Education and Trust: Why and How to Talk About Drugs with Adolescents

By Raúl Lescano Méndez
Content made possible by Youth RISE and the Robert Carr Foundation
You can read the Spanish version here

«A crucial aspect of drug education is being able to trust the judgment of others. Trusting that young people have the ability to think, make decisions, and respect their autonomy. It sounds nice, but in day-to-day life, it’s challenging to embrace that. Another important aspect is allowing yourself to be influenced by them. It also sounds great, but it’s important to recognize that there are things you don’t know. And to acknowledge that as an adult, you have many fears,» explains Angélica Ospina, the guest on the fourth episode of Las Drogas Como Son (Drugs as They Are), the Proyecto Soma podcast.

This time, we discuss minors, education, school, and drugs. In other words, why and how it is necessary to talk about drugs in school, which also leads to delving into misunderstandings about drugs and misconceptions about addiction.

Angélica Ospina holds a degree in psychology, a master’s in demography, and a Ph.D. in population studies. She is a research professor in the drug policy program at the Center for Research and Teaching in Economics (CIDE Central Region, Mexico), and her research focuses on population and health with a sociodemographic and life course perspective.

With Angelica, we will talk mainly about a research project she published in 2020 with Nancy Chávez Llamas: «Bien puestos,» an intervention for reducing risks and harms associated with substance use in high school youth. Additionally, it was accompanied by a workbook titled «Bien puestos, a manual for teachers and youth.» As a result, we will discuss the effects of myths on education, where they come from, how they spread, and their impact on users and society as a whole.

This is an edited version for reading purposes of the interview, which can be heard on our Spotify and YouTube channels.

To understand your work more in detail, what does it mean that your research focuses particularly on a sociodemographic and life course perspective?

I am interested in breaking down that universe, which is the population that consumes substances, and seeing what substances they consume, which populations consume them, and what their consumption patterns are. Who is experiencing problematic use, for example, and with which substances, and what other populations have non-problematic use. That’s the first part. As for the ‘life course,’ it involves how much time it takes to build consumption trajectories; under what circumstances certain individuals initiate substance use, how much time passes before they start using a second substance, a third, a fourth, a fifth; at what point, for example, they enter treatment. This is considering that prevention and intervention alternatives should not be universal but designed for specific moments when people are using substances. From there, we think about what particular messages would be appropriate at that moment; what are the characteristics around which consumption occurs, what is happening with people who seek treatment; and which substances they seek treatment for. It is different, for example, to start using substances at the age of 9 than to start at 20, whether it’s a legal or illegalized substance. Biologically there are different effects, but also socially. It’s about complicating the discussion; because, sometimes, we talk about drugs in general, but what are we talking about? Order matters, age matters, gender matters. It’s important to stop focusing on the substance and instead discuss the other contextual elements.

And what have you discovered about drugs? What would you say were the elements you demystified by studying the world of drugs from this perspective?

My contribution, perhaps, is to delve deeper and provide more elements to the debate, but there are very serious people who have been positioning that debate for a long time. There are many myths, but the most important one is the idea that all use is abuse. It’s a myth that does us a lot of harm because, although roughly 10% of the world’s population claims to have used an illegal substance at some point in their lives, problematic use is very low. Of that 10% who have used at some point, around 2% use regularly, and 6%, less than 1%, have problematic use. In the world, problematic use is around 10%. What does this mean? That even with substances we consider dangerous, such as heroin, dependence is not directly associated with the substance, but rather with specific conditions of the individual and the consumption context that make some people more prone to developing problematic dependence patterns. This suggests that we could act on those circumstances to prevent reaching problematic use; it also implies thinking that it is a process and that dependence or problematic use is not about consuming and becoming, in quotation marks, ‘addicted.’

Another aspect is recognizing that people use substances, legal or illegalized, for pleasure; to connect with others, to feel good, and that, in that sense, our intention is not to destroy ourselves. If we acknowledge that search for pleasure, other possibilities for prevention also open up.

