Substance Use Disorders (SUD) are chronic diseases that can and should be prevented using the disease prevention models used for preventing breast cancer, diabetes, heart dosease and the others. Why isn't it we ask? Why are we not screening children and monitoring their transitions to adulthood with winning strategies that guide them to adulthood free of a SUD? We know the risk-factors, we know if they have them for the most part.  Ah, the secret family tree. Forgot that we still have a stigma that lies about what this disease is about. We dare not ask if there are addiction issues in the household, right? How bad do families want to end the cycles of addiction and poverty? Creating a disease prevention model will need to overcome the shame and silence that lives in homes where the most recent generation raises the next. In the meantime, we will treat all children in communities with environmental risk factors as if they also have genetic risk factors. All children will receive interventions as if they are going home to issues of parental addiction. We will quietly rule out cases where those risks do not present themselves. We will train the community on the impacts of these risk factors and how to apply protective factors to empower prevention from within. The video below explains this science.