Most adults who meet the criteria for substance use disorder began their use in their teenage or young adult years. For this reason, early and effective substance use prevention for youth is extremely important. “Effective” is a key word when it comes to youth substance use prevention efforts.
For years, Project Drug Abuse Resistance Education (D.A.R.E) was one of the most widely used substance use prevention programs targeting school-age children in the United States. Billions of dollars were spent and countless other resources used on the D.A.R.E program, however, multiple studies done over several years have found that the program was ineffective in preventing substance use
How do we make sure that we are no longer wasting resources on ineffective prevention measures for youth? One way is to focus on youth who are potentially at the most risk for substance misuse before the use begins.
Who Is at Risk?
According to the Centers for Disease Control (CDC), 15% of high school students have used illicit or injection drugs (cocaine, inhalants, heroin, methamphetamines, hallucinogen, or ecstasy), and 14% of students reported misusing prescription opioids. This type of substance use is often associated with risky sexual behavior, experience of violence, and mental health and suicide risks. The following are risk factors for youth substance use:
- Family history of substance use
- Parents have favorable attitudes of substance use
- Poor parental monitoring
- Parental substance use
- Rejection of sexual orientation or gender identity by family
- Association with substance using peers
- Low academic achievement
- Lack of school connectedness
- Childhood sexual abuse
- Mental health issues
The most effective strategies for high-risk substance use prevention include engagement with parents and caregivers, family support, parental monitoring, and parental disapproval of substance use. Unfortunately, if a student meets the criteria for many of the above listed risk-factors, it is unlikely that they will receive the family connectedness or engagement necessary to offer a protective factor against future substance use.
According to the National Surveys on Drug Use and Health, about 1 in 8 children aged 17 or younger live in households with at least one parent who has a substance use disorder. For this reason, policymakers in the United States should push for specific prevention strategies and programs targeted to youth living in these households. D.A.R.E’s message focused on “drugs are bad and people who use drugs are bad people”. This type of messaging is very harmful for someone living with family members who have a substance use disorder. It is important that future prevention programs should honestly address the effects of substances, but steer away from any kind of stigmatizing language or messages.
Families that struggle with substance use disorders may also struggle with other challenges, such as mental illness, poverty, and domestic violence. Prevention programs should also include these issues and include accessible resources that someone in the family may be able to navigate.
Educators, community leaders, and clinicians are important pillars of prevention when parents are not able to engage with their children about substance use. If a student who meets the criteria for risky substance use behavior can engage with a trusted adult in a way that is non-judgmental, informative, and compassionate, it could make a difference in preventing future substance use.