Another myth is the difference between what is legal and what is illegal. Almost all of us were born under the regime of prohibition, and it seems that the legal or illegal nature is inherent to the substance. We forget that it is a historical, cultural condition and that substances did not always have that difference, that duality that makes us think that legalized substances, such as alcohol, which has much more social tolerance due to its legal status, are harmless; but if a young person is using marijuana, it seems terrible, right? This ‘legal and illegalized’ duality hides all the economic, political processes, etc., behind the decision to legalize or illegalize a substance. The risks of alcohol are minimized, deaths associated with its use are not discussed, and the risks related to illegalized substances are exaggerated.

The third is the idea that there are sober people and addicted people. All people use substances. We all consume coffee in the morning; we consume sugar, for example. We are all substance users at different times and in different contexts. This division of ‘addicts’ does us a lot of harm because it creates moral superiority: I don’t use certain substances, so I am better than another person who openly admits to using substances that, for various reasons, are illegalized. This separation allows sober people more access to resources, support networks, etc., and people, in quotation marks, ‘addicted,’ go through processes of erosion of these networks and capitals. So, someone with a better socioeconomic level will cope better with the effects, but if you are poor, these effects can ultimately be fatal. The self-fulfilling prophecy is fulfilled: marijuana equals delinquency, but if you observe the life course, how these events unfold, you realize that stigma plays a preeminent role.

Another myth is that marijuana is a gateway to drugs or the world of drugs. In the design of research, we have a very technical concept called the selectivity of your sample: who are your research subjects? Almost always, when we research problematic use, where do we go? To places where people are institutionalized because it’s where it’s easiest to find those people. We go to treatment centers, hospitals, maybe to jail. And these people are very particular; they not only consume substances but also have a lot of other conditions around them, and it’s very difficult to separate one thing from another. So, since we are interested in proving that marijuana is indeed the gateway drug, we often don’t consider that perhaps the first substance they used was alcohol, or tobacco, or another legalized substance. We don’t accurately account for what the first substance was; we start with the first illegalized substance. If we looked at the larger universe of users, we would see that many people use marijuana. Some use it once and never use it again; others don’t use marijuana but may try another substance but don’t make it a part of their daily lives. So, when we say, ‘marijuana is the gateway,’ we are overlooking all that diversity of trajectories. It is very dangerous because, for example, in Mexico —I imagine it happens in other countries in the region—, when a parent, a mother, a grandmother, uncle, etc., discovers that their son or daughter is using marijuana, they institutionalize them, and when you institutionalize people, they interact with others who have much more complicated trajectories. If they are young, you take them out of school, and the consequences of institutionalization itself can be worse than the consumption situation, which, at those ages, is experimental.

And the other myth would be abstinence as the main strategy against substances: drugs destroy, they are very bad, and all we have to do is get people to stop using them. That idea of ‘just say no’ is impressive. More than fifty years have passed, and we are still repeating it. If we look at substance use surveys, they show that the proportion of people who use and have used substances has increased, and they are getting younger and younger. It should be an indicator to say ‘this idea of abstinence as the only option is not working, let’s change our strategy,’ right? We have this idea that providing information about substances promotes use and that if we don’t talk about it, young people won’t use them due to some kind of magical spell of silence. And it turns out not to be the case.

Which of these myths would you say influenced your life for a while or affected your perspective on drugs? What were you taught about drugs in school?

