Drug Ed for Parents – It’s about relationships, not facts, stats and scare tactics

Parenting is a lot like being on a road trip. It can be fun to experience new places with our growing child, but it can also be challenging. It doesn’t help that we live in a society that emphasizes the hazards and highlights stories of youth in serious trouble. News flash – young people in BC today are doing pretty well (see Adolescent Health Survey 2013).

As parents (or those who support them) we want to do our best to help our kids thrive in today’s world. That includes helping them learn about substance use. Many of us struggle with how best to approach topics like substance use with our kids. Here are some fundamentals that can help:

  • Stay connected – more than anything, your child needs you! Show him (or her) you believe in him and support his interests. Foster a relationship that helps him, no matter what his age, talk about and share his thoughts and feelings.
  • Talk when it makes sense – every child is different, so there is no “right time” to start the conversation about alcohol or other drug use. But engaging children earlier in open exchange about the things that touch their lives is a helpful way to help them address those things. (What doesn’t help? Lectures and threats.)
  • Substance use is part of our culture – our children see people drinking around them, are exposed to advertising, hear about it in music etc. so this makes it an easy subject to bring up. Open-ended questions such as “what do you think about … ?” can be a useful way to start a conversation. Moving in to the teen years, you might ask questions like “When do you think you might be in a situation to use substances?” and “How do you think you would handle it?” Talking about alcohol or other drugs as they make choices on the path in to adulthood helps them to develop personal standards, minimize risks and critically assess popular assumptions about substance use.
  • Recognize we all make mistakes – and use them as opportunities to learn and to have an honest, open conversation with them. If you discover your teen has been using alcohol or other drugs, stay calm. Yelling and issuing threats does not work. It is important to not let our concerns and fears destroy our relationship with our child. Wait for the right time to have a conversation and when it is start by expressing your own concern “I’m worried because …” or “I’m afraid because …” and listen more than talk so your teen can express their own feelings, making sure they know they are listened to.
  • Be a positive role model – part of being a parent is modelling healthy behaviours and attitudes
  • Safety first! Ensure that your teen knows how to contact you or another trusted adult to find a safe way home, regardless of the situation they find themselves in.

Looking for more?

The Road Ahead: A Guidebook for Parents of Young Teens. A handbook to help parents of young teens make their trip through the teen years a positive experience for both.

Guide to Talking About Alcohol or Other Drugs. Having honest, open conversations about alcohol or other drugs is a key way to protect our children from harm related to substance use.

Cannabis Use and Youth: A Parent’s Guide. This guide explores facts and misunderstandings about cannabis and helps parents find ways to engage their children in conversations about cannabis (or any other subject).

Here to Help Infosheets. These touch on a variety of topics that may be of interest.

Cindy Andrew

Author: Cindy Andrew, Program Consultant, Helping Schools, Centre for Addictions Research of BC.

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC.

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Does Impaired Driving Reflect Impaired Learning?

If you’ve ever driven when really tired, or been in a car with a driver who’s really tired, you know what “impaired driving” feels or looks like. (For those who don’t: in a nutshell, it’s kind of scary.) Chances are, though, you don’t think of being tired as something bad. Instead, you know that being tired means you should be in bed, recuperating by sleeping for a while.

Drug-impaired driving is much the same thing. It’s less about whether a drug is good or bad, and more about where you are when you’re feeling a drug’s full effects. While avoiding intoxication may be the best option with any psychoactive drug, if it happens, the safest place to be enjoying or reversing the buzz is at home, at a pal’s house or in the back of a taxi or sober person’s vehicle. Almost anywhere but behind the wheel.

Even though we all know we shouldn’t drive impaired, it still happens.

  • In 2012, 6.5% of BC drivers tested positive for alcohol, and 7.4% tested positive for other drugs, cannabis and cocaine being the most commonly detected substances, according to a roadside survey report.
  • ICBC reports drug impairment (involving alcohol, illegal drugs and medications) was the key factor in 23% of fatal car crashes in 2013 (speed was key in 28%, and distraction in 29%).
  • Over the last five years, an average of 86 people per year lost their lives in impaired driving crashes on BC roads.

So, what’s going on with us? What narratives are running through our heads about our rights and responsibilities as drivers? What are the best ways to change some of our beliefs and behaviours? These are the kinds of questions we not only need to be asking ourselves, but should also form the foundation of our drug education programs in schools.

Instead, most of the conversations we have with young people about drugs are not really conversations at all, but lectures aimed at scaring students into saying whatever the adults in the room want to hear. The problem with this approach is that it isn’t working. Young people, particularly young males, continue to make up the bulk of those taking unnecessary risks with substances and vehicles. We should be wondering why, and we should be talking to students more often about the things that drive their decisions to drive under the influence.

