Early Intervention Strategies to Combat the Opioid Epidemic

Researchers posit that universal screening, enhanced mental health support, resource reallocation, and destigmatization efforts for adolescents with substance use problems are critical in preventing the onset of opioid use disorder (OUD) and combating the opioid overdose epidemic.  

In the US, 3 million individuals suffer from an OUD, resulting in over 100,000 opioid-related deaths in 2021, a five-fold increase since 1999. The financial costs of the epidemic are estimated to be $1.5 trillion in 2020, including costs related to health care, lost productivity, treatment, and criminal justice.  

Medications like methadone, buprenorphine, and naltrexone are some of the many advancements in OUD treatment, but limited access and insufficient screening contribute to ongoing treatment gaps. The effectiveness of these medications in adolescents and integrating medication management with psychotherapy is not yet well understood. Prevention strategies do not target individual risk factors and fail to incorporate early intervention. Other substance use disorders are the strongest predictor of developing OUD, particularly among adolescents and young adults experiencing increasing overdose rates. 

Proposed recommendations for early intervention included:  

• Frontline health care settings for children as young as 11 should implement universal screening for substance use and ensure they provide services for substance use disorders as needed, as research has shown that this can positively impact service initiation. Health care providers should prioritize equitable access to evidence-based treatment and resources for the opioid epidemic. 
• Prevention strategies for substance use among at-risk youth should address factors such as traumatic events, mental health conditions, personal and family history of substance use, lack of caregiver monitoring, affiliation with substance-using peers, and easy access to substances. Experts recommend interventions like Risk Reduction through Family Therapy (RRFT) and family-inclusive treatment services for caregivers with OUD. 
• Implement universal prevention strategies such as evidence-based prevention curricula in schools and educating parents through social norm campaigns. 
• Conduct extensive research on adolescent substance use and mental health disorders to determine effective treatment methods.  
• Provide additional and sustained resources to state and federal programs with representation from those with lived experience to ensure equal access to evidence-based services.  
• Promote destigmatization through mindful language choices and public education to increase the likelihood of youth and caregivers feeling comfortable with admitting substance use during screening.  

Researchers emphasized the importance of investing in prevention, early intervention, and treatment for adolescents who use substances while also researching to determine the most effective ways to implement these strategies and achieve the greatest public health benefit. 

“It is critical that we strategically incorporate efforts to intervene earlier in the OUD etiologic pipeline,” said researchers. “Effective, far-reaching change that will truly ‘move the needle’ will also require a significant overhaul of the system, including increases in reimbursement of services to support clinician and vital ancillary staff services.”  

Reference  

Danielson C K, McCauley J, Hinkley J, et al. Prevention and intervention with young people as a critical public health strategy to curtail the opioid epidemic: a call to action. Journal of Addiction Research & Therapy. 2023;14(4):521. PMCID: PMC10399295