AGuide for Schools on Prevention& Intervention of Substance Use : simplebooklet.com

Purpose and Audience:This guide supports School Administrators, Pupil Services Staff, Directors of Curriculum& Student Services, Classroom Teachers, and anyone serving in the role of Alcohol &Other Drug (AODA) Coordinator in designing and providing substance use preventionand intervention in schools.Understand emerging substance use issues and interventionsAccess substance use trend data for Wisconsin and the US and identify local data sourceson substance useIdentify and evaluate resources that include best practices for substance use prevention andintervention in schoolsAlign existing resources, identify gaps, and plan ways to address gaps in servicesSelect best practices for adult and student programmingObjectives:AcknowledgementsThe WISH Center team acknowledges the funding and partnership from the Wisconsin Department of Public Instruction as well as theWisconsin Commercial Tobacco Prevention and Treatment Program (CTPTP), Wisconsin Department of Health Services. Our gratitude andappreciation goes to the following individuals who reviewed and gave feedback on this document:The Wisconsin Safe and Healthy Schools CenterChelsea Bellville, West Regional Coordinator, CESAs 4, 10, & 11Alissa Darin, East Regional Coordinator, CESAs 1, 7 & 8Tracy Herlitzke, DirectorJenny Holle, Central Regional Coordinator, CESAs 2, 3 & 6Alie Hubing, Project CoordinatorKalli Rasmussen, Communications and Project CoordinatorKatharine Reid, Statewide Project CoordinatorJackie Schoening, Former Central Regional Coordinator, CESAs 2, 3 & 6Lynn Verage, North Regional Coordinator, CESAs 5, 9 & 12Carol Zabel, Former West Regional Coordinator, CESAs 4, 10 & 11From the Wisconsin Commercial Tobacco Prevention and Treatment Program (CTPTP), Wisconsin Department of Health ServicesLuke Witkowski, Youth Programs CoordinatorFrom the American Lung & Heart Association Kayleigh Day, MPH, CHES, American Lung AssociationZach Wilks-Metrou, MPH, CHES, American Heart AssociationFrom the Wisconsin State Council on Alcohol and Other Drug Abuse (SCAODA)Chris Wardlow, Catalpa Health + Outagamie County, Project Pre-Action CoordinatorFrom the State Superintendent's Advisory Council for Alcohol and Other Drug AbuseKaren Wegge, K-12 Physical Education/Health Curriculum Coordinator, DC Everest School District2Additional feedback and resources from:Erin Jacobson, Mental Health Navigator, DC Everest School DistrictAppleton Area School DistrictChippewa Falls School DistrictAbbotsford School DistrictSheboygan School DistrictThe Wisconsin Department of Public Instruction, StudentServices, Prevention and Wellness Brenda Jennings, Assistant DirectorEmily Holder, Education ConsultantMichael Morgan, Education ConsultantMeg Whaley, Health and Physical Education and TobaccoConsultant

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Dear Educator,Why do schools need to prioritize substance use? Substance use by teens can have a lasting impacton their health and wellbeing. Substance use is associated with negative consequences including riskof drug use later in life, school failure, and poor health outcomes, including poor mental health. Inaddition, the link between trauma (Adverse Childhood Experiences or ACEs) and substance use hasbeen firmly established (1). The use of substances during childhood and adolescence has greaterpotential to disrupt brain function in areas critical to motivation, memory, learning, judgment, andbehavior control, because the brain is still developing during these periods. Substance use prevention involves helping individuals develop the knowledge, attitudes, and skillsneeded to avoid or minimize future problems related to alcohol and other drug use. Substance useprevention programs in schools foster protective factors, such as school connectedness and positivepeer relationships, which can help students avoid engaging in risky behaviors and help students learnskills important to promoting healthy choices, such as decision making, goal setting, self-management,and bystander intervention.Substance use intervention involves helping individuals who are exhibiting signs of substance use ormisuse. In schools, these interventions may include screening for substance use as in Screening, BriefIntervention and Referral to Treatment (SBIRT), providing referral resources, connecting students withcommunity based organizations, or recommendations for treatment.This guide supports School Administrators, Pupil Services Staff, Directors of Curriculum & StudentServices, Classroom Teachers, and anyone serving in the role of Alcohol & Other Drug (AODA)Coordinator in designing and providing substance use prevention and intervention in schools. TheWISH Center team prioritized finding and sharing the most useful resources to assist schools that mayneed to modernize their substance use prevention and intervention efforts.Finally, you don’t need to do this work on your own. We encourage you to connect with communitybased resources who can partner to support and collaborate with your school to help you assess, plan,implement, evaluate, and sustain substance use prevention and intervention in your school.Sincerely,Tracy Herlitzke, MPH, MCHES®Statewide DirectorWisconsin Safe & Healthy Schools CenterForeword 1 The Role of Adverse Childhood Experiences in Substance Misuse and Related Behavioral Health Problems 3

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Table of Contents4This guide contains many links and is designed as an electronic resource.Foreword03Purpose, Objectives and Acknowledgements02Overview 05Implementation Considerations05Purpose of Policy in Prevention and Intervention06Specific Considerations for Substance Use Prevention/Intervention Policy07The Need for Comprehensive Substance Use Prevention and Intervention in SchoolsWhat does a Comprehensive Substance Use Prevention and Intervention Program Look Like?“What Works, What Doesn’t”AODA Program CoordinatorRisk and Protective FactorsPolicySAMHSA’s Strategic Prevention FrameworkState and National DataNeeds Assessment & Evaluation of Substance Use Program ActivitiesGathering DataEvaluation MethodsSustainability and Program IntegrationStudent ProgramsStrategic Prevention FrameworkConsider Other Funding SourcesTips for Writing a Successful GrantCurriculum & InstructionProgram ComponentsAdult ProgramsIntegration of Community ResourcesRegional Support and Related TrainingAdditional Related Training and Resources about Substance Use among YouthAdditional ResourcesReferencesEvidence-Based Program WebsitesExamples from Wisconsin School Districts: AODA Comprehensive ProgramsShare Your Examples!Wisconsin Requirements for Substance Use PreventionTerminology Used in this Guide0709101112141414161820202122222223242426272930313234353536Appendix A: Addressing Youth Vaping38Appendix B: Best Practices Guide: Addressing Youth Vaping & Nicotine Use in Schools39

