Substance Use Prevention and Recovery
Situation Statement
Though substance use and substance use disorder have been pressing social problems for decades, the public health burden and consequence associated with substance use has rapidly worsened in recent years. Drug overdoses have surpassed car accidents as the leading cause of accidental death and overdoses have contributed to a reduction in average life expectancy in the US. Much of the substance use-related morbidity and mortality is a result of a persistent treatment gap. Each year, about 90% of people who need treatment for SUD in Kentucky do not receive it. To address this gap in service provision, more community-level programming is required to meet the complex needs of Kentuckians who use drugs. Cooperative Extension is uniquely positioned, both with deep connections to each Kentucky county and with its transdisciplinary team of specialists, to address the holistic needs of Kentuckians who use drugs including mental health, fair housing, second-chance employment, nutrition and physical health, and much more.
Youth Focus
Substance use and substance use disorder are persistent public health problems in Kentucky. Kentucky youth fare worse than their US counterparts in terms of numerous indicators of drug use and drug-related harm including cigarette and smokeless tobacco use, vaping, alcohol use, and illicit drug use such as opioid and methamphetamine use. Accordingly, the recent University of Kentucky Cooperative Extension Service Needs Assessment (2023) indicated substance use prevention is the primary concern among most Kentucky counties. Nevertheless, few Kentucky communities support prevention efforts that are informed by research. Cooperative Extension is well-positioned with deep collaborative community ties to support evidence-based prevention programming. Such programs may target substance use directly or indirectly by focusing on pertinent risk and protective factors and promoting overall well-being for Kentucky youth.
Long-term Outcomes
Adult
- Increased recovery capital
- Reduced adult substance use
- Reduced adult substance use disorder
- Reduced adult overdose fatalities
- Reduced stigma related to adult substance use
- Improved quality of life
Youth
- Improved social and emotional competency
- Reduced youth substance use
- Reduced youth substance use disorder
- Reduced youth overdose fatalities
- Reduced stigma related to youth substance use
- Improved quality of life
Medium-term Outcomes
Adult
- Increased availability and accessibility of evidence-based recovery capital-building programs
- Enhanced community partnerships that target recovery from substance use disorder
Youth
- Increased availability and accessibility of evidence-based prevention programs
- Enhanced community partnerships that target youth prevention
Short-term Outcomes
Adult
Substance use prevention and recovery behaviors for adults include, but are not limited to, pro-social activity, employability, building supportive networks, healthy coping and stress management, and mental health support.
- Increased knowledge about addiction as a chronic disorder
- Increased awareness of community resources to support prevention and recovery
- Increased confidence making decision related to substance use (i.e. substance use refusal skills)
- Increased confidence and motivation to use destigmatized language
- Increased intentions to employ health-promoting behaviors (e.g., exercise, healthy nutrition, positive coping, etc.).
Youth
Substance use prevention and recovery behaviors for youth include, but are not limited to, pro-social activity, positively relating to parents and other non-parental adults, building supportive networks, healthy coping and stress management, substance use refusal self-efficacy, and peer pressure management.
- Increased knowledge about substance use and its effects
- Increased awareness of community resources to support prevention and recovery
- Increased confidence making decisions related to substance use (i.e. substance use refusal skills)
- Increased confidence and motivation to use destigmatized language
- Increased intentions to employ health-promoting behaviors (e.g., exercise, healthy nutrition, positive coping, etc.).
Learning Outcomes
Adult
Audience: Families and Individuals
Project or Activity: Addiction Education
Content or Curriculum: Publications, Addiction 101, Harm Reduction 101
Inputs: Programmatic materials, community partners, ASAP Boards and Community Coalitions, residential treatment centers, detention centers, healthcare providers, clergy, and healthcare providers
Date: Ongoing
Audience: Families and Individuals
Project or Activity: Stigma Reduction
Content or Curriculum: Publications, Language Matters, Addiction 101 Engaging People with Lived Experience (Testimonies), Mind Art Recovery Kentucky
Inputs: Programmatic materials, community partners, ASAP Boards and Community Coalitions, residential treatment centers, detention centers, healthcare providers, law enforcement, and clergy
Date: Ongoing
Audience: Families and Individuals
Project or Activity: Recovery Capital Building
Content or Curriculum: Healthy Choices for Your Recovering Body (HCYRB), Recovering Your Finances (RYF), Recovery Gardens, Positive Employability, Question. Persuade. Refer (QPR), Mind Art Recovery Kentucky
Inputs: Programmatic materials, community partners, ASAP Boards and Community Coalitions, residential treatment centers, detention centers, healthcare providers, law enforcement, and clergy
Date: Ongoing
Audience: Communities
Project or Activity: Policy, Systems, and Environmental (PSE) Approaches
Content or Curriculum: Addiction 101, Recovering Your Finances (RYF), PROFIT, Building Recovery Ready Communities (e.g. presenting to coalitions), Resources for Family Members and Concerned Others, Parenting in Recovery
