“If you’ve been out in the snow too long and you’re freezing and someone takes you into a good, warm place and they’re like, take a hot shower, it burns. It burns because all of that blood flow goes to your core to protect you, but it feels like you're on fire.”

This is how Cairo Justice, a community advocate and Americorps member with the Lawrence County Health Department, describes the experience of young people seeking help for substance use, using an analogy she heard in a meeting. When someone has been freezing for a long time, warmth can hurt at first. Even something meant to heal, like a hot shower, can burn. It can be hard to accept help, especially with stigma and barriers that persist, Justice said.

For many students in Kentucky, reaching out is not immediate relief; it can feel overwhelming and sometimes inaccessible. Yet across the state, communities are working to ease that initial “burn,” expanding mental health care, reducing stigma and building recovery-focused solutions.

Going Beyond Myths

Contrary to popular belief, addiction is not a moral failing. It is a public health issue that can affect young people from all walks of life. The American Society of Addiction Medicine explains addiction as a “treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences.”

According to the Kentucky Department of Education, tobacco/nicotine makes up the largest portion of behavior events involving drugs, alcohol, or tobacco (66.8%), followed by marijuana use (22.2%), other drug use (7.9%), and alcohol use (2.1%). The Kentucky Lantern indicates that Kentucky youth increasingly experience accidental overdoses.

Dr. Alex Elswick, Assistant Extension Professor for Substance Use Prevention and Recovery at the University of Kentucky, and co-founder of Voices of Hope in Lexington, emphasizes the importance of dispelling common myths. One he hears a lot among youth is that “everyone’s doing it.”  Another misconception he hears for adults and youth is that “addiction happens to certain kinds of people—bad people, weak people, people who are criminals, or people who come from broken homes or any way that we try to categorize it.” 

Speaking from his personal experience as a person in recovery, Dr. Elswick shared that he thought, as a young person, if he was making good grades, showing up to class, and playing well in sports, he didn’t have a problem. “The reality is that substance use disorder is kind of an equal opportunity offender. It really doesn't matter what your demographic background is. Certainly, there are certain risk factors that'll make you more likely or less likely, but it's not a type of person,” he explains.

He says teens overestimate peer substance use, which can create pressure to experiment. Dr. Elswick uses this example when speaking to students: “If I really believe that 85% of my peers are smoking and I’m not, then I probably do think I’m an outsider.” He thinks that’s an important myth to bust, because it equates to a form of peer pressure.

There are contradicting ideas about what substance use is, as students have different ideas of what it really means, and adults should guide students to debunk these myths, not consume them. 

Students Feel Left Behind

Students can feel left behind as stigma grows and support feels far out of reach. Brisa Lopez, a senior at Opportunity Middle College/Lafayette High School in Lexington, KY, notes that support in schools can feel limited and confusing. “I am unaware of any help other than the numbers they have on the lanyards,” she says, referring to crisis hotlines printed on school IDs.

Lopez emphasizes that students need guidance that helps them make decisions for themselves. Justice and Lopez both agree that we have to “help students understand why they want to quit. Quit for themselves, not for societal approval.” 

Chris Williams, a counselor at a dual-credit program through Opportunity Middle College, says that what data shows is that addiction can affect anyone, regardless of race, socioeconomic status, or sexual orientation. 

Williams believes that substance use and mental health are intertwined, and shouldn’t be looked at so independently. He says there needs to be more education and openness, because once bonds or relationships have been established with students, someone will be more willing to come and ask for help.

In regard to programs like D.A.R.E. (Drug Abuse Resistance Education), Williams thinks it did a good job at responding to the criminalization of drugs. Criminalizing something doesn’t leave the door open for conversation, he says. “[It] really creates something that's taboo, and typically people aren't gonna wanna talk about that. So, I think D.A.R.E. is a good response to that,” he adds.

