Healthy Start Stories |
Ingmar Franken

Substance abuse among young people: ‘With input from the target group itself, we hope to better understand what it takes to prevent young people from becoming addicted.’

We almost all take it sometimes. A beer, a glass of wine, a cigarette. Often it remains with ‘recreational use’. But for some people, the urge for stimulants is so great that there is an addiction. Not infrequently, the first signs of addiction arise in adolescence, a period that is pre-eminently characterized by discovery and trying. But how is it possible that one person stays experimented with experimentation and the situation is getting worse with the other? And what does it take to ensure that young people do not become addicted? Ingmar Franken, professor of Clinical Psychology and ambition core team member at Healthy Start, talks about this.

“It sounds innocent: the first joint or beer in puberty. And fortunately, that is often the case. For most young people, the use of substances, such as alcohol or drugs, remains within limits. But that doesn’t apply to everyone. For some of the young people, the first joints or beers are the start of a negative spiral. For example, regular smoking leads to less desire for school. This increases the risk of truancy. And before you know it, truancy leads to hanging on the street, wrong friends, debts and sometimes even crime. Substance abuse is therefore often not isolated and can have a major impact on all aspects of life. Meanwhile, most young people with these kinds of problems stay under the radar for a long time. The danger is that they only come into the picture when the problems are so serious that the way back is very difficult. I want to know how we can better help these young people. How do we prevent them from becoming addicted and coming into contact with the justice system?”

Young people end up in a negative spiral: from smoking to truancy, wrong friends and even crime

From conscription to addiction care

“My whole career I have been interested in substance abuse and addiction. Yet that interest arose purely by chance. Just before I went to college, I was called up for conscription. I didn’t want that and so I had to fulfill an alternative task. That became a project in what is now called addiction care. It was a forced alternative, but that’s exactly where my fascination with substance abuse and addiction arose.

After the alternative military service, I went to study psychology. There I learned more about addictions and about the interaction between substance use and the brain. My interest grew and I decided to work as a therapist in addiction care. That was intense work. The target group itself was already challenging, but I also found it frustrating that half of the patients were back at the point where they started within three months. Why didn’t the treatments work? At the same time, I began to wonder which comes first: the addiction or a disruption in the functioning of the brain. In retrospect, these questions turned out to be the start of my scientific career.

I now know: once addicted, it is very difficult to get life back on track

“I am now many years further and wiser. Research has yielded a lot of knowledge. At the same time, I have come to the conclusion that it is very difficult for those who are addicted to get life back on track. That is why I now want to focus more on preventing addiction. I am thinking in particular of young people who are dependent on resources, but who are not yet in the sights of professional assistance. There are opportunities here. Let us make sure that they do not become patients.”

Why do young people become dependent on resources?

“Within Healthy Start, we conduct research into substance abuse among young people in a special way. As scientists, we are used to working top-down: we come up with the research questions and draw up hypotheses. But within Healthy Start we ask young people themselves what is going on and what they need. This provides very valuable information. For example, we now know that substance abuse mainly occurs among young people who are vulnerable and do not dare to say ‘no’.

With input from the target group itself, we hope to better understand what it takes to prevent young people from becoming addicted. To investigate this further, together with scientists from TU Delft, we are developing a smartphone app with which we ask young people every day, sometimes even every hour, where they are, with whom, what they do and how they feel. This allows us to check whether there are certain patterns that lead to substance use. In addition, we want to know whether feedback on this motivates young people to look at their own behavior. We also focus on delinquent behavior. Within regular care, substance abuse and criminal behavior are often treated separately, but research shows that these behaviors often arise from the same reasons. For example, some young people use drugs and commit a crime to suppress depressive feelings.”

It is precisely the future dreams of young people that can be a motivation to stop drinking alcohol and drugs

“We don’t just focus on addiction and delinquent behavior. We also want to know what young people’s ambitions are. What do they want to achieve in life? What dreams do they have for the future? I think there is still too little attention for this. And that’s a shame. Because it is precisely the future dreams of young people that can be a motivation to stop drinking alcohol and drugs.”

A push in the right direction

“I really hope that with Healthy Start we can reach young people who are experiencing problems with substance abuse but are not getting help at the moment. What do they need? Do they perhaps have debts or mental health problems? Good help is already available for many problems. We are therefore not going to develop new treatment programs, but mainly try to give young people a push in the right direction.

In the long term, I would also like to focus on healthy forms of pleasure. The current research focuses mainly on negative forms, such as drugs and alcohol, but dancing and social activities, for example, also provide pleasure. Coincidentally, a Healthy Start project will soon be launched into the influence of music on the physical and mental health of young people. A great initiative. I hope that with this kind of research we can help young people find sustainable forms of pleasure in life.”

I hope that eventually we can help young people find sustainable forms of pleasure in life

Discover what your passion is

“Of course, I also run into things. The discussions with young people and other stakeholders, such as aid workers and municipalities, provide very valuable input. But then you also have to do something concrete with it. That is why it is important as a scientist to keep your goal in mind. Where do you want to go? At the same time, you must remain flexible and open to the input of others. That sounds contradictory, but I see it as an enrichment of my work as a scientist.

Finally, I work a lot with enthusiastic, young scientists. That gives me a lot of energy. Nevertheless, I would advise them not to focus on a scientific career. It is precisely within Healthy Start that you have the opportunity to get to know other roles that also require scientific knowledge. I am thinking, for example, of a ‘knowledge broker’. Find out what your passion is and if you leave science, don’t see that as failure. You can also use your knowledge and skills in other ways.”

Ingmar Franken’s Healthy Start perspective
“The ambitions of Healthy Start are closely aligned with my own way of working. I’ve never been a standard ‘ivory tower researcher’, I know what it’s like to stand with my feet in the clay. But within Healthy Start I discover what it is like to involve different target groups in scientific research in a professional way. I not only work with young people and scientists from TU Delft, but also with municipalities, addiction care, researchers from the Department of Criminology, Forensic Psychology and specialists from the Erasmus Medical Center. In the long term, we also want to do brain research. What I like about Healthy Start is that it brings together very energetic and open-minded people. With a group of people like that, I think you get the best science.”

Ingmar Franken is involved in the ambition ‘tackling juvenile delinquency and addiction’ as core team member.

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