Adolescence is a difficult and confusing time for a child. External stressors often pressure teenagers to act out and employ unhealthy coping mechanisms. They may turn to alcohol, tobacco, and other drugs (ATOD) to delay or avoid their anxieties altogether, causing them to exhibit more risky behaviors and putting them at risk for adverse health impacts later in life. Arkansas regional prevention providers deter the onset of ATOD among youth through changing perceptions, attitudes, behaviors, and local conditions that increase the risk of ATOD abuse.
An estimated 16% of students in 2020 reported using a drug, including tobacco or alcohol. While this number has been steadily decreasing since the start of the pandemic, drug usage can lead to patterns of risky behavior that put youth at risk for short and long-term health impacts. To deter the use of ATOD among adolescents, experts must know the scope of abuse statewide. The Department of Human Services (DHS), Division of Adult, Aging, and Behavioral Health (DAABHS), and the MidSOUTH Center for Prevention and Training began collecting statewide data on adolescent ATOD abuse to drive decisions about where to focus their efforts.
Once they had enough data, they began dissemination and outreach through the Arkansas State Epidemiological Outcomes Workgroup (SEOW). Arkansas Foundation for Medical Care (AFMC) was the analytic and advisory agent in the workgroup. We consolidated the data into a report titled Risk Factors for Adolescent Drug and Alcohol Abuse in Arkansas. For over 20 years, this book has provided community and government leaders with valuable behavioral health data they can use to inform prevention programs throughout the state.
Behavioral Health Data
Researchers collect data throughout the state each year through surveys. The Risk Factors book divides the statewide data into 13 regions based on county. DAABHS and MidSOUTH established regional prevention providers (RPPs) to promote ATOD prevention efforts at the regional, county, and community levels. RPPs respond to the needs of their respective regions and support anti-drug coalitions and community organizations that support drug prevention efforts.
The book also includes demographic data for the state (percentage of children, homeless children enrolled in public school, unemployment rates, children living in foster care, etc.), which helps narrow down demographics and regions that need the most intervention. Each demographic factor includes a definition, source, and state rate. Some data also includes graphs of the data from previous years so RPPs know the results of their efforts.
Perhaps the most valuable parts of the Risk Factors book are the state, region, and county profiles. These profiles provide a detailed breakdown of each risk factor per county. Some factors have green check marks beside them, denoting when a risk factor has a more significant occurrence at the county or region level than at the state level.
ATOD Prevention Strategies
Arkansas' 13 RPPs use the Risk Factors book to inform their prevention efforts throughout the state. Hayse Miller, an RPP at Family Service Agency in Region 9 (Saline, Pulaski, Lonoke, and Prairie Counties), says prevention efforts in his region include various outreach and education techniques. "We provide general information about reducing ATOD, but we also provide organizations in our region with information that relates to mental illness," he says. One of the recent initiatives Region 9 has recently rolled out is the Stop the Stigma project, which encourages law enforcement officers and first responders to be more sensitive when interacting with someone with SUD or other addiction-related disorders. "We also conduct assessments in Saline and Pulaski counties for law enforcement, prosecutors, judges, and treatment providers and discuss barriers to treatment," Hayse says.
Region 9 also follows the Center for Substance Abuse Prevention's six prevention strategies:
- Information Dissemination — When an organization calls Hayse, he goes through an assessment to ask what types of materials and information they need. "Sometimes, I'll give them pamphlets about ATOD or a related topic. Other times, they need information for a presentation they're giving, and I'll provide that to them," Hayse says. Some RPPs even put up signs and billboards in the community that raise awareness of the nature and extent of ATOD use, abuse, and addiction.
- Education — RPPs also conduct peer-leader programs and youth and adult mentoring groups to improve critical life and social skills. "I was part of a program where 20 of us got together and provided employability training," Hayse said. "We covered communication, job interviewing, conflict resolution, and other topics." The educational courses are meant to be a two-way interaction between the educator and the participants. The interaction and ability to ask questions separate this strategy from information dissemination, where RPPs simply provide information to other organizations and community members without interacting with the public.