I studied in a Catholic school, so, you know, imagine that. Besides, I have very conservative and morally dual parents when it comes to substances. I never had information about substances. My dad was always a bit of a drinker, and there was a lot of alcohol around. I have many anecdotes from when I was a child, with my dad drinking with us and giving us alcohol. Especially with a lot of gender-based learning, like the importance of knowing how to drink, and so, ‘I’m going to teach you how to drink.’ It made me drink at a very young age. Of course, I love alcohol and dancing. I used to come home very late in the early morning, drunk, and he would say, ‘Have a glass of wine with me,’ and I was in secondary school, so I was happy. Later, I studied psychology, and the idea of addiction, this discourse of illness, was very strong. But, at the same time, my friends were users. Not me because I was very “Mocha” (straight-laced), as we say in Mexico, they would pick me up from parties and keep a close eye on me. But my friends were a mess, and sometimes we had parties at my house. When my dad realized, for example, that there was cocaine in the house, it was a scandal, and my response was always to hide it, obviously, deny it to the end. Later, I did my professional practice in a children’s hospital and became very good friends with a second-year resident who worked all shifts. He charged his colleagues for doing shifts. I would say, ‘damn, how do you do it? You’re always so fresh, so bright.’ And then he taught me that there were certain legal substances he injected himself with to work three days in a row and stay sharp. He was my first harm reduction teacher because then we would party — I didn’t live with my dad anymore, of course — and he, who always said he loved intravenous administration, would connect us to saline after the party, saying that we would be radiant, no matter how much we had messed ourselves up the night before. He was a turning point in my life. He was a great connoisseur of medical substances that help you stay on your feet, and he dosed perfectly according to your weight. He was an expert pharmacologist and also in body care: what to eat after partying, what substances, for example, shouldn’t be mixed because it’s harmful. And many years later, when I started working on HIV prevention, I began to see people injecting substances, and that’s when I could connect the dots.

With people injecting substances on the northern border [of Mexico], social exclusion was very evident, where it’s not the substance that destroys people but the living conditions, and where basic personal care practices make a difference. Being in contact with people doing harm reduction allowed me to confront moral constructions and understand that even people’s biochemical responses are influenced by personal experience and context. That changed me a lot.

How did the idea of bringing these new perspectives to school come about? In «Bien Puestos,» you start with a question: why talk about drugs in school?

When we did harm reduction on the border, it often happened that very young kids would come and ask us what we were doing, and it always made us uncomfortable. Obviously, they challenged us. In their transgression, they would say, ‘I already know, I already use drugs.’ And I questioned this moralism in front of young people. In these informal conversations that arose, we would ask them who they talked to about drugs, and they would say with the dealers. That was a problem, not to demonize the figure of substance dealers, but many times we also don’t reflect on the kind of message we share when we are with non-user people, especially when they are minors. For example, the users we worked with, were seasoned junkies and always said that heroin was better than an orgasm and I don’t know what else. But they never talked about the downsides and that sometimes they were crawling. That message, for a twelve-year-old kid, is quite biased, and that romanticization, especially in the younger ones, generates curiosity and glamorization of consumption. That’s where this started: damn, no adult is talking to these kids about substances, and there are substances everywhere. It’s not about saying, don’t use, or use like this, but it’s just like in sexuality: What’s your question? Why do you want to start now? With whom?

What was the main challenge of transitioning from working with older vulnerable populations on the street to talking to young people in school?

The main challenge is assuming that young people, even if they are minors, are subjects of autonomy. It’s not about giving up adult guardianship but establishing horizontal dialogues, not as equals because obviously, we are not equal. I am a lady with a certain socioeconomic universe, with a different cultural capital. I am not a fifteen-year-old girl, but I can still recognize that they can teach me things and that they are not naive. The problem is the way adults think about relationships with young people. I feel that a very important part of drug education is being able to trust the judgment of others; that they are young people, I insist, capable of thinking and making decisions, and we can respect their autonomy. It sounds nice, but in daily life, it’s very complicated to assume that, right? And the other thing is allowing yourself to be touched by them; it also sounds very nice, but it’s important to recognize that there are things you don’t know and to acknowledge that oneself, as an adult, has many fears. The myths we mentioned at the beginning are deeply ingrained, so when a twelve-year-old kid or a thirteen-year-old girl tells you that they are using marijuana and that they were at a party with clones and I don’t know what, you can’t help but be scandalized. But overcoming moral panic is crucial to being able to talk about substances. You can’t talk about substances and say, ‘no, but I’m sober.’ When you say, ‘well, yes, I do have some experience with certain substances,’ it allows two people with different experiences to speak as people and contribute something we have learned so that you don’t have to go through that. Because who wants a bad trip or to be violated at a party, right? You don’t want that.

