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The Oklahoma Strategic Prevention Framework for Prescription Drugs (SPF Rx2) program will address prescription drug misuse, particularly prescription opioids among Oklahomans of all ages. The purpose of the Oklahoma SPF Rx program is to improve community understanding of the dangers of prescription drug misuse through community-based prevention actions and partnerships with the Healthcare sector. The project will raise awareness about the risks of sharing medications, and promote collaboration between the state, tribes, pharmaceutical and medical communities to increase the use of the Oklahoma Prevention Monitoring Program (PMP) and improve prescribing practices. Oklahoma will leverage the success of the Strategic Prevention Framework State Partnership For Success (SPF-PFS) grant and current SPF Rx grant to further develop the necessary infrastructure and capacity to accomplish the following goals over a five-year period: (1) Utilize the SPF in two high need communities to reduce priority prescription opioid problems; and (2) Improve utilization of healthcare sector opioid prescribing quality improvement programs in two high need communities. This will be accomplished through (1) strategic planning at the state and local levels, (2) collaborating with state agencies, tribes, and the pharmaceutical and medical communities to increase the use of the Oklahoma Prevention Monitoring Program (PMP) and improve prescribing practices; (3) engaging key community stakeholders; (4) continually monitoring data from the Oklahoma PMP; (5) enrolling prescribers in practice dissemination programs aimed at increasing the utilization of evidence-based pain and opioid management guidelines; and (6) using the OKImReady communication campaign at the state and local levels to continue to educate Oklahomans on substance use prevention, treatment, and recovery with a special focus on opioid use disorder, serving an estimated 1,250,000 Oklahomans per year and 1,500,000 over the lifetime of the project. The Oklahoma Department of Mental Health and Substance Abuse Services, as the Single State Agency, is well-positioned and equipped to effectively coordinate the SPF Rx2, and has demonstrated success in preventing and reducing substance use problems.

Ohio's Strategic Prevention Framework for Prescription Drugs Grant 2021 will raise awareness bout the dangers of prescription drug misuse, work with the pharmaceutical and medical communities on the risks of over prescribing and increase the utilization of the Ohio's Automated Rx Reporting System (OARRS). It will enhance infrastructure and prescription drug prevention throughout Ohio focused on targeted metropolitan communities. The number of expected people served during the project will depend on the targeted communities and strategies selected with guidance from SAMSHA's Opioid Overdose Prevention Toolkit.

The goal of Maine’s Comprehensive Approach to Address Prescription Drug Misuse Project (CAA-PDM) is to increase the number of citizens living safe, healthy, and productive lives by decreasing opioid and stimulant misuse, dependence, and drug overdose deaths in Maine. This will be accomplished through raising awareness about the risks of misusing or sharing medications, educating medical providers and prescribers on recommended alternatives to opioid or stimulant prescriptions as well as safe policies for prescription monitoring and tapering, and increasing community prevention activities in areas with the greatest need. The Maine CAA-PDM project will enhance prevention strategies and reach populations and stakeholders who have yet to be actively involved in evidence-based practices for controlled prescription safety. The project will focus on all Maine citizens ages 12 and older, medical and pharmaceutical providers, and endeavor to reach communities not previously reached by this grant, such as veterinary hospitals, dentists, and VA Healthcare facilities and the other priority populations such as the refugee/immigrant communities. In the first year’s strategic planning process, enhancements to both the Maine PMP and SEOW dashboard will be used to identify areas of greatest need at both the state and community levels which will direct resources where they are needed most and facilitate the implementation of targeted strategies. In addition, through collaboration with various existing stakeholder groups, a training curriculum for medical providers will be developed and implemented on topics including safe opioid prescribing practices education, safe medication tapering, and when to choose alternative treatment. Community level targeted prevention strategies will be selected and recommended for the recipients of the grants we will offer to locate new local collaborations. Those strategies will be recommended for communities to carry out using the SPF process as well as community level data from the Prescription Monitoring Program and the State Epidemiological Outcomes Workgroup. Mass reach health communications will be developed and used in conjunction with localized social media campaigns to raise awareness in Maine about the dangers of prescription drug misuse along with other opioid and stimulant prevention related messages. The project goals are to; 1) Increase knowledge, attitudes, and beliefs about the dangers of prescription drug misuse; 2) Decrease prescription drug overdose deaths; 3) Enhance Maine’s data infrastructure and surveillance data gathering tools to better inform. Success of this project will be measured by a decrease in overdose deaths, an increase of evidence based policies and practices implemented at the local level and an enhanced data infrastructure system to proactively address the areas of highest need with evidence based resources, interventions and support.

