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kottke.org posts about Harvey Milkman

How Iceland Has Dramatically Lowered Rates of Teen Substance Abuse Over the Past 20 Years

posted by Jason Kottke   Mar 02, 2020

There are certain links I’ve posted here that I think about more often than others. One that I think a lot about — weekly at least — is Emma Young’s story for Mosaic about Iceland’s very successful program that’s steered the nation’s teens away from drug and alcohol abuse. At the center of the Icelandic strategy is an insight by psychologist Harvey Milkman about a strategy of replacing substance and other unhealthy addictions with healthier natural highs:

At Metropolitan State College of Denver, Milkman was instrumental in developing the idea that people were getting addicted to changes in brain chemistry. Kids who were “active confronters” were after a rush — they’d get it by stealing hubcaps and radios and later cars, or through stimulant drugs. Alcohol also alters brain chemistry, of course. It’s a sedative but it sedates the brain’s control first, which can remove inhibitions and, in limited doses, reduce anxiety.

“People can get addicted to drink, cars, money, sex, calories, cocaine — whatever,” says Milkman. “The idea of behavioural addiction became our trademark.”

This idea spawned another: “Why not orchestrate a social movement around natural highs: around people getting high on their own brain chemistry — because it seems obvious to me that people want to change their consciousness — without the deleterious effects of drugs?”

BTW, this is a somewhat controversial view but it has always made sense to me for those with mild addictions or depression. Speaking strictly for myself, I’ve found that when healthier alternatives are available to me (spending time with family & friends, exercise, exploring, reading a good book), I spend a lot less time mindlessly doing things that give me the same sort of brain buzz but which I don’t consider positive or worthwhile (drinking alcohol, watching TV, eating poorly, and especially reloading Instagram over and over again like a lab rat slapping that lever to get more cocaine).

But back to Iceland. By giving teens access to more healthy activities, getting parents more involved in their children’s lives, implementing curfews, and administering annual surveys, the country has made great strides over the past two decades:

Today, Iceland tops the European table for the cleanest-living teens. The percentage of 15- and 16-year-olds who had been drunk in the previous month plummeted from 42 per cent in 1998 to 5 per cent in 2016. The percentage who have ever used cannabis is down from 17 per cent to 7 per cent. Those smoking cigarettes every day fell from 23 per cent to just 3 per cent.

The way the country has achieved this turnaround has been both radical and evidence-based, but it has relied a lot on what might be termed enforced common sense. “This is the most remarkably intense and profound study of stress in the lives of teenagers that I have ever seen,” says Milkman. “I’m just so impressed by how well it is working.”

Young did a follow-up last year about the expansion of the program into other areas of the world.