Abstract
Opioid abuse is a problem in the US, particularly among the youth population. This is a health risk behavior that has arisen in the US for quite some time, largely due to the influence of the pharmaceutical industry’s push of drugs like Oxycontin onto the market (Coplan et al., 2016). The US Department of Health and Human Services (2020) reports that 0.7 percent of young people aged 12 years and up have reported an opioid use disorder, such as heroin or prescription pain reliever, in the past 12 months. One of the objectives of Healthy People 2030 is to “reduce the proportion of people who had opioid use disorder in the past year” (Healthy People 2030, 2021). This paper discusses the program that can be initiated to address this issue. It identifies the target group, the key stakeholders, the plan of action, and the barriers to be overcome.

Introduction

Health promotion is needed to prevent further abuse and to reduce the current numbers. For instance, in Pennsylvania, Governor Wolf “voiced his support for House Bill 1190, which proposes a school-based substance abuse prevention and intervention program for all students in grade kindergarten through 12” (Govenor.PA, 2017). Minority youths are particularly at risk because of the prevalence of opioids in the urban areas, cities like Pittsburgh and Harrisburg. Educating adolescents about the dangers of these drugs is one intervention program that can be conducted. Another is to use social media to help increase health literacy about opioid use and promote an abstinence program in which teens pledge that they will not use opioids. It can be a place where people share stories and provide support to one another. Because social media is the most popular media space among teens today, it makes sense to use it as an intervention to increase health literacy (Doster, 2013; Roberts, Callahan & O’Leary, 2017).

Target Group

The target group is urban youths ages 12 and up who are susceptible to opioid use because of their environment. This is a vulnerable population that is at-risk for developing an opioid use disorder considering the availability of these drugs on the streets and the culture of drug use that has become more and more prevalent among the young. As Healthy People 2030 points out the baseline for this population is 0.7 percent of the 12 and up population is a user of opioids. The goal is to get that range down to 0.5 percent.

The determinants of health relevant to the target group are environmental factors, economic factors and cultural factors. Environmentally, many of these teens who live in urban areas are surrounded by opportunities to engage in drug usage; they are also consumers of media in which drug use is promoted heavily, particularly in music and hip hop videos, films, and streaming shows. There is an aggressive promotion of drug culture most media, so a counter-culture of abstinence from opioids needs to be promoted in its place.

Economically speaking, many of these youths come from families or communities that are impoverished or near the poverty line. But that is not the case for all. Many users also come from suburban homes and even affluent homes. So this is not an issue that is divided between rich and poor people. On the contrary, it is an issue that spans all classes.

Culturally speaking, the main drivers as factors are peers, groups and media (Bandura, 2018). The culture of drug use is promoted heavily in media, which targets adolescents and older teens. These teens are further pressured by peers to engage in opioid use (McCoy, Dimler, Samuels & Natsuaki, 2019; Xu & Cao, 2020). Groups can be a positive source of cultural influence, especially churches and schools, but they are not necessarily active in the promotion of health literacy with respect to opioid use and avoiding dangerous drugs like these.

Health Promotion Theory

To promote resistance to opioid use among the youth population, Keleher’s Framework for Health Promotion Action should be utilized. Keleher’s Framework for Health Promotion Action begins by identifying the causes that affect the health issue, and it proceeds to establishing what priorities need to be put in place so that there is some investment that travels upward. This leads to various stakeholders getting involved and being willing to take on some action so as to combat the health problem (Keleher, 2002). With various stakeholders on board, from educators to nurse practitioners to social media influencers and celebrities, a great movement can get underway to facilitate the objective of the Health People 2030 campaign. All of it leads to the facilitation of accountability among the target population by promoting and reinforcing positive narratives that encourage resistance to opioid use among the young.

The reason this is a good health model for intervening in this program is that it supports the intervention strategy of using social media as a foundation for interacting with the target population. Social media is where young people interact more than any other one place. They are all connected in this manner and because it is new media rather than old, individual users can have a great deal of impact in terms of how it is used.

The model first issues a directive to responsible adults to do their part in helping in this initiative. This means enlisting both parents and teachers to take an active role in teaching the young population about the dangers of opioids. They have to remember that the young are getting one message from media about how great drugs are, so they need to be told that the reality of drug use is much different from what popular media suggests is the case. Opioids can lead to addiction and to death; they ruin lives, and young people do not get that message from popular media. One of the important principles of this model is that it associates the civic role with the intervention: everyone has a responsibility to help out.

The danger factors next have to be identified,...…be taken this winter to see how many youths are thinking about or are currently using opioids. This can be done by way of simple survey, either on social media or through school systems. This data will need to be collected so as to establish whether improvements are made later on. To measure results it is best to give the program at least one year, starting this fall and ending it at the end of summer 2022. Then a second survey can be conducted similar to the first to see if percentages have decreased.

Barriers

Barriers to the program may come in the way of funding, so it might be necessary to ask for donations from stakeholders in the community. However, other barriers might be cultural as members of the community question why another program oriented towards the youth is needed when they themselves have their own issues and no one is helping them. In response to this kind of barrier it can be explained that everyone is in this boat together and that when one group begins to help another group, there is a pay it forward process that occurs and good things come back around.

Evaluation Strategies

The evaluation strategies should be both qualitative and quantitative. Personal interviews with youths will give one sense of whether the program is having any impact, and surveys in which percentages and statistics can be collected will provide another sense of whether the program has been effective. The survey method has already been explained above and can be conducted through schools or via social media. It should be done at baseline prior to the implementation of the program and after one year. It could be continued yearly for as long as the program remains in existence. Interviews can be conducted online via social media or in person through the headquarters based in the urban center.

Implications

The implications of this activity for nursing practice, education and policy are numerous. It means, first of all, that there has to be collaboration and coordination among these various sectors so that they can achieve a common aim. Nurses have to be focused on increasing health literacy about opioid use and how it harms health. They should work with educators to develop a curriculum that focuses on this. This also facilitates preventive health, which should be a goal of every nurse practitioner. Policy under the Affordable Care Act was to improve preventive health, so this is one way to achieve that goal as well.

Conclusion

Addressing the issue of opioid use among the youth is not a simple task to achieve just by way of education. It actually takes a community coming together and offering hope and a way out for youths so that their time is not seen as lost. Youths need support on social media and in physical terms, with tutoring, training and work so that they can develop themselves and achieve something higher in life.