Tools and Resources

Health promotion is about helping people embrace their health so they can both “roll with the punches” and reach their full potential. Or, as the World Health Organization (WHO) puts it, it is "the process of enabling people to increase control over their health and its determinants, and thereby improve their health" (WHO, 2005).

Health is a state of physical, mental, emotional and social well-being. More than simply the absence of disease—or a goal people try to achieve in life—health is a resource people need to facilitate everyday life. Without health, people struggle when faced with daily challenges.

One of the key questions about health promotion involves implementation. How do we “promote health” in a way that measurably improves people’s lives?

According to WHO, effective health promotion mediates “between people and their environments, synthesising personal choice and social responsibility in health” (WHO Regional Office for Europe, 1986), as opposed to putting the onus of good health on the individual alone. In other words, it forces us beyond an individual, disease-oriented, behaviour-change model by focusing attention on behavioural, social and environmental factors in play at different levels of society—from the individual, through family and community, to a national or global scale.

When applied to substance use, this means we need more than social marketing campaigns emphasizing individual responsibility for lifestyle choices. We need a comprehensive approach that addresses inequities, fosters public participation, strengthens community health services and coordinates healthy public policy.

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The social ecological model represents a way of understanding and applying the principles of health promotion in the community setting. This means it helps communities recognize, explore and address the social and environmental factors—not just individual factors—that influence citizens’ health and learning, particularly in the area of drug use.

The model recognizes that a person’s relationships and environment have a strong influence over their individual behaviour. In other words, an individual’s choices and behaviours are often the result of what they see, hear and experience in the world. Therefore, health initiatives in a community should focus on addressing the factors that influence the individual—family, cultural values, community norms, public policy, institutions—rather than on changing the individual.

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Getting healthy requires a community to adopt a way of thinking and working together that is inclusive and adaptable. Known as "comprehensive community health", this approach recognizes and addresses individual, social and environmental factors that influence a wide range of social and health issues in a community, including issues related to drug use.

Comprehensive community health is based on "health promotion" as defined by the World Health Organization’s Ottawa Charter for Health Promotion (1986). It's built on three important principles:

• Inclusion refers to uniting the voices of all stakeholders. This means that individuals and groups, including marginalized and minority populations, need to be engaged in building and nurturing a shared vision of what it means to be healthy and live in a healthy community.
• Intersectoral action refers to the weaving together of community groups and associations, businesses, health and social service agencies, schools and so on to foster community health. It reminds us that no one sector can be held responsible for ensuring the well-being of a community.
• Multiple strategies and approaches is about surrendering to the fact that matters of health and happiness are as complex as human beings themselves, and that there is no "one way" to achieve well-being. Multiple strategies and approaches are needed to draw us away from a narrow dependence on any single intervention or strategy. They are also needed to ensure that all stakeholders work as one to promote healthy outcomes.

Applying a comprehensive community health approach begins with adopting a framework for community health that helps citizens set out a shared vision, principles, values and beliefs. The elements of this framework --and other tools for applying the comprehensive community approach--are available in the Promising Practices section of this website

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Like most things involving humans, drug use is complex and involves an interplay of a range of factors: individual (e.g., knowledge, attitudes, skills), social (e.g., family attitudes, cultural values, community norms), and environment (e.g., media, political, economic). Therefore, addressing drug-related harms requires a comprehensive approach that takes into account that same range of factors. The challenge is to determine the most effective and efficient ways to influence the unique mix of individual, social and environmental factors at play in your school or community.

The social ecological model recognizes the complex relationships through which factors operating at several levels contribute to the health and wellness of individuals, schools and communities. The model recognizes that factors at different levels can influence (powerfully or weakly) factors at any other level, and that these relationships are not necessarily mediated through adjacent levels.

For example, community norms might influence individual behaviour directly or indirectly through their impact on school policy. However, the influence from either channel may be mitigated through family values and the strength of the family relationships. On the other hand, social and political factors may create differences in access to resources that either strengthen or weaken other factors.

Outside of the real-world context, it is impossible to know which factors are most powerful or to decide what should be the focus of health promotion in a given context. Nonetheless, what is certainly required is a balanced approach that addresses environmental as well as social and individual factors.

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A drug is a substance that alters the way your body functions physically and/or psychologically. Drugs that act on your central nervous system (CNS) affect the way you think, feel or behave. Sometimes called “psychoactive substances,” these drugs include caffeine, alcohol, tobacco and cannabis (marijuana), among many others.

