Supporting families to prevent substance abuse

Despite what the lack of snow and downright balmy temperatures would tell us, Christmas is indeed coming up this week.  My house is abuzz with excitement amongst my family including my three children.  A couple of weeks ago, as is tradition, we picked out the tree and put up the ornaments.  With a daughter approaching the teen years and a couple of younger ones, we have many, many ornaments of the homemade variety.  Lots of pipe-cleaners, popsicle sticks, and glitter glue. Each ornament has its own story. As the kids hang each ornament there is the retelling of those stories.  This is one of my favorite parts of Christmas and is what the season is all about, celebrating family.

As we come upon another Christmas, there are many families in Maine and across the United States who are struggling right now due to the addiction crisis. We see the seemingly endless headlines about Mainers who are overdosing on opiates or heroin and dying or having to be hospitalized. For those families, Christmas is very, very different this year.

The good news is that leaders across the state are rallying to respond to this crisis. Maine lawmakers from both sides of the aisle announced a plan to beef up enforcement and treatment resources. Meanwhile, law enforcement, treatment, and prevention task forces have been convened by the U.S. Attorney Thomas E. Delahanty II and have been meeting bi-weekly. (I was appointed to serve on the prevention task force and I can report plans are moving along quickly.) We know there are many families suffering right now and this is an all-hands-on-deck push to put programs and resources in place to give them the help and support they need and deserve. I think it is safe to say all of us on the task forces feel the heavy sense of urgency and responsibility to turn the tide on this public health issue.

Parents and the Power of Prevention

Earlier this month, I wrote an article describing the critical role prevention plays in addressing this crisis. I proposed that we need to introduce universal prevention programming in elementary schools. This strategy will ensure the next generation has the protective factors and self-regulation skills to reduce their risks of developing substance use disorders. The other critical piece in the prevention strategy has to be supporting parents and families.

The National Institute on Drug Abuse describes the risk and protective factors that impact youth across five domains. Domains include the individual level, peers, schools, community, and family. Family is one of the most critical domains. Despite what it might seem like when our children are acting especially rebellious, they do look to us for guidance when it comes to issues such as drugs and alcohol.

As parents, there are two ways in which we can communicate that guidance. The unspoken, or parental modeling, is what we communicate to our children through our behavior. For example, if we come in after a hard day at work and say, “What a day, can you grab me a beer?”, we are modeling for our kids that substances are used to cope with stress. We can also model positive behavior around substances, such as taking medicines as prescribed (e.g. not taking higher doses, using medicines prescribed to others) or by not making alcohol a central focus of family gatherings. The spoken is parental monitoring. This includes checking in, and having regular conversations with our teens around drug and alcohol use. Prevention research establishes that modeling positive behavior and being engaged with our children through parental monitoring are both effective in reducing the risks of youth developing substance use disorders.

The good news is that the latest Maine Integrated Youth Health Survey data released this month shows favorable trends in both areas. One question Maine middle school and high school youth are asked is if they have had conversations with at least one parent in the last twelve months around drugs and alcohol. This question represents one aspect of parental monitoring. Another question that is asked is if their family has clear rules and values around the use of substances. This question represents one aspect of parental modeling.  The chart below maps out the trend for both of these questions amongst Maine high school youth:

MIYHS parental monitoring


The chart above demonstrates a vast majority of Maine high school youth report that their families have clear rules around drugs and alcohol. Additionally, there has been a statistically significant increase between 2009 and 2015. Meanwhile, a significant increase has been seen in the percentage of Maine high school youth reporting talking to their parents about drugs in the past year. However, that number is still less than 50% so there are more gains to be made. This is perhaps one of the best areas where we can support parents and families. We can equip them with the information they need along with the tips and tools to help them feel confident in initiating the conversations.

The beauty of this approach is that these conversations are protective in two ways.  One is certainly the information parents can provide to their kids about the risks of drugs and alcohol. But secondly, just the fact that the parents are having this communication with youth is protective. Parents don’t need to have the big, scary, 80’s sitcom “very special episode” drug talk. Frequent, small conversations are more effective. The frequency of these conversations communicates to the teen that this is important, it communicates a family value around drugs, and it communicates that the parents care about this and are there to help keep their teens safe.

So along with creating universal prevention programming, Maine should look at how it can provide support to parents to educate and guide their children at home. This is a time to tap the innovation of our public sector, including those Healthy Maine Partnerships and Drug Free Communities coalitions who’ve been doing this work for the past decade. Let’s look for parent education and outreach programs that are working and invest in taking those statewide. If you know of a program that is working well in your area, please share it below in the comment section. Let’s all work together to support parents and ensure all Maine families get to celebrate the holidays.

Thank you for reading and following my blog. To all of my readers I wish you a very Happy Holiday season and a very Merry Christmas!

Scott M. Gagnon, MPP, PS-C

About Scott M. Gagnon, MPP, PS-C

Scott M. Gagnon, MPP, PS-C is a Certified Prevention Specialist and is the Director of Operations at AdCare Educational Institute of Maine, Inc. He currently serves on the Maine Substance Abuse Services Commission as well as the U.S. Substance Abuse and Mental Health Services, Center for Substance Abuse Prevention National Advisory Council. Scott volunteers as the Chair of the marijuana policy education and advocacy group, Smart Approaches to Marijuana Maine and is the current Board President of the Maine Council on Problem Gambling. Scott also serves as a Co-chair of the Prevention & Harm Reduction task force of the Maine Opiate Collaborative, the effort convened by U.S. Attorney Thomas E Delahanty, II to address Maine's growing opiate and addiction crisis. Scott is the recipient of the 2015 Maine Public Health Association's Ruth S. Shaper Memorial Award and 2015 Healthy Androscoggin Will Bartlett Award and is also the 2013 recipient of the Maine Alliance to Prevent Substance Abuse Prevention Award.