youth substance abuse: building resilience and reducing harm...

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Copyright © 2017 Arizona Board of Regents, All rights reserved • SanfordInspireProgram.org For a complete list of references, refer to the On-Demand Module ‘Youth Substance Abuse: Building Resilience and Reducing Harm.’

Youth Substance Abuse: Building Resilience And Reducing Harm Transcript

Chapter 1: Introduction and Key Terms

Module Overview

Transcript:

If you work in a school, you may encounter young people who are abusing drugs or alcohol. Substance abuse poses risks to young people’s lives and development, and it can have a devastating impact on families. The question is: As someone who works with and cares about kids, what can you do about it? In this module, you will learn about the risk factors for youth substance abuse and how you can build resilience against those risk factors. Take a moment to read the title of each section to see how this experience is organized, then click “Proceed” when you are ready to continue.

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Terms and Definitions

Transcript:

Here are four terms that will be used throughout this module. In everyday conversation, these terms are sometimes used interchangeably even though they have clear differences in meaning. Based on your own background knowledge, place them in order from least to most severe. Click “Submit” when you are finished.

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Transcript:

Here is the correct order. Hover over each term to reveal its definition.

Substance Use

Substance Abuse

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Physical Dependence

Substance Use Disorder

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Substance Abuse vs. Substance Disorder

Transcript:

In this video, you’ll hear a licensed substance abuse counselor and author discuss the difference between substance abuse and a substance use disorder - which is commonly referred to as an “addiction.”

It’s surprising for people to realize that many people use all the other drugs and they do not become addicted to them. Now they may abuse them - use too much. But there’s a line that’s crossed in addiction where you are no longer able to have control over your decision-making process when the drug is in your brain. And that’s where the confusion comes. Approximately 10% of the population [of people who use] will fall into that category of addicted. But there’s confusion because we’ll have a higher percentage than that are abusing - are abusing tremendously. And so we may think, “Well, you’re an addict or an alcoholic.” But they may in fact not be - they may just be abusing. How can we tell? They will be able to control how much they use. That’s the difference that we will be able to see. So, for instance, they’ll be able to drink five beers and walk away. The alcoholic, once he starts, cannot stop.

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Common Symptoms

Transcript:

Before we continue, take a moment to review some common symptoms of a substance use disorder. As a teacher or someone who works with young people, you might not be able to observe all of these signs directly. However, you should be aware of them - especially if you’ve built a relationship with a student and he or she discloses one or more of these things to you.

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Time

Social

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Distress

Chapter 2: Prevalence

Prevalence

Transcript:

Now that we’re clear on what use, abuse, and addiction are, it’s worth asking: How common are each of these things among young people? Here are some statistics from the 2014 National Survey of Drug Use and Health and the 2014

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Monitoring the Future Survey. Try matching each statistic with what you think it represents, then click “Submit.”

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Risks

Transcript:

The use and abuse of alcohol and illicit drugs pose risks to young people.

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For example: research has found that early initiation into drug and alcohol use predicts poor academic performance and association with substance-abusing peers (Windle et al., 2005). It also increases the risk that a child will develop a substance use disorder later in life (Behrendt et al., 2009; Chen, Storr, & Anthony, 2009; Colder et al., 2013; Hingson, Heeren, & Winter, 2006). Accidents involving alcohol use - such as alcohol poisoning and motor vehicle accidents - are a leading cause of death and disability among teenagers (Centers for Disease Control, 2015; Gore et al., 2011). Finally, heavy marijuana use in adolescence may pose risks to a child’s developing brain - including lower IQ in adulthood (Hall & Degenhardt, 2014; Meier et al., 2012).

Misconceptions

Transcript:

The risks posed by drug and alcohol use are serious. However, even with widespread experimentation, only about 5-10% of the young people who try alcohol or drugs develop problematic patterns of use or substance use disorders (SAMHSA, 2014, 2015; Kirkpatrick et al., 2000).

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Video

Transcript:

One of the challenges we have is we live in a society where there’s confusion about, “Is the addiction in the person, or is it in the drug?” So, the thing I teach the families I work with - I work almost exclusively with families nowadays - is to educate them about, then think about that fact. If the addiction was in alcohol, if the addiction was in the drug, then everyone who drank would be an alcoholic.

