The alcohol and other drug prevention community has made some strides in getting information out on the Internet, but competing messages from the alcohol industry and others still hog much of the bandwidth, according to Eric Helmuth, director of Internet services at Join Together.

Nearly 9 of 10 adolescents go online, and about 10 percent of youths aged 9 to 18 report having visited a drug-prevention website at least once, according to a report from the federal Office of National Drug Control Policy (ONDCP) -- a figure that has not changed over the years despite investment in more sophisticated online resources, such as ONDCP's Freevibe site. (On the positive side, that was about twice the number of kids who reported visiting a "pro-drug" website.)

Meanwhile, however, the alcohol industry recently doubled its annual spending on Internet banner ads, shelling out $21.6 million for about 50,000 such ads in 2002 alone. And a Fall 2003 study by the Center on Alcohol Marketing and Youth (CAMY) estimated that overall, 13 percent of visitors to websites maintained by alcohol companies were underage, with a few sites like the popular Bacardi.com receiving up to 60 percent of their traffic from people under the age of 21.

"It's not enough to 'have a network guy' anymore; prevention programs must invest in personnel skilled in using emerging technologies," says Helmuth. "We must stay up to date with technology and culture, which evolves almost as fast as hardware and software, because the Big Bad Wolf out there certainly does."

The alcohol industry, in particular, has been successful in driving traffic to its website by offering "trinkets and trash " -- features such as screensavers, cartoons, music, and contests -- similar to past real-world tobacco and alcohol marketing campaigns featuring baseball hats, t-shirts, and other youth-friendly items.

Helmuth describes the Internet as a "native environment" for youth, who surf effortlessly between downloading music, using Instant Messenger (IM) to communicate with friends, and researching topics for school or fun. More than half of youth surveyed say they go online to help them find out what's cool in fashion and music, for example.

Parental controls are of limited effectiveness in blocking youth access to objectionable content, especially given the growing number of places that youth can access the Internet. "The Internet by its nature is difficult to control: information wants to be free, and each generation of youth is more Internet-savvy," notes Helmuth. Unfortunately, he adds, "The Internet will probably become even more hazardous in the future. We need to meet young people, online, with more than just simple education or social-marketing websites."

"Will we match pro-drug and alcohol-industry websites? No," says Helmuth. "Even if we had the same money, we are not going to be as cool and enticing as the 'dark side.'" But he says, the same aspects of the online world that make it dangerous -- such as anonymity and freedom of information -- can work to the advantage of the prevention community.

"We need to develop next-generation online assessment and intervention tools that help kids 'too cool' to talk to an adult, who have a variety of issues, from curiosity to harmful use to early dependence," says Helmuth. "We must meet this very Internet-savvy audience in cyberspace with interactive content that goes beyond educating younger kids about the negative effects of drinking or drugs."

Some promising examples of this deeper interaction do exist, he notes. A number of colleges, for instance, are using Web-based alcohol education and intervention programs to teach incoming freshmen about the dangers of alcohol use and screen for signs of dependency among new students. AlcoholScreening.org, which Join Together developed, has provided screening, constructive feedback and referral to over 200,000 Internet users concerned about their drinking.

Savvy online intervention tools can be especially effective in reaching those individuals with little real-world interaction with addiction professionals. But these resources are in their infancy, and though early effectiveness research is encouraging, much more work remains. "We must invest in research and evaluation so that we know what works in online screening, and we must figure out how to effectively and safely expand it to reach broader and younger audiences," says Helmuth.

He also suggests other potential avenues for online prevention research and development. "Can we engage youth in peer-to-peer social marketing via chat rooms or IM? What about online support groups for youth? It may or may not be effective, but we have to find out."

The rapid growth in Internet use affect prevention groups in other ways, Helmuth says. The phenomenal growth of online content and e-mail has caused information overload and burnout among even the most ardent users, making it harder to hold together a constituency. "It has become very hard to stay in touch with people now," he says. "It's harder to be heard, and even harder to be remembered. Gone are the days when you could treat an e-mail blast like a cheaper and faster direct-mail or fax campaign."

Helmuth says the future may well lie in relationship marketing, using tools perfected by for-profit companies like Amazon that have come to dominate the Internet. "As the web got bigger and bigger, e-tailers had to get better and better at the relationship," he says. "Amazon.com was once the only game in town; now they excel amid enormous competition because they customize your experience, making it easy, saving you time, remembering what you like, what you did the last time you visited the site. We need to learn from the worlds of business and politics, and build online relationships."

In the cluttered, competitive online world, nonprofit groups need to think of their supporters as customers, stresses Helmuth. "You are competing for their time, attention, and money," he says. "If you are still counting your online success by 'hits,' then you are missing the boat. Care about the right people, not the most people."

Helmuth advises prevention groups to use their website as a 'flytrap' -- "a golden opportunity to engage the right people in a relationship, because they have sought you out." Prominently offering an e-mail newsletter on the home page is an especially effective way to build a relationship, and has the advantages of being easy to produce, scalable, fast and flexible, simple to forward to others, and excellent for driving traffic to your website. Helmuth also recommends that groups with a significant membership base consider working with an online customer-relationship management (CRM) firm to better understand and target their audience.

Using relationship-focused tools, Mothers Against Drunk Driving (MADD), Helmuth notes, has experienced 363-percent growth in its e-mail list and a 500-percent increase in its online contributions, and has found that personalized e-mails generate 155 percent more responses. "Not everybody needs to make that big an investment," he says. "But ask yourself: If you are not at least offering a simple e-newsletter on your home page, costing you less than $25 per month, why not?"

Even the addiction field's biggest challenge -- building a national constituency movement -- can be facilitated by online technology, says Helmuth. "These tools will open up new possibilities to build constituencies supporting change," he says. "We have long known that in prevention, education efforts alone, even high-tech ones, will never be sufficient. More advanced online screening, intervention and referral won't be enough, by itself. We also have to build a broad public constituency for effective policies."

"Most people involved in prevention really don't do a lot of advocacy, even though we all believe in it. We are, by and large, not making much headway," he continues. "We must figure out how to recruit a much larger constituency, and the Internet is the best way to do it."