Substance Use prevention & intervention

Overview

Promoting and supporting chemical health is an important component to achieving success personally and academically. Research has consistently shown that youth chemical use, in any form, can have detrimental effects on their personal, social, and academic success. Furthermore, substance use during adolescence can impact overall health and brain development. That is why it is crucial for us to work together to support the chemical health of our students and prevent youth substance use and abuse.

Here at Farmington Area Public Schools, we are committed to meeting the needs of our students in this regard. We offer school-based counseling and support services to students who may be struggling with substance use. Additionally, we collaborate with community-based professionals for consultation and care coordination, whenever necessary.

Where do we begin?

As parents, understanding and addressing the challenges of drug and alcohol use among students is crucial. It can be difficult to know where to start, but early conversations and awareness make a significant difference. This section is here to guide you in recognizing signs of substance use, understanding its impact on your child's development, and providing support.

By fostering open communication and being informed, you play an essential role in helping your child make healthy, informed choices.

Conversation Starters

Drugs and Alcohol

Cannabis

Opioids

• For more information about in school screening for substance use: Screening, Brief Intervention, and Referral to Treatment

• Your primary care physician, therapist, school nurse, chemical health coordinator, administrator, or counselor can help connect you with resources to support the best next step for your child.

Continuing substance use, despite negative and harmful consequences, is often an indicator that additional support is needed. If you have noticed that your child's substance use is causing challenges within the family system, school, or the community, we encourage you to consider a substance use comprehensive assessment. This assessment is a screening conducted by a licensed addiction professional and can help determine the level of support your child may need

If there is insurance coverage, call the number on the insurance card to review coverage and get a list of providers.  If there is no insurance coverage and you live in Dakota County, please visit this page for information on the Behavioral Health Fund or Direct Access funding. Funding may also help with high deductibles/copays -You can receive an assessment through the county or a referral can be made through the school's Chemical Health Coordinator

Common Terminology

• Comprehensive Assessment: substance use disorder assessment that helps determine diagnosis and appropriate level of care.  An assessment is the first step in determining if there is a substance use diagnosis and need for treatment.

• Day Treatment: site-base treatment, typically Mon-Fri, with a school component

• Residential (Inpatient) Treatment: treatment administered on-site, staying for a certain length of time, often 20 - 90 days, depending on facility and insurance

• Intensive Out-patient Treatment (IOP): treatment services provided several times per week for several hours each day, allowing one to stay in their home environment.

• Direct Access: Ability for individuals to avoid going through a third party for access to treatment. Individuals can go directly to a treatment facility to receive services. This is available for both those with insurance (high copays) and those without insurance. Contact the county directly for more information on financial aid if needed. 

• School Component: refers to a treatment center that offers a school component for those who are in treatment during the school year, allowing clients to stay current with credits.

• Dual Diagnosis/Co-occurring Disorders: when both a mental health and substance use disorder are identified, often presenting at the same time. It is important that both are managed appropriately by skilled clinicians.

Treatment Options and Approaches for Youth Substance Abuse 

Common treatment approaches include Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Eye Movement Desensitization and Reprocessing (EMDR) Therapy, Motivational Interviewing, and the Twelve-Step Approach, among others. Often, a multidisciplinary clinical team works together to implement more than one approach. Each modality has its advantages and its limitations. 

A relatively newer approach to mitigating the risks associated with substance use is the Harm Reduction Model. 

“Harm reduction is an approach that emphasizes engaging directly with people who use drugs to prevent overdose, improving the physical, mental, and social wellbeing of those served, and offering low-threshold options for accessing substance use disorder treatment and other health care services.”SAMHSA 2022Rather than focusing on complete abstinence from substance use, harm reduction places the agency of change on the individual and acknowledges that some degree of drug use (both licit and illicit) in society is likely. Harm reduction focuses on reducing adverse consequences while prioritizing safety. It emphasizes one’s physical and mental health along with their social and economic well-being over the measurement of drug usage.

This article presents a brief overview of youth substance use data to understand its prevalence, and then explores the harm reduction model as one approach to mitigating and reducing risks associated with youth substance use. 

