Nathaniel Koutsostavros had a rough adolescence. An absent father and a bipolar grandmother created a tough life at home, while weight issues and depression made high school painful.
At 17, he turned to drugs and soon spiralled out of control, often spending $300 a day on cocaine. Looking back, many of those days remain a blur, but the Toronto native does remember the prevention programs that tried to stop him from what he had become, and how they didn't seem to work.
"It was unrealistic," says Koutsostavros, now a recovering drug addict who remembers the scare tactics used to ward teens away from substance abuse. "If someone would have came to me and honestly talked to me about drugs, it probably would have helped a little more."
'I feel like scare tactics are the worst things you can use with drugs.' — Nathaniel Koutsostavros
Koutsostavros recalls being plied with horror stories about how one ecstasy pill could kill, or how smoking marijuana would lead to schizophrenia. Daring teenagers not to use drugs simply goaded them into trying them, he says.
"I feel like scare tactics are the worst things you can use with drugs."
The 21-year-old, who completed a stint in rehab a year and a half ago, now shares his experiences with high school kids, offering a realistic view of what happens to addicts. No horror stories, just the facts.
It's an approach that a leading scientist in the U.S. is trying hard to push into practice all over North America.
Dr. Nora Volkow, director of the National Institute on Drug Abuse, says teens are more likely to respond to drug prevention messages if they come from other young people. But, she cautions, teens are also more likely to take drugs if their peers do as well.
"We need to tailor addiction programs to take into account these two factors," says Volkow. "A message that is targeted towards really emphasizing the negative consequences in a way that is tailored for adolescents would be more effective."
A multi-pronged drug prevention approach, which targets an adolescent's family, school and community, would pack the hardest punch, she says. But while evidence for the success of such programs exists, Volkow says only a handful of schools and communities implement them. And that's something she hopes will change.
"You need simple, realistic, user-friendly prevention approaches, otherwise it won't go anywhere," she says.
Teen brains are different
Part of the solution is understanding just how different teenage brains are.
Volkow explains that teen brains are thought to be more likely to experiment with drugs because they are still developing. The connections between the area of the brain which make decisions and the area which takes action aren't as strong as those in adults, she says.
"That connection is not fully developed until you're in [your] 20s and as a result puts you in a much more vulnerable position to control your desires if you're an adolescent," Volkow explains.
Meanwhile, once exposed to drugs, Volkow's institute has shown that teenagers are more vulnerable to becoming addicted because their developing brains are able to adapt and learn certain behaviours faster than adults.
"When kids start taking drugs and the earlier they take it, the greater the risk of addiction," she says.
And when teens do get to a point where they are hooked onto a substance, their addiction must be treated as a disease, she says, and not as a weakness or a lack of moral fibre.
"Drugs are devastating to our society, it's sort of enraging in a way," says Volkow, explaining that she considers drugs — which include alcohol — the number 1 cause, directly or indirectly, of deaths among young people.
"Why then aren't we taking a more aggressive approach to prevention and treatment? As a society perhaps we incorporate [substance abuse] as things that are inevitable, but that's not the case, it need not be."
Alcohol also a problem
Dennis Long knows communities can do more to prevent teenage substance abuse.
The director of Breakaway, a Toronto-based outreach and addiction treatment centre, has been in the field for 35 years and says the numbers for youth drug use aren't declining in any significant way.
But he says it's important that teen drug abuse prevention programs get away from focusing solely on addiction because adolescents use substances differently.
'We get parents in here that are very upset they've discovered a joint in their son or daughter's room and yet, when we start talking to the young person we find they're drinking at an alarming rate but the parents are like 'oh that's OK, it's just beer.' — Dennis Long
Long explains that teenagers have a higher tendency to stay clean during the week and then binge on any given substance over the weekend, meaning prevention efforts have to take such habits into consideration.
He adds that it's also important for parents and teachers to realize that substances like alcohol can be just as dangerous as hard drugs when abused.
"We get parents in here that are very upset they've discovered a joint in their son or daughter's room and yet, when we start talking to the young person we find they're drinking at an alarming rate but the parents are like 'oh that's OK, it's just beer,"' he says. "We have to start to look at how we endorse certain kinds of behaviour patterns among young people."
Ultimately, Long's team tries to stay realistic when reaching out to teens.
"We don't come from a hard-line abstinence base, that's completely ineffective," he says. "We give them the straight facts, drawn from scientific evidence. We don't try to scare them."