Video Summary

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Transcript:

Young people do not develop substance use disorders solely due to the chemical properties of the drugs they consume. Other factors are in play. In the next section, we will learn what some of these risk factors are.

Chapter 3: Risk Factors

Risk Factors

Transcript:

Risk factors are conditions that - if present in a child’s life, increase the likelihood that he or she will abuse substances or developing a substance use disorder (Anthony, Jenson, & Howard, 2016). Click each tab to learn about different risk factors. As you read, keep this question in your mind: What do many of these risk factors seem to have in common?

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Trauma

Stress

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Social Isolation

Environment

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Patterns of Use

Transcript:

All of the risk factors you just reviewed can have the effect of creating anxiety or emotional pain. Alcohol and drugs have the ability to provide relief from that pain through altered states of consciousness. However, because the effects of alcohol and drugs are inherently temporary, their use is self-reinforcing. This is why it can be easy to get “stuck” in a pattern of using drugs and alcohol as a coping mechanism (V. Narloch, personal communication, 4/10/16).

Video

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Transcript:

The thing about drugs is, they make you feel good - and they do it very quickly. And alcohol is in there as well. So, if I get something that makes me feel good, and then…I’m gonna use it. And if you try to take it away from me, I’m gonna fight to hold onto it.

The drug use, the alcohol abuse…that is a symptom of a bigger problem that no one wants to have to deal with, but we do need to deal with it. So if we look at it that way, that’s all totally different versus, “If we just got rid of the drugs, everything would be fine.” No, because now they don’t have anything to cope with all the stress that they have, so they have to do something different. So we could say that addiction is a wake-up call to the rite of passage issue - you could make that argument. You could even make the argument that the rite of passage issue - or delayed emotional growth - is actually a bigger issue than the addiction itself.

When you have an empowered child, the chances of them wanting…seeing their solutions to their problems through addiction - through drugs - reduces way down.

Chapter 4: Building Resilience

Building Resilience

Transcript:

How can we empower young people, and help them develop the skills and strength to overcome the risk factors for substance abuse? We can’t erase students’ trauma histories, we can’t alter their family dynamics, and we usually have little control over the environments that they exist in outside of school. What we can do is take steps to build student resilience. Resilience describes the process of overcoming risk factors and learning

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how to cope with adversity in healthy and adaptive ways (Chandler, Roberts, & Chiodo, 2015; Fergus & Zimmerman, 2005; Theron, 2016). We will now review some strategies that can be used to build student resilience. These strategies are helpful for all students and can act as a form of protection against many problematic behaviors - not just substance use.

Prioritize Relationships

Transcript:

The first strategy is to prioritize relationships. A key factor in resilience is a child’s belief that he or she has support from peers and adult authority figures (Aldridge et al., 2016; Liebenberg et al., 2016). Take steps to build positive, supportive relationships with your students (Bond et al., 2007). Talk to them, learn about their lives, and demonstrate that you care about them and respect their experiences. It can also help to pair young people with peer or teacher mentors with whom they can bond and discuss problems (Chandler, Roberts, & Chiodo, 2015).

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Strengthen Connectedness

Transcript:

The second strategy is to strengthen students’ connectedness to school. Research has shown that students who feel a strong sense of connection to school are more likely to make positive health choices and abstain from substance use (Bond et al., 2007; Sacks et al., 2014; Skager, 2013). These connections should begin in the early grades and then be strengthened throughout adolescence. Encourage students to participate in activities that foster connection to school and peers. Examples might include sports, clubs, peer mediation, peer support groups, student council, and so on. Also, as the mother at the beginning of this module said: involve parents. Keep them updated on their child’s academic progress, and invite them to participate in the life of the school. Young people whose parents demonstrate higher levels of involvement in their schooling are less likely to use and abuse substances (Fergus & Zimmerman, 2010).