Prevalence of Youth Substance Use 

The number of youth experiencing the negative impacts of substance misuse and abuse is significant. Here are a few key data points from the National Center for Drug Abuse Statistics to get a sense of the prevalence of youth substance use.

• More than 2 million youth aged 12-17 report using drugs in the past month
• In Minnesota, teenagers are 18.79% MORE likely to use alcohol than the average American in their age group
• Nearly half (46%) of youth report having tried illicit drugs by the time they reach 12th grade
• 11.2% of overdose deaths are aged 15-24 years

Research – and experience – teaches us that drug use has the potential to harm every aspect of one’s life, including:

• School attendance
• School performance
• Mental health 
• Physical wellbeing 
• Peer relationships
• Family system 
• Motor vehicle safety

Risk Factors that Contribute to the Likelihood of Youth Substance Use

So, what makes one youth choose to experiment with e-cigarettes, alcohol, marijuana, or opioids? What makes another youth avoid it altogether, and still another end up addicted and in need of intensive treatment? 

The answers are complex and multi-faceted. Research does show, however, that the presence of certain risk factors leads to a greater likelihood of substance use:

• Early aggressive behavior 
• Lack of parental supervision
• Academic problems
• Undiagnosed mental health challenges 
• Peer substance use
• Drug availability in the environment 
• Poverty
• Peer relationships/peer rejection
• Child abuse or neglect 

The presence of one or more of these risk factors is associated with increased likelihood of youth substance use and abuse. The earlier the risk factors occur in childhood, the greater the risk of youth substance abuse. Additionally, risk factors that occur for a prolonged period of time (e.g., from PreK through middle school), are also associated with an increased likelihood of youth substance abuse.  

It is important to keep in mind that not all youth who experience one or more of these risk factors will develop substance abuse problems. Protective factors like strong parental support and involvement or caring adults can diminish the influence of strong risks (like having friends who abuse substances). 

Harm Reduction Strategies Work Better Than Zero Tolerance in Youth 

While the number of youth who use, misuse, or abuse substances is high and the risks associated with this behavior are significant, youth tend to tune out the familiar “zero tolerance” and “abstinence only” messaging. They are less likely to engage with parents/caregivers and with the professionals who care for them when they feel condemned by their choices. 

A 2019 study from the University of British Columbia and the University of Calgary found that teens respond better to harm-reduction messaging than they do to zero-tolerance messaging. 

“Youth were more receptive when their parents talked – in a non-judgmental way – about substance use or could point to resources or strategies to help minimize the harms of use. This approach seemed to work better in preserving family relationships and youth health,” said Emily Jenkins, Ph.D., a UBC professor of nursing who studies youth substance use.

So, what does that look like in practice, either as a healthcare professional who works with youth, a school-based practitioner, or a parent/caregiver? Often, it takes the form of motivational interviewing. 

Harm Reduction and Motivational Interviewing

One of the most effective ways to put harm reduction into practice is through the use of motivational interviewing. Motivational interviewing is a counseling method, or approach to intervention, that helps people identify their internal motivation to change their behavior. Motivational interviewing recognizes how difficult it can be to change behavior and honors this challenge with empathy, active listening, and support of self-determination or self-efficacy.  

There are 4 key principles associated with motivational interviewing: 

Express Empathy

Empathy is foundational to motivational interviewing and effective work with youth. Professionals who seek to implement a harm reduction approach seek to understand the youth’s behaviors and situation from their point of view. It is not about judging, condemning, or moralizing the behavior, but creating a safe environment and expressing care and concern. 

Develop Discrepancy

A youth develops discrepancy when they begin to see a mismatch between where they are and where they want to be. For example, when a 17-year-old identifies a goal of attending a 4-year university but chooses to spend time with friends vaping after school instead of completing homework or researching colleges. The professional who is working with the youth does not tell the youth what they ought to be doing, but rather helps them identify what their goals are and see how those goals are (or are not) connected to their behaviors.

Roll with Resistance

It’s the professional’s job to help the youth reach a new understanding of themselves and their behaviors. It is not the professional’s job to challenge, oppose, or criticize the youth. To help a youth develop a greater understanding of their substance use behaviors, a professional may reframe or offer a different interpretation of a situation. 

