Issue No. 22

Welcome to the Blueprints Bulletin

Leadership Letter: 

Several opioid settlements with pharmaceutical companies have been determined with more to come. Many of these resources are being distributed by states with the aim of addressing education, economic, social, and health hardships and creating sustainable innovations to address the opioid epidemic. This month’s newsletter highlights the role of prevention – most notably, scaling evidence-based preventive interventions listed on the Blueprint registry – as one approach embedded within a larger prevention strategy for guiding the effective use of these settlement funds.
 
The Power of Prevention
 
With the current opioid addiction and overdose crisis, many countries around the world have been ramping up treatment and harm-reduction services to mitigate the negative consequences associated with drug use. What is also needed, however, is prevention!
 
Dr. Diana Fishbein of the National Prevention Science Coalition to Improve Lives wrote an op-ed titled “Prevention is our best – and most underrated – weapon against opioids,” emphasizing the critical role for prevention in the battle against the opioid epidemic, which has only been exacerbated by the COVID-19 pandemic.
 
Over the past 30 years, prevention research shows that systematically addressing the root causes of behavioral problems among vulnerable populations and promoting protective and supportive environments will steadily divert trajectories away from substance use disorders, including opioid use disorders, later in life. The same risk and protective factors in child and adolescent families, schools, peer groups and neighborhoods that affect smoking, alcohol use and cannabis use are also predictive of advancing to opioid use.
 
Research on periods of vulnerability during youth development and the kinds of social and environmental factors that increase risks associated with substance use have led to the design and testing of numerous evidence-based prevention interventions that have been shown to reduce risk factors as well as increase protective factors. These evidence-based programs have multiple benefits – with some showing decreased or delayed drug experimentation in adolescence and young adulthood.
 
In this 15-minute talk, prevention scientist Dr. Phillip Graham provides a powerful and compelling case explaining the role of evidence-based individual, family, school, and community-level preventive interventions in the prevention of youth substance use and opioid misuse.
 
Opioid Settlement Funds
 
The opioid settlement funds offer a pressing opportunity to promote dissemination and scaling of effective prevention programs across communities and social systems. Settlement funds could save lives and abate lifelong harms from substance use disorders (including opioids) if they are allocated to the most effective preventive interventions targeting youth, families, and/or schools.
 
For this reason, states and jurisdictions should fund initiatives demonstrated by research to work and not fund programs shown not to work.

Investments in early intervention preventive approaches among youth and families will result in significantly lower long-term rates of substance use disorders. 

Blueprints-Certified Preventive Interventions
 
Primary prevention programs listed on the Blueprints registry are designed to improve child development, support families, and enhance school experiences. These programs are developmentally appropriate and many have been shown to either prevent the initiation of substance use or escalation of use.
 
Several organizations have published guidance on how to spend newly allocated opioid settlement funds on substance use prevention and mental health promotion that specifically reference the Blueprints registry. For example: 

• This opioid policy briefing from the National Prevention Science Coalition recommends the Blueprints registry as part of a Strategy for Preventing Opioid Use Disorders in Communities. The brief reviews current challenges regarding opioid use disorder and provides recommendations and strategies for prevention.

• Blueprints was referenced in a news piece titled: How To Invest Opioid Settlement And Federal Funding To Prevent Substance Use And Promote Youth Mental Health. Specifically, the news article said: “Too often, programs and interventions are not sustained on a long-term basis because of resource limitations and a lack of infrastructure. To ensure sustainability, recipients of funds should use established evidence-informed programs whenever possible and appropriate, as designated by reputable lists such as Blueprints for Healthy Youth Development.”

• John Hopkins Bloomberg School of Public Health released several “Principles for the Use of Funds from the Opioid Litigation,” including to Invest in Youth Prevention using compilations of effective youth primary prevention interventions, such as those listed on the Blueprints registry. 

Blueprints-certified programs can be effectively scaled when integrated into a comprehensive service delivery system based on an assessment of need, delivered at the community level, and supported by a monitoring and evaluation data infrastructure.
 
