Module One

Introduction

### Time

The anticipated time for the module is four hours.

### Learning Objectives

Participants will be able to:

-   Identify by name at least three other participants

-   Practice responding to proponents of various viewpoints of
    prevention

-   Understand the history of drugs in America and its impact on current
    viewpoints

-   Review the building blocks of successful prevention

### Materials and Preparation

1.  Prepare an overhead or LCD projector with the appropriate slides.

2.  Adapt the agenda to your schedule and provide for participants.

3.  Place a participant manual on each seat. Be ready to use the
    following information and work sheets:

-   **Viewpoints of Prevention**

-   **History of Drugs in America**

-   **A Timeline of Prevention**

-   **Evolution and Training of the Prevention Discipline**

-   **Building Blocks for Successful Prevention Programs**

4.  Make a copy of the pre-test for each participant, if using pre-post
    tests.

5.  Prepare role-play cards for the Viewpoints of Prevention activity.

6.  Have handy a chart pad and markers.

7.  Set up a videocassette recorder and monitor to show a video on the
    history of drugs.

> **Trainer Note:**
>
> If you have multiple trainers, it is advisable for each trainer to
> present during Section 1. The section can be divided as follows:

-   Trainer A can present slide 1, **Welcome** through slide 6,
    **Introduction** and the getting acquainted activity

-   Trainer B can present slide 7, **Attitudes About Drugs** through
    slide 10, **Viewpoints** and the video

-   Trainer C can present slide 11, **Drugs of Abuse** through slide 17,
    **Introduction**.

### Format of Facilitator Notes

Trainer instructions are in *italics.* Suggested narrative is in normal
font.

### Integrating the Strategic Planning Framework throughout the SAPST

*The Substance Abuse Prevention Specialist Training (SAPST) is designed
to cultivate readiness in community level prevention providers to
operate as prevention professionals in the context of increased
accountability to funders, to other providers and of course to
communities. Prevention as a field is operating in an environment of
increased accountability for the services provided and the outcomes
achieved by those services. In order to meet the challenge of achieving
measurable positive population level outcomes and the increasingly
stringent accountability standards preventionists must employ a data
driven, outcomes based planning process.*

*Which leads to the question: "How does the Substance Abuse Prevention
Specialist Training support a data driven, outcomes based planning
process such as SAMHSA/CSAP's Strategic Prevention Framework?" It is
incumbent upon the facilitators of this curriculum to draw connections
between the information in each of the modules and the Strategic
Prevention Framework (SPF) to answer this question. The material covered
in modules 1, 2, 4, 5, 6, 7 & 8 (the final module) feeds into what
should be contained in a data driven, outcomes based strategic plan. In
each module of the SAPST, facilitator notes provide some examples of how
the content supports the SPF. Facilitators should be diligent in drawing
these and other connections between the modules and the SPF when
conducting the SAPST. This helps to solidify the connections for
participants, not only between the SPF and the modules, but also among
the modules themselves.*

*The background information provided in Module 1 is useful to understand
the general context of prevention, to provide an overview of the
"culture" of prevention services as well as some of the likely
perspectives that preventionists encounter in their work. The content
and exercises regarding "Attitudes about Drugs" and "Viewpoints of
Prevention" are means for participants to begin to separate empirical
evidence or "hard data" from "soft data" like anecdotal information.
Both types of information can be useful to providers in defining needs,
assessing capacity, community readiness and developing strategic plans.
Empirical evidence or "hard data" such as incidence and prevalence rates
is vital to the SPF Assessment Step; data of this nature generally
indicates the ATOD- related problems in a community. Anecdotal
information such as the prevailing view of a community's readiness to
address specific ATOD-related problems is also important to assess as
part of the SPF Capacity Building and Mobilizing Step and account for in
a strategic plan (SPF Planning Step).*

Slide 1

*Show slide 1, **Welcome Substance Abuse Prevention Specialist
Training.***

*Welcome participants to the training and introduce yourself, other
trainers, and hosts or sponsors.*

The purpose of this training is to provide an overview of basic
information for substance abuse prevention professionals. This is a
basic curriculum that will introduce participants to the prevention
field. Becoming truly competent, sensitive and resourceful prevention
professionals is an ongoing process involving continuing education and
practical experience in the field. The substance abuse prevention
profession is a young and evolving profession and, whether you are new
to the field or have many years\' experience, continuing education and
experience will contribute to your expertise in many of the areas we
will overview here.

*Lead a brief discussion, asking the following questions:* What is
prevention? What does it look like in your community? What do you want
to prevent/create?

*Optional activity-*

*This activity is especially helpful when participants have worked in
the treatment field and may be unclear about the differences between
prevention and treatment.*

I\'d like to tell a story that may illustrate the difference between
prevention and treatment. Two friends, Susan and Fernando, are fishing
on a river when Fernando looks up river and sees a man in the water! He
is struggling to stay afloat, so Fernando drops his fishing pole and
pulls the man out of the water. The man is sputtering and cold, and
Susan calls an ambulance on her cell phone to take the person to a
hospital. Susan and Fernando go back to fishing. Pretty soon they look
up river again and see a woman in the water! She is strug­gling, too, so
Fernando drops his fishing pole again and pulls the woman out of the
water. She is not in very good shape, so Susan calls another ambulance
to take her to a hospital. The friends return to fishing when they look
up river and see a whole group of people in the water! They are
struggling to stay afloat, but look like they are dragging each other
down. Fernando drops his fishing pole and starts hauling people out of
the water. He looks up and sees Susan walking away, up river. He calls
to her to come help pull these people out of the river, and Susan
responds that she is going up river to find out why all the people are
ending up in the water.

The people in the water represent individuals who are already in trouble
with alcohol, tobacco or other drugs. Do you think we will always have
some people in the water, or that we will ever completely eradicate
substance abuse? We know we will always need ambulances, representing
treatment providers, to provide treatment services for those already
harmfully involved with substances. We in prevention, however, work up
river. We go up river to find out what contributes to people ending up
abusing substances and needing treatment services. We want to know
exactly what is causing people to fall into *this* river, which may be
different from river to river. Perhaps we go upstream and find a fence,
built to keep people away from the river, has fallen and needs to be
rebuilt. Maybe we find a slippery slope running into the river and can
plant vegeta­tion on the slope to prevent people from falling down the
slope. Maybe we find a big sign announcing, \"The water\'s great, jump
in!\" and we can take the sign down and replace it with a warning sign.

So, in prevention, we work to find out what is causing people to abuse
substances in *our* community, and then we work to reduce those risks
and to build protection against substance abuse. In this curriculum we
will offer a research-based process communities can use to assess their
community's unique needs in relation to substance abuse and its
contributing factors, find where gaps exist in their current prevention
plan, use proven prevention strategies to design programs and services
that will enhance their particular community\'s efforts to prevent
substance abuse, and evaluate the effectiveness of their efforts.

*Ask participants if this story helps clarify what prevention is and how
it differs from treatment. Solicit comments and questions toward this
end.*

*Optional activity-*

*Have participants form small groups and develop their own prevention
story, building on an analogy that works for their community/culture.*

Slide 2

*Show slide 2, **Definition of Prevention** and define prevention in the
context of this curriculum. Let participants know that you will expand
upon this definition of prevention in Module 2.*

In 1997, the Center for Substance Abuse Prevention (CSAP) funded six
regional Centers for the Application of Prevention Technologies (CAPTs)
to assist those working in the prevention field to apply science-based
prevention strategies and programs. In 1989, the Substance Abuse
Prevention Specialist Training (SAPST) was developed by CSAP\'s Western
CAPT in response to multiple requests from prevention specialists in
state agencies and community-based organizations in the region for
assistance in translating research into practice. It is based on the
Prevention Generalist Training developed by the Colorado Alcohol and
Drug Abuse Division.

