Preventing or delaying youth drug use has long-term benefits, reducing future substance use problems and associated health issues. Numerous studies show that school-based prevention programs are key in addressing substance use disorders and other problem behaviors. These programs provide students with the skills to avoid drugs, improving their mental and physical health long into adulthood. Yet, as Oregon grapples with rising youth overdose rates, its educational system has failed to fully implement evidence-based prevention strategies, despite the significant body of research available.

“There’s an enormous amount of evidence about what can be done to prevent these problems,” said Anthony Biglan, a senior scientist at the Oregon Research Institute who has spent 30 years studying youth prevention. His sentiment is echoed by Rodney Wambeam, a prevention scientist from the University of Wyoming, who emphasized, “It pays off in huge dividends.” The research on school-based prevention programs consistently shows that they can save lives and tax dollars by reducing substance abuse and its long-term consequences.

Prevention science, while relatively new, has grown significantly since the mid-1990s, with more than a dozen U.S. universities now offering programs dedicated to this field. These programs teach strategies to prevent problems like substance abuse, youth suicide, and gun violence. Janet Welsh, principal investigator at the Evidence-based Prevention and Intervention Support Center at Pennsylvania State University, works to help schools and communities adopt evidence-based prevention practices. She explains that “evidence” is not a clear-cut label but exists on a continuum, with varying levels of strength and reliability.

In Oregon, however, the situation is less straightforward. An investigation by The Lund Report revealed that many school districts in the state are struggling to meet state requirements for comprehensive, research-backed substance use prevention programs. These efforts are compounded by minimal support and accountability from state agencies. Many schools rely on outdated, ineffective methods like a single chapter in a health textbook to address prevention, despite state laws mandating scientifically-backed approaches.

The research community, however, is determined to change this. Pamela Buckley, the principal investigator at Blueprints for Healthy Youth Development, one of the top clearinghouses for prevention programs, explained that her team’s role is to sift through “a lot of noise” to identify the most reliable studies. “It’s really hard to cut to the chase about what to trust,” she said. Blueprints and other clearinghouses like CrimeSolutions and What Works Clearinghouse provide evaluations of programs, ensuring they meet rigorous standards and are effective at reducing substance use and other risk behaviors.

While clearinghouses have made strides in identifying reliable programs, there are still challenges. One major hurdle is that randomized control trials, which are considered the gold standard in research, are expensive and difficult to replicate. Buckley’s analysis of 851 studies between 2010 and 2020 found that nearly 80% failed to meet basic criteria for minimizing bias, casting doubt on many of the results. Without high-quality studies and reproducible results, it is difficult for prevention science to make broad claims about what works.

Moreover, funding for replicating studies is scarce. As Brittany Cooper from Washington State University noted, there’s often little support for studies that aim to replicate previous research, as funding agencies prioritize innovation over validation. This lack of independent replication hinders the ability to fully trust the results of many studies, even those deemed promising.

One notable example of a program that has gained widespread attention is the PAX Good Behavior Game. The program, which teaches self-regulation and impulse control to elementary school children, has been shown to reduce future substance use and other behavioral problems. While PAX has been widely adopted in several districts in Oregon, it has received mixed reviews from clearinghouses. Some, like Blueprints, rate the program as having “insufficient evidence,” while others, like the What Works Clearinghouse, endorse it as having strong evidence.

The lack of consistent ratings across clearinghouses is just one of the issues educators face when selecting prevention programs. Oregon’s 2021 law requiring the implementation of social-emotional learning (SEL) programs, such as Character Strong and Second Step, illustrates this challenge. These programs are designed to help students develop emotional regulation and empathy, skills that can reduce substance use. However, despite their popularity in Oregon, these programs have not been fully validated by the top prevention clearinghouses. Character Strong, for example, is used in 26 districts but has not yet been certified as evidence-based by any of the four major clearinghouses.

Despite these challenges, there are successes. Programs like PAX and SEL initiatives like Second Step show promise, and community-based interventions have been effective at reducing substance use in some regions. In Forest Grove, the PAX Good Behavior Game is widely used, and it has been shown to improve classroom behavior and reduce the likelihood of substance abuse later in life.

However, experts agree that for prevention to be truly effective, Oregon needs better coordination and more robust support for schools in implementing evidence-based programs. Prevention scientists, like Emily Tanner-Smith from the University of Oregon, emphasize that while high-quality research can give us confidence in the effectiveness of certain programs, no program is guaranteed to work in every context. Ongoing research and adjustments are necessary as both kids and their environments change.

In conclusion, while Oregon has made strides in adopting prevention programs, more work remains to ensure that schools are using effective, evidence-based strategies to combat substance use. The state must invest in high-quality research, support districts in selecting proven programs, and ensure that prevention efforts are consistently evaluated for their effectiveness. By doing so, Oregon can reduce the impact of substance use on its youth and help build a healthier future.