Psychoeducation has been widely applied for different health related conditions (mental and medical disorders) in both clinical and community settings. Broadly speaking, psychoeducation is a process of teaching clients specific and general information about their illness and treatment (1). Specific information provides more detailed illness-related information, e.g., diagnosis and therapeutic trajectories, while general information includes more translational and general content, such as problem-solving skills and healthy life-style (1). Since the 1980s, when Anderson et al. introduced the term psychoeducation (2), translational research has reshaped the psychoeducational regimens and transferred findings from basic science to more practical level. By growing the knowledge of neuroscience in the context of mental illness, our understanding of risk factors, precursors, neural correlates, and therapeutic approaches has been much improved and the field of neuroscience-informed psychoeducation has emerged. “Neuroeducation”, “internal education”, “neuroscience literacy”, “neuroliteracy” and “Brain talk” are other relevant terms used to describe a class of interventions intended to educate individuals and reframe their perceptions of mental illness using neurobiological knowledge (3–5).

The application of psychoeducation in the treatment of substance use disorders (SUD) can be traced back to the 1940s, when alcoholism was acknowledged as an independent public-health problem and “the mantle of stigma covered the subject” (6). Early interventions targeted primarily treatment-seeking individuals who were at later stages of the addiction cycle characterizing severe SUD, rather than earlier stages such as substance experimentation or problem use (7, 8). Years later, psychoeducational interventions advanced by going beyond therapeutic interventions and getting applied as a tool for addiction prevention, particularly for children and adolescents. The first flashes of a psychoeducational program for children appeared in a commercial cartoon produced by the Partnership for a Drug-Free America (PDFA) in response to a cartoon that tricked kids to smoke. The PDFA’s cartoon featured the effects of drugs on the brain, depicting them as an egg dropping into a frying pan (9). Another example of such “Scare tactics” was the “Just Say No” campaign, known as Drug Abuse Resistance Education (D.A.R.E.), which aimed to teach students about the dangers of substance use by sending uniformed cops into the schools (10). These zero tolerance campaigns prevalent between the 1970s and 1980s were unsuccessful in reducing substance use behaviors.

Given the failure of such fear-based deterrence attempts, a new wave of educational approaches has emerged, characterized by non-judgmental and informative content that encourages students to make informed decisions about substance use (10). These educational approaches largely focused on knowledge and skill development in prevention, early intervention, and harm reduction formats. The knowledge includes information regarding the harmful effects of substance use and corrects normative expectations, while the skills training builds personal and social competencies, as well as establishes refusal skills (11). Accordingly, several successful educational interventions have been developed and tested in school settings; such as Red Frogs (12), Just Say Know Prevention Program (10), Unplugged (13), Life Skills Training (11), Project Towards No Drug Abuse (14), Reconnecting Youth (RY) (15), School Health and Alcohol Harm Reduction Project (SHAHRP) (16), Project ALERT (17) and ALERT Plus (18), Reasoning and Rehabilitation V2 (R&R2) program (19).

Over the past few years, interventions for adolescent have evolved from their initial focus on classic drug-related knowledge (e.g., the biological impact, including short- and long-term consequences of substance use, substance use standards, and prevalence) and skills training to leveraging adolescents’ curiosity about the brain’s involvement in substance use (20). The “Seductive Allure of Neuroscience” (SANE) (20) for adolescents has revealed a unique opportunity to integrate neuroscience knowledge with substance use prevention. The SANE proposes that psychological phenomena are more appealing and health messages more persuasive for adolescents when they are accompanied with brain-related information. For example, a recent harm reduction program, the ‘Respect Your Brain’, developed by Debenham and colleagues (2022), aimed to leverage neuroscience literacy of young people using a series of short animations (21). They found that watching brain-related animations could effectively engage people with the topics and positively change their attitudes towards the brain and substance use. Another program (22), which applied neuroscience to improve drug-based knowledge and teach practical coping skills is the ‘Illicit Project’. This program covered different aspects of the neuroscience of SUD in three modules including Alcohol and the Developing Brain; MDMA, Cannabis Use, Harm Reduction; and Mental Health and Wellbeing. Evidence from the pilot study indicates lasting effects (6 months) of the program on reducing drug and alcohol use compared to the control group who received health education. Therefore, it seems that knowledge about the role of the brain in the etiology and maintenance of SUD could lead to meaningful change in thoughts and behaviors (23). Moreover, given the high potential for learning and flexibility during adolescence, young people can benefit from preventive interventions to reduce the probability of SUD later in life (24, 25).

