<p>Jeff Wolfsberg is an internationally-recognized expert and thought leader in drug education, adolescent and family health and personal leadership speaker, radio talk show host, and writer. Jeff’s articles and comments have appeared in TIME Magazine, FOX-TV, National Public Radio, Independent School Magazine, the Educational Digest, the Boston Globe and Herald, and numerous national media outlets. Jeff was kind enough to answer my questions about substance abuse.</p><p><strong>1. What is the most popular form of substance abuse for high school students? Why is that so?</strong></p><p>Alcohol and marijuana remain the most widely used substances on all campuses both secondary and higher education. One concerning trend is prescription drug abuse has doubled in the last five years. Most notable among the abused prescribed drugs are the opiates including, but not limited to, Oxycontin and Vicodin. We see widespread abuse of prescription stimulants in the college setting as well. These drugs would include Ritalin and Adderall often prescribed to treat ADD/ADHD.</p><p><strong>2. What makes teenagers want to engage in such dangerous activities?</strong></p><p>The research around the initiation of alcohol and other drug use by teens suggests a myriad of explanations. The teen years are a time where peer acceptance is a deep need among teens. There is a strong desire to fit in to one’s social group and this can lead to alcohol and other drug initiation. I intentionally use the word “initiation” because the factors leading to initiation are different than those that contribute to sustained and dependent use of alcohol and other drugs.</p><p>Since this article is about private schools, it is important to note the research done by Professor Suniya Luthar at Columbia regarding affluent communities and families. Teens that come from these groups have the highest levels of anxiety, depression, and eating disorders as compared to all other socioeconomic teen groups. The research suggests that excessive achievement pressure and detachment (both physical and emotional) from parents contribute to these conditions. Alcohol and other drugs can be seductive choices to self-medicate these problems for teens.</p><p>Family dynamics also play a role in the initiation and continuation of teen alcohol and other drug use. In some families, teens are allowed too much power. Alcohol and other drug use by the teen then becomes an unconscious attempt redress the imbalance by calling attention for the need for help. Alcohol and other drug may also alleviate some of the anxiety that comes with too much power. If the teen does not have enough power, then alcohol and other drug use creates a false sense of power and omnipotence. Keeping with the theme of Dr. Luthar’s work, when teens feel a detachment from parents, both physical and emotional, then alcohol and other drug use can be an attempt to draw them closer.</p><p>During my work in a drug treatment center, the most significant deficit that teens felt in their lives was a relationship with their fathers.</p><p>There are many reasons involved in the decision to drink or use other drugs, it is becoming clear that drug education, based on lessons from research, delivered in the proper context and in the appropriate way has the potential to reduce alcohol misuse, drug use (specifically tobacco marijuana, and cocaine) and/or at least to delay the onset of experimentation.</p><p><strong>3. Is there any evidence that private school students use drugs and alcohol more than public school students?</strong></p><p>No. There is little difference between alcohol and other drug use rates of public and private schools. What appears to be the most salient difference is the availability of substances “on campus” appears to be less at private than public. There are private school campuses where alcohol and other drug use exceed national averages.</p><p>Alcohol and other drug use rates by schools and communities is more of a reflection of awareness and effective programming rather than the socioeconomic status of the individuals making up a defined community.</p><p><strong>4. What can private schools do to prevent substance?</strong></p><p>Private schools are in the best position to bridge the gap between science and practice in the field of drug education and mental health. The freedom and resources available to private schools put them in a unique position to be transformative in developing drug education programs. Private schools are not bound by standardized testing like public schools and often their small classroom size is conducive to effective drug education and mental health programs.</p><p>Developing effective drug education programs that achieve positive outcomes requires time and systems change. Effective programs should attempt to affect behavior both on the individual level and institutional level. Funding for drug education programs in public schools is often year-to-year and sporadic. Strategic plans that show initial promise can be abandoned when funding dries up. Unfortunately, this uncertainty can lead to lukewarm institutional support for programs that most think will not be there next year anyway.</p><p>The first thing all schools need to do is abandon the myth that early drug education in elementary and middle school provides an inoculation effect against future alcohol and other drug use during the teen years. The research tells us this is not so. Drug education and mental health programs have to be sustained over the developmental lifespan of adolescents. Each stage of the teen’s life is unique and has to include social-emotional learning to meet the needs expressed during that developmental stage.