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Foster Self-Efficacy

Transcript:

The third strategy is to foster self-efficacy. Students who believe in their own ability to solve problems and handle difficult situations are more likely to manage stress in healthy ways, and less likely to turn to substances as a coping mechanism (Cunningham, 2010; Fergus & Zimmerman, 2005). As educators, we should recognize students’ strengths and provide opportunities to demonstrate competence (Cunningham, 2010). One way to do this is by giving them responsibility for mentoring and helping others. Peer mentoring, peer counseling, and peer tutoring are all examples of activities that can help students build and show competence. Finally, we should validate young people as individuals who can form their own opinions and make good choices (M. Speakman, personal communication, 4/27/16; Skager, 2013). When we express our belief in students, we can increase their belief in themselves.

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Options

Transcript:

If you’d like to analyze a brief case study to check your understanding of strategies for building resilience, click “Learn More.” Click “Proceed” if you’re ready to continue to the next section.

Optional: Case Study

Transcript:

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Read the case study. Imagine that you are one of Anthony’s teachers, and think about what you could do to build his resilience.

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Check for Understanding

Transcript:

Place a check next to all of the actions that could have the effect of increasing Anthony’s resilience, and protecting against the development of a substance use problem.

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Chapter 5: Prevention

Prevention Education

Transcript:

Prevention education can work in tandem with the resilience-building strategies that you just learned about. The goal of prevention education is to stop or delay the initiation of substance use, and it is especially important for elementary and middle-school aged students. These students are less likely to have tried or be actively using alcohol or drugs than their older counterparts, for whom harm-reduction approaches may be more appropriate (Chen, Storrr, & Anthony, 2009; Evans-Whipp et al., 2013; Lee et al., 2016; Poulin & Nicholson, 2005). If you would like to explore the characteristics of effective and ineffective drug and alcohol prevention education, click “Learn More.” If you already learned about effective prevention in the module Drug Use in Schools: A New Look at an Old Problem, you may proceed.

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Prevention Program Characteristics

Transcript:

Let’s take a moment to tap into your background knowledge. Place a check next to all of the statements that you think describe characteristics of effective prevention programs.

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D.A.R.E.

Transcript:

For many years, Drug and Alcohol Resistance Education - or DARE - was the most widely used drug-education program in the United States. It was also pretty ineffective. Multiple studies showed that it had little long-term effect on students’ attitudes toward drugs or decision to use drugs (Ennett et al., 1994; Lynam et al., 1999; Pan & Bai, 2009; West & O’Neal, 2004). Click the video if you’d like to hear a student activist and former police officer explain why. Otherwise, click “Proceed”.

Optional Video: Nick and Sarah

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Transcript:

Sarah Saucedo:

As far as what would make drug education ineffective, I think we could start with what we’re already doing. So, being condescending, masking the truth about the realities of drug use and the seriousness of drug use, overly punitive policies, abstinence only…These are things we’re currently doing that aren’t working.

Nick Dial:

When you make something taboo, and it’s “No, no, no, no,” obviously for a lot of people the natural reaction is to push back. I think the biggest issue with DARE and these punitive actions is this whole time, it’s this scare tactic. And they take this approach that, “If you take marijuana, it’s a schedule one. The most dangerous drug,” and all these horrible things are gonna happen. And, I mean, look at the propaganda through the years - “the devil’s garden”, and all of these over the top things. What happens? They get a friend, or somebody tries it. Oh. They didn’t die. They didn’t go crazy. Huh. Then they try it. So then what they find out, all of a sudden they find out that they were lied to. It’s not true. It’s not as horrible and extreme as they’re making it out to be.

What are Characteristics of Effective Programs?

Transcript:

Drug and alcohol education programs can be effective in helping young people abstain from use, delay use, or use in moderation (Anthony et al., 2016; Botvin & Griffin, 2014; Rhew et al., 2016). And in fact, some of the most impactful modern programs were built upon lessons learned from the

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weaknesses of earlier efforts. Take a moment to watch a drug and alcohol education curriculum developer discuss some of the characteristics of effective programs.

Video: Mary Harthun

Transcript:

We help kids in this particular curriculum think about their values. What the values are of their family, of their community, and then talk about their norms. What do they actually do? Do those norms fit their values? If what they’re doing isn’t really what they believe they ought to be doing, then what kinds of changes can they make in their lives? We don’t hammer kids with, you know, “This is really gonna hurt you.” We’re just going to give them some strategies, give them the language that they may be able to use in situations.

