By Rikhil Ranjit, SBHA Youth Advisory Council member
The following reflects Rikhil’s lived experiences, thoughts, and opinions.
As teens, we have probably seen more and more students turning to drugs for wide-ranging reasons. Personally, Georgia’s Forsyth County has seen a dramatic growth of high school students turning to the abuse of alcohol, marijuana, and, more recently, opioids and other unused/expired medication. I used to think I was immune to the drug crisis in high schools and that there was no possibility those issues could directly affect me. But, seeing my closest friends and peers involving themselves in that behavior has encouraged me to seek out avenues to minimize opioid’s impact on us as students, and I hope your experiences make you feel the same way. I have been involved in my county’s drug council, working on projects such as trying to create safe storage for expired opioids and distributing Deterra drug pouches, a bag used to deactivate unused or expired medications. Still, I recognize that we need a more holistic answer.
An unexplored method of resolving this crisis is intersecting school-based health centers with the fight against the opioid epidemic. Recently, across certain month periods, “overdose deaths among persons aged 10–19 years (adolescents) increased 109%”, and “90% of deaths involved opioids” (Centers for Disease Control and Prevention, 2022). This unnoticed rise begs the question of what we can do because consider this: 14% of high school students nationally have taken unprescribed opioids (Evans, 2020), but more than half of 10th graders visiting doctors weren’t asked about substance use (Hingson et al, 2013).
Here are three ways I think school-based health centers are already helping:
First, these centers are just more accessible. Students are not forced to travel long distances or struggle to find the best treatment, knowing they can visit a health center in their school to seek assistance.
Second, they de-stigmatize addiction treatment. Health centers can implement universalized screening tools that every student needs to go through annually, allowing for swift transitions from detection to treatment of opioid abuse. There is little concern about stigma deterring a student from attending a health center. In fact, studies suggest that students are 21 times more likely to approach a school-based health center than a community clinic.
Third, these centers work. Endorsed by the American Medical Association and the World Health Organization, school-based health centers can implement a screening, brief intervention, and referral treatment model called the SBIRT model. The model begins as guidance through positive reinforcement for students to continue making healthy choices and brief advice with patient-centered discussion. Adolescents who may be facing many consequences from substance use would be turned to specialized treatment (or the school-based health center can provide treatment themselves). This treatment could include community services to promote positive social connections or school activities to build self-esteem. This model within school-based health centers can be a huge catalyst in reducing opioid abuse. You can learn more about the SBIRT model here!
While the use of school-based health centers in the youth opioid crisis is promising, it’s a work in progress. In New York, fewer than half of clinicians were aware of SBIRT, but after being introduced to it, three-quarters agreed that implementing SBIRT may be an effective way to combat the opioid crisis (Harris, 2021). States like West Virginia and California have spent millions on school-based health center models to combat the opioid epidemic, but there is an overall lack of centralized data on school-based health centers in substance abuse. There needs to be a platform where reports can be shared, collaborated, and researched to find ways to hedge these centers as a primary fight against teen addiction rates. But until then, let’s continue to spread the word and ensure every teen can avoid going to substances in the first place. SBHCs can be effective in disseminating this education, from promoting effective pamphlets encouraging substance-free environments to collaborating with community and parent advisory councils to coordinate better events highlighting the harms of turning to substances.
Bibliography
Evans, R., Widman, L., Javidi, H., Adams, E. T., Cacace, S., Prinstein, M. J., & Desmarais, S. L. (2020). Preliminary Evaluation of a Prescription Opioid Misuse Prevention Program Among Rural Middle School Students. Journal of community health, 45(6), 1139–1148. https://doi.org/10.1007/s10900-020-00899-5
Harris, B. R., & Rich, J. H. (2021). Upstream prevention of opioid misuse in school-based health centers: provider attitudes, perceptions, and practice. Journal of Social Work Practice in the Addictions, 22(3), 200–211. https://doi.org/10.1080/1533256X.2021.1935153
Hingson, R. W., Zha, W., Iannotti, R. J., & Simons-Morton, B. (2013). Physician advice to adolescents about drinking and other health behaviors. Pediatrics, 131(2), 249–257. https://doi.org/10.1542/peds.2012-1496
Juszczak, L., Melinkovich, P., & Kaplan, D. (2003). Use of health and mental health services by adolescents across multiple delivery sites. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 32(6 Suppl), 108–118. https://doi.org/10.1016/s1054-139x(03)00073-9
Tanz LJ, Dinwiddie AT, Mattson CL, O’Donnell J, Davis NL. Drug Overdose Deaths among Persons Aged 10–19 Years — United States, July 2019–December 2021. MMWR Morbidity and Mortality Weekly Report. 2022;71(50). doi:https://doi.org/10.15585/mmwr.mm7150a2