Alcohol and Other Drugs: Issues, Approaches and Standards in Programs for Youth

1. PAD/ODAP March 2010 Alcohol and Other Drugs:Issues, Approaches and Standards in Programs for Youth

2. PAD/ODAP March 2010

3. PAD/ODAP March 2010 �Substance use is a key health/ social issue for adolescents and should remain an important target within health, education and social services.�

4. PAD/ODAP March 2010 Presentation Overview Alcohol and other drugs: substance use and misuse Perspectives on prevention Intersectoral and multi-risk factor approaches Programming to increase resiliency Programming to engage youth Standards and practices A little bit about Parent Action on Drugs

5. PAD/ODAP March 2010 What is a �drug�? Anything other than food that changes how the body or mind works A broad category which can include prescribed medicines, over-the-counter medications, caffeine, colas, tobacco and alcohol; drugs that illicit or legal for some or everyone

6. PAD/ODAP March 2010 Drug, Set and Setting How a substance affects you depends on� The drug itself � components, toxicity, amount The individual taking the drug � age, body type, gender, allergies, biology Circumstances under which the drug is taken

7. PAD/ODAP March 2010 What do we know about student drug use?

8. PAD/ODAP March 2010 Students in Ontario (grades 7 -12) 58.2% used alcohol 25.6% used cannabis 18% used prescription (opioid) pain reliever (non-medically) 11.7% smoked cigarettes 3.2% used Ecstasy 2.6% used cocaine

9. PAD/ODAP March 2010 Continuum of Use

10. PAD/ODAP March 2010 Student Drinking on the Continuum

11. PAD/ODAP March 2010 Student Marijuana Use on the Continuum

12. PAD/ODAP March 2010 Did Not Use

13. PAD/ODAP March 2010 Risks of substance use Physical health Mental health Social � family, friends, school adaptation Emotional � affect, social competencies Cognitive � attention, executive functioning

14. PAD/ODAP March 2010 Alcohol Related Risks Short term risks Alcohol poisoning Regrets about behaviour and sexual decisions Property damage Fights Impaired driving Long term risks Cancers and liver disease Alcoholism Significant Issues : gender lens, sexual assault

15. PAD/ODAP March 2010 Short term risks Dizziness and sickness Paranoia Poisoning from contamination Sexual regrets Impaired driving Long term risks Respiratory conditions Cognitive functioning and mental health outcomes Significant Issues : gender lens Marijuana Related Risks

16. PAD/ODAP March 2010 Prevention A range of practices, strategies and interventions which aim to: Avoid the use of substance(s) e.g. abstinence Delay the use of substance(s) e.g. age of first time use Avoid or reduce the problems associated with the use of substance(s) e.g. harm reduction Decrease the use of substance(s) e.g. moderation Stop the use of substance (s) e.g. cessation

17. PAD/ODAP March 2010 KAS framework:

18. PAD/ODAP March 2010 Checking our attitudes

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20. PAD/ODAP March 2010 Addictions and Mental Health Making the Connection Drug use can function as a short term solution for youth with: depression anxiety eating disorders learning disabilities ADHD shyness

21. PAD/ODAP March 2010 Relationship between substance use and mental health symptoms Create Trigger Exacerbate Mimic Mask Independent Source: Centre for Addiction and Mental Health

22. PAD/ODAP March 2010 Personal Safety and Injury Prevention Drinking and driving / boating / snowmobiling Marijuana use and driving Binge drinking Fights and aggression Risky environments

23. PAD/ODAP March 2010 Chronic Disease Tobacco/smoking linked to cancer deaths � lung, mouth, larynx, esophagus, bladder, kidney and pancreas; increases risk of heart attack and stroke Alcohol linked to liver disease, stroke and heart disease, gastro-intestinal tract, mouth and esophagus cancers Women at increased risk for breast cancer related to tobacco and alcohol

24. PAD/ODAP March 2010 Physical Activity Team sports Individual sport School performance Personal fitness Family supports

25. PAD/ODAP March 2010 Healthy Eating Body Image Food choices Family engagement Food preparation

26. PAD/ODAP March 2010 Sexual Health Decision making Dating and relationships Unintended pregnancy Pregnancy Sexual harassment