Drugs are often grouped as legal versus illegal, or soft versus hard. But these categories can be confusing and misleading. The legal status of substances changes over time and location. And the concepts of "hard” or “soft” are impossible to define because a drug’s effects differ from person to person. A more useful classification relates to the impact drugs have on your CNS:

• Depressants depress or decrease activity in your CNS (e.g., decrease heart rate and breathing) and can produce a feeling ranging from relaxed to euphoric. Alcohol and heroin are examples of depressants.
• Stimulants stimulate or increase activity in your CNS (e.g., increase heart rate and breathing) and can produce a feeling ranging from alert to incredibly confident. Caffeine, tobacco, amphetamines and cocaine are stimulants.
• Hallucinogens affect your CNS by making things look, sound and feel very different from what they normally do. Magic mushrooms and LSD are examples of hallucinogens.

Some drugs, including cannabis, can have multiple effects and do not fit comfortably into any one category.

When people use drugs, they are manipulating the pleasure and reward system in their brain to achieve some benefit, or at least a perceived benefit. (Our brains are wired to associate life-sustaining activities—eating, sleeping, sex—with pleasure or reward. Drugs tap into that wiring and modify our feelings of pleasure, as well as our movement, emotion, thinking and motivation.)

Some drugs can have can have much greater impact on our pleasure and reward centre than natural behaviours. This intense response encourages repeated use of a drug. Unfortunately, repeated use—especially in high doses—is often associated with significant harm.

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All psychoactive drugs have the potential to both help and harm a person. It depends on the type of drug used (e.g., a stimulant such as caffeine or a depressant such as alcohol) and the amount, method, frequency and setting of use.

Some of the most common short-term and long-term harms associated with drug use include

• relationship problems at home or work
• performance problems at home or work
• money and legal problems
• injuries (or death) due to falls, accidents or overdose
• violence and unwanted sexual activity
• unwanted pregnancy
• chronic health problems such as cancer
• physical and/or psychological dependence

While the use of almost any psychoactive substance by children or adolescents may be a cause for concern, there are a number of factors that determine how probable or serious the resulting harm may be. Repeated use of a substance, especially on a daily basis, may pave the way for a strong habit or dependence which can be hard to break.

Intense patterns of use tend to require significant funds to support the habit and compete with other social demands and expectations from family and the community. There is also evidence that patterns of intense use temporarily blunt the capability of an individual to experience pleasure in other ways – the reward centres of the brain have become "hijacked" by the need to be repeatedly provided with rewards from the drug of choice, whether it be alcohol, tobacco, cannabis or some other psychoactive substance.

Fortunately, most drug use is experimental or social. However, it cannot be emphasized enough that even occasional use can be hazardous and, at the wrong time and in the wrong dose and wrong place, even fatal. The consequences of occasional heavy use (e.g., alcohol poisoning) are the most frequent causes of serious harm from substance use. Dependence, though serious, is much less common.

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Partying can be fun. On the other hand, you know things can get out of control when people are drunk or high. If you choose to use alcohol or other drugs with your friends, be smart about it. Making a plan before you go out (and sticking to it) can help you and your friends stay safe.

Before you go out

• Set your limits. Decide how much alcohol you’re going to drink, or how high you want to get, before you leave your house. Talk with a friend about how you’re going to help each other stick to the limits you set.
• Make an exit strategy. Decide how long you want to stay out, and which circumstances will lead to an early departure (e.g., if the party gets out of hand, or if one of you is having a bad time or drinks too much and feels sick).
• Have a bite to eat for the road. Eat solid foods before you start drinking. While eating doesn’t stop you from getting drunk, it can help slow down the absorption of alcohol, and may fill you up so you drink less.
• Plan your ride. Think about how you’re getting home. If you’re taking a vehicle, choose a designated driver. If not, find out if someone is willing to pick you up. Whatever you do, always have bus or cab fare handy, just in case.

Staying safe when you’re out

• Take it slow
  • Take your time, especially if you’re new to alcohol or other drugs. You don’t know how your body’s going to react.
  • Drink in small sips, rather than in large gulps. This helps you drink more slowly.
  • Avoid having more than two alcoholic drinks in any 3-hour period. If you don’t like being empty-handed, alternate between alcoholic drinks and non-alcoholic drinks.
  • Don’t get involved in drinking games or activities that lead to quick drinking. Your body metabolizes alcohol at a set rate, so the effects of fast consumption can continue long after the drinking stops. You may not realize how drunk you are until it’s too late.
• Get the mix right
  • Be careful of sweet drinks. It’s harder to gauge how much alcohol you’re drinking when you’re consuming liqueur or sweet cocktails.
  • Don’t mix substances. Each drug (including alcohol) has a unique impact on your body, and when you mix substances, you can’t predict how they’ll interact with one another.
• Be aware
  • Watch your glass. Limit the chances of someone messing with your drinks by making them yourself or getting them directly from the bartender.
  • Keep your drink with you at all times, even when you go to the bathroom.
  • Illegal drugs like ecstasy or meth can vary widely in purity and strength, so you can never be sure exactly what you’ve got. The safest thing is not to take them. But if you do, take small doses and monitor the effects.
• Stick to your partying plan
  • Don’t drink or take drugs if you’re going to drive. Getting behind the wheel when you’re under the influence can lead to accidents, injuries and death. You could lose your licence, your friends, and your life.
  • Call someone or take a bus or cab home rather than ride with someone who’s been drinking. Don’t believe them if they tell you they’re fine to drive.