The SAPST, updated in 2003, and again in 2005 by representatives from
all five regional CAPTs, is designed to disseminate to pre-service or
in-service prevention personnel up-to-date research and methods in the
prevention field and to contribute to the develop­ment of professionally
trained substance abuse prevention specialists.

*Tell participants that you will overview the contents and agenda of the
SAPST in a few minutes, but first you would like to set the stage for
the rest of the training.*

Slide 3

*Show slide and post easel page labeled, **Expectations**. Ask
participants to share their expectations of this training. Record
expectations on easel page and post. Refer to this page during and at
the end of the training, and look for opportunities to incorporate as
many participant expectations as possible.*

Slide 4

*Show the slide and refer participants to the information sheet,
**Agenda** and review it.* *Ask participants if they have any questions
about the agenda. Address any disparity between participants\'
expectations and the agenda. Incorporate expectations as possible as the
training progresses, and point out expectations that are clearly beyond
the scope of this training. Encourage participants to network with each
other and trainers to share resources and meet their needs.*

> The process we will be using to teach the curriculum incorporates many
> different learn­ing styles in an effort to make learning enjoyable and
> comfortable for everyone. We will be providing a lot of content
> information on many topics, and participants will be working
> individually and in cooperative learning groups with their fellow
> students. We know that you all bring with you a variety of knowledge,
> backgrounds and experience. Some may want us to slow the pace and
> others familiar with some of the information may want us to speed up
> the pace. We will work to strike a comfortable balance, and encourage
> participants to be flexible so that the needs of everyone can be met.

You all have a valuable resource in your Participant Manuals and I would
like to orient you to the manuals at this time. *Orient participants to
their manuals now.*

Slide 5

*Show slide and post easel page labeled, **Ground Rules**. Ask
participants to brainstorm Ground Rules that they believe will support a
group environment that is amicable and conducive to learning.*

*Using the chart pad, write down the suggested ground rules. Be sure to
include the following:*

-   *Start and end on time, including breaks*

-   *Give everyone an opportunity to speak*

-   *Respect others\' opinions*

-   *Set cellular phones to \"vibrate\" or \"off\"*

-   *Have fun!*

*Display the Ground Rules where everyone can see them. Refer to and use
the ground rules in group discussions throughout the SAPST.*

Slide 6

*Show the slide and post easel page labeled, **Parking Lot**.*

If questions are asked that we know we will cover later in the
curriculum, or that are outside the scope of what we can address here,
we will ask permission to record them on the Parking Lot. Trainers will
review \"parked\" questions frequently so that we remember to address
them at the appropriate point in the curriculum or can foster networking
among participants to address them.

*Share any pertinent \"housekeeping\" information, (e.g. location of
bathrooms, telephones, refresh­ments, etc.).*

As part of our evaluation process, we will ask you to complete a
pre-test now and a post-test at the end of the curriculum. This process
will enable us to evaluate the effectiveness of the SAPST curriculum.
The test is only used internally as a measure of our success in meeting
the curricu­lum goals. We ask that you record your names on the test only
so that we may com­pare your pre- and post-test scores. You will receive
both your pre- and post-test to take with you at the end of the SAPST.
*Distribute a copy of the pre-test to each participant. Collect
pre-tests as they are completed and score them. Retain pre-tests until
post-tests are submitted on the last day of the SAPST and you have had a
chance to score the post-tests and compare them with the pre-test
scores.*

Slide 7

*Show the slide, **Intro­duction**, and review it.*

*Select and lead one of the Getting Acquainted activities listed below.
It maybe helpful to prepare an easel page with supportive instructions
for your selected activity*.

*Activity 1: Group Resume*

*Have participants create a group resume with their tablemates (6-8
people working to­gether). They are to include the following:*

-   *Their names and work roles*

-   *Skills each member brings to the training*

-   *Years the members together have worked in prevention*

-   *The strangest thing the members have in common, that they are
    willing to share with the whole class*

*Have each group take turns reporting to the whole class. Have a
co-trainer keep a running tally of the number of years of participants\'
experience in prevention and report this num­ber to debrief the entire
activity, noting the vast experience and varied skills represented. Ask
members to network and share their expertise with each other this week.*

*Activity 2: Sharing Circle*

*Have participants form a circle in an open space in the room. Have
participants toss a nerf ball or other soft object to each other. The
receiver shares one of the following about himself or herself:*

-   *The origin of their name*

-   *Where they would travel if money was no constraint*

-   *What animal they would like to be.*

-   *How they would spend one million dollars*

*Toss the object around the circle until everyone has had a chance to
share.*

*Activity 3: The Name Game*

*This works well if participants are seated in a horseshoe arrangement,
or you may have them form a circle. Have everyone remove his or her
nametags. The trainer begins by stating his or her first name. Moving
clockwise around the circle, have the next participant repeat the
trainer's name and state his or her own first name. Continue around the
circle, having each participant repeat all the names of those before
them until play returns to the trainer who repeats everyone\'s name in
the circle.*

*Activity 4: Yarn Web*

*Have participants form a circle. The trainer begins with a ball of
yarn, holds the yarn end and tosses the ball to another member in the
circle. The receiver shares something they bring to their work in the
prevention field, (e.g. the reason they work in this field, what they
hope to accomplish by their work, something they hope to contribute,
etc.) They then keep a hold of the yarn and toss the ball to another
person in the circle until everyone has had a chance to share. Debrief
by pointing out the web we form and connect the web to the ongoing
networking you hope will continue through the week.*

*Activity 5: People Bingo*

*This activity requires that the trainer prepare Bingo cards in advance,
with such categories as the following:*

-   *Where I live*

-   *My job*

-   *My favorite book*

-   *My favorite movie*

-   *My birthplace*

-   *A significant personal mentor*

-   *A personal hero*

-   *A word to describe me*

-   *Most interesting place I\'ve visited*

*Each participant receives a bingo card, and everyone moves around the
room asking participants to share the information requested in one
square and sign that square. Each fellow participant may sign only one
square of an individual\'s Bingo card. The first person to get all
his/her squares signed is the "winner." De­brief by asking a few
participants to share someone they found who has traveled to an
interesting place, or named an interesting hero, etc.*

*Activity 6: Commonalities*

*Have participants stand and find a partner. The pair is to identify
something they have in common. Then have each pair find another pair.
The foursome is to identify something they have in common which was not
previously used by either pair. Foursomes then join with another
foursome and identify something the 8 of them have in common which was
not previously used by either foursome. The activity continues until the
entire class is one group and identifies something they have in common
which has not yet been mentioned.*

*Activity 7: Meet Your Neighbors*

*Have participants form a circle with their chairs. The trainer begins
by standing in the middle of the circle and announcing, \"I\'d like to
know everyone who\...*

-   *\...has blue eyes,*

-   *\...has a brother*

-   *\...has a sister,*

-   *\...was born in this state,*

-   *\...has a pet*

-   *\...has ever written their congressperson," etc.*

*Everyone who fits that description must stand and move to another chair
at least two chairs away from their original chair, in musical chairs
fashion. The trainer also participates. Whoever is left standing without
a chair moves to the center of the circle and asks the next question.
Continue the game as long as people are enjoying it and learning about
each other.*

*Activity 8: Polling*

*In a very large group, have participants meet each other at their
tables, sharing their names and jobs. Then poll the entire group, asking
participants to raise their hands if they have worked in prevention for
more than 5 years, if they are new to prevention, if they work in
schools, in community agencies, in government, if they are parents, etc.
You can toss in a fun question at the end, using humor to bond the group
to each other and to you as trainer.*

We encourage you all to continue to get to know each other and network
throughout the week together. The trainers will be regrouping you
periodically throughout the training so that you will have an
opportunity to work with many others.

