Adolescent Substance Use

Substance use, including the use of opioids, cannabis, and other drugs, is common among adolescents and young adults, and overdose has become a leading cause of death among youth in Canada and the United States. Many young people who use substances also experience co-occurring mental health concerns. Evidence-based approaches to youth substance use care exist, including overdose prevention and safety strategies (such as naloxone) and medications for addiction treatment. These approaches remain adult-oriented, however, unevenly implemented in youth-serving settings, and insufficiently centered on the needs and goals of youth and their families. This study develops and pilot tests a written "practice companion" that helps clinicians and other trusted adults provide developmentally appropriate substance use care to youth ages 14 to 24 in hospital and community settings. The practice companion offers practical, easy-to-use guidance organized by substance and by pattern of use. It addresses cannabis and other substances that youth commonly use and that clinicians frequently seek support with, alongside a strong focus on overdose prevention through its core elements: naloxone, other safety strategies, overdose prevention and safety education, and medications for opioid use disorder. It also attends to co-occurring mental health needs and to how poverty, housing instability, and other social circumstances shape substance use and access to care. The research team will first interview youth who use substances, their families and caregivers, and clinicians to learn how each element of care should be adapted for young people. The team will then produce the practice companion and pilot test it with 60 youth across three sites, in British Columbia, Québec, and Massachusetts. After receiving care guided by the practice companion, youth will complete an interview about whether the care was relevant, useful, appropriate, and acceptable. Families and clinicians will also be interviewed to assess how feasible, sustainable, and faithful to its design the practice companion is in practice. Throughout the study, the team will work closely with youth and families who have lived experience through a community-based participatory research approach that includes Community Advisory Boards. Findings will guide a larger future study of the practice companion's effectiveness.

This study will evaluate whether the Integrated Community Engagement (ICE) Collaborative can help prevent alcohol, tobacco, and other drug use among youth living in rural communities. The study is coordinated through the West Virginia University Prevention Research Center and will be conducted in participating public schools and County Prevention Coalitions located in up to 36 rural counties in West Virginia. Students in grades 7 through 12 at participating public schools will complete confidential online surveys once each year for four years. The surveys will assess alcohol, tobacco, and other drug use, as well as family, peer, school, and community factors that may increase or decrease the risk of substance use. All participating counties will receive reports summarizing these survey results at the school and county levels. Counties will be randomly assigned to one of two groups. Counties in the intervention group will receive support from trained Network Coordinators who will work with local County Prevention Coalitions to review community data, engage local stakeholders, develop action plans, strengthen prevention efforts, and support implementation of community-selected prevention strategies. Counties in the comparison group will receive survey reports but will not receive this implementation support. The researchers will compare the two groups to determine whether the ICE Collaborative reduces youth alcohol, tobacco, and other drug use and improves community factors that support healthy youth development. The study will also evaluate whether the intervention strengthens community prevention coalitions, stakeholder engagement, resource development, and implementation of prevention programs and policies

The goal of this study is to conduct a clinical trial to understand effects of providing multilevel intervention to young people in the legal system. The multilevel intervention includes flexible care management using ACRA/ACC principles, family support, and overdose education. This study aims to test the implementation strategy, as well as the outcomes of the intervention with participants. The first question the study will address is how successful was implementation. This will be measured by the number of youth receiving case management, family support, naloxone supplies, and overdose prevention curricula, and adoption by the participating county court systems. The second question the study will address is whether the intervention impacted youth behavioral outcomes, such as overdose risk awareness, knowledge of how to use naloxone, and number of days per month using substances. Researchers will compare youth who received the intervention to youth who received usual treatment to see if the intervention increases overdose risk awareness and knowledge, and decreases frequency of substance use. Participants will receive the intervention (if assigned to) and complete study surveys. Participating counties will provide data on implementation, and site visits will also be performed to track each county's performance.