Substance use prevention and early intervention: Key steps to reduce harm and prevent use before it starts  

Republished from Cultivating Connections, the blog of the King County Department of Community & Human Services

Substance use disorders continue to impact people from all walks of life. As the understanding and science of addiction evolves, so too does our understanding of ways to prevent substance use disorder and increase support for communities. As a follow up to the blog post on substance use disorder treatment, we are taking a closer look at prevention. 

King County aims to reduce stigma of those with substance use disorders, prevent drug use among youth and young adults, and partner with community organizations to provide whole person care that reduces substance use. This blog details some of King County’s investments in youth and young adult prevention, partnerships with community organizations, and other education and outreach efforts.

There’s not one single cause of substance use disorder—it’s a complex condition. With increased understanding of risk factors, we can work upstream to help prevent substance use disorders and support positive outcomes.

Prevention: How it works across the spectrum 

As you can see in the graphic below, we can think of actions to address substance use disorder along a continuum. It’s important to note that the way people interact with continuum is not linear, and people may access various supports throughout their journey. In this blog post, we focus on one of the earlier stages along this continuum, preventing overdoses and other harmful impacts of drug use from occurring in the first place.   

Supports for youth and young adults

The link between adverse childhood experiences and substance use suggests that programs that support kids and families can help youth thrive and reduce substance use over the long term. This includes programs that support the mental health of young people and their communities. Here are a few examples of several King County programs that support youth mental health and increase awareness of risks of substance use.  

  • School-Based Screening, Brief Intervention, and Referral to services or treatment (SB SBIRT) is currently in 13 school districts and one private school around King County. School-based SBIRT promotes social and emotional health and prevents substance use for middle and high-school students. Once a student fills out a brief survey, they are offered opportunities to connect to individualized resources and speak with a caring adult who has been trained in the school-based SBIRT model. In the 2022-2023 school year, 11,867 youth were screened in schools using the school-based SBIRT tool. When the screening identified an immediate safety or prevention/intervention concern, 60.8% of high school students and 50% of middle school youth received a brief intervention. 
  • Expanded mental health supports. King County is expanding mental health supports in school-based health centers through 2025. The centers provide a range of services from primary care to well-child exams and mental health counseling, and collaborate with schools to address any concerns or adverse experiences that affect students’ healthy development. 
  • youth-led communications campaign helps promote mental well-being and substance use prevention among young people. Last year, Best Starts for Kids awarded funding to Creative Justice to support young people in a mental health communications campaign. Creative Justice is working with Converge Media and a group of young people to help connect more youth to resources to enhance their mental health.    
  • The Youth Healing Project invests in mini-grants to create mental health supports for young people. Now 14 projects are underway, led by young people across the county, developing creative tools and supports to reach their peers. Programs cover a wide range of interests, including knitting circles, yoga, art, and virtual gathering places for peers to connect.  
  • Juvenile Justice Youth Behavioral Health Assessments (JJYBHA)  This program provides mental health and substance use disorder screening and assessment services and psychological evaluations services for King County youth 12 years or older who have become involved with the juvenile justice system. JJYBHA teams help families connect to behavioral health and other support services, resulting in a warm hand-off between the legal and behavioral health systems. 
  • MIDD Emerging Issues Initiative – Seattle Public Schools  New in 2023, with funding through the MIDD behavioral health sales tax fund, Seattle Public Schools is launching an opioid prevention and opioid overdose response. Planned activities include a health promotion campaign, updated classroom lessons on opioids, parent education, and increased partnerships with substance use disorder agencies. Planned activities include establishing a supply of naloxone on every campus, developing training for responders, including staff and teachers, and statewide training dissemination. 

Expanded partnerships with community organizations

Through the expansion of funds from the local MIDD behavioral health fund, King County is working with community-based organizations to develop programs directed to meet the needs of groups disproportionately impacted by substance use disorder, including people who are unhoused.    

  • The Community Behavioral Health Treatment – This initiative provides mental health and substance use disorder services to people who are not served by Medicaid, including people who are non-citizens, people in jail, and people on Medicare. This initiative provides essential services not covered by Medicaid such as outreach, transportation and substance use disorder peer support.  
  • Mental Health First Aid – If you see someone experiencing a mental health crisis, do you know what to do? Mental Health First Aid is an 8-hour training course that gives people the skills to respond to someone experiencing a mental health crisis or substance use challenge or issue.  
  • Older Adult Crisis Intervention/Geriatric Regional Assessment Team – GRAT is a specialized outreach crisis and mental health assessment, including a substance use screening, that is age, culturally, and linguistically appropriate for King County residents 60 years and older who are experiencing a crisis in which mental health or alcohol and/or other drugs are a likely contributing factor. 
  • Coordinated action to address overdose in unhoused populations: In response to the rapid rise in fatal overdoses among people experiencing homelessness, the Department of Community and Human Services, Public Health – Seattle & King County (Overdose Prevention, and Health Care for the Homeless), and the King County Regional Homelessness Authority have joined together to assess needs of service providers that work with people who are unhoused. For example, Public Health is providing technical assistance to housing providers on minimizing the risk of overdose in housing agencies.  

Education, outreach and reducing stigma

Public Health has developed materials and campaigns to help youth, adults, and community organizations have the information they need to prevent risks from drugs that are circulating in our community. The campaigns also aim to reduce stigma for people with substance use disorder. Here are descriptions of three recent communication campaigns.  

  • Laced and Lethal is an online resource with information about fentanyl, how to spot an overdose, and treatment resources. The website includes downloadable toolkits, including talking to teens about fentanyl. This website was designed with the input of young people and has since been expanded to provide information for adults.  
  • Talk even if is a campaign that has been running on social media that helps parents have conversations with young people in their lives about the risks of fentanyl and other drugs. The website includes questions people can ask their teens, such as, “Do you know anyone that might be using fentanyl or pills? You don’t have to tell me who. I just want you to be prepared to help them.”  
  • Don’t Count Us Out is a campaign you may have seen on billboards across King County and social media that emphasizes the many people who have recovered from substance addiction. The campaign brings to light that stigma such as feelings of shame and judgement stop many people from getting the help they need.  
  • Posters and free materials – Public Health has many free posters available for our communities. The posters are designed for schools, community groups, and service providers. You can request and download posters about looking for signs of opioid overdose, fentanyl warnings, information on emerging drugs such as xylazine, and stickers on carrying naloxone. Resources are available at 

These are just some of the many approaches that King County and community partners are working on to support young people, parents and our broader region to prevent substance use disorder in the first place.  

Originally published July 19, 2023