This previous newsletter highlights examples of effective frameworks for broad dissemination of Blueprints-certified programs.
 
Scaling of evidence-based programs, such as those listed on the Blueprints registry, is also part of a comprehensive national strategy to prevent opioid use disorder launched by the National Prevention Science Coalition to Improve Lives.
 
Conclusion
 
In sum, we believe that effective allocation of state opioid settlement funds toward prevention can and should be used to establish the infrastructure needed for a comprehensive approach to preventing youth substance use and mental health problems.
 
If you are aware of initiatives that use opioid settlement funds for large-scale dissemination of evidence-based preventive interventions listed as Model/Model Plus or Promising on the Blueprints registry, we are interested in profiling your work. Please contact us at blueprints@colorado.edu.
 
And as always, thank you for your continued interest in and support of Blueprints.

Sincerely,

Pamela Buckley, PhD
PI, Blueprints Initiative
Pamela.Buckley@Colorado.edu

Karl G. Hill, PhD
Board Chair and Co-PI
Karl.Hill@Colorado.edu

Blueprints for Healthy Youth Development is developed and managed by the University of Colorado Boulder, Institute of Behavioral Science, with current support from Arnold Ventures and former funding from the Annie E. Casey Foundation. Each intervention included in the Blueprints database has been reviewed carefully by an independent advisory panel that looked at research on the intervention’s impact, practical focus and potential for implementation in public systems.

Blueprints News and Resources 
Opioid Response Resources
 
In lieu of featuring one Model/Model Plus and one Promising program as we have historically done in each newsletter, we are highlighting two Blueprints-certified programs with high-quality evaluation studies demonstrating an impact on reduce of opioid use. These include:
 
Model/Model Plus Programs

Project Towards No Drug Abuse (classroom-based drug prevention program designed for at-risk youth that aims to prevent teen drinking, smoking, marijuana, and other hard drug use).
 
Study 1 – Sussman et al. (1998), Simon et al. (2002)

• Measured cigarettes, alcohol, marijuana, cocaine/crack, hallucinogens, stimulants, inhalants, and other drugs (depressants, PCP, steroids, heroin, etc.).
• Findings showed reductions in hard drug use (including opioids) prevalence rates at 1-year and 4-5-year follow-ups.

Study 2 – Dent et al. (2001)

• Measured cigarettes, alcohol, marijuana, cocaine/crack, hallucinogens, stimulants, inhalants, and other drugs (depressants, PCP, steroids, heroin, etc.).
• Findings showed reductions in hard drug use (including opioids) prevalence rates at 1-year follow-up.

Study 3 – Sussman, Dent & Stacy (2002), Sussman, Dent et al. (2002), Sussman et al. (2003)

• Measured cigarettes, alcohol, marijuana, cocaine/crack, hallucinogens, stimulants, inhalants, and other drugs (depressants, PCP, steroids, heroin, etc.).
• Findings showed reduced problem behavior rates (i.e., hard drug use, alcohol use, tobacco, and marijuana use) at 1-year follow-up, and reduced hard drug use at 2-year follow-up.

Study 4 – Sun et al. (2008)

• Measured cigarettes, alcohol, marijuana, cocaine/crack, hallucinogens, stimulants, inhalants, and other drugs (depressants, PCP, steroids, heroin, etc.).
• Findings showed reductions in hard drug use (including opioids) frequency at 1-year follow-up. 

Promising Programs

PROSPER (delivery system that attempts to foster implementation of evidence-based youth and family interventions, complete with ongoing needs assessments, monitoring of implementation quality and partnership functions, and evaluation of intervention outcomes).
 
Study 1 – Spoth et al. (2007, 2015), Redmond et al. (2009)

• Measured “Illicit Substance Index,” including marijuana, methamphetamines, ecstasy, opioids, and medications prescribed for someone else, as well as alcohol and cigarettes.
• Findings showed lower rates of lifetime use of gateway drugs (alcohol, cigarette, marijuana) and illicit drugs (marijuana, meth, ecstasy, prescription misuse, opioids), and lower rates of marijuana and inhalant use in the past year.

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