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. 2023 Oct;24(Suppl 1):99-110.
doi: 10.1007/s11121-023-01566-6. Epub 2023 Jul 1.

Prevention of Opioid Use and Disorder Among Youth Involved in the Legal System: Innovation and Implementation of Four Studies Funded by the NIDA HEAL Initiative

Kym Ahrens  1 , Natalie Blackburn  2 , Matthew Aalsma  3 , Kevin Haggerty  4 , Kelly Kelleher  5 , Danica K Knight  6 , Elizabeth Joseph  7 , Carrie Mulford  8 , Ted Ryle  9 , Marina Tolou-Shams  10
Affiliations

Prevention of Opioid Use and Disorder Among Youth Involved in the Legal System: Innovation and Implementation of Four Studies Funded by the NIDA HEAL Initiative

Kym Ahrens et al. Prev Sci. 2023 Oct.

Abstract

Youth involved in the legal system (YILS) experience rates of opioid and substance use disorders (OUD/SUDs) and overdose that is well above those in the general population. Despite the dire need, and the existing programs that focus on treatment of these problems in YILS, research on opioid initiation, and OUD prevention, including feasibility and sustainability, are severely limited. We present four studies testing interventions that, while not necessarily novel as SUD treatments, test novel structural and interpersonal strategies to prevent opioid initiation/OUD precursors: (1) ADAPT (Clinical Trial No. NCT04499079) provides real-time feedback using community-based treatment information system data to create a more effective mental health and SUD treatment cascade to prevent opioid use; (2) HOME (Clinical Trial No. NCT04135703) provides youth experiencing homelessness, including YILS, with direct access to shelter in independent living without prerequisites as an opioid initiation prevention strategy; (3) LeSA (Clinical Trial No. NCT04678960) uses the Trust-Based Relational Intervention® to equip YILS and their caregivers with self-regulatory and communication skills during the transition from secure confinement to reduce opioid initiation/re-initiation; and (4) POST (Clinical Trial No. NCT04901312) tests two interventions integrating interpersonal/drinking and drug refusal skills, case management, and goal setting among YILS in transitioning out of secure detention as opioid initiation prevention strategies. We discuss early implementation barriers and facilitators, including complexities of prevention research with YILS and adaptations due to COVID-19. We conclude by describing anticipated end products, including implementation of effective prevention interventions and integration of data from multiple projects to address larger, multi-site research questions.

Keywords: Adverse childhood experiences; Hybrid trials; Implementation science; Juvenile justice; Juvenile legal system; Opioid use; Prevention; RCT; Substance use.

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Conflict of interest statement

Conflict of Interest The authors declare no competing interests.

References

    1. Aalsma MC, Aarons GA, Adams ZW, Alton MD, Boustani M, Dir AL, Embi PJ, Grannis S, Hulvershorn LA, Huntsinger D, Lewis CC, Monahan P, Saldana L, Schwartz K, Simon KI, Terry N, Wiehe SE, & Zapolski TCB (2021, Sep). Alliances to disseminate addiction prevention and treatment (ADAPT): A statewide learning health system to reduce substance use among justice-involved youth in rural communities. Journal of Substance Abuse Treatment, 128, 108368. 10.1016/j.jsat.2021.108368 - DOI - PMC - PubMed
    1. Aalsma MC, Dir AL, Zapolski TCB, Hulvershorn LA, Monahan PO, Saldana L, & Adams ZW (2019, Sep 6). Implementing risk stratification to the treatment of adolescent substance use among youth involved in the juvenile justice system: Protocol of a hybrid type I trial. Addiction Science & Clinical Practice, 14(1), 36. 10.1186/s13722-019-0161-5 - DOI - PMC - PubMed
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    1. Ahrens K, Haggerty K, Coatney A, Albertson K, & Ryle T (2021, October). Opioid prevention for transitioning incarcerated youth: Feasibility/acceptability of a SMART protocol evaluating skill/social connection-based interventions of different intensities. In APHA 2021 Annual Meeting and Expo. APHA.
    1. AHRQ. (2019, May). About learning health systems. Agency for Healthcare Research and Quality. https://www.ahrq.gov/learning-health-systems/about.html

MeSH terms

Substances