On Thursday, February 25, 2021, the National Association of State Alcohol and Drug Abuse Directors (NASADAD) presented their resource guide, Reaching Youth At Risk for Substance Use and Misuse: Early Intervention Resources and Practices, developed with funding from the Conrad N. Hilton Family Foundation. Adolescent substance use prevention is a priority for the Hilton Foundation and was aligned with examining the feasibility of integrating SBIRT into pediatric care settings, including community health centers and school-based health centers.  


Early intervention (EI) is an important strategy that seeks to identify youth at risk for substance use and misuse and stop or reduce use before it escalates. Research indicates that early intervention can reduce youth substance use, misuse, and related problems before more severe conditions occur (National Academy of Sciences, 2015). Yet, early intervention has received less focus than other parts of the substance use continuum. 


The resource guide was developed to assist single state agencies (SSAs) for alcohol and drugs and their partners in expanding and improving implementation of early intervention for adolescents and transitioned aged youth. Dr. Tracy Flynn from NASADAD defined the target audience, which included adolescents between the ages of 10 to 19 and transitioned-aged youth between the ages of 18 to 25, who were at risk for substance use. 


Early intervention is also important for adolescents and transitioned-aged youth (TAY) because they have not been diagnosed with substance use disorder (SUD). In 2017, 52 percent of adult patients admitted for SUD treatment reported their age of initiation was before the age of 18, according to SAMSHA. Early intervention can reduce youth substance use, misuse, and related problems before more severe conditions occur.  


The resource guide provides state by state descriptions of early intervention services for each state, including SSA-funded services and samples of services offered as of Fall 2020. This information was provided by youth, treatment centers, prevention coordinators, or other state staff. The resource guide includes links to resources on all 50 states and the District of Columbia, with data on settings, service types, and targeted subpopulation. Forty-five states and DC provide early intervention to adolescents or TAY, and 43 states & DC provide EI to adolescents, 41 states & DC provide EI to TAY. Most early intervention programs are provided in schools, but some other settings include substance use agencies, mental health clinics, youth centers, or public health clinics. TAY are served less in most settings except for in mental health and public health clinics. Service types provided range from individual counseling to group counseling, motivational interviewing, SBIRT, etc.  


The second half of the presentation included state examples with highlights on programs in Massachusetts, New Jersey, and Tennessee.   


In New Jersey, the Division of Mental Health and Addiction Services highlighted the New Jersey Community Research Initiative (NJCRI) program. NJCRI is the largest and most comprehensive HIV/AIDS community-based organization and the first AIDS services organization in New Jersey. With 28 percent of LBGTQ youth who dropped out of school due to harassment & bullying, 20 percent experience homelessness, and 40 percent of the total population are not likely to have support. Finally, LGBTQ youth use injection drugs and cocaine at three times the rate of non-LGBTQ youth. NJCRI provides a host of services, including street outreach, behavioral health, and a homeless drop-in center.


In Massachusetts, early intervention programs are school-based intensive case management for students between the ages of 8 to17, who are at risk for developing substance use disorder. At the Beverly Middle School, the Student Assistance Program + receives referrals from school through the weekly school-student service meeting, and the most popular service provided is individual counseling. Services are provided via telehealth now due to the COVID pandemic, and families meet between 6-24 months. As a result of the increase in adolescent vaping, the Northshore Recovery High School, local YMCA, and Justice Resource Institute (JRI) provide early intervention for students referred for non-violent offenses. Students receive psychoeducational support, called Tx, in the district rather than ISS or OSS that would be on their school records.


In Tennessee, the Oasis Center provides early intervention and substance use prevention services to youth, including crisis intervention, youth leadership, and community engagement. The Reaching Excellence As Leaders (REAL) program provides life-changing diversion for at-risk middle and high school males for 6 to 13 weeks. The juvenile court provides referrals. 


For more examples of early intervention programs across the nation, the Reaching Youth At Risk for Substance Use and Misuse guide can be accessed here