In recent decades, prevention has become an increasingly important challenge for public interventions in the addiction field
Addiction prevention programmes are defined as a series of actions that promote protective factors and eliminate or reduce risk factors for substance use – Photo: Shutterstock
The importance of prevention
Preventing addictive behaviours among adolescents is a major challenge for society as a whole. However, prevention activities are often insufficiently prepared and are based more on beliefs or ideologies than on scientific knowledge. Moreover, these activities lack homogeneity, both in terms of lines of intervention and funding, and are not adapted to the specificities of the target population.
Dianova believes that the prevention of addiction among young people should integrate societal developments (new drugs, new modes of consumption, changes in legislation, etc.) through the use of scientifically validated strategies based on standards and methodological guidelines. These strategies are based in particular on:
- The acquisition of psychosocial skills (problem solving, decision making, interpersonal skills, stress management, etc.);
- Interventions aimed at developing parenting skills (communication skills, conflict management, ability to set limits, etc.);
- Prevention strategies tailored to youth with vulnerability factors (e.g. those whose parents suffer from substance use disorders).
Education-based approaches
Young people are not the only people who use substances, but adolescents today are growing up in an environment where drugs, both legal and illegal, are ubiquitous.
In most countries across the world, substance use increases sharply during adolescence. As young people’s social networks expand, their alcohol consumption becomes more frequent and intense, and the quantities consumed – in a single episode – are often significantly higher than those of adults. Tobacco and cannabis use tends to follow a similar pattern, with low levels of use up to the age of 15, which then tend to increase to more than half of adolescents between the ages of 17 and 18.
Providing information about drugs involves conveying objective and scientifically validated knowledge, while ensuring that it is well understood. But providing information is not enough.
Moreover, while these three drugs are the most problematic in terms of the number of people affected, the impact of other drugs, in particular synthetic opiates, must also be taken into account. Some of these synthetic drugs, manufactured illegally, are tens or even hundreds of times more potent than traditional street heroin or prescription opiates. Given the propensity of many young people to engage in more or less dangerous experimentation, it is vital not only to prevent addictive behaviours in general (especially at an age when the brain is not yet fully developed), but also to inform and raise awareness so that one day’s experience is literally not the last [1].
Gaining young people's trust
Experiences during adolescence are fundamentally positive; they are not only a source of learning and creativity, but also have a structuring value in allowing them to gain autonomy and to refine their perception of the world, of others and of themselves. It is therefore undesirable (and impossible) to prevent young people from having their own experiences. Therefore, drug prevention actions should also be based on the eventual lived experience of adolescents.
Effective prevention approaches also involve gaining the trust of young people by telling them the truth. Programmes aimed at young people must start from the premise that it is impossible to prevent all substance use.
Rather than focusing on abstinence, programmes should focus on preventing the most at-risk behaviours by addressing the personal and environmental factors that may trigger or maintain them.
Effective preventive action is built in the medium and long term from a comprehensive perspective: of course, young people must be informed, but they must also be supported in their perception of the risks and benefits associated with different drugs, their protective factors must be reinforced, they must be encouraged to participate in activities that reinforce their self-esteem and enable them to develop a positive and satisfying relationship with the world.
Thus, in the field of prevention, educational, empowering and self-management perspectives have now replaced traditional, dissuasive and restrictive approaches, thanks to advances in knowledge in the social and human sciences.
Dianova's recommendations
Dianova recommends the development of comprehensive and early prevention strategies, involving not only the target population (e.g. school pupils), but also parents and community actors. These programmes should include not only in-school modalities (e.g. psychosocial skills development), but also out-of-school modalities, such as parenting programmes, while ensuring that adolescents have healthy participatory spaces for leisure and free time.
Finally, it is essential that programmes be not only flexible and diverse, but also adapted to the characteristics of the target population. In particular, the design and implementation of such programmes should be based on a gender perspective, i.e. they should be able to respond to gender-differentiated needs, in view of the distinctions between men and women or boys and girls, both in terms of use behaviours and social representations or, in the case of younger adolescents, psychological or physical development.
A structured and planned process
Prevention is often one of the pillars of the policies implemented by different governments. However, it must be stressed that an effective preventive approach is not improvised. On the contrary, these initiatives must be organised, supervised, planned over time and carried out by professionals. The organisation of a preventive action usually consists of several important phases:
- First phase: defining the problem and clarifying its values. Teams should never embark on a prevention action without first defining a simple question: What exactly do we want to prevent? Answering this question is not as obvious as it may seem: what are drugs, what do we mean by risky or problematic use, etc.? This is why it is better to discuss the question beforehand in order to arrive at a clear and as precise as possible statement of the phenomenon to be prevented.
- Second phase: understanding the phenomenon to be prevented. It is difficult to prevent a problem if one does not know its exact nature, its consequences or its prevalence in a given population. This step requires models and methods of analysis of the patterns, causes and consequences of problematic substance use.
- Third phase: programme planning. In this phase, the goal of the programme, i.e. the ideal situation in which the team considers the programme to be successful, should be established as precisely as possible. Planning usually includes the statement of general (long-term) or intermediate (short- or medium-term) objectives and the definition of the means used to achieve them. Finally, it is imperative that the objective set is both specific and measurable/quantifiable.
- Fourth phase: implementation of the programme. The implementation of the programme depends mainly on the choice of the means to be used, whether they are based on an educational approach to risk factors, on the development of personal skills, or on approaches based on social influence, in particular through intervention with parents and families or significant others.
- Fifth phase: evaluation of the programme. The evaluation phase consists, firstly, in checking that the programme is running well and, secondly, after its completion, in checking that the objectives have been achieved. In the first case, the aim is to lead the programme and continuously improve it; in the second case, the aim is to evaluate all the results and impacts of the programme with a view to feedback and knowledge sharing.
[1] In recent years in the United States, opioid overdose deaths have doubled among adolescents, even though opioid use has declined dramatically among this population.