27. PAD/ODAP March 2010 Resiliency Lifton (1994) : identified resiliency as the human capacity of all individuals to transform and change, no matter what their risks; it is an innate �self-righting mechanism� 15 year old student (Resiliency in Action) �Bouncing back from problems and stuff with more power and more smarts�

28. PAD/ODAP March 2010 Protective Factors Individual Self esteem Trust, optimism, sense of hope Positive coping skills Childhood competency- regular chores, having a part-time job Family One responsible adult throughout childhood Family stability and security High parental expectations, support and supervision

29. PAD/ODAP March 2010 Protective Factors School Provides stable and safe environment to learn Engages positively with teachers and other students Nurtures commitment to learning and sharing with others

30. PAD/ODAP March 2010 Community Provide social support in the form of belonging, stability and continuity Meeting adults in the community who help them develop trust, autonomy and initiative

31. PAD/ODAP March 2010 Community Provide support to parents in their nurturing roles Provide an open, supportive and educational climate for the basic infrastructure where family life is lived (daycare, employment, recreation, etc) and a context where shared values and expectations are developed

32. PAD/ODAP March 2010 Youth resiliency Long-term developmental studies have followed individuals raised in extremely high-risk environments that included significant levels of poverty, alcoholism, drug abuse, physical and sexual abuse, and mental illness.� Researchers found that at least 50 percent and usually closer to 70 percent of these individuals grow up to be not only successful by societal standards, but �confident, competent, and caring� persons (Werner & Smith, 1992).� The reason some individuals succeed when faced with risks and adversity is resiliency � the capability of individuals and systems (families, groups and communities) to cope with significant adversity or stress in ways that are not only effective, but tend to result in an increased ability to constructively respond to future adversity.� Lifton (1994) identified resiliency as the human capacity of all individuals to transform and change, no matter what their risks; it is an innate �self-righting mechanism�.� It is important to understand that resiliency is not a static state.� Rather, this capacity for resiliency develops and changes over time, is enhanced by protective factors within the individual and their social environments, and contributes to the maintenance or enhancement of health. Long-term developmental studies have followed individuals raised in extremely high-risk environments that included significant levels of poverty, alcoholism, drug abuse, physical and sexual abuse, and mental illness.� Researchers found that at least 50 percent and usually closer to 70 percent of these individuals grow up to be not only successful by societal standards, but �confident, competent, and caring� persons (Werner & Smith, 1992).� The reason some individuals succeed when faced with risks and adversity is resiliency � the capability of individuals and systems (families, groups and communities) to cope with significant adversity or stress in ways that are not only effective, but tend to result in an increased ability to constructively respond to future adversity.� Lifton (1994) identified resiliency as the human capacity of all individuals to transform and change, no matter what their risks; it is an innate �self-righting mechanism�.� It is important to understand that resiliency is not a static state.� Rather, this capacity for resiliency develops and changes over time, is enhanced by protective factors within the individual and their social environments, and contributes to the maintenance or enhancement of health.

