Developing Harm Reduction in the Context of Youth Substance Use: Insights from a Multi-Site Qualitative Analysis of Young People’s Harm Minimization Strategies

YouthREX Research Summaries ask Just Six Questions of research publications on key youth issues. These summaries get at what the youth sector needs to know in two pages or less!

1. What was this research about?
The study explored youth understanding of substance use and strategies for reducing harm. The researchers argue that prevention approaches often emphasize abstinence goals, which do not resonate with youth. They say these approaches fail to acknowledge how young people view substance use and the social contexts they’re navigating.

This study raises critiques of the narrow focus of prevention programs. Rather than helping youth to develop skills that will assist them in identifying and mitigating harms, many prevention programs focus on avoiding use altogether. Researchers draw attention to harm reduction programs: “Harm reduction includes abstinence goals but is based on a philosophy of starting where the user is at and offers a pragmatic, yet compassionate set of strategies designed to reduce harmful consequences of substance use for both the user and the broader community” (p. 2).

2. Where did the research take place?
The research took place in British Columbia, Canada.

3. Who is this research about?
The research is about youth. It explores why they do or don’t use substances and the various strategies they use to reduce risk and harm. The study analyzes data collected from interviews with 83 youth between the ages of 13 and 18.

“This study suggests that youth are actively engaging in strategies to minimize the harms of substance use within their local contexts — yet are doing so on an informal or ad hoc basis” (p. 9).

4. How was this research done?
Data was collected from three research sites, identified by pseudonyms:

• The City – a large urban centre with a population of 604,000
• The Valley – a suburban city, with a population of approximately 133,000
• The North – a town and surrounding a First Nations reserve in a rural setting, with a population of approximately 4,800

The study drew on data collected from the Researching Adolescent Distress and Resilience (RADAR) study. This is a qualitative study conducted in B.C. between 2012 and 2014. It used ethnographic methods, meaning researchers paid attention to contextual factors affecting participants. Interviews were conducted (lasting between 30-120 minutes), for which participants received honourariums of $20. Interviews were then transcribed and analyzed to identify themes and key findings. Youth did not need to have parental consent to participate in the study.

5. What are the key findings?
The study found that youth take up a range of informal harm minimization strategies:

The City:

• Youth participants in this region described their peers who used substances as popular or cool. However, they also described substance use (aside from cannabis use) in negative terms.
• They maintained substance use limits by avoiding contexts where limits might be exceeded. They described staying away as a form of self-protection.
• When youth in The City chose to use substances, they minimized risk by using in moderation and making choices about types of substances used. They avoided use of substances they saw as especially risky.

The Valley:

• Youth in this region described their social contexts as stratified on the basis of substance use. Youth who did not use substances held negative views of youth who did.
• Similarly to youth in The City, youth in The Valley minimized potential harms by avoiding contexts where substances were being used.

The North:

• Youth in The North described substance use among their peers as commonplace. They described contexts where boredom and lack of opportunities led youth to see substance use as an activity in itself.
• Youth in The North tangibly grappled with issues related to intergenerational substance use and the ongoing impacts of colonization and social marginalization.
• Youth in The North described their harm minimization strategies as developing after watching or experiencing the negative effects of substance use. Some youth avoided perceived harms by reducing use or abstaining all together.

Overall, the study found that youth experiences, perspectives, and tools for managing substance use were deeply impacted by geographical, social, and cultural factors. Youth developed strategies and approaches that allowed them to navigate substance use in alignment with their own perspectives and values.

6. Why does it matter for youth work?
This study shows the importance of developing harm reduction frameworks and practices responsive to cultural, social, and geographical contexts. Youth workers supporting youth who use substances can use the findings outlined in the study to develop interventions that meet youth needs and contribute to risk minimization.

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Categorised in: Research Summary