We set up the activities in the curriculum so the kids are having an opportunity to talk to each other, to interact with each other all the time to solve problems, to make decisions, so they’re learning from each other.

In the classrooms where the teachers are letting the kids have their voice in talking about their experiences, and where teachers are being very honest - and some of them are very honest about some of their own experiences - I think that makes a difference.

And if you let the kids talk about it, too. Most of the kids in the classroom are gonna say, “I’m not interested. I’m not gonna do that. I want to wait. This is why I want to wait.” And if kids hear those stories, I think that’s going to be really helpful to them.

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Chapter 6: Harm and Reduction

Harm Reduction

Transcript:

Even if we take steps to foster resilience, and even if we provide effective prevention education, the reality is that some young people will still use alcohol or drugs. Harm reduction refers to a set of strategies whose goal is to enhance safety and reduce the negative consequences associated with drug use (Harm Reduction International, 2016; Kelly, 2012; Poulin & Nicholson, 2005; Poulin, 2006; Rosenbaum, 2014; Skager, 2013). Harm reduction is a public-health approach to substance use, and its end goal is the preservation of life and well-being. It operates from the belief that one way to work toward this goal is to help drug users increase safety - rather than ignoring, condemning, or punishing them.

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Characteristics

Transcript:

Each of the cards onscreen shows a characteristic of harm reduction. Click each one to see an example of what it could look like in practice.

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Effectiveness

Transcript:

Research has shown that harm reduction messages can be effective in causing young people to reject dangerous behaviors related to drug and alcohol use. For example, the School Health and Alcohol Harm Reduction Project provided training to high school students on skills like how to count standard drinks, “how to monitor their own drinking, and how to avoid becoming intoxicated” (Kelly, 2012, p. 328). A team of researchers then compared the drinking behaviors of high school students who received the harm reduction curriculum to a control group who did not. Students who received harm reduction education were more likely to be non-drinkers or supervised drinkers at a 1-year and 32-month follow-up. The students who did drink consumed significantly less alcohol than students in the control group, and reported experiencing less alcohol-related harm (McBride et al., 2004; McKay et al., 2014). Other studies have found that harm reduction messages from school staff predicted a decrease in alcohol-related harms like binge drinking, drinking and driving, or riding in a car with a driver under the influence of alcohol or drugs (Evans-Whipp, 2015; Poulin & Nicholson, 2005; Kelly, 2012).

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Age Appropriate Messaging

Transcript:

Harm reduction approaches are most appropriate for older adolescents. They may be inappropriate for elementary and middle-school-aged students. This is because younger students have less cognitive maturity, and may be more likely to misinterpret harm reduction as an endorsement of substance use (Kelly, 2012; Poulin, 2006). It should be noted that harm reduction is completely consistent with the message that abstinence is the most effective way to avoid drug and alcohol-related harm. However, it also acknowledges that if some students still choose to use, there is information that can help them protect themselves from accidental injury or death. If you’d like to analyze a brief case study to check your understanding of harm reduction, click learn more. Click proceed if you’re ready to continue to the next section.

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Transcript:

Read the case study. Imagine that you are a staff member at this school, and think about actions that could be taken to reduce the drug-related harm being described. When you’re finished, click “Proceed.”

Check for Understanding

Transcript:

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Place a check next to all of the statements that could be helpful harm reduction actions for addressing the problem described in the case study.

Feedback

Feedback 1-6

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Recap

Transcript:

Let’s recap where we’ve been in this module. We learned about key terms surrounding the issue of substance abuse, and explored its prevalence among young people. We learned about the personal and environmental conditions that place young people at risk for using or abusing substances. We learned about concrete actions educators can take to build youth resilience against substance use and other risky behaviors. Finally, we learned about key principles in prevention and harm reduction.

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As educators, we can help young people keep themselves safe and reach their potential. In order to do this, we must work together to establish communities of support within our schools where students are informed, connected, and have access to the help they need.