*Refer back to the slide, **Intro­duction**. Explain that now in Section
1 we will look at the history of drugs and prevention in our country.*

As we begin to look at these topics, it is important to recognize that
we as prevention professionals bring with us our own attitudes about
drugs and prevention. Many of these attitudes have roots in the families
and communities in which we grew up, as well as in our own life
experiences.

Let's begin looking at some of our attitudes and their influence on our
work. *Ask participants to organize themselves into groups of about four
people they haven\'t met yet. Or they can work with their tablemates if
already arranged in small groups at tables.*

Slides 8-9

No matter how knowledgeable or competent prevention professionals may
be, our work---what we do for others---is invariably colored by the
attitudes we grew up with. It is important that we become aware of those
attitudes. It is also important that we explore and challenge those
attitudes which may be counterproductive.

*Show slide, **Attitudes about Drugs*** *and ask participants to discuss
the questions in their groups.*

*Allow participants about 15 minutes for groups to discuss the
questions. Reconvene the class and ask volunteers to report any
interesting discussion to the large group. Remark on the common, but
mistaken, attitude that tobacco and alcohol are not drugs. Point out
that attitudes about drugs also have cultural context, and ask
participants if cultural context came up in their discussions. Ask how
culture can be taken into consideration when addressing attitudes about
drugs.*

*Show the next slide, **Attitudes About Drugs** and review it.*

For the sake of common understanding, we will define \"substances\" to
include tobacco, alcohol, all illegal drugs, legal and over-the-counter
drugs of abuse (e.g. prescribed medica­tions, sleeping pills, alertness
pills, cold, allergy and flu medications,) inhalant substances, even
herbs, beverages and other substances that are used for their drug
effects. Since much of the research upon which this curriculum is
focused is based on adolescents, any use of tobacco, alcohol, or any
other substance used for its drug effects by minors is considered
substance abuse.

*Tell participants you'd like them to join you in an activity which will
further explore the attitudes about drugs and the viewpoints of
prevention which exist in all communities. Organize participants into
groups of 6 persons each. Have them count off 1-6 within each group, so
that each person has a number from 1 to 6.*

Slide 10

> *Show slide, **Viewpoints of Prevention** and refer participants to
> the corresponding information sheet. Provide the instructions which
> follow.*

This work sheet describes six prototypical viewpoints of prevention.
I\'d like you to read the viewpoint corresponding to your assigned
number. After you have read your viewpoint, I\'d like you to have a
discussion in your group. I want you to represent your viewpoint as
faithfully as you can. Try to get inside the head of the person
repre­senting that viewpoint, and then express your views to the rest of
the group from that point of view. Remember, these are not isolated
viewpoints; these six systems of thought represent millions of people.
During the discussion, you can be flexible---you can even change your
mind---but be sure that you initially speak from the point of view
assigned to you. And please use the Ground Rules we established earlier
for your discussion. The question for discussion before your group is
very simple: What do you think is the best way to address the problem of
drugs? You will have 15 minutes for your discussion.

Slide 11

*After 15 minutes, show the slide, **Viewpoints of Prevention** and
discuss the questions.*

*Reassure participants by humorously reminding them that they were only
role-playing and that they are not to be held liable for their point of
view in real life. Point out that viewpoints of prevention also occur
within cultural context. Ask participants how culture might influence
individuals' or groups' viewpoints of prevention? Conclude by noting
that as prevention professionals, they will be coming into contact with
people who hold these views, and it is important to be prepared to
encounter and address them.*

Our current society is not the only society to have addressed the
harmful effects of alcohol, tobacco and other drugs. By reviewing the
history of drugs in America, we can understand the roots of some of our
current views, policies, and beliefs about drugs. We can also learn from
the mistakes of the past.

Video

*Show the video, **Altered States** and refer participants to the
information sheet, **History of Drugs in America.** This video is about
60 minutes in length. If you are concerned about time, you may chose to
show 30 minutes of the video at this time and offer to show the
remainder during the last half hour of the lunch break.*

*Be aware that the racial and cultural stereotyping presented and
discussed in the video is a real part of our country's history, can
evoke strong feelings among participants, and unfortunately influences
some people's thinking to this day. Be prepared to debrief concerns
expressed by participants. Reinforce the importance to prevention
professionals of understanding and providing accurate information about
current drug use patterns and methods that challenge stereotyping of all
kinds.*

*Conclude discussion of the video by focusing on and emphasizing just
how ingrained alcohol, to­bacco, and other drugs are in the fabric of our
society and how bound up they are with our history as a nation. Ask if
anyone was raised or has lived in another country, and how the history
of drugs in other countries differs from that in America, and what the
implications of this might be for prevention professionals. Suggest that
as prevention professionals we have the opportunity to influence the
next stage of the history of drugs in America, and to shape how future
generations will view drugs, drug abuse, prevention, and the development
of healthy attitudes and behaviors.*

Slide 12

*Show slide, **Drugs of Abuse -** **Classifications** and review it.*

*Tell participants that, although, for the most part prevention
professionals do not treat chemically dependent individuals, they are
often asked questions about alcohol, tobacco, and other drugs (ATOD) and
their effects. It is not appropriate for prevention professionals to
tell youth, parents, and community members that this is not their area
of expertise. While it is wise to refer people to other sources of
information, prevention professionals should be able to provide general
information when asked about ATOD and their effects. Many of us will
take further coursework in this area to increase our knowledge in this
area. An update on the effects of alcohol, tobacco & drugs on the brain
is included in Module Six.*

Slide 13

*Show slide, **Drugs of First Use**.*

Drugs of first use are the most common drugs of initiation among youth
and typically precede the use of other illicit drugs such as cocaine,
LSD, and heroin. Drugs of first use include tobacco, alcohol, and in
some communi­ties inhalants and marijuana.

Prevention efforts focus first on drugs of first use since these drugs
are readily available and frequently used by children and adolescents.
Further, since research has shown that the age of first use of any drug
is related to later drug use by adolescents, focusing early prevention
efforts on drugs of first use is a developmentally sound strategy. One
study has shown that young people who begin using drugs before the age
of 15 are twice as likely to have problems with drugs than those who
delay initiation of use until after the age of 19 (Hawkins, Catalano, &
Miller, 1992).

A study conducted at the Center for Addiction and Substance Abuse at
Columbia found that children who use drugs of first use (tobacco,
alcohol, and marijuana) are up to 266 times more likely to use cocaine.
A study at the University of Michigan Institute for Social Research
found that among high school seniors, daily tobacco smokers were much
more likely to use every kind of controlled substance than non-smoking
students. The more cigarettes a student smoked, the more likely he or
she was to use marijuana and cocaine (Johnston, O\'Malley, and Bachman,
1987). Alcohol and tobacco cause more health and related problems than
other drugs. More people die each month from alcohol and tobacco related
problems than all illicit drugs combined (Torabi, Bailey, and
Majd-Tabbari, 1993).

For these reasons it is logical and reasonable for prevention
professionals to focus on delaying the initiation and reducing the use
of drugs of first use. For national data on current prevalence of use of
various drugs by youth and trends in drug use, see the Monitoring the
Future survey results at
[www.monitoringthefuture.org](http://www.monitoringthefuture.org/).