The IL SPF Rx project will address 3 main goals focusing on prescription drug misuse: use PMP data and the SPF to design prevention activities; expand the infrastructure of healthcare professionals who understand the SPF, PMP, and dangers of prescription drug misuse by training healthcare students and integrating information in curricula; and deliver activities based on current facts and evidenced-based strategies to prevent misuse by high school students. The Illinois Department of Human Services Division of Substance Use Prevention and Recovery (IDHS/SUPR) submits this application for SAMHSA/CSAP Funding Opportunity Announcement (FOA) SP-21-001, Strategic Prevention Framework for Prescription Drugs (SPF Rx) grant. The IDHS/SUPR Bureau of Prevention Services manages prevention funds of Illinois Substance Abuse Block Grant, as well as many previous SPF grants. Illinois proposes to train medical communities on risks of overprescribing to young adults, increase awareness and access of the PMP by healthcare professionals, and raise community awareness by bringing prescription drug misuse prevention activities and education to high schools. IL PMP data will inform needs assessments and strategic plans as indicators of project outcomes to reduce the number of prescription drug misuse, overdose-related deaths, and prescription misuse adverse events among individuals 18 years and older. To achieve these outcomes, more than 600 healthcare students will be trained and 600 high schoolers are estimated to receive prevention activities in Year 1. Over 5 years, more than 6,000 individuals will be trained/impacted by prevention activities. One sub-recipient will serve areas in Illinois identified by the SPF driven needs assessment using PMP data. Current data identifies Cook county as the hub of overrepresented overdose deaths mainly due to fentanyl, yet a need for prevention services targeting high school youth has received less attention even though the number of emerging adults who misuse prescription drugs increases compared to low rates for adolescents. Illinois Youth Survey data points to potential risk factors including multiple drug use associated with adolescent prescription drug misuse. The sub-recipient will coordinate and provide training of healthcare students to provide prescription drug misuse prevention/education activities to high school youth. Most trainers will be college age to potentially increase acceptance of trainers and their messages. The Evaluator and sub-recipient will assist IDHS/SUPR in complying with SAMHSA/CSAP reporting expectations. The sub-recipient will assist IDHS/SUPR in local needs assessments and expansion of sectors represented on the Illinois Opioid Crisis Response Advisory Council through the Prescribing Practices Committee and Equity Committee. The committees will build on strategic planning and SPF activities, as well as contribute to state and local policy/legislative changes.

The Alabama Strategic Prevention Framework Prescription: Only Yours As Prescribed 2.0 (ASPFRx OYAP 2.0) project seeks to prevent and reduce prescription drug misuse and the negative consequences associated with it while improving capacity and infrastructure in communities with health disparities, less access to care, and poorer behavioral health outcomes in young adults in the identified high need populations within the state. The targeted regions will have high concentrations of individuals with significant health disparities, elevated levels of substance use, poverty, and less access to care resulting in poorer behavioral health outcomes. The population of focus will be young adults aged 18-25 with a specific focus on deaf and/or hard of hearing individuals. The project seeks to continue utilization of a structured approach set forth by the existing strategic planning framework, the strategic prevention framework for prescription drugs, and implementation of evidence-based practices and programs with sound evaluation to reach identified populations. The goals of the project are to: (1) Prevent and reduce young adult prescription drug misuse in communities with health disparities; (2) Reduce prescription misuse-related problems in Alabama communities that have less access to care and poorer behavioral health outcomes; and (3) Improve prevention capacity, coordination and infrastructure at the state and community levels. The objectives the project seeks to attain are: (1) By 2026, prevent and reduce prescription drug misuse and its negative consequences among young adults aged 18-25 by 3%; (2) Annually identify and collaborate efforts with pharmaceutical and medical communities, per region (four regions), to address the risks of overprescribing; and (3) Provide outreach and awareness initiatives, tools, trainings, and technical assistance to a minimum of 400 individuals per year, 100 individuals per region, on approaches to ensure successful outcomes are sustained over time resulting in a minimum of 2,000 individuals reached during the project period. A comprehensive approach utilizing the six CSAP strategies will comprise the strategies/interventions to address the goals and objectives. Information Dissemination, Education, Alternatives, Community Based Processes, Environmental and Problem Identification and Referral strategies will address risk and protective factors and include culturally appropriate information about prescription drug misuse as it relates to individual communities. The inclusion of the educational system collaborative efforts and supportive services, youth/parent after-school involvement with prescription drug misuse initiatives and youth mentorship/recruitment efforts, representation of the recovery community, constituent initiatives to address policies such as prescription drug availability, Alabama Department of Mental Health's Office of Deaf Services, Alabama's Prescription Drug Monitoring Program (PDMP), prescribers and patient awareness will be integral to the success of the ASPFRx OYAP 2.0 project.

