An ounce of prevention is worth a pound of cure. – Benjamin Franklin

Whether speaking of fire protection for your city as Mr. Franklin was or eating a healthy diet to keep our hearts strong, prevention is a sound argument to avoid undesired consequences in the future. The familiar saying also applies to prevention of substance misuse, especially in youth and young adults. It is well-known that brain development continues until approximately 25 years; due to this continuing growth, teenagers and young adults are at double-risk because of their natural inclination to take risks at this stage and from the harm that the substance itself may cause on a maturing brain.1 There is growing acknowledgment that using evidence-based interventions during sensitive periods of development, such as adolescence, can provide a layer of defense and resilience to avoid substance misuse and the harm that ensues.

Tennessee is making progress, but we still have work to do in preventing youth substance misuse in communities across the state. In 2017-2018, 48,000 Tennessee teenagers ages 12-17 used alcohol in the past month; 39,000 used illicit drugs in the prior month.2  For 18–25-year-olds, 337,000 reported using alcohol and 150,000 used illicit drugs in the past month.2 These numbers show that there is sufficient need to enact evidence-based interventions in our state.

There are some agencies and programs that have started to provide Tennessee with the building blocks for successful prevention initiatives. One key influencer in the state is the Prevention Alliance of Tennessee which provides resources for prevention to 46 counties, 25 of which include a youth coalition. 3 The prevention alliance reports statistics supporting prevention in TN. In communities that actively support prevention, there is 44% lower adolescent misuse and a 19% lower adolescent use when funding has been used specifically to address substance misuse. Another interesting figure from this group is that for every $1 invested in primary prevention in TN, $4.60 is saved. 3  Some other programs in TN supporting youth prevention are an elementary school prevention pilot program in the rural community of Sunbright and 4-H Health Rocks youth prevention curriculum. However, so far, these have been isolated efforts, and there is a need to grow and maintain community-based prevention initiatives throughout the state.

The SMART Policy Network will review and compare evidence-informed youth prevention initiatives being used in TN and other states. Best practices and recommendations will be identified to address a number of issues that influence child, youth, and young adult substance misuse prevention. Some of the issues to be explored are:

  • Funding for youth prevention initiatives.
  • Adverse childhood experiences (ACEs) and the effect on substance misuse.
  • Collegiate recovery programs.
  • Effects of social workers in public schools on substance misuse.
  • Tailored evidence-based prevention addressing community identified needs.



1Compton, M., Jones, C.M., Baldwin, G.T., Harding, F.M., Blanco, C., & Wargo, E.M. (2019). Targeting youth to prevent later substance use disorder: An underutilized response to the US opioid crisis. American Journal of Public Health, 109 (S3), pp. 185-189.

2Substance Abuse and Mental Health Services Administration. (2020). 2017-2018 National Surveys on Drug Use and Health: Model-Based Estimated Totals (in Thousands) (50 States and the District of Columbia).

3Prevention Alliance of Tennessee.


Policy Brief

Preventing Youth Substance Misuse in Tennessee

Adolescent substance misuse and its consequences continue to be a challenge in Tennessee communities. To address the problem of substance misuse in Tennessee’s youth and young adults, it is helpful to look at how widespread the issue is; what factors contribute to use; and how it affects communities, families, and individuals. This brief highlights the nature of the youth substance misuse problem in Tennessee and provides recommendations on how the state can move forward with further investments to help address youth substance use prevention.

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October 2021


Youth Prevention SMART Team

Karen Pershing, MPH, CPS II
Executive Director
Metro Drug Coalition


Alex Mason, PhD
Department of Preventative Medicine
UT Health Science Center


Johnnie Bower
Johnnie Bower
SMART Policy Network Graduate Research Assistant
UT Knoxville Doctor of Nursing Practice Student


Jennifer Tourville
Jennifer Tourville, DNP, CPNP
Director of Substance Misuse Outreach and Initiatives, UT System
Clinical Assistant Professor, UT Knoxville College of Nursing


Katie Cahill
Katie Cahill, PhD
Associate Director
Howard Baker Jr. Center for Public Policy
UT Knoxville