Opioid Response

The Extension Opioid Crisis Response Workgroup (EOCRW) was given a charge from the Extension Committee on Organization and Policy (ECOP) to identify and assemble resources to help Extension play a stronger and more strategic role in addressing the opioid crisis, and more generally behavioral health challenges that emerge over time. This publication provides useful information to help the Land Grant Extension system play a larger role in helping to address the crisis. This resource provides information about: the findings of a nationwide survey of Extension Behavioral Health programming; an extensive literature review on opioids and substance abuse; links to potential partners, networks, and grant opportunities; and the Extension Opioid Response Strategic Plan Report.

Opioid Response

By: Mark Skidmore, Ph.D.

A T T R I B U T I ON

Opioid Response

ISBN: 978-1-7340417-3-6

Publish Date: 7/7/2020

Citations for this publication may be made using the following:

Skidmore, M. (2020). Opioid Response (1st ed., 2nd rev.). Kansas City: Extension Foundation. ISBN: 978-1- 7340417-3-6.

Producer: Ashley S. Griffin Technical Implementer: Retta Ritchie-Holbrook and Rose Hayden-Smith

Welcome to the Opioid Response eFieldbook, a resource created for the Cooperative Extension Service and published by the Extension Foundation.

This work is supported by New Technologies for Agriculture Extension grant no. 2015-41595-24254 from the USDA National Institute of Food and Agriculture. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture.

For more information please contact: Extension Foundation c/o Bryan Cave LLP One Kansas City Place

1200 Main Street, Suite 3800 Kansas City, MO 64105-2122 https://extension.org/

T A B L E O F CON T E N T S

Attribution .............................................................................................................................................. 2

Table of Contents..................................................................................................................................... 3 Welcome............................................................................................................................................................................. 4

About Us ................................................................................................................................................. 5

Resources and ECOP Final Report ............................................................................................................. 7

Potential Partners.................................................................................................................................... 7

Shared Extension Programming.............................................................................................................. 11 CAPE – Community Assessment and Education to Promote Behavioral Health Planning and Evaluation...................... 11 Chronic Pain Self-Management Program ......................................................................................................................... 12 Community-Based Opioid Awareness .............................................................................................................................. 13 Generation Rx ................................................................................................................................................................... 14 Life Skills Training.............................................................................................................................................................. 15 Mental Health First Aid ..................................................................................................................................................... 16 PROmoting School-community-university Partnerships to Enhance Resilience (PROSPER) ........................................... 17 Strengthening Families Program 10-14 ............................................................................................................................ 18

Welcome

Overdoses are now the leading cause of death of Americans under the age of 50, the impacts of which are being felt in every region of the country in both rural and urban places. Most of these fatalities are tied to heroin or prescription painkillers. In addition to loss of life, the societal costs of the crisis in the form of direct healthcare costs, lost productivity, and costs related to criminal justice are estimated to be as high as $78 billion. In many states, universities within the Land Grant system are responding to the crisis. However, the Extension Committee on Organization and Policy (ECOP) believes that a coordinated Land Grant effort could provide a more comprehensive and impactful strategy for addressing the ongoing crisis. The Extension Opioid Crisis Response Workgroup (EOCRW) was given a charge from the Extension Committee on Organization and Policy (ECOP) to identify and assemble resources to help Extension play a stronger and more strategic role in addressing the opioid crisis, and more generally behavioral health challenges that emerge over time. This publication provides useful information to help the Land Grant Extension system play a larger role in helping to address the crisis.

This resource provides information about:

•

EOCRW

• the findings of a nationwide survey of Extension Behavioral Health programming

• an extensive literature review on opioids and substance abuse

• links to potential partners, networks, and grant opportunities

• and the Extension Opioid Response Strategic Plan Report.

The First Edition publication for the Extension Foundation’s Impact Collaborative Summit of April 2019 was designed to support Impact Collaborative (IC) Summit participants, and was intended to be a tool that can provide a bridge of information through program development and evaluation. After October 2019, a second edition of the publication was developed in preparation for the October 2019 Impact Collaborative Summit.

