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In 2016, nearly 1,500 individuals died in Texas due to opioids. While deaths related to prescription opioids has declined in recent years, misuse remains high. In 2016, nearly one in ten Texas students in grades 7-12 acknowledged misusing opioids at least once in their lifetime, while lifetime use of illicit opioids was less than 1 percent.
The state’s opioid-related primary prevention strategy is based within the Social Ecological Model; the effectiveness of health promotion programs is significantly enhanced through the coordination of interventions targeting multiple levels. The presenters will discuss Texas’s strategy for the incorporation of evidence-based primary prevention activities as related to two federally funded projects – the Strategic Prevention Framework for Prescription Drugs (SPF-Rx) and the Texas Targeted Opioid Response (TTOR).
Methods and Results
Intrapersonal factors, such as refusal skills and harm perceptions, and interpersonal factors, such as parental monitoring and communication, are being targeted through state-funded youth universal prevention programs and, to date, opioid misuse prevention activities have reached more than 10,000 youth and 4,000 adults. At the organizational level, Texas is developing two campaigns, one aimed at encouraging prescribers to register and utilize the Texas Prescription Monitoring Program (which is not currently mandated) and the other an academic detailing pilot with community pharmacists. To target community availability and accessibility of prescription opioids, 52 state-funded prevention coalitions are focused on community drug disposal activities: drug take-back events, permanent prescription drug disposal boxes, and distribution of individual drug deactivation pouches. Since the summer of 2016, over 8,000 pounds of medication have been disposed and over 35,000 individual pouches have been distributed.
Discussion and Prevention Implications
Multilevel primary prevention requires extensive coordination, both at the state and local levels. Capacity for collaboration has varied across the state, which has required additional training and technical assistance. However, primary prevention providers now feel more empowered regarding opioid misuse in their communities.
While much of the national effort towards reducing the opioid crisis has focused on access to evidence-based treatment and tertiary prevention, past public health crises point to the need to incorporate evidence-based primary prevention. Rather than focusing on one strategy, communities should develop strategies targeting multiple levels of influence to have the greatest likelihood of behavior change.