The Massachusetts SPF Rx Project has as its goal to develop a strategic plan that will address prescription drug misuse, engage partners, conduct activities that raise awareness about the dangers of sharing medications—including opioids, benzodiazepines and stimulants—and work with pharmaceutical and medical communities on the risks of overprescribing to young adults. Massachusetts has identified its overall population of focus for the prevention of substance use disorder (SUD) as being those at highest risk of opioid overdose or other SUD, including the potential of prescription drug misuse. Key objectives are: (1) Strategic planning: By the end of year 2, develop a strategic plan that identifies communities with high rates of potentially inappropriate prescribing or prescription drug use and prioritizes activities for primary and secondary prevention efforts; update the plan annually in years 3-5. (2) Engagement and work groups: By month 3 establish an advisory and engagement structure; and by the end of year 2 engage individuals and organizations from 100% of the following sectors in the strategic planning process: community members, healthcare providers, key stakeholders, adult, youth, young adults, elders, and youth and families and people in recovery from substance use disorder. (3) PDMP: By end of year 4, provide community stakeholders with easy-to-use tools for tracking and displaying trends of prescription medications with high misuse potential by incorporating selected MA PMP prescription drug use data sets and interactive charts and maps into the state’s public data portal—the Massachusetts Population Health Information Tool. (4) Other implementation activities: By no later than Year 4, develop and implement activities statewide or in targeted communities to: (a) conduct a community-based public education campaign to increase awareness of prescription drug misuse; (b) continue to educate prescribers on the use and benefits of accessing the MA PMP; (c) continue to collaborate with pharmacies to ensure timely input into the MA PMP database; and (d) conduct medication disposal programs, and effective law enforcement activities aimed at reducing inappropriate prescribing and multiple provider episodes (i.e., doctor shopping).

The Pennsylvania Strategic Prevention Framework for Prescription Drugs (SPF Rx) Project proposes to increase knowledge among adolescents and young adults of the risks of controlled substances, ultimately reducing misuse and associated opioid overdose deaths within identified high need counties. These goals will be achieved by deploying targeted multi-media campaigns to the public, prescribers, and dispensers. Adolescents and young adults aged 15-24 will be a specific population of focus for this project. The Pennsylvania Department of Health (DOH) has identified the following project objectives: 1) Increase awareness and knowledge of the dangers of prescription drug misuse; 2) Increase prescriber and dispenser utilization of the Prescription Drug Monitoring Program (PDMP); 3) Increase utilization of PDMP data in local overdose prevention program planning, implementation, and evaluation. These goals will be achieved by deploying targeted multi-media campaigns to raise awareness of dangers of prescription drug misuse amongst adolescents and young adults (age 15-24); creating strategic messaging and outreach to prescribers and dispensers regarding utilization of the PDMP and application of the Pennsylvania Prescribing Guidelines; and engaging state and local stakeholders relevant to the goals of the project. The Pennsylvania Department of Health, Office of Drug Surveillance and Misuse Prevention (ODSMP), as the lead agency, will utilize the Strategic Prevention Framework model to plan, implement, and evaluate media campaigns and outreach activities. The ODSMP will engage Pennsylvania’s Opioid Command Center to maximize cohesion with existing work underway in the Commonwealth. The Opioid Command Center consists of 16 state agencies, the Office of Attorney General, and the High Intensity Drug Trafficking Area (HIDTA) and is responsible for leading the Commonwealth’s response to the opioid crisis. Additionally, the ODSMP will establish a workgroup consisting of local stakeholders from the identified high need counties to provide guidance on the project.

The North Carolina Strategic Prevention Framework for Prescription Drugs (SPF-Rx) program will raise awareness about the dangers of sharing medications and work with medical communities on the risk of over-prescribing to young adults. It will also raise community awareness and bring prescription drug abuse prevention activities and education to schools, communities, parents, prescribers, and their parents. In addition, SAMHSA will track opioid overdoses and the incorporation of PDMP data into needs assessments and strategic plans as indicators of the program success.

