The remote, mid-Atlantic country of Iceland has been in the news for the past few months for a very important and impressive reason – it has managed to decrease levels of teen substance abuse there by leaps and bounds. Twenty years ago, Icelandic teens were among the heaviest drinking teens in Europe. A 1998 survey of fifteen and sixteen year olds at that time found that 42% of them had been drunk in the past month, and 17% had at tried marijuana. 23% of the kids surveyed smoked cigarettes. However, a follow up survey conducted in 2016 showed major changes to these figures: only 5% of contemporary teens surveyed had been drunk in the past month, 7% had tried marijuana, and only 3% were cigarette smokers. These are the most drastic changes ever seen in teen drug substance abuse research anywhere, and now other countries and municipalities want to know why, and how this was achieved, and are attempting to follow suit. It’s hard to say yet if other countries can find the same success as Iceland, which has only 330,000 residents, and which is nearly a thousand miles away from it’s nearest neighbors, but many scientists, organizations, schools, and governments are now looking to Iceland for ideas and inspiration about ways to apply what they have done there to their own teenage population, and all hope for similar results.
How It All Began
How did this all happen? Well, it all starts with an American, actually – a psychology professor by the name of Harvey Milkman, who currently spends part of his year teaching at Reykjavik University. In the 1970s, Milkman focused his doctoral studies on drugs and drug use and participated in an internship at Bellvue Psychiatric Hospital in New York City. There, he became interested in not only why people do drugs, but why they do certain drugs, and he wrote his doctoral dissertation on why some drug users choose heroin and others choose amphetamines. He postulated these decisions were mostly based on the ways in which each individual deals with and experiences stress. After his dissertation was published, he was invited by the US National Institute on Drug Abuse to work with other researchers to study this and other substance abuse questions as a team. Together, the group worked to understand why people start using drugs, why they continue, when they reach a threshold of abuse, and when and why they relapse. It was during this time that Milkman began to see that drug users were yes, getting addicted to drugs, but more specifically, were getting addicted to the changes in brain chemistry that were created by the drugs – and he began to wonder about other, alternative ways brain chemistry can be changed, without the use of drugs at all.
Soon, Milkman found himself working at Metropolitan State College in Denver, where he continued his work and research in this area. He was awarded a $1.2 million grant to implement a program called “Project Self-Discovery” which offered local, at-risk teens, who were already using drugs, an opportunity to participate in “natural high” alternatives to drugs and crime. Participants were invited to his program to learn whatever they wanted – life skills training, music, dance, art, martial arts, and sports – and were assured that this was not a drug rehabilitation program. They were told the program would last three months – but it was so successful, many stayed for years, and stayed out of trouble in the process.
Iceland’s Plan & Program
As a result of this program, he was invited to speak in Iceland about his work and was subsequently asked to be a consultant for the first residential drug treatment center for teens in that country. He returned again and again to help out there and give more talks, and eventually attracted the interest of a researcher at the University of Iceland, Inga Dora Sigfusdottir. Sigfusdottir was so intrigued by his success that she wondered if the sort of program he had begun in Denver could not only be used to help adolescents get off drugs, but could also keep them from starting to use drugs and alcohol in the first place. She contacted Milkman, who had had the same ponderings as well, and discussed her ideas. She moved forward with her beliefs and created a survey of Icelandic teens to determine their current levels of use, with hopes to develop a program to make changes. The mayor of Reykjavik was on board (a third of the country’s population lives within the confines of that capital city); he understood that drug education was not appearing to be successful there, and was ready to try something different.
Sigfusdottir quickly learned from her survey that there were many commonalities amongst the teens who did not use or abuse drugs. The non-using teens were generally actively involved in sports, weren’t outside at night, and spent time with their parents during the week. She reported these findings to the mayor, and as a result, in 1998, a program called Youth in Iceland was born.
Youth in Iceland
The introduction of Youth in Iceland made many broad changes to the everyday lives of Icelandic teens. First of all, it made the purchase of cigarettes illegal to individuals under the age of 18, and the drinking age was set at 20. All advertising of alcohol and tobacco was also eradicated and made illegal. Curfews, still in place today, were enacted that required 13-16 year olds to be home by 10pm in the winter, and midnight in the summer. Law required the formation of parental organizations in every school, and school councils were established nationwide that included parent representatives. Talks were offered for parents about spending time with their children, knowing their children’s friends, and about keeping their teens home in the evenings. Home & School, the national umbrella organization for these parental organizations, created agreements for parents to sign. These agreements can vary from school to school, but generally encourage parents to disallow unsupervised parties, to not buy alcohol for minors, and to keep an eye on all teens – not just their own.
In addition to these changes, Iceland put a great deal of funding into creating positive activities for teens. With Milkman’s research on encouraging “natural highs” in mind, the country began to build facilities for leisure for its youth. Today, a visit to Reykjavik will find a vast number of sports facilities, ice skating rinks, public heated pools, community centers, and programs for music, dance, art, and organized sports – but they didn’t stop there. In addition to building these facilities, Iceland made it easy and affordable for teens to be a part of these activities by offering money to low income families so their children could participate, and in Reykjavik, all families are given $250 per year per child to pay for their recreational activities. As a result, the number of teens participating in organized sports grew from 23 to 46 percent in the first fifteen years that the program was in place.
The program seemed to be working, and is still working. It seems that giving kids activities to focus upon, and outlets for their energy, and places in which to achieve and feel accomplished as individuals, does in fact keep them drug and alcohol free. “In other words, give them something to do besides dope,” said Milkman in a recent interview. It seems like common sense, certainly. Many people have observed in their own personal experience that teens that are heavily involved in activities at and after school are often less likely to turn to substance abuse or crime – no scientific studies necessary. But the scale upon which Iceland has demonstrated this fact has resulted in outcomes that are far beyond the wildest dreams of most.
Can This Work Elsewhere?
After hearing about the successes of Iceland, many other countries and communities would like to try to recreate their results – but is it possible? The small size of Iceland is certainly a factor in their success, but their unique situation has not been enough to sway other places from trying to replicate what they have done there. In 2006, Youth in Europe began, and it works in conjunction with Youth in Iceland. The surveys conducted by Youth in Iceland have been completed elsewhere as well but on a smaller scale. Although no country has embraced their own program to the same level as Iceland has theirs, currently thirty-five cities in seventeen countries have surveyed their own teens and have sent the surveys back to Iceland for analysis. What they choose to do with the results is up to them – and the levels of participation by these cities has varied greatly; some have attempted to create many of the same programs as Iceland, but others have received Youth in Iceland’s analyses and have still chosen to do nothing. Regardless, none have yet shown anywhere near the incredible results that Iceland has.
In the United States, smoking and drinking among teens has certainly declined in recent years, but nowhere near the rate of Iceland. About 40% of tenth graders and 55% of twelfth graders in the USA reported using alcohol in the past year, which is a decrease from the past, but sounds immense when compared to Iceland’s figures. It’s hard to say whether a widespread implementation of the things Iceland has done would have an effect here. The United States currently has a population of 321 million people, compared to the 330,000 people living in Iceland. Furthermore, the differences in culture could be a major obstacle as well. Today, the United States seems to focus on treatment and punishment for drug and alcohol abusers over prevention, and our attempts at prevention education seem to fail consistently. Perhaps if United States politicians, physicians, and citizens got behind a program like Iceland’s Youth in Iceland, we could begin to see a major change – but the push would have to be universal, and that would be difficult if not impossible in a country as large and diverse as ours. Says Milkman, “It has to not be done in an autocratic or totalitarian way – the community has to buy into it” – and that may unfortunately be our biggest challenge, indeed.