Teen Opioid Abuse: Can LifeSkills Training Reduce Misuse?
An evidence-based prevention program has shown promising results.
Posted Mar 28, 2016
by Marco Sterling
Discovering an effective "teachable moment" for seventh grade students, researchers in Pennsylvania and Iowa are reporting significant results with LifeSkills Training, or LST.
Focusing on helping students develop practical skills for resisting drug use, one timely course of LST is proving to have lasting effect throughout the teen years. Furthermore, by combining LST prevention intervention with the Strengthening Families Program: for Parents and Youth 10-14 (SFP), even greater success rates are achievable.
After marijuana and alcohol, US Health and Human Services reports (1), the most commonly abused substances by Americans aged 14 and older are prescription and over-the-counter drugs. These also account for the most commonly abused drugs among high school seniors.
About 11 percent, or 1 in 9 young people aged 12-25 used prescription drugs non-medically within the past year. According to the National Institute on Drug Abuse (NIDA), Vicodin, a commonly prescribed opioid pain reliever tops the list at 8 percent. (2)
Offering opioid prevention intervention in the lives of teens, researchers identified a successful "teachable moment" while working with seventh graders. Evaluating the impacts of school-based interventions on teens' prescription opioid misuse, Dr. D. Max Crowley of Duke University and colleagues from Pennsylvania State University lately reported on a data study from a recent trial PROSPER prevention program.(3)
PROSPER, or PROmoting School-community-university Partnerships to Enhance Resilience, is a prevention intervention program led jointly by Mark Greenberg of Penn State University, and Richard Spoth of Iowa State University, with NIDA funding.
Choosing between LifeSkills Training (LST), All Stars (AS), and Project Alert (PA), 14 Iowa and Pennsylvania communities selected their preferred PROSPER intervention. All three programs were "universal," meaning that all seventh graders received the training, not just "at-risk" kids. Most students, together with their families, had also received the Strengthening Families Program: for Parents and Youth 10–14 (SFP) program the prior year.
Focusing on developing practical skills for resisting drug use, all three PROSPER programs included classroom sessions addressing social and psychological factors leading to drug experimentation. Likewise, important components of all three programs included games, discussions, role-playing, worksheets, online content, posters, and videos.
Control communities were identified for all 14 PROSPER program communities, from which comparison analysis was drawn. At the 6th grade pre-test, and at the end of each year through 12th grade, all students were asked, "Have you ever used Vicodin, Codeine, Percocet or OxyContin not prescribed by a doctor?"
Isolating the effects of the three individual PROSPER programs on misuse of prescription opioids, Crowley and his colleagues reported interesting results. The researchers' analysis found that Project Alert did not significantly reduce opioid misuse with or without SFP. All Stars, when used in combination with the earlier SFP program, showed a seven percent reduction in opioid misuse as compared with students in the control communities. Without SFP, both All Stars and Project Alert actually showed a nearly two percent increase in misuse.
LifeSkills Training, however, showed a four percent decrease in misuse, even when offered without the earlier SFP program. When paired with SFP, LST proved even more successful, with a nine percent reduction in misuse of prescription opioids among 12th grade students.
Dr. Crowley and colleagues estimated the average community cost of a single case of teen prescription opioid misuse at $7,500, based on previously established research. By comparing this figure with Crowley's previous work estimating actual per student costs of PROSPER program materials(4), the research team then estimated the cost effectiveness of LST.
The PROSPER LifeSkills Training program cost $613 per student, and therefore represented a community savings of $6,887 for each teen that the LST program prevented from misusing opioids. Combining LST with SFP cost $3,959, thus saving the community $3,541 for each case of prescription opioid misuse prevented. While the community savings were less when LST was combined with SFP, the researchers noted that community health benefits were greater, because more teens were successfully prevented from misusing opioids.
Dr. Crowley noted, “This work illustrates that not only can existing universal prevention programs effectively prevent prescription drug misuse, they can also do so in a cost-effective manner." He added, "Our research demonstrates the unique opportunities to combine prevention across school and family settings to augment the larger prevention impact” (5)
Effectively reaching young students in their teachable moments is proving successful against teenage drug addiction. With proper prevention strategies such as Life Skills Training, opioid abuse can be successfully prevented. The costs of this training are more than offset through reduced community spending for health and social services related to teen opioid misuse.
The leading cause of injury death in the US is drug overdose.(6) Together with quicker response to overdoses and wider availability of drug addiction treatments, there is clearly room for more improvement in the prevention arena. LifeSkills Training offers very promising hope against the current epidemic of opioid abuse in America.
Marco Sterling is the editor of Palo Recovery, an addiction recovery blog.