A 2021 Strategic Prevention Framework for Prescription Drugs (SPF Rx) grant will allow the Iowa Department of Public Health (IDPH), Division of Behavioral Health, to continue collaborative work to reduce prescription drug misuse among Iowans ages 12-25 by raising awareness about the dangers of sharing medications and the risks of overprescribing to young adults. Although there has been a downward trend in prescription drug misuse among Iowa's young people over the past five years, Iowa youth ages 12-17 misused pain relievers at the second highest rate in the nation in 2018-19. And Iowa has the third highest rate of misused pain relievers in the US among all individuals over age 12. The proposed catchment areas will be three high-need Iowa counties, to be selected using a Request for Proposal (RFP) process that evaluates the need for SPF Rx programming based on Prescription Monitoring Program (PMP) and other indicators including: opioid-related treatment admissions and overdose deaths, poisoning hospitalizations, prescription drug use not prescribed by doctor (among youth in 6th, 8th and 11th grades), number of residents prescribed opioid analgesics, and number of opioid pills dispensed. The three sub-recipient counties will receive SPF Rx funding for infrastructure development and prescription drug prevention services designed to reduce opioid overdoses all while using SPF processes and deliverables. IDPH and sub-recipient counties will implement strategies including a SPF Rx media campaign ""Prescription Drugs Are Still Drugs"", and information dissemination of SAMHSA's Opioid Overdose Prevention Toolkit and the CDC Guidelines for Prescribing Opioids for Chronic Pain. Each county will select an additional strategy for a total of three strategies to reach targeted audiences. Services will impact all Iowa residents over age 12, but efforts will be focused on the two age groups where prevention services can affect future prescription drug misuse (youth ages 12-17 and young adults ages 18-25). IDPH's SPF Rx goals are to: 1) Decrease prescription drug misuse throughout Iowa, and prioritize and mobilize comprehensive efforts in the highest-need counties; 2) Reduce the consequences of nonmedical use of prescription drugs; 3) Use Iowa PMP data in the development of population-level interventions; and 4) Apply the SPF planning methods to the SPF Rx sub-recipients. By the end of Year 5, sub-recipients will have educated at least 50 percent of their populations ages 12-17 and 18-25 on the dangers of the misuse of prescription drugs with strategies implemented through the SPF process; and IDPH will have reached at least 50 percent (297,202) of Iowa's population ages 12-25. Services in the three counties will reach a total of 63,145 people over the grant period (15,786/year for four years).

The Little Traverse Bay Bands of Odawa Indians’ (LTBB) Significant Prevention Resulting in New Generations (SPRING) Strategic Prevention Framework for Prescription Drug project (SPF-Rx) will focus on two target populations in the project catchment area of Emmet-Charlevoix-Cheboygan counties: LTBB Citizens and non-LTBB Native American youth between the ages of 12 and 17 years old and LTBB community members ages 18 years old and older living in the LTBB community. We anticipate an average of 200 youth to be served annually, with approximately 1,000 youth being served throughout the five-year project. We anticipate over 1,500 adults per year to be served via community-based education and awareness, with approximately 10,000 reached over the five-year project. Goal 1: Promote emotional health and wellness in the LTBB community through raised awareness about the dangers of prescription drug misuse and abuse. Objectives: During the 60-month project, LTBB will … 1) Conduct 5 needs assessments to evaluate program outreach and prescription drug misuse and abuse data, with 70% of LTBB youth and 50% of LTBB adults in the project catchment area participating in the LTBB Youth and Adult Surveys annually. 2) Implement youth-focused primary and secondary prevention-based outreach and education to reduce yearly 30-day use of prescription drugs without a prescription to less than 1% and increase perception of risk to 90%, as measured by the annual LTBB Youth Survey. 3) Implement LTBB adult-focused primary and secondary prevention-based outreach and education to reduce average yearly 30-day use of prescription drugs without a prescription to 2% and increase prescription security and disposal efforts by 5% each, as measured by the annual LTBB Adult Survey. 4) Increase LTBB Health Park infrastructure to address prescription drug misuse through development and implementation of comprehensive Health Park-wide prescription drug policy and procedures, semi-annual professional development for LTBB Health Professionals, and increased use of PDMP data.

The overall purpose of the Connecticut Strategic Prevention Framework for Prescription Drugs (CT SPF Rx) 2021 initiative is to reduce the non-medical use of prescription drugs and prevent opioid overdoses via strategies that: increase public awareness and education of the dangers of prescription drug misuse; increase the capacity to understand and use Prescription Drug Monitoring Program (PDMP) data; and, build partnerships among stakeholders to expand resources and diffuse best practices across the state. Graduate students from the health profession programs at the University of Connecticut will be placed in health districts and departments which are burdened with health related tasks. A subset of the State Epidemiological and Outcomes Workgroup (SEOW) comprised of an interdisciplinary panel of stakeholders will be convened to review PDMP data for trends and applications of the data and make recommendations to address data gaps. The Prevention Subcommittee of the Alcohol and Drug Policy Council, with its broad representation of agencies and individuals with interests and resources in prescription drugs/opioid overdose prevention issues, will serve as the advisory council for the grant and help diffuse successful practices from the grant to other communities across the state. Evaluation using data gathered will be conducted at the state and community levels to track whether performance measures and objectives are being met and any needed adjustments. It is anticipated that by the end of the grant, approximately 1,016,688 individuals would be seen, experienced or otherwise impacted by interventions implemented in funded communities.