On the other hand, the rapid development of digital health technologies (e.g., mobile applications, websites), has introduced tremendous changes in the field of designing behavioral interventions and provides numerous opportunities for personalizing interventions and increasing their feasibility and accessibility. Digital platforms offer therapists and educators the chance to improve the quality of therapeutic and training services by incorporating unique features such as multimedia content, personalized feedback, and interactive elements. These platforms also allow services to be delivered affordably, regardless of time and location, which greatly enhances their scalability. Using digital health interventions also warrants the replicability and fidelity of the intervention and removes the barriers of differences in therapists’ skills and knowledge. Due to the popularity of digital health technologies, substantial progress has been made towards developing e-health preventive interventions (delivered via internet, computers, tablets, mobile technology, or tele-health) in the recent years (26–31). These interventions that typically offer a set of normative education and life skills training provide good empirical evidence and promising results about the efficacy of digital health in preventing or mitigating substance use in adolescents. Moreover, digital preventive interventions provide an opportunity for young users who prefer to remain anonymous during the training course and so reduce the stigma and embarrassment that they may perceive due to their needs for seeking help. This issue is complicated even further in adolescents, as they are highly impacted by stigma, and stigma can in turn create a major barrier to service seeking (32).

Acknowledging previous works, the present study aims to describe a conceptual framework for substance use prevention grounded in neuroscience knowledge and brain networks. Then, we propose key recommendations for developing a digital neuroscience-informed psychoeducation aimed at substance use prevention and introduce a sample educational app, termed ‘NIPA,’ as one of the novel tools developed to improve adolescents’ metacognitive awareness and enhance their resilience against SUD. Additionally, we provide preliminary feasibility and acceptability data regarding the app in a sample of college students and delineate the next steps for future studies.

A large body of research has implicated the mechanisms involved in substance use vulnerability in adolescents. Family history, genetic and environmental factors, and neurodevelopmental adaptations are risk factors known to be associated with increased vulnerability in young people (33). Moreover, SUD is more probable in the presence of cognitive immaturities, particularly in memory and learning, goal-directed behaviors, decision making and impulse control which are common during adolescence (34, 35). According to the Dual Systems Model and the Maturational Imbalance Model, adolescent risk-taking results from a temporary imbalance between two neurobiological systems: the subcortical socioemotional system, which is responsive to emotion, reward, and novelty, and the prefrontal cognitive control system, which guides controlled action, planning, and decision-making (36). A key assumption of both models is that the socioemotional system (System 1) develops faster and earlier in adolescence than the cognitive control system (System 2). As a result, adolescents are presumed to be particularly vulnerable to high-risk behaviors and tend to pursue quicker rewards (e.g., instant pleasure, peer acceptance) (37, 38). Consequently, during adolescence neural networks may respond differently to emotionally salient stimuli, such as substances. For example, in a hypothetical scenario, a young person who is new to high school and unable to find close friends may be more vulnerable to experiment with drugs, in the hope of finding friends and being accepted by a group of peers. Initial recreational and exploratory substance use leads to neurobiological changes that contribute to repeated and problematic use. As a result of these alterations and subsequent neuroplasticity, brain networks show abnormal functional reorganizations, leading to disrupted cognitive functions. However, a balanced functioning of these two systems could underpin a trait termed Resilience.

