Valerie Hardcastle, PhD, MA
Vice President of Health Innovation and Executive Director of the Institute for Health Innovation
Northern Kentucky University
Northern Kentucky University
Highland Heights, KY
It is clear that we need more effective ways of reaching patients with burgeoning use disorders, especially among rural juvenile and young adult populations, as they are now the primary demographic who is in danger of later dying from an opioid-related overdose. In addition, age at first use inversely correlates with the likelihood of developing a substance use disorder. Furthermore, adolescents engaging in substance abuse exhibit deficits in a variety of cognitive tasks, such as recall, attention, spatial skills and executive. However, even experienced pediatric healthcare providers can miss up to two-thirds of adolescents with moderate to severe substance use without the use of a screening tool.
Rural high schools provide a unique opportunity for screening adolescents, when the risks for future use and permanent brain damage are highest. The Substance Abuse and Mental Health Services Administration recommends universal screening for substance use with SBIRT, an evidence-based approach to the delivery of early intervention and treatment to people with substance use disorders and those at risk of developing these disorders. Using motivational interviewing strategies, clinicians can quickly assess the severity of substance use, then briefly intervene if needed, focusing on increasing the person’s insight and awareness regarding substance use. They can also refer to treatment those identified as needing more extensive treatment access to specialty care. The few schools that have implemented SBIRT in the school-based health clinics have seen positive outcomes. For example, when implemented in 13 rural schools in New Mexico, 85.1% of the students received brief intervention, after which the students reported decreased or no substance use at a six-month follow-up.
A partnership among Northern Kentucky University, Northkey Community Care, and the Owen County School System is integrating an SBIRT protocol in schools to better support youths who are using illicit substances by providing a cost-effective way to prevent opioid use disorder, especially in youth and young adults. This program has three goals: (1) Educate health and wellness staff located within the schools in SBIRT, (2) Track and analyze the outcomes of this education in terms of reported use, drug-related arrests, overdose rates, and attitudes toward illicit substances, and (3) Develop a “train the trainer” model for the Owen County health and wellness personnel to train teachers and others in the technique as well. This presentation will discuss the lessons learned from the initiative and provide tips for those who wish to implement similar programs in their school systems.
Sponsor: Northern Kentucky University