenced-based strategy, maintained intensive participant contact, and were offered in after-school settings at times when youth are most at risk for substance use.

The diversity of program participants also allowed analysis of patterns in risk and protective factors, and substance use as youth mature through adolescence, across genders, and across racial and ethnic groups. The study confirmed a "web of influence" among individual, family, peer, school, and community factors on youth substance use.

For example, when families are strong, family supervision and parental attitudes have a strong influence on the peers with whom young people choose to associate and also influence the choice to use substances or not. Likewise, when youth are strongly connected to school and are successful in school, they tend to associate with peers who do not use substances and tend not to use them themselves.

Gender plays an important role in risk, protection, and substance use. Boys participating in the study programs used substances at a much lower rate than comparison boys at program exit (29 percent lower), and at 6 months after exit (22 percent lower), but this effect had faded by 18 months after the program ended.

Program benefits for girls developed later, but were increasingly positive throughout the study period. Substance use rates for girls participating in the study program were 3 percent lower than comparison girls at program exit, and 9 percent lower 18 months later.

While programs that use multiple, science-based practices identified in the study produced stronger and longer lasting effects for both boys and girls, some program elements work better for one gender than the other. For girls, programs that focus on behavior-related life skills are particularly important for sustaining positive effects on substance abuse throughout the 18-month period of followup. For boys, participation in programs that emphasize interactivity with peers or adults are particularly important for strengthening program effects on substance use.

The 48 community programs studied were funded by SAMHSA's Center for Substance Abuse Prevention (CSAP) through the High-Risk Youth Demonstration Grant Program during 1994 and 1995. Programs were selected to ensure coverage of different regions of the country, various funding initiatives, and diverse target population characteristics. The objective was to assess the effectiveness of programs that spanned a broad range of strategies, capabilities, and participation.

Of the 10,500 youth involved in the study, 6,031 participated in High-Risk Youth programs; and 4,579 similar youth from the same communities did not receive services from the CSAP programs. All responses from study participants were collected using CSAP's National Youth Survey at four different times during the study: at program entry, at program exit, and at 6 and 18 months after youth exited the program.

"This study has significantly expanded our understanding of the prevention strategies that have the greatest potential to help even our most vulnerable youth lead drug-free lives," said CSAP Director Ruth Sanchez-Way, Ph.D.

For more information on the study, visit SAMHSA's CSAP Web site at

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