An article published last year in CommonHealth, written by two pediatricians who treat addiction, made an argument for the need for a strategy for teens in the opioid epidemic (http://www.wbur.org/commonhealth/2017/08/29/the-opioid-epidemic-needs-a-strategy-for-teens).
The authors presented data from CDC showing a greater than doubling of the drug overdose death rate for teens from 2014 to 2015, highlighting that addiction is oftentimes a youth onset condition.
According to the Office of Adolescent Health, 4,235 youth aged 15 to 24 died from a drug-related overdose, over half of which were attributed to opioids (https://www.hhs.gov/ash/oah/adolescent-development/substance-use/drugs/opioids/index.html).
The Need for Prevention
The need for youth and young adult substance use prevention generally, and opioid use prevention specifically, is clear.
Many states have put into place strategies to address the opioid epidemic, including establishing community drop-off locations for disposing of unused prescriptions and provider education regarding the risks associated with over-prescribing.
However, as the authors of this article noted, these and other related strategies do little to directly address the prevention of youth from initiating opioid experimentation.
Schools and communities have increasing addressed the opioid problem by creating opioid awareness days, coalitions, summits, programs, campaigns and other events across the US.
Less common has been expanding the use of evidence-based programs (EBPs) proven to prevent substance use among youth.
A recent study showed that youth ages 10-18 were more likely to report non-medical opioid use if they used marijuana and alcohol in the past 30-days (https://www.sciencedirect.com/science/article/pii/S0306460317301351).
Considerations in Planning Opioid Prevention
Below are several considerations when planning a broader strategy to effectively prevent opioid use among youth and young adults in your community and state.
First, adopt one or more evidence-based prevention programs shown to effectively prevent the onset and/or reduce the level of substance use among young people. Evidence-based programs have been proven by research to result in positive outcomes. Blueprints for Healthy Youth Development is an example of a registry of evidence-based programs designed to promote positive youth development, including those addressing substance use risks (http://www.blueprintsprograms.com/about).
Second, choose EBPs that provide a good benefit to cost ratio. An excellent source for this information is the document Preventing Youth Substance Use: A Review of Thirteen Programs from the Washington State Institute for Public Policy (http://www.wsipp.wa.gov/Reports/540).
Third, select EBPs that not only prevent substance use but also promote protective fitness and healthy habits among young people. Programs that integrate substance use prevention with positive behavior promotion are more likely to be accepted and used by youth, families and funders than those limited to just communicating substance use risks and harm.
Fourth, risk for substance use, including nonmedical use of opioids, increases through adolescence and peaks in young adulthood. This fact highlights the essential need to emphasize prevention efforts during later youth developmental periods where risk is at its highest.
Fifth, youth and young adults participating in sports may be at greater risk for opioid abuse due to increased exposure to injury and therefore being prescribed opioid analgesics to relieve pain. For this reason, young people participating in school, college and community sports should be considered at enhanced risk and targeted for substance use prevention programs.
Sixth, provide evidence-based prevention in multiple settings to reach a broader youth audience, and ensure overlapping prevention messages. Critical settings for providing prevention programs include schools and colleges, healthcare, youth and family organizations, juvenile justice, sports and recreation programs, and homes.
States and communities should continue to increase efforts to combat the opioid epidemic by adopting evidence-based substance use prevention programs that have been proven to delay the onset and reduce the amount of substance use among youth and young adults.
Since not all evidence-based programs are the same, choose carefully by considering program cost/benefits, whether they address positive behaviors, degree of practicality, and ease of use.
While prevention may not be as glamorous as treatment, this article highlights the urgent need to address youth addiction broadly—and opioids in particular—and to reduce access to both illegal and legal drugs.
To maximize effectiveness, youth opioid prevention efforts should encompass a continuum of activities such as medicine disposal programs and awareness campaigns, while at the same time increasing the greater adoption of evidence-based substance use prevention programs.
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