If something goes wrong

• If your friend has a bad reaction to a drug, they may become tense and panicky. If this happens, try to calm them by talking softly and moving them to a quiet, dimly-lit area. If they begin breathing quickly, help them slow down by breathing along with them at a slower rate. Ask them to follow your lead and tell them the panicky feelings will pass.

If something goes really wrong

• Call 911 and get help if your friend:
  • becomes unconscious after drinking alcohol, especially if five or more drinks were consumed in a short period of time
  • loses consciousness after taking drugs
  • has been drinking and is seriously considering suicide
  • has a seizure
• If your friend becomes unconscious, roll them onto their side and place a pillow in the small of the back, so they don’t roll back over (this way they won’t choke if they throw up). Stick around so you can monitor the condition until emergency help arrives. Keep in mind that your friend could still be metabolizing alcohol for another 90 minutes after passing out.
• Tell the emergency responders as accurately as you can how much alcohol or other substances your friend consumed. Contact your friend’s family as soon as possible.

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Discovering your child has been drinking or using illegal drugs can be a nightmare. But remember that what your teen needs most is YOU. And know that the best thing you can do for your child is to respond responsibly:

Stay calm. Yelling and making threats won’t help the situation. If anything, ‘freaking out’ will give your teen another reason to hide away and get drunk or high.

Talk to your child. When your teen is no longer intoxicated, take time to sit down and tell them how you feel. Say, “I’m worried because…” or “I’m afraid because… ” Then give your teen an opportunity to express their own feelings. Make sure they know you’re really listening. Don’t try to fill silences, as your teen might need time to think things through before speaking. And avoid turning the conversation toward your own experiences as a young person. They’ll only tune out and be turned off future talks.

Learn what your teen is taking, and why. Ask what kind of substances your teen is taking, and find out what led them to try them in the first place. Was it because their friends were drinking or taking drugs and they wanted to fit in? Was it for the “buzz” that comes from having an altered state of consciousness? Was it because they wanted a way to escape? You should also try to find out if your teen’s use was a one-time event, or if they plan to continue. If they’re not planning on giving up their use, find out why.

Understand the difference between a kid who takes drugs and a kid with a drug problem. Typically, there are three kinds of people who take drugs:

• the curious type who wants to know what being high feels like

• the person who occasionally takes drugs to fit in at parties or to have fun

• the person who needs to be in an altered state to feel okay about themselves and their world

Keep in mind that sustained substance use problems are most common among people who feel isolated or marginalized. Kids without connections or meaningful relationships in their lives tend to seek solace in “feel-good” drugs. On the other hand, even well connected kids can get into serious trouble from using too much or in the wrong place.

Discuss alternative choices. If your teen is using drugs because they like the buzz, suggest activities that will naturally boost their adrenaline levels, such as rock climbing or mountain biking or discuss guidelines for safer use. Having a cool goal that conflicts with substance use, such as a skateboarding competition, may make substance use less attractive to your teen.

Give it time. You probably won’t understand your teen’s drug use after one conversation. But you might discover your teen has less of a problem than you thought. That is, your teen could very well be experimenting with substances the way many young people do without ever becoming hooked. In this case, you will want to make sure they understand how to stay safe if they do choose to use. If a harmful pattern is emerging, you’ll need to be even more patient. But it may help to consider this: the path to your child’s drug use took time to build, so don’t expect a quick fix. In all likelihood, any harmful pattern of drug use is related to life challenges—feelings of failure or a lack of connection with loved ones—that sometimes take a great deal of work to resolve. It might even be related to physical and mental health issues.

Seek help. Not every parent is equipped to handle drug use issues on their own. If you need help understanding or communicating with your teen, look for local resources and organizations that can assist you. You could try talking to a school counsellor or your family doctor. You could also contact your regional Health Authority for assistance, or call the toll-free Alcohol & Drug Information & Referral Service at 1-800-663-1441.