In general, resilient people are characterized by their ability to recover quickly after experiencing environmental risk or adversity and by adaptively coping with negative events and emotions. Resilience can be inferred from resistance to maladaptive behaviors when individuals face tragic or life-threatening events (39). A growing body of neuroscientific research aims to elucidate the brain networks underlying resilience and connect them with related cognitive processes (24, 40). However, while relatively few studies have focused on the specific brain networks associated with resilience or vulnerability against SUD, growing evidence highlights the importance of specific neural networks in the progression of SUD (25, 35). These networks include the Attention Network, Default Mode Network, Salience Network, and the Executive Control Network. Each of these networks is involved in specific cognitive functions and their balanced interactions could enhance one’s ability to overcome emotional adversity, and resolve the barriers in favor of positive outcomes. One of the conceptual models that we have suggested to explain the underlying neurocognitive mechanisms underlying resilience is the “EASICoRe” model (41). This conceptual model defines the major cognitive target processes involved in the dynamic response to drug-related cues. According to this model, once vulnerable individuals are exposed to an Environmental trigger (both internal and external cues), their Attentional resources are selectively allocated to process different aspects of the trigger (e.g., emotional, physical), while their Memory is biased toward recollecting relevant drug-related memories. By integrating the information from attention and memory, the evaluation system starts processing the Salience of incoming information and comparing them with subjective goals/values based on available appraisal schemas. At this moment, various somatic signals originate from within the body transferring information related to bodily experiences (e.g., heart rate, respiration rates). These Interoceptive signals contribute to emotional/appetitive experience and affect decision-making particularly under risk and uncertainty. Followed by evaluation, Inhibitory Control may be activated to control impulsive desires and habits and direct behavior Response toward more goal-oriented action. From the perspective of neuroscience, each of these cognitive functions is correlated with an activation of a distinct brain network. ( Figure 1 ). In the following section, we describe these four networks and their dynamic interactive roles in building resilience against addiction.

Providing educational tools about substance use and addiction to adolescents is challenging, as they tend to be more influenced by their peers’ beliefs and may find it difficult to trust educational content, which traditionally tends to be stigmatizing and fear-based. The growth of the field of addiction neuroscience is a novel and promising path that helps prevention scientists translate the complex science of the brain into comprehensible materials. This brain-derived education that capitalizes on the SANE (20) phenomenon particularly when delivered via a digital platform, captivates younger audiences and facilitates dialogue between them and scientists who view addiction as a brain disorder rather than a moral or criminal issue (62). To facilitate the development of such digital educational intervention, we summarize the most important considerations in the following section in terms of content and structure.

Based on the theoretical background on the role of neural networks in substance use vulnerability among adolescents, a mobile application referred to as the ‘Neuroscience-Informed Psychoeducation for Addiction (NIPA) ¹ was developed as a metacognitive awareness program to promote resilience in the face of emotional triggers, particularly drugs and alcohol. The program delivers psychoeducational content in four 20-minute-long sessions, including neuroscience-based education and cognitive games and training. Once individuals install the application on their mobile devices, the first session is unlocked, granting access to the full content. All sessions follow a similar structure, which includes the following sections:

To investigate the feasibility and acceptability of NIPA, we conducted a pilot study with a sample of 85 undergraduate students (Mean age =19.09 years; Female=85%). Participants for the current study were included from an ongoing longitudinal cohort study of college students at a large, urban, mid-Atlantic public university. This study was approved by the university’s review board (HM20018784) and all participants provided informed consent. For a detailed review of study methods see (66). Participants were invited by email and screened for eligibility. Inclusion criteria included (1) being an undergraduate student age 18 or older (2); previous experience/use of alcohol, and/or tobacco, and/or cannabis, and/or other drugs; and (3) being willing and able to download the app and complete the program. Eligible participants were asked to complete a set of self-report assessments (e.g., Barkley Deficits in Executive Functioning Scale, Monetary Choice Questionnaires). Study data were collected and managed using REDCap electronic data capture tools (67, 68).

Once participants completed the pre-intervention baseline assessments, they started the NIPA program and after the final session of the intervention, they completed post-intervention assessment, which included feasibility and acceptability measures to evaluate the utility of NIPA as an educational program ( Figure 2 ). The present paper reports the feasibility results, whereas the outcomes of the pre- and post-assessments are reported in another study.

