June 22, 2023
“People First: Stop Stigma and Discrimination, Strengthen Prevention”
The International Day Against Drug Abuse and Illicit Trafficking is observed annually on June 26. The Society for Adolescent Health and Medicine (SAHM) supports this day by acknowledging the complex and multi-faceted challenges of global substance use and illicit trafficking. This day raises awareness of opportunities to strengthen efforts to create a world free of the negative consequences of substance use and illicit trafficking [1]. In strong support of the 2023 United Nations theme, “People First: Stop Stigma and Discrimination, Strengthen Prevention,” SAHM calls upon all who work to protect the health and well-being of adolescents and young adults (AYA) to put people first, stop stigma and discrimination, and strengthen prevention as they address substance use and illicit trafficking.
People First
SAHM recommends putting people first by starting with respect, empathy, and compassion when discussing substance use and illicit trafficking with AYA [2]. Reassessing how we engage with and the messages we send to young people will create a valuable paradigm shift as we work to address substance use and illicit trafficking throughout the world [1,3-5]. Preventing and reducing the burdens of substance use and illicit trafficking on AYA demands that health care providers, educators, researchers, advocates, policy makers, and communities put young people first and engage collaboratively with them and their families in a supportive manner. AYA are experts in their lived experiences and SAHM implores all to work collaboratively with them to deepen a mutual understanding of the hidden causes of, burdens of, and solutions for substance use and illicit trafficking. Creating non-judgmental spaces for AYA to discuss substance use and illicit trafficking can be a vital first step towards creating safe, equitable, and supportive environments that reduce negative outcomes and help young people thrive [4-6].
Stop Stigma and Discrimination
Young people and their families face widespread stigma and discrimination when attempting to address problems around substance use and illicit trafficking. SAHM strongly supports stopping stigma and discrimination against AYA who engage in substance use and/or illicit trafficking. Everyone who interacts with AYA should use non-stigmatizing, person-first, and medically accurate language to facilitate discussion and connection with treatment [4]. Stigma and discrimination increase racial disparities and inequities in substance use care and can create insurmountable barriers for our most vulnerable young people [7]. Health care providers, educators, researchers, advocates, policy makers, and communities can all take action and make a difference. By using non-judgmental, person-first, and inclusive language we can create environments where all young people are empowered to seek care and treatment for substance use disorders [5-7].
Strengthen Prevention
The need has never been greater to strengthen prevention efforts for young people around the globe. SAHM urges all who work with AYA to utilize evidence-based prevention practices to optimize the health and well-being of AYA [8]. Even though stigma and discrimination have historically limited research into the prevention of substance use and illicit trafficking, a growing body of evidence supports the need for compassionate primary and secondary prevention efforts to optimize the well-being of young people [1,3-9]. Health care providers should create clinic-based opportunities for primary and secondary prevention by providing early screenings and offering behavioral and medication-based treatments. Policy makers should create systems that offer alternatives to punishment and provide pathways to recovery for those who have become ensnared in substance use and/or illicit trafficking [2,11]. We should even strive to create pathways to avoid the need for these altogether. Educators, researchers, advocates, and communities can continue to increase awareness of the hidden causes of, short- and long-term effects of, and effective solutions for substance use and illicit trafficking [10]. We can all play a role in creating more equitable societal structures to strengthen prevention and give all young people equal access to positive life options.
A Call to Action
The global burden of substance use and illicit trafficking on AYA is complex and multi-faceted; it demands that all of us act to promote the health and well-being of young people throughout the world. We must: 1) put people first by starting with respect, empathy, and compassion when discussing substance use and illicit trafficking with AYA; 2) raise awareness of and actively reduce the negative impact of stigma and discrimination on young people who engage in substance use and/or illicit trafficking; and 3) optimize the health and well-being of AYA by strengthening primary and secondary prevention efforts and seeking opportunities to provide all young people equal access to positive life options. Together, we must enact the goals of “People First: Stop Stigma and Discrimination, Strengthen Prevention” to help our adolescents and young adults thrive and to create a world free of the negative consequences of substance use and illicit trafficking.
References
- United Nations, 2023. International day against drug abuse and illicit trafficking. Available at: https://www.un.org/en/observances/end-drug-abuse-day. Accessed June 4, 2023.
- Vienna NGO Committee on Drugs, 2023. What are you doing to mark World Drug Day on 26 June? Available at: https://vngoc.org/2023/06/what-are-you-doing-to-mark-world-drug-day-on-26-june/#:~:text=The%20UNODC%20theme%20for%20the,and%20discrimination%2C%20strengthen%20prevention%E2%80%9D. Accessed June 16, 2023
- National Institute on Drug Abuse, 2014. Principles of adolescent substance use disorder treatment: a research-based guide. Available at: https://nida.nih.gov/sites/default/files/podata_1_17_14.pdf. Accessed June 4, 2023.
- Alinsky RH, Hadland SE, Quigley J, Patrick SW. Recommended terminology for substance use disorders in the care of children, adolescents, young adults, and families. Pediatrics. 2022;149(6). DOI:10.1542/peds.2022-057529.
- Bagley SM, Hadland SE, Carney BL, Saitz R. Addressing stigma in medication treatment of adolescents with opioid use disorder. Journal of Addiction Medicine. 2017;11(6):415–6. DOI:10.1097/adm.0000000000000348.
- Levy SJL, Williams JF, Ryan SA, et al. Substance use screening, brief intervention, and referral to treatment. Pediatrics. 2016;138(1). DOI:10.1542/peds.2016-1211.
- McKnight-Eily LR, Okoro CA, Strine TW, et al. Racial and ethnic disparities in the prevalence of stress and worry, mental health conditions, and increased substance use among adults during the covid-19 pandemic — United States, April and May 2020. MMWR Morb Mortal Wkly Rep 2021;70:162–6. DOI: http://dx.doi.org/10.15585/mmwr.mm7005a3.
- United Nations Office on Drugs and Crime, 2022. World drug report 2022. Available at: https://www.unodc.org/unodc/data-and-analysis/world-drug-report-2022.html. Accessed June 4, 2023.
- Richter L, Vuelo L, Oster R. Recent legislation can dramatically improve substance use prevention: here’s how to seize the opportunity. Available at: https://www.healthaffairs.org/content/forefront/recent-legislation-can-dramatically-improve-substance-use-prevention-here-s-seize. Accessed June 14, 2023.
- Volkow ND, Han B, Einstein EB, Compton WM. Prevalence of substance use disorders by time since first substance use among young people in the US. JAMA Pediatrics. 2021;175(6):640. DOI:10.1001/jamapediatrics.2020.6981.
- Substance Abuse and Mental Health Services Administration, 2012. SAMHSA’s working definition of recovery. Available at: https://store.samhsa.gov/sites/default/files/d7/priv/pep12-recdef.pdf Accessed June 16, 2023.