- Alternatives — Each region provides alternative activities and social events that exclude ATOD to redirect the target audience from settings that feed their addiction. Instead, attendees participate in safe and healthy activities that provide positive alternatives to alcohol and drug use. "We are running a hooked on fishing activity where community members have access to a free fishing pole, and they can go fishing as an alternative to abusing drugs. We redirect the unhealthy behavior to something positive through activities like this," Hayse says.
- Problem ID and Referral — "Some community members call me and ask me to help them find a local recovery service in the community," Hayse says. "When that happens, I will refer them to an organization that can meet their needs." Usually, RPPs screen individuals to identify exposure to multiple risk factors and if primary prevention services are sufficient or if they need referrals to treatment elsewhere in the community.
- Community-Based Processes — This strategy involves assessing community needs and assets and bringing together community organizations to address those needs. "When we identify an issue, we invite others from the community to come together and gather all the resources we need to address the issues present in the community," Hayse says. RPPs provide training for community members and volunteers to ensure that, when they are in the field helping with prevention efforts, they're all educated on the same processes and procedures for addressing ATOD and other issues.
- Environmental — Prevention strategies also involve the creation of policies, procedures, laws, and regulations that influence the incidence and prevalence of substance use in the general population. "A few years ago, you could purchase cigarettes in Arkansas at age 18. Now, the age is 21," Hayse says. RPPs were behind this change, which helped to reduce the prevalence of underage tobacco use throughout central Arkansas.
By following these six prevention strategies, Hayse and the other RPPs across the state ensure that prevention efforts are successful. They continually assess and alter their strategies and approaches to best fit the community's needs.
Given the Changing Landscape, RPPs Must be Ready to Adapt
One of the most significant parts of ATOD use that Hayse has noticed is a recent uptick in e-cigarette and vape users. "This has been a community-wide problem," Hayse says. "We have received calls of children being referred to poison control because they are ingesting flavored nicotine packs for vapes." Hayse says that children believe that since the packs smell good, they are harmless, but they are very poisonous.
Overall, though, trends fluctuate constantly, depending on the substance. One year, tobacco use will go down; the next year, it will go back up. It is important, however, that the RPPs continue to assess their regions and rely on data from the Risk Factors book to stay aware of trends and respond accordingly.
"With every coalition meeting that we had," Hayse says, "I would take copies of the Risk Factors book with me so we could talk about data from each specific county or region." Hayse also used the State Epidemiological Outcomes Workgroup book in his meetings. RPPs find that access to the Risk Factors and SEOW books is beneficial because they can glance at the data and take more hands-on approaches to address specific substances.
How Can Others Help?
Health care professionals and other responsible parties can help deter the onset and first use of ATOD among youth and adolescents by setting an example. "Right now, we're still acting on that old cliché, 'Do as I say, not as I do,'" Hayse says. "If you go to the fair or a community event, adults often walk around with open cans of beer or openly smoking cigarettes. They're not being discreet about it. That has an impact on youth."
Hayse also mentioned that musical performers sponsored by the ATOD industry negatively influence children and teens. "We have to change our actions so that we can say 'Do as I say and as I do," Hayse says. "Some people have a skillset of being enthusiastic and engaging. Use that skill to influence others." Hayse says society must also learn to shed its holier-than-thou attitude toward ATOD use. "We need to get away from the mindset that kids who use ATOD are bad. They're not bad. They just need the proper example to be set," he says. "I try to remind young people who say 'we all make mistakes' that using drugs and alcohol are not mistakes. They are decisions. A mistake is slipping and falling on a puddle of water on the floor or rushing to get to work, not paying attention, and running a red light. Choosing to drink or do drugs is not a mistake. It's a choice you make."
Through education, community involvement, referrals, and policy change, RPPs play a critical role in implementing prevention efforts throughout the state. They rely on community members and other health care professionals to help further impact individuals who use ATOD. Call the Family Service Agency (501-372-4242) or any of Arkansas's Regional Prevention Providers and get involved in activities, education, and prevention efforts that reduce ATOD use and improve health outcomes throughout our state.
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