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Abstract
BackgroundReducing harms of youth substance use is a global priority, with parents identified as a key target for efforts to mitigate these harms. Much of the research informing parental responses to youth substance use are grounded in abstinence and critiqued as ineffective and unresponsive to youth contexts. Parental provision of substances, particularly alcohol, is a widely used approach, which some parents adopt in an attempt to minimize substance use harms; however, research indicates that this practice may actually increase harms. There is an absence of research exploring youth perspectives on parental approaches to substance use or the approaches youth find helpful in minimizing substance use-related harms.MethodsThis paper draws on interviews with youth aged 13–18 (N = 89) conducted within the Researching Adolescent Distress and Resilience (RADAR) study in three communities in British Columbia, Canada. An ethnographic approach was used to explore youth perspectives on mental health and substance use within intersecting family, social, and community contexts. This analysis drew on interview data relating to youth perspectives on parental approaches to substance use. A multisite qualitative analysis (MSQA) was conducted to examine themes within each research site and between all three sites to understand how youth perceive and respond to parental approaches to substance use in different risk environment contexts.ResultsWithin each site, youths’ experiences of and perspectives on substance use were shaped by their parents’ approaches, which were in turn situated within local social, geographic, and economic community contexts. Youth descriptions of parental approaches varied by site, though across all sites, youth articulated that the most effective approaches were those that resonated with the realities of their lives. Zero-tolerance approaches were identified as unhelpful and unresponsive, while approaches that were aligned with harm reduction principles were viewed as relevant and supportive.ConclusionsYouth perspectives illustrate that parental approaches to substance use that are grounded in harm reduction principles resonate with young people’s actual experiences and can support the minimization of harms associated with substance use. Evidence-based guidance is needed that supports parents and young people in adopting more contextually responsive harm reduction approaches to youth substance use.
Highlights
Reducing harms of youth substance use is a global priority, with parents identified as a key target for efforts to mitigate these harms
Recognizing the key role that parents play in influencing the amount and frequency of youth substance use as well as resultant harms, there is a strong focus in research and practice to develop and deliver public health campaigns and family-based interventions aimed at supporting parents in minimizing the harms of youth substance use [4,5,6]
Conducted in British Columbia (BC), Canada between 2012 and 2014, this multisite qualitative study drew on ethnographic approaches to understand how youth experiences of mental health and substance use are shaped by their family, social, and community contexts [21]
Summary
Reducing harms of youth substance use is a global priority, with parents identified as a key target for efforts to mitigate these harms. Global statistics demonstrate that substance use is concentrated in youth populations [2], and the WHO [1] identifies youth as vulnerable to substance-related harms In response to these concerns, the United Nations’ General Assembly convened a special session in 2016 focusing on the world’s drug problem, which included a roundtable discussion focusing on the “significant health challenge” of child and youth substance use [3]. Much of this work has been in the area of drug use prevention, which has largely reflected abstinence-based, zero-tolerance ideologies [7] Such approaches have been critiqued as unresponsive to many youth contexts, and ineffective in reducing harms associated with substance use, in part because they deter youth from seeking help in instances of unsafe use, such as intoxicated driving or over-consumption [7,8,9,10]. Youth voices have been absent from the development and implementation of these approaches, which has contributed to the lack of resonance of parental strategies with the actual context of youths’ lives, and has limited opportunities for parental responses to youth substance use that effectively minimize harm [10]
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