Tuesday, I was fortunate to have been invited by my friends at the Bangor Public Health Substance Abuse Task Force to a meeting they organized with Office of National Drug Control Policy Director Michael Botticelli. This followed the drug strategy round table featuring Mr. Botticelli and called together by Senator Angus King. While the round table focused much attention on the need for better access to treatment services, among other related issues, the afternoon meeting with the task force focused on the role of primary prevention in the heroin and opiate abuse epidemic.
The Director well noted, that the heroin situation is significant and that it is absolutely imperative that we look at how we can decrease barriers to treatment, increase access to treatment, while also addressing issues of employment and education that contribute to drug abuse. But he also stressed that there is another key element in this battle, which is the role of primary prevention. The reality is, that it is not common that someone who is abusing heroin, started with heroin. Many people, including most of our young adults who are struggling with heroin addiction, started by abusing another drug at a very early age. Commonly that involves either the early use of alcohol, marijuana, or often both.
We have significant portions of youth in Maine who are using drugs at a very early age. Data from the 2013 Maine Integrated Youth Health Survey indicated that of those high school age youth who reported using marijuana; 1 out of 5 of them started before the age of 13. Looking at the same data for Maine middle school youth, we see that 1 out of 4 reported using marijuana before age 11. Turning to alcohol, the MIYHS data indicates that of those who reported using alcohol, 1 out of 4 high school youth started before age 13 and 1 out of 3 middle school youth started before age 11. As the father of an 11-year-old daughter these statistics are particularly unsettling, as they should be for us all.
The science is clear in terms of the age of onset of substance use and the likelihood of developing an addiction that lasts into adulthood. Initiating substance use very early in life puts a person at increased risk of developing such an addiction. It starts with tobacco, alcohol, and marijuana, and can escalate to other substances including prescription opiates and heroin. So with this knowledge in mind it then becomes clear that one way we can significantly impact the heroin issue now and in the years ahead, is to work together to dramatically reduce the number of our Maine youth who are starting drug use at such an early age.
As with the current heroin epidemic, there is no one single solution or silver bullet to address the early substance use issue. There are many contributing factors at play including environmental and biological risk factors. However there are two key spheres of influence on our youth which play significant roles in youth substance abuse. Those are parents and community.
Parents have one of, of not the, most significant roles in youth substance abuse. In prevention science, we know that the parent-child dynamic can provide powerful protective factors, in significantly reducing the likelihood a young person will start experimenting with drugs and develop an addiction. One of the best tools in a parent’s arsenal is communication. Parents having conversations with their pre-teens and teens about the risks of substances is a powerful prevention strategy. We’re not talking about having the Big Talk like we saw in so many 80s sit-com “very special episodes.” In fact, what we find is frequent, short conversations has more impact. That is because through that frequency, parents are also communicating to their children that this is an important issue, an important family value. As much as we may think our kids aren’t listening to us and tuning us out, this sort of practice really does resonate and stick with our kids. If you are a parent, or if you know of a parent looking for tips and resources to have these conversations, the Maine Office of Substance Abuse and Mental Health Services has a great website, Maineparents.net, where a lot of great information is available.
While parents have maybe one of the most important roles in youth substance abuse, they shouldn’t and can’t be in this alone. Parents need support in this role. We can’t expect parents to know drugs and drug abuse inside out while they are working and trying to run a household. That is where the community comes in. Those of us who work in community coalitions, such as the Drug Free Communities coalitions, implement many awareness and education programs to help provide this information to parents, along with coaching on how to have these conversations with youth. But another key way we can support parents is through positive community norms and environments.
We make parents’ jobs tougher when we have policies or community norms that celebrate or encourage the use of substances. It makes the job much more challenging because in communicating risks and values, we are now also expecting parents to cut through the political and pop-culture messages that promote “safer” drugs and frame the legalization of drugs as social movements. That’s a tall order for anyone frankly. Especially when some of these messages and messengers are very well-financed and retain slick PR firms.
Today, Governor Paul LePage will convene his summit focusing on the heroin epidemic. I expect there will be many similar conversations as were had Monday at Senator King’s round table. It is my hope that as these summits are concluded, we can find a way to have all of our initiatives working together in concert. It is also my hope that we can all come to a common understanding that whatever our approach, we need to make sure we are addressing the roots of heroin abuse and other substance abuse issues. How can we work together, work better, work smarter, to stop addiction before it begins? How can we support communities in protecting and strengthening environments with positive norms where young people can live, grow and thrive? How can we support parents in their efforts to keep their children on a path towards wellness and success?
What we know from the Drug Free Communities experience is that the more that we collaborate and work towards common goals, the more success we have in reducing youth substance abuse and creating healthy communities. Now is the time to set aside politics and to get to it. Let’s work together and strengthen our approach to stopping drug addiction before it begins.