Delaware will utilize the SAMHSA Strategic Prevention Framework's five steps and two guiding principles to establish a comprehensive approach to mitigate the prescription drug crisis in Delaware. The Division of Public Health (DPH) will collaborate with community stakeholders to bring awareness about the dangers of misusing prescription drug medication and partner with the medical community to create and disseminate information on safe prescribing on medications. A baseline needs assessment with be conducted to revise the strategic framework to prevent youth ages 12-25 years from misusing and abusing medication. Delaware will use an ecological model to ensure that youth across the state are given prevention resources and information to build sustainable and culturally competent, safe communities. As part of the Strategic Prevention Framework, DPH will first conduct an assessment using data from the Prescription Monitoring Program (PMP), Emergency Departments, Emergency Medical Services, Delaware State Survey, and the Delaware Youth Risk Behavioral Survey. Once this is conducted, DPH will work with community and medical partners to identify new partnerships to build capacity to respond to the needs identified and specifically focused on youth. DPH will collaborate with partners to assess and revise as needed the current strategic plan and the goals and objectives identified in this funding opportunity. The current goals and objectives are as follows: Goal 1: Work with pharmaceutical and medical communities to raise awareness of the risks of overprescribing to young adults to change prescribing practices. Goal 2: Raise community awareness on the dangers of sharing medication and bring prescription drug abuse prevention activities and education to schools, communities, parents, prescribers, and their patients. Goal 3: Implement the Prescription Monitoring Program data, morbidity and mortality data, and other surveillance data into a community needs assessment and revise state strategic plans to track program success. Once DPH begins to implement the project in year one, the performance measures to meet the objectives within the goal will be reviewed annually for their impact and sustainability. This project will serve the 973,764 residents in the state because all have the opportunity to reduce the overdose rate and prevent youth from overdosing.

The Maryland Department of Health proposes to implement the “Preventing Prescription Drug Misuse in Maryland” initiative, an infrastructure development and prescription drug misuse prevention project funded by 2021 SPF-Rx. The initiative will support targeted prescriber and pharmacist education on safe controlled substance (CS) prescribing and dispensing with a specific focus on identifying and preventing prescription drug misuse among youth and young adults. After updating the 2016 SPF-Rx Strategic Plan, prevention activities will be implemented across the state and targeted outreach will occur to providers in jurisdictions which demonstrate concerning prescribing and opioid misuse trends including Maryland’s Eastern Shore counties (Kent, Queen Anne’s, Dorchester) and mid-size counties (Cecil, Washington, Allegany, Calvert, Carroll) disproportionately impacted by CS prescribing and hospitalizations. The Office of Provider Engagement and Regulation (OPER) plans to reach an average of 200 providers a year, and at least 1,000 providers by the end of the grant through the following goals and objectives: Goal 1: Increase healthcare providers’ capacity to identify and prevent prescription drug misuse among youth and young adults by implementing evidence-based provider education programs Objective 1.1: By the end of year 5, Academic Detailers will complete 300 visits with providers on evidence-based detailing curriculum addressing use of the PDMP and safe opioid prescribing Objective 1.2: By the end of year 3, the state Medical Society in partnership with the School of Pharmacy will have trained 400 providers within the training series on care coordination and effective communication when prescribing and dispensing CS Goal 2: Reduce unsafe or inappropriate CS prescribing and dispensing by providers with clinically appropriate trainings and tailored resources Objective 2.1: By the end of year 5, the Project Advisory Council will convene 3 provider specialties to develop data-driven resources on safe CS prescribing practices Objective 2.2: By the end of year 5, opioid prescribing to youth and young adults will decrease by 10% within the jurisdictions implementing Academic Detailing by educating Primary Care Providers and pediatricians on the risks of overprescribing to those patients Goal 3: Reduce prescription opioid related overdoses by ensuring Maryland providers offer patients education on safe storage and disposal of unused medications Objective 3.1: By the end of year 5, the PDMP will disseminate safe storage and disposal of CS prescription materials for providers to offer patients to 1,000 Maryland providers and dispensers through Academic Detailing and the Provider-Pharmacist training series With the support of this grant opportunity, OPER will engage prescriber specialties in targeted peer-developed outreach and education, coordinate educational efforts between pharmacists and prescribers, and develop and evaluate community-specific educational efforts to prevent the misuse of CS and to encourage disposal of unused prescription drugs.

