Article 1 –Drug Abuse Prevention: What Works
Institute of medicine (IOM 1994) proposed a new framework based on Gordon’s operational
classification of disease prevention.
Divided the continuum of care:
o A) Universal (anti drugs and alcohol info at schools)
o B) Selective (targets subsets like children of alcoholics)
o C) Indicated (targets people who aren’t clinically diagnosed, but exhibit serious
o *They replace primary, secondary and tertiary
The IOM classification system’s prevention programs targets an audience continuum (the degree to
which someone is at risk).
Risk factor: an association between some characteristics or attribute of an individual, group, or
environment and an increased probability of certain disorders.
Protective factors: inoculate or protect persons and can strengthen a persons determination to
reject or avoid substance abuse. Can inhibit self-destructive behaviours and situations that advance
The IOM model doesn’t correspond well with the public health model.
The IOM model targets interventions and reduction of new cases.
Universal Preventive Intervention Strategies:
mission: to deter the onset of substance abuse by providing all individuals the information
and skills necessary to prevent the problems.
Example of general: use of seatbelts, shots, prenatal care, etc.
Example of substance abuse: in school education, public awareness campaigns
All designed to reach an entire population, without regard to individual risk factors
All designed to delay or prevent substance abuse, but don’t recruit participants.
All programs typically have lower staff to audience ratio and require less time.
All programs typically have staff members from other fields who were trained.
Selective Preventive Intervention Strategies:
Mission: to target specific subgroups that are believed to be at greater risk than others. Risk
groups may be identified by biological basis, psychological, social, or environmental factors
associated with substance abuse.
Example of general: home visitations for low birth weight children, yearly mammograms for
women with a history of breast cancer.
Example for substance abuse: special clubs for children of alcoholics (the children are drug
free, but they’re at risk for developing an addiction)
All programs are designed to delay or prevent substance abuse
All programs recruit specific participants
All programs require skilled staff and are generally more expensive per person
Indicated Preventative Intervention Strategies:
Mission: identify individuals who are exhibiting early signs of substance abuse and other
problem behaviours associated with substance abuse. Participants may or may not be