Call them what you like – substance education initiative, Public Service Announcement, or propaganda – This is Your Brain on Drugs and Reefer Madness are just two examples of (comically) flawed attempts to educate youth about substances. Traditionally, substance education models have been fueled more by politics and morality than by a desire to develop an evidence-based approach to educating students (Reist, 2009). While not nearly as dramatic as the above examples, Ontario’s current substance education model has its own flaws. I argue that it is ineffective because it provides an incomplete picture of substances and relies too heavily on students’ ability to make difficult decisions. Further, it does not protect children from substances in any meaningful way: many students use alcohol, tobacco, cannabis, and other drugs before they leave high school, even though it is illegal to do so (CAMH, 2019) and substance education has been taught in schools for more than a century (Reist, 2009). I would suggest that Ontario move towards a more honest approach to teaching students about substances that is more realistic and less politically and morally motivated. Rather than focusing on prevention and punishment, such an approach would centre around substance literacy, harm reduction, and connectedness.
Issues
The Ontario HPE curriculum document fails to consider many of the factors that may affect substance use and decision-making, including personality and genetics (Canadian Institute for Substance Use Research, 2017). It asks Grade 4, 5, and 6 students to be more self-disciplined than adults. Outside school walls, alcohol advertisements abound; students walk by cannabis dispensaries and corner stores selling cigarettes regularly, and yet we expect that once they learn what substances are and how they affect their mental and physical health their curiosity will be tempered by this limited information. This is a simplistic approach to a complex issue. We are expecting more from adolescents whose ability to make decisions is less developed than their adult counterparts.
In addition, junior students rely on their peers for support, which fosters a sense of connectedness. This connectedness is also a key component of an effective substance education program (OPHEA, 2019). Here I would advocate a more personal approach to substance education. Talking openly and honestly about substances and addictions with people who use them is one way to provide an authentic learning experience for students that will pique their interest (Sibbald, 2009). The purpose is not to glorify using substances, but to provide accurate information about their effects, why people choose to use them, and the circumstances in which they first used them. This approach would allow students to have meaningful conversations about situations that might involve substance use instead of focusing solely on developing their abilities to say no. It may also provide context for students who are less interested in chemical differences between substances and knowing their effects than the human aspect of substance use (Sibbald, 2009).
Another focus of the substance use component of the HPE curriculum is describing the effects of substances on physical and mental health. (Ontario, 2019). This is a start. However, it does not answer the questions students want and need to know, such as, why do people use substances in the first place? Students who are curious about things, but feel they cannot ask their teachers or parents, ask their friends, or search the internet. Being exposed to misinformation about substances is potentially more harmful to students than educating them honestly about the reasons people use substances. Schools have a great opportunity to provide students with valuable information about substances, not only about their effects and how to say no to them, but why so many people use them.
How to Move Forward
An important consideration when thinking about substance use is that millions of Canadian adults and children use substances every day for a variety of reasons. Some children use substances like Ritalin or Concerta to manage symptoms of Attention Deficit Hyperactivity Disorder (Storebø et al, 2015). Many Canadian adults regularly use alcohol safely (Canadian Centre on Substance Use and Addiction, 2019). Adults and children use substances like Acetaminophen and Ibuprofen to cure aches and pains. In other words, there are many ways to use substances in a way that improves health rather than diminishes it (Canadian Institute for Substance Use Research, 2017).
There are also dangers associated with using licit substances. Further, many licit substances are similar in chemical composition to illicit substances (Reist, 2009), however, we focus our efforts on educating students about the dangers of illicit substances. Students should be educated not only about the effects of misusing illicit substances but licit substances also, which are in some cases easier to obtain. The same applies to illicit substances: education should focus more on harmful behaviours rather than substance use generally. By teaching students the benefits and risks associated with a wide range of substances, we will move towards the goal of improving students’ substance literacy.
Students will encounter substances, both licit and illicit, and will be presented with opportunities to use them. This cannot be avoided. They will be exposed to information from a variety of competing sources, some of whom have their best interests at heart and others who do not. Substance literacy is a way to help students navigate those competing claims (Reist, 2009).
Effective substance education depends on establishing and maintaining connectedness between students, parents, schools, and communities (Canadian Institute for Substance Use Research, 2017; CAMH, 2020; Joint Consortium for School Health, 2009; OPHEA, 2019; Sibbald, 2009; Reist, 2009). It has been proven that individuals more connected to their community are less likely to engage in risky substance use behaviour (Reist, 2009). Further, decisions related to substance use are heavily influenced by socioeconomic factors (Canadian Institute for Substance Use Research, 2017). We need to avoid moral judgments and extend help to those who need it. We need to teach our students to do the same. Promoting a culture of inclusivity and openness will increase the likelihood those who need help will seek it out.
