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Some advocates for children in Massachusetts are suggesting another way to help stem the opioid epidemic: Beginning with a survey, screen every public school student for substance use.
With more than 1,000 overdose deaths last year, advocates say the state should focus on prevention as early as middle school.
The idea is to add substance use to other screening already done by school nurses.
"Similar to the way they do hearing and eye tests, all with the goal that this is a normal process where kids are brought into their nursing offices and given a screening," said Mary McGeown, president and CEO of the Massachusetts Society for the Prevention of Cruelty to Children.
Eight Massachusetts schools are now testing the screening process, and starting this fall seven more districts will do so. Lawmakers are holding a hearing Thursday on a bill to take the program statewide.
McGeown says so far participating schools have learned that there are very few seventh to ninth graders with a serious substance abuse problem.
"In about 10 percent of the cases there is brief counseling, that the individual reports that they have used alcohol or have used marijuana," McGeown said, "and it's a one-on-one, often with the nurse who has just conducted the assessment, where they talk about the choices. Research suggests that that changes that youth's behavior.
"In a very, very small percentage of those 10 percent, really 1 or 2 percent, there's a referral to treatment," she added. "And it's at that point that a parent would be called."
McGeown says screening every student would cost about $2.5 million in the first year, but that cost would go down once all school nurses were trained on the screening, which would be done once in middle school and twice in high school.
Dr. Sharon Levy, medical director of the Adolescent Substance Abuse Program at Boston Children’s Hospital, helped develop a version of the screening. It’s a brief written survey that takes less than a minute to complete.
"It asks them: In the past year, how many times have you had a drink with alcohol in it? How many times have you used marijuana? How many times have you used tobacco?" Levy explained. "They could say never, once or twice, about monthly, or weekly or more. And what we found was that their responses really predicted their substance use risk very, very well."
For example, if a student was using a substance weekly or more, that would be considered a severe substance use problem. Then the school nurse — and, if necessary, a guidance counselor — would develop a plan for treatment.
Each school district would determine the specifics about confidentiality, when to make referrals for treatment and when to call parents.
Jack Reilly, of Centerville, says as a parent he would have welcomed that information.
His 22-year-old daughter Becca has been in recovery since he and his wife confronted her about her drug use three years ago. He says he did everything within his power to protect his daughter from addiction.
"I did everything I could to insulate my children because I was part of this disease as a son of two alcoholics, as a sibling of a brother who died of this disease," Reilly said. "I did everything I could to insulate my children from this disease and it wasn't enough."
Reilly says he believes if his daughter had gone through the screening and answered honestly, it would have helped his family "enormously."
"Given my history, I think a light bulb would have gone off," he said.
At the State House Thursday, Reilly will be among those asking lawmakers to provide substance use screening for every public school student in Massachusetts.
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