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Preventing Drug Abuse Among Children and Adolescents (In Brief)

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 - 707KB), 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.

NIH Study: Research-Based Strategies Help Reduce Underage Drinking (January 2014)

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

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.”

Severe Mental Illness Tied to Higher Rates of Substance Use (January 2014)

National Institute on Drug Abuse (NIDA)

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.

Tobacco, Drug Use in Pregnancy Can Double Risk of Stillbirth (December 2013)

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

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.”

NIH Study Finds Chronic Alcohol Use Shifts Brain's Control of Behavior (August 2013)

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

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."

Antismoking Medication Shows Promise for Treating Alcohol Dependence (June 2013)

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

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.

Brain Patterns May Help Predict Relapse Risk for Alcoholism (May 2013)

National Institute on Alcohol Abuse and Alcoholism (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.”

Research Hints at New Approach to Addiction (April 2013)

National Institute on Drug Abuse (NIDA)

A study in rats found that stimulating a specific part of the brain reduces compulsive cocaine seeking. The finding suggests a potential approach to changing addictive behavior. Compulsive drug taking, which brings a range of negative health and social consequences, is one of the most challenging aspects of human drug addiction. In 2011, an estimated 1.4 million Americans age 12 and older were past-month cocaine users. No medications have been approved by the U.S. Food and Drug Administration for treating cocaine addiction. To gain insights into the neurobiology of compulsive drug use, researchers have been using an animal model of cocaine addiction. Trained rats learned to push levers to receive cocaine. When the cocaine doses were later followed by a mild electric shock to the foot, most rats stopped pushing the levers. Some rats, however, exhibited compulsive cocaine seeking by continuing to push the levers in spite of the foot shocks.

Prior Marijuana Use Could Increase Addictive Power of Nicotine (March 2013)

National Institute on Drug Abuse (NIDA)

Rats previously exposed to tetrahydrocannabinol (THC), the main addictive ingredient in marijuana, found nicotine more rewarding than did rats not exposed to THC. Although the doses of THC used in this study were high, this research suggests that marijuana use may increase the risk for nicotine dependence, which—through the use of tobacco—is the leading cause of preventable death in the United States.

Youth Interventions Lower Prescription Drug Abuse (March 2013)

National Institute on Drug Abuse (NIDA)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
National Institute on Mental Health (NIMH)

A new study found that middle school students in small towns and rural areas who received brief interventions had lower rates of prescription drug abuse into late adolescence and young adulthood. Prescription drug abuse is taking a medication without a prescription, or in ways or for reasons not prescribed. Abuse of prescription drugs can have serious and harmful consequences, including addiction, poisoning, and even death from overdose. Surveys have found that prescription and over-the-counter medications are among the top substances abused by young people. Developing successful community-based interventions to prevent this abuse is an important public health goal. A team of researchers conducted three studies to assess the effectiveness of brief community-based interventions among rural or small-town students in grades 6 or 7. The studies did not target prescription drug abuse specifically. Rather, all three studies used universal preventive interventions, which address general risk and protective factors for substance abuse.

Scientists Identify Molecular Events That Underlie Fetal Alcohol Spectrum Disorders (February 2013)

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Scientists have identified a molecular signaling pathway that plays an important role in the development of fetal alcohol spectrum disorders (FASD). The new research in cells and mice, supported by the NIAAA, points to candidate genes for FASD susceptibility and may open new avenues for developing drugs to prevent alcohol damage to the fetal brain. “Prenatal alcohol exposure is the leading preventable cause of birth defects and developmental disorders in the United States,” says NIAAA Acting Director Kenneth R. Warren, Ph.D. “These new findings are yet another important contribution from researchers who have been at the forefront of scientific discovery in FASD.”

Many Doctors Don’t Ask Teens About Alcohol (February 2013)

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) In a new study, more than one-third of 10th graders reported recent alcohol use. But many did not recall their doctors asking them about drinking or counseling them about related harms. The finding reveals important missed opportunities to prevent underage alcohol use. Unhealthy alcohol use is the third-leading preventable cause of death nationwide. Alcohol is the most widely used substance of abuse among youth, and dangerous binge drinking is common among underage drinkers. Research has shown that asking adult patients about alcohol use and advising them to cut back on risky drinking can have lasting effects. This type of screening and brief counseling by healthcare providers is linked to reduced drinking. Growing evidence suggests that adolescents might also benefit from alcohol screening and counseling.

