Yellowstone County, Montana Comprehensive Addiction and Recovery Act (CARA) - Yellowstone County, Montana is experiencing a local drug crisis involving opioids, prescription drug misuse, methamphetamine, fentanyl, and polysubstance risk. Recent surveillance data show Yellowstone County opioid overdose emergency department visits, hospitalizations, deaths, and suspected opioid overdose EMS incidents exceeding statewide rates. County-level youth survey data also show that 14.3% of Yellowstone County high school students reported lifetime prescription pain medicine misuse, compared with 11.6% nationally. CARA funding will allow the Healthy Outcomes through Prevention & Education (HOPE) Coalition to expand youth-focused prevention strategies that reduce initiation and misuse, increase perception of harm, strengthen trusted-adult communication, improve access to prevention and support resources, and change community norms around youth opioid, methamphetamine, and prescription drug misuse. HOPE will serve Yellowstone County, with Billings Public Schools/School District 2 serving as a primary implementation hub because it reaches the largest concentration of county youth and provides defined school, athletic, family, and partner settings for implementation and evaluation. United Way of Yellowstone County will serve as the legal applicant and fiscal agent for the project. Countywide activities will use HOPE’s partner network, media channels, website, QR-coded resources, Business Readiness Toolkits, and community dissemination pathways to reach youth, parents/caregivers, schools, employers, athletic programs, healthcare and behavioral health partners, law enforcement prevention partners, and youth-serving organizations. The project will implement five integrated CARA strategies. HOPE will expand student athlete safe recovery prevention through When the Game Slows Down; strengthen emerging drug threat communication through Rocky Mountain HIDTA, ODMAP/EMS-informed monitoring where available, and Bad Drug Megaphone; provide family prescription drug misuse prevention through safe medication and caregiver communication resources; create Youth Support and Referral Pathways that help trusted adults connect exposed or early-initiating youth to non-clinical mental health, substance use, crisis, and family support resources; and partner with the Yellowstone County DUI Task Force on drug-impaired driving prevention messaging. Expected outcomes include improved coordination among prevention partners; increased youth participation in prevention planning and message testing; expanded youth-, parent-, and caregiver-facing prevention resources; increased trusted-adult confidence to talk with youth and connect them to support; increased use of prevention and support resources; more schools, athletic programs, businesses, and youth-serving partners adopting prevention-supportive practices; improved emerging drug threat communication; and progress toward CARA’s long-term outcomes of reducing and preventing youth opioid, methamphetamine, and prescription drug misuse and changing the culture and context regarding acceptability of youth use/misuse. HOPE will participate in the CARA National Cross-Site Evaluation and report required core measures for 8th, 10th, and 12th grade students every two years, including past-30-day prescription drug misuse and perception of risk.