A cartoon image of a brain listing different types of impairments

A screenshot from the drugsanddriving.ca website.

Honest, open and real conversation about alcohol and other drugs is one of the goals of Drugs and Driving, a project involving a range of classroom learning activities, a variety of web apps, and even a free iPhone app. Drugs and Driving is designed for Grade 10 students but can be used in other grades as well. The program is less about telling kids about the dangers of drugs and driving and more about helping them reflect on a range of issues related to impairment. What are the things that might cause impairment? How do I know if I am impaired? Why should I care? How do we make decisions? How can I influence the decisions of my peers? These are important questions for all of us.

Bodner Nicole-

Author: Nicole Bodner, Centre for Addictions Research of BC

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC.

What good are drinking guidelines if no one knows about them?

Do you know the effects that having a glass of wine a night is having on your health? Or how your risk for certain diseases and cancers increases with every drink? If your answer is “no,” then you aren’t alone. Despite the fact that 78 percent of us drink, many Canadians aren’t aware of Canada’s Low-Risk Alcohol Drinking Guidelines (LRDGs), let alone what the guidelines are (no more than two a day, 10 a week for women; three a day, 15 a week for men). This is why the Canadian Centre on Substance Abuse (CCSA), the Centre for Addictions Research of BC (CARBC) and the Canadian Vintners Association (CVA) explored the educational potential of social media by taking to Twitter this summer to promote the LRDGs.

Part of the reason there isn’t much awareness around the guidelines could be that they are relatively new. Published in 2011, the LRDGs were developed by the National Alcohol Strategy Advisory Committee using existing provincial drinking guidelines, such as those produced by CARBC, the Centre for Addiction and Mental Health and Éduc’alcool. The LRDGs provide men and women with drinking limits that can help to reduce alcohol-related harms like chronic illness and injury. Resources such as a brochure, a poster, and summaries on the relationship of alcohol and cancer, and the impact of alcohol on youth and women have all been developed to promote the guidelines, but the Twitter campaign marked the first time that a coordinated, multi-partner social-media strategy had been used to educate people.

Working together, CCSA, CARBC and the CVA planned and launched a month-long Twitter campaign that ran from mid-August to mid-September, featuring weekly themes, informative resources and a campaign hashtag (#CdnLRDG in English; #DCAFRcan in French). In addition to the above brochures and posters, some of the more lighthearted resources shared through the campaign included the Home Bartending Challenge and the How to Drink Properly video series. The late-summer time frame allowed for tweets related both to events where drinking commonly occurs, such as summer long weekends and frosh week, and to alcohol-related health promotion days, such as International Fetal Alcohol Spectrum Disorders Awareness Day. Online tools such as bitly link tracking, which allowed the group to see what resources got the most clicks, Hootsuite and Twitter analytics, Google Analytics, and Cision social media monitoring, helped the group measure success, and see what worked and what could be improved upon.

A sample of some of the #CdnLRDG tweets seen during the campaign.

A sample of some of the #CdnLRDG tweets seen during the campaign.

Twitter provided an easy way to spread low-risk drinking messages and engage with respondents. By sharing and retweeting each other’s content, participants reached new audiences beyond their own Twitter followers. The #CdnLRDG campaign hashtag was used in every tweet, so anyone interested in the campaign could follow all conversations. Participants could also include other alcohol-related hashtags in their tweets, effectively “crashing the party” of other conversations — another great way to open up the conversation to more audiences.

Overall, the Twitter campaign increased website visits an average of 78% for the three organizations leading the campaign. However, in analyzing Twitter engagement, it was mostly healthcare organizations and workers retweeting content as opposed to the general public, who might have seen the tweets, but just not engaged in conversation. This isn’t surprising, since most of CCSA and CARBC’s followers are healthcare organizations. Extra efforts will be required to directly reach the general public in future campaigns. Yet the LRDG campaign highlights what educational goals can be accomplished with social media and great partnerships!

Authors: Tina Barton, Communications Advisor; Sheena Gereghty, PhD, Knowledge Broker
Canadian Centre on Substance Abuse

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC.

Drug Education Takes Many Forms

Drug education does not solely require educating people about drugs; it can also mean educating them about how to use drugs safely. This increases their capacity to mitigate the risks related to drugs, empowering them to manage their substance use. In turn, this helps them make better decisions about use in the context of their own unique situation.

The Safer Use series, developed by the Centre for Addictions Research of BC, offers practical ways for people who use substances to be active players in their own well-being, including helping them develop skills in managing their patterns of use, as well as adopt safer modes of use and ways to mitigate risk.

