
Iceland knows how to stop teen substance abuse - zdw
https://mosaicscience.com/story/iceland-prevent-teen-substance-abuse
======
mundo
All of the pessimism ("This only worked because Iceland is so small/white/etc,
it would never work in the US") in this thread baffles me. Are there a lot of
other wildly successful approaches we should try first? Did you not read the
bits about the Icelandic approach working well in other cities?

If anything, it sounds like the lesson here is that what worked so well is not
just the approach, it's the implementation. (It's not like "build a sports
facility" or "pass a curfew" or "encourage parents to spend more time with
their kids" haven't been tried in the US) What I took home is that those same
approaches which have had limited success when done on a small scale work a
lot better when they're well-funded and taken seriously and used consistently
for a long time.

~~~
Trill-I-Am
Diversity is not the issue, poverty is; serious, chronic poverty the type of
which Iceland doesn't have.

~~~
mjolk
Reducing non-legal-substance abuse is considerably easier in Iceland as well;
comparative to the US, it's quite difficult to find drugs in Iceland -- they
don't have an equivalent Mexico[0] (or other similarly unstable country) for
which narcotics can trivially flow through as Iceland is an island.

[0] [https://www.cia.gov/library/publications/the-world-
factbook/...](https://www.cia.gov/library/publications/the-world-
factbook/geos/mx.html) see transnational issues, illicit drugs

~~~
aylmao
Where there's demand, there's supply.

Mexico wouldn't be such a drug-trafficking powerhouse if it didn't have the
world's biggest consumer market right above.

~~~
mjolk
Without getting into a discussion of addiction, the choices of those at risk
of addiction, decision making in young adults, or any other aspect of this
kerfuffle, even if Iceland had the demand, they wouldn't have the supply --
it's incredibly hard to get high on drugs that aren't physically there. Access
is a major factor.

~~~
aylmao
Bro, drug-dealing is a multi-billion enterprise. Drug dealers are using 747s,
submarines, tunnels, speed-boats, etc to supply.

Trust me, there IS drugs in Iceland. And I can asure you, if there were a
spike in demand drug dealers wouldn't fold their arms. Locals would grow
weed/cook meth in their backyard and find ways to smuggle foreign product too.

~~~
mjolk
> Bro, drug-dealing is a multi-billion enterprise. Drug dealers are using
> 747s, submarines, tunnels, speed-boats, etc to supply...Trust me, there IS
> drugs in Iceland.

Grammatically, 'there "are" drugs in Iceland', but that's besides the point.
Anecdotally, I've been around them in Iceland and they were treated as a
rarity and not like they are here (northeast US), where I could find them
within 30 minutes of asking.

It's quite difficult to make a tunnel or a submarine that travels from Mexico
from Iceland. There are few airports in Iceland and they take smuggling quite
seriously as by-air is one of the very few ways to transport illicit goods.
Finally, the social mores around production of methamphetamine are far
different than hearing someone you know took a pill while partying. Ease of
supply chain deeply matters.

edit: Also, please don't call me "bro"

~~~
aylmao
> Also, please don't call me "bro"

Sorry, won't do.

> Grammatically, 'there "are" drugs in Iceland', but that's besides the point.

Welp, honest gramatical mistake from a non-native speaker. Even the best of us
make mistakes sometimes, thanks for the correction.

Having said that, please don't correct me any more, I personally felt it more
pedantic than helpful, and I think you can read over small issues like that to
keep conversation centered on what matters (:

> Anecdotally, I've been around them in Iceland and they were treated as a
> rarity and not like they are here (northeast US), where I could find them
> within 30 minutes of asking.

Anecdotally, I go to school in the northeast US, and I know the density of
consumers there is pretty high; I assume higher than Iceland. Unsurprising
there's dealers all over too.

\--

I see what debate we're falling into here; does supply create it's own demand?
There's plenty of literature on the issue, and I will agree with you in that
the easy of supply matters.

Your original comment and subsequent replies make me believe you think drugs
is a supply-centered issue, when in fact thats far from true, and I know this
for two reasons:

1\. The US has for years been on a "war on drugs", and now they brought Mexico
into it. Yet this hasn't been effective at all as a means of stopping drug
consumption.

2\. Island tackled drug demand instead, and it had fantastic results.

Is supply in Iceland constrained? For certain drugs perhaps. But this doesn't
matter to the main point of the article. We can have a look at a point I made
you didn't address; weed. Weed consumption is on the ground in Iceland, yet
anyone could grow weed in their backyard to satisfy supply. Alcohol is legal
in Iceland too, I suppose there is a lot of supply. 20 years ago, they were
trying to cut supply and it didn't work. So now they did something different,
and it worked.

Look, if you think the reason the US is in such a bad drug situation all
because of Mexico, I can't convince you you're wrong, you'll have to figure
that one out on your own. What would convince you of this? What data is needed
to convince people like you of the fact the problem is in the demand and so
the US should focus on the well-being of its population instead of paying lots
of money so Mexicans kill each other?