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Substance use prevention and intervention falls within a wider system of interventions andsupports designed to ensure the safety, health and success for all students. Substanceuse among youth may be a symptom of other mental health conditions, includingaddiction. While the rates of use of alcohol, tobacco and other drugs among school ageyouth have diminished in Wisconsin over the past ten years, the risks and consequencesof substance use for youth remain significant, according to the Centers for DiseaseControl’s analysis of Youth Risk Behavior Survey results. The report identifies the downward trend in substance use while pointing to potential newrisks: “Substance use prevalence declined during 2009–2021. From 2019 to 2021, theprevalence of current alcohol use, marijuana use, and binge drinking and lifetime use ofalcohol, marijuana, and cocaine and prescription opioid misuse decreased; lifetimeinhalant use increased. In 2021, substance use varied by sex, race and ethnicity, andsexual identity. Approximately one third of students (29%) reported current use of alcoholor marijuana or prescription opioid misuse; among those reporting current substance use,approximately 34% used two or more substances.” Substance use is more than a behavior issue. Comprehensive approaches to preventionand intervention can support students experiencing a wide range of mental healthconcerns. A new study from the American Academy of Pediatrics highlights the combinedrisks of substance use and other mental health conditions in noting that one third ofstudents misusing prescription opioids were more likely to say they had seriouslyconsidered suicide, made suicide plans or felt sad or hopeless in the last year. Anotherstudy shared by the National Institutes of Health cites a correlation between daily use ofcannabis (marijuana) and a diagnosis of schizophrenia among young men.The Need for Comprehensive Substance UsePrevention and Intervention in SchoolsOverview5Back to the Top

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6What does a Comprehensive Substance Use Preventionand Intervention Program Look Like?Comprehensive programs for substance use prevention and intervention function as part of amulti-level system of supports (see image below from the Wisconsin Department of PublicInstruction) where strong relationships, a positive and welcoming school climate and demonstratedsense of belonging mark the student experience. Considerations that are specific to acomprehensive approach to substance use include:District Substance Use PolicyNeeds Assessment and Review of Local DataPrevention StrategiesSelected, & Targeted Intervention Strategies for StudentsTraining and Resources for AdultsReferral PathwaysProgram EvaluationThe image below from the Department of Public Instruction AODA Program Grant WritersWorkshop highlights the structure of a tiered system of supports and interventions that can formthe structure of a comprehensive system.Back to the Top

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With limited time and resources, schools must carefully identify what actions will have the greatestpositive impact in providing for the safety and wellbeing of children. In it’s Best Practices Toolkit,Athena, the site for prevention professionals in Washington state, states what works in prevention:Focus on healthy alternatives to useEnhance connections to prosocial adults, peers and organizationsUse structured interactive approaches that include skill practiceFocus on normative education that portrays true use rates and miscorrects misperceptionsThe guidance document also reminds schools that not all approaches to prevention are helpful,and some may even be harmful. Some prevention strategies, even those used in recent decades,may have been effective for some students, but may have harmed more vulnerable students. What doesn’t work in prevention:Fear Arousal – Scary Images and Scare TacticsOne-time Assemblies and EventsPersonal Testimony from People in RecoveryMock Car CrashesReinforcing Exaggerated Social NormsThe Illusion of Truth Effect: Myth BustingDrug Fact Sheets and Knowledge-based InterventionsRole Play that Conditions Youth to be Drug Users or DealersMoralistic AppealsGrouping At-Risk Youth Together“What Works, What Doesn’t”7Back to the Top

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SAMHSA’s Strategic Prevention FrameworkIn the publication, A Guide to SAMHSA’s Strategic Prevention Framework, the Substance Abuseand Mental Health Services Administration (SAMHSA) promotes a five-step process that supportsan understanding of the complex nature of substance use within the context of a particularenvironment, such as schools. In addition, the approach reinforces a need for prevention work thatis sustained through a systems approach and that this system has the capacity to support theneeds of diverse people within the system.1. Assessment: Identify local prevention needs based on data (e.g., What is the problem?) 2. Capacity: Build local resources and readiness to address prevention needs (e.g., What do youhave to work with?) 3. Planning: Find out what works to address prevention needs and how to do it well (e.g., Whatshould you do and how should you do it?) 4. Implementation: Deliver evidence-based programs and practices as intended (e.g., How canyou put your plan into action?) 5. Evaluation: Examine the process and outcomes of programs and practices (e.g., Is your plansucceeding?)8Back to the Top

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Risk and Protective FactorsPrevention works by mitigating risk factors and leveraging protective factors. Ascited in Youth.gov, programs and practices that reduce risk factors and increaseprotective factors have a greater likelihood of success. These may include activitiesthat reduce availability of substances, increase the likelihood of school success,provide positive physical development and educate caregivers and families aboutsubstance use and supportive parenting practices. Early prevention andintervention efforts are key to protecting a child’s health and wellbeing. Risk factorsthat emerge in a child’s early life and persist through young adulthood may haveeven greater bearing on the likelihood of early substance use and potentialaddiction.9Back to the Top

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Youth mental health issues often coincide with behavioral risks like substance use. Youngpeople who engage in substance use do so for two primary reasons: to enhance a positivestate and to cope with a negative state, such as an experience of stress, anxiety, and otherpsychological distress. Mental health continues to be a focus of concern for school age youth. Vaping and othernicotine products present a challenge for schools due to their addictive nature. While many factors outside of school influence a student’s mental health, school environmentsimpact their positive or negative mental health. Mental Health, Substance Use and Addictionin School Age YouthHelp is AvailableIf you feel like you are in a crisis, please text “HOPELINE” to 741741; call or text 988;or use the chat feature at 988 lifeline.org. 59% of high school studentsreport experiencing at leastone mental health challengewithin the past year. Understanding Addiction to Support RecoveryMore than half of students (51.6%) reported experiencing anxiety. This is a significant increase from 2017 (39.9% of students).Source: 2023 Wisconsin Youth Risk Behavior Survey, Link10Back to the Top59%

