Afterschool Heals Tennessee: A Q&A on the opioid crisis

To help shatter the myths during National Drug and Alcohol Facts Week, we bring you a story of how an afterschool state network is leveraging afterschool programs to support children, youth, families, and communities facing the opioid and substance use epidemic.

In this Q&A with the Afterschool Alliance, Mary Graham, president and CEO of the United Ways of Tennessee and the lead staff at the Tennessee Afterschool Network, gives us a view of the current opioid and substance use situation in her state and describes a new initiative to bring community partners, families, and foundations together to improve the lives of children and young people. 

What’s the bird’s-eye view of the opioid crisis in Tennessee, especially as it impacts children and young people?

Tennessee is one of the states most deeply impacted by our national opioid crisis, second only to West Virginia. Tennessee experienced 1,186 overdose deaths in 2016; 13,034 non-fatal overdose outpatient visits in 2015; and 7,092 non-fatal overdoes inpatient stays in 2015.

In 2017, 6,879,698 painkiller prescriptions were filled in Tennessee—and we only have 6,716,000 people living in the state. Between 2010 and 2015, the incidence of Neonatal Abstinence Syndrome (NAS) – infants born with substance addictions due to exposure in the womb – among enrollees in TennCare (Medicaid) more than doubled, from a rate of 11 to 24 per 1,000 live births. Kingsport, one of our afterschool network hubs run by the United Way of Greater Kingsport, is currently working to address the highest incidence of NAS births in both the state and the country.

Afterschool offers many protective factors to encourage prevention and support students whose lives have been touched by the opioid crisis. Are there particular challenges or gaps in the current system of protective factors for young people? If so, what are they?

In terms of the opioids crisis specifically, our state has been focusing resources on treatment, with little eye to protective factors, the long-term impact on youth, or the role afterschool programs can play in prevention and helping families recover. Tennessee has been investing considerable funds in training staff to recognize and work with students who have faced adverse childhood experiences (ACES), and the Tennessee Afterschool Network (TAN) has been highly engaged in the statewide coalition work, providing training for afterschool professionals and beyond. We are excited to be expanding this work.

Your new initiative is called Afterschool Heals Tennessee and takes a comprehensive view of supporting students, staff, families, and the community. Can you tell us about that spectrum of supports and your plans to build or improve on them?

With generous funding from the Charles Stewart Mott Foundation, AmerisourceBergen, and United Ways of Tennessee, we are launching Afterschool Heals Tennessee as a strategic and much-needed response to the opioid crisis in our state. Through this work, we will be expanding both the depth of educational content for afterschool professionals and the engagement of and support for our youth and families. We will be using a train-the-trainer approach and evidence-based content, as well as new content. This effort would include professional development for afterschool program staff; engaging, educating and supporting children, youth, parents and grandparents more extensively; and being at the center of the conversation around prevention and recovery.

We’ve also built youth engagement into this work. Youth are being recruited for a peer-to-peer anti-stigma campaign, advisory council, and other efforts. In fact, we hope to connect this work to work we will be doing in service learning via a grant from National Youth Leadership Council (NYLC).

New partnerships will also be key--with different parts of our departments of education and health, as well as new organizations, like Systems of Care Across TN (SOCAT), the mental health community, school districts implementing trauma-informed environments, juvenile justice, and our faith community.

We are forming a task force and have recruited a field manager and a youth engagement manager. This work will definitely take a village. We do believe this work will elevate TAN as an expert in our state. We plan to produce a white paper on our work, its outcomes, and the impact of afterschool programming in our state—to educate legislators, potential funders, and other audiences about the role the network and afterschool programming can have in tackling this crisis and other health issues.

What are some of the challenges you see ahead for the effort?

The biggest challenge facing us is the stigma facing those with substance abuse problems. Educating people and getting those who need help to ask for it will be a challenge—but one that we will combat with training, tools, social media, and a plethora of events and resources.

Do you have any advice for other networks or afterschool professionals seeking to help young people and families who are struggling with opioid issues?

Start with a pilot area or two and get some successes under your belt. We started with Knoxville and Kingsport areas, where our hubs in those areas held drug take-back events, trained professionals in ACES and trauma informed care, gave resources to grandparents about managing and storing their medications, and provided positive parenting classes. Additionally, we were partners on a three-hour Tyler’s Light educational program for more than 7,500 7th through 12th graders in the Tri-Cities area. This work has given us some lessons learned, as well as some credibility in terms of our ability to be part of the solution.

Is there anything else you’d like the field or community leaders to know?

This work is important and essential to what afterschool programming is to children and their families. We know that OST programming teaches children and youth to make smart decisions, and it also helps them cope and heal. We also have tremendous engagement of parents and other caretakers. And for afterschool networks, this work increases our voice, our partnerships, our outcomes, and our presence and power as a force that improves lives.