Reflections on 40 Years of Drug Abuse Prevention Research

• Author: J. David Hawkins,Zili Sloboda,Mary Ann Pentz,Linda B. Cottler
• Date: 01 January 2009
• Published date: 01 January 2009
• DOI: 10.1177/002204260903900114
• Subject Matter: Article

© 2009 BY THE JOURNAL OF DRUG ISSUES

JOURNAL OF DRUG ISSUES 0022-0426/09/01 179-196

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Zili Sloboda, Sc.D., is a Senior Research Associate at the Institute for Health and Social Policy, The

University of Akron. Her research focuses on drug abuse epidemiology and prevention. Currently

she is conducting a randomized controlled trial assessing the impact of substance abuse prevention

programming delivered by D.A.R.E. off‌i cer-instructors. Linda B. Cottler, Ph.D., is Professor of

Epidemiology in the Department of Psychiatry at Washington University School of Medicine in St. Louis,

MO, and Director of the Epidemiology and Prevention Research Group. Her research has focused on

methods for conducting research, specif‌i cally alcohol and drug abuse and dependence, its comorbidity

with other disorders, and consequences, such as HIV and STDs. J. David Hawkins is the Endowed

Professor of Prevention and Founding Director of the Social Development Research Group, School of

Social Work, University of Washington. His research focuses on understanding and preventing child

and adolescent health and behavior problems. He is co-developer of the Communities That Care

prevention system. Mary Ann Pentz, Ph.D., is Professor of Preventive Medicine and Director of the

Institute for Prevention Research at the University of Southern California. She specializes in conducting

large community- and school-based trials for prevention of tobacco, alcohol, drug use, and obesity in

adolescents and children.

REFLECTIONS ON 40 YEARS OF DRUG ABUSE

PREVENTION RESEARCH

ZILI SLOBODA, LINDA B. COTTLER, J. DAVID HAWKINS, MARY ANN PENTZ

Over the past twenty-f‌i ve years, tremendous progress has been made in the area

of drug abuse prevention research. The accumulated f‌i ndings from longitudinal

studies of adolescents regarding the factors associated with vulnerability to the

substance use and abuse and trends from national surveys of substance use

showing their association to societal perceptions of the harmfulness resulting from

the use of these substances have informed the development of effective innovative

prevention strategies. The 1990s saw a reversal in the perception of the value

and importance of drug abuse prevention research with recognition of the f‌i eld’s

approach to intervention development and implementation and its scientif‌i c rigor in

demonstrating intervention impact. This paper ref‌l ects on this history anticipating

both the positive and negative aspects of the future for the f‌i eld.

REFLECTIONS OF 40 YEARS

Prior to 1974, the year the National Institute on Drug Abuse (NIDA) was

established, drug abuse prevention researchers struggled to develop effective

interventions without suff‌i cient guidance or knowledge of how drug-using

behaviors began or how these behaviors progressed. Most available information

180 JOURNAL OF DRUG ISSUES

SLOBODA, COTTLER, HAWKINS, PENTZ

came from cross-sectional studies that compared characteristics of users versus

non-users or case studies of drug abusers. However, with the creation of NIDA

came plans for an array of epidemiologic databases, including longitudinal studies

that followed cohorts of adolescents over time to examine the risk factors that

lead to substance use and abuse. Although this information proved helpful, prior

failure to demonstrate the effectiveness of prevention programming resulted in a

moratorium on prevention research funding that lasted for several years. Thus, the

prevention research program of today is relatively young.

In this short history of about 25 years, several specif‌i c achievements in the f‌i eld

of substance abuse prevention have moved it from an art to a science. Among these

achievements is the extensive epidemiologic research base that provided consistent

f‌i ndings relative to the origins and pathways of substance use, the adaptation of

theories of behavior change to address drug use, and the development of both

research and statistical methodologies.

EPIDEMIOLOGY

Information from the national epidemiologic surveys, the Monitoring the

Future Study and the National Household Survey on Drugs, provided substantive

information on the characteristics of drug users, ages of onset or initiation of

drug use, and factors that were found to be associated with trends in drug use.

Marijuana and cocaine were of particular interest, and such areas as perceptions of

harmfulness of use and perceptions of levels of social acceptance were examined

(Bachman, Johnston, & O’Malley, 1990; Bachman, Johnston, & O’Malley, 1998).

Longitudinal studies provided more specif‌i c information on the factors that made

children and adolescents more susceptible to the use of drugs. Studies of the 1970s

and 1980s focused on the increased risk of progression to the use of marijuana for

those who used the licit drugs of tobacco and alcohol (Anthony & Petronis, 1995;

Kandel, 1975; Kandel & Yamaguchi, 1993).

Hawkins, Catalano, and Miller (1992) summarized the risk factors that

emerged from this research, which was expanded by Glantz and Pickens (1992).

Their interest was differentiating the factors associated with the onset of drug use

from those associated with progression to abuse and dependence. The inf‌l uence of

the risk and protective factor-focused approach to prevention was fully embraced

when the Institute of Medicine published the report Reducing Risks for Mental

Disorders, in 1994 (Mrazek & Haggerty, 1994). The report acknowledged the

extensive information accumulated on the biological and psychosocial factors

that have been found to be associated with the onset of a variety of public health

problems, including alcohol and drug abuse and dependence, and highlighted

those rigorous prevention trials that demonstrated effectiveness in reducing risks