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State and National DataA variety of tools and reports are available on the CDC website to help to understandsubstance use among youth across the country: National High School Youth RiskBehavior Survey Data from the Centers for Disease ControlThis interactive site allows users to examine risk behaviors in six categories: unintentional injuries and violencetobacco use/vaping/e-cigarettesalcohol and other drug usesexual behaviorsdietary behaviorsphysical activityThe site allows users to compare results from national, state, territorial, and localsurveys, examine trends over time, and view results by race/ethnicity, sex, or grade.Districts seeking to establish or strengthenexisting prevention and intervention supportsshould review local data sources todetermine the needs of their students andstaff, as well as state and national data onsubstance use and related risk behaviors.The Centers for Disease Control andPrevention (CDC) supports substance useprevention and intervention work by providingthe National Youth Risk Behavior Survey(YRBS), an optional service for individualschools and districts.10In addition to the national data available, the Wisconsin Department of Public Instructionprovides multiple reports and data summaries on its Wisconsin Youth Risk Behavior SurveyData on the Wisconsin DPI Website, including graphs, comparisons and summaries.Back to the Top

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Wisconsin Requirements for Substance Use Prevention118.01(2)(d)2.d.As part of its requirements for education for pupil personal development, Wisconsin statute118 holds each school board responsible for programming designed to provide students with“awareness about drug abuse, including prescription drug abuse, and prevention,” as well asthe impact of alcohol and other drug abuse on decision-making and suicide, and the risksassociated with driving while under the influence of alcohol and other drugs.PI 38 Under this chapter of Wisconsin law, the State of Wisconsin encourages districts to “developcomprehensive kindergarten through grade 12 programs to prevent or ameliorate alcohol andother drug abuse among minors,” and provides information about comprehensive programsfor districts wishing to apply for additional grant funding, where the following components mayform part of a comprehensive a program:1.Provides accurate and up-to-date information on health promotion and risk behaviors.2.Provides accurate information about youth attitudes and behaviors about AODA andrelated youth risk behaviors.3.Provides a strong focus on life skill development, such as decision making, goal settingand communication skills.4.Emphasizes key concepts that cut across many health and safety issues.5.Provides multiple instructional strategies.6.Is developmentally appropriate and builds on a pupil's prior knowledge.7.Provides a sense of safety and community in the classroom.8.Provides clear and consistent messages.9.Involves parents and guardians in instructional programs.11Back to the Top

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AODA / ATODAAlcohol, Tobacco and Other Drug Abuse. Acronyms commonly used in the literatureand resources cited in this guide. In this guide, AODA / ATODA may be usedinterchangeably with the term Substance Use.TERMINOLOGY USED IN THIS GUIDECSMHSA Comprehensive School Mental Health System, as cited in the DPI’s webpage,includes a continuum of services and supports to promote student and staff mentalhealth by fostering social and emotional wellbeing and positive school culture, andeliminating systemic barriers to wellbeing and success for all students. A CSMHSincreases health equity by ensuring all students and staff have access to theprevention, early intervention, and treatment supports that they need, when they needthem, free of stigma.Cultural ResponsivenessIn the DPI’s publication Wisconsin’s Model to Inform Culturally Responsive Practices,Cultural Responsiveness describes the beliefs, knowledge, and practices educators,schools, and districts need to reach and teach diverse students within their culturallyresponsive multi-level systems of support. Educational EquityBased on the DPI’s AODA Grant Guidance, every student has access to the educationalresources and rigor they need at the right moment in their education across race,gender, ethnicity, language, ability, sexual orientation, family background, or familyincome.Evidence Based Prevention“There are many strategies confirmed by research that are shown to positively impactthe health behaviors and choices of young people. These research-validated strategiesare known as evidence based programs and have been proven effective over time usingthe most rigorous evaluation methods. Evidence-based strategies depend on{practitioners’} commitment to implementing them with fidelity to the intended design ofthe program.” (Best Practices Toolkit: What Works, What Doesn’t) As noted on the Wisconsin DPI’s website, “Evidence-Based Practices means usingprograms, practices, and procedures with the best available evidence of effectivenessthat fit the school's and district's population and values.” 12Back to the TopPreventionPrevention activities work to educate and support individuals and communities toprevent the use and misuse of drugs and the development of substance use disorders.(SAMHSA.gov) In schools, prevention interventions may focus on environmental andcommunity factors and policies such as limiting access to substances, developmentalfactors including risk and protective factors, or skill development. (Youth.gov)E-Cigarettes, Vapes(Electronic VaporProducts)E-cigarettes, also known as vapes, are battery-operated devices that heat a liquid andproduce an aerosol. They come in many shapes and sizes, and they typically containnicotine. Some e-cigarettes can also be used to deliver cannabis and other drugs. Aperson using an e-cigarette inhales this aerosol into their lungs. Bystanders can alsobreathe in the aerosol when the person using the e-cigarette breathes the aerosol out.

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Risk and Protective FactorsSAMHSA defines Risk and Protective Factors as those factors that influence a person’schances or likelihood of developing a substance use disorder. Risk factors include“biological, psychological, family, community, or cultural level that precede and areassociated with a higher likelihood of negative outcomes.” These may include priortrauma, family history of substance use or low achievement in school. Protective factorssupport a lower likelihood of substance use and mitigate any risk factors. Protectivefactors may include a strong sense of belonging in school, adequate supervision, or theavailability of after-school activities.TERMINOLOGY USED IN THIS GUIDESBIRTScreening, Brief Intervention, and Referral to Treatment is a well‐established,comprehensive public health model used to address selected health behaviors within apopulation, and has been used in school settings to quickly and effectively assessareas of concern, engage in a time-limited brief counseling intervention, and assessand refer for further intervention.Substance UseTerm used in this guide to indicate use of substances such as alcohol, tobacco andother drugs by youth and adults. Some resources will also use the term SubstanceMisuse.Substance Use DisorderAs defined in The Diagnostic and Statistical Manual Disorders (DSM-5), a problematicpattern of use of an intoxicating substance leading to significant impairment or distress.See Wisconsin Department of Health Services.Stigma“Stigma can be understood as an attribute, behavior, or reputation that is sociallydiscrediting, and substance-related problems appear to be particularly susceptible tostigma.” Great Lakes PTTC Preventing and Reducing StigmaReferral Pathways“The policies and procedures in place to assure a youth with behavioral health needsgets referred, assessed, and funneled to the proper services and resources needed.”(SAMHSA, 2015) Referral pathways in schools provide next steps for staff when theyidentify a student in need, coordinate supports within schools and between schools andoutside organizations and improve student outcomes through early identification andintervention. (Wisconsin DPI School Mental Health Referral Pathways Guide)13Back to the TopRestorative PracticesRestorative Practices is a social science that studies how to build positive relationshipsand repair harm between people. The use of restorative language and other restorativepractices helps to reduce bullying and violence, improve behavior, strengthenrelationships, restore relationships and repair harm between members of thecommunity.e-MLSSAccording to the Wisconsin RtI Center, Equitable Multilevel Systems of Supportsystematically provides differing levels of intensity of supports (interventions/additionalchallenges, collaborative structures, monitoring of learner progress) based upon learnerresponsiveness to instruction and intervention.

