On March 2, 2022, Guillermo Prado, Ph.D., University of Miami Faculty Affairs vice provost, Graduate School dean, and professor at the School of Nursing and Health Studies, participated in a powerful roundtable discussion convened by the bipartisan House Select Committee on Economic Disparity and Fairness in Growth titled "Substance Use: Destroying Families, Communities, and the Opportunity for Prosperity.” 

Dr. Prado was invited to share his expertise as a distinguished researcher in the field of substance abuse prevention who has earned widespread recognition for his innovative and culturally syntonic approach to working with Hispanic families and youth.

He was joined by research economist Jevay Grooms, Ph.D. of Howard University, West Virginia Office of Drug Control policy director Matthew Christiansen, M.D., M.P.H., psychiatrist Katherine Pannel, D.O., of Mississippi, and Michael Gray, who became an activist after losing a child to an accidental fentanyl overdose.

The timely roundtable met the day after the State of the Union address, during which President Joe Biden committed to beating the opioid epidemic, to more “funding for prevention, treatment, harm reduction, and recovery,” and to “full parity between physical and mental health care.”

Committee chair and Congressman Jim Hines (D-CT), opened the roundtable by noting the role addiction plays in the “economic disparity and devastation” of our communities. “We have been fighting the war on drugs for more than a generation and we have not won that war,” he said.

Ranking Member Congressman Bryan Steil (R-WI) called attention to skyrocketing numbers of overdose deaths among young people, making it the leading cause of death for 18-to-45-year-olds. “Substance abuse thrives where traditional family and social support structures fail,” he said, setting the stage for a dialogue on how to address the root causes of the crisis.

The speakers expressed concern that many overdose deaths are linked to widespread and deliberate lacing of illicit drugs with small but deadly amounts of fentanyl, a synthetic opioid that is 50 times more potent than heroin and 100 times more potent than morphine.

Dr. Prado's contributions to the roundtable helped members expand their understanding of how proactive, evidence-based, substance abuse prevention programs can provide parents with effective and culturally-relevant tools to help their kids communicate with them and cope with peer pressure.

“Substance use is not an individual public health problem, it’s a public health crisis that’s part of families, part of communities,” said Prado, emphasizing the urgency of taking prevention programs to scale by embedding them within school systems, primary care settings and communities, as he has done with his signature family-based prevention program, Familias Unidas.

Prevention is “much more cost-effective, and the effects of prevention are both short-term and long-term,” he said, noting that 40 percent of twelfth graders and 1 in 6 eighth graders have already tried illicit drugs.

Dr. Prado described how randomized clinical trials of Familias Unidas have shown reductions in drug use of 20 to 40 percent. Ensuring programs targeting kids and families have undergone rigorous testing is crucial to their success in schools and other community settings.

Rather than invest millions if not billions of taxpayer dollars in programs “that have no rigorous evidence,” noted Dr. Prado, “we should be investing in programs that do have the evidence base.”

In response to a comment by Congressman Byron Donalds (R-FL) that he had spoken with his sons about never using illicit drugs, Dr. Prado noted that in some families communication “is not where it should be to have those difficult conversations.” “For those types of families,” he explained, “telling the youth not to engage in substances…may actually encourage the youth to use drugs.”

If there is evidence that “just say no” or other similar approaches may actually be counterproductive in some cases, then what does work, Rep. Himes asked Dr. Prado.

“Programs that give parents tools, programs that develop skills among young people, programs that have been evaluated,” Dr. Prado responded. He described how Familias Unidas brings together ingredients specific to Hispanic culture, such as a focus on how immigrant parents and kids acculturate to the U.S. at different speeds, which can lead to family conflict.

At the same time, added Dr. Prado, while “culture and context are really important, oftentimes these [evidence-based prevention] programs are very adaptable, and they have core ingredients or content that cuts across populations.” He noted that with some minor changes, Familias Unidas was successfully adapted for use with white non-Hispanic families in Pennsylvania.

When other panelists talked about how substance abuse can often co-occur with mental health problems, Dr. Prado emphasized that substance abuse prevention programs can impact mental health outcomes as well.

“Family programs are very efficacious and effective in reducing drug use and concurrent conditions in part because the parents are the change agents of that kid’s behavior, and it gives parents the tools to be able to prevent…some of the escalation,” he said.

Dr. Prado concluded his remarks by talking about the importance of intervening along the continuum from primary prevention to treatment.

“We have to think from a developmental lens, where we are targeting our elementary school children, our middle school children, our young adults, and our adults,” he said. “So it’s really important to think about targeting effective programs across the continuum and across the lifespan.”

The full roundtable discussion can be viewed at: https://lnkd.in/d3GnJQmQ

Written by SONHSNews

Dr. Guillermo "Willy" Prado is the former Director of Prevention Science and Community Health at the University of Miami Miller School of Medicine's Department of Public Health Sciences. Dr. Prado is currently a secondary professor in the department.