The problems associated with the use of alcohol, tobacco, and other drugs (ATOD) extract a significant health, social, and economic toll on American society. While the field of substance abuse prevention has made great strides during the past decade, two major challenges remain. First, the field has been disorganized and fragmented with respect to its research and prevention practices; that is, there are often separate ATOD prevention "specialists." Second, both the prevention researchers who test the efficacy of specific prevention strategies and the practitioners who implement prevention efforts often lack an overall perspective to guide strategy selection. To address these limitations, we present an ATOD causal model that seeks to identify those variables (Domains) that are theoretically salient and empirically connected across alcohol, tobacco, and illicit drugs. For the researcher, the model demonstrates important commonalities, as well as gaps, in the literature. For the practitioner, the model is a means to recognize both the complexity of the community system that produces ATOD problems and the multiple intervention points that are possible within this system. Researchers and practitioners are thus challenged to work synergistically to find effective and cost-effective approaches to change or reduce ATOD use and associated problems.

In the current study, we used a qualitative approach to investigate relevant beliefs and norms associated with codeine and promethazine hydrochloride cough syrup (CPHCS) consumption, initiation, and perceived addiction among 48 alternative school students who identified themselves as current CPHCS users. In general, both boys and girls believed that CPHCS addiction started during an individual's initial consumption. A majority of both groups reported that their second CPHCS event was initiated during the same or next day after their first event. Our findings suggest that friends and an innovative form of hip-hop music called "screw" are strong reinforcers of CPHCS use.

The use of 3,4-methylenedioxymethamphetamine (MDMA or "ecstasy") appears to be increasing worldwide, with "rave" attendees being one high-risk population. To date, however, only one study has collected ecstasy use information from rave attendees in the United States. To address this limitation, we collected self-report drug use information from 70 adult "club rave" attendees within the Baltimore-Washington corridor in April and May 2002. Data collection was scheduled between 12 A.M. and 5 A.M. Participation rates were high, with 85 percent of the club rave attendees completing the interview. Eighty-six percent of the respondents reported lifetime ecstasy use, 51 percent reported 30-day use, and 30 percent reported using ecstasy within the two days preceding the interview. While past-year ecstasy users were comparable to non-users with respect to a host of demographic and drug use variables, non-ecstasy users were significantly more likely than past-year users to perceive risks associated with the regular use of alcohol and ecstasy. Not surprisingly, non-ecstasy users were significantly more likely than past-year users to perceive harmful long-term physical and psychological effects associated with ecstasy ingestion. These findings suggest that rave attendees may be an important population for ecstasy-related prevention efforts.

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