Dr. Elswick says that D.A.R.E. “wasn’t effective, period, at preventing substance use,” because it didn’t address any of the actual risk factors. While widely recognized, programs like D.A.R.E often fail because they do not address the underlying trauma or risk factors that contribute to substance use. Experts have called for more holistic support, education, and discussion, and harm reduction.

Williams says that though he knows people question whether that’s the purpose of school—if the school system is designed to focus on mental health—his personal opinion is that “I don't think we have the luxury to be autonomous. I think that schools do serve an important part of the community.”

Plus, he says, there’s pressure on schools to do well. “So I think it's difficult sometimes for schools to be willing to give up some of that time when they know that that's not necessarily going to maybe immediately [be] correlated to a higher test score designation,” he says. “But I would also argue that I think the healthier your students are, that, too, is going to benefit how your school performs.”

According to Elswick, peer-based programs can be especially helpful. “Because that way instead of programming getting delivered from an old guy like me, it's coming from someone who's a peer, who's of the same age and like-minded and all that sort of thing,” he says. 

Youth recovery systems are most effective when they are designed with young people in mind. Too often, students feel left behind, and trauma-informed care aims to close this growing gap.

Trauma-Informed Approaches, Peer Support, and Connection Matter

Justice and Dr. Elswick agree that trauma-informed approaches are essential. Justice highlights the power of meaningful social connections, noting that “the opposite of addiction is connection.” Students who are isolated or disconnected from peers, school, or community opportunities might be more likely to engage in potentially dangerous behaviors. Communities need to be proactive in making sure every kid's voice is heard.

Instead of trying to scare young people into abstinence, Dr. Elswick described a trauma-informed approach that recognizes “that kids who are using drugs almost certainly have a variety of pre-existing risk factors. They're not using drugs because they're bad kids, they're using drugs because they have mental health disorders or trauma or all these other things.”

Dr. Elswick adds, “Instead of asking, ‘What’s wrong with you?’ it’s like, well, ‘What happened to you? And what are the needs that need to be met?” Meeting people where they are is a critical part of the work. He stresses that youth programs are most effective when they recognize the underlying causes of substance use, including trauma and mental health challenges, rather than simply promoting abstinence.

Voices of Hope, co-founded by Dr. Elswick, is a peer-based recovery community center. “We’re peers with lived experience,” he explains. This approach creates a level playing field, allowing people to feel understood and supported.

Research shows the most effective way to reduce stigma is through “contact-based strategies,” Elswick explains. “Which is really just a fancy way of saying kind of person first, oftentimes storytelling.”

“The more that we talk about substance use and substance use disorder, the more that we reduce stigma, the more that we bring people kind of out of the shadows and out of the silence, and then people are less afraid to reach out for the help that they need,” he says. He adds that involving peers in youth programming as much as possible is really helpful.

Justice agrees that peer support is critical. She encourages students to help their friends stay connected. “So seriously, we just have to keep showing up for people, show them that we love them, that we do care about them,” she says.

Hope and Recovery

Despite challenges, hope remains. Elswick says substance use disorder is a “good-prognosis disorder,” meaning most people recover. “There’s plenty of hope,” he says. Justice also emphasizes the importance of open, stigma-free conversations about substance use. The more communities talk honestly, the less shame surrounds seeking help.

Experts converge on key solutions: reduce stigma, meet youth where they are, invest in mental health services, and build strong social connections. Whether through counseling, peer recovery programs, family education, or simply creating safe spaces to talk, Kentucky can improve outcomes for young people facing substance use challenges.

Stepping into a hot shower after being frozen can hurt, but it’s also the start of healing. For Kentucky’s youth, seeking help may feel overwhelming at first. With proper resources, trauma-informed care, and community support, that first step does not have to be taken alone.

Recovery from substance use is possible and treatment is available. For help and support, please visit FindHelpNowKY.org or contact the Substance Abuse and Mental Health Services Administration 24/7 hotline at 1-800-662-HELP (4357).