I started my career 16 years ago as a case manager for people who had substance use and mental health disorders. After a few years, the stories of my clients’ lives began to meld together into a fairly complete picture of how the community had forgotten prevention.

Every one of them had started using drugs and alcohol as young teenagers, mostly to deal with the pain of traumatic events in their childhood. Many had acted out in ways that got them suspended, expelled and eventually jailed.

As adults, they longed for someone who loved them unconditionally, which is what I suppose they longed for as children as well. Their stories and their perseverance despite incredible hardship, brought me to prevention.  

For the past 10 years, I have been working at The Opportunity Alliance, supporting communities in Cumberland County in their efforts to prevent young people from using alcohol and drugs. I have seen prevention work.

It may not always seem like prevention works, as Maine is in the midst of an opiate epidemic, but the seeds of this current problem were sown many years ago. The prevention efforts that are now underway need more support from the community to keep us from having a new epidemic five to 10 years from now.  

In the communities that have engaged in prevention efforts with The Opportunity Alliance, there are statistically significantly fewer young people in 2015 than in 2009 reporting they used tobacco, alcohol or misused prescription drugs on a regular basis.

This is what the communities are doing:

Encouraging young people to wait as long as possible to use any substance.

The longer young people wait to use any alcohol or drugs, the lower their risk of having a substance use disorder later in life. While not all people who use drugs and alcohol at an early age will become addicted, most people who have a substance use disorder started at an early age.

The brain is still developing until age 25, especially the part of the brain controlling judgment. This is why young people make riskier decisions than adults when they use drugs and alcohol, and why early use can impact the development of decision making for a lifetime. When young people wait to try substances, they give their brain time to develop and are more likely to make better decisions related to their use.

Providing nurture and structure.

Young people thrive when they are cared for (nurture) and when adults create healthy boundaries (structure) for them. When nurture and structure are balanced, young people are less likely to use drugs and alcohol.  

This balance looks like parents telling their child they love them and therefore will call other parents to make sure there won’t be alcohol at the party. It looks like the principal ensuring that a student caught using marijuana at school gets the education and support they need, not just a suspension. It looks like police officers enforcing alcohol and drug laws, but diverting young offenders to effective education and support programs.  

Having rules and consistently following through with the rules.

There’s no need for harsh punishments, just good follow through. When the consequences are too harsh, people turn a blind eye to what might look like “experimental” substance use. The teacher, parent, police officer, coach — no one wants to be responsible for a young person missing out on more school, friends, freedom or sports than is absolutely necessary.

Having consequences that everyone can live with and a way for young people to get the support they might need helps us to all follow through with the rules we’ve created.

Helping kids to be resilient.

Young people who have experienced a single trauma in their life, have lived through the death of a parent, or live in families with constant dysfunction, are more at risk for using substances. Drugs and alcohol can be an escape from the pain of traumatic experiences. But when young people are connected to supportive adults, when they are taught coping skills, they become resilient and are able to recover from difficult situations. It just takes one caring adult in a young person’s life to make a big difference.

It takes the whole community.

No one entity can do prevention. Youth substance use is a community problem that requires a community response. This isn’t a problem parents or schools can solve on their own.

When prevention is working, it looks like schools providing effective drug and alcohol education, parents with skills to be nurturing and offer healthy boundaries, neighbors taking an interest in neighborhood young people, enough support services for young people with social and emotional needs, prevention organizations providing skill-building opportunities for everyone, and businesses and communities providing resources and volunteers.  

Everyone has a role. What’s yours?

Liz Blackwell-Moore is the prevention coordinator at The Opportunity Alliance in South Portland.