Stigma can be a major barrier to how well prevention and treatment programs work amid the opioid crisis. Physicians, their patients, and pharmacists all can play a role in identifying and preventing nonmedical use of prescription drugs. Because of a lapse in government funding, the information on this website may not be up to date, transactions submitted via the website may not be processed, and the agency may not be able to respond to inquiries until appropriations are enacted.

Individual-level efforts might involve interventions with children who are at risk, while community-level strategies might address social determinants of health and other factors that influence substance use. Importantly, prevention activities have a variety of benefits beyond reduced substance use, including lower long-term treatment costs, less premature mortality, and overall higher quality of life for young people, among many others. Figure 1 illustrates prevention strategies that can work to address risk factors for substance use at the individual, relationship, and school and community levels.

International Overdose Awareness Day

• NASHP’s case study on Connecticut highlights a state’s successful approach to supporting a comprehensive prevention infrastructure.
• The latter category, which has a much longer history of abuse, includes opium (and such derivatives as heroin), hallucinogens, barbiturates, cocaine, amphetamines, tranquilizers, the several forms of cannabis, and alcohol.
• OUD is a medical condition that can affect anyone – regardless of race, sex, income level, or social class.
• Drugs known to produce physical dependence are the opiates (i.e., opium and its derivatives) and central-nervous-system depressants such as barbiturates and alcohol.
• A more specific model, the SAMHSA Strategic Prevention Framework, guides state officials and local providers in assessing all of these risk factors to tailor prevention responses to the real needs and strengths of a specific community.

Also, dependence on prescribed drugs is not uncommon, especially with tranquilizers and hypnotics. What was once a serious social problem of dependence on prescribed barbiturates has been overtaken largely by the widespread use of benzodiazepine tranquilizers such as diazepam (Valium), alprazolam (Xanax) and chlordiazepoxide (Librium) . Developing and testing new, safe, effective, and sustainable strategies to prevent substance use or misuse and their progression to substance use disorders or other negative health effects is a key research priority for NIDA. When we act early, we can prevent illegal substance use, including illegal opioids, and misuse of prescription medications, like opioids, that can lead to substance use disorders. The following examples show best and promising practices for implementing these allowable primary prevention activities, using settlement funding or other funding streams. As the only study of its kind, the ABCD study will yield critical insights into the foundational aspects of adolescence that shape a person’s future.

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For updated information on reducing the risks related to prescription opioids, clinicians can refer to the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain. Drugs that either depress or stimulate the central nervous system have long been used for nonmedical reasons. Depressants include all sedatives and hypnotics such as barbiturates and benzodiazepines (minor tranquilizers). The main stimulants are amphetamines or their derivatives and cocaine, a natural component of the leaves of the coca plant. Amphetamines can be taken by mouth or injected; cocaine is either injected or inhaled through the nose.

• Continued investment of evidence-based practices and strategies for reducing substance use, supporting early intervention, and reducing harms is critical to building a future addiction infrastructure.
• A recent study among 29 states and the District of Columbia showed the percentage of overdose deaths involving counterfeit pills more than doubled from July 2019 to December 2021, and more than tripled in the Western United States.
• NIDA also supports research to examine the social and economic impact of certain laws and policies in preventing substance use and its negative health effects.
• Strategies to prevent substance use — especially in adolescents — and help people get treatment can reduce drug and alcohol misuse, related health problems, and deaths.
• Some people who use drugs go on to develop substance use disorders or experience other harms.
• Developing and testing new, safe, effective, and sustainable strategies to prevent substance use or misuse and their progression to substance use disorders or other negative health effects is a key research priority for NIDA.

It is important to note that many risk and protective factors are not a result of choices an individual person makes, but rather are a facet of their inherited genetics, family, life circumstances, and other aspects of their biology and environment. Better understanding these factors is critical to developing prevention strategies that lessen the impact of risk factors and bolster or introduce new protective factors. NIDA funds research to identify risk and protective factors and seek ways to prevent substance misuse and substance use disorders even when multiple risk factors are present. As noted, primary prevention works best when instituted at multiple points, and evidence-based prevention programs in schools offer an array of educational opportunities that increase skills, socioemotional wellness, and connections with others that may serve as protective factors against future substance use. In Virginia, Fairfax County offers an array of school-based prevention services, including education about drugs; group and individual prevention services for students, staff, parents, and the Fairfax County community; and partnerships with both school resources officers and parent-teacher-student organizations. Substance use in youth can lead to a variety of negative outcomes, including health issues, poor academic performance, and increased risk of addiction and overdose.

