Coie et al. ( 1993) coined the term prevention science to describe the systematic and empirically driven approach to studying the averting of psychological and behavioral disorders, including substance abuse. They noted the multidisciplinary nature of this "new" discipline, joining together the combined expertise of psychology, psychiatry, public health, sociology, criminology, education, and human development. In the past decade, prevention science has coalesced into a vibrant and informative domain of study. Reflections of this include the founding of professional organizations devoted to prevention science (such as the Society for Prevention Research), special editions of journals devoted to prevention, and the plethora of recent journal articles focusing on prevention of mental health problems in general, and substance abuse in particular. Clearly, this is a field that has emerged from its nascent stage to a new level of scientific maturity and sophistication.

The damaging consequences of alcohol and drug abuse impact individuals, families, and the systems in which they live. They can be expressed in financial terms: it has been estimated that federal, state, and local drug control policies substance abuse cost the United States approximately $20 billion per year ( Office of National Drug Control Policy, 1996). It can also be expressed in the incalculable suffering and lost potential of those afflicted with substance use disorders. Prevention is clearly the most cost-effective means of mitigating the negative effects of substance abuse.

Substance abuse undermines physical health. For example, chronic alcohol abuse is associated with diseases of the liver, central nervous system, and heart (see Goodwin & Gabrielli, 1997). Often, as in the case of the brain disorder Korsakoff's syndrome, the damage resulting from alcohol abuse is irreversible. Additional health problems stemming from the use of other substances are well documented (see Lowinson, Ruiz, Millman, & Langrod, 1997). Well-known examples are lung cancer caused by smoking, and pervasive central nervous system damage resulting from the inhaling of solvents. In addition, many substances are toxic in excessive doses, resulting in numerous acute and chronic effects on physical health, potentially leading to permanent disability or death. Finally, substance abuse increases the risk for acquiring other health-related problems, such as HIV, sexually transmitted diseases, or trauma secondary to accidents while under the influence of psychoactive substances.

Mental health disorders often occur with substance abuse. Comorbidity is relatively common, with up to one third of individuals with psychiatric disorders reporting a lifetime history of substance abuse disorders as well ( Helzer & Pryzbeck, 1998). In some instances, psychiatric disorder precedes or even contributes to the development of substance abuse, whereas in others, emotional and behavioral disturbances arise within the context of alcohol and drug use problems. A large body of research has delineated the disproportionate representation of psychological dysfunction in substance abusers (see Tarter, Ammerman, & Ott, 1998). Included are problems in personality, mood, self-esteem, coping, behavior, and social functioning. Once again, some of these psychological difficulties may be evident prior to the onset of substance abuse, although psychological functioning often worsens over time in individuals with substance use disorders. . .

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