A B OU T U S

In February, 2017, the Extension Committee on Organization and Policy (ECOP) approved the establishment of the Extension Opioid Crisis Response Workgroup (OECRW). Communities across the nation are experiencing growing numbers of opioid-related fatalities. ECOP invited the EOCRW to consider the ways in which Cooperative Extension Services (CES) could expand the capacity to help address the crisis. The EOCRW included members directly involved in the development of the strategic plan (workgroup members) as well as a set of expert partners who provided feedback and guidance. Dr. Mark Skidmore, Director of the North Central Regional Center for Rural Development (NCRCRD) at Michigan State University served as the leader of this task force.

Workgroup Members:

Workgroup

• Mark Skidmore, NCRCRD, Michigan State University

• Alison Brennan, NCRCRD, Michigan State University

• Ronald A. Brown, Association of Southern Region Extension Directors

• Courtney Cuthbertson, Michigan State University

• Jami Delifield, The Ohio State University

Alex Elswick, University of Kentucky

•

• Novella Johnson Ruffin, Virginia State University

Richard Klemme, APLU

•

• Brian Kowalkowski, College of Menominee Nation

• Anne Lindsay, University of Nevada-Reno

• Daniel Perkins, Pennsylvania State Unversity

• Roger Rennekamp, The Ohio State University

Ahlishia Shipley, USDA-NIFA

•

Sandy Sulzer, Utah State University

•

Expert Partners

• Mark Skidmore, NCRCRD, Michigan State University

• Amy Chilote, North Carolina State University

• Autumn Guin, North Carolina State University

Candy Gabel, University of Missouri

•

• Catheryn Hockaday, Iowa State University

Daniel Perkins, Penn State University

•

David Young, Montana State University

•

Gina Crist, University of Delaware

•

Lajoy Spears, University of Guam

•

Mary Ellen Wright, Clemson University

•

Richard Spoth, Iowa State University

•

ECOP Members:

1890 region

• Mark Latimore, Fort Valley State University

• Vonda Richardson, Florida A&M University

• Carolyn Williams, Prairie View A&M University

North Central region

Jason Henderson, Purdue University

•

• Beverly Durgan, University of Minnesota

Chuck Hibberd, University of Nebraska

•

Northeast region

• Bill Hare, University of District of Columbia

Chuck Ross, University of Vermont

•

Chris Watkins, Cornell University

•

Southern region

Ed Jones, Virginia Tech

•

• Gary Jackson, Mississippi State University

Tom Dobbins, Clemson University

•

Western region

• Louis Swanson, Colorado State University

Scott Reed, Oregon State University

•

Fred Schlutt, University of Alaska

•

R E S OU R C E S AN D E CO P F I N A L R E P O R T

Final Report

Extension Opioid Crisis Response Workgroup Final Report

Resources

Extension Behavioral Health Survey Results Final Administered by: Extension Opioid Crisis Response Workgroup

Extension Opioid Crisis Response Potential Partners List This resource was compiled by the Extension Crisis Response Workgroup

A Review of Research Related to Education and Prevention (September 2018)

P O T E N T I A L P A R TN E R S

This list was compiled by the Extension Opioid Crisis Response Workgroup. A printable (PDF) version is available here.

1) Federal

a) Centers for Disease Control and Prevention (CDC) - https://www.cdc.gov/

b) Centers for Medicare and Medicaid Services (CMS) - https://www.cms.gov/

c) Food and Drug Administration (FDA) - https://www.fda.gov/

d) MentalHealth.gov - https://www.mentalhealth.gov/

e) National Institutes of Health (NIH) - https://www.nih.gov/

i) National Institute on Alcohol Abuse and Alcoholism (NIAAA) - https://www.niaaa.nih.gov/

ii) National Institute on Drug Abuse (NIDA) - https://www.drugabuse.gov/

iii) National Institutes of Mental Health (NIMH) - https://www.nimh.nih.gov/index.shtml\

iv) National Institute on Minority Health and Health Disparities (NIMHD) - https://www.nimhd.nih.gov/

f) National Institute of Nursing Research (NINR) - https://www.ninr.nih.gov/

g) National Library of Medicine (NLM) - https://www.nlm.nih.gov/

h) US Department of Agriculture (USDA) - https://www.usda.gov/topics/opioids

i) Office of Partnerships and Public Engagement - https://www.usda.gov/partnerships