Kansas Department for Aging and Disability Services (KDADS),will target the priority issue of prescription drug misuse, raise awareness regarding medication sharing and the risks of overprescribing. The proposed catchment area includes a primary focus on prescription drug abuse community awareness and prevention activities in schools, communities, parents, prescribers and the patients they serve. Those identified as highest risk are those aged 15-34 years old. Specific focus will be placed on regions with high drug overdose burden. Eastern and Central Kansas has been identified at highest risk in the state across a wide variety of factors. Due to unique health disparities, strategies will also be focused in Western Kansas that is primarily rural/frontier to ensure diversity across population densities and risk factors in Kansas. The goals of the project are to facilitate the new five-year Kansas Prescription Drug and Opioid Misuse and Overdose strategic plan, including infrastructure development and development/enhancement of prevention activities to reduce misuse and overdose, implement prevention activities identified within the strategic plan update, including providing education and raising community and provider awareness about risks associated with medication sharing and overprescribing.

The Southern Plains Tribal Health Board’s (SPTHB) SPF Rx project aims to reach the 39 federally recognized American Indian Sovereign Nations housed in Oklahoma, beginning with 10 initially so that a strong foundation is in place to build a Native-focused, culturally sensitive OUD prevention infrastructure. SPTHB will initially serve 87,000 tribal citizens annually through current partnerships with 7 sovereign nations. SPTHB’s SPF Rx project will broaden our existing prescription drug misuse prevention efforts by creating a statewide, Native-focused infrastructure that builds upon our county-specific initiatives from previous substance use prevention funding. We will initiate awareness campaigns and capacity-building about opioid use disorder (OUD) and prevention, as well as the role and value of Prescription Drug Monitoring Programs (PDMP) as a tool to deter OUD. Goal One is to Raise awareness about the dangers of sharing medications and work with pharmaceutical and medical communities on the risks of overprescribing to young adults in tribal communities. Goal Two is to Raise tribal community awareness and bring prescription drug abuse prevention activities and education to schools, communities, parents, prescribers, and their patients. Goal Three is to Incorporate Prescription Drug Monitoring Program (PDMP) data into tribal needs assessments and strategic plans as indicators of the program’s success.

The purpose of the NJ Division of Mental Health and Addiction Services' (DMHAS) NJ SPF-Rx project is to raise community awareness and bring prescription drug abuse prevention activities and education to schools, communities, parents, prescribers, and their patients. The project will also raise awareness about the dangers of sharing medications and work with pharmaceutical and medical communities on the risks of overprescribing to young adults. One of the goals of this project is to build capacity to strategically utilize the NJ Prescription Monitoring Program (NJPMP) to inform our prevention strategies by identifying drug misuse trends and individual users who are at a high risk for addiction and potential overdose. Using this insight, NJ can tailor the appropriate marketing, educational, and treatment programs to similar groups of individuals. Furthermore, the project will monitor changes in prescription drug misuse among youth ages 12-17 and adults 18 years of age and older. Prevalence data will be routinely provided through analyses using the real-time DMHAS administrative client data system known as the New Jersey Substance Abuse Monitoring System (NJSAMS). DMHAS will use NJPMP data and other epidemiological data, to provide training for the its Regional Prevention Coalitions on how to use these data to inform their prevention strategies and evaluate the outcomes of their work. The Regional Prevention Coalitions will implement the NJ SPF-Rx project by delivering community-based education regarding the consequences of prescription drug misuse. The Coalitions collaborate with the medical community, law enforcement, and county government to tailor messages that are targeted to the various communities in their region or county. A priority will be programming focusing on young athletes, since literature suggests that for adolescent males, participation in sports such as football and wrestling increases the odds of using opioids non-medically. DMHAS will continue to utilize the ""Tackling Opioids through Prevention for Athletes"" (TOP) toolkit developed for its current SPF Rx grant. In addition, NJ SPF-Rx project will provide education for health professionals on the latest information and guidance on managing pain and preventing prescription opioid abuse. DMHAS will collaborate with the Partnership for a Drug-Free New Jersey for live and webinar-based training for health care providers on evidence-based approaches for managing pain and minimizing risks of medication misuse. The NJ SPF-Rx project will serve an estimated 25,000 individuals annually, with a total of 125,000 over the five-year grant period.

