Research informs us that most young people who initiate the use of alcohol, tobacco, or other substances do not go on to develop a problem with substance dependence. Nevertheless, one-third of young people begin a journey down the road to dependence. Before addressing the difference between adolescents whose use becomes addictive or dependence and those who do not develop these problems, it is important to ponder the underlying reasons, from research and those adolescents provide, why they use. It is a well-established premise that adolescent substance use begins with experimentation. With that said, the more salient question to be answered is the motivation behind their experimentation.
Prevention and intervention research provides three motives:
1) A coping motive
2) A drug-experience motive 3)
A peer-influence motive
Identifying and understanding the motivation for alcohol and drug use has definite prevention and treatment implications. In short, a simple question to ask any adolescent in counseling, whether individual or group, is, “What purpose do alcohol and drugs serve?” and with an understanding of the motive for use, as well as the purpose, therapists, prevention specialist, and interventionists can proceed to provide a connection to the risk factors.
Risk factors are those predictors associated with an increased likelihood of substance use or other behavioral disorders. An important question often asked by parents is where they should look for risk factors. Risk factors have been found in the individual (e.g., genetic predisposition) and the environments in which young people are socialized, including the family (e.g., family conflict), the school (e.g., school failure), the peer group (e.g., friends who use substances) and the community (e.g., availability of alcohol and drugs).
It is necessary to point out that many of the risk factors for substance use can eventuate into other problems, including but not limited to, delinquency, teen pregnancy, dropping out of school, violence, depression, and other problem behaviors. In examining risk exposure, there are two common patterns. For some children, risks begin to accumulate early, because early development challenges without protection lead to increasing challenges as youth are exposed to new environments (e.g., school, peers). This has been referred to as a “snowball pattern” of risk. For example, a mother smoking during pregnancy might impact fetal and early childhood development, which may lead to cognitive delays. Such delays may, in turn, lead to poor school adjustment and greater association with other poorly achieving youth in school settings. These factors can lead to great vulnerability to early substance use.
A second pattern of risk is exposure to friends who use drugs and to positive norms about drug use. Over time, this exposure, when not countered with protective factors, may lead some to succumb to this snowstorm pattern of risk. For example, greater exposure to drug availability, favorable attitudes toward use, peer use, and weakening from the family during a time of increasing dependence may lead some youth, even those without earlier patterns of risk, to develop substance use problems.
Protective and Promotive Factors
In any discussion of adolescent substance use, the questions often asked are, “Why is it that some adolescents exposed to risk factors succumb to alcohol and drugs and others who are exposed to those same factors do not?” “What motivates those who do not succumb to go on and develop healthy lifestyles and not become involved in problem behaviors?” The answers lie in the identification and utilization of protective factors that promote positive outcomes and which protect against the impact of risk exposure. Protective are those predictors that buffer the effects of risk factors on substance use, and promotive factors are those predictors that have a direct negative relationship with substance use.
Longitudinal prospective research studies have identified seven factors that promote positive social development:
1) High intelligence
2) Resilient temperament
3) Social, emotional, and cognitive competence
4) Opportunities for pro-social involvement
5) Recognition for positive involvement
6) Bonding, and healthy beliefs
7) Standards for behavior
It is necessary to understand that the first three factors are comprised of individual characteristics that protect adolescents, even in the presence of risk. The last four protective factors involve three environmental processes that protect adolescents.
The identification of risk and protective factors that lead to the development of prevention approaches, seek to increase protection while reducing risk. Wide ranging types of programs have been found to be effective, not only in the prevention of alcohol and drug use, but also with their corresponding problems.
Effective school-based programs include enhancing, instructional, and classroom management skills, using classroom curricula that promote social, emotional and cognitive competence, and tutoring. School programs focused on improving academic performance and bonding to school and reducing classroom management problems have produced reduction in early aggressiveness. The following represent effective policies and programs for presenting problem behaviors:
• Prenatal and infancy programs
• Early childhood education
• Parent training
• After-school recreation
• Mentoring with contingent reinforcement
• Youth employment with education
• Organization change in schools
• Classroom organization, management, and instructional strategies
• School behavioral management styles
• Classroom curricula for social competence promotion
• Community and school policies
• Community mobilization
In conclusion, it is important to understand that, regardless of the prevention approach, the focus should be on both reducing risk and enhancing protection for the adolescent. For maximum effect, prevention programs should address risk and protective factors early, and only those prevention interventions that have demonstrated effectiveness should be used to address community profiles of risk and protection. The implication is clear, the earlier we as prevention specialists, therapists, staff workers, consultants and all those who have a passion for working with adolescents start with prevention interventions and approaches, the sooner we can save lives, because saving lives is the ultimate goal in our work.
Fred Dyer, PhD., CADC, is an internationally recognized speaker, trainer, author and consultant who services juvenile justice/deten- tion/residential programs, child welfare/foster care agencies, child and adolescent residential facilities, mental health facilities and adolescent substance abuse prevention programs in the areas of implementation and utilization of evidence-based, gender-responsive, culturally competent, and developmentally and age appropriate practices. He can be reached at www.dyerconsulting.org