A systematic review of alcohol and other drug prevention strategies

The use of alcohol and illicit drugs is a serious public health concern and entails considerable burden of disease.  Recent estimates indicate that about 4.5% of the global burden of disease as measured in disability-adjusted life years is attributable to alcohol, and 0.9% to illicit drugs (1). Effective prevention strategies can minimise disease burden by reducing problematic use as well as the harms associated with alcohol and illicit drugs.

Prevention strategies can be classified as either universal (“primary”) or selective (“secondary”). Universal prevention strategies address the entire population within a particular setting, whether that is within families, schools, colleges, or communities (2). Unlike selective prevention programs, universal programs are delivered to everyone without prior screening for risk factors. Universal prevention strategies are designed to delay or deter the onset of problems or disorder. Within the context of alcohol and other drugs, universal prevention strategies focus on delaying the onset of use and reducing problematic use and substance-related harms. Universal strategies can be structural (i.e., policies), family-based or individual (often conducted within a school setting) (3). The peak age for the onset of alcohol and other drug use is adolescence, and universal programs often target younger age groups as a result. However, prevention of substance-related harms is critical across the lifespan (4), and universal preventative strategies aren’t necessarily confined to younger age groups.

The current systematic review will focus on the full range of universal prevention strategies designed to reduce the use and/or harms associated with alcohol and other drugs across the lifespan. Several recent reviews focusing on the universal prevention strategies for alcohol and other drugs have recently been published. However, these focus on selected settings (i.e., schools) or target particular demographic groups (i.e., young people). The current review will synthesise the information from these reviews to provide an overview of the evidence for a range of universal alcohol and other drug prevention strategies that is relevant across different intervention settings and age groups.