Primal prevention of drug abuse: An emerging but unrecognized public health issue

Drug abuse (DA) continues to be a major global public health concern that has devastating impacts on individuals, families, communities, and countries. While rehabilitation and treatment methods have improved, prevention remains the cornerstone of any effective strategy to control DA (1). Three categories are widely acknowledged in the field of DA when it comes to prevention. Primary prevention targets individuals who are at risk of starting drug use (i.e., modification of risk factors), secondary prevention Involves early diagnosis and prompt treatment of DA (i.e., screening), and tertiary prevention focuses on individuals experiencing substance use disorder or suffering from its consequences (i.e., treatment and rehabilitation) (2). Primordial prevention which was introduced approximately half a century ago as a health promotion concept, focuses on preventing the emergence and development of risk factors for disease, rather than addressing existing risk factors (i.e., primary prevention) or diseases (secondary and tertiary prevention) (3). In the context of DA, it involves addressing the root causes of DA such as the social, environmental, political, and cultural determinants that predispose individuals or communities to substance use (3). It refers to strategies aimed at preventing the emergence or development of risk factors for diseases, which one of the main focuses is on the “first 1000 days” from conception to a child's second birthday.