As the age of drug use initiation decreases, interventions targeting the delay or reduction of problematic substance use among young people have expanded significantly. Preliminary forms of such interventions focused on reducing supply, reducing or delaying drug demand, and limiting the health and social harmful effects of substance use by criminalizing it (69). Although these classical approaches showed promise in reducing substance use by providing general knowledge about its negative consequences and teaching certain resistance skills, they appear to be ineffective in raising individuals’ awareness of the critical role of the brain in preventing or maintaining substance misuse. This kind of neuroscientific approach to reshaping the understanding of addiction as a brain disorder rather than a criminal justice issue, is an emerging field that seems to be more persuasive and acceptable among young people.

This new approach simplifies complex concepts about how different substances affect the brain, how neurocognitive mechanisms underlie the development of addiction, and how the brain can build resilience against SUD. Additionally, it could help adolescents better understand their own cognitive health. This is particularly important for adolescents with undiagnosed psychiatric disorders, such as ADHD. Parents and teachers of these youth might report behaviors such as leaving tasks incomplete, struggling to enjoy activities, and making impulsive decisions. Unaware of these symptoms and associated cognitive dysfunctions, adolescents become vulnerable to more serious challenges in daily life, such as a lack of persistence in pursuing long-term goals and being easily distracted by impulsive thoughts or risky behaviors such as substance use). Therefore, it seems necessary to provide adolescents with applied neuroscientific knowledge that can increase their understanding and awareness of cognitive functions, the long-term consequences of substance use on the brain, and evidence-based strategies to build resilience and improve brain health.

Moreover, framing drug-related education with brain-based language provides a safe learning environment for adolescents, where they don’t feel labeled or stigmatized for their attitudes toward substance use. The efficacy of such an intervention could increase even further when delivered through a digital platform, which is a salient communication tool for young people. Digital platforms have a number of benefits that can increase the efficacy of prevention and intervention efforts, such as: (1) higher anonymity compared to in-person sessions; (2) highly reproducible manner of intervention delivery; (3) by being available 24/7, they can provide ‘on demand’ therapeutic services when individuals need them most; (4) reduce stigma by diminishing the potential for public exposure; and (5) high scalability – increased access at low cost. Given the importance of expanding digital neuroscience-informed psychoeducation interventions for substance use prevention, we developed NIPA as a novel mobile app designed to inform adolescents about the neurocognitive mechanisms of addiction. It is noteworthy that NIPA uses a network perspective to discuss these neurocognitive processes affected by substance use, as brain networks provide a more accurate understanding of cognitive functions compared to other levels of analysis. This is supported by recent neuroimaging studies that focus on brain network analysis to represent the complex functional interactions between different regions underlying specific cognitive processes (70, 71).

Results from this pilot study support the feasibility and acceptability of NIPA among college students. We found that the brain games were the section liked the most by our participants, while the brain training strategies were rated lower compared to other sections. The mean scores for different measures of acceptability, including enjoyment, perceived convenience, informativeness, applicability, effectiveness, continuity, recommendation to peers, and satisfaction, were relatively good. Moreover, we received some qualitative feedback on various aspects of the program, which will be used to revise and modify subsequent versions of the app. These changes may help ensure that the content is more persuasive and acceptable for adolescents and emerging adults, enabling it to influence their awareness of the harmful effects of drugs on the brain and their intention to use or continue using them.

We wish to acknowledge a few limitations of our study. First, the small sample size and the lack of a control group reduce the generalizability and comparability of the results. Second, our sample was comprised predominantly of females with only a few male participants, which restricted our ability to examine gender differences in the analysis. Third, to improve learning and facilitate effective consolidation of the content, we are currently developing homework assignments to be completed between the sessions. Despite these limitations, our study introduces a novel psychoeducational tool in the field of addiction prevention for adolescents. Our findings support the feasibility of such neuroscience-informed interventions among adolescents in a college setting. Moreover, this app program has the potential to be used as a preventive tool for high school students and as a harm reduction intervention for adolescents who recreationally use drugs and alcohol. Additionally, that, due to its simple and comprehensible content, the app could be integrated into the therapeutic course of SUD treatment to raise patients’ awareness about the importance of seeking cognitive training interventions. However, further research is needed to determine whether using the app can change individuals’ attitudes and intentions toward drug use, as well as improve cognitive outcomes such as decision-making and impulsivity in each of these contexts.