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This edition of Skills for Educators will give health educators guidelines for helping young people make healthy decisions about drugs. It is divided into the following sections:
Helping Young People Make Healthy Decisions About Drugs: Risk Taking, Harm Reduction, and Non-judgmentMaking Decisions Young people make many decisions about whether or not to take a variety of risks. Traditional drug education has stressed abstinence as the only way to manage risk. These efforts, particularly the War On Drugs philosophy of the 80s and 90s, have used campaigns like "Just Say No." These campaigns focus on telling young people what their decision should be as opposed to helping young people develop a decision-making process. A core assumption of some of the educational campaigns developed by the War on Drugs is that young people experiment with drugs as a result of peer pressure. Thus, educational activities associated with these campaigns have centered on the development of "refusal skills" which help youth resist pressure and influence from other youth to use drugs. These campaigns often employ scare tactics and shaming labels of drug users in response to any authentic curiosity or interest a young person may have about trying alcohol or a drug. Critical Thinking For educators interested in helping youth develop critical thinking skills, there are several problems with the "Just Say No" style of drug education. Consider the following:
Harm Reduction Harm reduction can provide educators with a framework that encourages youth to think critically. Harm reduction is a set of practical strategies that help to reduce the negative consequences of drug use, incorporating methods from safer use to managed use to abstinence. Harm reduction strategies meet drug users "where they're at," addressing conditions of use along with the use itself. Harm reduction encourages youth who are curious about drugs to weigh possible risks and benefits and make conscious decisions. Harm reduction also helps youth who are already using drugs to assess their relationship with drugs: is their use recreational? a form of coping? out of control? What can they do to make their use healthier? A Continuum of Drug Use The abstinence model has only two options: abstinent or using drugs. There is no exploration of different ways people use drugs. Some people who use drugs become addicted and their lives are devastated. However, most people do not have such severe consequences. Harm reduction uses a continuum to describe the different relationships people have with drugs:
This continuum allows users to identify where they are on the spectrum with any given drug and to decide if they want to make changes. Drug, Set and Setting Another important element of Harm Reduction philosophy was contributed by Dr. Norman Zinberg in his book Drug, Set and Setting: The Basis for Controlled Intoxicant Use. Zinberg pointed out that in order to understand how drugs can be harmful, we must look not only at the drug, but also at the "set" — or the individual who's taking it — and the "setting" where it is taken. Examples of harm in relation to set:
Examples of harm in relation to setting:
Peer Pressure on Educators Adults are supposed to have power and influence over young people. If youth do not heed our advice, implement our suggestions, and have the outcomes we prefer, we may feel like failures. Other adults are pressuring educators to dictate abstinence to youth. Our bosses, funders, school boards, parent committees, county agencies, and policies may be pressuring us to use methods that don't work for the young people we serve. These policies overestimate the influence that adults have on youth. Over the past few decades, all youth in the US have received strong messages from adults stressing abstinence. Yet the majority of youth have tried alcohol and/or drugs. Clearly, if telling young people to abstain was the answer, it would have worked by now. Adopting a Non-judgmental Stance One of the basics of Harm Reduction philosophy is adopting a non-judgmental stance when helping program participants make decisions about drug use. Admittedly, this can be difficult. If you have been negatively impacted by drug use (yours or someone else's), it may make it difficult for you to adopt a non-judgmental stance, particularly if you have not worked through all of your feelings about those experiences. It is important to remember that not everyone will have your same experience with drug use. If you have strong moral or ethical objections to drug use, it will also be difficult for you to be non-judgmental. Adopting a non-judgmental stance can be even more difficult when you are working with young people. When you hear that a young person is using or thinking of using a particular drug, you may feel worried, sad, or frustrated. Non-judgment doesn't mean you become an unfeeling robot; it means you do not share that judgment with the youth. If you judge them, they are not likely to change; they are more likely to start lying to you about their behavior. On the other hand, if you have had very positive experiences with drugs use, it may be difficult for you to see that some young people can be negatively impacted by the same drug that you enjoyed with little or no consequence. No one can adopt a non-judgmental stance perfectly, but it can help us support a young person to make a decision that feels right for them, not the decision that feels right to us. Non-judgment in Action The following are suggestions for non-judgmental support of critical thinking with regard to drug use: For youth who may want to experiment:
For youth who share about an experience with drugs:
For youth who are using:
For youth who are having problems related to their use:
Although the young person may try to reassure you, you have not criticized their choice, only expressed your feeling about it. Ultimately, they will have to decide whether they are concerned enough to make a change in their behavior. Values Clarification Before working with young people in the area of drug use, it is important to be aware of your own issues and biases. Which of the following best describes your attitude about drugs (including alcohol):
Which of the following best describes your attitude about young people using drugs (including alcohol):
Which of the following best describes your attitude about your own use of drugs (including alcohol):
Which of the following best describes your attitude about your own use of drugs (including alcohol):
How much of an impact has other peoples' drug use had on your life (including alcohol):
Rate your agreement or disagreement with the following statement: I feel comfortable talking openly to young people about my experiences with drugs (including alcohol):
Resources The more informed you are about drugs and drug use, the better. A good resource is From Chocolate to Morphine by Dr. Andrew Weil and Winifred Rosen. The book is balanced and informative. In particular, there are tips for using alcohol wisely and suggestions about the use of marijuana that can be helpful for working with youth. If you are meeting resistance on the part of other educators, administrators, or teachers to using a harm reduction approach, the following pamphlet may be helpful: "Safety First: A Reality-Based Approach to Teens, Drugs, and Drug Education," by Dr. Marsha Rosenbaum. "Safety First" is available from the Drug Policy Alliance at 415-921-4987 or www.safety1st.org For general information about Harm Reduction, contact the Harm Reduction Coalition at 212-213-6376 or www.harmreduction.org. Several other resources are listed in the November 2000 edition of Topic in Brief. Home | Index | Topic in Brief | Evidence-Based Programs Skills for Educators | Skills for Youth | Current Research Library | Statistics | Theories & Approaches | Links Professional Credits | Learning Activity | Forums | Archives
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