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Strategies to Address the Problems of Substance Abuse in Schools and in Our Community Michael Edwards, M.A.

       While writing this article, there have been a variety of opinions in the editorial pages concerning the critical issue of substance abuse and the role of law enforcement at Kennett High School. The point of this article is to steer clear of this polarizing debate, and find consensus by focusing on substance abuse prevention information based on current research and offer resources for our community. There are many who are addressing and responding to the issue of substance abuse in our community. One of many approaches is the Student Assistance Program.

The Student Assistance Program: Kennett High School

      The Student Assistance Program at Kennett High School is a grant funded position, funded by the Governor’s Commission on Drug and Alcohol Prevention, Intervention and Treatment. In addition to my position as an Outpatient Clinician and Substance Abuse Counselor at Northern Human Services, two days a week, I provide outreach services to Kennett High School and the community within Northern Carroll County. 

      Substance abuse has negative ramifications in many aspects of a community, (social, family, economic, legal, health), and assessing the community’s capacity and resources requires a team approach; working with a number of agencies and providers. Therefore, my responsibilities include regularly submitting articles so that the community is aware of this resource.

      This unique position allows me to work with Kennett staff and teachers to help high school students reduce risk factors such as alcohol, drug and tobacco use; factors which may interfere with a student’s academic ability and social skills.  Depression, anxiety, relationship issues, divorce related issues, grief, trauma, and stress are also addressed as they often co-occur with substance abuse.

      By promoting the making of healthy and effective decisions by students, and increasing students’ development of their strengths, it is generally felt that a student who receives help and support in dealing with stressful life circumstances will be better prepared to handle the academic and social tasks they encounter in the course of their education.

      In addition, there is strong evidence that heavy use of alcohol and drugs by adolescents affects their brain development, specifically the prefrontal cortex; the area responsible for judgment, reasoning, and emotional regulation. It is one of many reasons why we need to focus specifically on youth substance abuse prevention education.

      The program is intended to provide confidential services to students as well as their parents when they become involved with the Student Assistance Counselor. The exception to this is when there is a question regarding the safety of the student. Parental involvement is encouraged since it is often through improving communication between parent(s) and student that students are helped most.

Brief solution-focused counseling and stress management skills are provided to help more effectively cope with stressful life circumstances.  Students who may benefit from a more intensive level of services are referred to the appropriate agency. The program also provides education about difficult life issues with age-appropriate lectures and materials in the classroom. The Student Assistance Counselor makes contact with students through a variety of methods:

(1) Since the Fall of 2006, students have been seen individually, some mandated as a result of a
substance abuse violation, some who have been referred by teachers/staff, and students who have referred themselves.

 (2) In class presentations on substance abuse prevention have been made to virtually every Kennett High School student, through the Health Education curriculum and/or classroom presentations. Last Fall, presentations were made to all incoming  9th graders so that students are aware that they have the Student Assistance Program as a resource. Within the Health Education curriculum, students have been taught aspects of the “Challenge Course” curriculum; an evidence based curriculum on substance abuse prevention, stages of addiction and stress management skills. Additional prevention information is available in the school’s library.

(3) Teachers, guidance and staff  have been made aware of the process of identification, assessment and referral of students who may benefit from a more intensive level of services.

(4) Community awareness of the program to parents/members of the community is made regularly through monthly Drivetime interviews on our local radio station, WMWV-93.5FM, and articles in our local newspapers.

      Current research suggests that Student Assistance Programs implemented within schools which focus on substance abuse prevention are more effective in changing adolescent’s behavior and perceived risk of illegal substances as compared to no intervention, or treatment following a substance abuse diagnosis. Nevertheless, the following data suggests we need to increase our efforts.

Data on Rates of Addiction in New Hampshire

(1) New Hampshire currently is in the top ten states per capita in rates of adolescent drug and        
       alcohol abuse.
(2)  12% of New Hampshire residents age 12 and up have a substance abuse problem.
(3)  While most states in the U.S. have declining rates of adolescent marijuana and alcohol use,   
        New Hampshire’s is increasing.
(4) New Hampshire is one of the top three states per capita for marijuana use by those age 12 and older.
(5) New Hampshire has been rated the bottom five in the country for access to treatment.
(6) The numbers of adolescents in Carroll, Coos and Grafton County that regularly use either alcohol, marijuana and tobacco is higher than the state and national average and has been increasing, despite the national trend which is decreasing. 
(7) The perceived risk of binge drinking (i.e., five or more drinks within one hour), and the   
        perceived risk of marijuana use (i.e., more students believe binge drinking and marijuana are    
        not a “great risk”) are higher in the Counties in Northern New Hampshire and are higher
        than the national average.

