To begin understanding the science of prevention, consider a common scenario. Two underage teenagers decide to try alcohol for the first time by stealing a couple bottles from their parents’ liquor cabinet. Both are around the same age, have similar body composition and family background, and have chosen to make the same poor decision. The end result for each of them, however, is completely different. Teen A feels disconnected, nauseous and complains of a severe headache the next day. Teen B feels great, experiences no unpleasant physical symptoms and is interested in trying a little more next time.
What is the difference between Teen A and Teen B? The answer lies in their individual abilities to process chemicals like alcohol, which was inherited through the genetics of their parents. Teen A was born with a built-in protection from addiction; her body responded adversely to the chemical. Why would she want to feel that way again? Teen B, on the other hand, was born with a genetic predisposition that places her at a higher risk for addiction. As prevention specialists, we must consider not only genetics but also other individual risk factors for addiction, which include childhood trauma, physical/sexual abuse, favorable parental attitudes towards substance use, academic failure, and poor neighborhood attachment, among others.
Compass Mark believes that effective addiction prevention begins with building and promoting individual protective factors. These protective factors include opportunities and rewards for school involvement, family attachment, positive self-image, community involvement, self-control, and many, many others. A helpful example that demonstrates the principle of prevention is a balance scale. Adding pennies to one side of the scale may change the balance only slightly, but each penny added serves an important purpose in tipping the scale one way or another. Likewise, prevention is the gradual, consistent process of adding protective factor “pennies” to an individual’s life until the balance swings in the right direction. While we are unable to change an individual’s genetic predisposition to addiction, we can counteract it by infusing their lives with multiple protective factors. Just like other public health approaches that can help people overcome heart disease or Type 2 diabetes, our work is proven to help prevent the disease of addiction.
When determining the most effective addiction prevention programs for our community, Compass Mark considers the following:
- What risk factors (community, family, school, peer or individual) are highest?
- What is the level of risk for our target population? For example, will the prevention program serve the general population, those at highest risk, or those already experimenting with alcohol, tobacco, other drugs and gambling?
- What prevention strategy is the most appropriate?
To answer the final question, Compass Mark aligns all programs with at least one of the six proven strategies for prevention addiction developed by the Substance Abuse and Mental Health Services Administration (SAMHSA).
- Information Dissemination: Provides awareness and knowledge on the nature and extent of alcohol, tobacco and drug use, abuse and addiction, as well as problem gambling, and the effects on individuals, families and communities. Examples: brochures, presentations
- Education: Involves two-way communication, teaching life and social skills, including decision-making, refusal skills and managing emotions. Examples: a curriculum with a set number of lessons
- Alternative Activities: Fun, drug-free activities to prevent people from using alcohol, tobacco, other drugs and gambling. Examples: Post-prom parties, community centers for youth
- Problem Identification & Referral: Targets people who have experimented with alcohol, tobacco, other drugs and gambling to see if their behavior can be reversed through education. Examples: Student Assistance Programs in the schools, community hotlines
- Community-Based Process: Activities include community organizing and enhancing effectiveness of services and coalitions. Examples: MADD chapters, training community volunteers
- Environmental: Establishes or changes written and unwritten community standards, codes, ordinances and attitudes, therefore lowering use. Examples: increasing tobacco taxes, billboard campaigns
The field of addiction prevention is often misunderstood, as evidenced by the prevalence of “scare tactics” and other negative messaging which attempt to change behaviors based upon fear alone. Research consistently shows that scare tactics such as graphic warnings, images of drug use trends, and repeated sharing of tragic stories can lead to increases in problem behavior. This practice is especially concerning for those at highest risk for addiction. When presented with a fear-based message regarding substance use, people respond in one of three ways: They remain in denial or become numb to the information; they experience high anxiety which disables their ability to make good decisions; or they react with rebellion, showing a more favorable view of substances they’ve been warned about.
Compass Mark is committed to providing fact-based information on the consequences of substance use and gambling, and does not support the use of scare tactics or other ineffective fear-based messages. Instead, we offer information and resources which include clear, concrete action steps designed to empower people on a healthy and successful life path. Throughout our fifty years of experience in this field, we have determined that evidence-based curriculum, delivered on an ongoing basis by trained professionals, is one of the most effective methods for preventing substance use and addiction in our community.
In addition to offering critical prevention programs and services, Compass Mark also seeks to continually evaluate the content, tone, and messaging around substance use. We are eager to build partnerships with those who share our commitment to avoid fear messaging and reduce stigma surrounding the disease of addiction. The following questions are helpful for evaluating appropriate prevention messaging:
- Is fear the primary element of the message?
- Can it stand the test of time?
- Will the message erode by the light of truth or experience?
- Does the message include concrete steps to avoid the problem? For example, does it address decision-making, refusal skills, anger management, emotional regulation, etc?
Compass Mark provides guidance to communities, schools, and workplaces on prevention best practices that can lead us all towards a healthier future. We understand that our work isn’t magical or one-size-fits all, but highly complex and focused upon clear, measurable outcomes. Using the building blocks of science and public health, we uniquely tailor our programs to the needs of individual persons and their environment. When done correctly, prevention is a cost-effective, long-term investment that transforms lives and strengthens the fabric of our community. For more on prevention strategies that work visit SAMHSA’s Strategic Prevention Framework page.