On an old wooden table we see an old-fashioned balance scale, with pears and weights in the pans. It's near a window.

It may be a hard sell–in the middle of a public health pandemic, with an addiction crisis still looming–to get excited about prevention science. But we are always passionate about preventing substance misuse and problem gambling, and love to share that excitement with you.

While coronavirus takes center stage, public health is always in the news. Most take for granted the systems which, year after year, keep us safe and healthy, but behind the scenes, thousands in Pennsylvania work to keep air and water clean, food safe to eat, and help us to prevent domestic violence, sexual abuse, racial & ethnic discrimination, gun violence, addiction, mental illness, and other diseases. Addiction prevention is grounded in the same public health principles used to lower rates of COVID-19 or trauma: a balancing act between risk factors and strengths, or protective factors.

Risk & Protective Factors

We’ve all likely seen charts showing the coronavirus risk levels for different activities: grocery shopping has a low level of risk, while spending an hour in a crowded bar is very risky. There are different levels of risk for developing addiction disorders also: waiting until age 21 to drink alcohol lowers the risk for addiction, while experimenting with alcohol in middle school is quite risky, based on brain development. Having one or more relatives addicted to drugs, alcohol or gambling means your risk is much higher than someone who has no relatives with addiction disorders, based on genetics. Sometimes we can control our risk factors, and sometimes we cannot.

Looking at COVID-19 as an example, let’s examine how our strengths, or protective factors come into play. You can make a low-risk activity such as grocery shopping even safer by wearing a mask over your nose and mouth and by keeping at least 6 feet from other people. These protective factors may even balance out any risk factors you have for the virus, such as a weakened immune system.

Substance use and gambling disorders luckily have protective factors also. Being involved with and connected to your family (whatever that term means to you), school, workplace, or community lessens your chance of developing addiction. Having a belief system–religious, spiritual, or secular–based ethics which helps you make sense of things does also.

A Balancing Act

All public health professionals–whether they work with gun violence, heart disease, or addiction–have the same goal: to build protective factors to the point where they outweigh risk factors. The point of Pennsylvania’s recent restrictions on indoor dining and gym attendance is to eliminate the riskiest opportunities for contracting coronavirus, in hopes that our communities stay healthy enough that hospitals aren’t overwhelmed. With addiction disorders, we have a range of tools to keep protective factors high:

  • Conversations starters for parents and caregivers to use with their children
  • Lessons that teach youth how to cope with hard feelings
  • Fun events as alternatives to using substances or gambling
  • Grassroots coalitions which mobilize the community
  • Policies in schools that provide help to students who experiment with alcohol or other drugs
  • Media campaigns to educate the public
  • Laws that require alcohol be sold only to adults

Any one of these tools might not be enough to prevent an individual from gambling or using substances and developing an addiction. However, the more tools that we use in any given individual, family, school, or neighborhood, the more likely the balance scale will tip toward health.

The Power of Prevention

Don’t usually think about prevention? You’re likely not alone. There are, however, compelling reasons to both try out skills at home and to support prevention efforts in your community.

Cost savings. Funding prevention makes good financial sense. Paying for “upstream” programs like the ones listed above avoids substantial costs to schools, employers, and to the healthcare, child welfare, and criminal justice systems. Prevention programs save, on average, $18 for every $1 invested! Budget-strapped Pennsylvania desperately needs this kind of savings.

Quality of life. There are profound benefits of preventing the harms caused by substance and gambling misuse and addiction. Dollars can be counted, but there is no way to accurately quantify the absence of harms on the human heart. Impaired driving; on-the-job accidents; lost childhoods; poor health and early death: these traumas change people and their loved ones permanently. We need to react by arresting impaired drivers, providing counseling for children, and offering the best medical care, but even better? Helping people to lead rich, full lives free from these harms. This is our passion and our commitment to our PA communities.