April 2019

The Opioid Epidemic

By Richard Tench
Students are coming through our doors exhausted; some are sleeping in cars, tents, hotels or on random couches. For some students, the only food they receive is provided by the schools. Some students must not only provide for themselves every day but also care for younger siblings.
 
This is the true impact of opioid abuse, a national epidemic in America, and the number of affected students is rising. As school counselors, we must educate ourselves and develop trauma-centered systems of support to ensure these students have at least one safe place.
 
Risks and Reality
Students affected by opioid abuse can have an increased risk for:
  • Poor nutrition
  • Chronic poverty
  • Domestic violence
  • Child abuse/neglect
  • Homelessness
  • Low educational achievement
  • Poor parenting skills
  • Lack of healthy support system
The characteristics and symptoms can vary greatly depending on when the student was exposed to opioids and if the student is currently using opioids. In the classroom, opioid-induced trauma can manifest as defiance, withdrawal from academic work and social activities, anxiety or depression. Repeated exposure to traumatic events could lead to post-traumatic stress disorder and result in students being unable to concentrate on their academic work. See ASCA’s position statement on trauma-informed schools.

Power of Partnerships
Schools can’t combat the opioid epidemic alone. Through partnerships with community agencies, local colleges and universities and local police departments, schools can create prevention education programs supplying students, families and community members with information and resources to combat the ongoing epidemic.
  • College/university partnerships: Many professional programs require their pharmacy or medical students to address public health, and having them come into schools to educate students provides them a perfect opportunity to impart their knowledge. Consider using graduate students in science or health courses as part of a drug education unit and to provide hands-on sensory activities for children as early as elementary school. In secondary schools, students can begin to have more in-depth conversations about how different chemicals and drugs affect the human body and further explore the damage created by opioids through activities and experiments.
  • Community agencies: Schools, students and families benefit when schools empower the professionals in the community to share their areas of expertise. Community mental health providers, health departments and other agencies can provide school-wide programming or work with individual teachers in various subject areas to provide information and resources for students and families.

    In West Virginia, we’ve benefited greatly from Handle with Care (HWC): The West Virginia Defending Childhood Initiative. The initiative’s goal is to prevent children’s exposure to trauma and violence, mitigate negative effects experienced by children’s exposure to trauma, and increase knowledge and awareness of this issue.

    Model HWC programs promote safe and supportive homes, schools and communities that protect children and help traumatized children heal and thrive. HWC promotes school/community partnerships aimed at ensuring that children who are exposed to trauma receive appropriate interventions to help them achieve academically despite what they may have endured. HWC’s ultimate goal is to help students succeed in school. Regardless of the source of trauma, the common thread for effective intervention is the school or child care agency. HWC programs support children exposed to trauma and violence through improved communication and collaboration between law enforcement, schools/child care agencies and mental health providers, and the programs connect families, schools and communities to mental health services.
  • Law enforcement: Partnering with local law enforcement agencies can provide school administration a heads-up when a student at the school has been at the scene of a traumatic event. Police officers are trained to identify children at the scene and to collect the necessary information to contact the child’s school.
  • Teachers: Teachers can be trained on the impact trauma has on learning and behavior in the classroom and be equipped with interventions to help the student. Academic interventions can range from providing time to sleep in the clinic to postponing a test or major project.

    When identified students exhibit continued behavioral or emotional problems in the classroom, the school counselor can work with them to provide trauma-focused interventions or make a referral to an established community partner.
Where Do We Come In?
Unfortunately for our students, not all school districts and communities have the luxury of being equipped with high-quality mental health resources to provide intervention and therapy to our students. So, knowing that some resources are unavailable, how can we address the epidemic and begin the process of healing for our students?

Build trust and rapport: School counselors and other school personnel must focus on building relationships with students. When students are provided a safe, nurturing environment with individuals who genuinely care about their well-being, the students are more likely to share their story. School counselors have the ability to pair teacher insights with current behaviors to determine if a student is not acting normally and offer potential intervention.

Think beyond the data: There is more to the story than attendance, grades and discipline when students are in crisis, either from their own opioid use or that of a family member. Traditional ways of examining behavior and attendance do not paint the entire picture when a student has suffered trauma. As an education team, the school must examine what aspects of the student’s life have been affected by the recent trauma. For instance, if school staff knows personal hygiene is an issue because there is no running water at home, offer the student the opportunity to shower in the locker room prior to the school day. And if lack of food in the home is preventing the student from succeeding at school, arrange for a community soup kitchen or food pantry to offer short-term assistance to get the student through the crisis.

Practice trauma-informed leadership: School counselors should make it a priority to equip teachers and other staff to put trauma-focused pedagogy into practice. By using a trauma-focused approach with all students, regardless of the situation, the school helps students gain a sense of belonging and begin to build trusting relationships, which are essential in healing. Implementing a trauma-focused approach could also entail implementing mindfulness techniques in the classroom and counseling practice. Students often experience increased levels of anxiety and demonstrate lack of self-regulation during stressful and/or stimulating situations.

Expand education: Beyond students, schools must collaborate with community agencies to create educational opportunities for parents/guardians addressing the issues facing students around the opioid crisis. In many communities across the country, drug task force units aid in community awareness and monitoring of drug activity. Schools need to ensure that they support and are supported by such initiatives. Unfortunately, not all communities have organized community outreach prevention, resulting in schools being the sole source of information for some families. Thus, schools must be able to provide information outlining the risk of opioid use and have contact information available if a family needs more assistance.

Offer small-group interventions: Students who have experienced or continue to experience trauma and do not have the resiliency skills to process the stress require assistance from trained, trauma-focused staff at their school. School-based interventions might not focus on the trauma itself but instead focus on ways to improve academic performance or attendance, to help the student build a sense of confidence and efficacy. Small groups focused on trauma can also create a support system for students and allow them to see that they are not alone.

As the opioid epidemic continues to create havoc in our communities and break families apart, we must be more vigilant than ever when addressing the opioid crisis. Building and maintaining community partnerships and providing trauma-focused pedagogy gives our students a fighting chance during the opioid epidemic. We must become leaders in the school and provide guidance in incorporating trauma-informed practice into everyday curriculum. We must create safe, nurturing schools providing students the structure they so desire.
 
Richard Tench, LPC, NCC, NCSC, rtench@mail.kana.k12.wv.us, is a school counselor at St. Albans High School in St. Albans, W.Va., and president of the West Virginia School Counselor Association.