33. PAD/ODAP March 2010 From lit search, what strategies are working to increase resiliency? Youth engagement/development Parent support Peer involvement School connectedness Community capacity Youth engagement: Meaningful youth engagement is built on the recognition that every young person has something to contribute to the active betterment of Canadian society. Research has shown that youth who have been engaged and are active participants in society turn into adults with less health, career, family and societal traumas and distresses. Additionally, they are better able to handle those stresses and in turn to give back to society more effectively and generously (Health Canada) Engagement means acting as real partners with input into decision-making, planning, implementation and evaluation. (McCreary Centre, BC) Parent Support According to several recent Canadian studies, youth ages 11-15 identify parents and peers as their key influencers.�Strengthening Families � a program which combines several health promotion strategies including supportive environments, awareness, education and skill-building and community action has been shown to be effective in reducing initiation rates of alcohol and other drug use, plus reducing targeted risk factors like family conflict.� Tweens to Teens � Toronto Public Health. Parent Action on Drugs is the agency which delivers training on Strengthening Families in Ontario Peer involvement Given that friends are seen as key influencers, research bears out that �peer-led interventions on alcohol and other drug use are more effective than adult-led interventions in the short term � unless peer-led booster sessions are included and then interventions were much more effective than teacher-led interventions for a longer time� Tweens to Teens, Toronto Public Health School connectedness CAMH recently looked at school connectedness as a risk/protective factor particularly. Initial results indicated that a significant number of these youth feel disconnected from their school, don�t trust their teachers, and are dissatisfied with the general disorder in schools � in Grade 9. Unfortunately the CAMH project has been put on hold until further funding is made available. However, school programs which aim to incorporate student input and address health holistically are having more success in engaging youth � Comprehensive School Health programs show promise because they address instruction, support services, and address a healthy physical environment as well as a healthy psycho-social environment. Community capacity Community development has proven to be an effective tool in reducing inequities and addressing priorities for community health. It also is effective in supporting its youth as active partners in the community. Two programs which have shown success in supporting youth with mental health and drug use issues are based on these concepts and have been included in your packages. They include: �Community capacity Building and Mobilization of Youth Mental Health Promotion � The Story of the Community of West Carleton: How the Community Helper Program Evolved from a Community�s Experience with Youth Suicide� �From the Inside Out: Promoting Resiliency in Early Adolescence�, McCreary Centre, BCYouth engagement: Meaningful youth engagement is built on the recognition that every young person has something to contribute to the active betterment of Canadian society. Research has shown that youth who have been engaged and are active participants in society turn into adults with less health, career, family and societal traumas and distresses. Additionally, they are better able to handle those stresses and in turn to give back to society more effectively and generously (Health Canada) Engagement means acting as real partners with input into decision-making, planning, implementation and evaluation. (McCreary Centre, BC) Parent Support According to several recent Canadian studies, youth ages 11-15 identify parents and peers as their key influencers.�Strengthening Families � a program which combines several health promotion strategies including supportive environments, awareness, education and skill-building and community action has been shown to be effective in reducing initiation rates of alcohol and other drug use, plus reducing targeted risk factors like family conflict.� Tweens to Teens � Toronto Public Health. Parent Action on Drugs is the agency which delivers training on Strengthening Families in Ontario Peer involvement Given that friends are seen as key influencers, research bears out that �peer-led interventions on alcohol and other drug use are more effective than adult-led interventions in the short term � unless peer-led booster sessions are included and then interventions were much more effective than teacher-led interventions for a longer time� Tweens to Teens, Toronto Public Health School connectedness CAMH recently looked at school connectedness as a risk/protective factor particularly. Initial results indicated that a significant number of these youth feel disconnected from their school, don�t trust their teachers, and are dissatisfied with the general disorder in schools � in Grade 9. Unfortunately the CAMH project has been put on hold until further funding is made available. However, school programs which aim to incorporate student input and address health holistically are having more success in engaging youth � Comprehensive School Health programs show promise because they address instruction, support services, and address a healthy physical environment as well as a healthy psycho-social environment. Community capacity Community development has proven to be an effective tool in reducing inequities and addressing priorities for community health. It also is effective in supporting its youth as active partners in the community. Two programs which have shown success in supporting youth with mental health and drug use issues are based on these concepts and have been included in your packages. They include: �Community capacity Building and Mobilization of Youth Mental Health Promotion � The Story of the Community of West Carleton: How the Community Helper Program Evolved from a Community�s Experience with Youth Suicide� �From the Inside Out: Promoting Resiliency in Early Adolescence�, McCreary Centre, BC