Safer use

One of the challenges in developing the series was how to address effectively the needs of people who are experienced in substance use yet may be using in risky ways.  As the development process unfolded, it was helpful to constantly ask is the content

  • Easy to understand. “Clear but not simplistic” is a useful principle to keep in mind. The aim is to help the reader grasp and use the content as easily as possible. Some ways to do this include using audience-appropriate everyday words (e.g., “drunk” rather than “intoxicated”) as well as clarifying with illustrations and using informative headings such as “before you start” and “things to avoid.”
  • Relevant. Knowing the audience is so important. Material that is tailored to address specific concerns helps engage people and draw them in. For instance, techniques of safer injecting may matter to street-entrenched youth, but would be less relevant for club- or party-going youth who may be more concerned about “safer tripping” strategies.
  • Useful. Ensuring suggested practices are doable and practical improves the chances they will be adopted. This involves going beyond the ideal (e.g., recommending the use of sterile water) and providing more accessible alternative measures (e.g., boiling tap water). While it’s critical to ground content in sound theory and evidence, lengthy explanations of the research behind a suggested practice can obscure key messages.
  • Credible. Making sure the content is objective and balanced helps build trust. Drug education efforts risk being discredited when messages conflict with the experience of the audience. Therefore it is important to offer an honest and even-handed discussion that acknowledges the positive effects of drugs as well as potential harms.

No substance use is completely without risk, but educating people who use drugs to manage use more safely affirms their self-efficacy – the capacity to increase control over their own health.

Reimer Bette-

Author: Bette Reimer, Research Associate, Centre for Addictions Research of BC

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC.

Risk of Injury: The Implications of Mental Health, Alcohol and Gender

Each year, hundreds of thousands of deaths occur due to intentional and unintentional injuries related to alcohol use. Alcohol impairs coordination as well as our ability to perceive and respond to hazardous situations, making it more likely that we will get hurt. Research shows the risk for injury increases as the amount of alcohol use increases. For example, someone consuming five or more drinks on one occasion is 10 times more likely to get injured in the following six hours. But are certain people more likely to get injured when they drink? Are there additional factors associated with alcohol use that could further increase your risk of injury?

In my Master’s thesis, I looked at how alcohol use, mental health symptoms and gender contributed to the risk of injury for British Columbians. I used data from the Alcohol and Other Drugs Monitoring Study, which collects data from people who are admitted to the Emergency department at the Royal Jubilee Hospital in Victoria and Vancouver General Hospital.

I found that the risk for injury increased as the amount of alcohol use increased. The greatest risk of injury is for men, and those consuming six or more drinks in the six-hour period prior to the injury event. I also found that mental health symptoms such as anxiety or depression exacerbated the effect of alcohol and the likelihood of injury among women. Women who consumed alcohol and had mental health symptoms were almost twice as likely to be injured compared to women without mental health symptoms.

Why would the presence of mental health symptoms place women at a greater risk for experiencing injury from alcohol use? It could be that women experiencing mental health issues are more likely to drink as a form of self-medication; however, it is difficult to determine the direction of this effect, as long-term alcohol use has been known to lead to the development of depression and anxiety. Another possible explanation is that because women with mental health symptoms are more likely to take medication to treat the symptoms, the alcohol may be interacting with the medication and resulting in detrimental effects. Finally, higher levels of impulsivity are found among individuals experiencing depression, and it may be that the combination of impulsivity and alcohol use could result in someone engaging in more risk-taking behaviors, thereby placing them at a greater risk of injury.

How can we use this information to help prevent future injuries? It is important that health care providers are aware of the combined effect of mental health symptoms and alcohol on risk of injury. If individuals presenting injuries at the emergency departments could be quickly screened for mental health symptoms such as anxiety and depression, the treatment of these symptoms could potentially result in a reduction of risky alcohol use and help to prevent future injuries. For future research, we hope to continue to look at the inter-relationships between these three factors on risk of injury. In particular, we want to look at whether the risk may differ when comparing violent to non-violent related injuries.

audra roemer

Author: Audra Roemer, Centre for Addictions Research of BC

Audra Roemer completed her Masters Degree in Clinical Psychology at the University of Victoria in July 2014 and will be starting her PhD in September 2014. She studied at the University of British Columbia for her Bachelors degree; her research interests include: substance use, family and individual risk factors, gender, prevention, violence and injury, and child and adolescent development.

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC.

Will minimum prices work to minimize harm?

The recent changes to pricing rules in alcohol-serving establishments across BC have been met by applause, discontentment, indifference — and confusion. In effect, two changes were announced: the fact that restaurants and bars can now have happy hour drink specials, allowing them to change the price of alcoholic drinks throughout the day, and the introduction of province-wide minimum drink prices, which apply at all times, not just during happy hour.

BC's new minimum prices for standard alcoholic drinks in booze-serving establishments.

BC’s new minimum prices for standard alcoholic drinks in booze-serving establishments.

