National Institute on Drug Abuse (NIDA)
The NIDA booklet, Preventing Drug Use Among Children and Adolescents: A Research-Based Guide for Parents, Educators, and Community Leaders, Second Edition (PDF - 707 KB), synthesizes the findings of 20 years of prevention science and identifies a set of principles that are characteristic of efficacious and effective science-based prevention programs. This In Brief web edition provides highlights from the full report and presents these key principles, an overview of program planning, and important first steps for those learning about prevention. This web-based edition serves as an introduction to research-based prevention for those new to the field of drug abuse prevention and provides key information for those planning prevention services in their own communities. Selected resources and references are also provided.
This section provides examples of recent scientific advances from National Institutes of Health (NIH)-sponsored research and is not intended to be a comprehensive list. For updates on tobacco use research, please see the Recent Scientific Advances page of the Tobacco Use Research Highlights.
Many medications prescribed for common conditions such as depression, diabetes, and high blood pressure interact with alcohol. The resulting health effects can range from mild (nausea, headaches, loss of coordination) to severe (internal bleeding, heart problems, difficulty breathing). Older adults are at particular risk of experiencing alcohol-medication interactions. According to a new study, nearly 42% of U.S. adults who drink also report using medications known to interact with alcohol. Among those over 65 years of age who drink alcohol, nearly 78% report using alcohol-interactive medications. The researchers analyzed data from more than 26,000 adults ages 20 and older who participated in the National Health and Nutrition Examination Survey (1999–2010). The survey asks participants about alcohol use in the past year and prescription drug use in the past month. The main types of alcohol-interactive medications reported in the survey were blood pressure medications, sleeping pills, pain medications, muscle relaxers, diabetes and cholesterol medications, antidepressants, and antipsychotics. The findings show that a substantial percentage of people who drink regularly, particularly older adults, could be at risk of harmful alcohol and medication interactions.
A new NIDA-funded study analyzed the content and demographic reach of a popular pro-marijuana Twitter handle in 2013 and found that only ten percent of the messages mentioned any risky behaviors associated with marijuana use. Given that over 70 percent of followers were 19 years of age or younger—an age group that is using social media at increased rates—these findings underscore the importance of monitoring social media sites that focus on drug use and using this information to develop strategic prevention efforts. Messages could include the risks that increase when marijuana use begins as a teen, including addiction, cognitive impairments, and the dangers of driving while intoxicated.
A new NIAAA- and NIDA-funded study shows an increased number of marijuana-positive Colorado drivers involved in fatal motor vehicle crashes since Colorado's legalization of medical marijuana in 2009. By comparison, no similar increase was seen in the 34 states that did not have medical marijuana laws when this study was conducted. During the same time period, there was no change in the number of alcohol-impaired drivers in fatal motor vehicle crashes in either Colorado or the 34 states with no legalization of marijuana. Although this study did not determine a cause-and-effect relationship between the marijuana use and the vehicle accidents, research shows that both alcohol and marijuana impair driving. The authors suggest that these findings underscore the need for enhanced education about the dangers of driving under the influence of drugs, including marijuana.
A NIDA-funded study shows that adolescent girls who were involved in the juvenile justice system and participated in Multidimensional Treatment Foster Care (MTFC) showed decreased drug use over a two-year period in young adulthood. MTFC is a family-focused prevention program to encourage healthy behaviors in at-risk teens within the foster care system. Youths are placed individually with well-trained and supervised foster parents. Program supervisors assess youth's adjustment daily and provide consultation, support, and crisis intervention. The MTFC intervention is focused on strength-building and positive reinforcement, and specific treatment services are tailored to the youth's age and developmental level. The results show that participation in MTFC reduced the influence of partner drug use which was significantly associated with the young women's concurrent drug use.
A new study, funded by NIDA, shows that incorporating the web-based Therapeutic Education System (TES) intervention in the treatment of drug abuse can not only help people stop using drugs, but can also keep them in treatment longer. TES is a web-based version of the Community Reinforcement Approach plus Contingency Management, a packaged approach with demonstrated efficacy. It consists of 62 interactive modules that teach patients how to achieve and maintain abstinence from drug use and includes prize-based motivational incentives to encourage adherence to treatment. Patients given TES were less likely to drop out of treatment than those in the control group. Also, the web-based intervention helped patients stay abstinent from drug use, even those who were not abstinent at the beginning of the study. With such findings, web-based interventions like TES are promising additions to drug abuse treatment.