Chapter 7: Expert Interviews

Context

Notes:

In the Foundation section you were introduced to several topics related to youth substance abuse and resilience. Click on any of these topics to hear an expert elaborate on it in greater detail.

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Substance Use and Coping Skills

Notes:

We live in a culture where a child at 12 may know things that - in previous generations - a person might not know until they were 18 or 20. So now they have all this extra knowledge and information and they want to grow up, but our culture doesn’t really provide structured life skills for adults. We just kind of hope it takes place; we kind of know what it is, but it’s never been written down. And so one of the things, then, is the problem that happens, is, I call it the “magic moment.” In one moment at age 18, the child’s life - the adolescent’s life - changes dramatically. And not just a little change. Not just, “Okay, you’re one year older now.” It’s like, all of a sudden you go from zero empowerment - power and empowerment meaning I have choice - to total empowerment as an adult. So, prior to that one moment you can’t join the service without them, you can’t get married without them, you can’t own property, you can’t move next door - all of your power comes through your parents. And then the magic moment occurs. Where’s the period of adjustment? The young people, once they hit eighteen, and they’re expected to be adults - but they may not have learned life coping skills - then they will continue to use drugs to make up for the lack of life coping skills.

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Building Self-Efficacy

Notes:

A lot of the work that I do is educating parents on fine-tuning their parenting style to - interestingly enough - give more power to their adolescent children (when we can catch them at that age). And they do that through two major ways. Number one: let them make decisions that they normally would not let them make. Number two: accept their opinions about life, about things, that they would never accept that opinion - ever. And in fact what they’re doing is they’re allowing the child to practice adulthood, so there is a period of adjustment.

So, if you’re put in a parenting position like a teacher is, it can be helpful to know some of these things - whether you like it or not, you’re put in that position. If you give them power when they don’t expect it, then it can give startling results. Part of that power is listening to them, and validating - this is stuff people know, but to tie it to parenting is another issue because you have that responsibility to form them, shape them, teach them. And then in one moment, oop - Okay, now it’s yours. This is a problem. It wasn’t as big a problem so many years ago because the whole village was teaching life skills to them through teachable moments.

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Providing Validation

Notes:

If you’re someone who works with young people and you suspect a substance issue - to have some compassion for them and realize there’s these underlying issues that are going on with them. That doesn’t make it okay - understanding is not the same as agreeing with or justifying. So you can have that understanding, and that alone - when you have a conversation with them - ask them. Talk to them. Really valida- and once again, we don’t have as much time as we used to have. But you’re in a position to try and find out what’s really going on there. Now they may lie to you, of course. So if you see yourself in a limited role, because you can’t do everything here, but you can ask them: “Do you trust me enough to be honest with me?” And look them right in the eyes. And talk to them like you would an adult even though they’re not an adult yet. And say something like that, “Do you trust me enough to be honest with me? Have you been using pot? Have you been drinking?” And I know that if you have been using - because of your age and because of the circumstances - there will be some punishment for you. But what if that punishment - whatever that is - was worth it because of you being able to solve whatever problem…and if the child says “This problem has no solution,” go “Okay.” Instead of arguing with them, you go, “Okay, maybe it doesn’t.” So you validate their opinions, right involved. And this…you can’t do active listening because you read about it and took a seminar. The thing that keeps people from active listening are their own active issues going on inside their own head.

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Harm Reduction

Notes:

People use drugs. Let’s not push it under the rug, let’s not pretend it’s not happening out of fear or shame. Let’s just say people - especially young people - use drugs. So where do we go from there, right?

So I’d like to draw attention really quickly to the harm reduction we already use when we’re talking about alcohol. I remember being taught in high school - and maybe this could just be to my individual high school - but I was taught that when you’re drinking, you know, don’t drink, because you’re underage first of all, and it’s illegal, but also because it’s dangerous. But if you are drinking, don’t binge-drink, for example. Don’t have more than five drinks in one session. Drink lots of water between your alcoholic beverages because it’ll dehydrate you and increase your risk of overdosing. If you’re a woman, be careful of who’s handing you your drinks and, you know, if you’re leaving your drinks alone. These are harm-reduction practices that we already use for young people and that are actually very effective. So drawing on that, we need to be talking the same principles about, quote-unquote, “illegal drugs.”