Paraprofessional Approach to Home-Visiting Preventive Intervention for American Indian Teen Mothers Prevents Early Precursors for Problem Behavior (January 2013)

National Institute on Drug Abuse (NIDA)

Drug use among American Indian youth is higher than among any other racial ethnic group in the United States, and American Indian teens are nearly twice as likely to have children as other U.S. teens. Investigators tested the impact of a culturally sensitive home-visiting preventive intervention to strengthen parenting practices, develop maternal social skills, and reduce maternal drug use to improve outcomes for youth. At 12 months’ postpartum, mothers in the intervention group had significantly greater parenting knowledge, parenting self-efficacy, and home safety attitudes and fewer externalizing behaviors while their children had fewer externalizing problems. In a subsample of mothers with any lifetime substance use at baseline, intervention children had fewer externalizing and dysregulation problems than those in the comparison group, and fewer were identified as clinically at risk for externalizing and internalizing problems. This research reflects the potential of early intervention for changing risk trajectories for youth and highlights the ability to sustain meaningful impacts from home visiting with well-trained paraprofessionals.

Regular Marijuana Use by Teens Continues To Be a Concern (December 2012)

National Institute on Drug Abuse (NIDA)

The 2012 Monitoring the Future survey, an annual survey of 8th, 10th, and 12th graders, showed continued high use of marijuana by the Nation’s 8th, 10th, and 12th graders combined with a drop in perceptions of its potential harms. The survey was carried out in classrooms around the country this past year, under a grant from the NIDA. Low perception of harm can signal future increases in use. Only 41.7% of eighth graders see occasional use of marijuana as harmful; 66.9% see regular use as harmful. Both rates are at the lowest since the survey began tracking risk perception for this age group in 1991. As teens get older, their perception of risk diminishes. Only 20.6% of 12th graders see occasional use as harmful (the lowest since 1983), and 44.1% see regular use as harmful, the lowest since 1979.

NIH-Funded Study Links Long-Term Marijuana Use, Especially When Started During Adolescence, With Decreased IQ and Impaired Cognitive Function (September 2012)

National Institute on Drug Abuse (NIDA)
National Institute on Aging (NIA)
National Institute of Mental Health (NIMH)

NIH-funded research shows that long-term marijuana use is associated with impaired intellectual functioning, especially if usage starts during the teen years. Over 1,000 study participants were given neuropsychological tests in early adolescence, prior to initiation of marijuana use, and then retested in mid-adulthood. Study members with more persistent marijuana dependence showed greater IQ decline and greater impairment across five different cognitive domains, especially executive function and processing speed. This is the first long-term prospective study to test young people before their first use of marijuana and again after more than 20 years of use. The study was thus able to rule out pre-existing differences in IQ between heavy marijuana users and others; it is also significant for including degree of cannabis exposure and age of onset as factors. Those who started use during the teen years showed greater IQ decline than those who began use as adults. These latter results are especially troubling, given recent data showing increased marijuana use among teens over the last 5 years, along with declines in perceived risk of harm associated with use. The results of this study are consistent with the notion that cannabis may actually cause some of the neuropsychological deficits seen in regular cannabis users.

Cognitive Changes May Be Only Sign of Fetal Alcohol Exposure (July 2012)

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Most children exposed to high levels of alcohol in the womb do not develop the distinct facial features seen in fetal alcohol syndrome, but instead show signs of abnormal intellectual or behavioral development, according to a study by researchers at the NIH and researchers in Chile. These abnormalities of the nervous system involved language delays, hyperactivity, attention deficits, or intellectual delays. The researchers used the phrase “functional neurologic impairment” to describe these abnormalities. The study authors documented an abnormality in one of these areas in about 44% of children whose mothers drank four or more drinks per day during pregnancy. In contrast, abnormal facial features were present in about 17% of alcohol-exposed children.