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School district policy is a tool to provide clarity and direction towards maintaining a highquality and supportive learning environment for all students. Effective policies also ensurethat school districts are in compliance with federal/state law and are representative of thevalues of the educational community. As stated in Wisconsin’s Framework for Multi-Level Systems of Support, the use of schooldistrict policy to maintain and support health and wellness is a universal strategy to meet theneeds of students. Written policy can provide procedures that create equitable systems toprevent and respond to behavioral situations involving substance use. Because schools areoften in the unique position to be the first to notice changes in behaviors that may indicate aconcern or problem, systems can be created to provide early intervention and coordinationof resources to students and families. School districts in Wisconsin must adhere to Wisconsin Statute Chapter 38 when developingwritten policy regarding “Comprehensive kindergarten through grade 12 AODA programs”including pupil assistance programs, curriculum, instruction, staff development and youthoriented activities.Purpose of Policy in Prevention and InterventionPolicyImplementation Considerations14Back to the Top

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As a district enters the process of revising policies and procedures at the locallevel, the following areas highlight promising practices that support acomprehensive approach to creating coherence in policy development.Align policy to state law, including: Comprehensive AODA programming, including pupil assistance programs(Prevention) Curriculum and Instruction (Prevention)Adult Programs including Staff Development (Prevention and Intervention)Student Programs and Youth oriented activities (Prevention and Intervention)Engage students, families and staff Foster local involvement and commitment, emphasizing district needs andinclusive decision makingCreate a team with diverse stakeholders that will work in partnership to reviewand consider updates to the policyFocus on Data Informed Decision MakingUse data and local evidence to examine your policy and to drive planningdecisions, understanding the policy strengths, needs and gapsIdentify priorities, goals and improvement strategies that fit localcircumstancesUse local continuous improvement processes to develop, review and reviseResearch policy changes, create a rough draft and engage in the approvalprocess from the local governing bodyConsider cyclical reviews of policy with the use of data for sustainability andcontinuous improvementProcedures for Updating AODA Policies15Back to the Top

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Specific Considerations for Substance UsePrevention/Intervention PolicyDistricts may use a range of prevention and intervention strategies that are supported throughpolicy. When considering which approaches will be utilized, consider adopting strategies inaccordance with your local data, district needs and methods that promote positive, instructionalapproaches, and prioritize helping students involved in substance use.Alternatives to Exclusionary PracticesFor students identified at risk for substance use, establish procedures that promoteinstructional approaches and brief interventions, such as SBIRT (Screening, Brief Intervention,and Referral to Treatment), small Student Assistance Program groups and tier 2 interventions. Consider Restorative Practices, including formal conferences and problem-solving circles,instead of punitive, zero-tolerance policies such as suspension or expulsion.Allow for individual circumstances and the context of the behavior to be considered in thestudent discipline policies and procedures. Prioritize maintaining relationships and studentengagement over applying disciplinary consequences.Stigma ReductionStudents identified as at risk for substance use may be adversely impacted by negativestereotypes and common stigma associated with substance use. Schools and districts shoulduse language that supports students and their families, including using person first and othernon-stigmatizing language. In it’s Stigma Reduction Language Guide, Shatterproof offersguidance and best practice examples of inclusive language to support schools. The WISE – Initiative for Stigma Elimination (WISE) is a nationwide coalition of organizationsand individuals promoting inclusion and support for those affected by mental illness andaddiction/substance use through the advancement of evidence-based practices for stigmareduction efforts. WISE and Rogers Behavioral Health offer training and support for schoolsengaged in learning about stigma reduction, including the Up to Me curriculum Other resources on stigma reduction can be found at: National Institute on Drug AbusePartnership to End AddictionGreat Lakes Prevention Technology Transfer Network’s Preventing and Reducing StigmaCommunication of AODA PoliciesStudent handbooks may be used to reflect all student-related policies and procedures,highlighting all prevention efforts and consequences for violation of the policies.Opportunities to create open dialogue between parents and students about policies and theirimpacts can be fostered through parent forums, education nights, etc.16Back to the Top

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Specific Considerations for Substance UsePrevention/Intervention Policy ContinuedStaff EducationDefine how staff will engage in coordinated programs of staff development focused on essential learningof student protective and risk factors, student supports and resources and current substance use trends.Include staff role in early identification of student risk factors and role in referral to district support teamthat provides coordination of student assistance services.Services for StudentsDefine developmentally appropriate education provided to all students using evidenced-based curriculumand prevention programs. Policy may include options for parents to view and/or engage in the preventioncurriculum learning. Bear in mind that “one and done” or episodic events such as public speakers or“mock crash” incidents should be woven into a comprehensive educational approach to prevention.Identify Student Assistance Program (SAP) components including screening, referral procedures and in-school support groups. Additionally, policy may clearly identify roles of the SAP team members andunique training of SAP team members.Designate the role of community partnerships for AODA prevention and intervention, including ReferralPathways for students/families to access treatment services. Clarify how district programs will support thereduction of barriers to access treatment services, supporting equitable approaches to mitigate disparities.Alignment to Athletics and Co-curricularsWith athletics and co-curriculars being an integral forum for student learning and development, districtpolicy may reflect how participation in such activities is connected to protective factors or risk factors ofsubstance use. Code of Conduct will reflect district policy to promote health and wellness, as well as specifyingconsequences for substance use violations as it pertains to athletics and co-curricularsSearch and SeizureIn accordance with school safety procedures, clarify search and seizure procedures on school grounds,including substances found in lockers, on person or in vehicles. Define who can conduct searches with specification given to educational roles and the use of lawenforcement K9 units. For additional information, see the Wisconsin Department of Justice Safe Schools Legal Resource ManualBreathalyzers and Drug TestingSpecifics can include how students are selected via random sampling or if a student would be subject to abreathalyzer test due to reasonable suspicion.Policies that include other drug testing may specify the provider of the testing, the parameters ofconfidentiality and the protocols for student selection of drug testing.VapingSee Appendix A and Appendix B as well as the WISH Center Vaping Resources webpage for moreinformation.17Back to the Top