Community Interventions

We are far from where we need to be in addressing  substance abuse within our community, and it is certainly more complex than simply addressing one variable in the equation, such as changing parental attitudes.  Current research underscores the importance of a multifaceted approach which includes:

(1) Educational interventions designed to change a teen’s knowledge, beliefs and attitudes about high risk behavior, including alcohol and drug use, and bullying.

(2) Changing environmental factors which lead to high risk behavior; (a) drug and alcohol use among peer groups, (b) drug and alcohol use within families, (c) homes and other environments lacking in supervision and too much unstructured time, especially after school, between 3PM –7PM, (d) and replacing these risk factors with protective factors, such as more structured, supervised and rewarding activities which give teens a sense of accomplishment and self worth.

(3)  Parental involvement, parent training and modeling has also been proven to be an effective means to reducing alcohol, drug and tobacco use by teens.  Improving communication skills between parent(s) and teen(s) helps teens avoid environments and peer groups that may lead to high risk behavior.

(4) Increasing prevention education in middle and high schools which include teaching social skills, refusal skills, role playing, and assertive communication skills.  Children as young as 5th grade can be taught about avoiding poisons that are found in almost every home (huffing, inhalant abuse), and the difference between illegal drugs and drugs that are prescribed by a doctor, especially with the substantial increase in recent years in prescription drug abuse.

(5) Making youth aware of the legal consequences of drug possession and distribution. Although the program focuses on the biopsychosocial aspects of addictions, many individuals with substance abuse addiction have lengthy legal histories which further complicates their recovery.  As adolescents are using substances at an increasingly younger age, they are also showing an increase in criminal activity. Recently, we conducted a presentation to all ninth graders on substance abuse and the law.  Students asked the Student Resource Officer about the consequences of violating the school policy and local laws in regards to substance abuse.

(6) Enforcing laws prohibiting minors from access to tobacco and alcohol. Last Fall, we took part in the annual SYNAR survey, a nationwide survey to determine if stores are in compliance with tobacco laws. With the help of Kennett High School students, we found that Carroll County had the highest rate of non-compliance of tobacco laws which prohibit selling tobacco to minors. 50% of stores sampled in the survey were willing to sell tobacco to a minor; 2-3 times the rate of other counties in New Hampshire and substantially higher than the 20% national rate. This is the second year in a row that Carroll County had such high rates, as compared to declining rates in other counties. As a result, a letter was sent to all Police Chiefs  in Carroll County informing them of the results and suggesting greater enforcement of tobacco laws.

(7) Access to treatment is a major problem in New Hampshire, as there has been a reduction in treatment options in recent years. However, current research supports that in addition to financial and insurance obstacles, an individual’s motivation towards treatment is the most significant factor in their recovery.  It is the nature of the addiction, the social stigma,  denial, shame and guilt, which leads most individuals to not seek treatment. They are in the “pre-contemplative stage”, either unaware or unwilling to make any commitment towards treatment, even if they have access to inpatient and residential treatment, and therefore, simply do not show up or complete the course of treatment. Residential treatment has a “success” rate of 10%-20%. Outpatient treatment has similar outcomes. For some, relapse is part of the process towards recovery. In addition, Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) provides connections and a supportive community, yet, for some, it is not the only path towards recovery.

      Therefore, a more comprehensive approach must also consider increasing prevention education for our youth and adults within our community and concurrently, improve treatment protocols including more treatment providers who are able to prescribe agonist and antagonist medications on an outpatient basis. Mental health and substance abuse clinicians should also strive to keep up to date with current and evidence-based treatment therapies including motivational interviewing, motivational enhancement therapy along with cognitive behavioral therapy, so as to better meet the needs of individuals with a substance abuse diagnosis.

      In addition, the strong correlation between mental health disorders and substance abuse suggests that more treatment providers should be capable of screening, assessment and treating co-occurring disorders;  removing barriers between the two and creating a “one stop” approach to mental health and substance abuse treatment.

      Individuals (parents and adolescents)  interested in receiving information on substance abuse prevention can reach me at Kennett High School at 356-4343, or e-mail me at m_edwards@sau9.org.
Also, please visit the Valley Outreach website: www.forparentssake.com .

References: Substance Abuse and Mental Health Services Administration, 2006, 2007; The Center for Disease Control - Youth Behavior Risk Survey 2005; 2002 -2004 Sub-State Report of Substance Use & Serious Psychological Distress;  New Hampshire Center for Public Policy Studies, 2006, 2007; Department of Health and Human Services – SYNAR Survey, 2006, 2007.