substance use – Page 4 – Matters of Substance

When we hear the term “harm reduction,” we often think of supervised consumption services, needle exchanges or clean crack pipes. These are all important, life-saving measures, but is there a way harm-reduction can be applied to more casual substance users, such as the student who takes MDMA at a music festival, or the guy who likes to have a few beers after work or on the weekend?

About 15 years ago, I moved to Victoria from a small town in northern Canada to go to university. Almost immediately, I was introduced to the electronic music community. Soon, I was spending many a weekend dancing the night away at bush parties, sweaty halls or cramped basements. The scene was vibrant, welcoming and offered opportunities to experience all kinds of new things—including drugs I had never heard about before. Suddenly, I was seeing people ingest things with names I couldn’t spell or pronounce. I had a lot of questions: what did these drugs do? Where did they come from? Were they safe?

Luckily, there was an easy way to get some answers. At almost every one of these parties, there was a booth decked out in Christmas lights and beaded bracelets. A hand-painted banner was draped across the front that read “IslandKidz.” Modeled after the Dancesafe movement emerging around the same time in the U.S., the booth and its tireless volunteers were on hand to give out balanced information on various substances, hand out safe sex supplies, test pills or powders for adulterants, or just be a sober person to talk to if you were feeling overwhelmed or needed a safe space. They weren’t there to condone or condemn you for using drugs; it was your choice, and they believed you had the right to accurate information in order to make an informed decision.

An old photo of the IslandKidz booth in action.

I couldn’t believe that a service like this existed. (And, it turns out, we were lucky to have it; many other similar organizations weren’t able to operate with the relative ease that IslandKidz did at the time.) It made me feel empowered and respected, not vilified or dismissed—as many in that subculture often felt, whether they chose to use drugs or not. I didn’t know it then, but this would be my first encounter with harm reduction—and it would be far from my last. I would eventually end up volunteering for IslandKidz, driving down countless logging roads and spending many a late night chatting with partiers, handing out info flyers, and scraping mystery pills to see what they might contain.

Harm-reduction organizations like this appear to be making a comeback these days; look at groups like Karmik in Vancouver, ANKORS in the Kootenays, DanceSafe across the U.S., or Toronto’s TRIP Project. But they are far from the only harm-reduction measure trying to reach recreational substance users. In this series, we will hear about a website offering safer-use limits for illicit drugs developed by users themselves, a report that became a touchstone for almost every media article on festivals this summer, and some advice on ways to possibly avoid “bad” ecstasy. We hope these pieces help expand your idea of what harm reduction can be.

Author: Amanda Farrell-Low, Research Assistant, 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

More than half of the people who seek help for an addiction also have a mental illness. These concurrent disorders present some of the most complicated and difficult-to-treat cases for our healthcare system. The links between mental health and substance use are complex, and causality can vary or be unclear. For example, a young person might use alcohol to cope with anxiety; on the other hand, the use of alcohol and drugs may promote or worsen the presence of psychological symptoms. Regardless of the direction, one way to approach the problem is to try to understand the common factors that can underlie both.

Research suggests there are many developmental pathways through which substance-use disorders and mental illnesses arise, but let’s look at one example: a child who tends to be socially withdrawn, displays emotions such as anxiety and depression, and is fearful of new experiences. Children with these characteristics seem to be at a greater risk of developing concurrent disorders. One study has shown that children with this temperament at age three were more likely later in life to attempt suicide, meet the criteria for depression, and experience alcohol-related problems. Another study of those showing these behaviours in early childhood revealed heightened activity in brain areas sensitive to reward during adolescence, which was later tied to higher levels of substance use in young adulthood.

At first blush, the developmental path to concurrent disorders might seem unavoidable, but with increasing knowledge of risk factors comes the capacity to address the issue from a preventive approach. Often overlooked, children who are socially withdrawn and anxious can be seen as less problematic by parents and teachers than their peers with overt behavioural problems. Because of such tendencies, the essential first step towards intervention is to inform parents, childcare professionals and teachers about how to detect concerning behaviours in children.

While drug-based education aimed at preventing or delaying substance use is often implemented in schools, earlier interventions that enhance social skills are lacking. Emerging evidence suggests that such interventions can be effective in addressing problems that can lead to concurrent disorders later in life. Interventions to enhance parenting skills can be beneficial in reducing behavioural and substance use problems. School-based programs where teachers are trained to implement curricula aimed at improving cognitive, emotional and social competencies in young students are showing promising results, but need to be further examined to ensure their effectiveness. Each child is unique and the best intervention strategy will be one tailored to meet his or her specific needs.

To improve policies, programs and practices in addiction prevention, detection and treatment, the Canadian Centre on Substance Abuse (CCSA) has partnered with organizations such as the Mental Health Commission of Canada, the Canadian Executive Council on Addictions, and the Ontario Centre of Excellence for Child and Youth Mental Health to provide evidence-based information through a number of CCSA publications:

Childhood and Adolescent Pathways to Substance Use Disorders outlines personality and environmental factors that increase or decrease the risk of developing a substance use disorder (see also Concurrent Disorders).
Collaboration for Addiction and Mental Health Care: Best Advice offers principles and examples from practice to enhance much-needed collaboration between mental health and addictions services.
Systems Approach Workbook contains a module on Integrating Substance Use and Mental Health Systems that includes practical tips.

Concurrent disorders are both preventable and treatable, with earlier detection and intervention producing better long-term results. More information is available at www.ccsa.ca.

Author: Opal McInnis, M.Sc., Research and Policy Analyst, Canadian Centre on Substance Abuse; PhD Candidate, Department of Neuroscience, Carleton University.

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

Tag: substance use

Harm reduction in recreational settings

Detecting and addressing mental health and substance use disorders — the earlier the better