What costs, procedures, and processes are critical to preventing youth substance abuse?

This study evaluates the relationships between the costs, procedures, processes, and outcomes of a school-based substance abuse prevention program for high-risk youth from six urban elementary schools. Program procedures, including peer groups for youth and a family involvement component, were assessed in terms of the costs expended to implement these procedures. Contrary to expectations, participation in the program was linked to increased willingness to use and increased use of alcohol, tobacco, and other drugs (ATOD's). Social responsibility was found to be a critical process, with higher levels of social responsibility related to decreased ATOD use and willingness to use. The program group, and specifically the peer group procedure, was inversely related to social responsibility. The iatrogenic effect of the program on social responsibility was, however, temporary as it was not present at followup tests. Recommendations for future programming efforts are discussed.