Despite having made great strides in reducing adolescent binge-drinking rates, illicit substance use remains significantly above national targets for health promotion and disease prevention in the USA and Canada [1–3]. In 2014, marijuana use and nonmedical use of psychotherapeutics were the most common types of illicit drug use by North American adolescents and there is very little evidence that rates of cannabis use have changed over the past 10 years. More concerning is that rates of adolescent substance use disorder remain high and unchanged over this period [3]. These data suggest that there is a need to shift the focus of prevention efforts away from universal approaches to more targeted intervention strategies designed to help those most at risk of transitioning to substance use disorders.
