More than 67,000 people died from drug overdose in the United States in 2018 with opioids having accounted for more than 46,000 of those deaths. The COVID-19 pandemic has only increased death and overdose from opioid and other substance misuses across the country. Furthermore, at least 75 percent of people with a substance use disorder (SUD) began their substance use during childhood or adolescence.
One potential strategy for preventing SUD is to provide family-focused, primary-prevention interventions in adolescence. The National Academies of Sciences, Engineering, and Medicine’s Board on Children, Youth, and Families convened a workshop that examined how such interventions have been used to address SUD in primary health care settings. The workshop considered barriers to and opportunities for implementing these interventions, and highlighted existing policy efforts to incorporate these interventions into statewide health care strategies. Since many terms used in this proceedings can have multiple definitions, the workshop planning committee outlines the following key definitions:
- Prevention: universal prevention addressing the entire population, regardless of risk level;
- Adolescent: youth aged 10–19, with an emphasis on the earlier years in the range;
- Health care setting: including all health care providers (e.g., pediatricians, physician assistants, and nurse practitioners), as well as health educators;
- Caregivers: the people in a child’s life who have primary responsibility for monitoring and supervising that child; and
- Substances: most often refers to illicit drugs, such as opioids.
This workshop was a hybrid meeting, with both in-person and virtual participation, and was held on May 5th and 6th, 2022. Discussions on the first day made the case for family-focused interventions in health care settings and outlined the barriers and opportunities that might exist during implementation and scale-up of such interventions. The second day highlighted policies available to support family-focused interventions and featured perspectives from several federal agencies on their work related to substance use disorder. Finally, the workshop concluded with a small-group activity for those attending in person. The small groups discussed the components needed for future interventions in health care settings to be successful. Following discussion, the small-group leaders reported to the plenary group.
This proceedings document is organized into five chapters. Following the introduction, Chapter 2 presents family-focused interventions that can be used in health care settings. Chapter 3 covers the various barriers to and opportunities for both initial program implementation and widespread scale-up, while Chapter 4 highlights federal agency perspectives on these interventions. Finally, Chapter 5 presents ideas for future directions to prevent substance use disorder in adolescence, including obtaining funding, sustainability of the workforce and interventions, and effective strategies for engaging families.
This proceedings has been prepared by the workshop rapporteur as a factual summary of what occurred at the workshop. The planning committee’s role was limited to planning and convening the workshop. The views contained in the proceedings are those of individual workshop participants and do not necessarily represent the views of all workshop participants, the planning committee, or the National Academies.