and alcohol problems is one of the most important public health
issues facing the world today.
Nobody disagrees with that. But few agree on how, exactly, we
go about doing it.
Why? For a lot
of reasons, starting with the slipperiness of the whole concept of prevention.
The slipperiness flows from the fact that "prevention"
exists in relation to other behaviors not existing. Prevention activities are considered
effective only in the absence of behaviors that, we're told or
that we infer, would otherwise have occurred.
That's why proving
that prevention works--or making a case for
a particular approach to prevention--is tough. In a world as
restless as ours, isolating the variables that produce behavior
change is next to impossible.
in a couple in our work that are reasonably foolproof (and unfortunately,
still all-too rare) but we'll get to them in a minute.
Number One. Problem Number Two stems from the way we define terms.
And not surprisingly, one of the trickiest terms of all is "prevention"
That's because over the years, "prevention" has come
to include dozens of approaches to discouraging substance abuse--from peer counseling in schools and "just
say no" media campaigns to programs promoting sterile needle
use and safer sex among IV drug users.
In the process, the notion of what prevention is--and what it's intended to prevent--has
gotten pretty muddy.
That's the purpose of this brief statement: to separate the dirt
from the water and clear away some of the confusion.
We'll start by
examining what prevention is and isn't, discuss what types work
best in which settings, and conclude by describing how Do It
Now fits into the unruly universe of prevention programs and
substance abuse prevention programs and activities are aimed
at a similar goal: to reduce the likelihood of chemical dependency
isn't a program or a curriculum and doesn't necessarily imply
a particular set of beliefs about the nature of chemical use
Instead, it's an interdisciplinary process aimed at empowering
people--young, old, and middle-aged; black, white,
yellow, red, and brown; gay, straight, and none-of-the-above--with the information, skills, and resources each
needs to lead productive, satisfying lives.
At its most obvious, direct level, drug and alcohol prevention
provides people with tools (information, life-skills training,
or linkage with resources) that enable them to avoid chemical-related
risks in their lives altogether.
Then there are
other, less-obvious levels.
The public health field has long recognized three
different levels of prevention, each directed at a different
segment of the population:
||Primary prevention is directed towards the general public and non-affected
groups. Primary substance-abuse prevention is often geared toward
promoting greater self-awareness and informed decision-making.
Target groups include children and adolescents, or those in high-risk
groups (e.g. children of alcoholics).
focuses on "risk reduction" involving those already
affected by a problem. Secondary substance abuse prevention targets
users, and may focus on use-related problems, treatment alternatives
or self-help options.
rehabilitative and focuses on helping those who are already experiencing
major health or behavioral problems related to chemical use.
three levels form a continuum that encompass our total public
health response to substance abuse problems.
Each is valid in its own context; all are necessary to achieve
the goal--slippery though it may be--of "preventing" drug and alcohol abuse.
Thirty years ago,
drug abuse prevention had a simple enough goal: to scare away
as many potential users as possible and lock up those who couldn't
be scared away.
The disease of alcoholism was the only form of chemical dependency
that enjoyed any status as something other than moral weakness.
And much of what was done in the name of "prevention"
generally focused on depictions of alcoholism, its developmental
sequence, process, and effects.
When it existed
at all, drug education-prevention was simplistic, sensationalistic
(yet still managing to be boring in the process), and clueless.
shows, and videos were duly dragged out of closets, dusted off,
and played to glassy-eyed students. Print information was usually
worse--obsolete within months (some was probably
obsolete before it was written) and chockful of dated statistics, cultural stereotypes,
and factual inaccuracies.
emotional impact of such information was fear; and the scarier
the context and conclusion, the better it was thought to "work."
The problem was
that it didn't.
With the explosion of youthful drug use that ignited in the 1960s,
the ineffectiveness of scare campaigns became clear: Young people
stayed away in droves, laughing off sensationalistic materials
and ignoring warnings that didn't jibe with their own personal
But this created
a new informational vacuum: The youth culture knew that the old
message was wrong--or, at best, irrelevant
to their values and experience. Still, they didn't really have
much--short of trial and error--with which to replace it.
we came in.
Established in 1968
as an alternative, youth-oriented prevention project, Do It Now
dedicated itself to encouraging healthy choices by developing
accurate, unbiased information which incorporated the "look
and feel"--and the language and
values--of the youth culture itself.
We didn't portray
use and abuse in moralistic terms, but in practical ones. We
believed--and continued to believe today--that truth is not only stranger than fiction; it's also stronger than fiction, and more
likely to produce the sorts of cognitive changes that precede
real life change.
We call it "realistic
information." And over the past three decades, we've distributed
hundreds of millions of examples of it--in
the form of pamphlets, booklets, posters, and other materials--to thousands of agencies, schools, and other organizations
around the world. And they say it works.
Aside from their
support, we could also point to thousands of instances of overdose,
addiction, and other drug problems that didn't happen to prove it. But you wouldn't see anything if we
of readers who've taken the time to write or call over the years
have told us they owe their lives--or their post-drug lives,
at least--to things they couldn't see that they
first started to see in the pages of our publications.
It's the essence
of what our approach to prevention is all about.
And it makes
doing what Do It Now does worth all the effort.
of the Do It Now Foundation message is the notion that each of
us is fully responsible for the quality and direction of our
own lives. We simply don't accept the premise that people are
powerless victims, and we don't reinforce it in our publications.
Other key points in our philosophy include the value and necessity
of both honest self-appraisal and self-acceptance.
We believe that
the key to personal effectiveness is simply to begin where we
are now: to tell the truth about who and what we are--freckles and all--and accept responsibility
for making changes when we don't like what we see.
For this reason, we present information in a context of actions
that readers can take on their own behalf to avoid problems--or
reduce risk, if the potential for problems already exists. We
question the value of materials presented without this context,
which we believe only adds to the informational "noise"
that's such a big part of life today.
Still, in affirming
the uniqueness of each individual, we also acknowledge the universal
traits, drives, and values that link us all.
And because we recognize that people vary in the way they formulate
and experience their lives, we maintain the value of, and need
for, a variety of approaches to prevention, which we do our best
to provide in publications addressing the various informational
needs and developmental stages of our audience.
Our current publications roster includes primary prevention-oriented
materials for children and adolescents, secondary-prevention
titles directed at users and high-risk populations, and individual-
and family-oriented recovery materials.
We also offer
a variety of materials for general audiences on topics ranging
from sexuality and sexually-transmitted diseases to such behavioral-health
topics as date rape, street gangs, and domestic violence (which
often coincide with drug and alcohol abuse), and the health problems
of older people.
Through the years, Do It Now Foundation has been honored to serve
its national and international constituency with innovative and
alternatively focused drug, alcohol, and behavioral health information.
And with your continued support, we hope to keep on doing it
now--and doing it well--for
as long as that needs doing.