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While not required by the state of Wisconsin, districts may provide an AODA ProgramCoordinator as part of their comprehensive approach. If a district applies for an AODAProgram Grant, the district is asked to name the district AODA Program Coordinator.An AODA Program Coordinator was described in the 1991 Wisconsin Department of PublicInstruction publication, Alcohol And Other Drug Abuse Programs - A Resource andPlanning Guide, as:”a professional school employee holding a license issued by the Department of PublicInstruction…who is designated by the school board to: coordinate program activities amonggrade levels, build community and AODA program components for consistency andintegrity; assist in writing, reviewing, and updating AODA policies and procedures; keepinformed, communicate, and make recommendations regarding current materials, laws,grants, research, and community resources; act as a consultant and liaison for the districtregarding AODA issues; coordinate program review and evaluation; work cooperativelywith and serve on district committees for related programs such as at-risk, suicideprevention, and protective behaviors; ensure that there is a network that provides staffsupport; coordinates the development and implementation of AODA classroom curriculum;and provide ongoing system analysis.” When looking for guidance in creating the AODA Program Coordinator position, districtsare advised to consult PI 38.13 where the following categories may form part of acomprehensive program:1. Provides accurate and up-to-date information on health promotion and risk behaviors.2. Provides accurate information about youth attitudes and behaviors about AODA andrelated youth risk behaviors.3. Provides a strong focus on life skill development, such as decision making, goal settingand communication skills.4. Emphasizes key concepts that cut across many health and safety issues.5. Provides multiple instructional strategies.6. Is developmentally appropriate and builds on a pupil's prior knowledge.7. Provides a sense of safety and community in the classroom.8. Provides clear and consistent messages.9. Involves parents and guardians in instructional programs.AODA Program Coordinator18Back to the Top

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Knowing what is considered to be a comprehensive K-12 AODA program is helpful indefining the AODA Coordinator position. Consultation with the Department's Alcohol andOther Drug Use/Abuse (AODA) Prevention Program Assessment Tool is an additionalmethod for gaining an understanding of a comprehensive program and defining the rolesand responsibilities of the Coordinator position. The following categories are assessedwhen using the DPI’s tool:School EnvironmentCurriculum and InstructionStudent ProgramsPupil ServicesAdult ProgramFamily and CommunityThese broad categories may be useful in creating a position description, defining roles andresponsibilities and determining training needs. Wisconsin requirements as stated in PI38.18(3) item (c) call for districts to provide the “name of the AODA program coordinator,and evidence that the AODA program coordinator holds a current license issued by thedepartment,” thus requiring the AODA Program Coordinator to have a valid DPI licenseallowing them to work with students, including, but not limited to a license as a schoolcounselor, school psychologist, school social worker, principal, etc. In some districts, a partnership with a community agency was formed to create and provideAODA Core training. Click on the link for an example from the Appleton School district:2022/2023 ATODA TRAININGS Appleton Area School District/Catalpa Health ContractedServices Other resources for obtaining training for AODA Coordinators may include:Great Lakes Prevention Technology Transfer NetworkMid-America Prevention Technology Transfer Network Partnerships for SuccessTalk They Hear YouLesson Plans and Activities | National Institute on Drug Abuse (NIDA) (nih.gov) Many of these lessons include fact sheetsWISH Center - ATOD ResourcesWISH Center - School SBIRTAODA Program Coordinator Continued19Back to the Top

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There are multiple methods of data that can be utilized to guide areas ofimprovement in programming and to set future goals. Data may includequalitative sources, including observations and perception surveys andquantitative sources, including information that has been counted andmeasured. When initially collecting data, use a baseline measure that willallow a comparison once the implementation of policies andprogramming occurs. Multiple forms of data should be used whenconsidering areas of improvement to prioritize, as singleton sources ofdata may not convey the complexity of factors involved in programimplementation. The following are data sources to consider:Who is participating in programming?Universal student engagementTier 2 student engagementWhat are the needs that have been identified?Needs AssessmentFor information and resources in planning and assessing adistrict's current comprehensive AODA program, visit the DPI’sStudent Services Prevention and Wellness AODA webpage andfind the links for assessment tools, including the DPI AODAAssessment ToolDPI Tobacco Prevention Program Assessment ToolSearch Institute Developmental Assets Attitudes and BehaviorsYouth Risk Behavior Survey dataMeasures of student engagement, belonging, and safetyOffice referrals, School Resource Officer reportsStudent and Parent input/feedbackThe Guide to StrategicPrevention Frameworkrecommends that whenassessing substance use withinthe school and community,prevention planners may wish toengage with the followingquestions: What substance misuseproblems (e.g., overdoses,alcohol poisoning) andrelated harmful behaviors(e.g., prescription drugmisuse, underage drinking)are occurring in thecommunity?How often are thesesubstance misuse problemsand related harmfulbehaviors occurring? Whichones are happening themost?Where are these substancemisuse problems and relatedharmful behaviors occurring(e.g., at home or in vacantlots, in small groups orduring big parties)? Who is experiencing more ofthese substance misuseproblems and relatedharmful behaviors (e.g.,males, females, youth,adults, members of certaincultural groups)?NEEDS ASSESSMENT & EVALUATION OF SUBSTANCE USEPROGRAM ACTIVITIES In order to measure the impact of substance use prevention and interventionstrategies, programming should be monitored for progress in a systematicway. Program evaluation can be completed on an ongoing basis through aprocess of continuous improvement. Measurement of progress can informfuture decision making and can build an understanding that the desiredoutcomes of the program are occurring and making a positive impact.GATHERING DATAWhat are outcome measurements?AODA violationsAthletic or co-curricular Code of Conduct violationsReferrals for AODA servicesAttendance dataAchievement data20Back to the Top