~~~
mjolk
> Having said that, please don't correct me any more, I personally felt it
> more pedantic than helpful,

And won't do :)

Didn't mean it to be pedantic -- I spend a lot of time around non-native
english speakers and "correct mistakes in passing" without any sort of
judgment. Likewise, they correct my grammatical/word-choice issues with non-
english languages, but apologies if I offended as that was not the point.

\--

> Your original comment and subsequent replies make me believe you think drugs
> is a supply-centered issue

Not entirely, but in first-time users or casual users, it definitely changes
the equation of whether or not they get pulled into an evening.

> 1\. The US has for years been on a "war on drugs", and now they brought
> Mexico into it. Yet this hasn't been effective at all as a means of stopping
> drug consumption.

I think Mexico has always been a part of it -- the US is quite effective in
reducing/policing large-scale illicit drug production within its borders, but
this doesn't really matter when we have a neighbor with no meaningful interest
in doing so as long as the harm is extra-national.

> We can have a look at a point I made you didn't address; weed.

Sorry, I mentioned this in a different comment, but weed is a far different
thing than what I consider to be _serious_ drugs. It's still not something you
can wildly grow in Icelandic climate or soil though.

> Look, if you think the reason the US is in such a bad drug situation all
> because of Mexico, I can't convince you you're wrong, you'll have to figure
> that one out on your own.

I didn't say that the US's addiction problems are fully because of Mexico (or
other weakly policed nations), near did I think I imply it.

> What data is needed to convince people like you of the fact the problem is
> in the demand and so the US should focus on the well-being of its population
> instead of paying lots of money so Mexicans kill each other?

Do you really think Americans pay money for Mexicans to kill each other? I'm
sorry, but this is absurd. Making something illegal will reduce its supply
(drugs, guns) and create a market for criminals. If a country can't control
the criminals within its borders, or worse, as is the case with Mexico, lets
itself be controlled by crime and corruption, that's a demonstration of a
failure of government.

------
tristor
Interesting report. I wonder how they motivated kids to attend the after-
school programs? It doesn't really talk about that extensively. At least for
me, I used to attend an after-school program and a major motivator was being
able to spend time doing things with girls I liked. The party scene at that
time mostly was a proxy for the same thing. Giving teens a chance to socially
and romantically interact outside of the structure of school might be all
that's needed to get people to show up and participate.

I pretty much agree with their conclusions though from my own personal
experiences. The most trouble I've gotten into in my life, even as an adult,
was out of boredom more than anything else.

~~~
r00fus
I thought that's something that churches try to monopolize.

~~~
tristor
Well, religion and the church have been successfully used for centuries to
control people, provide a moral compass, and give teenagers and children a
place to interact with each other outside of the rigors of daily life. So,
yeah... Basically.

~~~
r00fus
Well what I guess I'm saying is that this phenomena of having the government
provide such places ... competes with a main focus of churches - and in the
US, churches have large political power.

I guess I don't see such a solution being feasible here for that reason.

------
Gargoyle
This article says there are only 49 places to buy alcohol in Iceland, which
does seem like it could make it much easier to control.

[https://warontherocks.com/2015/09/your-guide-to-drinking-
in-...](https://warontherocks.com/2015/09/your-guide-to-drinking-in-iceland/)

~~~
funnyfacts365
Oh man. And then they drink 'till comma whenever they get out of the country,
because alcohol it's so expensive in Iceland.

How do I know? Married to an Icelandic woman, have seen my fair share of drunk
Icelandic people when they come to Portugal on vacation, and do they get
wasted...

~~~
flukus
It seems to scale too, when rich Saudis are on vacation...

------
mahyarm
Could you find towns or regions of 300k in the USA with a similar lack of teen
substance abuse too?

