The full literature review and executive summary may be downloaded below.
Over the past decade, communities within the United States have been engaging in efforts to prevent opiate misuse and overdose deaths. Nationally, the number of overdose deaths due to opiates has continues to increase (Scholl, 2019) supporting the need for continued efforts to prevent opiate misuse and overdose deaths.
Recent surveillance data highlights a continued threat of methamphetamine, resurgence of cocaine, increase in illicit use of marijuana, and spike in vaping in the United States (DEA, 2019; Johnston et al., 2020).
Taken together, these reports on current substance use patterns in the United States support the need for maintenance of current efforts on opiate misuse, implementation of strategies to prevent vaping and cannabis use among adolescents and young adults, and continued monitoring and acknowledgment of the potential threat of cocaine and methamphetamine use. It is important that prevention practitioners and researchers follow these substance use trends and implement a comprehensive set of strategies to address these different substances. When possible, strategies that are effective in preventing multiple substances should be considered to best utilize limited resources.
To provide prevention providers a tool to address emerging substance use by implementing strategies that they are currently, or recently, have utilized to address opiate use and associated consequences within their communities, a review of the literature was conducted.
First, prevention strategies that had been implemented in North Carolina (NC) to address opiate misuse were identified using the North Carolina Substance Abuse Prevention Block Grant (NCSAPBG) Intervention Categorization Interventions Allowable for All Provider Agencies (last updated on 8-10-18). Then, the peer- reviewed literature was searched for manuscripts that assessed the effectiveness of strategies, utilized to address opioids, on preventing vaping, cannabis, methamphetamine, and cocaine use or intervening variables. For a manuscript to be selected, it must have met the following criteria: (1) test a prevention intervention or strategy that can be categorized as information dissemination or environmental strategy; (2) the strategy must have been previously utilized to address opiates (based on inclusion within the NCSAPBG Master Grid; and (3) address an emerging substance based on epidemiological trends (i.e., vaping, cannabis, methamphetamine, and cocaine). Manuscripts published in PubMed between January 1, 2000 through December 31, 2019 were considered.
SUMMARY OF FINDINGS AND RECOMMENDATIONS
The findings from the literature review indicate that strategies should be substance specific and tailored to the needs of the communities. The most promising information dissemination strategies were communication campaigns and public service announcements. It is important that these campaigns have been developed utilizing theory and input from the target population and have demonstrated or show promise of effectiveness. The environmental strategies related to reducing access of substances to adolescents and young adults may be the most promising. An environmental strategy from the opiate, and alcohol, literature that could be relevant for cannabis and vaping products is secure storage when obtained and used legally by adults. However, more suitable strategies for legal (adult) cannabis and vaping products may come from alcohol or tobacco environmental strategies that regulate sale (e.g., outlet density, proximity to schools, etc.).
The dynamic nature of substance use threats calls for timely research on effective strategies that can be utilized by community agencies to protect their communities. Practitioners and researchers should work together to empirically test intervention strategies to ensure that evidence-based strategies can be quickly implemented within communities to minimize the adverse effects of substance use behaviors.
DEA. (2019). Drug Enforcement Administration National Drug Threat Assessment 2019. US Department of Justice. https://www.dea.gov/sites/default/files/2020-01/2019-NDTA-final-01-14-2020_Low_Web-DIR- 007-20_2019.pdf
Scholl, L. (2019). Drug and Opioid-Involved Overdose Deaths—United States, 2013–2017. MMWR. Morbidity and Mortality Weekly Report, 67. https://doi.org/10.15585/mmwr.mm6751521e1
East Carolina University
Kathleen L Egan, PhD, MS
North Carolina Training and Technical Assistance Center
Jamie Edwards, MA, M.Ed, LCAS/A, CPS