When it comes to prevention and treatment of substance abuse, the experts agree: what works for Jack in Peoria may not work for Jill in Santa Barbara.
Programs to change behavior are affected by individual family background, age, environment, and the drug being abused. ""People want simple answers, and there are none," says Ann Tafe, executive director of the Alcoholism and Drug Abuse Association in Boston. "There are too many levels to treating addiction."
But all treatment and prevention programs go head-to-head with a seductive American irony that contributes to substance abuse and confusion over values for teens. This is the blindspot between the heavy use of alcohol and all kinds of drugs by many adults, and society's desire to keep youths from abusing themselves with substances.
Ask Steve Ainsley, publisher of the Santa Barbara News Press about the irony.
When the city council of the nearby town of Carpenteria banned the sale of alcohol on city property for the annual festival, the Chamber of Commerce complained the event would lose money. And a youth-club sponsor said a beer truck at the event was their biggest fund-raiser.
"We wrote an editorial stating that if the festival died because alcohol wasn't served there, then the problem of alcohol is a lot bigger than the festival," Ainsley says. "We got lots of phone calls and letters opposing the editorial. What kind of message are we sending to our kids when Mom and Dad can't go out without drinking?"
Teachers, sociologists, and youth workers across the US say that most teens not only want guidance from Mom and Dad, but that parents or other adults who offer consistent, low-key advice about drugs and alcohol can make a difference.
"Parents are usually deeply involved in kids' lives in elementary school, and then less so in junior high, and not much in high school," says Mike Couch, principal of Dos Pueblos High School in Santa Barbara. "Frequently, if a student has a problem, the parent or parents have given up, or they don't know what to do."
But the results of several studies refute hopelessness. A study by Big Brothers/Big Sisters of America of nearly 1,000 children from ages 10 to 16 found that children from low-income households with mentors were 46 percent less likely to begin using illegal drugs than other kids, and 27 percent were less likely to begin to use alcohol at all.
A study by The Partnership for A Drug-Free America found that teens who reported learning about the risks of marijuana from their parents were half as likely to smoke it as those who hadn't. But even with parental discussions about marijuana, about 21 percent of the teens in the study went ahead and smoked marijuana.
This illustrates the difficulty of intervening successfully in the lives of many young people. Either from peer pressure, or seeing adults in their families use drugs, or because they believe media glamour, they experiment. And because alcohol and drugs persist within a larger community, many activists now endorse a "holistic" approach to prevention and treatment.
"People are beginning to understand that this notion of coming together as a whole community to deal with these problems means that nobody has the answer by themselves," says Paul Jellinek, vice president of the Robert Wood Johnson Foundation, which funds a number of community projects.
"Successful programs now and in the past," says Kathy Akerlund, a prevention specialist for Colorado's Alcohol and Drug Abuse Prevention Services,"generally have multiple strategies, not short-term programs, but long-term with plenty of options like tutoring, mentoring, getting the family involved."
The community-wide approach puts less of a focus on specific youth problems after they occur, instead paying more attention to strengthening the support of children in crucial developmental stages.
This means viewing families and teens as valued entities in the community. Schools, churches, and health-care and law-enforcement agencies organize in new ways. In turn, the community is strengthened.
In Minnesota, a three-year project confirmed the validity of a community strategy. Project Northland combined classroom and community interventions to prevent alcohol use by teens in 24 school districts. Some 90 percent of parents also became involved.
By combining skills training in school and alcohol-free extracurricular activities linked to the community, the project reduced the onset of alcohol use by 28 percent.