~~~
haser_au
For kicks, I looked for one. I got as far as Anchorage, Alaska. In 2012, ~35%
of "youth" have consumed alcohol in the past 30 days

Research:
[http://justice.uaa.alaska.edu/research/2010/1010.voa/1010.04...](http://justice.uaa.alaska.edu/research/2010/1010.voa/1010.04.youth_alcohol_access.update.pdf)

List of Cities:
[https://ballotpedia.org/Largest_cities_in_the_United_States_...](https://ballotpedia.org/Largest_cities_in_the_United_States_by_population)

------
anotheryou
I'm so glad I had just 6 hours of school per day. While I did play in a music
schools ensemble, I'm much more fond of the time I spent in bands and esembles
away from schools hierarchy and with people I especially cared about. Same
goes for doing art and programming founding a venture for concerts and so much
more...

------
8421504
I imagine that family-centrism makes it much worse for the minority who have
abusive narcissists for parents.

~~~
_archon_
This is a problem in every society, and must be addressed in a different way.
If the role of government is to provide its children with a fundamental
understanding of themselves and how to manage their individual motivations,
perhaps the resulting adults will be better equipped to rise above their
parents' shortcomings? Strong family and team dynamics will pull how healthier
people live into stronger contrast in such a situation.

------
Analemma_
Oy, this thread. I've griped about this before -
[https://news.ycombinator.com/item?id=12864151#12865128](https://news.ycombinator.com/item?id=12864151#12865128)
\- we really need a snappy name for the "I know it works in every other
country, but it can't possibly work in the US" argument-slash-fallacy.

It's not inherently wrong and it can be true, but it's used so reflexively and
across so many different domains (drug use, public transit, taxes, guns,
health, voting, labor rights) that I have to think it's more of a thought-
terminating-cliché to shut down any discussion of the topic than an honest
attempt to find a solution. People just don't want to think about it, and it
causes a ton of cognitive dissonance to see that a solution they politically
dislike can work, so they jump to this.

~~~
netsharc
You can probably call it racism...

~~~
Analemma_
I figured my comment was inflammatory enough as is so I didn't mention it, but
yes, that is probably part of it.

------
prog_1
Doesn't anybody have a problem that the nature of their approach is first and
foremost prohibition?

~~~
_archon_
It would appear that the nature of their approach is first and foremost to
ensure that any change they make is data-driven best practice for the
situation at hand. In iceland, it included prohibition of purchase by minors
and provision to minors by adults. More importantly, their changes created a
situation where children were more likely to spend more of their time with
adults who cared about them, in an active and engaged society. Curfews make me
uncomfortable, but I can see that this encourages children to be in safe
places overnight. Prohibition makes me uncomfortable, but it makes consumption
more expensive and difficult, so child users will be less likely to become
addicts. Widely available after-school classes and programs... have no
downsides other than cost, which (it would seem) are clearly worth it.

Where does best practice lie? If I were to start a civilization from scratch,
I think I would use this model as a strong data point when organizing how
education and the laws pertaining to youth were concerned.

I have some more libertarian leanings than some of the implementations
presented can accommodate, but perhaps if I were an Icelandic teen I would
direct my frustrations on a hobby or class I picked up because my government
mandated that I have access to it if I wanted to.

------
bussierem
They cut smoking/drinking by providing facilities for after school programs
for kids to sign up for, which presumably a large portion have been told to go
by their parents (probably to stop them from smoking/drinking).

I know this observation has zero bearing on the data presented, but I also
noticed that not a single child in those photos has anything resembling a
smile. NONE of them look happy to be there.

~~~
jacobolus
The weird requirement that everyone smile at cameras and photographers only
take pictures of smiling people is a relatively recent cultural convention,
started in the US and then spread around the world by US influence. I think it
has something to do with the culture of photography used for
advertising/sales.

If you try taking pictures of very young children who haven’t yet been
indoctrinated into the smile-for-the-camera tradition, they’ll make a wide
variety of facial expressions for the camera. But American (& al.) children
learn very young that the cultural norm is to always make sure to smile when a
camera is pointed at you. Even if the children don’t figure this out for
themselves (and they usually do), parents and other adults are often quick to
tell them to smile or scold them for not smiling.

If you look at pictures of people in posed pictures in the 19th century or in
parts of the world where there are few cameras/photographs, the standard
expression is usually a serious/formal one. And if you look at candid
pictures, people will just be making whatever natural expression they had.

