On January 26th 2016, CSSDP Okanagan, a fledgling chapter, hosted its first public information talk. Our guest speaker was Dr. Marvin Krank. He has extensive research experience in substance use, with a focus on use by adolescents. His presentation for us was, “In the age of rational drug policy, is prevention necessary.”

Dr. Krank first addressed the issue of the “War on Drugs,” and visited the point that this “war” causes great harm, with no real reduction in use. He also pointed out that the harm caused by this war has far-reaching impacts, from our own families and neighbourhoods to major conflicts around the globe. Additionally, Dr. Krank stated that many mistakes have been made, but there are mistakes made on the other side of the issue as well. He then went on to discuss that how we address use matters. Unrestricted access carries potential for great harm, and even how we as a society depict use has considerable consequences. Later in the talk, Dr. Krank touched on this when he urged the importance of minimizing commercialization, especially as it relates to youth-targeted advertising. In essence, Dr. Krank advocated for the need for an evidence-based approach to drug policy, with research findings regarding the etiology and consequences of substance use factored into how we, as a society, rationally deal with the reality of substance use.

Dr. Krank explained that his research focused on teens as they are at a developmental point in their lives where crucial neural and cognitive growth and changes are occurring. It is at this point in brain development when the frontal cortex and its executive functions, can be inalterably impacted by choices made when the individual is grappling with identity development and the need to be self-determining. He then went on to share findings from a study he conducted in the North and Central Okanagan regions of British Columbia. This study looked at 1,305 students in grades 7 to 9, and assessed how what they thought about substances early in adolescence impacted their use of them in later adolescence. In this study, youth were asked such questions as, “What do you expect to happen when you drink a moderate amount of alcohol,” and “How much would you like this outcome,” to get a sense of how the students thought about the risks and benefits associated with substance use. The study found that greater positive outcome expectancies were positively associated with substance use later in adolescence, and with an increased amount of use. In other words, Dr. Krank’s study found that later substance use can be predicted by earlier beliefs about substances and their use.

For background information, Dr. Krank referenced Dr. Daniel Kahneman’s work with dual processing approaches to understanding how the brain makes errors in judgement (Thinking Fast and Slow, 2011. MacMillan Press). This approach says that there are two systems at work in decision-making: System 1 being the “Associative Machine,” responsible for the automatic processing that occurs quickly, and usually below our level of awareness, and System 2, which involves executive functioning and working memory, and thus is a slower, more rational process. In System 1 processing, cognitive biases are found to be a common feature. These biases lead us to reach for the answers that are consistent with what we already believe, as well as to think that rare events are more common than they really are; for example, when we think that “everyone is having more ‘fun’ on the weekend than I am” (Facebook posts, anyone?). In Dr. Krank’s study, they found that the students who over-estimated social norms also showed more conformative behaviour, and experienced greater substance use. Dr. Krank added to this by pointing out that the adolescent brain, which is still developing its working memory and executive functions, relies even more on the default processing of System 1. This makes adolescents more vulnerable to cognitive biases and poor decision making.

Dr. Krank also covered the role of social learning in producing cognitive biases, such as occurs from exposures to parental and peer behaviour, and popular culture. This comes back to the commercialization issue. Dr. Krank discussed studies that considered the impact of alcohol advertisements on youth, whose findings confirmed that such exposures form automatic associations, and that alcohol use is correlated with exposure to advertisements. Further, researchers have found evidence that automatic associations can affect the influence of the social environment.

The significance of these findings speaks to prevention initiatives, specifically: drug literacy programs. It is important to consider that, improperly done, these programs can cause automatic associations to form and lead to outcome expectancies, thus increasing risk for substance use. He added that it is known that the use of facts to counteract myths about use does not maintain its benefit past 24 hours, and that both types of information create outcome expectancies. Dr. Krank urged that these programs need to be scientifically assessed for their usefulness, rather than taking for granted that educating youth about the perils of substance use works.

According to Dr. Krank, an important area for research is the role of social cognition in adolescent substance use. Perhaps this could reveal effective methods for targeting substance use cognition to counterbalance social influences. Dr. Krank also urged that we keep a strong check on youth–targeted advertisements of all substances as they become legal. Further, he suggested that promoting social activities and stress coping skills could play an important role in preventing substance use. In the end, Dr. Krank did stress that prevention efforts are still important even this coming time of, hopefully, rational drug policy.