Are We Teaching Kids to Judge People with Addiction?

It's a memory that's permanently etched in my mind, dating back a few decades now.

I perched next to someone I knew. "You know, the only people who act like that are on drugs." I ignorantly spoke, parroting the messaging I'd been getting for a few years now.

They stopped. "You know, I used to use drugs."

Here was someone I respected sitting next to me, and what they said challenged everything I thought I understood.

I had learned that 'drugs are bad and bad people use drugs.' Simple wording, easy to repeat. Just say no. If you don't just say no, you must be a wicked person.

In the course of a three-minute conversation, my grasp on substance use, what it means to struggle, the reasons why certain spaces are so filled with substance use, and how people recover transformed.

All I knew about substances up until that point, I had learned from school prevention programs. To my knowledge, (though clearly untrue), I had never met anyone who used.

Judgment or Education

The mantra of many youth-focused prevention programs is simple: "Don't do drugs." It seems like fine advice. But does it actually work?

The most well-known of these programs would be DARE. You know, the one where the cop comes to your school, gives you cool pencils, and maybe tells some stories? The idea of stopping substance use before it starts makes sense, and DARE has seemed to improve relationships between the community and police officers.

Yet, research has repeatedly shown that participation in DARE has no positive impact on substance use either in the short (Perry and colleagues, 2003) or long term (Lynam and colleagues, 2009).

More recently, DARE has adapted a curriculum based on building life coping skills and emotional health called Keepin' It Real. Unlike the old DARE, Keepin' It Real has been shown to reduce the risk of alcohol use and vaping for 30 days in elementary school students compared with controls (Hansen and colleagues, 2023).

As well, more substance use education programs are being implemented by substance use clinicians and health educators, highlighting the health and well-being aspects of substance use rather than criminalization.

What to Say When You Talk to Your Kids About Drugs (And Addiction)

1. Most People Who Use Substances are Hurting
There are huge correlations between trauma, mental health conditions, and substance use disorders. One study found that among participants in residential treatment for substance use, 95 percent had an anxiety disorder, 90 percent lived with depression, and 62 percent met criteria for PTSD (Robinson and Deanne, 2022). Most people affected by addictions aren't bad people under the influence of other bad people. They just want to feel better.

2. Substance Use Disorders Are Not a Choice
We focus on the "choice" aspect of substance use because that's what kids have control over, but when we break it down, that "choice" component gets messy. We know that adverse childhood experiences are linked to the use of substances in adulthood (Zhu and colleagues, 2023). A study of 634,284 participants found that people who lived in poverty in childhood were significantly more likely to use substances as adults (Manhica and colleagues, 2021). The experience of child abuse and neglect appears to be a particularly powerful risk factor.

3. Recovery is a Thing

I've learned a lot more from people in recovery than from drug-use prevention programs. This is one of the most critical pieces to discuss with youth. If they find themselves using substances and fall into a hole, there is help. Within substance use prevention programs, it is common to spotlight the consequences of substance use. I remember vividly viewing pictures of the lungs of long-term smokers and learning about meth's effects on teeth. When it comes to treatment, all I remember is a brief mention of AA. What I took away from that: once you've used drugs, it's too late for you. While I do believe this is changing, talk about recovery is a minority in substance use education.

4. This Is How You Can Get Help
There seems to be a philosophy that if we tell kids that it can get better after addiction, that we are somehow granting permission to use. Yet, that's just not how it works. We know this from other areas, for example, the dangerous myth that suicide prevention efforts will give people ideas. Youth are already using substances. If deterrence can happen, that's great, but we can't take an all-or-nothing approach to substance use prevention. As mentioned by many public service announcements, it is helpful for parents to talk to their kids about drugs, but part of that should also be how to access support. Simply telling kids that their parents do not approve of substance use encourages them to hide their use. Ultimately, we need to show youth where to get help and reinforce that seeking help early is worthwhile.

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5. People Struggling with Addiction Are People First
One of the most powerful prevention strategies is linking the wisdom of people in recovery. Hearing from someone who has been there and made it through gives a compassionate tale of how painful substance use disorders can be, as well as what life after can look like. Humanizing addiction and recovery sends a message that substance use disorders and the conditions that lead to these can be treated.

Closing

We've come a long way when it comes to substance use prevention, but we have a long way to go. I hope that, in time, judgment and shame will give way to compassion. We can commit to compassionate conversations, support youth in seeking help, and challenge stigma when we see it. Actions make a difference.