Substance abuse in children: prediction, protection, and prevention.

OBJECTIVE To review the latest studies on risk and protective factors for the development of substance abuse and the effectiveness of prevention interventions for the pediatric population. DATA SOURCES Multiple bibliographic databases, including MEDLINE and ERIC, were used to develop a comprehensive review of the literature on substance abuse prevention during the last 10 years. Selected indexing terms included substance abuse prevention, risk factors, and protective factors. Research monographs from the National Institute on Drug Abuse and the Center for Substance Abuse Prevention were used, along with information from authors of prevention curricula. STUDY SELECTION Study populations included children from birth through adolescence who were enrolled in controlled, prospective, and/or longitudinal studies of either protective or risk factors for the development of substance abuse or response to substance abuse prevention programs. Studies of adult patients that investigated predisposing risk factors for substance abuse (eg, genetic implications) were also used. Care was taken to ensure studies included children from diverse racial and social backgrounds. DATA EXTRACTION Information was abstracted and summarized from peer-reviewed publications. Controlled random-designed studies were used to determine prevention program efficacy. DATA SYNTHESIS Main results of the review are summarized in a qualitative format. CONCLUSIONS Factors that contribute to the emergence of substance abuse in the pediatric population are multifactorial. Behavioral, emotional, and environmental factors that place children at risk for the development of substance abuse may be remediated through prevention and intervention programs that use research-based, comprehensive, culturally relevant, social resistance skills training and normative education in an active school-based learning format.