2. Dangerous Journeys A metaphor for passage through the teen years Marvin Krank

3. How can we help youth get through these perilous times

4. Mixed messages

5. Project on Adolescent Trajectories and Health (PATH): social context, cognition, risk-taking behaviour, and health outcomes Three-year longitudinal study Three-year longitudinal study Funded by the SSHRC and CIHR Funded by the SSHRC and CIHR Partnership with SD#23 Partnership with SD#23

6. Social Context CognitionBehavior Health Outcome Overview of theoretical approach  Social factors modify cognitions about risky behaviors  Cognitions affect transitions to risk-taking behavior  Risk-taking behaviors impact on health outcomes

7. Life style choices begin in adolescence Drug and alcohol use begin in the early teens Drug and alcohol use begin in the early teens –Many smokers begin before age 14 Risky choices have long- term consequences for youth Risky choices have long- term consequences for youth –early pregnancy –accidents –unhealthy lifestyles –lost opportunities

8. Grades 7-10 are a time of significant transitions in drug and alcohol use

9. A small, but significant percentage of these youth used drugs and alcohol in the past week Male Female EightNineTenEightNineTen Alcohol20%33%36%18%25%29% Drunkenness10%16%21%8%19%20% Cigarettes4% 9%5%12%13% Marijuana7%13%20%7%17%20% Hallucinogens4%2% 3% Inhalants5%4% 5%2%

10. High risk behaviours tend to co-exist Drug and alcohol use, early and unsafe sexual activity, and violence tend to co- occur Drug and alcohol use, early and unsafe sexual activity, and violence tend to co- occur For example, heavier drug and alcohol use is linked to being both a victim and a perpetrator of sexual assault. For example, heavier drug and alcohol use is linked to being both a victim and a perpetrator of sexual assault.

11. Drug and alcohol use are highly correlated Used alcohol Percent used marijuana No2.8% Yes44.9%

12. Are aboriginal youth at greater risk? Nine out of twelve comparison measures show higher levels of use Nine out of twelve comparison measures show higher levels of use May mask levels of use as we have a lower level of participation and higher drop out rate (50% versus 20%) May mask levels of use as we have a lower level of participation and higher drop out rate (50% versus 20%) School drop outs have much higher levels of use! School drop outs have much higher levels of use!

13. Culturally Specific Risk Factors Ethnic Dislocation (May, 1982; Oetting, Beauvais &Velarde, 1982; Trimble Padilla, & Bell, 1987) Ethnic Dislocation (May, 1982; Oetting, Beauvais &Velarde, 1982; Trimble Padilla, & Bell, 1987) Acculturation Stress (LaFromboise, 1988) Acculturation Stress (LaFromboise, 1988) Alienation from the Larger Culture (Moncher et al., 1990) Alienation from the Larger Culture (Moncher et al., 1990) Unstructured time on reservations, during which drinking is also a response to boredom (Edwards & Edwards, 1988) Unstructured time on reservations, during which drinking is also a response to boredom (Edwards & Edwards, 1988)

14. Why we should care

15. Adolescent risk is based on what they do Unsafe sex in youth leads to teen pregnancy, low birth weight babies, and STDs including HIV Unsafe sex in youth leads to teen pregnancy, low birth weight babies, and STDs including HIV Drug and alcohol use increase unintentional injuries, the leading cause of death in youth Drug and alcohol use increase unintentional injuries, the leading cause of death in youth

16. Early and heavy alcohol use is correlated with many negative outcomes Health Health –Aches and pains –Accidents –Hospitalization Violence Violence –Victim –Perpetrator –Various kinds Bullying Bullying Assault Assault Sex Sex –Early sex –Regretted sex –Sexual assault Problem behaviours Skipped school Stayed out all night without parent permission Damaged property Warned or detained by police School detention Stole something outside of home Stole at home Suspended out of school Suspended in school Ran away from home Carrying weapons

17. Modern Risk Prevention Programs Deal with social and cultural influences Deal with social and cultural influences Encourage alternative activities Encourage alternative activities Correct misconceptions about drug and alcohol use Correct misconceptions about drug and alcohol use

18. Contemporary Evidence-based Methods Less confrontational Less confrontational Motivate change Motivate change Meet individuals where they are Meet individuals where they are –Age and Stage appropriate Culturally responsive Culturally responsive –Community participation Can be brief interventions Can be brief interventions

20. Canoe Journey, Life’s Journey Development of Culturally Relevant Life Skills Manual Development of Culturally Relevant Life Skills Manual Canoe Journey as a metaphor for life’s journey Canoe Journey as a metaphor for life’s journey Use of other traditionally Native symbols, particularly the Medicine Wheel Use of other traditionally Native symbols, particularly the Medicine Wheel Medicine Wheel generally understood to have similar meaning across tribal boundaries Medicine Wheel generally understood to have similar meaning across tribal boundaries

21. Conclusion The real war on drugs is the battle for the hearts and minds of our youth The real war on drugs is the battle for the hearts and minds of our youth We don’t want to prevent them from taking the journey, but we do want them prepared for challenges along the way. We don’t want to prevent them from taking the journey, but we do want them prepared for challenges along the way.