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Why Adolescence Matters in Preventing Substance Abuse

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 (Tetiana Garkusha/iStock)

In order to understand people who develop substance abuse disorders as adults, it's important to recognize when they were first exposed. The majority of adults who develop substance abuse disorders first used drugs or alcohol during adolescence. In her new book, “The Addiction Inoculation: Raising Healthy Kids in a Culture of Dependence,” Jessica Lahey translates the research around addiction and explores practical ways parents and educators can use this information to support kids.

Lahey’s motivation for writing this book is personal. Born into a family with a history of addiction, she found herself struggling with alcoholism as an adult. After finding her path to sobriety, Lahey – a career educator –  began to teach teens at an inpatient drug and alcohol rehabilitation center. These experiences, along with the task of raising two teenage sons, prompted her to spend years researching the core elements of efficacious addiction prevention. 

Explore Root Causes

Many of today’s educators and parents came of age during the War on Drugs, “Just Say No,” and school assemblies that included harrowing stories of a late-stage addiction. But effective prevention programs involve much more than blanket warnings, says Lahey. Adults need to examine why an adolescent uses drugs or alcohol in the first place. In the words of Chris Herren, former NBA Player, and recovering heroin addict, too often “we focus on the worst day and forget the first day.” Adolescents take that first drink for any number of reasons – including a desire to escape the pressures of school or home, to ease social anxiety, to fit in, or to cope with trauma. 

“If a kid is drinking because they are trying to numb out what they feel is wrong with them, what can we do to help them feel like they are enough?” asks Lahey. “And there is so much we could be doing. All the best substance abuse programs are, at their heart, social-emotional learning programs.” If adults can help kids manage their emotions without using alcohol as a form of self-medication, says Lahey, we increase their chances of making it to adulthood substance-free. 

Understand the Adolescent Brain

The brain goes through two major growth spurts: from birth to age three and again in adolescence. During these periods, the “brain is acutely sensitive to outside influences including chemicals,” says Lahey. Simply put, the teenage brain is more prone to the damaging effects of drugs and alcohol than the adult brain.  


At this stage of brain development, adolescents are wired to crave risk, new experiences, social acceptance, and independence. At the same time, teens often struggle with impulse control and risk assessment. “If you want to see your teenager become even more volatile, add substances into the mix,” says Lahey.

But the very things that make the teenage years challenging can also be harnessed in powerful, positive ways. “The brain is primed right at that moment to seek novelty and boost dopamine,” says Lahey, so adults have “an incredible opportunity to push kids in a direction of positive risks that up their competence.” Let them engage in new, exciting activities that create that dopamine rush they crave. Encourage them to join a new club, try out for a part in the play, take that rock-climbing class, become a volunteer for a cause they care about, or explore the woods –  any activity that catches their attention and pushes them out of their comfort zone. Exercise, time in nature, team activities, and meaningful work all support mental health.

Amplify Protective Measures

Several factors put children at increased risk for substance abuse, including adverse childhood experiences, family history of substance abuse, low academic achievement, peer culture, and lack of school connectedness. But none of these factors are destiny, says Lahey, and she wants to absolve the shame and guilt that some parents may feel when they recognize their child is in a higher-risk category for one reason or another. Instead, she wants parents to feel empowered by what they can do, starting today.

There are plenty of ways adults can amplify protective measures that will reduce a teen’s risk level. These include getting them academic support; setting clear family expectations about substance use; building healthy sleep, exercise, mindfulness, and nutrition habits as a family; and enlisting other adult allies to help, such as mentors, pediatricians, guidance counselors, and coaches. Research shows that “as long as a kid has one supportive, protective adult in their life, then they can overcome a whole bunch of risk factors,” says Lahey.

Talk About It Openly and Honestly

When it comes to drugs and alcohol, our kids need transparent, honest, and evidence-based information from trusted adults. Lahey’s advice for having these conversations boils down to this: Start early and keep it up, because the more you talk the easier it gets. Twenty-nine percent of middle schoolers and 61 percent of high schoolers report that they have a close friend who uses substances. According to Lahey, we can inoculate kids by equipping them with useful information, including refusal skills. Practice scripts they can use when they encounter peer pressure – including an exit strategy, such as a word or emoji they can text you if they want you to come pick them up. 

And don’t worry about being a hypocrite if you use substances yourself, says Lahey. You can still urge your children to wait because chemicals interact differently with the adolescent brain than with the adult brain. “If you do harm to your brain during that period, there's no going back to fix it.”

Look for ways to help them understand how avoiding substance use is in their immediate best interest –  how it will positively impact their athletic and academic performance or personal goals. “Kids can feel really bulletproof, but you can help them understand how drug and alcohol use affects their hopes and dreams and goals –  which, of course, requires you to know what their hopes and dreams and goals are,” says Lahey. This personal approach taps into their internal motivation and self-efficacy –  or that “sense of control, agency and hope, even when the world around them feels out of control.”

Implement Evidence-Based School Programs

In Lahey’s research, she found that school-connectedness was the “only education-related variable that protected kids against every single adverse life outcome.” In other words, when kids felt safe and cared for at school, they had better outcomes on just about every measure. 

Research also shows that the more invested the principal and superintendent are in prevention programs, the more invested the entire school community will be –  leading to greater program efficacy. “It's really hard for one school nurse to pull it off alone,” says Lahey. “So many of the risk situations are community-based, so the solutions are going to be community-based, too.” 

Strong prevention programs have an SEL component, teach children refusal skills, and give them clear, compelling evidence that helps them understand how their brains work and how substances can affect their lives. School leaders can use the Blueprints for Healthy Youth Development registry to explore programs that have clear evidence of effectiveness. 


Despite the challenges, Lahey says that she feels “really optimistic” about our ability to support this new generation of teenagers. “There is so much we can be doing to help kids. It’s not like we have exhausted all of our options in preventing substance abuse. The programs are there, they are tested, and they are evidence-based. I'm hoping that what I've provided here is at least a way to think about getting started.”

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