Understanding the Social and Biological Aspects of Adolescent Development: The Implications for

Substance Use Prevention

Jason Burrow-Sánchez, PhDProfessor | Dept. Educational Psychology

Director | MP Prevention Technology Transfer CenterUniversity of Utah

June 19, 2019Utah Coalition Training Summit 2019

https://pttcnetwork.org/mountainplains

Key Questions

• What are the prevalence rates for adolescent substance use and substance use disorders?

• What are important biological and socialdevelopmental markers for adolescents?

• How do we connect prevention programming with developmental markers?

SAMHSA’s Strategic Prevention Framework• Comprehensive

Planning Process – to prevent substance use/misuse

• 5 Steps and 2 Guiding Principles

Source: https://www.samhsa.gov/capt/applying-strategic-prevention-framework

IOM Continuum of Care

Source: IOM, Mrazek & Haggerty, 1994

Prevention Triangle

Primary Prevention“Universal”

Secondary Prevention“Selective”

Tertiary Prevention“Indicated”

Source: Walker et al., 1996

80%

15%

5%

18.1 18.1

12.4

9.4

6.46.7

8.6

6.1

2.1 2.1

Alcohol E-Cigarette Marijuana Cigarette Prescp Rx

6, 8, 10, 12th Grades - Utah

Lifetime 30-Day

Source: SHARP Survey Data, 2017

Age/Grade

Use

31.8 32.1

25

16.3

9.2

14.7 15.5

12.3

4.63

Alcohol E-Cigarette Marijuana Cigarette Prescp Rx

12th Grade - Utah

Lifetime 30-Day

Source: SHARP Survey Data, 2017

42.5

34 34.1

15.6

26.7

20.9

13.5

7.5

Vaping (Any) Vaping Nic Vaping Flav Vaping Mar

12th Grade

Lifetime 30-Day

Source: Johnston et al., 2019 – Monitoring the Future

Source: Utah DSAMH 2016 Annual Report – 2014/15 SAMHSA & SHARP Data

12,080

1,326

SUD

Num

ber o

f You

thUtah Youth Treatment Need vs. Received

NEED TX RECEIVE TX

Why is Adolescent Brain Development Important?

Image Source: NIDA, www.drugabuse.gov

Major Parts of the Adolescent Brain• Cortex Area

• Prefrontal Cortex

• Limbic Area• Emotion

• Amygdala (fear, anger)• Hippocampus (new

memories)• Hypothalamus (hormones)

• Brain Stem• Keeps us alive

Content Source: Walsh, 2013Image Source: NIDA, www.drugabuse.gov

Reward Pathway

Image Source: NIDA, www.drugabuse.gov

Image Source: NIDA, www.drugabuse.gov

Source: https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain

Adolescent Risk Taking, Impulsivity, and Cognitive Control• Risk taking

• Engage in sensation-seeking behaviors • Adolescents engage in more risk-taking than younger or older

age groups

• Impulsivity• Correlates with risk-taking• Emotional rather than cognitive process

• Cognitive Control• Consequential thinking, decision making, problem solving

Source: Boucher & Sandhu (2013)

Puberty

Major Psychological Tasks

• Identity Development• Self

• “How do I see myself?”

• Others• “How do I see others?”• “How do others see me?”

• World• “How do I see the world?”• “How does the world see me?”

Identity Worksheet

Descriptors 

Evaluation

Self

Others 

“+” or “‐” 

Source: Burrow-Sánchez et al., 2015

Social Markers of Adolescent Development• Age-based social markers:

• 13: Teenager

• 16: Driver’s License

• 18: Adult• Vote• May or may not be eligible for youth/adolescent

programming• Join Military

• 18-21: Use Tobacco Products Legally

• 21: Use Alcohol Legally

Adolescent Development

Birth Puberty Adolescence Young Adulthood

0 11-13 13-18 19 >

Adolescent

Family

Peers School

Community

Neighborhood

Societal Norms

Laws

Geographic Differences

Prevention of Substance Use• Prevent youth from using the substance

“Have you ever used a substance?”

• Prevent the delay of onset of substance use“When did you first use the substance?”

• Prevent the use of substances from becoming more severe

“How do you decrease the use of a substance?”

Perceived Risk and Substance Use

• Perceived risk of using a substance• Higher risk correlates with lower use

• Disapproval of using a substance• Higher disapproval correlates with lower use• Peer versus parental disapproval

• Use of a substance• Higher risk and disapproval correlates with less use

4.71%

4.99%

5.94%

5.76%

6.46%

8.80%

9.02%

36.57%

27.78%

27.66%

26.54%

25.75%

20.91%

16.21%

Utah

North Dakota

South Dakota

Wyoming

Total U.S.

Montana

Colorado

Perception of Risk Versus Use of Marijuana: Past 30 Days

12-17 Risk 12-17 Use

Source: National Survey on Drug Use and Health, SAMHSA, 2016-17 State Estimates

Source: Tsai et al., 2018

37.5

32.3

17.4

4.7

43.7

26.8

16.1

5.2

Friend/Family Use

Flavors

Less Harmful

Easier to Get

Reasons for Vaping

Middle School High School

Prevention (and Intervention) Principles

• Prevention is important• Prevent substance use or prevent problem from worsening

• Teach about changes in body and brain• Developmental growth periods• Effects of substances on brain/body

• Teach emotional regulation• Anxiety, anger, and negative moods

• Teach problem-solving and decision-making skills• Understanding consequences, choices, and planning of behavior

• Teach influence of contextual pressure• Peer pressure, social media, advertising

Ages, Developmental Tasks, & Areas of Intervention

Ages Developmental Tasks Intervention Areas

12-14 Identity, risk taking/impulsivity, emotional regulation

Emotional regulation,problem-solving, decision-making, peer relations

15-17 Identity, individuation, connection, exploration

Problem-solving,decision-making, etc.

18-20 Identity, school-to-work(school)

Goal setting, school and vocation skills

21-24 Identity, early adulthoodStability, goal attainment, transitions from school or work

Thank You!!

Jason Burrow-Sánchez, PhDEmail: jason.burrow-sanchez@utah.edu