Preventing substance abuse: the state of the art.

While drug abuse among adolescents and young adults has begun to decline from the epidemic levels of the late 1970s, it remains a serious national health problem. Much information from research suggests that young people at the junior and senior high school levels are the most vulnerable to the social pressures that lead to experimental and then regular use of psychoactive substances. Well-designed prevention programs for youngsters in these age groups have the potential to prevent the onset and development of regular drug use. Primary prevention strategies developed over the past two decades--media campaigns, school drug education programs, and "generic" programs--are reviewed, and evaluative research is discussed. The authors describe two additional prevention approaches--the "macro" approach (creating a climate of nondrug use) and positive peer pressure strategies--for which early data suggest genuine promise for the future.