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Problematic Substance Use Prevention

Brief overview

Many young people experiment with substance use at some point during their development. For some students, this experimentation is low risk and for a relatively short period of time. For others, it may develop into a significant problem.

Substance use occurs along a spectrum (commonly called a continuum of use) ranging from no use at all to experiencing a substance use disorder. A comprehensive approach requires evidence-based strategies that address the needs of all students, regardless of where they fall on the continuum of use.

A horizontal continuum showing no use on the left and substance use disorder on the right. Screen reader support enabled. A horizontal continuum showing no use on the left and substance use disorder on the right.

The role of the SMH professional

As a SMH professional, you have a role to play in supporting educators with mental health promotion efforts, and in providing prevention and early intervention services in this area.

Research suggests that school communities can play an important role in preventing problematic substance use by

  • fostering welcoming and inclusive environments
  • offering universal mental health promotion programming and encouraging self-care
  • enhancing social-emotional skills to build confidence and resilience

SMH Professionals can help to convey the importance of building social-emotional skills and creating a sense of belonging at school to reduce the risk of problematic substance use.

Any adult in a caring relationship with students can play a role in early intervention by noticing that substance use may be impacting students’ lives.  You may wish to share the educator version of this info-sheet with school staff to help them notice signs of problematic substance use.  They are the eyes, ears and hearts who may notice first.  As a SMH professional, it could be you that notices signs that may point to the presence of a substance use problem.  Common signs you might notice when working with a student include

  • ignoring responsibilities at work, school, or home
  • giving up activities that they used to find meaningful or enjoyable
  • changes in mood (e.g., feeling irritable and paranoid)
  • changing friends
  • having difficulties with family members, friends, and peers
  • being secretive or dishonest
  • changing sleep habits, appetite, or other behaviours
  • borrowing money or having more money than usual

Some students require additional opportunities to build resilience and coping skills.  Strategies for prevention include

  • small group interventions that promote protective factors and wellbeing with youth who experience additional risk factors
  • individual or group structured psychotherapy designed to address mild-to-moderate anxiety and depression

Educators can also reinforce skills as part of daily classroom life. You can offer the educator version of this information for suggestions.

Trained SMH professionals may undertake intervention using Motivational Enhancement Therapy (including Motivational Interviewing) and Cognitive Behavioural Therapy approaches for students with identified problematic substance use concerns.  Some students with more significant needs in this area will require referral to more specialized substance use services.

For more information

Learn more about effectively increasing well-being to reduce problematic substance use through the Preventing Problematic Substance Use through Positive Youth Development resources.  Here is an infographic that could be shared with education professionals to highlight their important role in preventing problematic substance use:

Infographic for education professionals to highlight their important role in preventing problematic substance use.

And here is a video from Western University, Centre for School Mental Health that outlines the role of schools in building protective factors:

Learn more about evidence-based practice for SMH Professionals supporting students with problematic substance use in A Practice Guide for School Mental Health Professionals: School-Based Interventions Related to Student Cannabis Use.

You can find additional fact sheets for educators and parents on this website:

We’ve covered this topic on several occasions, most recently in a SIG co-led by CAMH, AMHO, and Toronto Public Health in February 2018. The session focused on the legalization of cannabis.

If you are a school mental health professional registered with a professional college and would like access to this material, please contact us.

Contact us. We can review relevant research to help to answer your question. In cases where several requests focus on the same theme, we can arrange for a more comprehensive review which will be shared on the School Mental Health Ontario site.

Brief summary of evidence-informed strategies by tier

All members of the school community have a role to play in promoting wellbeing and preventing and intervening with problematic substance use. At each tier of a comprehensive model, different professionals have different roles. Click on the options below for Tier 1, 2 and 3 to review evidence-informed strategies for school mental health professionals and other members of the school community at each tier.

School mental health professionals can

  • Contribute to the professional development of all staff in the area of mental health literacy, social-emotional learning, stigma reduction, etc.
  • Help school staff identify and implement evidence-based SEL approaches.

Other members of the school community can

  • Implement SEL programming across grades.
  • Allocate training and staff meeting time each year to build capacity among staff to promote social-emotional outcomes among students.
  • Partner with health unit to support parent and school community education.
  • Provide parents and guardians with important information by sharing the info sheets for families.
  • Prioritize healthy relationships with students.
  • Collaborate with public health partners to provide resources about health promotion and risk reduction.

School mental health professionals can

  • Offer evidence-based intervention for students with mild-to-moderate mental health problems through structured psychotherapy approaches (e.g. CBT and variants like BRISC, STRONG).
  • Offer group-based mental health promotion such as the Healthy Relationships Plus Program (which school mental health professionals can co-facilitate with public health nurses) or the Healthy Relationships Program for LGBT2Q+ youth.

Other members of the school community can

  • Participate in and support school activities that promote wellbeing, inclusion and connection (e.g., Gender Sexuality Alliances; activities and clubs for Indigenous youth or racialized youth).

School mental health professionals can

  • Use evidence-based assessment and interventions as described in A Practice Guide for School Mental Health Professionals: School-Based Interventions Related to Student Cannabis Use.
  • Refer for additional community services as needed.

Other members of the school community can

  • Learn about the continuum of use so that you can recognize when substance use may be problematic.
  • Refer students for assessment and intervention with your school mental health professionals if you are concerned.

Suggest a topic

We will continue to expand our resources based on input. Please send us your ideas for topics to cover so we can meet your professional learning needs.