Expanding School Staff Knowledge Regarding Youth Opioid and Other Substance Use Behaviors

Overview: We describe a training that was delivered to school staff that addressed opioid use disorder (OUD) and other substance use disorders (SUDs) in youth and the impact of COVID-19 on OUD, SUDs, and mental health. We discuss how the training was evaluated and highlight the need for school staff training.Proposal text:

Background: Drug use during adolescence is a risk factor for the later development of substance use disorders (SUDs) and other mental illnesses and is associated with negative academic outcomes (Bugbee et al., 2019; NIDA, 2020). Children of parents with SUDs are at increased risk for mental health challenges and developing SUDs in adolescence (Straussner & Fewell, 2018). The isolation associated with social distancing during COVID-19 places those with SUDs at risk for return to use and heightens existing mental health disorders (LeSaint & Snyder, 2020).

North Carolina, has been disproportionally impacted by opioid-related mortality. In 2017, North Carolina experienced 19.8 overdose-related deaths per 100,000 persons compared to a national average of 14.6 (North Carolina Department of Health and Human Services [NCDHHS], 2017). Due to the increase in opioid and other substance use in both adolescents and parents/caregivers, there is a need to train school personnel on opioid use disorder (OUD) and other SUDs. Therefore, a three hour virtual training was delivered to school health center staff that addressed: (1) screening, symptoms, and treatment of OUD in youth; (2) equity in assessment and treatment of SUDs (i.e., cultural humility, implicit bias, and equity in the provision of care); (3) the effects of parental OUD and SUDs on youth; and (4) the impact of COVID-19 on the opioid epidemic, SUDs, and mental health.

Methods: Participants’ knowledge of OUD and SUDs was measured using a 10-item instrument at pre- (before the training) to post-test (after the training). The instrument consisted of 9 questions that assessed knowledge of key topics covered. An additional question asked participants to rate their confidence in knowledge about OUDs in youth on a scale of 1 (low confidence) to 5 (high confidence). The sample included 42 school-based health center staff (e.g., nurses, social workers, counselors). The average years of experience in the field was 10.8 years. Additionally, the sample identified as 52% white, 31% Black, 2% American Indian or Alaskan Native, and 14% other. Ninety-eight percent of the sample identified as female.

Results: Sixty-seven percent of the participants demonstrated an increase in their total percent of correct responses from pre- to post-test, 7% demonstrated a decrease, and 26% of participants got the same total percent correct from pre- to post-test. A Wilcoxon signed-rank test indicated that this change from pre- to post-test was statistically significant (Z = -4.00, p < .001). Seventy-nine percent of participants indicated an increase in their confidence levels about OUD in youth from pre- to post-test and 21% of participants’ confidence levels stayed the same. A Wilcoxon signed-rank test indicated that the change from pre- to post-test was statistically significant (Z = -5.19, p < .001).

Conclusions: Given the effects of OUD and other SUDs among adolescents and families, there is a critical need to deliver trainings to school staff through a social justice and health equity lens for this vulnerable population. The exacerbating effects of COVID-19 on substance use have further highlighted the need to educate school personnel on OUD and SUDs in youth.