~~~
andrei_says_
As a photographer, 80% of my time is consumed with removing the frozen into
frigid mask smile from the faces of my subjects.

Natural emotions and thus facial expressions are fluid and involve things
beyond our control.

A smile held for the camera accompanied with non-smiling eyes (very rarely can
someone create a smile in the eyes and hold it) looks unnatural.

------
kelvin0
TL;DR: Idle kids 'waste' their energy getting into self destructive behaviors.
When the youthful energy is focused on a useful and valued skill, the chances
of addictive behaviors is significantly lowered.

~~~
edejong
TL;DR 2: Using a continuous and meticulous data-driven approach, Iceland was
able to positively exercise large-scale social change.

~~~
akjainaj
Well, "large scale"... it's a culturally/racially homogeneous country of a
little over 300k people. Whatever works there will probably not work anywhere
else

~~~
obmelvin
The exact solution may not work, but the overall approach to finding a
solution very well could.

I also somewhat disagree with the notion that systems working in smaller
countries cannot work in larger or more diverse countries (esp. regarding free
education the US). It may be really, really damn hard, but such is the price
of advancement of society.

~~~
DKnoll
Calling Iceland even a 'smaller country' seems a bit of a leap, even if it
were a city it would still be far from being considered a large one.

~~~
chimeracoder
> Calling Iceland even a 'smaller country' seems a bit of a leap, even if it
> were a city it would still be far from being considered a large one.

Just a few numbers to put in perspective:

* Iceland's population (as of 2013) was 323,000.

* As of 2015, the US had 58 cities whose population was over 320,000. Combined, these cities account for about 16% of the total population of the US.

Though, even that's a bit misleading, because city populations aren't actually
as meaningful as metropolitan populations (since city boundaries are
arbitrary, and traveling between a city and the adjacent suburbs is easy).
Since Iceland is an island, it's more elucidating to compare it to
metropolitan areas:

* The US has 155 metropolitan areas whose population is larger than the 320,000. Together, these cities account for 74.7% of the US population. So, three-quarters of people living in the United States live in a metropolitan area whose population is greater than that of the entire country of Iceland.

~~~
mos_basik
That's beautifully put. Thank you.

------
saiya-jin
very contained and rather unique place. very little of their success is
transferable elsewhere though.

it's easy to police borders of a super tiny country in the middle of atlantic
ocean, not interesting place for smugglers. (been there, and apart from
Reykjavik whole island is almost completely empty with tiny closed villages
here and there).

> A law was also passed prohibiting children aged between 13 and 16 from being
> outside after 10pm in winter and midnight in summer.

totalitarian approach, could be successful but also strapping every kid to the
bed would prevent drug consumption. its a question how far will state go to
remove freedom to protect citizens.

~~~
jameshart
What does border policing have to do with the article?

~~~
Gargoyle
The rest of that sentence indicates it has to do with smuggling. In other
words, given the border situation, there should be less contraband
availability. And so presumably less abuse of controlled substances.

I'm not sure it really is a major factor, but it's a valid point to raise.

~~~
jameshart
Ah, but this is not a comparison study between Iceland and other countries,
this is a comparison between Iceland _today_ and Iceland _in 1998_.

So the 'smugglers did it' hypothesis must be that 20 years ago, Iceland was
larger and located closer to major continents, making it a better target for
smuggling contraband, but that volatile icelanic geology has moved it out into
the north atlantic and led to the reported changes in juvenile delinquency and
substance abuse. Possible. We should conduct further studies to eliminate this
confounding factor.

~~~
Gargoyle
Has snark _ever_ been a convincing tool? I think it must be among the very
least effective tactics available.

The point here is that due to having less contraband, any efforts to restrict
the substances can be more effective. If there's more contraband floating
around, restrictions are harder to enforce.

In other words, you can get more result for your effort if there aren't
alternative ways to obtain the substances.

------
tn13
The last time I checked Iceland's population was 323,002 mostly homogeneous
racially similar people in geographically and economically similar region.

Good for Iceland that their teenagers don't smoke as much. But there is little
information for other countries in there.

Smoking is going out of fashion pretty fast in USA too.