Inputs: Programmatic materials, community partners, grant funding, elected officials, health coalitions, and other key stakeholders
Date: Ongoing
Youth
Audience: Families and Individuals
Project or Activity: Substance Use Prevention Programming
Content or Curriculum: Botvin Lifeskills, Strengthening Families, 4-H Health Rocks, Engaging People with Lived Experience (testimonies),
Inputs: Programmatic materials, paid staff, volunteers, community partners, health coalitions, schools and school staff
Date: Ongoing
Audience: Families and Individuals
Project or Activity: Positive Youth Development
Content or Curriculum: Health Rocks, Positive Employability, Mindful Mechanics, Get Experience in Mindfulness (GEM), Social/Emotional Health-Focused Programming
Inputs: Programmatic materials, paid staff, volunteers, community partners, faith-based organizations, health coalitions, schools and school staff
Date: Ongoing
Audience: Communities
Project or Activity: Community-Based Substance Use Prevention
Content or Curriculum: Substance Use Prevention Education (i.e. Addiction 101, Ad Hoc Webinars, etc.), Engaging People with Lived Experience (testimonies), Strengthening Families
Inputs: Programmatic materials, paid staff, volunteers, community partners, elected officials, faith-based organizations, health coalitions, and faith-based organizations
Date: Ongoing
Evaluation
Adult
Outcome: Increased knowledge about addiction as a chronic disorder (initial)
Indicator: Number of participants who reported an increased knowledge of substance use prevention, addiction, and/or recovery (or related subject matter)
Method: Self-reported surveys
Timeline: Post-program/curricula survey administration
Outcome: Increased awareness of community resources to support prevention and recovery (initial)
Indicator: Number of partnerships with community organizations, institutions, agencies, or individuals to address substance use/recovery in the community
Method: Program metrics agents will track, and report based on their activities and partnerships related to substance use prevention, addiction, and/or recovery)
Timeline: Post-program/curricula survey administration (ST) and follow-up survey (BC).
Outcome: Increased confidence making decisions related to substance use (i.e. substance use refusal skills) (Short-term, ST, and Intermediate, BC).
Indicator:
- Number of participants who reported intended behavior change as a result of participation in substance use prevention and/or recovery programming.
- Number of participants who reported that they intend to use self-care strategies to improve their recovery and/or substance refusal skills.
Method: Self-reported surveys
Timeline: Post-program/curricula survey administration (ST) and follow-up survey (BC).
Outcome: Increased confidence and motivation to use destigmatized language (intermediate)
Indicator: Number of participants who reported an increased ability to use destigmatized language
Method: Self-reported surveys
Timeline: Repeated self-reported surveys and/or follow-up evaluations to capture behavior change over time
Outcome: Increased intentions to employ health-promoting behaviors (e.g., exercise, healthy nutrition, positive coping, etc.). (Short-term, ST, and Intermediate, BC).
Indicator:
- Number of participants who reported that they intend to use self-care strategies to improve their recovery and/or substance refusal skills (ST)
- Number of participants who used self-care strategies to improve their recovery and/or substance refusal skills.
Method: Self-reported surveys
Timeline: Post-program/curricula survey administration (ST) and follow-up survey (BC)
Youth
Outcome: Increased knowledge about substance use and its effects (initial)
Indicator: Number of participants who reported an increased knowledge of substance use prevention, addiction, and/or recovery (or related subject matter)
Method: Self-reported surveys
Timeline: Post-program/curricula survey administration
Outcome: Increased awareness of community resources to support prevention and recovery (initial)
Indicator: Number of partnerships with community organizations, institutions, agencies, or individuals to address substance use/recovery in the community
Method: Program metrics (agents will track and report based on their activities and partnerships related to substance use prevention, addiction, and/or recovery)
Timeline: Post-program/curricula survey administration
Outcome: Increased confidence making decisions related to substance use (i.e. substance use refusal skills) (Short-term, ST, and Intermediate, BC).
Indicator:
- Number of participants who reported intended behavior change as a result of participation in substance use prevention and/or recovery programming.
- Number of participants who reported that they intend to use self-care strategies to improve their recovery and/or substance refusal skills.
Method: Self-reported surveys
Timeline: Post-program/curricula survey administration
Outcome: Increased confidence and motivation to use destigmatized language (intermediate)
Indicator: Number of participants who reported an increased ability to use destigmatized language
Method: Self-reported surveys
Timeline: Repeated self-reported surveys and/or follow-up evaluations to capture behavior change over time
Outcome: Increased intentions to employ health-promoting behaviors (e.g., exercise, healthy nutrition, positive coping, etc.). (Short-term, ST, and Intermediate, BC).
Indicator:
- Number of participants who reported that they intend to use self-care strategies to improve their recovery and/or substance refusal skills (ST)
- Number of participants who used self-care strategies to improve their recovery and/or substance refusal skills.
Method: Self-reported surveys
Timeline: Post-program/curricula survey administration (ST) and follow-up survey (BC)