Minimum unit pricing is not a new concept. All provinces, except Alberta and Quebec, have some type of minimum pricing policy. Even prior to these new changes, BC had minimum pricing policies in place in liquor stores, though prices were much lower than many other provinces. These new requirements will bring the rest of the province in line with municipalities such as Victoria, which have had minimum unit pricing policies and bylaws in bars and restaurants for quite some time to reduce violence and other late-night order problems.

While the new requirement to charge at least $3 per standard drink may cause prices to increase at some establishments, many British Columbians will likely not notice the implementation of the minimum unit pricing—and in some instances, happy-hour specials will make booze cheaper than it was before. I can’t remember a time when I paid less than $5 for a beer at an establishment; $3 sounds like a steal. But minimum pricing isn’t really about getting “a good deal;” this bold move by the BC government is a step towards reducing alcohol-related harms in our province.

Every year in BC, there are more than 80,000 alcohol-related crimes, 1,800 alcohol-related deaths, and 18,000 alcohol-related hospitalizations. While many of us enjoy alcohol without incident, these staggering numbers remind us of how many of our fellow British Columbians are negatively affected by alcohol use. The introduction of minimum prices could reduce these numbers.

There is strong evidence that minimum alcohol pricing avoids punishing the majority of responsible drinkers while having the greatest impact on the behaviour and health of those most at-risk. Using BC hospital data, a recent study published in the American Journal Public Health found that for every 10 percent increase in minimum prices there was an immediate 9 percent reduction in hospital admissions for injuries and poisonings ‒ and a similar reduction in serious illnesses caused by alcohol (such as liver cirrhosis and cancers) two to three years later. Similarly, we have found immediate and delayed effects from minimum price increases on alcohol-related deaths. Is $3 really such a steep cost for reducing harm?

The BC government has listened to the strong research evidence supporting minimum prices and has taken a step in the right direction by implementing these prices for bars, restaurants and other establishments that serve alcohol. It is refreshing to see decisions being made will protect British Columbians while also respecting that alcohol is an important part of our culture and economy. However, in order to fully realize the harm-reduction potential of minimum pricing policies and offset the potential impact of happy hours, government needs to follow through on updating and overhauling minimum pricing in liquor stores. According to our research, this will have a much larger impact on high-risk consumption and related harms.

Kara Thompson, CARBC

Author: Kara Thompson, Centre for Addictions Research of BC

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC

Reducing harm? There’s an app for that.

Imagine you’re out enjoying a sunny patio at a pub with a few friends. You’re just about to finish your pint of beer and are really craving another one, but are trying to cut back on your drinking. You pull out your phone and open up an app that reminds you your goal for the week is to not have more than two standard drinks per day, and that pint you punched into the tracker was actually 1.7. You pause for a moment, then take a look at coping strategies you’ve tracked over the past few weeks to help deal with the desire to drink. One you’ve found particularly effective is treating yourself to a fancy booze-free cocktail while out with friends, so you order one of those instead of another beer.

Given our society’s increasing tech obsession, it’s no surprise that harm-reduction tools have made their way into the digital realm. Here are three helpful Canadian web- or app-based harm-reduction tools we’ve come across in our travels (or, in one case, created ourselves). Are there others you’d like to add? Share them with us!

saying whenSaying When: How to quit drinking or cut down: This app was designed by the Centre for Addiction and Mental Health. It’s the app I basically described above: it starts by asking you some questions about your drinking habits, the impacts of your drinking and goals you would like to set for yourself, then reminds you of Canada’s low-risk drinking guidelines. You can then track both your drinks and urges to drink, document effective coping strategies and access other information on tips for meeting your goals or accessing more help if you feel you need it. It actually reminds me of some popular fitness tracker apps that are available these days.

 

good to goGood to Go? This app was developed as part of our Drugs and Driving website, which is aimed at helping young people to make informed decisions about getting behind the wheel after using a substance. The app includes a brief quiz that asks you questions about things like your mood, what substances you’ve used and how long ago you used them and then lets you know if you are “good to go” or not. But it is really designed more as a fun educational resource with embedded videos and factual content than as a real-time screening tool. It builds awareness about how different substances and other factors can impair your driving in different ways.

 

game iqGam_iQ: This quiz website is one of BC Responsible Gaming‘s prevention efforts. Answer the questions to find out how much you know about gambling, how to gamble responsibly and the resources available if you are a problem gambler. It’s also aimed at younger folks and initially launched with a chance to win a post-secondary scholarship. While the prize has already been awarded, it’s a brief and interactive way to get people thinking about gambling responsibly. The website also contains lots of other online tools aimed at different age groups or demographics.

If you have found any other harm-reduction apps, websites or digital tools, we would love to hear about them!

amanda photo

Author: Amanda Farrell-Low, Research Assistant: Social Media, Centre for Addictions Research of BC

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC