In the wake of findings pointing to the relatively unabated rates of alcohol, tobacco, and other drugs (ATOD) use by adolescents (Barnes, Welte, Hoffman, & Dintcheff, 1997; Johnston, O'Malley, & Bachman, 1994, 1995, 1996), the effectiveness of substance use prevention programs has been seriously questioned (Segal, 1995; Tobler, 1986, 1992). This is especially true when considering prevention's modest or mixed results in reducing the number of young people who experiment with or begin ATOD use (Brown & Horowitz, 1993; Moore & Saunders, 1991; Schaps, DiBartolo, Moskowitz, Palley, & Chrugin, 1981; Tobler, 1986, 1992). This point is echoed in the comments of Dr. Abraham Wandersman (1997), professor of psychology at the University of South Carolina, who, in speaking of prevention programming in schools, remarked: "There's a surprising disconnection between the latest prevention research and the prevention programming that schools actually enact ... Most schools aren't using the best-known information or the best prevention science" (p. 30). Past prevention efforts have resulted in only temporary effects, and others have not been implemented as well as expected on a national level (Pentz, Bonnie, & Shopland, 1996; Perry & Staufacker, 1996). Consequently, there is a sense of ineffectiveness and confusion among public and professional communities about what really works in reducing adolescent substance use and abuse.
Among the many professions dealing with adolescent substance use, social work is at the forefront. Our roles are linked through the provision of direct public services, entitlement programs, administrative decisions, and social policy development. In particular, social workers in community school systems encounter these problems regularly, as they are asked to evaluate and intervene on behalf of adolescents with substance abuse-related difficulties (Zunz, Turner, & Norman, 1993).
Adolescent Substance Use and Abuse Prevalence and Trends
The extent of adolescent substance use continues to be a fluid phenomenon. Public opinion tends to view adolescent substance use as having steadily increased over time, despite findings in the 1980s pointing to an overall decline (Schinke, Botvin, & Orlandi, 1991). In 1993 there was an upsurge of adolescent ATOD use, along with increasing acceptance of drug use, a perceived ease of accessibility for alcohol or drugs, and less perceived "risk" or danger of negative health consequences resulting from such use (Johnston et al., 1994, 1995, 1996). From 1998 to 1999 trends of adolescent alcohol and drug use appeared to be relatively unchanged (Johnston et al., 2000).
Substance-using behaviors among youths are unique in that they are marked by early initiation (Oetting & Beauvais, 1990). For instance, smoking is initiated around age 12, alcohol at 12.6 years of age, and drugs around 14.4 years of age (Bell & Bell, 1993). Over time use tends to be heavier and includes multiple drugs (Windle, 1991). With the advent of newer drugs (for example, Rohypnol, GHB, and ecstasy) or rediscovered drugs of the past (for example, LSD), drug use among youths may be perpetuated (Johnston et al., 2003) well beyond high school and into their young adult and college years.
Generally, the types of drugs used by today's adolescents have remained the same (Cole & Weissberg, 1995). Today's "drugs of choice" include inhalants, stimulants, marijuana, "designer drugs" composed of synthesized opiate or heroin derivatives, and nonmedical pain relievers and stimulants (Johnston et al., 1994, 1995; Substance Abuse and Mental Health Services Administration [SAMHSA], Office of Applied Studies, 2003). Historically, youths have used marijuana, inhalants, marijuana or hashish, hallucinogens, LSD, PCP, ecstasy, ice, cocaine, crack, heroin, other opiates, stimulants, tranquilizers, nitrites, barbiturates, cigarettes, steroids, and alcohol (Abadinsky, 1991). …