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0 6SMARTIE GoalsThe SMARTIE, Specific, Measurable, Attainable, Relevant, Time-based, Inclusive and Equitable goal framework can be used to recorda focused direction for the programming. Objectives are then createdto align to goals, followed by evidence and indicators of success.SMARTIE goals may work in alignment to district or building annualgoals as a part of a strategic planning process.Evaluation MethodsThere are a variety of methods that can be used when determining if aprogram is working and how it can be improved, including:PDSA CyclesPlan, Do, Study, Act creates a systemic process for continuousimprovement. This repetitive model organizes the implementationand improvement process by creating small predictions and tests thatonce completed, provide an organization feedback to adopt, adapt orabandon the strategy. PDSA cycles can support scaled implementation when you arestarting a new program or strategy by breaking applications intosmaller steps for evaluation.Key Performance Indicators (KPI)KPI’s are indicators of progress towards a desired level of progressor a specific result. To determine KPI’s, a logic model can be used as a visualrepresentation between the program activities, including inputs,processes, and outputs, and their intended impacts.21Back to the Top

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SUSTAINABILITY AND PROGRAM INTEGRATION SAMHSA’s Strategic Prevention Framework recognizes the value of creating “an adaptive andeffective system” that involves diverse community partners, in which decisions and actions aredriven by data, and that the plan for prevention evolves as the needs of the community or schoolchange. A system that is powered by a team and integrated within a larger system of supportswithin a school is more likely to be successfully implemented and maintained. For moreinformation, see A Guide to SAMHSA’s Strategic Prevention Framework.DPI Student AODA Mini-Grant ProgramThe Department of Public Instruction’s (DPI) AODA Student Mini-Grant Program allowsstudents to submit proposals/projects, with costs up to $1,000. For more informationregarding Student AODA Mini-Grants go to the following link: AODA Mini-Grant. DPI AODA Program GrantThe Department of Public Instruction’s (DPI) AODA Program Grant assists school districts intheir development of comprehensive AODA programs which includes both prevention andintervention services. The discretionary grant program supports the development andexpansion of district-wide comprehensive kindergarten through grade 12, alcohol and otherdrug abuse prevention and early intervention programming as part of a coordinated schoolhealth program. For more information regarding AODA Program Grants go to the followinglink: https://dpi.wi.gov/sspw/aodaTitle IVA FundingThis federal grant provides districts with funds focused towards building capacity to ensurethat all students have access to high-quality educational experiences. Districts havesignificant flexibility in using these funds to support three priority areas. One of the areasbeing improving school conditions for learning to ensure safe and healthy students. Formore information regarding Title IVA funding go to the following link https://dpi.wi.gov/titleivaDrug Free Communities (DFC) Support ProgramThis program supports the efforts of community coalitions working to prevent and reducesubstance use among youth. For more information regarding DFC Support Program go tothe following link: Drug-Free Communities (DFC) Support Program Strategic Prevention FrameworkConsider Other Funding SourcesThe braiding of local, state, and federal funding sources is essential to sustainability. Below areexamples of a few funding sources.22Back to the TopFor state level resources, information and timelines for AODA Program Grants, AODA Mini-grants, as well as contact information for DPI consultants, please visit the DPI Website.

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PROGRAM COMPONENTSUnder PI 38 AODA programs should meet the curriculum & instruction requirements of Wis Stat sec 118.01 (2) (d) 2. c. and 118.01 (2) (d) 6.It is important to make data driven decisions when selecting practices and programs to supportsubstance use prevention and intervention in schools. See the section in this guide on “NeedsAssessment & Evaluation of Substance Use Program Activities” for data sources, andstrategies to evaluate the impact of a chosen strategy. It is recommended to use Evidence-Based Practices when providing prevention andintervention services within a school program. These programs provide quality material andmay offer training. As stated on the Wisconsin DPI’s website, “Evidence-Based Practicesmeans using programs, practices, and procedures with the best available evidence ofeffectiveness that fit the school's and district's population and values.” An evidence-basedapproach is: applied across all key system featuresimplemented as designed and intendedselected collaboratively through use of local dataculturally responsivesupported through policy, resource allocation, training and coaching, and accountabilitymeasures and structuresThe following link provides an “Excellence in Prevention Strategies” list. If you select “schools”in the “where will you implement” section, “drugs” in the “what problems do you wish toaddress” section, and then whatever else matches your district in the remaining sections, thiswill generate a list of evidence-based programs to consider: https://theathenaforum.org/EBP. As you begin to identify needs, consider what adult practices or systems changes are neededin order to best meet the needs of the identified target population. Be sure to consider whatyou are doing for all students, some students, and then targeted students. The diagram on thenext page is provided by the Wisconsin Department of Public Instruction which can help guidedevelopment of a comprehensive program.Curriculum & Instruction24Back to the TopSee Appendix B for vaping prevention and intervention programs.

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Below is a list of some evidence-based prevention programs being used in Wisconsin. LifeSkillsProject AlertToo Good for DrugsStrengthening FamiliesGuiding Good ChoicesAll StarsAnother option is to use Promising Practices. These are strategies that have been shown to alterindividual choices toward substance use. Promising Practices can also be evidence-basedprevention strategies that have shown positive outcomes in reducing risk factors or increasingprotective factors for drug use.Below are a variety of websites that support districts in the identification of evidence-based orPromising Practices.Center for the Study and Prevention of Violence-Blueprints for Violence Prevention Evidence for ESSA SAMHSA Evidence-Based Practices Resource Center Collaborative for Academic, Social, and Emotional LearningCurriculum & Instruction25Back to the Top

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The key to any successful program in schools is the active participation of the students. Peerprograms are oriented toward both prevention and intervention. Responsible students are selected,then trained in specific skills as well as AODA-related issues, and they are given the opportunity tohave a profound influence on their fellow students through these programs.Examples of peer helping/listening, peer to peer education, and peer leadership approaches:Sources of StrengthHOPE SquadNAMI Raise Your VoiceREDgenFACT (Fight Against Corporate Tobacco)SADD (Students Against Destructive Decisions)TATU (Teens Against Tobacco Use)tMHFA - teen Mental Health First AidPeer MediationStudent clubs such as Unity/Diversity, Gay-Straight Alliance, Drama, Black Student UnionSchool-based mentoring programsWashington state’s Best Practices Toolkit states that effective programs interactively build socialskills, communicate positive peer norms, involve students in youth-led activities and point toimmediate consequences of substance use rather than far-off threats such as cancer or death.Once popular throughout the state, this model for Student Assistance Programs trained staff tounderstand and recognize chemical dependency and mental health concerns, the family dynamicsin a dysfunctional family system, what enabling is and how it affects behavior, codependency, braindevelopment, interventions, recovery, developmental assets and resilience. This first step in thelearning is referred to as Core Training. Further training provides staff with the skills to facilitateSAP support groups. Facilitated support groups are the primary service delivery system in an SAPprogram.Appleton Area School District is one example of a district using the Student Assistance Programmodel as a part of their Comprehensive School Mental Health services to provide small groupsdriven to provide peer to peer support in a structured curriculum. To see an example of thepromotional materials for the training, click on this link: saptraining 2022-2023 AASD Public.docx -Google Docs Related Student Assistance Program examples:Anger ManagementGrief SupportFamily ChangeFriendship Student Assistance Programs (SAP)Student ProgramsPeer Programs 26Back to the Top

