Prevention Programs

Prevention Focus

Universal prevention activities target an entire population such as all grade nine students or all parents of high school students with the aim of promoting the health of the population or preventing or delaying the onset of substance use. Activities are targeted to a general population that has not been identified or pre-selected upon the basis of individual risk. There is generally no indication that any particular member of these groups is using psychoactive drugs or is at risk of using, but engaging in this type of prevention has definite benefits compared to the costs. Universal prevention consists of activities and interventions that are applicable to everyone in the group and thus this approach avoids labeling.

Selective prevention targets specific subgroups deemed to be at greater risk including those with academic problems, family issues and dysfunction, issues of poverty, problematic social environments, or a family history of substance abuse, with more intensive programming. Program recipients are targeted not because of specific individual needs assessment or diagnoses but rather because of epidemiologically and empirically established risk.

Compared to universal programs, selective programs have smaller numbers of participants per group who are known and who are specifically recruited to participate in the intervention. Programming is longer and has a more intensive structure featuring more intrusive intervention with a goal of changing existing behaviors in a positive direction. A higher degree of skill is required among program leaders and staff and there is also a greater cost per participant, but along with this a greater likelihood of demonstrating positive change. As selective programs do not individually assess participants it is critical to be clear upon the variables and characteristics being considered for group selection and some general screening should still occur.

Indicated prevention is for those who are already using or involved with psychoactive drugs who are typically not yet dependent, but are at a high risk to be so in the future. This type of programming is individualized and typically includes a formal counseling component for the student and also for the family as warranted. Individual rather than group work is recommended with this population as bringing them together can serve to normalize their behavior and increase substance use. Indicated prevention also targets injection drug users (IDU) and works to teach them harm reduction techniques [Page 671]with or without a goal of abstinence. These are the most costly types of programs.

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