[http://www.usatoday.com/story/news/nation/2016/12/13/teens-d...](http://www.usatoday.com/story/news/nation/2016/12/13/teens-
drinking-smoking-drugs-study/95349684/)

~~~
sean_patel
> Smoking is going out of fashion pretty fast in USA too.

Source?

Yes, Smoking traditional tobacco is going out of fashion pretty much around
the world. It's been replaced by the increasing popular E-Cigarrettes /
"Vaping", which is also Tobacco and poses the same health risks as traditional
tobacco.

Especially very prevalent among-st Teenagers and young people. Heavily
marketed by Big Tobacco as "Safe".

Sources:

1) CDC: Tobacco Use Among Middle and High School Students — United States,
2011–2015:
[https://www.cdc.gov/mmwr/volumes/65/wr/mm6514a1.htm?s_cid=mm...](https://www.cdc.gov/mmwr/volumes/65/wr/mm6514a1.htm?s_cid=mm6514a1_w)

1) England: Smoking rate continues to decrease while vaping gains in
popularity [http://www.vapingpost.com/2016/09/22/england-smoking-rate-
co...](http://www.vapingpost.com/2016/09/22/england-smoking-rate-continues-to-
decrease-while-vaping-gains-in-popularity/)

2) The good news is that cigarettes are out these days. The bad news is that
tobacco is still in. [http://www.teenvogue.com/story/vaping-tobacco-
popularity](http://www.teenvogue.com/story/vaping-tobacco-popularity)

~~~
ThrustVectoring
>E-Cigarrettes / "Vaping", which is also Tobacco and poses the same health
risks as traditional tobacco.

This is wrong, and absolutely harmful information to spread. Cigarette smoking
causes cancer through burning tobacco plant matter, a process that releases a
variety of toxic chemicals. Vaporization of e-liquid does not burn tobacco
plant matter, and thus doesn't have the same issues.

E-liquid is basically nicotine, glycerol and/or proplyene glycol solute, and
flavoring. Nicotine replacement products aren't associated with cancer risk.
The solute is much the same stuff as in asthma inhalers. There isn't really
good research for the flavoring, but it's generally ingredients that are
recognized as safe to put in food.

Overall, vaping is likely at least an order of magnitude safer than smoking.
Probably two. That's not anywhere near "the same health risks as traditional
tobacco." I'm personally more worried about spending lots of time near busy
roads. If a policy causes X more people to vape per person that no longer
smokes, X would have to be at least 100 for me to think it's a net negative.

~~~
manarth

      Nicotine replacement products aren't associated with cancer risk
    

There is evidence that Nicotine replacement products do increase the risk of
cancer. Every source I've read says that the risk is less than smoking
cigarettes, but vaping (for example) is still an increased risk over not using
nicotine at all.

Current NHS advice puts vaping at 95% less risk than smoking, which is to say
an increased risk (5% of the smoking risk), compared to not vaping.

\- [https://www.nhs.uk/smokefree/help-and-
advice/e-cigarettes](https://www.nhs.uk/smokefree/help-and-
advice/e-cigarettes)

\- [http://scienceblog.cancerresearchuk.org/2009/04/24/can-
nicot...](http://scienceblog.cancerresearchuk.org/2009/04/24/can-nicotine-gum-
cause-mouth-cancer/)

\-
[http://www.nhs.uk/news/2009/04April/Pages/NicotineGumCancer....](http://www.nhs.uk/news/2009/04April/Pages/NicotineGumCancer.aspx)

\- [http://www.cancer.net/navigating-cancer-care/prevention-
and-...](http://www.cancer.net/navigating-cancer-care/prevention-and-healthy-
living/stopping-tobacco-use-after-cancer-diagnosis/health-risks-e-cigarettes-
smokeless-tobacco-and-waterpipes)

~~~
ThrustVectoring
Yeah, the research on nicotine replacement products isn't very mature. The
links you gave are interesting, but more along the lines of "nicotine can do
the same sort of things to mouth cells that happens when you have mouth
cancer", not "we took a look at X number of people and looked at mouth cancer
incident rates".

The NHS advice is interesting, thanks for contributing it. It's a good sign
that I'm on the right track - I put it at "one to two orders of magnitude", or
to use the same units, 1% to 10% of the cancer risk of cigarettes. The NHS is
likely biased towards saying things cause cancer (because incentives - nobody
causes a ruckus if something they thought causes cancer is safe, but everyone
gets way riled up if something the NHS thinks is safe causes cancer). So my
updated belief is now that vaping causes less than 1% of the cancer that
smoking does, per user.