Slide 14

*Show slide, **Supply/Demand Reduction**. Slide displays titles only.
Click on this slide again to display examples.*

As we begin to look at how we have approached substance abuse prevention
in our country, we need an understanding of the difference between two
major drug prevention strate­gies--- supply reduction and demand
reduction. Supply reduction strate­gies seek to reduce the supply of
available drugs. *Ask participants for some examples of supply reduc­tion
initiatives with which they are familiar. (Confiscation of drug
shipments, destruction of crops, criminal penalties for possession and
distribution, limitations on alcohol outlet density, and \"compli­ance
checks\" for underage alcohol sales are examples of supply reduction
strategies).*

Demand reduction strategies seek to reduce the demand for drugs*. Ask
participants for some examples of demand reduction initiatives with
which they are familiar. (Assessment and treatment services, drug abuse
prevention curricula in schools, sobriety support services, and
parenting substance abuse prevention education are examples of demand
reduction strategies).*

In substance abuse prevention, we use both supply reduction strategies
and demand reduction strategies. Prevention demand reduction programs
include K-12 prevention educa­tion curricula, resistance skill training,
parenting education, and mentoring programs. Prevention supply reduction
strategies include environmental strategies such as limiting
availability of drugs through tax increases, limiting hours of sale, and
limiting alcohol outlet density.

Slide 15

*Show slide, **Discussion Questions**, and discuss the questions with
the entire group.*

*Refer participants to the information sheets, **Timeline of
Prevention** and **Evolution and Training of the Prevention
Discipline**. Explain that the first information sheet presents our
profession's approach to substance abuse prevention over the last 50
years. The second provides an overview of the development of the field
of prevention; ask participants to read these at their convenience.*

Slide 16 (Optional)

*Show optional slide, **Evolution and Training of the Prevention**
**Discipline**, and review it, using the worksheet as your guide. Ask
participants to discuss what elements define a discipline. Some elements
of a developed discipline include theory, methods, education, training,
ethics, certification, college degree, etc. In light of this
information, suggest that substance abuse prevention is an emerging
discipline.*

Slide 17

*Show slide, **Building Blocks for Successful Prevention Programs**.*

*Ask participants what, in their experience, makes for effective
prevention programs. After some discussion, show the slide and refer
participants to their work sheet, **Building Blocks for Successful
Prevention Programs. ***

These \"building blocks\" form a crucial knowledge base upon which to
build successful and effective preven­tion programs. One module of the
SAPST is dedicated to each of the \"building blocks."

[The program is facilitated by knowledgeable and competent
staff.]{.underline}

The purpose of the SAPST curriculum is to contribute to the development
of knowledge­able and competent prevention professionals by advancing
prevention science knowledge and its application to prevention program
planning.

[The program is based on sound theory and uses practice grounded in
research.]{.underline}

In Module 2 of the curriculum, three major theoretical approaches
currently utilized in the field of prevention are presented, including
Risk & Protective Factor Theory, Resiliency Ap­proach and the
Developmental Assets Model.

[The program is systematically planned and assessed.]{.underline}

In Module 3 we overview the 5-step Strategic Prevention Framework for
building successful preven­tion. In Section 3 we also discuss the role of
research, especially as it relates to CSAP\'s Principles of Effective
Substance Abuse Prevention and NIDA Prevention Principles and to
enhancing prevention programs using scientifically-defensible methods.

[The program is evaluated.]{.underline}

In Module 4 we discuss evaluating prevention programs in detail,
offering scientific methods to measure program outcomes and impacts. The
logic model is the basic tool of evalua­tion presented in Module 4.

[The program is sensitive to people from a variety of backgrounds and
cultures.]{.underline}

In Module 5 we explore various dimensions of culture and consider how to
develop culturally sensitive prevention programs.

[The program is developmentally appropriate.]{.underline}

Note that in Section 6 we provide information on human development
models and the signifi­cance of incorporating knowledge of human
development into prevention efforts.

[The program incorporates the media.]{.underline}

In Module 7 we focus on working with media advocacy and literacy and
utilizing positive \"social norming\" to develop prevention media
messages about alcohol, tobacco and other drugs.

[The program utilizes a code of ethics.]{.underline}

In module 8 a formal code of ethics from the National Association of
Prevention Professionals and Advocates is offered for review and
discussion.

The final module of the curriculum will offer the opportunity to apply
the informa­tion learned in the various modules of the SAPST.
Participants will review a poorly designed grant application and propose
suggestions for improvement based on prevention knowledge gained in the
training.

Slide 18

*Show slide, **Introduction.***

*Answer any questions participants may have. Ask them how they might use
the information and tools presented in this section. Show the title
slide, Introduction, review today's topics and preview Day 2 topic*

### INFORMATION SHEET {#information-sheet .HeadInfSheet}

# Agenda

These are the modules the Center for Substance Abuse Prevention's
Western Center for the Application of Prevention Technologies recommends
for training prevention professionals. Create an agenda for participants
based on your schedule.

**SECTION 1 Introduction**

Welcome

Expectations

Agenda

Participant Manuals

Ground Rules

Parking Lot

Pretest

Getting-Acquainted Activity

Attitudes About Drugs and Drug Prevention

Viewpoints of Prevention

History of Drugs in America

Evolution of the Prevention Discipline

Building Blocks of Successful Prevention

**SECTION 2 Prevention Research**

Current Approaches to Prevention

**SECTION 3 Prevention Program Planning**

The Strategic Prevention Framework

The IOM Classification

Prevention Principles

Enhancing Prevention Programs

Cultural Competency

Sustainability

**SECTION 4 Evaluation**

Building a Logic Model

Developing an Evaluation Plan

Measures and Sources of Evaluation Data

Internal and External Evaluation

**SECTION 5 The Cultural Context of Prevention**

Some Elements of Culture

Dimensions of Diversity

Culture and Prevention Programming

Gathering Information about Communities

**SECTION 6 Using Human Development in Prevention**

Changes

Maslow's Hierarchy of Needs

Emotional Development

Social Development

Moral Development

Prevention Strategies Focused on Emotional, Social, and Moral
Development

Brain Development

The Medicine Wheel Model of Human Development

**SECTION 7 The Media and Prevention**

The Role of Media in Prevention

Media Advocacy

Media Literacy

Social Marketing

Scare Tactics

**SECTION 8 Bringing It All Together**

Ethics in Prevention

Review

Applying the Information

Closing

### INFORMATION SHEET {#information-sheet-1 .HeadInfSheet}

# Viewpoints of Prevention

Represent your viewpoint faithfully in the discussion. You can be
flexible---you can even change your mind---but be sure that you
initially speak from the point of view described below.

1\. THE MORAL CRUSADER

You fervently believe that alcoholism and other drug dependence is a
sin. People who lapse into addiction are morally flawed and will no
doubt go to hell unless they are reformed. People who are strong willed
resist the temptations of drugs and follow the righteous path.

**The key to prevention** is warning and redeeming: warning people not
to be tempted by the evil of drugs and redeeming those who have fallen
under the spell and wish to rejoin society.

**The question you want answered:** If it's bad to use drugs---and it's
obviously bad---why shouldn't we try to get everyone on the straight and
narrow and throw the ones who refuse in prison?

2\. THE SOCIOECONOMIC AND ETHNIC CHAUVINIST

Everything you've seen leads you to believe that alcoholism and other
drug dependence is a malady of the poor and nonwhite. These people use
drugs to escape from their miserable existence, and drug use continues
the cycle of their poverty. They use drugs because they don't know any
better and they perpetuate their travails by becoming dependent.

**The key to prevention** is isolation: keeping addiction in the ghettos
and not letting it spread to the middle and upper classes.

**The question you want answered:** What's wrong with doing a little
triage---cutting off the people who have willingly sold themselves out
and trying to protect the rest of us?

3\. THE DOCTOR

Addiction is clearly a disease. People who are drunk, high, or otherwise
under the influence of drugs need to be cleansed of the substance within
them. You no more tolerate the resistance of the addicted patient than
you would tolerate the resistance of a tubercular patient.

