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.
A single screening question about drinking frequency in the past year could help doctors identify adolescents at risk for alcohol problems, according to a new study funded by the NIAAA. Researchers led by Duncan B. Clark, M.D., Ph.D., Professor of Psychiatry at the University of Pittsburgh Medical Center, asked nearly 1,200 young people ages 12 through 20 about their alcohol use and screened them for alcohol use disorder (AUD) using a computer-based questionnaire. Adolescents between 12 and 17 years of age who reported drinking at least one standard drink on three or more days in the past year were most at risk for alcohol problems. Screening for AUD based on the 3-day guideline demonstrated 91% sensitivity—indicating that a youth with AUD was likely to be detected by the screen—and 93% specificity—meaning those without AUD were likely to have a negative result. For adolescents ages 18–20, the researchers found that the best screen for alcohol problems was to ask whether individuals had engaged in 12 or more drinking days in the past year. "This finding confirms that a single question can be an effective screen for AUD," said Dr. Clark. The study also supports the use of the age-based screening thresholds put forward in NIAAA's Alcohol Screening and Brief Intervention for Youth: A Practitioner's Guide.
Marijuana use disorder is common in the United States, is often associated with other substance use disorders, behavioral problems, and disability, and goes largely untreated, according to a new study conducted by the NIAAA. The researchers interviewed more than 36,000 U.S. adults about alcohol use, drug use, and related psychiatric conditions. The analysis found that 2.5% of these adults experienced marijuana use disorder in the past year, while 6.3% had met the diagnostic criteria for the disorder at some point in their lives. The data show that marijuana use disorder is about twice as common among men than women, and that younger age groups are much more likely to experience the disorder than people age 45 and over. The study also found that past-year and lifetime marijuana use disorders were strongly and consistently associated with other substance use and mental health disorders. "These findings demonstrate that people with marijuana use disorder are vulnerable to other mental health disorders," said Nora D. Volkow, M.D., director of NIDA. "The study emphasizes the need for such individuals to receive help through evidence-based treatments that address these co-occurring conditions."
The 24/7 Sobriety Program, a criminal justice program that requires offenders convicted of alcohol-related offenses to stop drinking and submit to frequent alcohol testing (with swift, certain, and modest sanctions for a violation), was linked, in an NIAAA-funded study, to a significant reduction in county-level mortality rates in South Dakota. The researchers analyzed county-level mortality data from 2000 to 2011. Aided by the fact that different counties implemented 24/7 Sobriety at different points in time, they were able to compare within-county changes in mortality to the implementation of 24/7 Sobriety. The program was associated with a 4.2% decrease in all-cause mortality over six years, with the largest reductions occurring among women and individuals over 40. "If these results are replicated in future studies, it could advance our understanding of how interventions within the criminal justice system can be used to improve public health," said George F. Koob, Ph.D., Director of NIAAA.
In the United States and throughout the world, men drink more alcohol than women. But a recent analysis by scientists at the NIAAA indicates that longstanding differences between men and women in alcohol consumption and alcohol-related harms might be narrowing in the United States. Researchers examined data from yearly national surveys conducted between 2002 and 2012. They found that the percentage of those who drank alcohol in the previous 30 days increased for females from 44.9% to 48.3%, but decreased for males from 57.4% to 56.1% between 2002 and 2012. The NIAAA Director George F. Koob, Ph.D. noted that the evidence of increasing alcohol use by females is particularly concerning given that women are at greater risk than men for a variety of alcohol-related health effects.
Two to three brief training sessions can significantly increase pediatricians' use of techniques for identifying and treating young people with potential alcohol, substance use, and mental health problems, according to a new study. The screening, brief intervention, and referral to treatment (SBIRT) techniques could be important tools for preventing and treating these common problems among young people. Researchers measured SBIRT use among three groups of clinicians: (1) a "pediatrician-only" group that was offered three SBIRT training sessions and was expected to conduct full SBIRT assessments and brief interventions by themselves; (2) a group of pediatricians who had one training session and only assessed patients and referred them to clinical psychologists "embedded" in the practices; and (3) a "usual care" group. The researchers found that both intervention arms administered more assessments and brief interventions than those in the usual care arm. However, overall pediatrician attention to behavioral health concerns was still low. "This research provides valuable new information about strategies that might improve implementation of SBIRT in everyday pediatric practice settings," said NIAAA Director George F. Koob, Ph.D.
Boys are more likely than girls to receive a prescription for antipsychotic medication regardless of age, researchers have found. The team looked at prescription data for 2006–2010 and found antipsychotic use increased with age in both boys and girls. Approximately 1.5% of boys ages 10–18 received an antipsychotic prescription in 2010, although the percentage falls by nearly half after age 19. Among antipsychotic users with mental disorder diagnoses, attention deficit hyperactivity disorder (ADHD) was the most common diagnosis among youth ages 1–18, while depression was the most common diagnosis among young adults ages 19–24 receiving antipsychotics. "In addition to having a new look at antipsychotic use among youth, one positive finding coming from this study is that around 75% of these kids have at least some contact with a psychiatrist," said NIMH Director Thomas Insel, M.D.
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.