A Series About Opioids: Climbing the Road to Receovery

A star athlete being scouted by colleges is sidelined by an unfortunate injury and becomes dependent on pain medication. A gifted musician slated to perform a solo in the school talent show self medicates with street drugs to deal with the anxiety of performing. One of the “popular kids” is actually an introvert who can only face going to school each day by drinking before school each morning.

Substance abuse doesn’t discriminate. It is not an “adult” problem. Last school year, 327 Anne Arundel County students who were suspected to be under the influence of some substance were seen in county school health rooms. National statistics also show that one in 10 adolescents with a substance use disorder receives no treatment.

Fortunately, there is a new tool for high school students seeking a way to confront the demons of substance abuse. The Anne Arundel County Department of Health and the County Public Schools has formed a partnership and developed the STAR (Screening Teens to Access Recovery) Program, which allows school health nurses in every county high school to utilize technology to connect students in a telesession with a licensed therapist from the Department of Health. Sessions take place through a secure portal to ensure privacy.

Based on the screening, the therapist works with the student to explore available treatment options and decide the next steps. A student does not need a referral or parental permission to seek help, he or she just has to see the school nurse and ask. However, the therapist and school health nurse will encourage those seeking help to include their parents, guardians, caregiver or another trusted adult in the process.

Screening Therapist Kathy Waisman-Bush says the objective is to make students feel comfortable about opening up about their substance abuse and any other stressors that may be making life difficult. “During the brief screening process, we discuss with the student what brought them to ask for assistance, who they see as their system of support, the specific substance(s) of use, frequency of use, and resulting consequences if any,” says Waisman-Bush. “We briefly discuss how long they have been using any particular substance(s) and how they came to use this substance. For instance, questions around being prescribed a particular medication or use of medication independent of adult supervision is important.”

The therapist tries to develop a snapshot of the whole student, Waisman-Bush says, “because mental health concerns and substance misuse consistently coexist for many adolescents. Getting a sense of all symptoms is important in offering treatment options.” For example, she notes, if a student is self-medicating with substances to manage stress, anxiety, or depression, the correct referral would be for mental health treatment with a therapist that sees co-occurring cases. This will determine if outpatient counseling will suffice, or if the student requires more intensive in-patient treatment and therapy.

School Health Nurse Tracy Marcalus, BSN, RN, who serves the students of Arundel High School hopes parents are receptive to the program. “It never hurts for a parent to ask their student if he/she needs help with an addictive substance,” Marcalus says. If parents are concerned about negative patterns with their student making poor choices about substances, they should tell the teen to visit the school nurse to learn about the STAR program. “It is private and confidential. As a community—parent, teacher, nurse—the best we can do is try. Even if the student chooses not to proceed through the program, he or she will have a better understanding of the resources available in school when ready.”

More information about the STAR program is available on the county health website, aahealth.org.