Stanly County Youth Empowerment: Building resilient communities to combat underage substance use. - This project will address alcohol and opioid use among youth 12-17 years of age in Stanly County, North Carolina. A comprehensive prevention approach, with a mix of evidence-based education, community organization, and environmental strategies, will be utilized. The Youth Drug Survey, Life Skills Training, community engagement, creation of a Youth Council, and adoption of the Project Lazarus Toolkit by medical providers are some of the key strategies. Stanly County is in the Central Piedmont region of North Carolina. It has a population of 61,482. County residents are predominately white (85.6%); with African Americans (12.1%), Latino (4%), and Asians (2.2%) making up a small part of the population. Demographics for children in Stanly County are similar (79% white, 12.4% black, 7.5% Latino, 2.6% Asian). While 12.9% of white residents lived in poverty (lower than the 16.1% state average), poverty is a major concern among minority populations. In Stanly County, 38% of African Americans and 30% of Latinos live in poverty. The main focus of this project is children 12-17 years old. There are approximately 3,500 children in this age group in Stanly County, and they constitute 36.3% of those under 18 years of age. Children and youth under 18 make up 21.8% of the population of Stanly County. Of these, 23.9% live in poverty and 31.4% of their families receive SSI, SNAP, or food stamps. For Stanly County students who were categorized as economically disadvantaged, only 43.4% were at or above grade level in reading and mathematics. This project will utilize three main evidence-based strategies to engage the entire community in reducing underage drinking. First, we will utilize the Youth Drug Survey (YDS), in middle and high schools, to assess use of alcohol, tobacco, marijuana and prescription drugs and the perceptions of risk associated with these substances. We already know that many Stanly County youth are experiencing poverty and are faltering academically. Therefore, the second strategy will be to implement Life Skills Training (LST) in Stanly County Schools. The LST program is an evidence-based substance abuse prevention program that reduces substance use through improving self-management skills, social skills, drug awareness, and drug resistance. SAMHSA rates this program at a 4.9 of 5.0. Finally, SAMHSA emphasizes the importance of engaging the community in addressing substance use issues. The Project Lazarus Coalition was established in Stanly County in 2015. This project will be used to increase community involvement in the Coalition and create a youth component. Opioid use is also an important focus of this proposal. The N.C. Opioid Data Dashboard noted there were 64.6 opioid pills dispensed in 2017 for every man, woman, and child in Stanly County. The STOP Act which limited opioid prescriptions for acute issues did not address chronic pain prescribing practices. The Project Lazarus Toolkit offers guidance on prescribing for chronic pain patients and is endorsed by the N.C. Medical Board. It will be provided to all providers in Stanly County. This project will target at least 20% of the total population (12, 296) every year in all five years (61,482).