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As directed by PI 38 of the Wisconsin Administrative code, the Department of PublicInstruction has developed an Alcohol and Other Drug Use/Abuse (AODA) PreventionProgram Assessment Tool. This tool is intended to give districts guidance in developing andmaintaining a comprehensive alcohol and drug prevention/intervention program. Oneelement of such a program is staff professional development. Click on the following link tosee the assessment tool: Alcohol and Other Drug Use/Abuse (AODA) Prevention ProgramAssessment ToolAdult Programs Similar to Student Assistance Programs, Employee Assistance Programs (EAP) can supportschool and district staff in substance use prevention and intervention efforts. On the USDepartment of Health & Human Services website an employee assistance program “providesassessment, short-term counseling, referral, management consultation, and coachingservices to federal employees, and is available 24 hours a day, 365 days a year.”https://www.hhs.gov/about/agencies/asa/foh/bhs/employee-assistant-program/index.htmlMany employees are eligible for EAP services as a part of their health insurance. Consultyour policy to determine if you are eligible for this service. Partnering with community resources some Wisconsin school districts have been able tooffer staff and students mental health support “in-house”. The Chippewa Falls School districtis one example of a district offering mental health support services within the district. Utilizingthe Interconnected System Framework the district has invested their own resources andpartnered with community providers to offer a Student and Family Assistance Program. Thisis where each student or their family members can receive four free counseling sessions(four per family). Check out more about the Cardinal Cares program: https://cardinalcare.info/Employee Assistance Programs Adult Programs27Back to the Top

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The Department of Public Instruction encourages districts and community partners to“provide opportunities for local citizens and the community, school, agencies and institutionsto become active partners in addressing education and community concerns.” Theseofferings can span a wide variety of topics and may include public forums for discussion onemerging community issues such as alcohol and drug use prevention for minors. Anotheropportunity that many schools take advantage of to provide current and up-to-date alcoholand drug information are extracurricular code signing events. Many schools require a parentor guardian to attend these events with students. In addition to going over the extracurricularcode of conduct and consequences for code violations, it's a chance to provide informationon substance use prevention. Schools may have speakers come in to address the student body during school hours andparents and community members can be invited. Other times, schools coordinate eveningspeakers or are purposeful in providing updates or information in non-school hour offerings.Adult Programs ContinuedCommunity EducationAdult WellnessAs we learn more, we come to understand the importance of wellness along the continuum ofcomprehensive school based mental health services. For some time, schools have had staffwellness programs. In recent years, these programs have become centerpieces for schooldistricts encouraging staff self-care. One example of such a program can be found byfollowing this link: https://www.sheboygan.k12.wi.us/staff-wellnessAnother tool available free of charge to help promote and encourage staff resilience is theCompassion Resilience Toolkit. This toolkit walks school staff through 12 sections that helpto define compassion, compassion fatigue and burnout, the systems that drive fatigue, howto build a staff culture of compassion and concludes with strategies for developing mind,spirit, strength and heart resilience. School staff from around the state have been trained asfacilitators to bring the toolkit to their colleagues. 28Back to the Top

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Districts and schools are encouraged to partner and share resources and ideas with localcoalitions that may have personnel and financial resources to support prevention andintervention efforts. Local coalition efforts can be enhanced by the resources andtechnical assistance provided by The Alliance for Wisconsin Youth. The purpose of thisorganization is to enhance and support the capacity of member coalitions in theirsubstance use prevention and youth development work. Over 90 Wisconsin coalitionsare members of the Alliance. The Alliance for Wisconsin Youth provides access toresources and a network of coalitions that can strengthen prevention efforts locally.Community coalitions or partnerships may include members from:Human Services see Wis Stat sec 51.42 Law Enforcement Local and county government agenciesJudicial entities (Juvenile court, Restorative Justice programs) After-School ProgramsOther Youth Serving OrganizationsYouth and families also benefit when districts build Referral Pathways that provideguidance and information for resources internal and external to the schools (including re-entry support when a student is returning from treatment.) INTEGRATION OF COMMUNITY RESOURCES29Back to the Top

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As your team works to identify needs, root causes and begins to lay out the action plan,consider what training needs your district(s) have to build capacity around selectedstrategies. The Wisconsin Safe and Healthy Schools Center provides a variety of trainingand technical assistance opportunities in areas such as School SBIRT, CompassionResilience, Restorative Practices, Vaping, YMHFA and more. Please see the completetraining calendar at https://www.wishschools.org/training/.WISH Center Resources-AODA : https://www.wishschools.org/resources/atod.cfmContact the WISH Center:wishschools@cesa4.org www.wishschools.org Regional Support and Related TrainingDIRECTOR PRESIDENT VICE PRESIDENTFor state level resources, information and timelines for AODA Program Grants, AODA Mini-grants, as well as contact information for DPI consultants, please visit the DPI Website.Wisconsin Department of Public Instruction: https://dpi.wi.gov/sspw/aoda.30Back to the Top