ii) Rural Development - https://www.rd.usda.gov/

iii) Food and Nutrition Service - https://www.fns.usda.gov/

i) US Department of Education (DoE) - https://www.ed.gov/

i) Family and Community Engagement - https://www.ed.gov/family-and-community- engagement?src=rn

j) US Department of Health and Human Services (DHHS) - https://www.hhs.gov/opioids/

i) Administration for Community Living - https://www.acl.gov/

ii) Centers for Disease Control and Prevention (CDC) - https://www.cdc.gov/

iii) Health Resources and Services Administration (HRSA) - https://www.hrsa.gov/

iv) Indian Health Service (IHS) - https://www.ihs.gov/

v) Office of Adolescent Health (OAH) - https://www.hhs.gov/ash/oah/

vi) Office of the Assistant Secretary of Health (OASH) - https://www.hhs.gov/ash/index.html

vii) Substance Abuse and Mental Health Services Administration (SAMHSA) - https://www.samhsa.gov/

viii) The Center for Faith-based and Neighborhood Partnerships - https://www.hhs.gov/about/agencies/iea/partnerships/index.html

k) US Department of Justice (DOJ) - https://www.justice.gov/

i) National Institute of Corrections (NIC) - https://nicic.gov/

ii) Office of Justice Programs (OJP) - https://ojp.gov/

iii) Office for Victims of Crime (OVC) - https://www.ovc.gov/

l) US Department of Veterans Affairs (VA) - https://www.va.gov/

m) White House

i) President’s Commission on Combating Drug Addiction and the Opioid Crisis - https://bit.ly/3wiZNNK

ii) Office of National Drug Control Policy - https://www.whitehouse.gov/ondcp/

2) State and Local

a) Association of State and Territorial Health Officials (ASTHO) - http://www.astho.org/default.aspx

b) National Association of Counties (NACo) - http://www.naco.org/

c) National Association of County and City Health Officials (NACCHO) - https://www.naccho.org/

d) National Association of Medicaid Directors (NASMD) - https://medicaiddirectors.org/

3) Quasi-Federal Agencies

a) Corporation for National and Community Service - https://www.nationalservice.gov/

b) Council of State Governments (CSG) - https://www.csg.org/

i) The Federal Interagency Reentry Council - https://csgjusticecenter.org/nrrc/projects/firc/

ii) The National Reentry Resource Center (NRRC) - https://csgjusticecenter.org/nrrc

c) National Academies of Science, Engineering and Medicine (NASEM) - http://www.nationalacademies.org/

d) National Academy of Medicine (NAM) - https://nam.edu/

i) NAM Action Collaborative - https://nam.edu/programs/action-collaborative-on-countering-the-u- s-opioid-epidemic/

ii) National Endowment for the Arts (NEA) - https://www.arts.gov/

4) Nonprofits

a) AgriSafe Network - https://agn.memberclicks.net/

b) Annie E. Casey Foundation (ACF) - http://www.aecf.org/

c) Boys and Girls Club of America - https://www.bgca.org/

d) Center for Substance Abuse Research (CESAR) - http://www.cesar.umd.edu/

e) Arnold Ventures, formerly Laura and John Arnold Foundation (LJAF) - https://www.arnoldventures.org/

f) Lions Club International - http://www.lionsclubs.org/EN/index.php

g) Milken Institute - http://www.milkeninstitute.org/

h) National Rural Health Association (NRHA) - https://www.ruralhealthweb.org/

i) Robert Wood Johnson Foundation (RWJF) - https://www.rwjf.org/

j) Urban Institute - https://www.urban.org/

5) Miscellaneous Professional Organizations

a) Addiction Policy Forum (APF) - https://www.addictionpolicy.org/

i) Addiction Resource Center (ARC) - https://www.addictionresourcecenter.org/

b) American Correctional Association (ACA) - http://www.aca.org

c) American Jail Association (AJA) - https://www.americanjail.org/

d) American Society of Addiction Medicine (ASAM) - https://www.asam.org/

e) Community Oriented Correctional Health Services (COCHS) - http://www.cochs.org/

f) National 4-H Council - https://4-h.org/about/leadership/national-4-h-council/

g) National Governors Association - https://www.nga.org/

h) National Organization of State Offices of Rural Health (NOSORH) - https://nosorh.org/rural-opioid- resources/

S H A R E D E X T E N S I ON P ROG R AMM I NG

This area of the resource provides summary information about existing programs being used by Extension in several states to address the opioid crisis. These are programs that could potentially be shared and used in other states seeking to play a larger role in addressing the crisis. For more information about these programs, please reach out to the contact person provided.