</p><p>Schools need to identify high-risk groups within their community and customize their drug education and mental health programs to meet the needs of those groups. When drug education programs are too generalized, they under-serve some groups and over-serve others. For instance, there is good reason to conduct some elements of the drug education program in gender specific groups. Female alcohol use is different from male use, the consequences are different and the risks are different. Other higher risk groups would include teens on medication and those teens we know who are dealing with mental health issues like depression and anxiety.</p>It’s important to note that adolescent high-risk behaviors cluster. Meaning, where there is drinking, it is safe to assume that there may be other drug use, sexual activity, and other risk-taking. Therefore, drug education programs can no longer be conducted in isolation, but rather integrated into a comprehensive wellness strategy which views teen alcohol and other drug as behaviors existing on a continuum of risk.<p>This may sound somewhat self-promotional, but I suggest schools work with a certified prevention specialist. The science around school-based wellness programming is complicated and requires a professional to perform assessments, design programs, and maintain institutional momentum. An overlooked aspect of a drug education program’s efficacy is the disposition of the instructor. A well-designed program delivered by an instructor with improper training and/or lack of enthusiasm for the material will not produce positive outcomes. This is another reason to work with professional instructors with training and commitment to the material.</p><p>Drug use by teens is often categorized as adolescent rebellion, thrill seeking or peer pressure. These are convenient labels that often minimize and deny the connectedness of teen alcohol and other drug use with adult social systems like family, school, community, and culture. Teen drug use is unique and needs to be addressed, however; effective drug education programs address teen drug use from an ecological viewpoint that doesn’t scapegoat teen substance use.</p><p>A school cannot change what is does not measure. Often missing in the planning stages of a drug education program is building in assessment and evaluation opportunities. Performing a school-wide assessment of a range of student behaviors and attitudes allows prevention professionals and administrators to design programs based on real data and measurable outcomes. Some areas to measure are alcohol and other drug use, school connectedness, sexual behaviors, stress, sleep patterns, and parental controls. Schools need to let go of binary thinking regarding drug education outcomes and stop determining program success strictly on a “use” “no use” basis. It is unproductive and not consistent with what we know about behavioral change. The goals of a drug education program should be to support and encourage those students who are making the choice to remain alcohol and other drug free. And, for those students who will not make that choice, guide and intervene in such a manner as to not allow their use to escalate into dependence.</p><p>School-based prevention is one of three strategies we use in this country to control illicit drug use – the other two being enforcement and treatment. There has been a lot of research analyzing the cost-effectiveness of enforcement and treatment, but very little regarding prevention until recently. School-base drug education programs have the added benefit by not only reducing the use of illicit drugs but licit drug use like alcohol and tobacco as well. Research has shown for every dollar invested in prevention, seven dollars are saved on enforcement and treatment.</p><p><b>5. What are some of the warning signs parents can look for?</b></p><p>Since this article is geared towards a private school audience, it is useful to recognize that there are differences among private and public school students. Private school students are often socially sophisticated and highly motivated. These attributes can masks significant impairment issues such as developing addictions, anxiety, depression, and other assorted self-destructive behaviors. Traditional hallmarks of the troubled teen such as falling grades, delinquent behavior, and a change in physical appearance may be absent in private school students.</p><p>Private school parents have a hypersensitivity to privacy, which can fuel a reluctance to engage the school’s mental health resources. Private school parents can enable their teen’s alcohol and other drug use by defending and rescuing their children from consequences that could have a curative effect on alcohol misuse or other drug use.</p><p>Some signs to look for that can be attributed to both substance use and mental health issues are:</p><ul><li>Achievement that is absent of joy</li><li>Over-developed need for privacy</li><li>Over-protective of their cell phone</li><li>Abnormal resistance to family values and/or family time</li><li>Angry outburst</li><li>Unaccounted for money</li></ul>Parents should not discount their intuition or “feeling” something is wrong. The best protective factors against teens developing problems with substances are a loving and connected relationship with their parents.