Recognizing the signs of an overdose, explaining to people - to young people - how drugs work in their brains, and then also explaining, especially with the rise of opiate overdoses, the specific risks of taking prescription painkillers…those are all harm-reduction practices that we could begin instituting right now.

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Peer Support

Notes:

If you look at the efforts that we have made in the past on behalf of addressing this generation’s addictive behavior, and you see that basically we have hit many walls in terms of trying to figure out how to communicate with them, how to find the answer, how to have the mentorship available that’s going to create some evidence of success. And all of a sudden a group of kids come along and say, you know, that’s not exactly what we’re looking for. We’re looking for the answer from each other. And we feel that we can trust each other, we feel that there’s a sense of honesty that’s here that isn’t always available within the adult world. And about the time they gather together and rely on each other, and find that they not only have the capacity to share, but to work as a community through those issues that they all face, we find that peer-to-peer is probably the most powerful opportunity that we have. And it totally aligns with the current research.

So, about the time you put them together in a situation where there is unconditional support, where people aren’t being judged, where everyone’s accepted equally, and everyone walks through that door with the same opportunity to be able to find support and friendship and establish relationships, then you’re going to be able to address trauma without having to wait until a crisis occurs

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A Parent's Perspective

Notes:

First and foremost, if you see behavior changes - you know, you’re with that student a lot, a large part of the day. And so I would just say, notice behavior changes, notice weight loss, disheveled-ness, not fulfilling their academic…to their ability. You know, academically, changes in any of that. And I would say largely that if you do see that, then the next step would be to notify a parent or maybe have a conference with a parent. Be bold, I guess. You know, a lot of times it’s such a taboo thing, you don’t know exactly how to approach it, but, you know, as a teacher or an administrator just be bold and care enough to really bring it out. It may not be it, but if it is it, to catch it early.

We’re talking about their very lives. If it goes well, they have hope, and a chance. If it doesn’t go well, it will only end one way.

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Effective Prevention

Notes:

Your drug education needs to be science-based and not based on fear tactics or scare tactics or propaganda. So, if you’re gonna have drug education, you need to tell them, “You can’t overdose on marijuana, but there may be risks involved in smoking it.” When students know they’re being taught the truth, in my opinion as a young person,that makes me much more liable to believe it and to want to practice it and follow it for my own safety.

It’s totally reasonable to say, “Look, you’re a young person. It’s against the law. We don’t want you using drugs.” But that decision ultimately is always going to be up to the student when they’re in the moment. So if we can teach them to have a mindframe of, “I don’t want to do this now because I understand it will have negative consequences for me,” I think that’s a little healthier and a little more effective than, “I really kinda want to try this because I’m not sure, but I might get in trouble. So maybe if I find a way to do it without anybody knowing, I can get away with it.”

I think you have to look at the age of the kids too, and what they’re able to handle conceptually as well. So, and…then think about the experiences these kids might be having and find out from them what kinds of experiences they’re involved in at that particular time.

It’s important that the teacher allow the kids to have a voice in the activities. They say how they would do things in their family. So you’re helping kids, again, with this language, with some communication strategies... we listen to stories from different groups of kids, so we’ve incorporated all their stories, all their situations in the curriculum in the scenarios that they see. And I think that’s really important, so kids see themselves in the message - in the prevention message

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Shift in Thinking

Notes:

Young people are vulnerable, and as they make their way through adolescence they may engage in behaviors that pose risks to their health and well-being. As educators, we may wonder if there is anything we can do to protect children from these risks - or even if it is our place to do so. But perhaps what is needed is a shift in thinking. You can’t stop a young person from using drugs or engaging in other risky behaviors - especially if he or she is determined to do so. What you can do - what any supportive adult in a child’s life can do - is create conditions that will make him or her less likely to use drugs in the first place. You can make a child feel welcome, valued, and part of a community. You can respect his or her thoughts and opinions, and help him or her problem-solve. Finally, you can equip young people with knowledge they can use to protect themselves, and make safe, healthy decisions.

youth substance abuse: building resilience and reducing harm...

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