Interventions to Reduce Prescription Drug Misuse: What Do CSAP’s Partnerships for Success Communities Implement?

The Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Substance Abuse Prevention’s (CSAP) flagship initiative is the Strategic Prevention Framework Partnerships for Success (SPF-PFS). SPF-PFS addresses underage drinking, prescription drug misuse, and other issues across over 600 communities within grantees in 49 states, 8 territories/jurisdictions, 13 tribal organizations, and the District of Columbia. CSAP encourages SPF PFS grantees to support community subrecipients in “implementing a comprehensive prevention approach, including a mix of evidence- based programs, policies, and/or practices that best addresses the selected prevention priority(ies).” This presentation describes the most common types and combinations of interventions implemented by PFS subrecipient communities to address the urgent epidemic of prescription drug misuse (PDM).

Project directors in SPF-PFS subrecipient communities described the interventions they implemented on a web-based Community Level Instrument twice each year. This instrument allowed the project directors to categorize their interventions by service type, SAMHSA strategy type, IOM category, ecological intervention target, evidence-base, and population sub-group targets. Evaluation and technical assistance staff collaborated closely with grantees to ensure the accurate categorization of the interventions.

In the fiscal years 2014 through 2017, 339 PFS community subrecipients across 45 grantees implemented a total of 1197 intervention activities targeting PDM. Each subrecipient implemented an average of 3.5 intervention activities (range 1 to 26) targeted at PDM, about 21% of which were media campaigns, 18% other information dissemination activities, 22% environmental strategies (e.g. prescription drug drop boxes), and 20% prevention education programs. About half of the interventions targeted whole communities, with only 20% targeting individual young people, 10% targeting families, and 11% targeting institutions or organizations. Project directors defined less than half (43%) of their PDM interventions as evidence-based programs, policies, or practices (EBPs), much lower than the percentage of underage drinking targeted interventions defined as EBPs.

This session presentation will highlight the evidence-base that communities use to select interventions that address PDM, as most communities defined their interventions as EBPs because they appeared on a list provided by their state-level grantee or on a federal registry. We will examine where gaps may exist in the research base for common PDM interventions and describe some promising related interventions that PFS communities implemented. This presentation will conclude with a discussion of what prevention researchers need to do to improve the evidence-base and EBPs available to address PDM.