The purpose of the West Virginia Strategic Prevention Framework for Prescription Drugs (SPF Rx) program is to enhance and expand infrastructure and to develop and implement prescription drug prevention efforts in West Virginia on the state, regional, and local levels for identified high-risk counties and communities. The estimated number of individuals to be directly served annually is 45,424 and 227,120 throughout the five years of the grant. Goals of the program include (1) To enhance the state's SPF based prevention infrastructure to address prescription drug misuse among youth ages 12-17 and adults ages 18 years and older; and (2) To prevent and reduce prescription drug and illicit opioid misuse and abuse. The SPF Rx program will target the following prevention priorities to achieve its goals and objectives: needs assessment, strategic planning, financing/coordination of funding streams, organizational/structural change, development of inter-agency coordination mechanisms, policy development to support needed service system improvements, quality improvement, performance measure development, and workforce development. To build community infrastructure, WV will provide workforce development that supports the proper use of the Prescription Drug Monitoring Program, and will expand training in evidence-based practices to ensure the entire state prevention infrastructure has the most relevant and up-to-date skills to help reduce substance use/misuse across the state. WV will convene a state level advisory council to identify evidence-based programs and practices that meet the needs of the population to be served, assure that leadership teams, training, models, and other prevention capacity is in place for each evidence-based program and practice, assure sustainable workforce development strategies are implemented, provide logistical support, and help guide strategies for effective adoption and sustainability of practices.

The MS Department of Mental Health, with the MS Public Health Institute, and Bartkowski & Associates Research Team, proposes MS SPF Rx, which will permit MS to target prescription drug misuse specific to prevention. MS has been beset by increasing overdose death rates with the proliferation of high-potency opioids. MS SPF Rx will raise awareness about the dangers of sharing medications and work with pharmaceutical and medical communities on the risks of overprescribing. MS SPF Rx will also raise community awareness and bring prescription drug abuse prevention activities and education to schools, communities, and the healthcare system. The project team will facilitate SAMHSA’s tracking of reductions in opioid overdoses and the incorporation of Prescription Drug Monitoring Program (PDMP) data into needs assessments and strategic plans as success indicators. MS SPF Rx is governed by one overall goal: to increase awareness of prescription drug misuse and related risk behaviors of overprescribing and sharing of prescribed medication. Objective 1.1 is to, by the end of year 1, enhance and document improvements to the existing SUD/OUD prevention infrastructure to include a focus on prescription drugs, with attention to both the prevention implementation and evaluation infrastructures in MS. Strategies associated with Obj.1.1 include entry into PDMP data-use agreements; the creation and use of a MS SPF Rx Strategic Planning Opioid Reduction Team (SPORT); and the development of a strategic opioid plan. Evaluation infrastructure enhancements will include tracking the impact of quality improvement plans. Objective 1.2 is to increase by 10% of baseline Mississippians’ awareness of prescription drug misuse risk and reduce by 10% of baseline risk behaviors associated with overprescribing and sharing prescribed medications by the end of year 1. Activities related to Obj.1.2 include the creation of a menu of appropriate evidence-based prescription drug misuse prevention programs from which SPORT coordinators can choose, with emphasis on CSAP strategy variations (e.g., prevention education, environmental strategies, drug disposal); sharing data at regular intervals to foster data-driven implementation at community level; and fostering prescriber and pharmacist regulatory awareness/compliance using prescriber report cards, etc. Objective 1.3 is as follows: to increase MS’s utilization of PDMP data to decrease by 10% of baseline prescription drug misuse through the creation of a PDMP Prescriber Report Card Timely Response (PRCTR) protocol by the end of year 1. Key strategies linked to Obj.1.3 entail the creation of a PRCTR protocol in the MS SPF Rx strategic plan that delineates how to enlist PDMP data to foster opioid misuse prevention through data-driven EBP community programming, resource allocation, coalition optimization, technical assistance provision, etc.; and tracking the effects of the PRCTR protocol and integration of protocol refinements for the duration of the project. The team is prepared to implement MS SPF Rx in concert with other SAMHSA grants or, as a standalone project that will significantly enhance prevention.

Cherokee Nation's SPF-Rx Project, Think SMART, will serve the Cherokee Nation (CN) Reservation. The purpose is to raise awareness about the harms of sharing medication and overprescribing as well as increase utilization of Prescription Drug Monitoring Program data in the community. The 143,035 Cherokee Nation citizens residing on the Reservation will be impacted by this project. The Reservation covers all of six counties and parts of an additional eight counties in northeast Oklahoma. The counties include Adair, Cherokee, Craig, Delaware, Mayes, McIntosh, Muskogee, Nowata, Ottawa, Rogers, Sequoyah, Tulsa, Wagoner, and Washington. The goals and objectives center around the following priority issues of the Think SMART campaign: (1) Raise awareness about Safe Solutions Campaign through implementation of a media campaign to discourage medication sharing, promotion of prescription drug take backs, safe storage, and safe disposal options. (2) Increase Medical Education and PDMP awareness, through information dissemination to decrease stigma and trainings about dangers of co-dispensing controlled substances. (3) Raise Awareness about dangers of prescription drug misuse, through a multi-media campaign. (4) Raise awareness about local Recovery resources, through website outreach and collaborative agreements. (5) Raise awareness of Treatment and increase access to Narcan, through website information, trainings for physicians to become X-waivered to provide MAT services, and distribution of Narcan.