CAPE – Community Assessment and Education to Promote Behavioral Health Planning and Evaluation Brief Description Community behavioral health outreach focused on planning community-scale initiatives. Community needs assessment; development of community action plans; and Mental Health First Aid training.

Duration Long-term, sustained community participation

Research Support

• Integrates best practices in community development, but not considered evidence-based according to SAMHSA standards.

• Mental Health First Aid is an evidence-based program. See corresponding section for details.

Costs

• Video lectures, Webinars and corresponding materials provided free of charge.

• See Mental Health First Aid section for associated costs.

Contact Info John Leatherman, PhD

Links

Training

•

YouTube Video

•

URL : https://www.healthbench.info/community-behavioral-health-training-2019.html Approach Type: Community Format: In-person , Training , Video Lectures , Webinars MD Addiction: Mental Disease Response Type: Capacity Building , Needs Assessment , Strategic Planning Targeted Audience: Community , Elected or Appointed Leaders , Extension Professionals

Chronic Pain Self -Management Program

Brief Description Educational program delivered once a week for six weeks to increase self-efficacy for pain management. Classes are highly participative, where mutual suppo rt and success build the participants’ confidence in their ability to manage their health and maintain active and fulfilling lives. The program is intended for people who have a primary or secondary diagnosis of chronic pain.

Duration 1 session per week for 6 weeks

Research Support CPSMP has also been rigorously evaluated in two randomized clinical trials funded by Health Canada and the Canadian Institutes of Health Research (CIHR). Evidence for significant impacts:

Learning

•

Behavior

•

Results

•

Costs See all training options Materials: Curriculum material costs can be found here Contact Info Dr. Lisa Washburn Phone: 650-242-8040 Mailing address is 711 Colorado Avenue, Palo Alto, CA 94303 Or complete the online form

Link SMRC

URL : https://www.selfmanagementresource.com/programs/small-group/chronic-pain-self-management/

Community-Based Opioid Awareness

Brief Description Educational program includes factsheets, town hall events, presentations, documentary film screenings with discussion, and Mental Health First Aid training.

Duration Single session events; various lengths, from several hours to full day

Research Support

• Research-based resources, but as a whole is not considered evidence-based according to SAMHSA standards.

• Mental Health First Aid is an evidence-based program. See corresponding section for details.

Costs Free online resources.

• Warning: This Drug May Kill You has a small licensing fee for public showings

• Chasing the Dragon: The Life of an Opiate Addict has no fee.

• See Mental Health First Aid section for associated costs

Contact Info Courtney Cuthbertson, Ph.D.

Links

Community behavioral health

•

Warning this drug may kill you

•

Chasing the dragon

•

YouTube Video

•

URL : https://www.canr.msu.edu/afre/projects/cape_community_assessment_and_education_to_promote_b ehavioral_health_planni

Approach Type: Community , Household , Individual Format: Film Screenings , In-person , Presentations , Training MD Addiction: Opiate Addiction Response Type: Education Targeted Audience: Community , Individuals

Generation Rx

Brief Description Educational program started at Ohio State University in the College of Pharmacy. Promotion of safe use of prescription medications and information regarding dangers of misuse.

Duration Short-term; variable session length

Research Support Research-based resources and program evaluation indicating learning impacts, but is not considered evidence-based according to SAMHSA standards.

Costs All resources are provided at no cost and can be accessed online.

Contact Info Chelsea Pekny, Assistant Professor, Global Pharmacy Initiatives Coordinator, The Ohio State University

Links

Generation Rx

•

YouTube Video

•

URL : https://www.generationrx.org/ Approach Type: Household , Individual Format: Handouts , In-person , Online , Resources MD Addiction: Prescription Opioid Addiction Response Type: Education Targeted Audience: Children , College Students , Community , Elected or Appointed Leaders , Extension Professionals , Individuals , Teachers , University Professionals , Youth , Youth Leaders

Life Ski l ls Training

Brief Description Education and prevention activities that include comprehensive, skill-based programming to prevent teen risk behaviors. Teaches communication skills and promotes healthy coping strategies. Prescription drug ancillary module available.

