Substance use prevention has historically failed at preventing substance use. Infamously, the DARE campaign, which served as the primary source of information about drugs for a generation of Americans, actually increased risk of substance use among some populations. Today, DEA officers lecture high school assemblies on how “one pill can kill”; if students are lucky, they leave with a box of naloxone. Meanwhile, youth overdoses, which skyrocketed during the fentanyl era, have yet to return to pre-2016 levels. 

Our youth deserve better. They deserve facts, not fearmongering. In an age where misinformation is a click away, they need to know how to find trusted information that keeps them safe. And they need to know where they can get help if they fear their or a loved one’s substance use has become difficult to manage, without fearing consequences like school suspension, exclusion from extracurriculars, and even incarceration.

The way to do this is through harm reduction-based prevention curricula. Prevention efforts must accept the basic fact that many youth experiment, and that curricula that exclusively promote abstinence are destined to fail. Research has long invalidated the use of abstinence-based sexual education, finding that it increases young people’s risk of contracting a sexually transmitted infection, becoming pregnant at an early age, and experiencing sexual assault. In fact, evidence-based sexual education is actually more likely to cause youth to postpone sexual activity than approaches promoting abstinence. We need a similar shift for youth substance use prevention: an approach that addresses the harms of substance use without resorting to misinformation and that acknowledges that youth who do choose to use substances for any reason deserve to be safe.

This approach is not novel. The Stanford REACH Lab’s Safety First curriculum integrates harm reduction and has reached over 100,000 students who report better understanding of how to reduce the risks of substance use, including through avoiding substances altogether. Harm reduction-based prevention curricula can include factual, non-exaggerated lessons about what drugs actually do; coping strategies that young people can use to reduce distress without resorting to riskier substance use; and, with the knowledge that some youth are already using substances (most experimentally rather than problematically), information about harm reduction resources to avoid overdose and other avoidable risks.

When youth know how to protect themselves, they are empowered to make better choices. Harm reduction-based prevention respects youth autonomy and gives them the knowledge they need to thrive, regardless of whether they choose to use substances.