NIDA released the results of a new study showing that the medication baclofen can help prevent relapse in cocaine-dependent males. Drug cues, even subliminal ones, can trigger people with drug addiction to seek and participate in drug use. The drug baclofen, which is commonly used to prevent spasms in patients with spinal cord injuries and neurological disorders, interferes with the brain's early response to these subliminal drug cues and can stunt the internal processing of drug-related cues that can lead to relapse. In the study, males who received baclofen had significantly reduced responses to drug cues than those in the control group. As a comparison between the two groups, there were no significant differences when other images were seen, showing that baclofen works exclusively by blocking the effects of drug cues. These new findings suggest that baclofen can be used to help people with drug addiction avoid triggers and potential relapse.
Strategies recommended by the Surgeon General to reduce underage drinking have shown promise when put into practice, according to scientists at the NIAAA. These approaches include nighttime restrictions on young drivers and strict license suspension policies, interventions focused on partnerships between college campuses and the community, and routine screening by physicians to identify and counsel underage drinkers. NIAAA researchers Ralph Hingson, Sc.D., and Aaron White, Ph.D., evaluated studies conducted since the 2007 Call to Action to Prevent and Reduce Underage Drinking. "An evaluation of the recommendations in the Call to Action reveals that certain strategies show promising results," said Hingson, director of NIAAA's Division of Epidemiology and Prevention Research. "While progress has been made in addressing underage drinking, the consequences still remain unacceptably high. We must continue research to develop new interventions and implement existing strategies that have been shown to be effective."
People with severe mental illness such as schizophrenia or bipolar disorder have a higher risk for substance use, especially cigarette smoking, and protective factors usually associated with lower rates of substance use do not exist in severe mental illness, according to a new study funded by the NIDA. Previous research has shown that people with schizophrenia have a shorter life expectancy than the general population, and chronic cigarette smoking has been suggested as a major contributing factor to higher morbidity and mortality from malignancy as well as cardiovascular and respiratory diseases. These new findings indicate that the rates of substance use in people with severe psychosis may be underestimated, highlighting the need to improve the understanding of the association between substance use and psychotic disorders so that both conditions can be treated effectively.
Smoking tobacco or marijuana, taking prescription painkillers, or using illegal drugs during pregnancy is associated with double or even triple the risk of stillbirth. Researchers based their findings on measurements of the chemical byproducts of nicotine in maternal blood samples; and cannabis, prescription painkillers, and other drugs in umbilical cords. Taking direct measurements provided more precise information than did previous studies of stillbirth and substance use that relied only on women's self-reporting. "Smoking is a known risk factor for stillbirth, but this analysis gives us a much clearer picture of the risks than before," said senior author Uma M. Reddy, M.D., M.P.H., of the NICHD. "Additionally, results from the latest findings also showed that likely exposure to secondhand smoke can elevate the risk of stillbirth."
Chronic alcohol exposure leads to brain adaptations that shift behavior control away from an area of the brain involved in complex decision-making and toward a region associated with habit formation, according to a new study conducted in mice by scientists at the NIH. The finding provides a biological mechanism that helps to explain compulsive alcohol use and the progression to alcohol dependence. The brain's prefrontal cortex is involved in decision–making and controlling emotion, while the dorsal striatum is thought to play a key role in motivation and habit formation. Past studies have shown that alcohol–dependent individuals show problems with skills mediated by the prefrontal cortex, such as impulse control. These same individuals often show exaggerated neural response in the dorsal striatum to alcohol–related cues. "These findings give important insight into how excessive drinking affects learning and behavioral control at the neural level," said Kenneth R. Warren, Ph.D., acting director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA). "The shift to increased striatal control over behavior may be a critical step in the progression of alcoholism."
A smoking-cessation medication may be a viable option for the treatment of alcohol dependence, according to a study by scientists at the NIH. The study found that varenicline (marketed under the name Chantix), approved in 2006 to help people stop smoking, significantly reduced alcohol consumption and craving among people who are alcohol dependent. Alcohol dependence is a chronic disease that includes symptoms such as craving, loss of control over drinking, withdrawal symptoms after stopping drinking, and tolerance, the need to drink greater amounts of alcohol to feel the same effect. “This is an encouraging development in our effort to expand and improve treatment options for people with alcohol dependence,” says Kenneth R. Warren, Ph.D., Acting Director of the NIAAA.
Distinct patterns of brain activity are linked to greater rates of relapse among alcohol-dependent patients in early recovery, a study has found. The research may give clues about which people in recovery from alcoholism are most likely to return to drinking. “Reducing the high rate of relapse among people treated for alcohol dependence is a fundamental research issue,” said Kenneth R. Warren, Ph.D., Acting Director of the NIAAA. “Improving our understanding of the neural mechanisms that underlie relapse will help us identify susceptible individuals and could inform the development of other prevention strategies.”