A Comprehensive Approach:
Preventing Blood-Borne Infections Among Injection Drug Users
Chapter 3, Section 2: Key Strategies
PRIMARY DRUG PREVENTION
Primary drug prevention is a key strategy in a
comprehensive approach to preventing blood-borne diseases among IDUs
and reducing the spread to others. By helping individuals avoid drug
use and drug injection altogether, these programs help eliminate the
risk of injection-related blood-borne virus transmission. Primary drug
prevention programs, which are conducted in a variety of settings, including
schools, families, and community-based organizations and through a variety
of channels, such as the media, are largely aimed at youth to encourage
them to avoid or delay the age of first use of alcohol, tobacco, marijuana,
inhalants, and other drugs. Avoiding or delaying substance use can help
youth prevent many problems associated with it, including truancy, academic
failure, violence, thefts, motor vehicle crashes, homicides, injuries,
suicides, and risky sexual behaviors (Ary et al., 1999; Berger and Levin,
1993; Cohen et al., 1997; Donovan et al., 1988; Farrell et al., 1992;
Osgood et al., 1988).
PRIMARY
DRUG PREVENTION
Community
Coalitions Are Powerful Agents for Change
Over the last 25 years, many community
groups and coalitions have sprung up to respond to a variety of social
problems in the U.S. Among the most powerful are coalitions that have
worked to prevent alcohol and drug use among youth and to achieve drug-free
communities. These coalitions recognize that primary prevention is not
so much a specific program-though those are important-but a process over
time in which a variety of individuals and groups come together to study
and then address the problem of drug abuse and related issues (Rusche,
1995). The results include strengthened organizations, more consistent
policies, shared understanding of different viewpoints, changed social
attitudes, and reduced drug use. Three good examples of community coalitions
are:
Join Together founded in 1991, which
supports community-based efforts to reduce, prevent, and treat substance
abuse across the nation. In 1996, Join Together broadened its scope
to include gun violence prevention because of its belief that communities
need to employ comprehensive strategies that respond to the harms related
to substance abuse. Join Together produces reports, newsletters, and
community action kits; supports a National Leadership Fellows program;
sponsors public policy panels that examine and recommend changes in
public policies and practices related to substance abuse; provides technical
assistance designed to link people nationwide so that they can share
information and resources; and conducts surveys to measure and define
the community movement against substance abuse. Join Together is funded
by a grant from The Robert Wood Johnson Foundation to the Boston University
School of Public Health.
Community Anti-Drug Coalitions of American
(CADCA), which creates and strengthens the capacity of new and existing
coalitions to build safe, healthy, and drug-free communities. CADCA
supports its 4,300 members with technical assistance and training, public
policy initiatives, media strategies and marketing programs, and conferences
and special events. The President's Drug Advisory Council founded CADCA
in 1992 and it is currently funded by The Robert Wood Johnson Foundation,
the Knight Foundation, the Samuel Newhouse Foundation, the Annie E.
Casey Foundation, and the K-Mart Corporation.
The Miami Coalition, which is a broadly-based
community organization dedicated to reducing the problems of drug abuse,
addiction, and directly related social issues. The Coalition serves
as a convener and facilitator, bringing together diverse local institutions
and organizations to determine how Miami-Dade County can collectively
tackle this major criminal justice and health crisis. These groups have
included law enforcement, medicine, education, business and commerce,
the corporate workplace, the faith community, media, the banking industry,
neighborhoods, youth, and families. The Coalition, which was founded
by Dade County' s corporate and civic leadership in 1988, spent much
of its founding year in a strategic planning process that resulted in
a detailed analysis of community needs and resources related to the
local drug problem and the formation of task forces assigned to address
specific goals. This same process of analysis and response has been
continued and refined each year since then.
For more information: Join Together,
Boston, MA, 617/437-1500, www.jointogether.org; Community Anti-Drug Coalitions of America, Alexandria, VA, 703/706-0560,
www.cadca.org; The Miami Coalition,
Coral Gables, FL, 305/284-6848, www.miamicoalition.org. More information on primary drug prevention can also be obtained from
National Families in Action, a national drug education, prevention, and
policy center founded in 1977. NFIA, Atlanta, GA, 404/248-9676, www.emory.edu/NFIA.
PRIMARY
DRUG PREVENTION
Learning
What Makes A Program Effective
A number of primary drug prevention
programs have been rigorously evaluated and are recommended. They fall
into several categories:
Universal programs, which are designed to
reach a general population, such as all students in school-
Project Star (Pentz, 1995; Pentz et al., 1989)
Life Skills Training Program (Botvin et al., 1990;
Botvin et al., 1995a; Botvin et al., 1995b)
Adolescent Alcohol Prevention Trial (Donaldson
et al., 1994)
Seattle Social Development Project (Hawkins et
al., 1992)
Adolescents Training and Learning to Avoid Steroids
(Goldberg et al., 1996a; Goldberg et al., 1996b)
Project Family (Spoth, 1998)
Selective programs, which target groups at
risk or other subsets of the general population-
Strengthening Families Program (Kumpfer et al.,
1996)
Focus on Families (Bry et al., 1998)
Indicated programs, which target people who
are already experimenting with drugs or who exhibit other risk-related
behaviors-
Reconnecting Youth Program (Eggert et al., 1994;
Eggert et al., 1995)
Comprehensive programs, which include several
interventions to reach the general population, groups at risk, or those
already using drugs-
Adolescent Transitions Program (Dishion et al.,
1998)
For more information: Drug Strategies, 1999; NIDA,
1997.
This CDC Web site is no longer being reviewed or updated and thus is no longer kept current. This site remains to assist researchers or others needing historical content.