In 2006, more than 2.1 million youths ages 12 to 17 reported abuse of prescription drugs, predominantly opioids, according to results from that year's National Survey on Drug Use and Health. Did these young people know that a single use of prescription drugs with other drugs or alcohol can be lethal, or that repeated use can change how one responds to stressful events? It is unlikely that early teens are attending to such facts about the consequences of alcohol and drug use. Therefore, it is necessary to think creatively about how to communicate this important information to them in an engaging manner.

Interactive technology provides the opportunity to offer a private, personalized, immediate, and engaging experience available to anyone with access to an Internet connection. In this digital age, early teens are actively using the Internet for educational and recreational purposes. This has led to great interest in translating the theory and research that inform school-based prevention programs (e.g., social influence, competence enhancement)1 into online prevention programs.

Drugs4Real (https://www.drugs4real.com), created with support from the National Institute on Drug Abuse (NIDA) and with a portion developed with support from King Pharmaceuticals, Inc., is a Web-based alcohol and drug prevention program designed for students of an age at which they are particularly vulnerable to initiating alcohol and other drug use (11 to 14). This program was developed by Inflexxion, Inc., of Newton, Massachusetts. To develop this program, 11-to-14 year olds, parents of adolescents, professional school staff (teachers, counselors), and experts in adolescent substance use and prevention participated in focus groups and interviews. Their input was used to design a “blueprint” of content and design features from which Drugs4Real was created.

Multimedia approach

To benefit different learning styles and to create a rich educational experience, Drugs4Real teaches adolescents about the influence of alcohol and other drugs through engaging graphics, animation, sound, and video. Multimedia presentation of information can be especially helpful to students who might have reading, learning, or attention difficulties, who are at significant risk for initiating alcohol and other drug use.

Four main substance use areas are covered in Drugs4Real: Drug Basics, Tobacco, Alcohol, and Marijuana. Each area is introduced by a teen video host and includes facts about the specific topic as well as interactive games, animation, and video-based skill-building activities. All features are self-directed and tailored: Users can choose content based on their experiences with personal, friend, or family substance use. Teens learn different types of coping strategies and are encouraged to reflect upon which might work best for them.

The objectives of additional Drugs4Real features are as follows: 1) “Media Watch” describes how advertisers influence attitudes and perceptions about alcohol and tobacco; 2) “Rate Myself” self-assessments offer teens brief, motivational feedback on personal risk factors related to substance abuse; 3) “Did-You-Know” factoids counter misconceptions that many teens have about substance use; and 4) “Make-a-Page” allows teens to earn the opportunity to customize a personal page with images and music as a reward for using other parts of the program. Use of the overall Drugs4Real site is free of charge.

Drugs4Real also includes an Educator component that provides teachers, counselors, and other community stakeholders with resources (“Teaching Tools”) for using Drugs4Real in schools and community organizations. They also can generate aggregated traffic summaries and visitor statistics (“Reports”).

Research results

The efficacy of Drugs4Real was tested in a field trial with middle school students (grades 6 to 8) from eight schools in the greater Boston area. A total of 295 adolescents ages 11 to 14 participated; 52% were girls and 50% were nonwhite. Each participant was randomized to one of three study conditions: six sessions using the interactive online Drugs4Real program, six sessions watching alcohol and drug videos, or no active intervention. Each study condition occurred for three weeks. Data were collected at baseline, post-intervention, three-month follow-up, and six-month follow-up.

Eighty-five percent of the participants provided data at six-month follow-up. Those who had used the Drugs4Real program had significantly greater knowledge about drugs and the media than those who had no active intervention. They also had significantly lower intentions to smoke or drink than did the two other groups. In addition, participants who used Drugs4Real indicated higher satisfaction with the program than those who watched the alcohol and drug videos.

Technology shows great potential for teaching research-based alcohol and other drug prevention skills to early teens. While Drugs4Real can be used as an educational program for alcohol and other drug prevention, counselors also might be interested in providing it as a resource to families with addiction, early teens in treatment, or other community members.

The program is designed so that early teens can use it independently, but counselors and/or parents might appreciate the opportunity to review it alongside teens to initiate important discussions about the effects of alcohol and drugs on one's body and one's life.