**The key to prevention** is removal: getting drugs out of patients and
getting drugs out of society.

**The question you want answered:** Why don't we just set up treatment
facilities around the country and help those afflicted?

4\. THE SCARE MONGER

> People just don't understand the consequences of using drugs. You can
> overdose, you can become a drunk, you can get into a fatal car crash,
> lose your mind, and so on. If people only realized what horrible
> things could befall them if they used drugs, they'd keep far away.
>
> **The key to prevention** is fear: showing people as graphically as
> possible the lurid consequences of drug use.
>
> **The question you want answered:** Why should we hold back on showing
> people just how horrible using drugs is?

5\. THE EDUCATOR

We live in an enlightened age in which knowledge is power. If people use
drugs, it's only because they're not familiar with them. Once they know
what all the drugs are, how they affect the mind and body, and some of
the history behind different kinds of drugs, they won't be interested in
trying them.

**The key to prevention is** knowledge: giving people as much
information as possible about drugs and drug use.

**The question you want answered:** Why shouldn't we trust people's
innate intelligence and give them all the facts so they can make a safe
and healthy decision about drugs?

6\. THE BLAMER

The reason we're in such a sorry state is because some people aren't
pulling their weight. Parents are bringing up their kids too leniently.
Schools aren't setting good examples. Television, movies, and music are
replete with unhealthy role models. And politicians are bought off by
the big tobacco and alcohol corporations.

**The key to prevention** is accountability: making sure that everyone
toes the line about the harmfulness of drugs.

**The question you want answered:** Why can't we get tougher laws that
will hold parents, schools, media, and politicians to doing their part
to prevent drug abuse?

### INFORMATION SHEET {#information-sheet-2 .HeadInfSheet}

# History of Drugs in America

## Alcohol

Alcoholic beverages have been a part of the Nation's past since the
landing of the Pilgrims. According to "Alcohol and Public Policy: Beyond
the Shadow of Prohibition," a publication commissioned by the National
Institute on Alcohol Abuse and Alcoholism (NIAAA) and prepared by the
National Academy of Sciences, the colonists brought with them from
Europe a high regard for alcoholic beverages, which were considered an
important part of their diet. Drinking was pervasive because alcohol was
regarded primarily as a healthy substance with preventive and curative
powers, not as an intoxicant. Alcohol was also believed to be conducive
to social and personal health. It played an essential role in rituals of
conviviality and collective activity, such as barn raisings. While
drunkenness was condemned and punished, it was viewed only as an abuse
of a God-given gift.

The first temperance movement began in the early 1800's in response to
dramatic increases in production and consumption of alcoholic beverages,
which also coincided with rapid demographic changes. Agitation against
ardent spirits and the public disorder they spawned gradually increased
during the 1820's. In addition, inspired by the writings of Benjamin
Rush, the concept that alcohol was addicting and that this addiction was
capable of corrupting the mind and the body took hold. The American
Society of Temperance, created in 1826 by clergymen, spread the
antidrinking gospel. By 1835, out of a population of 13 million people,
1.5 million had taken the pledge to refrain from distilled spirits. The
first wave of the temperance movement (1825 to 1855) resulted in
dramatic reductions in the consumption of distilled spirits, although
beer drinking increased sharply after 1850.

The second wave of the temperance movement occurred in the late 1800's
with the emergence of the Women's Christian Temperance Movement, which,
unlike the first wave, embraced the concept of prohibition. It was
marked by both the recruitment of women into the movement and a
mobilization to close down saloons. The movement set out to remove the
destructive substance and the industries that promoted its use from the
country. The movement held that while some drinkers may escape problems
of alcohol use, even moderate drinkers flirted with danger.

The culmination of this second wave was the passage of the 18th
amendment to the U.S. Constitution and the Volstead Act, which took
effect in 1920, prohibiting the sale, manufacture, or transportation of
alcoholic beverages within the United States. Although Prohibition was
successful in reducing per capita consumption and some problems related
to drinking, the social turmoil it produced resulted in its repeal in
1933.

Since the repeal of Prohibition, the dominant view of alcohol problems
has been that alcoholism is the principal problem. With its focus on
treatment, the rise of the alcoholism movement depoliticized alcohol
problems as the object of attention; the alcoholic was considered to be
a deviant from the predominant styles of life of either abstinence or
"normal" drinking. The alcoholism movement is based on the belief that
chronic or addictive drinking is limited to a few, highly susceptible
individuals suffering from the disease of alcoholism.

The disease concept of alcoholism focuses on individual vulnerability,
whether it be genetic, biochemical, psychological, or social/cultural in
nature. According to this view, if the collective problems of each
alcoholic are solved, society's alcohol problem will be solved.

Nevertheless, the pre-Prohibition view of alcohol as a special commodity
has persisted in American society and is an accepted legacy of alcohol
control policies. Following the repeal of Prohibition, all States
restricted the sale of alcoholic beverages in one way or another to
prevent or reduce certain alcohol problems. In general, however, alcohol
control policies disappeared from the public agenda as both the
alcoholism movement and the alcoholic beverage industry embraced the
view that "the fault is in the man and not in the bottle."

This view of alcoholism has also been the dominant force in contemporary
alcohol-problem prevention. Until recently, the principal prevention
strategies focused on education and early treatment. According to this
view, education was intended to inform society about the disease and to
teach people about the early warning signs so that they could initiate
treatment as soon as possible. Efforts focused on "high-risk"
populations and attempted to correct a suspect process or flaw in the
individual, such as low self-esteem or lack of social skills. The belief
was that the success of education and treatment efforts in solving each
alcoholic's problem would solve society's alcohol problem as well.

Contemporary alcohol-problem prevention began in the 1970's as new
information on the nature, magnitude, and incidence of alcohol problems
raised public awareness that alcohol can be problematic when used by any
drinker, depending upon the situation. There was a renewed emphasis on
the diverse consequences of alcohol use---particularly trauma associated
with drunk driving, fires, and violence, as well as long-term health
consequences.

## Drugs for Nonmedical Purposes

The history of nonmedical drug use and the development of policies in
response to drug use also extend back to the early settlement of the
country. As with alcohol, the classification of certain drugs as legal
or illegal has changed over time. These changes sometimes had racial and
class overtones. According to Mosher and Yanagisako (1991), for example,
Prohibition was in part a response to the drinking practices of European
immigrants, who became the new lower class. Cocaine and opium were legal
during the 19th century and were favored drugs among the middle and
upper classes. Cocaine became illegal after it became associated with
African-Americans following Reconstruction. Opium was first restricted
in California in 1875, when it became associated with Chinese immigrant
workers. Marijuana was legal until the 1930's, when it became associated
with Mexicans. LSD, legal in the 1950's, became illegal in 1967, when it
became associated with the counterculture.

By the end of the 19th century, concern had grown over the
indiscriminate use of these drugs, especially the addicting patent
medicines. Cocaine, opium, and morphine were common ingredients in
various potions sold over the counter. Until 1903, cocaine was an
ingredient of Coca-Cola®. Heroin, which was isolated in 1868, was hailed
as a nonaddicting treatment for morphine addiction and alcoholism.
States began to enact control and prescription laws, and in 1906,
Congress passed the Pure Food and Drug Act. It was designed to control
opiate addiction by requiring labels that revealed the amount of drugs
contained in products, including opium, morphine, and heroin. It also
required accurate labeling of products containing alcohol, marijuana,
and cocaine.

The Harrison Act (1914) imposed a system of taxes on opium and coca
products, with registration and record-keeping requirements, in an
effort to control their sale or distribution. However, it did not
prohibit the legal supply of certain drugs, especially opiates.

