Parameters of preventing substance misuse in adolescents

Key to prevention of substance use disorders involves understanding the antecedents of drug misuse that often occur or surface in childhood and increase the likelihood of subsequently developing a range of risky behaviors in adolescence. Targeting these antecedent factors prior to their full emergence through effective preventive interventions has great potential to redirect the developmental trajectory towards healthy behaviors throughout the life span. In this chapter, we present examples of prevention program contents that aim to modify antecedents at different levels of analysis (neurobiological to large social environment). Although by adolescence, antecedent factors may have already exerted an influence, this is a highly plastic period of development with potential to alter malleable processes that may have been affected. Various modalities of program delivery are discussed in this context with an explanation of how programming might vary as a function of developmental age and risk status. Also, we delve into the debate about whether programming should focus on a single drug, all drugs, or more broadly on healthy lifestyles. In addition, we discuss the multiple challenges of translating scientific findings to programming. And finally, we suggest several future needs for innovations in prevention research and practice based on the scientific evidence.