THE FENTANYL FIX
Icelandic teenagers are saying no to drugs by getting high on life.
For the last 20 years, the island country has seen a dramatic decrease in adolescent drug and alcohol abuse after the federal government made a concerted effort to offer teens a more natural high.
"In other words, give them something better to do than dope," said Dr. Harvey Milkman, the psychologist behind Iceland's strategy.
The multifaceted approach includes state-sponsored recreational activities and after-school programs meant to enhance family ties and community bonds. Milkman says the results have been exceptional. Since 1998, for example, the number of 15- to 16-year-olds that self-reported to have been drunk within the last 30 days dropped from 43 to 5 per cent.
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Milkman began his career at New York City's Bellevue Psychiatric Hospital in the early 70s.
"We were kind of in the eye of the storm there at the beginning of the so-called drug revolution. It became interesting to me: why do people choose different drugs?"
Milkman studied a wide array of drug users, asking various personality questions and testing their behavioural and neurological reaction to their drug of choice. In the end, he found that users weren't addicted to the drug itself. They were addicted to reducing stress, with each drug providing a particular form of relief that aligned with their personality.
But the relief afforded by drugs doesn't have to come from a pill or a pipe.
"It became known in the late 80s that the brain is a giant pharmaceutical factory that manufactures its own mind altering chemicals. So why not get people interested in natural highs?"
In 1992, Milkman and his team opened up their laboratory, Project Self-Discovery, in Denver after receiving a $1.2-million US research grant. The program used art, music, dance, poetry, and nature activities to reduce stress in lieu of drugs and alcohol.
Milkman says once teens embraced these natural highs, their risk of drug use decreased dramatically.
At the same time, rates of teenage substance use were exceptionally high in Iceland. Nearly a quarter of 15- and 16-year-olds smoked daily, and binge drinking was the norm.
Following Milkman's success in Denver, the Icelandic government reached out to him to put his research into practice on a national scale.
Over the last 20 years, Milkman's research has helped inform what's now known as the Iceland approach.
"The whole country of Iceland kind of bought into that idea of creating opportunities for the kids to feel good without taking drugs."
The government offers vouchers that enable parents to freely enroll their children in sports. Government and corporate messaging highlight the importance of family ties, and teens abide by late night curfews.
Milkman says the program is built around providing teens with strong role models, and a positive outlet to express themselves.
He calls the approach a mindset, one that could be adopted anywhere, even in Vancouver, given willingness from government, parents, and teens.
"It has to not be done in an autocratic or totalitarian way — the community has to buy into it."
With files from CBC's On the Coast