Adolescence
Why We Need to Rethink Substance-Use Prevention
"Just Say No" did not work, so what now?
Posted May 18, 2023 Reviewed by Gary Drevitch
Key points
- When we understand the behavioral traits that indicate risk, we can work on curbing potential problems.
- Personality-focused interventions engage young people while recognizing and enhancing their strengths.
- Programs build cognitive behavioral skills relevant to personality style and reduce the risk of substance use.
Who else remembers the egg in the frying pan? “This is your brain…this is your brain on drugs…any questions?” Yes. A lot. Why did anyone think a frying egg would prevent teens from using drugs? All of us who grew up in the 80s remember the D.A.R.E scare tactics of our youth or the “Just Say No” campaign. Well-intentioned, but unfortunately, also totally ineffective.
We know a lot more now about what works to prevent adolescent substance use. I’ve written previously about what every parent of a teenager needs to know. But in honor of National Prevention Week, I want to advance a more radical idea: we need to rethink how we approach adolescent substance use. Yes, we should provide our kids with honest and accurate information about drugs. Yes, we should discuss our rules and expectations surrounding substance use with them. But as any parent of a teenager knows, these conversations are met with grunts and eye rolls (you should still have them).
Schools address this reticence by making participation in substance use prevention programs mandatory. Colleges have devised creative tactics to compel students to participate in substance use prevention programs, such as requiring proof of completion before they are allowed to register. One year the university where I worked made the online substance use program optional–and only 40 out of 4000 incoming students even clicked on the link.
This should give us pause. Why are students so reluctant to participate in substance use prevention programming? Millions of dollars have gone into creating effective programs and engaging content. Yet adolescents remain uninterested (at best) in participating in anything that sounds like substance use prevention. This may be a carry-over from the “Just Say No” days, where students assume that programming will focus on drug dangers.
New research shows that teenagers have a pretty accurate perception of the risks associated with drug use–in fact, sometimes they even overestimate risk–they just place more value on the perceived benefits of using alcohol or other drugs (fun with friends, exciting new experiences–refer to my previous post on the adolescent brain).
So, what to do? This is where the mom in me thinks it’s time for chocolate-covered broccoli. In other words, let’s get what’s good for our kids to them in a way they enjoy. Adolescents seemingly dislike anything that sounds like substance use prevention, but what they do like is fill out surveys about themselves. This permeates social media, where there are quizzes to find out what dog best fits your personality or to identify your inner superhero. It’s fun to learn about ourselves, and in the case of psychological surveys, the idea is to use this information to help guide life choices.
We have been applying this approach to help adolescents learn about themselves, how to accentuate their strengths and avoid potential pitfalls that come along with their unique traits. It turns out you can do adolescent substance use prevention without ever mentioning the word prevention. The reality is that some adolescents are more at risk of developing problems with addiction than others. It’s partly the luck of the draw regarding the genes we inherit and how our brains are wired.
Adolescents who are more impulsive or more anxiety-prone are at greater risk. But they aren’t destined to develop problems. Risk-taking adolescents might be more likely to experiment with alcohol or other drugs but also more likely to be entrepreneurs, CEOs, or fighter pilots. Risk-taking isn’t a bad thing per se. It can just put teenagers at elevated risk of substance use problems if they aren’t careful. This is where information, accompanied by strategies for managing one’s disposition, can be powerful. By understanding our natural tendencies, we can work on channeling them into the best version of ourselves.
It's time to rethink how we approach substance use prevention in adolescents and young adults. We need to move from telling kids to “Just Say No” to "Just Say Yes"–to learn about themselves and how to make choices that help them achieve everything they want out of life.
We have developed a free online beta version of a “Personalized Feedback Program” in which adolescents answer a series of questions about themselves, get feedback about their unique personality style, and learn about the good and the “not-so-good” associated with different traits, and how to channel those qualities to achieve their goals. You can learn more about the science behind this approach here. You can also download a free copy of the Substance Use Risk Profiles Survey from my website, a two-page survey to learn where you fall on four genetically influenced characteristics that can increase the risk for substance use problems. These have previously been used in school-based prevention programs, with remarkable effects on reducing adolescent substance use.