Study looks at prevention methods for prescription drug abuse

Most people are familiar with the proverb, “An ounce of prevention is worth a pound of cure.” A recent study from researchers seeking to prevent teen drug abuse points out that some prevention programs are measurably better than others, and prevention is cheaper than cures.

Over 12 million Americans have been abusing prescription painkillers known as opioids. Opioid abuse is expanding faster than all other forms of illicit drug abuse in the nation. The U.S. Center for Disease Control and Prevention reports that, apart from the substantial problems associated with abuse, opioid habits claim the lives of more Americans each year than by cocaine and heroin combined.

The scourge of prescription drug abuse has captured the attention of the country. Experts write papers, speak out in public and attempt to influence public policy on both sides of the issue. Some say the problem is a matter of supply – there are too many prescriptions being written. Others say that restricting drug access hurts patients without solving the issue.

Dr. Max Crowley is a National Institutes of Health research Fellow who works under the auspices of the Center for Child and Family Policy at Duke University. Dr. Crowley references the national conversation taking place these days about how available opioids should be. On the one hand they are a valuable tool for managing pain. On the other hand they are highly addictive drugs which many feel have been far too accessible to the public. This seems to be the opinion of the FDA, who has recommended tightening access to certain opioids.

How to balance those concerns has made for lively national debate. But Dr. Crowley believes that the discussion has missed one vital consideration, namely prevention. Crowley headed up a six year-long study conducted by researchers from Duke University and Penn State University, which followed 11,000 adolescents to see which of four prevention programs was most effective in lowering rates of prescription drug abuse. The study involved 28 school districts in Pennsylvania and Iowa, monitoring kids in grades 6-12.

The researchers paired school districts according to like demography. One school district in the pair was asked to use a prevention program like Project Alert, All Stars and Life Skills Training, and the other district, acting as a control, did not receive a program. One home-based program called Strengthening Families 10-14 was also evaluated. Each year students were administered a survey in which they were asked to self-report on any prescription drug misuse.

Crowley and his colleagues found that only one of the four programs investigated was effective as a stand-alone strategy. Life Skills Training consisted of 18 sessions used to help kids learn assertiveness and competency as tools for social interaction. The program reduced rates of drug abuse by four percent and was shown to be cost-effective as well at $15/student. The control districts which received no prevention programming showed a 25 percent abuse rate among students in grade twelve.

The best results were seen when Life Skills Training was used in combination with the home-based program, although All Stars plus the home-based Strengthening Families also showed good results. Crowley believes that the role of prevention in the current opioid debate is being ignored.

In fact, the study reveals how we ignore prevention efforts to our own detriment. The cost to society at large in helping someone overcome drug addiction is close to $8,000 per year. Compare that to the $15 spent per student to run an effective prevention program. The cost of prevention really does outshine the cost of cure.


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