Duration Multiple sessions (specific number varies by curriculum)

Research Support

• Evidence-based according to SAMSHSA standards

• Evidence for significant impacts: Learning, Behavior, Results

Costs

• Training of Trainers two-day workshop: $1,070

• Curriculum: $200-$395 (varies by curriculum)

Contact Info Lindsay Hughes

Links

Life Skills Training

•

YouTube Video

•

URL : https://www.lifeskillstraining.com/ Approach Type: Household , Individual Format: In-person , Role-based Scenarios , Skill Practice MD Addiction: Addiction

Response Type: Education Targeted Audience: Children

Mental Health First Aid

Brief Description Certification course to providing education to equip individuals to recognize and respond to mental health crises. The goal of Mental Health First Aid is to keep people safe until professional intervention can occur. Opioid response supplement with information on signs and symptoms of overdose; participants learn to administer Naloxone.

Duration Course length is eight hours

Research Support Evidence-based according to SAMHSA standards. Evidence for significant impacts:

Learning

•

Behavior

•

Results

•

Costs

• To become a trainer: $2,000 for one-week (40-hour) training; travel/lodging not included

• Certification course: Varies; Typically ranges from $25-$100 per person

Handbooks are $25 each.

•

Contact Info

Jami Dellifield

•

Amanda Raines

•

Links

Mental Health First Aid

•

YouTube Video

•

URL : https://www.mentalhealthfirstaid.org/ Approach Type: Household , Individual Format: In-person , Presentations , Role-based Scenarios , Skill Practice , Training MD Addiction: Mental Disease Response Type: Education Targeted Audience: College Students , Community , Elected or Appointed Leaders , Extension Professionals , Individuals , Teachers , University Professionals , Youth , Youth Leaders

PROmoting School -community-university Partnerships to Enhance Resi l ience (PROSPER) Brief description Collaborative, sustainable system for delivery of school-based and family-based substance use prevention. Relies on partnerships among community teams, university researchers, and Extension staff. Extension staff provide training and support. All programs implemented are evidence-based. Examples of programs implemented: Strengthening Families Program 10-14; Life Skills Training.

Duration Long-term sustained Community participation.

Research Support Evidence-based according to SAMHSA standards. Evidence for significant impacts:

Learning

•

Behavior

•

Results

•

Costs

• Highly variable and partially dependent on existing community resources, as well as the specific programs selected.

• Requires substantial monetary and human resources and grants are needed to launch.

• Demonstrated to be cost efficient and effective. High return on invest

Contact Info

Richard Spoth

•

Lisa Schainker

•

Links

Helping Kids Prosper

•

YouTube Video

•

URL : http://www.helpingkidsprosper.org/ Approach Type: Community Format: Guides , In-person , Training MD Addiction: Addiction Response Type: Capacity Building , Education Targeted Audience: Children , Community , Elected or Appointed Leaders , Extension Professionals , Individuals , Teachers , Youth , Youth Leaders

Strengthening Fami l ies Program 10 -14

Brief description Household-based educational program designed to reduce risk factors and increase protective factors to prevent adolescent substance use and other problem behaviors.

Duration Seven, two-hour sessions

Research Support Evidence-based according to SAMHSA standards. Evidence for significant impacts:

Learning

•

Behavior

•

Results

•

Costs

• Training costs: $4,200 (10-15 facilitators); $5,400 (16-30 facilitators); travel/lodging not included.

Materials: $548

•

• Detailed sample budget on implementation webpage

Contact Info Cathy Hockaday

Links

Helping Kids Prosper

•

YouTube Video

•

URL : http://www.helpingkidsprosper.org/ Approach Type: Household , Individual Format: In-person , Role-based Scenarios , Skill Practice , Training , Video Lectures MD Addiction: Addiction Response Type: Education , Prevention Targeted Audience: Children , Community , Elected or Appointed Leaders , Extension Professionals , Individuals , Teachers , Youth , Youth Leaders

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