The question whether brain research can be helpful in informing kids about drug use is nagging at me. I had the chance to ask a neurologist this question at a course at Harvard Medical School on school mental health. Luckily, it was the first session in the day and thereafter several other experts came around to it, more or less.
My question centered around what kind of health information can be effective. Examples I offered were the scare tactics that The Meth Project uses in its video ad campaign in Montana, the standard health class that crams in all the bad things drugs and alcohol can do that wash over kids because they’ve heard it all before, telling or showing kids how cognitive function is impaired by substance use (e.g., “This is your brain on drugs and here are the consequences”), or having MADD come in or showing kids mangled up cars from drunk driving teens – or is there something else?
And, how do you maintain a “do no harm” approach, if that even matters anymore since kids are exposed to the nasty effects of just about any risk behavior – from unsafe sex, eating disorders, drug use, peer violence, and relationship abuse – in the movies, on the Internet, and in their community.
What works?
Here were the answers:
Neurologist: Scare tactics may have immediate response but no real durable responses. I think: Yes, I know. That is the problem with PSAs intended to elicit fear and anxiety, so I push the question further. What you do you do with teens at risk? He says cognitive scripts and role-playing can be effective. (If you can engage them to take the exercise seriously, that is.)
Psychologist: Ok, says another panelist, scripts won’t work when the teen is under the influence, so…
Use a “damage control model”, she offered. In other words, help the teen come up with strategies for self care when at a party, like having a friend keep tabs, designate a driver, call home, etc. This assumes that friends have the wear-with-all, or that one has the courage to call a parent (even a cool parent who claims to be there under any circumstance if in trouble), or you know when you’ve had too much and can stop. Most of us grew up with this crisis-based friends and family model. I get the pragmatics of it. Kids will experiment so give them the tools to deal in the moment.
Behaviorist: Well, says another expert later in the day: Don’t let a kid get to the point they are using [street] drugs. This would assume that other substances have been tried that lead up to the hard stuff, but that’s not always the case. (We all hear about that one episode that killed a kid.) This approach suggests that you intervene with kids before any problems show up or persist, and teach the kids the skills to manage problems that arise – problems that usually are deficits in skills (flexibility/adaptation, emotional regulation, communication, and so on). You know, use PREVENTION. That means parents, teachers and doctors know when to intervene early enough. Sadly, that is hardly the norm.
Many of the problems that can lead to substance use or abuse can be subtle and persist under the radar. It seems to me the brain research is key to our understanding of the teen brain and addiction, but our tactics for prevention and intervention come down to some basic things with all experts basically in agreement:
- Stay connected to kids at all levels
- Check in with them, care about what is going on, stand by them in finding a solution together
- Collaborate (with student, teachers, parent, peers, community)
- Know about the strategies that work and don’t work in the classroom and out of school (recent research on bullying shows that some of the tactics we teach kids like “walk away”, “stand up for yourself”, “know it’s not your fault”, may be counterproductive), and
- Punishment doesn’t’ work.
If a kid is persistently in trouble or lagging behind, there is a reason – it most likely it has to do with developmental immaturity or lacking a skill/cognitive ability, communication skills, or is a survival reaction from traumatic experience. Pushing kids away with punishment will – on the whole – back fire. This message became loud and clear from a principal at a recovery high school. Her motto, “Don’t suspend, amend.” On the other hand, many kids fall through the cracks because they aren’t noticed or move with a crowd and get caught up in unsafe scenarios. So how to reach out and prevent at-risk behaviors?
Bottom line: Be engaged.
Relevant Resources:
Greene, Ross W. (2008). Lost at School: Why Our Kids with Behavioral Challenges Are Falling Through the Cracks and How We Can Help Them.
Helping Traumatized Children Learn
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