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0 6Prevention Tools: What Works, What Doesn’t. Washington’s Best Practices for Substance Abuse Prevention and MentalHealth Promotion Guide Prevention tools: What Works, what doesn't document. Developed by Joe Neigel, MonroeCommunity Coalition Coordinator. Last updated October 2019.The Role of Adverse Childhood Experiences in Substance Misuse and Related Behavioral Health Problems SAMHSA’SCenter for the Application of Prevention Technologies, June 2018 www.mnpr.org Alcohol and Other Substance Abuse Before and During the COVID-19 Pandemic Among High School Students - YouthRisk Behavior Survey, United States, 2021US Centers for Disease Control Supplements, April 2023Current Prescription Opioid Misuse and Suicide Risk Behaviors Among High School Students. Pediatrics April 2021; Young men at highest risk of schizophrenia linked with cannabis use disorder National Institute on Drug Abuse. May 2023A Guide to SAMHSA’s Strategic Prevention Framework SAMHSA, June 2019Risk and Protective Factors, Youth.govYouth Risk Behavior Survey Overview Video High School Youth Risk Behavior Survey Data US Centers for Disease Control Youth OnlineWisconsin Youth Risk Behavior Survey 2021 Wisconsin Department of Public InstructionSubstance Use Disorders Wisconsin Department of Health ServicesWisconsin School Mental Health Framework Wisconsin Department of Public InstructionWisconsin’s Framework for Equitable Multilevel Systems of Support Wisconsin RTI Center, July 2017Mental Health - Trauma Sensitive Schools Wisconsin Department of Public InstructionEquity: Wisconsin’s Model to Inform Culturally Responsive Practices Wisconsin Department of Public Instruction,September 2017School SBIRT - Screening, Brief Intervention and Referral to Treatment Wisconsin Safe and Healthy Schools CenterReferences32Back to the Top

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Wisconsin 2023-2025 AODA Grant Guidance Wisconsin Department of Public Instruction, January 2023Preventing and Reducing Stigma Great Lakes Prevention Technology Transfer CenterRisk and Protective Factors SAMHSA.govSchool Mental Health Referral Pathways Wisconsin Department of Public InstructionRestorative Practices Wisconsin Safe and Healthy Schools CenterStigma Addiction Language Guide ShatterproofUp To Me Curriculum Wise Initiative for Stigma EliminationLegal Resource Safe Schools Manual Wisconsin Department of Justice, September 2020Alcohol and Other Drug Use/Abuse (AODA) Prevention Program Assessment Tool and Tobacco Prevention ProgramAssessment Tool Wisconsin Department of Public InstructionDPI Data Collections, Reporting, and Student Data Privacy Frequently Asked Questions Wisconsin Department of PublicInstructionThe SMARTIE Goals and Objectives Worksheet National Council for Mental WellbeingWhat is a Key Performance Indicator?www.kpi.orgComponents of Logic Model US Centers for Disease ControlEmployee Assistance Program US Department of Health and Social ServicesCompassion Resilience Toolkit for Schools Wise Initiative for Stigma EliminationAlliance for Wisconsin YouthPI 38 Department of Public Instruction Administrative Rule Comprehensive School Health ProgramsWis Stats 118.01(2)(d)8References33Back to the Top

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ADDITIONAL RESOURCESUS Department of Education ResourcesUsing Evidence to Strengthen Education Investments (ESSER funding)Wisconsin Department of Public Instruction ResourcesSchool Mental Health FrameworkWisconsin’s Framework for Equitable Multi-Level Systems of Support DPI AODA Program Grant information and application2023-25 AODA Grant Program Guidance - PDF2023-25 AODA Grant Writers Workshop - PPTUS Department of Health and Human Services ResourcesVaping Prevention ResourcesOther Training and Technical Assistance:Great Lakes Prevention Technology Transfer NetworkMid-America Prevention Technology Transfer Network Partnerships forSuccessTalk They Hear YouLesson Plans and Activities | National Institute on Drug Abuse (NIDA)(nih.gov) Many of these lessons include fact sheetsWISH Center - ATOD ResourcesWISH Center - School SBIRTWisconsin Department of Health Services Resources Substance Use DisordersState Council on Alcohol and Other Drug Abuse (SCAODA)34Back to the Top

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In its guidance for AODA grant writers, the Department of Public Instruction suggeststhe following websites as resources when gathering information about evidence-basedprograms and practices:Athena Excellence in Prevention Strategy List Center for the Study and Prevention of Violence-Blueprints for Violence Prevention Evidence for ESSASAMHSA Evidence-Based Practices Resource CenterThe Collaborative for Academic, Social, and Emotional LearningEVIDENCE-BASED PROGRAM WEBSITESPolicy(seeking examples)AODA Program Coordinator Job DescriptionAbbotsford AODA Program Coordinator descriptionStudent ProgramsStudent Assistance Program CORE Training promotional materialsAdult ProgramsChippewa Falls School District Cardinal CareSheboygan Staff WellnessHandbook Language(seeking examples)EXAMPLES FROM WISCONSIN SCHOOL DISTRICTS:AODA COMPREHENSIVE PROGRAMS35Back to the Top

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Appendix A: Addressing Youth Vaping37Back to the TopAdditional resources:Best Practice Guide: Addressing YouthVaping & Nicotine Use in Schools WISH Center Vaping ResourcesNicotine is highly addictive and especially harmful to youth, whose brains continuedeveloping until about age 25. Early use can quickly lead to dependence sometimes evenbefore regular use and damage areas of the brain that affect attention, learning, mood, andimpulse control. This increases the risk of addiction to other substances and makes quittingdifficult, as the brain becomes reliant on nicotine to feel normal.Vaping is more than a bad habit—many students are addicted. Youth can developdependence faster than adults due to their heightened sensitivity. Withdrawal symptoms likeirritability, anxiety, depression, sleep issues, and difficulty concentrating often trap users in acycle of continued use to avoid discomfort. Addiction can also harm relationships, academicsuccess, and work performance.Punitive measures don’t work because addiction, not choice, drives behavior. Nicotine useduring adolescence can have long-term consequences, affecting relationships, school, andwork performance while increasing the likelihood of future substance addiction.FlavorsThousands of flavorcombinationsSynthetic NicotineIndustry muddying the waters.Nicotine, regardless of itssource has addictive properties.Addiction Happens QuicklyDays not monthsEspecially in developing brainsDisposableLoophole in 2020 FDAregulation. Disposables are oftencheaper or heavily discounted.High Nicotine CapacityThere are no limits on nicotine levels.The higher the concentration ofnicotine, the quicker youth becomeaddicted.Nearly 60% of Wisconsin high school students reported experiencingmental health challenges. Only 20% who felt sad, empty, hopeless,angry, or anxious said they received the help they needed. In the caseof vaping, the most common reason youth give for continuing to use e-cigarettes is “I am feeling anxious, stressed, or depressed.”

AGuide for Schools on Prevention& Intervention of Substance Use

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