Current drug laws are rooted in the 1970 Controlled Substances Act.
Under this measure, drugs are classified or scheduled according to their
medical use, their potential for abuse, and their likelihood of
producing dependence. The act contains provisions for adding drugs to
the schedule and rescheduling of drugs. It also establishes maximum
penalties for the criminal manufacture or distribution of scheduled
drugs.

## Creation of Agencies to Address Alcohol and Drug Abuse

Increases in per capita alcohol consumption as well as increases in the
use of illegal drugs during the 1960's raised public concern about
alcohol and other drug problems. Prevention issues gained prominence on
the national level with the creation of the NIAAA in 1971 and the
National Institute on Drug Abuse (NIDA) in 1974. In addition to mandates
for research and the management of national programs for treatment, both
institutes included prevention components.

To further prevention initiatives at the Federal level, the Anti-Drug
Abuse Act of 1986 created the U.S. Office for Substance Abuse Prevention
(OSAP), which consolidated alcohol and other drug prevention activities
under the Alcohol, Drug Abuse, and Mental Health Administration
(ADAMHA). The ADAMHA block-grant mandate called for States to set aside
20 percent of the alcohol and drug funds for prevention. In a 1992
reorganization, OSAP was changed to the Center for Substance Abuse
Prevention (CSAP), part of the new Substance Abuse and Mental Health
Services Administration (SAMHSA). While SAMHSA retained its major
program areas, the research institutes of NIAAA and NIDA moved to the
National Institutes of Health.

The Office of National Drug Control Policy (ONDCP) was established by
the Anti-Drug Abuse Act of 1988. ONDCP's primary objective was to
develop a drug control policy that included roles for the public and
private sectors to "restore order and security to American
neighborhoods, to dismantle drug trafficking organizations, to help
people break the habit of drug use, and to prevent those who have never
used illegal drugs from starting." In early 1992, underage alcohol use
was included among the drugs to be addressed by ONDCP.

Although Federal, State, and local governments play a substantial role
in promoting prevention agendas, much of the activity takes place at
grassroots community levels. In addition to funding from CSAP's
Community Partnerships grant program, groups receive support from
private sources, such as the Robert Wood Johnson Fighting Back program.

Today, despite the best efforts of Federal, State, and local
governments, drug abuse continues to pose serious threats to the health
and social and economic stability of American communities. However, two
hopeful trends have been occurring. The knowledge gained through
prevention research (e.g., the results of demonstration projects and
program evaluations) has led to the development of formal theories, best
practices, promising approaches, and rigorous evaluation methods. And,
in the late 1990's, policies, laws, and norms have been changing to
influence the incidence and prevalence of drug use: Tobacco companies
have been forced to stop unethical advertising campaigns geared toward
teenagers, and many communities have increased the price of alcohol and
tobacco through excise taxes and passed ordinances prohibiting billboard
advertisements by the alcohol industry.

## Bibliography:

Center for Substance Abuse Prevention. (1991). *A promising future:
Alcohol and other* *drug problem prevention services improvement.* CSAP
Prevention Monograph 1O (BK1 91).

SAMHSA. *National household survey on drug abuse: Main findings, 1990.*
(1991). BKD67.

Mosher, J. F., & Yanagisako, K. L. (1991). Public health, not social
warfare: A public health approach to illegal drug policy. *Journal of
Public Health Policy, 72*(3), 278--322.

National Clearinghouse for Alcohol and Drug Information. *Prevention
primer.* (1993). Rockville, MD: Author.

National Institute on Alcohol Abuse and Alcoholism. (1981). *Alcohol and
Public Policy: Beyond the Shadow of Prohibition.* National Academy
Press.

### INFORMATION SHEET {#information-sheet-3 .HeadInfSheet}

# A Timeline of Prevention

  ------------------------------------------------------------------------
  TIME         NATIONAL PERSPECTIVE     STRATEGY          ACTIVITIES
  ------------ ------------------------ ----------------- ----------------
  **1950's**   Drugs are a problem of   scare tactics     films and
               the ghetto, used to                        speakers
               escape pain and to avoid                   
               reality.                                   

  **early      Drugs are used to escape scare tactics     films and
  1960's**     pain and to avoid                          speakers
               reality, but they're                       
               more than just a problem                   
               of the ghetto.                             

  **late       Drugs are used to        information       films and
  1960's**     intensify life, to have                    speakers
               psychedelic experiences.                   
               Drug use is considered a                   
               national epidemic.                         

  **early      A variety of drugs are   drug education    curricula based
  1970's**     used for a variety of                      on factual
               reasons: to speed up                       information
               experiences, to                            
               intensify experiences,                     
               to escape, to expand                       
               perceptions, to relieve                    
               boredom, and to conform                    
               with peer behavior.                        

  **mid        Users become more        affective         curricula based
  1970's**     sophisticated and        education and     on
               society develops an      alternatives to   communication,
               increasing tolerance of  drug use          decision making,
               drug use.                                  values
                                                          clarification,
                                                          and self-esteem

  **late       Parents begin to form    affective         social skills
  1970's to    organizations to combat  education,        curricula,
  mid 1980's** drug abuse.              alternatives to   refusal skill
                                        drug use, and     training,
                                        training          parenting
                                                          education

  **mid 1980's Drug use is very         parent, school,   research-based
  to mid       complex.                 and community     curricula,
  1990's**                              partnerships      linkages, and
                                                          peer programs

  **mid 1990's The gap between research replication of    environmental
  to 2000's**  and application is       evidence-based    approaches,
               gradually bridged.       models and        comprehensive
                                        application of    programs
                                        evidence-based    targeting many
                                        approaches        domains and
                                                          strategies,
                                                          evaluation of
                                                          prevention
                                                          programs, media
                                                          campaigns, and
                                                          culturally
                                                          sensitive
                                                          programs
  ------------------------------------------------------------------------

### INFORMATION SHEET {#information-sheet-4 .HeadInfSheet}

# Evolution of the Prevention Discipline

Hundreds of years ago, barbers who used techniques like "blood-letting"
practiced medicine. Fifty years ago, teachers or athletic coaches who
had no formal training in counseling or human behavior conducted school
counseling. And 20 years ago, the treatment of alcohol and other drug
problems was provided by alcoholics and addicts in recovery, who used
only their own recovery experience to help others. Today, physicians
undergo years of academic training and extensive internships. Nearly all
school counselors complete graduate-training programs specifically
designed for this field. Finally, more and more universities have
undergraduate and graduate courses in addiction counseling.

Professions often evolve in this way. As the public comes to understand
the value of or need for a discipline, standards for training and
practice are developed. States develop certification and/or licensure
requirements, and universities develop programs to train people to work
in the profession.

In medicine, barbers weren't very effective in curing illnesses and
diseases. Teachers and coaches were ill equipped to handle the complex
problems of youth in the 1960's. Recovering individuals did not know how
to treat abusers of multiple drugs, culturally and ethnically diverse
clients, women and their children, addicts involved with the criminal
justice system, and clients with co-occurring disorders. Therefore, the
stimulus to develop standards of training and practice for a profession
is often the lack of expertise of practitioners to handle the complexity
of the discipline.

The alcohol, tobacco, and other drugs (ATOD) prevention field is in the
beginning stages of this evolution. Society's need to solve ATOD
problems, combined with a growing body of knowledge of "what works," is
stimulating an effort to increase the professionalism of prevention
providers. In addition, the prevention field has had the burden of
explaining why some highly publicized, widespread prevention programs
have failed to demonstrate an impact on the ATOD use patterns of youth.
Consequently, Federal and State governments have begun developing
certification standards for prevention providers. Universities are
developing courses and internships in prevention. In addition,
government entities that distribute prevention dollars are beginning to
insist that prevention programs use "scientifically defensible"
prevention strategies and programs and use established practices to
evaluate the outcomes of funded

programs. A well-trained staff is necessary to meet these requirements.

