Strengthen Policies & Practices for Establishments Selling Substances and Agencies Reducing Access to Substances

Addresses:

Availability of Substances in Community

When alcohol, marijuana, and other drugs are more available in a community, youth are at higher risk of substance use and violence. If youth think that substances could be easy to access, the risk increases for substance use and violence.

Community Norms Favorable Toward Substance Use

Community norms are shaped by social values, beliefs, attitudes, and behaviors held by members of the community. When community norms are favorable toward substance use, the risk increases for substance use, violence, and delinquency.

How does this strategy address risk factors or increase protective factors?

Research on substance misuse across the lifespan shows that federal, state, and community-level policies that address the price, place, and promotion of substances can result in positive benefits including a reduction in general use and related harms. Such policies specifically target and reduce youth substance use by addressing two risk factors: the availability of substances in the community and community norms favorable to substance use.

Many of the suggested implementation activities presented below are grounded in research involving youth tobacco, alcohol, and prescription use, however it is important to note that the same activities may be effective in reducing youth marijuana use. Given the novelty of legalized marijuana, there is a small (but growing) body of research on what works to reduce youth consumption of marijuana products. Until more information on marijuana misuse prevention becomes available, it is recommended that the evidence on alcohol and tobacco prevention efforts guide efforts targeting youth marijuana use.

Before You Begin


  • Understand the severity of substance misuse in your community. In order to select the best implementation activities for your community, you first need to understand youth misuse of substances within your community. Collecting and analyzing data on youth substance misuse will help you select targeted activities that will address the current needs within your community. To guide these efforts, communities should ensure they are using an effective assessment process that identifies relevant data, as well as indicates resources and gaps within their communities.

Resources:

  • Colorado communities should use Healthy Kids Colorado Survey (HKCS) data, which can be accessed via the HKCS Interactive Data Dashboard, as well as the CDPHE Community Health Equity Map.

  • The Colorado Consortium for Prescription Drug Abuse Prevention maintains a listing of various data dashboards which can provide data on mortality, emergency department visits, treatment admissions for substance abuse, etc. at the county or region level.

  • The Colorado Consortium for Prescription Drug Abuse Prevention also created the Prescription Drug Abuse Prevention: A Colorado Community Reference as a resource and reference guide for communities and organizations working to address the prescription drug use in Colorado. It contains information and resources that can help guide local efforts.


  • Analyze existing policies that impact the availability and price of substances in your community, as well as those that impact community norms surrounding substance use. Many of the evidence-based implementation activities outlined below first require an understanding of what ordinances, regulations, and requirements currently exist for establishments selling or promoting substances in your community.


  • Ensure current policies do not have unintended consequences that further entrench health inequities. For example, smoke-free housing policies that result in eviction could contribute to homelessness and loss of public benefits to families.

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Implementation Activities Aligned to Research

It is important to note that the uniqueness of your community, its resources, and its needs will ultimately determine what implementation of this strategy will look like. The list below offers suggestions and ideas of evidence-informed actions your coalition can consider taking as part of your implementation of this strategy.

Addressing Place

  • Measure and understand your community’s substance outlet density. Information about substance outlet density can be used to guide the development of new regulations that limit the availability of substances in communities and/or to understand the relationship between exposure to substance retail locations and specific outcomes (e.g., interpersonal violence, property damage).

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  • Educate stakeholders on how licensing and zoning regulations can control the density of establishments selling and promoting substances. Laws that limit the number of businesses that can sell, serve, or promote substances have been shown to reduce consumption and decrease related harms.

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  • Educate stakeholders on how social host ordinances can reduce alcohol use among youth. Social host ordinances target the locations in which underage consumption may take place by holding private individuals responsible for underage drinking events on property they own or lease. Such ordinances emphasize that allowing and enabling underage drinking is unacceptable, and reinforce community norms against youth substance abuse.

Resources:

  • The National Institute on Alcohol Abuse and Alcoholism’s Alcohol Policy Information System provides an overview of social host ordinances and compiles research supporting their effectiveness.


  • Educate stakeholders on how commercial host liability or “dram shop liability” can reduce alcohol use among youth. Dram shop liability holds alcohol retailers (e.g., owner of a bar or liquor store) legally liable for any harm resulting from service to underage customers. These laws have been linked to reductions in youth alcohol abuse and related harms.

Resources:

  • Learn more about dram shop liability laws here.


  • Educate stakeholders on how strengthening definitions within policies can prevent public substance use where youth may be exposed to the behavior(s). The modeling of substance use by adults can increase the likelihood that young people participate in the same behavior(s), so strengthening policies to reduce the likelihood youth will be exposed to substance abuse can reduce their misuse. Common examples of this are “smoke-free” policies for tobacco (e.g., Smoke-Free Housing, Smoke-Free Parks), however similar policies for other substances can be reviewed, developed, and/or strengthened.

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  • Educate stakeholders on how developing and maintaining limitations on the days and hours of sales can reduce substance misuse. Research shows that limitations on the days and hours of substance sales can reduce alcohol misuse in communities, as well as reduce related harms.

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  • A common example of this are bans on off-premises Sunday sales for alcohol, which is discussed in depth here.


  • Expand and promote permanent medication and vape product take back sites. Medication take back sites can reduce community access to prescription drugs and reduce their non-medical use. Additionally, these sites can be used to also promote community disposal of vaping products, other for tobacco and THC.

Resources:

  • Colorado communities can locate current disposal locations and options in your community using The Colorado Consortium for Prescription Drug Abuse Prevention’s safe disposal resource.


  • Promote safe prescribing practices among local healthcare workers. Since prescription drugs are not distributed in retail settings, the healthcare workers that prescribe them are an important stakeholder in combating prescription drug misuse. Research shows that safe prescribing behaviors can reduce misuse by limiting the availability of prescription drugs in a community. To encourage safe prescribing behaviors, coalitions should help disseminate research-informed guidelines among their local healthcare community.

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Addressing Promotion

  • Educate stakeholders on the benefits of restricting marketing tactics and merchandising for alcohol, tobacco, and marijuana. Reducing the likelihood that youth will be exposed to product marketing can result in decreases in youth substance misuse. Restrictions can include bans on substance marketing at family and youth-focused events, as well as restrictions on on point of sale (POS) advertising and promotions. POS advertising and promotions can include advertisements displayed on the interior and exterior of retail stores, coupons, and placement of products in specific store locations. These tactics encourage use, and can increase the chances that youth will begin using substances.

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  • Information on how tobacco POS advertisements and promotions influence substance abuse can be found here and here.


  • Educate stakeholders on the importance of responsible vendor programs and promote their use among retailers in your community.

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Addressing Price

  • Educate stakeholders on how increasing unit price can reduce underage initiation and use of substances. Public policies at the federal, state, and local level that increase the purchase price per unit of sale of substances such as tobacco, marijuana, and alcohol include increasing excise taxes on these products and/or instituting higher taxes at the point of sale.

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  • Advocate for the dedication of sales tax funding for local prevention efforts. In Colorado local jurisdictions may choose to levy additional taxes on substances, such as marijuana, if they are sold in the community. Delegation of these so-called “sin taxes,” can support youth substance abuse prevention and treatment efforts. Fees for licensing of outlets can also be applied to youth prevention programs.

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