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U.S. Department of Health and Human Services

Archival Content: 1999-2005

A Comprehensive Approach:
Preventing Blood-Borne Infections Among Injection Drug Users

Chapter 3, Section 2: Key Strategies


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).


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,;Link to a Non-CDC Link Community Anti-Drug Coalitions of America, Alexandria, VA, 703/706-0560,;Link to a Non-CDC Link The Miami Coalition, Coral Gables, FL, 305/284-6848, to a Non-CDC Link 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, to a Non-CDC Link


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.

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