
How targeting teenage drug use before it starts seems to be paying off
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This story is part of CBC Health's Second Opinion, a weekly analysis of health and medical science news emailed to subscribers on Saturday mornings. If you haven't subscribed yet, you can do that by clicking here.
A drug prevention program that began in Montreal has been found to reduce the risk of substance use disorders in teens by offering them tools and strategies to cope with personality traits like impulsivity and anxiety.
"If a young person is reporting very high levels of these traits, they're more likely to use substances as a way to manage those traits," said Patricia Conrod, founder of the PreVenture program, who is also a psychiatry professor at the Université de Montréal and a scientist at Sainte-Justine hospital in Montreal.
A recent study in the American Journal of Psychiatry looked at the impact of PreVenture in 31 Montreal-area high schools over a five-year period.
Conrod told CBC News that the odds of developing a substance use disorder increase as students get older. The study found the program helped reduce the growth in the odds of substance use disorder by 35 per cent year over year, compared with a control group.
The program focuses on such traits as impulsivity, sensation seeking, anxiety sensitivity and hopelessness — all of which may lead teens to turn to substance use to cope. During two 90-minute workshops given in Grade 7, students gain insight into their own personalities and tools to manage them.
The program uses cognitive behavioural therapy, interactive exercises and group discussions to find personality-specific coping strategies.
'I can deal with them, so I feel better'
Fara Thifault, 13, a Grade 7 student at Collège de Montréal, participated in a workshop last fall.
"I didn't realize I had negative thoughts, and when I did that [workshop], I realized, 'Yeah I get them a lot and this is how I can deal with them, so I feel better,'" she said.
Grade 10 student Romane Roussel, 16, said the workshops helped her, too.
"I'm less impulsive now because I use some techniques, I take a breather," she said.
Conrod said while a growing body of evidence supports the PreVenture program and others like it, schools across the country need sustained funding, including from federal and provincial governments, to deliver them more widely.
"Some substance use disorders are preventable, and we should be making sure that young people have access to the programs and the resources they need," she said.
The program is currently available in schools in five Canadian provinces, including Quebec, Ontario and British Colombia, as well as in several U.S. states.
Christine Schwartz, an adjunct professor at the Children's Health Policy Centre at Vancouver's Simon Fraser University, said policy-makers tend to prioritize treatment over prevention when it comes to substance use.
"It's a little bit harder for policy-makers to put the money towards prevention knowing they may not see the benefits — and there will be benefits in many of these cases, but they're not going to see them for several years," she said in an interview.
Schwartz was part of a team that examined school-based prevention programs around the world, including PreVenture.
"There's been a long history of using programs that haven't necessarily been effective," she said. "What's happening now is that policy-makers are increasingly turning to the research evidence."
What's missing, Schwartz said, is funding to maintain programs and put them in place more widely.
WATCH | Parent hires private investigator to track down daughter's drug dealer:
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Prevention before treatment
Justin Phillips's son Aaron died of a heroin overdose in 2013, when he was 20, in Indianapolis. She described him as an "impulsive, sensation-seeking kid."
He once skateboarded off the roof of her house, Phillips recalled, but said he was also very sensitive and sometimes anxious.
These are all traits, she said, that young people and their families don't always have the tools to recognize and manage.
"Had we had these tools, I absolutely believe things would have been different," she said in an interview.
The year after her son's death, Phillips founded an organization called Overdose Lifeline to supportother families dealing with addiction and to promote prevention. She is also involved with PreVenture, training people to deliver the workshops and working to bring the program to more communities in the United States.
"Prevention has never been something that we've put ahead of treatment," she said. "I remain hopeful, but I don't think we're moving as fast as me and all the countless other parents wish that we could."
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