It was also very challenging to choose which substances we talked about because then, do you show them this whole universe and get super technical, like when they show you the female reproductive system and give you those names that I don’t know if they are useful? Or do we start talking about what happens at parties, how my parties were, how yours are, and from there, we see what to do? It sounds obvious now, but it wasn’t at that moment. We started talking about alcohol because it’s in the house, and its use is highly normalized.

What do you think the Angelica from school would have asked present-day Angelica, who conducts these studies in school?

I think that Angelica didn’t even know that marijuana existed. But, I think, for example, if it is possible to socialize without consuming. That would be a question: what strategies could I implement to reduce peer pressure? I entered university very young, at fifteen, and had the need to be older and to look older; consuming was a way of telling my friends that I was just like them, and that put me in thousands of unnecessary risky situations, of course. I see this projected a lot in young girls, and that’s why one of the modules was about peer pressure because we found that many people started consuming because they wanted to be in the cool people’s group, for a sense of belonging. I would also have liked to know how to avoid hangovers, the aftermath, the headache. That would have been nice to know at the time.

«To give you a bit of context, these are the first three paragraphs written in the study ‘Bien Puestos’: ‘In Mexico, official strategies for preventing psychoactive substance use among young people have focused on abstinence as the sole goal. To achieve this, they resort to old communication tactics such as fear, stigma towards substance users, and the provision of inaccurate information about substances. In light of substance use trends, we can say that these strategies have failed among the young population in Mexico. The fear and misinformation promoted by official communication campaigns have created an ambivalent context towards psychoactive substances, characterized by widespread substance availability, high social tolerance for alcohol use, and zero tolerance for the use of illegalized substances. In this ambivalent environment, widespread misinformation persists regarding psychoactive substances, both among young people and adults, regarding the effects and risks associated with their use. Additionally, young people deal with their concerns and experiences with substances in isolation, and internment appears as the only possible treatment option for the use of illegalized substances, regardless of usage patterns, consumption trajectories, and the characteristics of those who use them‘.

This is work that you carry out in a very particular school in Aguascalientes, Mexico, with specific socio-economic and demographic characteristics. However, much of what is read in the report seems like a study conducted at the regional or Latin American level because many patterns and myths are repeated, and the mentioned failed strategy has been applied throughout the region for decades. What would you say this study tells us about the region, about Latin America, beyond having been conducted in a particular place in Mexico?

The CICAT (Inter-American Drug Abuse Control Commission) imposes drug policy and prevention strategies, and that is what countries apply. This translates into these similarities between countries. Another interesting aspect is that sometimes there is a discourse that we are producer or transit countries, but not consumer countries. Nowadays, this is a fallacy because the distinction between producers, transit, and consumers is blurred. Perhaps we do not have the scale of the problem that the United States has, but we have other problematic contexts. The war on drugs, for example, is very problematic, and doing harm reduction work in our violent communities is very challenging, something that people in the north do not face. The impossibility of our countries to think of a different discourse is also evident. Colombia, Mexico, and Uruguay sometimes turn the discourse on and off, but when we think about how to bring the regulation discourse to prevention practices, we cannot achieve it because we are too afraid to assume what regulation implies in terms of education.

Another point is the emphasis on the substance, as if the substance had agency, disregarding the effect of how we represent drugs in the treatment of the substance user. This practice of the ‘bad apple,’ for example: ‘get the bad apple out of school’… You’re talking about a thirteen-year-old! We downplay the effect of expelling a person from school in their life trajectory and maximize the effect of smoking a joint. It is disproportionate. Prohibition is a very efficient device because it stigmatizes people and turns the subject into a taboo. So, for example, when we talk to adults, teachers, and parents about substances, people don’t know the difference between marijuana and methamphetamine. Today’s young people have access to much more information and can easily tell you, ‘no, mom, cocaine is different from marijuana.’ It sounds funny, but that lack of information also hinders the possibility of having an open conversation because how can we talk if I don’t know what I’m talking about? 