34. PAD/ODAP March 2010 Youth Engagement The meaningful participation and sustained involvement of a young person in an activity with a focus outside of him or herself � �brain, heart, feet� Centre of Excellence for Youth Engagement 2004 Our working definition: Youth engagement is the meaningful and sustained involvement of a young person in an activity focusing outside the self. Full engagement consists of a cognitive component, an affective component, and a behavioral component - Head, Heart, Feet. Key Messages�� Meaningful youth engagement produces benefits to youth and the community in which they live.�� Through engagement, youth gain a sense of empowerment as individuals and make healthy connections with others, which is associated with reduction of risk behaviours and increased participation in positive activities that contribute to community.�� Youth engagement is a cross-cutting, comprehensive, strength-based practice for effective protection, prevention and intervention on multiple issues.�� The community gains from the contributions that youth bring to organizations, activities and their relationships. Key Successes�� Maintain a continuously updated, web-based literature review.��Develop a framework for measuring meaningful engagement.�� Encourage researchers to study the link between the developing adolescent brain and the impacts of positive youth engagement.�� Assist organizations and communities to implement and evaluate youth engagement programs, including the YMCA and the Toronto Police Service, where youth engagement is credited in part with the reduction of gun-related violence in the city.� Our working definition: Youth engagement is the meaningful and sustained involvement of a young person in an activity focusing outside the self. Full engagement consists of a cognitive component, an affective component, and a behavioral component - Head, Heart, Feet. Key Messages�� Meaningful youth engagement produces benefits to youth and the community in which they live.�� Through engagement, youth gain a sense of empowerment as individuals and make healthy connections with others, which is associated with reduction of risk behaviours and increased participation in positive activities that contribute to community.�� Youth engagement is a cross-cutting, comprehensive, strength-based practice for effective protection, prevention and intervention on multiple issues.�� The community gains from the contributions that youth bring to organizations, activities and their relationships. Key Successes�� Maintain a continuously updated, web-based literature review.��Develop a framework for measuring meaningful engagement.�� Encourage researchers to study the link between the developing adolescent brain and the impacts of positive youth engagement.�� Assist organizations and communities to implement and evaluate youth engagement programs, including the YMCA and the Toronto Police Service, where youth engagement is credited in part with the reduction of gun-related violence in the city.� Our working definition: Youth engagement is the meaningful and sustained involvement of a young person in an activity focusing outside the self. Full engagement consists of a cognitive component, an affective component, and a behavioral component - Head, Heart, Feet. Key Messages�� Meaningful youth engagement produces benefits to youth and the community in which they live.�� Through engagement, youth gain a sense of empowerment as individuals and make healthy connections with others, which is associated with reduction of risk behaviours and increased participation in positive activities that contribute to community.�� Youth engagement is a cross-cutting, comprehensive, strength-based practice for effective protection, prevention and intervention on multiple issues.�� The community gains from the contributions that youth bring to organizations, activities and their relationships. Key Successes�� Maintain a continuously updated, web-based literature review.��Develop a framework for measuring meaningful engagement.�� Encourage researchers to study the link between the developing adolescent brain and the impacts of positive youth engagement.�� Assist organizations and communities to implement and evaluate youth engagement programs, including the YMCA and the Toronto Police Service, where youth engagement is credited in part with the reduction of gun-related violence in the city.� Our working definition: Youth engagement is the meaningful and sustained involvement of a young person in an activity focusing outside the self. Full engagement consists of a cognitive component, an affective component, and a behavioral component - Head, Heart, Feet. Key Messages�� Meaningful youth engagement produces benefits to youth and the community in which they live.�� Through engagement, youth gain a sense of empowerment as individuals and make healthy connections with others, which is associated with reduction of risk behaviours and increased participation in positive activities that contribute to community.�� Youth engagement is a cross-cutting, comprehensive, strength-based practice for effective protection, prevention and intervention on multiple issues.�� The community gains from the contributions that youth bring to organizations, activities and their relationships. Key Successes�� Maintain a continuously updated, web-based literature review.��Develop a framework for measuring meaningful engagement.�� Encourage researchers to study the link between the developing adolescent brain and the impacts of positive youth engagement.�� Assist organizations and communities to implement and evaluate youth engagement programs, including the YMCA and the Toronto Police Service, where youth engagement is credited in part with the reduction of gun-related violence in the city.�

35. PAD/ODAP March 2010 Youth Engagement Spectrum Youth serving: youth as consumers only Youth input: youth evaluates or provides feedback on programs and service Youth engaged: Youth are actively involved in the program development and delivery Youth-led: program concept and/or organization came from youth Youth serving: youth as consumers only Youth input: youth evaluates or provides feedback on programs and service Youth engaged: Youth are actively involved in the program development and delivery Youth-led: program concept and/or organization came from youth

36. PAD/ODAP March 2010 Social Benefits for Youth Positive social interaction with other youth with similar interests Supportive social networks Increase personal knowledge and skill development Development of skills to cope with stressful life situations Increase self esteem Decreased drug use, teen pregnancy and anti-social behaviors Direct impact on peers both formal and informal

