School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada.
Community Health Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada.
Harm Reduct J. 2017 Jul 31;14(1):53. doi: 10.1186/s12954-017-0180-z.
Youth substance use programming and educational strategies are frequently informed by prevention approaches that emphasize abstinence goals, which often do not resonate with youth in their lack of acknowledgment of young people's social context and how young people perceive positive effects of substance use. Further, approaches to drug prevention have been critiqued as adopting a one-size-fits-all approach and therefore inadequate in addressing substance use in the context of population variation and inequities. In response to the limitations of current approaches to prevention, programming informed by harm reduction principles that aims to minimize harms without requiring abstinence is emergent in school settings. However, youth perspectives informing harm reduction are limited in both research and program development.
This paper draws on data from the Researching Adolescent Distress and Resilience (RADAR) study, which utilized an ethnographic approach to bring youth voice to the literature on mental health and substance use. Qualitative data collection included individual interviews (n = 86) with young people aged 13-18 across three communities-representing urban, suburban, and rural geographies-in British Columbia, Canada. A multi-site qualitative analysis of interview data was conducted to identify themes across and within each research site.
Across all three sites, young people's individual experiences of substance use were shaped by geographic, socio-cultural, and political contexts, with youth describing their use in relation to the nature of substance use in peer groups and in the broader community. To manage their own substance use and reduce related harms, youth employed a variety of ad hoc harm minimization strategies that were reflective of their respective contexts.
The findings from this study suggest the importance of harm reduction approaches that are contextually relevant and responsive to the lived experiences of youth. Youth perspectives in the development of harm reduction programming are needed to ensure that approaches are relatable and meaningful to young people, and effective for promoting the minimization of substance-related harms.
青少年物质使用项目和教育策略通常受到预防方法的影响，这些方法强调禁欲目标，但这些目标往往不被青少年所认可，因为它们没有承认年轻人的社会背景以及年轻人如何看待物质使用的积极影响。此外，药物预防方法受到批评，因为它们采用一刀切的方法，因此在解决人口变化和不平等背景下的物质使用问题时不够充分。为了应对当前预防方法的局限性，在学校环境中出现了一种以减少伤害为原则的项目规划，旨在最小化伤害，而不要求禁欲。然而，青少年在减少伤害方面的观点在研究和项目发展中都很有限。
本文借鉴了《研究青少年痛苦和韧性》（RADAR）研究的数据，该研究采用民族志方法将青少年的声音纳入到关于心理健康和物质使用的文献中。定性数据收集包括对来自不列颠哥伦比亚省三个社区的 13-18 岁青少年进行的个人访谈（n=86），这些社区分别代表城市、郊区和农村地区。对访谈数据进行了多地点的定性分析，以确定每个研究地点和地点之间的主题。
在所有三个地点，年轻人的个体物质使用经历都受到地理、社会文化和政治背景的影响，年轻人描述了他们的使用与同伴群体和更广泛社区中物质使用的性质有关。为了管理自己的物质使用并减少相关伤害，年轻人采用了各种临时性的减少伤害策略，这些策略反映了他们各自的背景。
这项研究的结果表明，需要采用与青少年生活经历相关且对其有反应的减少伤害方法。需要在减少伤害项目的制定中纳入青少年的观点，以确保方法与年轻人相关且有意义，并有效地促进减少与物质使用相关的伤害。
