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Rural Health Information Hub

Substance Use Disorder Prevention Models

Prevention programs target different populations at risk for substance use disorder (SUD). Prevention programs focus on helping individuals to develop knowledge and skills, or changing environmental and community factors that affect a large population. Providers, schools, public health departments, and other organizations in the community may collaborate to implement these programs. Programs can be implemented in settings such as schools, workplaces, and communities.

Prevention efforts are divided into three categories:

  • Universal preventive interventions reach an entire population to prevent substance use disorders.
  • Selective preventive interventions target subgroups of the population that are at risk for substance use disorders.
  • Indicated preventive interventions are aimed at individuals who are exhibiting early signs of having a substance use disorder though they have not been diagnosed.

Many SUD prevention and early intervention programs focus on children and adolescents, given that substance misuse early in life increases the chance an individual will develop an SUD. The National Institute on Drug Abuse developed a brief, Preventing Drug Use among Children and Adolescents, which describes approaches that communities can implement to prevent drug misuse among children and adolescents. These prevention programs focus on strengthening protective factors and reducing risk factors.

Some SUD prevention strategies are still being tested. For example, in March 2016, the Centers for Disease Control and Prevention (CDC) published the CDC Guideline for Prescribing Opioids for Chronic Pain, which summarizes the risks and benefits associated with prescription opioids and provides an evidence-based guide for providers and patients in shared decision-making about the use of prescription opioids. The guidelines aim to stop over-prescribing of opioids to prevent opioid use disorder. Future research will indicate the effectiveness of prescribing guidelines on rates of SUD.

There is no “best mix” of universal, selective, and indicated programs for a given population. While many SUD prevention programs have shown evidence of success, not all programs have been tested in rural populations. In addition, few prevention programs have been tested for use in workplaces or among older adults.

Models in this section: