Prevention is an important public health initiative and I’m grateful for the opportunity to work with Minnesota’s Regional Prevention Coordinator Lindsey Smith this past year. She’s been key to our events with Anoka-Hennepin Schools and was a panelist for our conference, From Statistics to Solutions. As this week’s guest blogger, Lindsey offers distinctions between reality and perception when it comes to young people and substance use … along with effective actions we can take to curtail this.
“Isn’t it inevitable that youth will use alcohol and drugs in high school?” “If only we could do a better job of educating everyone about the dangers.” These are things I hear on a regular basis in my work as a substance use prevention specialist. My response to both is: not quite.
(Mis)Perception of Youth Use
Perception is our reality, as the familiar saying goes. What we believe to be true is influenced by a number of factors. The way information is reported to us through the media and by word of mouth are great examples. Both communication vehicles look for compelling stories to tell, which often emphasize extremes. Gossip isn’t interesting if it is about a mundane trip to the grocery store. It is interesting if a car went crashing through the front door though. I should expect to see a car in the produce section the next time I stop at Cub, right?
The more unusual, extreme, or concerning something is, the more likely we are to hear widespread conversation about it. This also happens with youth substance use. Students who used over the weekend tend to talk about it more than students who spent their time babysitting or watching movies. Media coverage of substance use related stories tend to focus on teen use, not on teens who choose to abstain. We are inundated with messages about teens using substances, so it is not surprising the common perception of youth substance use is it’s “typical” and, thus, a somewhat acceptable norm.
Here lies the difficulty: our perceptions are inaccurate. The majority of youth are making positive, healthy choices about substance use. For instance:
- According to the 2014 National Survey on Drug Use and Health (NSDUH), 34.7 percent of 15-year-olds report they have had at least 1 drink in their lives. By default, this statistic also means 3 percent of 15 year olds surveyed report having never consumed alcohol.
- The NSDUH also found 22.8 percent of 12-20 year olds reported drinking alcohol in the past month. This also means2 percent did not drink alcohol in the past month.
The use rates shared above are nothing to ignore. The concern over this information should not overshadow the hope we find in the other side of each statistic, however. We need to do a better job of highlighting the truly typical choices our youth are making. Let’s remind young people, parents, and community members that it is not abnormal to choose health and safety. Everyone looks for opportunities to feel connected and a part of a common experience. Let’s not allow misperception of what that experience is to fool us into a mindset which is both inaccurate and detrimental.
A Community View of Prevention
Breaking down misperceptions about substance use to fuel new community norms is one example of a prevention strategy. Educating youth, parents, and other caring adults about the harms of substance use is another, but is often mistaken as the only option. Prevention strategies can also include a change in business practice such as checking IDs or community policies which limit youth access and exposure to substances.
Whether you think of these as system changes, environmental strategies, or work that takes a really long time, you may wonder why public health professionals bother with them. I think the answer is best understood through analogy, a dog analogy to be specific.
In my household, the family member most often at the doctor is our dog, Brooks. This poor guy has had quite the battle with allergies, torn ACLs, etc. These issues do not stop him from being a young dog who wants to play and run though! After his first ACL surgery, the vet told us he should not run, jump, or fuss with the wound on his knee (which is like telling a fish not to swim). How did my husband and I try to prevent these things from happening? At first we focused our energy on scolding him each time he tried to jump on the couch or started licking his wound. I’m convinced Brooks started to think we changed his name to “No” because we used the word so often.
After a couple of days, we got smarter. Brooks loves to jump on our bed, so we shut the door to our room anytime we were away. We had Brooks wear a cone to make his wound inaccessible. We even went so far as to leash him every time we went outside so he wouldn’t chase after rabbits. Instead of continuing to tell Brooks to change his behavior, we created environments for him which prevented the risky behavior from happening at all.
This is what we do in public health. We work to create environments which inherently promote health and prevent risky behavior from happening. Rather than relying solely on education to stop youth from using alcohol and drugs, we use strategies that impact the entire community in which youth live.
Concepts into Action
What might you do to put these concepts into action? Here are a few ideas to get you started:
- Think critically. Question information you receive that suggests it is normal for youth to use alcohol and drugs. Know that you have the majority on your side.
- Talk to youth about misperceptions. What do they believe the norm is? Why? Remember that youth do care about what their parents think, even if they try to convince you otherwise. Find talking points and conversation starters at samhsa.gov/underage-drinking or www.drugfree.org.
- Ask the same of adults. What do they believe is normal and why? Empower parents and caring adults to express their concerns about substance use for the young people in their lives.
- Find confidence in your healthy choices. It can be uncomfortable for both youth and adults to be open about their belief youth substance use is unhealthy. Be an example of the majority who believes this too. Find inspiration from others who already have at myonereason.com and www.abovetheinfluence.com.
- Find local data to learn what this looks like in your community. For those in Minnesota, sumn.org is a wonderful resource to locate this information.
- Get involved! Join a neighborhood group, a community coalition, or another effort working to promote youth health. Community collaboration has shown to be one of the most successful ways to change the environment and reduce substance use. For more information, visit cadca.org or www.rpcmn.org.
Lindsey Smith is the Regional Alcohol, Tobacco, & Other Drug Prevention Coordinator, serving Minnesota’s seven county metro area. In this role, she supports local communities working to prevent substance abuse by providing resources, training, assistance, and consultation. By engaging multiple sectors of the community and using public health principles as a guide, she assists community collaboratives in reaching their goals.
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