Teaching for Prevention: Addressing Substance Misuse in Schools

Substance abuse in high schools is not a future threat—it’s a present-day challenge. Data from the CDC shows that nearly one in three high school students reports current use of alcohol, marijuana, or vaping products. At the same time, misuse of prescription medications among teens continues to rise. In the face of these growing risks, schools must do more than just warn students about the dangers—they must equip them with the knowledge, skills, and confidence to make healthy, informed decisions.

Evidence-based substance misuse education helps students understand how substances affect the brain and body, recognize internal and external pressures to use, and develop the personal and social skills they need to resist those pressures. Some of the most effective school-based prevention programs ground themselves in three core strategies: social resistance skills training, normative education, and competence enhancement skills training. These principles guide Wayfinder’s Substance Misuse Collection, authored by addiction expert and behavioral health leader Dr. Jessica Stephen Premo.

Dr. Stephen Premo brings years of experience as a Licensed Marriage and Family Therapist and Licensed Addiction Counselor to the curriculum. Her work on SAMHSA-funded prevention programs and her leadership at Intermountain Health’s Integrated Addiction Medicine Clinic have shaped a research-backed, developmentally appropriate approach that centers student empowerment.

The Long-Term Impact of Substance Misuse Education

Longitudinal studies show that early, school-based prevention programs can have long-term benefits. In one study published in The Journal of Public Health Research, students who participated in a school-based program during junior high were significantly less likely to report illicit drug use 13 years later compared to their peers. The same study found reduced rates of lifetime marijuana use and misuse of prescription medications.

These outcomes are not the result of scare tactics that characterized popular substance abuse campaigns in past decades. They are the result of skills training—teaching students how to develop self-awareness, regulate emotion, resist pressure, and make intentional decisions under stress.

What Works in Substance Misuse Education

Before getting into the pitfalls of the “scared straight” programs many of us grew up with, we should consider what we now know to be effective. Effective substance misuse curriculum helps students:

• Understand the neurobiology of substances. Students learn how alcohol, nicotine, vaping products, and medications impact the adolescent brain by disrupting development, weakening decision-making, and increasing risk for addiction. Effective education is grounded in current findings from organizations like the National Institutes of Health (NIH) and the National Institute on Drug Abuse (NIDA) on the science of addiction and adolescent brain development.
• Build confidence and emotional awareness. Students who understand their emotional triggers and stress responses are better equipped to avoid unhealthy coping strategies. Classroom-based activities can help students identify emotions, manage anxiety, and apply healthy coping strategies like breathing exercises or asking for support. By developing these intrapersonal skills, students grow better prepared to make healthy choices when feeling distressed or pressured.
• Recognize and resist peer pressure. Research shows that direct and indirect social pressure is a key driver of early substance use. Students learn to identify these pressures and rehearse how to assert their values and boundaries in social situations. Effective programming helps students build practical strategies for handling high-risk situations, such as how to exit situations where substances are present or where they feel unsafe. It empowers them to take control of their safety, whether in social settings, at parties, or under peer pressure.
• Set clear personal boundaries. Refusal skills are taught explicitly through roleplay and real-world scenarios. Students practice how to confidently say no and exit risky situations without compromising relationships or safety. Actively practicing these boundary-setting strategies rather than simply learning about them makes students more prepared to use them in their lives.
• Correct misconceptions about substance use. Normative education is a powerful tool for prevention. Many students overestimate how many of their peers use substances, leading them to see use as normal or expected. Effective programming shares real, up-to-date data to shift those assumptions and help students feel less alone in making safe and healthy decisions. It also helps them understand the benefits of staying substance-free, including improved health, better decision making, stronger relationships, and more opportunities for personal and academic success.

What Doesn’t Work—and Why

After years of school-based education and widely visible shock campaigns, we now know that fear-based programs that rely on worst-case scenarios or shocking images fail to make a lasting impact. In fact, scare tactics and overemphasis on deleterious long-term effects tend to backfire, especially with teens, whose still-developing prefrontal cortices are naturally more inclined to focus on short-term consequences and peer acceptance. 

Instead of trying to frighten students into compliance, schools should equip students with helpful knowledge and relevant skills, trusting that young people can—and do—make healthier choices when they are well informed.

Who Can Teach Substance Misuse Curriculum?

While many schools assign substance misuse education to health or biology teachers, lessons and activities like Wayfinder’s can be effectively taught by any educator familiar with prevention education, whole-student learning approaches, or leadership development. Middle and high school teachers in advisory, student leadership classes, or homeroom settings may be especially well-positioned to deliver this content, having had extra time throughout the year to foster strong classroom relationships.

What matters most is not an educator’s content area, but the approach they take. Have educators been given the content knowledge to speak confidently about the risks of substance use? Are they trained in facilitating sensitive conversations? Can they create a learning environment where students feel safe exploring these issues? For programs like Wayfinder’s, these considerations are more important than explicit subject-area knowledge about substance misuse.

Creating a Safe + Supportive Learning Environment

Teaching substance misuse education requires both clarity and compassion. Here are several best practices for educators:

• Be mindful of trauma. Some students may have personal or family experiences with addiction. Lessons should be free from triggering content like photos or videos of substance use and should include space for breaks and processing.
• Provide resources. Teachers should be prepared to share school-based or community support resources with students and families, including school counselors, youth recovery groups, or helplines.
• Foster open dialogue. Students are more likely to engage when lessons feel relevant and respectful. Encourage questions, allow space for diverse perspectives, and avoid judgment. If your school or classroom has classroom norms or community agreements, it’s a great idea to review these before a substance misuse lesson or activity to remind students of the co-created expectations held for themselves and others.
  
• Empower with empathy. Educators should approach these topics with a tone of empathy, compassion, and assertiveness. Students need to feel safe, supported, and believed in.

Wayfinder’s Approach: Future-Ready Skills for Well-Being + Safety

Wayfinder’s Substance Misuse Collection is built on the belief that prevention is more than information—it’s about building the skills needed to make safe and intentional decisions. Aligned with state health standards and other national frameworks, the Collection includes teaching and learning resources for grades 6–12 such as:

• Interactive lessons on the effects of substances on the brain and body
• Activities to strengthen emotional regulation, problem-solving, and communication
• Real-world refusal skill practice
• Personal reflections
• Optional community engagement through guest speakers (ex: people in recovery, health professionals, or counselors)

The curriculum aligns with research-backed models of effective prevention and is designed to meet students where they are—developmentally, socially, and emotionally.

Building a Healthier Future

Substance misuse prevention is not a one-time unit. It is an investment in students' lifelong well-being. When schools prioritize prevention as part of a whole-student approach, they empower young people with the tools to thrive academically, socially, and personally.

With the right curriculum, training, and mindset, educators can shift the narrative from crisis to confidence. Substance misuse education doesn't have to focus on what students shouldn’t do. It can focus on what they can do—and who they can become when they make choices that protect their health, relationships, and future.