Community-Based Substance Use Prevention

Community-based substance use prevention involves changing the community context to reduce the prevalence of substance use among community members. The specific actions taken to prevent substance use will vary depending on the initiative but should include activities that target community-level factors that influence substance use, as well as the implementation of specific, evidence-based policies and programs that reach as many individuals as possible in the community. Many community-based prevention efforts are led by coalitions of community members. Ideally, these coalitions will include representation from diverse groups and organizations and comprise all stakeholders concerned about substance use. The use of broad-based coalitions helps ensure that prevention efforts are community-specific, responsive to community needs, and culturally relevant. Participation by community stakeholders and organizations also increases the likelihood that prevention programs are implemented in multiple contexts, reach large numbers of individuals in order to achieve community-level reductions in substance use, and can be sustained over time. Coalitions can also work to change local policies, regulations, and/or ordinances to reduce all community members’ access to substances and opportunities to use them. Community-based prevention can be very challenging, especially in under-resourced communities. In any community, it can be difficult to recruit community members to volunteer to participate in such initiatives and to sustain their interest over time. In addition, maintaining active coalitions, enacting policy changes, and implementing prevention programs requires significant human and financial resources. Communities are also likely to need technical support and ongoing consultation from researchers to help them plan, implement, and evaluate the success of their efforts. Despite these difficulties, some community-based prevention efforts have been demonstrated as effective in reducing substance use/abuse. Although these interventions vary in their complexity and mechanisms for achieving change, common features of successful community-based approaches include the following: (1) clear definition of the specific problem(s) to be prevented; (2) involvement of community members, often through broad-based coalitions; (3) assessment of community-specific needs and resources; (4) implementation of prevention programs, practices, and policies to address these needs; and (5) monitoring of these activities over time to ensure their effectiveness and sustainability. By following these steps and using interventions that have prior evidence of effectiveness from well-conducted research studies, communities should be able to achieve significant reduction in community rates of substance use.