What is substance use prevention?

The annual National Prevention Network (NPN) meeting was held in Seattle last fall and the University of Washington's David Hawkins gave a keynote address about substance use prevention. As our state expands prevention programming, particularly activities for preventing youth marijuana use, his keynote address provides a good reminder about what works and what does not.

Before a great deal of prevention research was done, many substance use prevention programs were used that have since proven ineffective. The last thirty years of research have made a significant difference in understanding what is most effective.

For example, while it may seem intuitively correct that providing information about drugs would be a straight-forward way to prevent young people from starting to use drugs, such a strategy actually increased drug use in some studies.

Locally, the UW's Social Development Research Group studied the effects of risk and protective factors on youth drug use. They found that protective factors can reduce youth drug use even in the presence of many risk factors.

Protective factors include the communication of clear standards in families, at schools, and in the community. When families, schools, and communities express clear standards against teenagers using drugs, youth are less likely to use drugs.

Individual prevention programs that encourage family bonding, teach skills that teenagers need to be able to avoid or refuse drugs, and provide parents with information about giving their children opportunities and recognition for pro-social behaviors have been found to be effective.

Communities have a role to play in prevention, too. Policies such as the minimum legal drinking age, taxes, and restrictions on where and when legal drugs are sold are proven methods for preventing youth drug use.

So, which prevention activities should be implemented in communities? Whichever ones address the problems specific to a community. Prevention activities are not one-size-fits-all. Know your community and what factors are putting teenagers at risk and what factors are protecting against drug use.

The entire keynote presentation may be viewed by clicking here.

Availability & norms are strong predictors of youth marijuana use

Lately, I've been engaging in discussions about what youth substance use prevention is and what it is not.  The field changed significantly over the past twenty years as research about healthy youth development increased.

To start with, a great deal of youth substance use prevention is based at the local level and starts with communities assessing their risk factors that contribute to teen drug use.  During a recent symposium at the University of Washington, researchers from the Social Development Research Group in the School of Social Work provided an overview of risk and protective factors specific to underage marijuana use.  

This first slide from the presentation explains that risk factors may be present in multiple domains: the community, the family, schools, and among individuals and their peers.  Within the community domain, "availability of drugs" and "community laws and norms favorable toward drug use" are identified as risk factors for youth marijuana use.

In this second slide, protective factors are identified.  Community factors that contribute to the prevention of underage marijuana use include "clear and healthy standards for behavior" and "pro-social opportunities".  

During the symposium, researchers focused on risk factors that are the strongest predictors of youth marijuana use.  They include availability of marijuana, perception of risk from using marijuana, and pro-marijuana norms among parents, youth, and in the community.

All of the slides may be viewed by clicking here.  A video of the presentation is available on the symposium website.

What is youth substance abuse prevention? Start with risk & protective factors . . .

What is substance abuse prevention?  Understanding risk and protective factors is one place to start to gain an understanding of what substance abuse prevention is and is not.

Communities working together to prevent youth substance abuse can look at what factors increase risk of substance abuse and what factors protect against substance abuse in their communities.  Risk factors can increase a person’s chances for drug abuse while protective factors can reduce the risk.  Prevention strategies work towards decreasing risk factors and increasing protective factors.

Above is a chart displaying risk factors for substance abuse as well as delinquency, teen pregnancy, school drop-out and violence.  Risk factors that the Prevention WINS coalition has identified in northeast Seattle are family management problems (regarding monitoring youth and setting consequences) and youth favorable attitudes towards drugs and alcohol.  In other communities risk factors may include low neighborhood attachment, lack of commitment to school, or early and persistent anti-social behavior.  Each community is different and, therefore, prevention strategies may vary community to community.

Protective factors include individual traits such as a resilient temperament and a pro-social orientation.  Community protective factors include opportunities for youth to be involved in pro-social activities and being recognized for those activities.  At home, families can bolster protection by increasing family bonds, reinforcing healthy beliefs and setting clear standards.

Marijuana use rates among WA high school seniors increases, higher than national average

Though the rates of marijuana use among Washington State high school seniors dropped between 2000-2003, it has steadily increased since then.  (Source: 2010 Tobacco, Alcohol, and Other Drug Abuse Trends in Washington State, page 41.)

As I posted yesterday about 2010 Healthy Youth Survey results, fewer Washington State students perceive that it is risky to use marijuana.  Research has shown that as perceptions of risk decrease, use increases.

I don't want to suggest that Seattle policy affects the rest of the state, but I do want to point out that I-75, the Seattle initiative that made marijuana the city's lowest law-enforcement priority, was passed in 2003.  Last year, Washington legalized marijuana for medical purposes. Currently, our state is in the midst of a debate about marijuana legalization.  A research-based risk factor for youth substance abuse is community norms favorable to drugs.  As we continue our conversations about marijuana policy, it behooves us to consider what messages our children are getting from them. 

Resiliency through optimism and praise

Less depression, health risks for teen optimists

Optimistic thinking appeared to protect against health risks such as emotional problems, substance use, and antisocial behavior according to a group of researchers in Australia.

How to teach children to be optimists: listen, don't label

Dr. Leslie Walker, Chief of Adolescent Medicine at Seattle Children's Hospital, provides parents with 5 tips on how to help children become optimists.

Walker says that above all, parents need to model a positive outlook. "Patterning after their parents is how kids figure out how to live," she says. "If parents are optimistic about what's going in their lives, you can expect the kids to follow."

Young people prefer praise to sex, money (and alcohol)

Sex, booze or money just can't compare with the jolt young people get from a boost to their self-esteem, says a new study of college students that found the desire for praise trumped other desires or needs.

The importance of providing youth with opportunities for pro-social involvement

The prevention strategies being implemented by the Prevention WINS coalition are based on risk and protective factors identified through community data. While we work to reduce risk factors such as easy access to alcohol and marijuana, favorable attitudes towards drugs, and families not monitoring their children, we strive to increase factors that protect our children from drug and alcohol use.

According to the Social Development Research Group at the University of Washington, two key protective factors are

(1) bonding to pro-social family, school and peers, and

(2) clear standards or norms for behavior.

Families, schools, community organizations, neighbors, and others can promote these protective factors by providing "opportunities for involvement in productive pro-social roles, skills to be successfully involved in these roles, and consistent systems of recognition and reinforcement for pro-social involvement. These factors protect against the development of conduct problems, school misbehavior, truancy, and drug abuse."

Be a part of creating a community that provides opportunities and teaches skills for pro-social involvement and then rewards young people for their involvement. Everyone in the community has a role to play.

Communities That Care

Communities That Care (CTC) now has its own Wikipedia page. CTC is a coalition-based prevention operating system that uses a public health approach to prevent youth problem behaviors such as violence, delinquency, school drop out and substance abuse. This model is similar to the one used by the NE Seattle Coalition to Prevent Underage Drinking. Like the coalition, CTC's main strategy focuses on strengthening protective factors that can buffer young people from problem behaviors and promote positive youth development. We also work to reduce risk factors.

CTC was developed by the Social Development Research Group at the University of Washington's School of Social Work.