Etiological theories and the primary prevention of drug use

FRANÇAIS :
Cet article critique les tendances en vigueur en matière de prévention de la toxicomanie, depuis les années 1980, influencées par le modèle social. Il oppose une recherche qui démontre l'interaction permanente qui s'établit entre, par exemple, les pairs et la toxicomanie. Il décrit le rôle que les théories étiologiques ont joué dans la prévention depuis trente ans et prône un examen de l'effectivité de ces théories en attirant l'attention sur le fait que les facteurs de risque relèvent de plusieurs domaines, sont extrêmement nombreux, et que leur combinaison est complexe.
ENGLISH :
Since the early 1980s, the social influence model has dominated the field of primary prevention research. Social influence programs generally take the form of standardized curricula, aimed at all members of broadly defined target populations. Evaluative research has employed a fundamentally inductive methodology, the goal of which is to generate successive "confirming instances" of program effectiveness among these broad populations. As a result, prevention research has largely stagnated, and has not availed itself of recent findings from basic research such as those reported in this issue. This research tells us that the relationship between peer group affiliation and drug use is reciprocal and not unidirectional as assumed in most social influence programs, that the scope of intervention efforts must be broadened because the processes involved in the initiation of drug use are far more complex than suggested by the theories on which current prevention efforts are based, and that programs should be targeted rather than universal as some individuals are at greater risk of developing a problem with drugs than others. (Author's abstract).