At a glance
- Youth substance use is a significant public health problem, and preventing drug use is one of the Administration's drug policy priorities.
- CDC’s ENGAGE: Evidence-Based Strategies to Prevent Youth Substance Use contains effective strategies and approaches to help local, community, state, and other organizations plan for and implement a wide range of prevention activities.
- Your organization can tailor the programs, practices, and policies in ENGAGE to address the specific needs of your community.
ENGAGE is a resource for action
Download the Prevention Resource
ENGAGE has three components that organizations can use to guide their youth substance use prevention efforts:
- Six strategies to prevent or delay youth substance use initiation
- Approaches for each strategy that can be tailored to address the specific needs of different communities
- Evidence for each approach in preventing youth substance use or related risk factors
Youth substance use is preventable
Youth substance use is a serious public health issue in the United States. In 2024, 9% of eighth graders, 16.9% of tenth graders, and 26.2% of twelfth graders reported using illegal substances in the past year.1 Substance use early in life comes with many consequences. These include substance use disorders, poor physical and mental health, and suffering for individuals and their families.234
The use of illegal drugs and misuse of prescription medications can have far-reaching effects on various aspects of youths' lives and result in a host of negative outcomes, such as:2567
- Impaired brain development
- Decreased performance at school
- Increased school absenteeism
- Increased risk for later substance use
- Increased risk of premature death
Strategies and approaches
ENGAGE includes strategies — selected through a rigorous evaluation process — that have the greatest potential to impact substance use behaviors, delay substance use initiation, or modify the risk and protective factors associated with substance use.
- School-based interventions
- Early childhood home visitation
- Parenting skills and family relationship programs
- Extracurricular activities and after-school programs
- Mentorship programs
- Community-level programs to create healthier communities
- Services and supports for youth exposed to violence and other adverse experiences
- Treatment and services for youth with early substance use behaviors
- Addressing substance use during primary care visits
- Screening combined with interventions
- Miech RA, Johnston LD, Patrick ME, O'Malley PM. Monitoring the Future national survey results on drug use, 1975-2024: Overview and detailed results for secondary school students. Ann Arbor, MI: Institute for Social Research, University of Michigan. 2025.
- Squeglia LM, Gray KM. Alcohol and drug use and the developing brain. Curr Psychiatry Rep 2016;18(5):46.
- Squeglia LM, Jacobus J, Tapert SF. The influence of substance use on adolescent brain development. Clin EEG Neurosci 2009;40(1):31-38.
- Giedd JN. Structural magnetic resonance imaging of the adolescent brain. Ann NY Acad Sci 2004;1021:77-85.
- Bugbee BA, Beck KH, Fryer CS, Arria AM. Substance use, academic performance, and academic engagement among high school seniors. J Sch Health 2019;89(2):145-156.
- Duncan PM. Substance use disorders: A biopsychosocial perspective. Cambridge University Press; 2020.
- Feigelman W, Gorman BS. Prospective predictors of premature death: evidence from the National Longitudinal Study of Adolescent Health. J Psychoactive Drugs 2010;42(3):353-361.