It goes without saying that teachers need to exercise professional judgment when educating students about substances. Some topics may be more appropriate for their students’ age group or more relevant to their interests and experiences. However, teachers should not decide to wait until students are older to openly address substances because of a misguided fear they will encourage students to experiment with substances. This line of thinking is not based in reality and ignores the fact that many children under-13 have used substances, or have a friend or family member that does (Children’s Health Policy Center, 2014). Additionally, students become significantly more likely to try substances the older they get. Teachers should be educating students before this happens.
I propose an approach that: relies more on creating and maintaining connections than on students’ decision-making; provides more information about the positive and negative effects of substances on health; and involves a more compassionate approach to substance users that shifts focus to reducing harms associated with substances and away from passing judgment on the millions of Canadians who use a variety of licit and illicit substances regularly. I propose we educate students honestly and provide them with the information and skills necessary to live healthy lives.
References
Canadian Centre on Substance Use and Addiction. (2019). Alcohol. Retrieved from the Canadian Centre on Substance Use and Addiction website: https://www.ccsa.ca/sites/default/files/2019-09/CCSA-Canadian-Drug-Summary-Alcohol-2019-en.pdf
Canadian Institute for Substance Use Research. (2017). Understanding Substance Use: A health promotion perspective. Retrieved from the Canadian Institute for Substance Use Research website: https://www.heretohelp.bc.ca/infosheet/understanding-substance-use-a-health-promotion-perspective
Centre for Addictions and Mental Health. (2019). Drug Use Among Ontario Students: Detailed Findings from the Ontario Student Drug Use and Health Survey. Retrieved from the Centre for Addictions and Mental Health website: https://www.camh.ca/-/media/files/pdf—osduhs/drugusereport_2019osduhs-pdf.pdf?la=en&hash=7F149240451E7421C3991121AEAD630F21B13784
Centre for Addictions and Mental Health. (2020). Primary Education Resources for Teachers. Retrieved from the Centre for Addictions and Mental Health website: httpds://www.camh.ca/en/health-info/guides-and-publications/primary-education-resources-for-teachers
Children’s Health Policy Centre, Simon Fraser University. (2014). OVERVIEW: Alcohol and drugs don’t mix with parenting. Retrieved from https://childhealthpolicy.ca/wp-content/uploads/2014/01/RQ-1-14-winter.pdf
Husak, Douglas N. (2002). Legalize This! The Case for Decriminalizing Drugs. Verso.
Joint Consortium for School Health. (2009). Addressing Substance Use in Canadian Schools. Retrieved from https://www.jcsh-cces.ca/upload/JCSH%20Substance%20Use%20Toolkit%20SchoolFamilyCommunity%20v1.pdf
Ontario. (2019). The Ontario curriculum, grades 1-8: Health and Physical Education. Toronto: Ontario, Ministry of Education. Retrieved from http://www.edu.gov.on.ca/eng/curriculum/elementary/2019-health-physical-education-grades-1to8.pdf
OPHEA. (2019). Cannabis Education: Activate the Discussion. Elementary School Discussion Guide. Retrieved from the OPHEA website: Cannabis Education: Activate the Discussion Elementary School Discussion Guide (ophea.net)
Reist, D. (2009). Rethinking Drug Education. Visions Journal. Retrieved from the Here to Help website: https://www.heretohelp.bc.ca/visions/schools-vol-5/rethinking-drug-education
Sibbald, A. (2009). Let’s Not Talk About It? Teaching teens about substance abuse. Alcohol & Other Drugs. Retrieved from the Here to Help website: https://www.heretohelp.bc.ca/visions/schools-vol5/lets-not-talk-about-it
Storebø, O. J., Ramstad, E., Krogh, H. B., Nilausen, T. D., Skoog, M., Holmskov, M., Rosendal, S., Groth, C., Magnusson, F. L., Moreira-Maia, C. R., Gillies, D., Buch Rasmussen, K., Gauci, D., Zwi, M., Kirubakaran, R., Forsbøl, B., Simonsen, E., & Gluud, C. (2015). Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). Cochrane Database of Systematic Reviews, 11, [CD009885]. https://doi.org/10.1002/14651858.CD009885.pub2