The other aspect that I feel is also pervasive and transversal in the region is how social welfare policies are diminishing and the strengthening of punitive policies. Those particularly targeted by these punitive policies are young individuals living in poverty. This is detrimental because our governments have chosen to invest in prisons. This leads us to question who becomes the scapegoat for drug-related issues, preventing us from discussing other matters such as inequality. What is the future for young people in marginalized communities? What do we offer them to keep them from entering the ranks of organized crime, and why does drug use seem so appealing? These are issues that go far beyond substances.

Finally, in particular, young people—due to adult centrism—have a particular need for expression. When we think about prevention strategies or any teaching practice, we are the ones who talk non-stop. And what has been shown for a long time is that we learn by doing things, and questioning ourselves. Substance education should also incorporate this active element. We are talking about a very particular school in a municipality in Aguascalientes, but this works in Peru as a script to have a conversation with the young people. There is also this enormous need for expression with their aesthetics and specific vibes that are well worth exploring. Because we also age, right? So, what are the tools we give for new people to enter and not necessarily repeat our discourse but to appropriate it and pose questions according to their age, their historical moment?

You mentioned how the discourse of prohibition is inserted both in substance users and the people around them. In the research, you mention a very interesting fact that is also seen a lot in everyday life. Many students indicated that they used some illegal substance or had connections with people who used substances recreationally without any problems. However, they continued to associate substance use with stigmatizing concepts, such as being sick, a delinquent, etc. How to understand the resistance of the stigmatizing discourse in the face of a reality that demonstrates the opposite?

The prohibitionist device has been very efficient. We must not forget that we have been close to a hundred years of prohibition. That judicial apparatus, if you will, has been very efficient in recruiting psychiatrists, and psychologists. The discourse of, in quotes, ‘addiction’ was created by prohibition, and then this thing that had never appeared in the history of humanity emerged: the disease of addiction. Some specialists appear who name it, classify it, and when you classify it, you give it a place in social structure: there are sick people and there are healthy people; and the sick must go to the hospital, creating some treatment technologies. In our daily lives, we adopt this, and the media are fabulous at helping us internalize these values. What is the social organization form that the system tells us we should follow? Well, we have to get up early, work all day, and enjoy a little at night, not too much, because tomorrow we have to get up early to work again. And everything that doesn’t work in this productive apparatus of accumulation has no place; it’s sick, wrong, deviant, abnormal, illegal, right?

And the other mechanism that is very efficient is stigma. If you position yourself critically against this, it is probably because you are surely using substances. And it turns out you are. So you are no longer a valid interlocutor in the debate because you are a user, and you are not seeing things clearly. Therefore, we must be critical from where we are looking at this phenomenon of drug use.»

«If it’s already challenging to comprehend concepts like the ineffective implementation of strategies over decades, how do we introduce ideas such as pleasure, experimentation, or recreation related to drug use into the debate?

The other day, I was talking to a colleague, and he said something really beautiful: you can’t shield someone from experience. In other words, it’s wrong to approach prevention from the perspective of avoiding an experience because experience ultimately defines us. With abstinence, it’s always about ‘don’t do it, don’t do it, don’t do it,’ meaning preventing you from living. So, there’s a significant design problem right there.

Another aspect is that the discourse on drugs has been focused on exposing the harms and damages they cause. However, everything in life involves some harm because living is dying, right? That doesn’t mean we wake up every day thinking about dying, but this approach is quite deceptive because it makes us forget why we use a drug. I don’t know if you drink coffee. I had coffee today because I love its taste, it wakes me up, and I enjoy being awake in the morning. I don’t drink coffee to get gastritis. But when we talk about cocaine, the first thing that comes to mind is a person who has had or is having a terrible experience with cocaine, and all the harm it caused. This entry seems deceitful and dangerously biased in itself. Young people who have experimented can say, ‘but I’m not like that, it won’t happen to me,’ and you tell them, ‘how can you say it won’t happen.’ All you’re doing is telling them not to do it. Once again, you position yourself in a moral place. So, first, we must reclaim the experience, and we cannot prevent the experience. Second, recognize that this experience is always personal. The beautiful and complex thing about substances is that my experience with a substance is not the same as yours, and it’s influenced by a myriad of physical, biochemical, biographical, contextual, and other factors.