Support Self-Efficacy

Supporting self-efficacy is helping the youth believe they have what it takes to make a change or perform a desired behavior. Professionals guide youth through the stages of change and reinforce their belief in the youth.  

Substance Abuse Treatment Is Not Black and White

Like everything worth fighting for in life, mitigating the risk of substance use is hard work. It requires a committed, team-oriented, and long-term approach. It may also require being open-minded to the harm reduction model. Here’s why: 

At one end of the continuum of consequences of youth substance use, the effects may be minimal. Consider a 21-year-old adult who consumes 1 glass of wine while at home. There is not likely to be significant risk associated with this one action. 

At the other end of the spectrum, youth substance use may be detrimental and life-threatening. Think of any youth who unknowingly takes an opioid laced with fentanyl, or a newly minted 16-year-old driver who gets in the car to drive while intoxicated. The risk associated with either of these two behaviors is huge. 

The line between these two ends of the continuum of consequences is not as clear as we might think. Rather than adopting a blanket zero-tolerance approach to all substance use, professionals who care for youth ought to fold in messaging and strategies that prioritize safety and education, the reduction of harm, and connection to resources. 

There is not one, single correct way to care for youth who are using, misusing, or abusing substances. The harm reduction model is a relatively newer approach to treatment, and many professionals who work with youth are still navigating the nuances of how it works (especially with adolescents). Sometimes our own discomfort can interfere with our ability to effectively intervene with youth. So remember this: it’s not black and white. Recovery and the journey toward health exist along a continuum. Each step toward safety and health count.

Adolescent Community Support

Finding the right support in the community can be crucial in times of need. Below you will find a short list of resources that can help you get started. Please keep in mind that this list is not exhaustive and there may be other community providers available. Additionally, it's important to note that there are limited resources specifically dedicated to adolescent substance use support. However, knowing where to reach out can greatly assist in finding the appropriate support. If you require any further assistance or have any questions, please don't hesitate to reach out to our ISD192 Chemical Health Coordinator.

Dakota County Adolescent Resource List
Comprehensive list of resources available to adolescents and families struggling with a range of behavioral health needs. 
Fast Tracker
Real time information and availability related to substance use disorder treatment providers with a broad range of filters to help you narrow down your search to fit your needs.
MHealth Fairview Adolescent Program
Dual diagnosis, residential and outpatient programming.
Nystrom & Associates Dual diagnosis, residential and outpatient programming.

Anthony Louis Center On-Belay House Dual diagnosis, residential and outpatient, family counseling and walk in drug screens.

Parent/Guardian/Caregiver Community Support

One of the key issues that parents and guardians may face is helping our loved ones, who are dealing with substance-use problems, identify the root cause of their use. It can be quite challenging to understand the underlying causes and find healthier solutions for them. You may feel confused, frustrated, and even angry. It is completely normal to have these emotions. Remember, you have every right to feel how you feel.

Rest assured, there are numerous support options available to help you on this journey. It is crucial to learn how to set boundaries and avoid enabling your child's substance use. At the same time, it is important to show your unwavering love and support. Taking care of yourself is the best thing you can do for your child during this difficult time. We encourage you to consider checking out a support group where you can connect with others who are going through similar experiences.
 

Al-Anon Family Groups (Local or Online)

Al-Anon/Alateen is a global fellowship of relatives and friends of alcoholics or addicts who share experience, strength and hope to solve common problems

Partnership to End Addiction (Online)

Free online support community for parents and caregivers who may have children experimenting with, or dependent on, substances. Register here to join.
 

Hazelden Betty Ford Family Program (Local)

Family care and support are an essential part of Hazelden Betty Ford’s healing mission because addiction takes a heavy toll on all family members and everyone in your family needs help to cope and heal. Our family programs and resources are available to you, regardless of whether your loved one with drug addiction seeks treatment.
 

Thrive! Family Support (Local)

Support for family members of people struggling with substance abuse or other destructive life choices.
 

Community Reinforcement And Family Training

CRAFT is a skills-based program for families of people who struggle with addiction. It is designed to support family members across multiple areas, including self-care, pleasurable activities, problem-solving, and goal-setting, while at the same time teaching behavioral and motivational strategies for interacting with their loved one and addressing resistance to change.