Substance Abuse Prevention and Treatment Block Grant

Targeted Populations and Service Areas

The SUBG program targets the following populations and service areas:

• Pregnant women and women with dependent children
• Injection drug users
• Tuberculosis services
• Early intervention services for HIV/AIDS
• Primary prevention services

SAMHSA requires that grantees spend no less than 20% of their SUBG allotment on substance use primary prevention strategies. These strategies are directed at individuals not identified to be in need of treatment. 

Primary Prevention Strategies

Grantees must develop a comprehensive primary prevention program that includes activities and services provided in a variety of settings. The program must target both the general population and sub-groups that are at high risk for substance use. The program must include, but is not limited to, the following strategies:

• Information Dissemination provides knowledge and increases awareness of the nature and extent of alcohol and other drug use, use, and addiction, as well as their effects on individuals, families, and communities. It also provides knowledge and increases awareness of available prevention and treatment programs and services. It is characterized by one-way communication from the information source to the audience, with limited contact between the two.
• Education builds skills through structured learning processes. Critical life and social skills include decision making, peer resistance, coping with stress, problem solving, interpersonal communication, and systematic and judgmental capabilities. There is more interaction between facilitators and participants than there is for information dissemination.
• Alternatives provide opportunities for target populations to participate in activities that exclude alcohol and other drugs. The purpose is to discourage use of alcohol and other drugs by providing alternative, healthy activities.
• Problem Identification and Referral aims to identify individuals who have indulged in illegal or age-inappropriate use of tobacco or alcohol and individuals who have indulged in the first use of illicit drugs. The goal is to assess if their behavior can be reversed through education. This strategy does not include any activity designed to determine if a person is in need of treatment.
• Community-based Process provides ongoing networking activities and technical assistance to community groups or agencies. It encompasses neighborhood-based, grassroots empowerment models using action planning and collaborative systems planning.
• Environmental establishes or changes written and unwritten community standards, codes, and attitudes. Its intent is to influence the general population's use of alcohol and other drugs.

Grantees should use a variety of strategies that target populations with different levels of risk. Specifically, prevention strategies can be classified using the Institute of Medicine Model of Universal, Selective, and Indicated, which classifies preventive interventions by targeted population. The definitions for these population classifications are:

• Universal: The general public or a whole population group that has not been identified on the basis of individual risk
• Selective: Individuals or a subgroup of the population whose risk of developing a disorder is significantly higher than average
• Indicated: Individuals in high-risk environments who have minimal but detectable signs or symptoms foreshadowing disorder or have biological markers indicating predispositions for disorder but do not yet meet diagnostic levels 

Tobacco Use Prevention—Synar Amendment

The Synar Amendment to the 1992 Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act (PL 102-321) aims to decrease youth access to tobacco. SAMHSA oversees the implementation of the amendment through the Tobacco/Synar Program. To receive their full SUBG awards, states (that is, all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, the Northern Mariana Islands, Guam, American Samoa, 3 Pacific jurisdictions) must enact and enforce laws prohibiting the sale or distribution of tobacco products to individuals under the age of 18.

The Synar legislation requires states to do the following:

• Enact laws prohibiting the sale and distribution of tobacco products to minors.
• Enforce such laws in a manner that can reasonably be expected to reduce the availability of tobacco products to youth under the age of 18.
• Conduct random, unannounced inspections of tobacco outlets.
• Report annual findings to the secretary of the U.S. Department of Health and Human Services by December 31 each year.