[R]esearchers told lawmakers Wednesday a prevention-focused model that has succeeded in Iceland is the best way to address substance abuse among Vermont teenagers.
In the last 20 years, Iceland has seen a drastic decrease in youth substance use — the percentage of 15- and 16-year-olds who had been drunk in the last month dropped from 42 percent to 5 percent between 1998 and 2016. The percentage of teens smoking daily went from 23 percent to 2 percent, and teen marijuana use dropped from 17 percent to 7 percent during the same time.
According to researchers, these shifts are because of a prevention model that targets the “causes of causes” of substance use — the environmental and social risk factors that lead to factors like boredom and disengagement that can cause youth substance use.
Now, researchers want to bring that Icelandic model to Vermont.
Michael Mann and Humberto Soriano presented to legislators at the Statehouse Wednesday about their work. The model is currently being implemented in 28 countries, as well as several states. Most recently, Mann has been working on prevention in West Virginia — a state he said is much like Vermont, particularly in terms of its rural population, only with more severe substance abuse problems.
Mann said results are much more difficult to accomplish through changes in individual behavior than through larger changes in culture — which is where the prevention model comes in.
“It may not be as sexy, but you get a lot more value for your money,” Soriano said. “An ounce of prevention is worth a pound of cure.”
The way the model works is that a government body — like Iceland, or the state of Vermont — will officially adopt prevention as their method for addressing youth substance abuse. Then, surveys sent out to schools can be used to determine each community’s strengths and challenges when it comes to youth substance use. The government is then able to work with specific organizations to implement solutions.
The researchers said the solutions they are interested in are not law or policy changes, but rather changes in the conversation and cultural norms among teens and their parents. For instance, they said in Iceland, teenagers used to party until 4 a.m. or later, and parents weren’t keeping close track of their childrens’ whereabouts. But Icelandic researchers used community education to change that norm, and now, most teenagers in Iceland have curfews around 11 p.m. — something they say has helped to significantly lower youth substance use.
Mann and Soriano said some parents aren’t going to be able to implement those changes at home, especially if they struggle with substance issues themselves. But they said prevention is much like a vaccine — you don’t need 100 percent of people to participate, the positive effects of 95 percent participation can carry over to that remaining 5 percent.
Mann, a professor at Boise State, and Soriano, a Chilean pediatrician, are two researchers who have studied the Icelandic model.
Mann said money for the programs is already there: he suggested the spending just needs to shift from the back end of the problem — on things like substance abuse treatment — to the front end.
But Soriano said the legalization of marijuana works against these prevention efforts. He said research has shown that greater access leads to greater consumption, and that Vermont’s 2018 legalization will certainly increase youth access to the drug.
“A pillar of American democracy is freedom, but my freedom stops when it starts hurting someone,” Soriano said.
Legislators in the Senate Committee on Health and Welfare and the House Committee on Human Services expressed interest in the Icelandic model. Sen. Virginia Lyons, D-Chittenden, called the researchers’ presentation “really effective,” and called attention to S.146, a bill that is proposing the creation of a Substance Misuse Prevention Advisory Council to replace the current Alcohol and Drug Abuse Council.
“In many areas in Vermont, it’s where you live and what resources you have,” said Holly Morehouse, executive director of Vermont Afterschool, an advocacy group. “Many of our young people in Vermont are isolated and don’t have the transportation or the resources to connect with one another or strong adult role models. … This isn’t a program you do for eight weeks, it’s really a whole approach to community.”
