Posted by Marlie Standen on August 31, 2020
Written by Marlie Standen, MSW RSW
From the moment you become a parent, it can feel like your world revolves around keeping your kid safe, protected, and out of harm’s way. When they enter adolescence, it might feel as though your ability to protect, secure, and keep safe is challenged.
Adolescence is characterized by heightened emotionality, novelty-seeking, risk taking and a burning curiosity and sense of exploration (Siegel, 2014). Further, this is also a time when teens seek independence from their caregivers and lean more into their peer relationships… a transition that can be tough for parents.
I chose to start this article about harm reduction and teen drug use in this way because it is important to recognize that talking about teen drug use can be really challenging, scary, and anxiety-evoking. After all, this can feel like one of those “avoidable” harms to your child and activate that parental need to protect, secure and keep safe.
So… how do you manage your own emotional response to your child’s drug and alcohol use? How can you have safe, productive and open conversations about substance use?
Harm reduction is a philosophy as well as a practical and pragmatic approach to drug and alcohol use that focuses on reducing harm and increasing safety.
Is based on the understanding that all human beings, including and especially adolescence, will engage in behaviours that have some level of associated risk, such as using drugs and alcohol.
Recognizes that substance use is complex; people use for a variety of different reasons, use to varying degrees, and experience different benefits and consequences of their use.
Strives to reduce shame and stigma associated with substance use/users and open up conversation.
Seeks to ensure people are (a) well informed of the risks of substance use and (b) educated in the different ways they can reduce harm and keep themselves and others safe.
Is an evidence-based approach that recognizes that ignoring drug use, turning a blind eye, or simply punishing those who use is much more harmful, at the population and individual level, than accepting it’s presence and trying to help people be more safe.
Importantly, harm reduction is a strategy to help prevent overdose and save lives.
The opioid crisis has taken so many lives to overdose, even among those who are not intentionally taking opioids due to lacing/contamination. In 2019, there were 3 823 apparent opioid related deaths in Canada; 76 of those were those under the age of 19 years old (Government of Canada, 2020). In 2019, there were 222 overdose-related hospitalization among those 19 years old and younger (Government of Canada, 2020).
All statistics are taken from The Ontario Student Drug Use and Health Survey (ODSUHS).
In 2019, less than half (42%) of students grade 7-12 report drinking more than “just a few sips” of alcohol during the past year
About one-in-seven (15%) high school students, and 22% of grade 12 students, report drinking hazardously or harmfully (as measured by standardized Alcohol Use Disorders Identification Test, AUDIT)
In 2019, about one-in-five (22%) of students in grades 7-12 report using cannabis in the past year, and about 2% report daily use
One-in-ten (11%) of students in grades 7-12 report using a prescription opioid pain reliever without a prescription in the past year
One-in-seven (15%) high school students report symptoms of a drug use problem, as measured by a standardized screener
It may be easier or more comfortable to assume “not my kid” … but it could be; and if they’re not using now, they may be in the future. Having conversations about harm reduction now can help keep your child safe in their future decisions about substance use. Further, educating your child even if they’re not using can put them in a position to help a friend.
Your anxieties about your child’s substance use and their safety are entirely valid- respond kindly to yourself. Take a breath. Seek your own support. Joining in conversation from a place of fear, panic or anger will be sensed by your teen and will more likely than not break down the conversation. If you can join the conversation from a calm and grounded place, your teen is also more likely to be able to remain calm and grounded.
We all have subjective beliefs about substance use based on personal experiences, upbringing, etc. It’s important to be aware if you tend to jump to black-and-white, right-and-wrong thinking. It’s also important to be aware if you tend to minimize substance use, and under-estimate the risks/harms for adolescents. Most importantly, it is important to be aware and educated about the facts and evidence about substance use, risks and safe practices. See the list of resources below for more information.
Managing your own emotions and expressing non-judgmental curiosity will set the foundation for a safe, open conversation. Ask open-ended questions about their beliefs about use, their reasons for using, and their awareness of the risks. This can also help you understand if there are problems underlying their use (i.e. anxiety).
Are you curious about using? What makes you curious?
Have you had the opportunity to use?
How does it make you feel when you use?
I’m a bit worried about your safety, and I’m wondering if you can tell me what you know about the risks of using this substance?
Are there ways that you try to keep safe when using?
Itis important to understand the difference between substance use, misuse, abuse, and dependence. This distinction helps guide how to respond and how to help if your need is in need. Check our CAMH’s Understanding and Finding Help for Substance Use and Addictions for a list of signs that your teens might be struggling with substance abuse or addiction. If you’re worried about your teen struggling with addiction, seek support from a therapist, family doctor or a youth addiction agency (see resources below).
If your teen is determined to use, they very well may use. Zero tolerance and no flexibility rules can push the teen to a place of secrecy and isolation, which can lead to more dangerous, risky use. This can also create significant feelings of shame in your teen, “I’m a failure”, “I’m bad”, “What’s wrong with me?” which can contribute to problems with their mental and emotional health.
Inviting your teen into the safety planning process helps them feel more in control and develop personal responsibility. Ask your teen about how they plan to stay safe when they use, and then co-create plans to help them keep safe.
Explore harm reduction resources yourself, then ask permission to share harm reduction information and education with your teen.
Understanding and finding help for substance use and addictions- for youth by the Canadian Mental Health Association
https://ontario.cmha.ca/documents/understanding-and-finding-help-for-substance-use-and-addictions/
Talking About and Spotting Substance Abuse by the Centre for Addiction and Mental Health
Substance Use and Mental Health Concerns in Youth by the Centre for Addiction and Mental Health
https://www.camh.ca/-/media/files/scoop_sheet_subuse_mhconcrn-pdf.pdf
Drug Education by Skylark Children, Youth and Families
https://www.skylarkyouth.org/what-we-do/programs-counselling-services/drug-education/
The Ontario Student Drug Use and Health Survey: The longest-running Canadian survey that shows trends in student substance use and mental and physical health by the Centre for Addiction and Mental Health
Harm Reduction: An approach to reducing risky health behaviours in adolescents (a scholarly article)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2528824/
Overdose Prevention Toolkit by Eva’s
https://www.evas.ca/overdose-prevention-toolkit
References
CAMH. The Ontario Student Drug Use and Health Survey (OSDUHS). Retrieved from https://www.camh.ca/en/science-and-research/institutes-and-centres/institute-for-mental-health-policy-research/ontario-student-drug-use-and-health-survey—osduhs
Government of Canada, June 2020. Opioid-related harms in Canada. Retrieved from https://health-infobase.canada.ca/substance-related-harms/opioids/
Harm reduction: An approach to reducing risky health behaviours in adolescents (2008). Paediatrics & child health, 13(1), 53–60. https://doi.org/10.1093/pch/13.1.53
NIDA. 2020, May 24. Why do adolescents take drugs?. Retrieved from
Siegel, Daniel. 2014, Feb 7. The ESSENCE of Adolescence. Retrieved from https://www.drdansiegel.com/blog/2014/02/07/the-essence-of-adolescence/
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