To be credible with participants, programmes need to be aware of the way young people view the benefits and the risks associated with substance use. All substance use meets some type of perceived need on the part of the user. While some needs may be met through a drug's effect (e.g., relief of pain, feeling of pleasure), others may be met through symbolism associated with use of a substance (e.g., sense of rebellion, feeling of belonging).
Young people use substances for many of the same reasons as adults (e.g., stress relief); however, there are some perceived needs or benefits that are more pronounced with young people because they satisfy issues related to adolescent development. These needs include: taking risks; demonstrating independence; developing values distinct from parents and other authorities; signalling entry into a peer group; seeking novel and exciting experiences; and satisfying curiosity.
A young person's view of how common or "normative" substance use is can be an important influence on his or her own use of substances. For instance, if there is a sense that most of their friends smoke, drink or use other substances, young people are more likely to do so. Some young people may use substances as consumer items -- in the same way they use clothes and music -- to establish an identity or image for themselves. Some youth do not choose substance use per se but rather choose a lifestyle that substance use is a part of, along with other elements such as alienation and rebellion.
Young people's attitudes and beliefs regarding substance use and risk tend to change rapidly and become more tolerant with increasing age. More so than adults, youth tend to minimize the risks associated with their own substance use, with young males tending to do so to a greater extent than young females. It has long been acknowledged that young people generally give less attention to long-term risks associated with substance use than they do more immediate social consequences (eg., being embarrassed in front of friends).
Views of risk by young people are linked to rates of use. In Canada, for example, attitudes of Canadian youth generally have become more accepting of substance use as rates have increased over the past 10 years. Attitudes of street youth tend to be more tolerant still and are influenced by a need to escape negative feelings and experiences and, in some cases, simply because they do not care (i.e., suicidal thoughts).
There is some indication that young people distinguish between lower-risk substance use and more problematic use. In one Canadian study of youth attitudes, those seen as using substances recreationally were considered popular socially, while daily or lone use was considered deviant and unacceptable. This perception by young people is in line with research that suggests that young people who engage in occasional substance use tend to be better adjusted psychologically than either non-users or heavy users.
While acknowledging the benefits of substance use perceived by young people, it is important that programmes work interactively with participants to help them weigh perceived benefits against perceived risks in an unbiased manner. With higher-risk youth, this is best achieved through motivational counselling.