This curriculum is designed to help professionalize the prevention
field. We know there are many prevention providers who want to increase
their effectiveness and are eager to find out "what works." And we know
that many college students are interested in working in prevention and
need training and experience to develop entry-level competence. We
designed this curriculum as a general overview of the prevention field
and as a stimulus for further learning.

### INFORMATION SHEET {#information-sheet-5 .HeadInfSheet}

+--------------+-------------------------------------------------------+
| ## Attitude  | Close your eyes and visualize an alcoholic. Now       |
| s About ATOD | visualize a crack addict. What were your              |
|              | visualizations like? What was the ethnic background   |
|              | of your alcoholic? What sex was your crack addict?    |
|              | Did you see a seedy, down-and-out person going        |
|              | through garbage cans? Did you visualize a well-known  |
|              | comedian or a professional athlete? Does a            |
|              | 15-year-old caught with a marijuana joint have a      |
|              | problem? What about the same kid with a bottle of     |
|              | beer?                                                 |
|              |                                                       |
|              | It's essential for professionals who work in the ATOD |
|              | prevention field to examine their attitudes about     |
|              | ATOD. Obviously, knowledge is important and can       |
|              | affect our attitudes. But sometimes we're not even    |
|              | aware of how firmly attitudes are entrenched. For     |
|              | example, most of us know that addiction to alcohol    |
|              | and other drugs is not a function of sex, ethnicity,  |
|              | or socioeconomic class. However, your visualization   |
|              | just now of an alcoholic and a crack addict may have  |
|              | reflected some stereotypes. That's normal and isn't   |
|              | necessarily harmful, as long as we understand that    |
|              | our stereotype does not reflect reality. For example, |
|              | if you work in a prevention program that has a        |
|              | largely white clientele, it would be erroneous to     |
|              | assume that crack is not used in the community. A     |
|              | 15-year-old with a joint or a beer may or may not     |
|              | have a substance problem. Only an assessment can      |
|              | determine this.                                       |
|              |                                                       |
|              | Prevention providers are encouraged to examine their  |
|              | attitudes about ATOD and to learn as much about       |
|              | substances as possible. While you certainly don't     |
|              | need to be an expert in pharmacology, you do need to  |
|              | understand basic information about categories of      |
|              | drugs and their effects. This information should be   |
|              | based on science and not on scare tactics.            |
+--------------+-------------------------------------------------------+
| ##           | Most helping professionals who don't have extensive   |
| Definitions  | training in ATOD find it difficult to determine if a  |
| of Use, Misu | client's substance use is problematic. They may rely  |
| se, Abuse, a | on personal experience and information (or            |
| nd Dependenc | misinfor­mation). Consider the following scenario: A   |
| e/ Addiction | high school counselor gets a call from a student's    |
|              | parent. The young man is 17 years old, came home from |
|              | a party on Saturday night smelling of alcohol and     |
|              | admitted to drinking at the party.                    |
|              |                                                       |
|              | His parents belong to a religious group that          |
|              | prohibits the use of alcohol, so neither has any      |
|              | experience with alcohol or other drug use. They want  |
|              | to know if their son has a problem. The high school   |
|              | counselor did her share                               |
+--------------+-------------------------------------------------------+
| ## D         | of experimentation in adolescence but is a moderate   |
| efinitions o | user as an adult. She assures the parents that nearly |
| f Use, Misus | all adolescents experiment and they have nothing to   |
| e, Abuse, an | worry about. Is she right?                            |
| d Dependence |                                                       |
| / Addiction  | Distinguishing between different levels of use can be |
| -- continued | helpful to the mental health professional in          |
|              | determining the type of intervention that's           |
|              | appropriate for a client. Yet these distinctions      |
|              | aren't appropriate for diagnosis. They simply provide |
|              | a guide for the mental health professional in         |
|              | recommending the course of action for a client. The   |
|              | following definitions are offered to frame the        |
|              | discussion of alcohol- and drug-abuse progression.    |
|              | You should understand that multiple definitions of    |
|              | use, abuse, and misuse exist. These are the           |
|              | definitions we are using for this discussion.         |
|              |                                                       |
|              | Most people use alcohol or other drugs (including     |
|              | caffeine and tobacco) at some point in their life. We |
|              | define "use" as the ingestion of alcohol or other     |
|              | drugs without experiencing negative consequences. Any |
|              | drug can be "used" according to this definition.      |
|              | However, the type of drug taken and the               |
|              | characteristics of the individual contribute to the   |
|              | probability of experiencing negative consequences.    |
|              | For example, it's illegal for minors to drink         |
|              | alcohol. Therefore, any use by a minor is considered  |
|              | abuse, and the probability that our high school       |
|              | student will experience negative consequences from    |
|              | drinking alcohol may be far greater than that         |
|              | probability for an adult. Similarly, the chances that |
|              | an adult will experience negative consequences from   |
|              | shooting heroin are greater than the chances that he  |
|              | or she will experience negative consequences from     |
|              | drinking alcohol.                                     |
|              |                                                       |
|              | When a person experiences negative consequences from  |
|              | the use of alcohol or other drugs, it is defined as   |
|              | "misuse." Again, a large percentage of the population |
|              | misuses alcohol or other drugs at some point. Many    |
|              | people overuse alcohol, become ill, and experience    |
|              | the symptoms of a hangover. This is misuse. However,  |
|              | misuse doesn't imply that the negative consequences   |
|              | are minor. Let's say that an adult uses alcohol on an |
|              | infrequent basis. It's her 30th birthday, and her     |
|              | friends throw a surprise party. She drinks more than  |
|              | usual and, on the way home, is arrested for driving   |
|              | while under the influence (DUI). She may not have     |
|              | problems with alcohol, but in this instance, the      |
|              | consequence isn't minor.                              |
|              |                                                       |
|              | > You may be wondering about the heavy user of        |
|              | > alcohol or other drugs who doesn't appear to        |
|              | > experience negative consequences. First of all,     |
|              | > remember that these definitions are meant to        |
|              | > provide the helping professional with a simple      |
|              | > conceptualization as a guide. Second, the           |
|              | > probability of experiencing negative consequences   |
|              | > is directly related to the frequency and level of   |
|              | > use. If a person uses alcohol or other drugs on     |
+--------------+-------------------------------------------------------+
| ## D         | an occasional basis, the probability of negative      |
| efinitions o | consequences is far less than if one uses them on a   |
| f Use, Misus | daily basis. However, because we are talking about    |
| e, Abuse, an | probability, it's possible that a person could be a   |
| d Dependence | daily, heavy user and not experience negative         |
| / Addiction  | consequences that are obvious to others. We say       |
| -- continued | "obvious" because people may be damaging their health |
|              | without anyone being aware of this for a long time.   |
|              |                                                       |
|              | We define "abuse" as the continued use of alcohol or  |
|              | other drugs despite negative consequences. As we      |
|              | discussed previously, the probability of negative     |
|              | consequences is proportional to the amount one uses,  |
|              | and if a problem is developing with alcohol, it's     |
|              | likely that continued use will become abuse. As an    |
|              | example, let's go back to the DUI the woman got after |
|              | her birthday party. For people who do not have an     |
|              | alcohol or other drug problem, getting a DUI would be |
|              | so disturbing that they would avoid alcohol           |
|              | altogether or at least refrain from driving after     |
|              | drinking alcohol. If, a month after receiving the     |
|              | DUI, the woman was again drinking and driving, this   |
|              | would be considered abuse.                            |
|              |                                                       |
|              | Addiction/dependence is the "compulsive" use of       |
|              | alcohol or other drugs regardless of the              |
|              | consequences. We worked with a man who had received   |
|              | three DUIs in one year. He was on probation and would |
|              | be sentenced to one year in prison if he were caught  |
|              | using alcohol. Yet he continued to drink. We define   |
|              | this man as clearly addicted to alcohol because the   |
|              | negative consequences did not affect his use.         |
+--------------+-------------------------------------------------------+
| ##           | As disciplines develop, they create a body of         |
| Justificatio | theories that drive both research and application. A  |
| n for Theory | theory is a "formulation of apparent relationships or |
|              | underlying principles of certain observed phenomena   |
|              | which has been verified to some degree" (Guralnik,    |
|              | 1984, p. 1475). This curriculum advances the current  |
|              | theories used in substance abuse prevention, which    |
|              | include the perspectives of risk and protection       |
|              | factors, resiliency, and the assets model. Some       |
|              | theories and related research have reached high       |
|              | levels of scientific rigor, which means that they've  |
|              | been tested and have shown some consistent            |
|              | correlations or outcomes. All disciplines support     |
|              | certain theories that attempt to explain why a        |
|              | certain condition exists. In substance abuse          |
|              | prevention, for example, the theory of risk and       |
|              | protection predicts that the greater the number of    |
|              | risk factors, the greater the likelihood that young   |
|              | people will abuse substances at some point in their   |
|              | development. The ultimate goal of this curriculum is  |
|              | to move the field of substance abuse prevention to    |
|              | "praxis."                                             |
|              |                                                       |
|              | Praxis means the combination of both theory and       |
|              | practice. The practice of substance abuse prevention  |
|              | should be enlightened and informed by theory.         |
+--------------+-------------------------------------------------------+