The WA SPF Rx project's primary population of focus are residents particularly youth and young adults, who have been identified as being at risk of misusing prescription drugs. This project is designed to address these risks by implementing a collaborative strategic plan that will include prevention campaign messaging, evidence-based prevention education, prescriber education, and increased utilization of the Prescription Drug Monitoring Program (PDMP). The Health Care Authority (HCA) will build on nearly 30 years of experience implementing the Substance Abuse Prevention and Treatment Block Grant (SABG), two State Incentive Grants, Partnerships for Success 2013 and 2018, State Targeted Response (STR), and State Opioid Response (SOR) grants by employing the Strategic Prevention Framework (SPF) to create community-level change through public education, prescriber education, and training. HCA plans to serve approximately 500,000 at risk individuals throughout the life of the project (100,000 per year) based on age group and high need community status; numbers served will be tracked through leveraged funding sources of federal block grant and discretionary grant funding. These efforts will be guided by the first strategy, to create and evaluate a coordinated strategic plan among state agency partners to prevent prescription drug and opioid use. The second strategy is to prevent prescription drug and opioid misuse, particularly among youth and young adults, by providing evidence-based prevention education activities in high-need communities. We aim to reduce the number of youth and young adults using prescription pain relievers to get high and using prescription drugs not prescribed to them. The third strategy includes promoting safe home storage and appropriate disposal of prescription medications to prevent misuse through expanding prevention campaign messaging with a particular focus on increasing awareness of prescription drug misuse issues in health care settings and to high-need communities. We aim to increase the number of adults that report safely and securely storing medication in the home and know how to properly return unused medication. The fourth strategy is to promote use of best practices among health care providers for prescribing opioids by expanding provider education through a detailed five-year training plan and increasing the utilization of the PDMP. We aim to reduce the number of opioid prescriptions prescribed to youth and young adults and education and train on the utilization of the PDMP.

New Mexico will increase awareness of the dangers of sharing medications and work with medical providers and pharmacies to increase awareness of the risks of overprescribing opioids to youth and young adults. The project will implement prevention strategies that reduce sharing of medications, help parents safeguard and properly dispose of medications, and teach youth, parents and young adults about the dangers of opioid misuse. The New Mexico Human Services Department, Behavioral Health Services Division, Office of Substance Abuse Prevention (OSAP) will implement the Strategic Prevention Framework for Prescription Drugs (SPF Rx) grant project in Bernalillo County. As the state's largest population center with 32% of its population, 42% of opioid-related overdose emergency department visits and 37% of the state's fatal overdoses occurred in this county which was also the focus of the state's first SPF Rx grant from 2016 to 2021. The Health Equity Council (HEC, formerly the Bernalillo County Community Health Council), will implement a range of evidence-based environmental, educational and information dissemination strategies aimed at reducing risky prescribing practices, increasing the perception of harm involved in taking opioids, decreasing sharing of medications, and increasing safe storage and disposal practices. HEC will focus many of its strategies on high-risk populations and those groups facing health disparities. The project will serve 101,974 individuals in Bernalillo County over the five-year grant period by meeting objectives that aim to: decrease concurrent opioid and benzodiazepine prescriptions and their concurrent use; decrease high dose opioid prescriptions; reduce youth social access to prescription painkillers by increasing locked storage of prescriptions, increasing safe disposal of prescriptions, and reducing sharing of prescriptions through messaging and information to providers, parents, grandparents, and guardians; increase pharmacy PMP checks and pharmacy patient education about the risks of opioids; and direct culturally appropriate messaging to high-risk subpopulations to reduce painkiller use and increase awareness of the risks of opioid misuse. The SPF Rx Advisory Council will utilize PMP and epidemiological data to identify other high risk areas of the state where media messages can be employed to reduce risky prescribing and risky use, especially of co-prescribed opioids and benzodiazepines, the most common cause of prescription opioid overdose death. The state-level OSAP project will strengthen partnerships with New Mexico's Prescription Monitoring Program (PMP), a program of the Board of Pharmacy, and the Department of Health, Epidemiology and Response Division.