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Before you agree to host a teen party involving alcohol, be clear on the laws about minors and drinking

In British Columbia, you’re allowed to serve alcohol to your own children in your own home. However, there are restrictions on serving alcohol to your children’s friends. Here are some rules and regulations you should keep in mind:

• It is illegal to serve alcohol to a person under 19.
• You could be held legally liable for any accidents or injuries that occur on your property. For this reason, it is important to understand what your home insurance covers.
• If alcohol is involved, you could be accountable for any harm your party guests experience after leaving your residence.

(In other words, you’re taking risks by hosting any kind of party that involves alcohol, even when the guests are of legal age to drink.)

You should also consider the benefits and consequences of hosting an event involving alcohol

Hosting a teen party provides you with a unique opportunity to observe and monitor your child’s behaviour when socializing. Not only are you given a chance to get to know your child on a different level, you also gain the comfort of knowing where your teen is—and what they’re doing—on a particular evening. The alternative may be that your teen heads out for the night and drinks somewhere else in a much riskier manner.

Regarding consequences, hosting a teen party involving alcohol may not be appreciated by the parents of your teen’s friends. You also run the risk of developing a reputation as a “laid-back parent” or even “a push-over.” Finally, you don’t know for certain how your teen and their friends will react to alcohol. Some may not have much tolerance for the substance, while others may be prone to overdoing it and either create a scene, pass out or make an unwelcome mess.

If you decide to host a teen party...

Make sure your child understands and agrees with the rules and parameters you establish for the party. Below are some things you might want to include in your pre-party discussions.

Limitations

Let your teen know that saying “yes” to alcohol is not the same as saying “yes” to intoxication. Explain that while teenagers may look and act like adults, they are in fact still developing physically, mentally and emotionally. Since alcohol affects teenagers differently than it does adults, party-goers between 16 and 19 years old should stick to the “one drink per hour” rule. Teens 15 and under shouldn’t drink at all.

Invitations

Using written invitations can help keep the party a manageable size and give you a chance to lay down parameters around start and end times, pick-up and drop-off options, and other details. Your invitations could also be used to give parents a heads-up about the alcohol issue. By asking that the invitations be signed by parents before a teen is allowed to join the party, you are showing your child’s friends and their parents that the party plans have been well thought out, and that the celebration will be monitored in a safe, responsible way.

Parental contact

If you’re not into the invitation idea, you might want to contact parents by phone. This way you can let parents know you plan to allow supervised drinking. You can also discuss transportation options and expectations. Use this opportunity to ask about emergency contacts in the event that a problem arises.

During the party

Provide appropriate supervision

At least one adult should be present at all times during the party. If you’ve planned a large party, make sure other parents or people of legal age are there to help you cover all the bases. You could assign each adult a different duty or station. For example, you could have one adult manning the front door to respond to party crashers. Another adult could be responsible for serving or monitoring the alcohol that is consumed.

Abstain for the night

While you may be tempted have a drink, you’re better off remaining clear-headed and alert, just in case any problems pop up unexpectedly.

Plan a safe ending

Ensure the safety of all guests by planning the end of the party before it starts. Teens who have been drinking should not be allowed to drive home. Take them home yourself, or arrange to have them picked up by their parents. If these options aren’t possible, use a taxi service and be prepared to provide cab fare. You may also want to be prepared for overnight guests in the event someone is unable to go home.

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Part of being a parent is modelling healthy behaviours and attitudes. Here are some ways you can demonstrate healthy behaviours at home in relation to substance use:

• Consider your use of medications. While medicine is extremely valuable, increasing reliance and over-use of medicines may send a message to young people that drugs are an easy way to solve problems.
• Avoid smoking tobacco.
• Set appropriate limits of frequency and quantity for your own use of substances (kids tend to model the patterns of their parents, so the more moderately and responsibly you use in front of your children, the better).
• Avoid getting to the point of intoxication, especially in front of your children.

Other ways to model responsible drinking:

• Say “no thanks” sometimes when offered an alcoholic beverage.
• When offering alcohol to guests, provide food and tell them non-alcohol options are also available.
• Never drink and drive, and never ride with someone who’s been drinking.
• Don’t let others drive after they have been drinking.
• Avoid giving the impression that drinking is glamorous or the only way to have fun through stories about your own or others’ drinking.
• Don’t portray alcohol as a dependable or reliable way to deal with stress (don’t say: “I’ve had a bad day. I need a drink!”).
• Demonstrate healthy ways of coping with stress without alcohol, such as exercise, listening to music or talking things over with family or friends.

For more information about using alcohol see guidelines for low-risk drinking.

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