+--------------+-------------------------------------------------------+
| ## J         | One of the challenges we face in prevention is        |
| ustification | understanding theory and the findings from research   |
|  for Theory  | to the degree that we can apply them to our substance |
| -- continued | abuse prevention programs. When we achieve this goal, |
|              | we have engaged in "prevention praxis." If our field  |
|              | didn't have a theoretical base, we'd simply run       |
|              | prevention programs with what we thought or felt were |
|              | the right ideas. We'd try to glean progress from only |
|              | our own observations and wouldn't consider what had   |
|              | been tried, tested, changed and tested again. Theory  |
|              | really helps us understand how to prevent substance   |
|              | abuse and answers questions about why some youth use  |
|              | substances and others do not.                         |
|              |                                                       |
|              | The Substance Abuse Prevention Specialist Training    |
|              | curriculum presents in depth the three most dominant  |
|              | theoretical perspectives today. This doesn't mean     |
|              | that other theories don't exist or that these are the |
|              | three best theories available. Theories change like   |
|              | most things do in life. Thomas Kuhn (1970) identified |
|              | four steps or changes theories cycle through; they    |
|              | are normal science, anomalies, crisis, and            |
|              | revolution. Theory that is accepted as the dominant   |
|              | view in the field is considered normal science.       |
|              | Researchers experiment with new applications of the   |
|              | established theory, extend and refine it, and         |
|              | accumulate knowledge. The second step is the          |
|              | anomalies stage. During this stage, people question   |
|              | why the theory doesn't fit the social problem they're |
|              | trying to solve. Things happen in the social world    |
|              | that the theory can't explain. The third stage is     |
|              | crisis. During this step, questions abound and people |
|              | severely critique the theory; the field shifts its    |
|              | interests, and new theories emerge that propose       |
|              | alternative ways of looking at the social problem.    |
|              | Anomalies amount and accumulate as people begin       |
|              | formally attacking the perspective. The fourth state  |
|              | is called revolution. During revolution the old       |
|              | theory is overthrown, and a new theory establishes    |
|              | itself as the reigning paradigm.                      |
|              |                                                       |
|              | The point of explaining this process is to show that  |
|              | the theories of today may not be the theories of      |
|              | tomorrow. So you may be thinking, why even consider   |
|              | any theory at all if it will go through this process  |
|              | eventually? The answer is that all theories help us   |
|              | understand the larger social context of substance     |
|              | abuse prevention. Without theories to guide us, we    |
|              | simply employ old techniques that may "feel" like     |
|              | they work, but in fact may be harmful. Theories, like |
|              | research knowledge, change over time. This is normal, |
|              | expected, and a valid part of a developing            |
|              | discipline.                                           |
+--------------+-------------------------------------------------------+
| ## B         | The Substance Abuse Prevention Specialist Training    |
| uilding Bloc | curriculum is designed to provide some crucial        |
| ks of Succes | elements of knowledge for the prevention              |
| sful Prevent | professional. This curriculum isn't designed to       |
| ion Programs | answer every question a professional has about        |
|              | prevention, nor is it equipped to be the only         |
|              | learning tool about the field. Instead, this          |
|              | curriculum is designed to jumpstart the learning      |
|              | process for new professionals in the field. It        |
|              | contains science-based information, orients the       |
|              | professional to current issues in prevention, and     |
|              | provides a few of the many essential building blocks  |
|              | you need to know when working in prevention programs  |
|              | or coalitions.                                        |
|              |                                                       |
|              | As with any developing profession, key elements or    |
|              | essential facts need to be presented and explored to  |
|              | train new members in the field. This curriculum has   |
|              | many core modules that are important to understand    |
|              | before implementing prevention programming. Just as   |
|              | the discipline of medicine began by advancing         |
|              | fundamental courses all doctors would need, this      |
|              | curriculum contains fundamental information for all   |
|              | preventionists. This curriculum, as mentioned         |
|              | earlier, is to be viewed as the first step to gaining |
|              | knowledge about the field of substance abuse          |
|              | prevention. Like any discipline, as this body of      |
|              | knowledge grows and expands, the professional must    |
|              | grow and expand to properly apply the principles      |
|              | identified by science. We may find that strategies we |
|              | employ in our prevention programs are no longer       |
|              | working or have been shown to need more rigorous      |
|              | evaluation.                                           |
|              |                                                       |
|              | We are at an exciting time in the evolution of        |
|              | prevention. We know more than ever about what works   |
|              | in substance abuse prevention programming. At the     |
|              | same time, new cohorts of substance abuse prevention  |
|              | specialists and coordinators are demonstrating        |
|              | interest in the field. College campuses are offering  |
|              | courses in substance abuse prevention, and students   |
|              | can earn degrees in this field. This curriculum       |
|              | captures some of the fundamental building blocks that |
|              | all students and prevention professionals need to     |
|              | incorporate into their practice to help advance       |
|              | effective and efficient substance abuse prevention    |
|              | programming at the national, State, county, and       |
|              | community levels.                                     |
+--------------+-------------------------------------------------------+

## References:

Kuhn, Thomas. (1970). *The structure of scientific revolutions* (2nd
ed.). Chicago: University of Chicago Press.

Guralnik, David B. (Ed.). (1984). *Webster's new world dictionary of the
American language.* New York: Simon and Schuster.

### INFORMATION SHEET {#information-sheet-6 .HeadInfSheet}

# Elements of Successful Prevention Programs

> **The program is facilitated by knowledgeable and competent staff.**

Purpose of the Substance Abuse Prevention Specialist Curriculum

> **The program is based on sound theory and uses practices grounded in
> research.**

Module 2: Prevention Research

> **The program is systematically planned and assessed.**

Module 3: Prevention Planning

> **The program is evaluated.**

Module 4: Evaluation

> **The program addresses participants from a variety of backgrounds and
> cultures, and it uses a code of ethics.**

Module 5: The Cultural Context of Prevention

> **The program is developmentally appropriate.**

Module 6: Using Human Development in Prevention

> **The program incorporates the media.**

Module 7: Prevention and the Media