But another very important thing is that our brains are wired to seek pleasure, and denying this pursuit of pleasure is like denying our, in quotes, ‘human nature.’ As we use substances, we experiment and the wiring becomes specialized in those very particular, unique ways of experiencing that pleasure. If we find something that alleviates our pain, believe me, we’ll use it. That’s why, in eroded contexts where people have few sources of pleasure, drugs become crucial because you can’t ask people to resign themselves to live in misery and discomfort. That doesn’t work. The question is, what other sources of pleasure do you offer so that substances are not the center of it.

There’s still a long way to go before discourses change, before we have a course or a subject in school that teaches and discusses drugs. In the meantime, what could teachers, parents, and caregivers do in the current context?

There are several lines of action. One is to demand responses from the State regarding substance use. If they harp so much on drugs killing and destroying, then the State should invest in this matter, right? The schizophrenia in this regard is impressive. On one hand, they say drugs kill and destroy, and on the other hand, the state investment in public health strategies against substances is minimal and has been shrinking. That’s because they’ve also convinced us that problematic substance use is a problem of character, a biographical flaw of yours, so it’s your problem or your dysfunctional family’s problem. And it’s not like that. Problematic substance use is a social problem and requires social intervention. We need to demand better services for addressing problematic use from the State. The services we offer to people with problematic use are degrading, and there are very few of them. In Mexico, with a population of 120 million, there are only half a million people. With so few, we should be able to offer them quality services because it’s a human right, not a favor.

On a micro-daily level, I don’t know if it’s too much to ask of the school institution because the school is part of the prohibition device. It could be a contradiction in itself. But if we think utopically, many of us have our children in private schools and we pay. So, just as we demand comprehensive sexual education, we need to demand that our teachers receive training on substances because a teacher should not be ignorant about the difference between marijuana and cocaine. They don’t know what experimental use and habitual use are. So, how is the approach going to be? Silence cannot be the state policy on substances. School is a fundamental institution for teaching us how to manage our pleasure.

On a micro-level, we have to give up this idea that if we don’t talk about it, it won’t happen. I don’t know where we get this idea that if we don’t talk about substances with our young people, magically the drug issue won’t come up. It’s false; they are already there. The idea of a world without drugs is not possible; we have to live with them, whether we like it or not. I know it’s not easy. I have a little boy, and of course, I get scared, but if we don’t establish those spaces to speak openly, they will do it with other people who may not be well-informed or interested in providing that information. That implies trusting our young people. We do the best we can, and the person, the young person, is a person and makes their decisions. The more information you give them, I am convinced they will make better decisions, but you won’t be able to prevent them from making mistakes, and you will also be there for them when they do. Because that’s also another myth: that if you have an addiction problem, you will always stay there, and it’s not like that. Just as we go through a love breakup and think we’re going to die at that moment, with substances, it’s the same. You can overcome those moments, and life goes on. It’s very important to be able to offer support networks beyond stigma. Stigma really kills. Stigma generates exclusion, throws people into networks of marginalization where there is indeed only drugs and criminality, and that kills people. Let’s think about what Johann Hari says: the opposite of addiction is not abstinence; it’s connection. And we use drugs because we seek connection. What spaces do we have in our homes, with the neighborhood kids, in school? We will realize that we generate few spaces for connection because we have a very authoritarian vision.

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This podcast is a production of Proyecto Soma and is possible thanks to the support of the international organization Youth RISE and the Robert Carr Fund.

The interview was conducted by Raúl Lescano Méndez | The coordination was led by Francesca Brivio Grill | Sound editing was done by Santiago Martinez Reid and Raphael Olaya | The music is a composition by Dr.100.»