The latter category, which has a much longer history of abuse, includes opium (and such derivatives as heroin), hallucinogens, barbiturates, cocaine, amphetamines, tranquilizers, the several forms of cannabis, and alcohol. Importantly, evidence-based prevention strategies can help people avoid substance use and substance use disorders. For those who do develop substance use disorders, safe and effective treatment can help. Ways to prevent opioid overdose are to improve opioid prescribing, reduce exposure to opioids, prevent illegal opioid use and prescription opioid misuse, and treat opioid use disorder. There are strategies that can help prevent overdose and support the health and well-being of communities.

Opioid use disorder and overdoses are preventable

Primary prevention is a public health strategy of intervening before negative health effects occur, including delaying or preventing young people’s use of harmful substances that may lead to overdose or other substance-related harms. Prevention requires understanding the multiple factors that influence individual choices and behaviors related to substance use. The socio-ecological model offers a framework for assessing the range of factors that put people at risk for experiencing the negative effects of substance use, as well as the factors that can protect against those risk factors.

A New Era in Drug Prevention: Comprehensive Systems for Lasting, Guaranteed and Sustainable Impact!

In Kansas, Kansas Fights Addiction will support two school districts in Douglas County in implementing school-based prevention pilots that will center building youth leadership capacity and implementation of youth-led initiatives. While many people try drugs at some point in their lives and even continue to use them, only some people develop substance use disorders. No single factor determines whether a person will develop a substance use disorder. These chronic but treatable health conditions arise from the interplay of many different individual and societal factors across a person’s life1. The Oregon Opioid Settlement Prevention, Treatment, and Recovery Board provided approximately $3.8 million to community-based organizations and regional health equity coalitions to increase the number of primary prevention initiatives in communities experiencing disproportionate effects of substance use and overdose. The funds will go to organizations that are rooted in existing linguistic and cultural systems, building on their community engagement efforts and infrastructure.

What are evidence-based prevention strategies? How are they delivered, and what kinds of activities do they include?

Administer naloxone or another opioid overdose reversal medication (if available) and then call 911. Try to keep the person awake and breathing and lay the person on their side to prevent choking. The emergency and Prevent Drug Misuse referral resources listed above are available to individuals located in the United States and are not operated by the National Institute on Drug Abuse (NIDA).

The age at which people start using drugs—and whether or not they continue—depends on many different individual and societal factors across a person’s life. Read more about risk and protective factors that impact whether people use drugs or develop substance use disorders. The development of effective, non-addicting pain medications is a public health priority. A growing number of older adults and an increasing number of injured military service members add to the urgency of finding new treatments. In 2015, the federal government launched an initiative to reduce overdose and prevent people from developing opioid use disorders. Coordinated federal efforts to safely address opioid misuse, addiction, and overdose while understanding, managing, and treating pain are ongoing.

Drugs known to produce physical dependence are the opiates (i.e., opium and its derivatives) and central-nervous-system depressants such as barbiturates and alcohol. Psychological dependence is indicated when the user relies on a drug to produce a feeling of well-being. In its most intense form the user becomes obsessed with the drug and focuses virtually all his interest and activity on obtaining and using it. Substance use disorders can involve illicit drugs, prescription drugs, or alcohol. Substance use disorders are linked to many health problems, and overdoses can lead to emergency department visits and deaths.

Why are some people more likely to develop substance use disorders?

For a teenager, risky times include moving, family divorce, or changing schools.35 When children advance from elementary through middle school, they face new and challenging social, family, and academic situations. Often during this period, children are exposed to substances such as cigarettes and alcohol for the first time. When they enter high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used. When individuals leave high school and live more independently, either in college or as an employed adult, they may find themselves exposed to drug use while separated from the protective structure provided by family and school.

The term addiction is often used synonymously with dependence but should probably be reserved for drugs known to cause physical dependence. For every overdose that results in death, there are many more nonfatal overdoses, each one with its own emotional and economic toll.3 OUD and overdose deaths continue to be a major public health concern in the United States, but they are preventable. A recent study among 29 states and the District of Columbia showed the percentage of overdose deaths involving counterfeit pills more than doubled from July 2019 to December 2021, and more than tripled in the Western United States. These pills are dangerous because they typically appear as pharmaceutical pills but often contain illegally made fentanyl and illegal benzodiazepines or other drugs, with or without people’s knowledge. Many regional and national media campaigns to address stigma are underway, and the SAMHSA-funded Prevention Technology Transfer Center offers a list of current campaign resources.