Teens Take Charge - Reducing Substance Abuse through Resilient Adolescent Investment

Substance abuse is a persistent and growing health concern in the United States, with more than 45 million Americans age 12 and older meeting the DSM-V criteria for Substance Use Disorder in 2021 (SAMHSA National Survey of Drug Use and Health, 2021). Substance abuse is particularly insidious because it affects multiple factors of a person's life - their health, financial/economic resources, emotional wellbeing, and their relationships (National Institute on Drug Abuse, 2022; Daley, 2013). Individuals with substance use disorder are at an increased risk of motor vehicle accidents, job loss, some types of cancer, cardiovascular disease, and infectious diseases from needle sharing (National Institute on Drug Abuse, 2022; Daley, 2013).

Adverse childhood events (ACEs) were first defined in an important public health study in the 1990s as a set of adverse events in a child's life, such as abuse and neglect, that negatively impact the health and wellness of that person into adulthood (Filitti et al., 1998; CDC, 2021). Substance abuse and other risky behaviors are more likely to appear in individuals with one or more ACE (Filitti et al., 1998). Therefore, it is important to use a trauma-informed lens to understand rates and dangers of substance abuse within the context of ACEs.

This proposed multi-level resilience-building intervention program targets substance abuse with a trauma-informed lens, particularly for adolescents in Orange County, Florida. The target population of teenagers was chosen because evidence indicates that more than three-quarters of individuals with substance use disorders first started using illicit substances before the age of 20 (Poudel & Goutam, 2017). This indicates that substance abuse prevention interventions should be targeted at teens and young adults before they first use illicit substances. Additionally, Orange County is an important area of choice because Florida is seeing rising rates of fentanyl use and overdose and a recent Community Health Needs Assessment in Central Florida named substance abuse as a top ten health concern (Florida Department of Health, 2022; Florida Department of Law Enforcement, 2021; Central Florida Community Collaborative, 2019). Finally, teens in Orange County, Florida are at particular risk of substance use because the county has a high rate of high schoolers who have experienced one or more ACE (Florida Charts, 2022).

The proposed multi-level intervention uses the Centers for Disease Control and Prevention (CDC) social-ecological model as theoretical basis, defining 4 levels of intervention - individual, relationship, community, and societal (CDC, 2022). The intervention consists of a 12-week summer program for high schoolers in Orange County, Florida aimed at teaching the students skills for resilience building in themselves, their relationships, their community, and society as a whole. The program will include twice weekly in-person educational sessions, sometimes with community stakeholder guest speakers, a companion app with digital checkpoints, and group community outings.

At the individual level, students will increase confidence, gain knowledge about substance use and ACEs, increase individual resilience, and improve drug-avoidance self-efficacy. The goals will be met through the learning sessions and digital checkpoints. At the relationship level, the participants will improve interpersonal communication skills and be encouraged to foster health social support systems. This will be done through teamwork and young adult mentorship. At the community level, the program will work to develop connections between students and community resources through group outings. And finally, the program will culminate with a project developed by the participants aimed at tackling social change. This will look like advocacy for a substance abuse-related issue. The students will be guided to develop and execute a social change such as writing letters to lawmakers, attending a civic meeting, or staging a protest.

In summary, this program uses theory-based interventions to provide Orange County, Florida teens with the knowledge and tools to improve themselves, their social circle, their community, and society. Substance abuse is a multi-faceted problem that requires a multi-faceted approach. The hope is that through confidence-building and adolescent engagement and empowerment, this group can see the improvements that they way to see.

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