Substance use and substance use disorder (SUD) are pervasive public health problems in Kentucky.  Nationally, the Commonwealth ranks third in overdose mortality rate, second in parental incarceration rate, and first in incidence of Hepatitis C due to injection drug use (CDC, 2021).  Furthermore, children in Kentucky are more likely to be neglected or abused than children in any other state (Child Maltreatment Report, 2019).  Consequently, youth in Kentucky report concerning levels of self harm (19%) and serious psychological distress (25%).  Taken together, youth in Kentucky face extraordinary risk for substance use and substance use disorder.  Currently, about 8% of KY high school students used cannabis in the past 30 days and about 13% used alcohol in the past 30 days.

Unfortunately, Kentucky has yet to provide youth with meaningful, sustained, evidence-based prevention programming.  To date, the vast majority of the existing prevention efforts in Kentucky have been a haphazard patchwork of programming.  A minority of KY school systems offer evidence-based programs and those that do have not managed to sustain programs year-over-year.  According to the prevention literature, and also according to our own experience, this lack of sustainability most often results from staff turnover.

To mitigate these risk factors and to address the lack of sustained prevention efforts in KY, UK Extension was awarded multiple extramural grants aimed at the delivery of a school-based and evidence-based prevention program called Botvin LifeSkills Training.  Botvin is widely considered the preeminent school-based prevention program in existence with more than 50 peer reviewed articles to demonstrate its effectiveness in reducing substance use and improving mental health and wellness.  Moreover, particular emphasis was placed on the development of local implementation teams which are designed to sustain the program year-over-year.  To address previously reported problems related to turnover, we took a layered approach to training local teams in which trainees included a combination of school and extension personnel. We anticipate this approach will prevent disruption during staff turnover.  Since 2020 and despite the Covid-19 pandemic, approximately 790 KY middle school students successfully completed Botvin with fidelity with reductions in drug use (by 75%), alcohol use (by 60%), and tobacco use (by 87%).