Alcohol and other drug prevention for older adolescents: It's a no brainer

Abstract

Older adolescence represents a critical period of brain development whereby the prefrontal cortex, responsible for higher level thinking and emotional regulation, is under construction. During this period, the brain is wired to underestimate risk and overestimate pleasure, which primes young people towards risky, pleasure-oriented experiences. Substance use during this time can hinder brain maturation and lead to development related disorders. However, young people are the most likely to drink at risky quantities, use cannabis, MDMA and cocaine in the previous 12 months than any other age group. Despite this, there are no validated, age-appropriate prevention programs targeting school leavers, which leaves a group of young people to navigate a landscape where drug use is the most common, without formal support. Drug and alcohol prevention programs should be developed for this age group that combine features of universal prevention programs and targeted intervention programs to support the wider range of drug use behaviours relevant to this older audience. This article outlines potential evidence-based strategies that programs could focus on in the future. [Debenham J, Newton N, Birrell L, Askovic M. Alcohol and other drug prevention for older adolescents: It's a no brainer. Drug Alcohol Rev 2019;38:327-330]

Age-Specific Rates of Onset of Cannabis Use in Mexico

“…First, the differences in the rates of onset by age, sex, and their progression across cohorts and periods in the Mexican population can inform interventions addressing prevention and harm reduction and can potentially increase their effectiveness. For example, targeted policies, such as behavior-modifying interventions for adolescents [47,48,49], could make a more efficient use of their resources by acknowledging the increasing rates of onset among female adolescents in their design and implementation (i.e., reframing eligibility criteria, and redesigning screening and demographic-based strategies). Future changes to the regulatory framework in the country will potentially alter patterns of cannabis use and perceptions of harms among the population, and in particular, these changes will put an emphasis on prevention and harm-reduction among adolescents [44,45].…”

Effects of Alcohol on the Developing Brain: The Adolescent at Risk

“…In the face of all the harm that alcohol can cause to adolescents' health, whether in the present or in their future life, it is fundamental that measures are adopted that can act preventively. In order to do this, it is necessary to seek to involve the family, friends, teachers and all workers in the health and education areas, directing efforts to identify current patterns of use and alcoholrelated harms, and problems related to consumption or after effects use and to assist adolescents to link patterns of consumption with current life style, social or health-related problems [56].…”

Effectiveness of a neuroscience-based, harm reduction program for older adolescents: A cluster randomised controlled trial of the Illicit Project

“…In Australia, mandatory health curricula ensure students in Years 8–10 (ages 13–16) receive substance use education, however senior students in Years 11–12 (ages 16–18) are not guaranteed the same education – despite this being the average age of initiation and escalation of substance useGuerin NaW, 2017; Xu et al, 2020;15 ( Guerin NaW, 2017 , Xu et al, 2020 ). Consequently, there are few programs targeting late adolescents ( Tremblay et al, 2020 )and late adolescent substance use prevention is lacking ( Debenham et al, 2019 ).…”

“…The finding, that prevention programs are more effective at reducing risky use, over single time use, suggests harm reduction targets should be a key consideration in the development of school-based interventions. Exploring new and innovative methods to engage young people in substance use harm reduction within the school environment is urgently required ( Debenham et al, 2019 ).…”