37. PAD/ODAP March 2010 Care: family-like environments where youth can feel safe and build trusting relationships Youth: build on youth�s strengths and their unique talents: give youth a voice Knowledge: provide meaningful learning opportunities, youth activities are �about� something. Give them the chance to learn new and useful things Assessment: peer provide feedback and evaluation to the experience. Also have opportunity for self and peer evaluation and opportunities to grow as individuals. Care: family-like environments where youth can feel safe and build trusting relationships Youth: build on youth�s strengths and their unique talents: give youth a voice Knowledge: provide meaningful learning opportunities, youth activities are �about� something. Give them the chance to learn new and useful things Assessment: peer provide feedback and evaluation to the experience. Also have opportunity for self and peer evaluation and opportunities to grow as individuals.

38. PAD/ODAP March 2010 Essential Characteristics of Youth Engagement Provide opportunities for skill development and capacity building. Provide opportunities for leadership Encourage reflection on identity Develop social awareness Like conventional youth development programs, activities will seek to develop academic, intellectual, civic, emotional, physical, employment, social and cultural competence 2. Leadership in the youth engagement context involves a genuine transfer of decision-making power to the youth. At minimum, this means the ability to make decisions in the design and direction of their own programs. Youth may also participate as decision makers in various levels of the organization such as serving on adult-led boards and committees. Some organizations have created separate structures in the form of youth-led advisory boards and youth councils. 3. Youth are supported in their development of a critical and political analysis of identity issues. This is often achieved through anti-oppression training, discussion and creative expression. Familiarity with identity issues enables youth to make the links between the factors that affect their own lives and the systemic factors that affect their community and society at large. 4. As the youth gain a greater awareness of their own identities, they are encouraged to develop a consciousness beyond the self. They are guided through the transition from self-awareness to social awareness and given opportunities to reflect on the responsibilities of citizenship. In some programs, youth are provided with the skills, training, and resources to become the agents of change in their community Like conventional youth development programs, activities will seek to develop academic, intellectual, civic, emotional, physical, employment, social and cultural competence 2. Leadership in the youth engagement context involves a genuine transfer of decision-making power to the youth. At minimum, this means the ability to make decisions in the design and direction of their own programs. Youth may also participate as decision makers in various levels of the organization such as serving on adult-led boards and committees. Some organizations have created separate structures in the form of youth-led advisory boards and youth councils. 3. Youth are supported in their development of a critical and political analysis of identity issues. This is often achieved through anti-oppression training, discussion and creative expression. Familiarity with identity issues enables youth to make the links between the factors that affect their own lives and the systemic factors that affect their community and society at large. 4. As the youth gain a greater awareness of their own identities, they are encouraged to develop a consciousness beyond the self. They are guided through the transition from self-awareness to social awareness and given opportunities to reflect on the responsibilities of citizenship. In some programs, youth are provided with the skills, training, and resources to become the agents of change in their community

39. PAD/ODAP March 2010 Canadian Standards forYouth Substance Abuse Prevention From the Canadian Centre for Substance Abuse (www.ccsa.ca) School-based and Community-based program standards Recommended Steps: Assess the situation Prepare a clear and realistic plan Build capacity and sustainability Implement a comprehensive initiative Evaluate the initiative

40. PAD/ODAP March 2010 Guidelines for Family-based Skills Training Programs offering prevention skills training for families are a critically important option Most of the family factors associated with problematic substance use are also linked to other health and social issues Health promotion �teams� can adapt, build on or implement evidence-based programs, adhering to best and better practices

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44. PAD/ODAP March 2010 Our Approach Based on current information and best practices: Youth-to-youth strategies Involvement of target audience in development of programming Empower parents and youth to increase their personal skills and resilience

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46. PAD/ODAP March 2010 PAD�s Activities Consultation Evaluation & Research Knowledge Exchange/Transfer Skills Building Training Community Action and Capacity Building Supportive Policy and Environments

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48. PAD/ODAP March 2010 Hook up to breast cancer prevention! We now know that we can lower our risk of breast cancer. Here are three ways. ?Eat smart. ? Get physical. ? Limit the alcohol. Breast Cancer. You can do something about it.

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