Addressing the Opioid Epidemic on BYU Campus through CAPS-O Program

Zach Annis, Katie Angerhofer, Tyler Flinders, and Jake Payne

December 2018
 Table of Contents

Evaluation Purpose……………………………………………………………………….pg. 3

Health issue……………………………………………………………………………….pg. 4

Stakeholders……………………………………………………………………………....pg. 6

Description of Program…………………………………………………………………...pg. 9

Logic model……………………………………………………………………................pg. 13

Evaluation Design………………………………………………………………………...pg. 14

Evaluation Plan…………………………………………………………………………...pg. 15

Data Collection…………………………………………………………………………...pg. 17

Data Analysis…………………………………………………………………………….pg. 18

Interpretation……………………………………………………………………………..pg. 19

Limitations……………………………………………………………………………….pg. 21

Conclusion………………………………………………………………………………..pg. 23

Appendices……………………………………………………………………………….pg. 25

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 Evaluation Purpose

What is the purpose of this evaluation?

Opioid usage in the state of Utah is a widespread health issue that affects the lives of

many individuals and families throughout the state. The purpose of our evaluation is to reduce

the usage of opioids in college aged adults in the Provo/Orem area. This will be done through a

health education strategy and providing resources that provide social support through Counseling

and Psychological Services (CAPS), an existing organization. As part of our evaluation, we will

aim to identify the root causes of opioid abuse in college aged adults and evaluate what social

factors may lead to the widespread abuse. In efforts to better manage opioid abuse we will strive

to evaluate the prevalence of opioid abuse among the people we survey and those that take part

in our intervention. Understanding the depth and magnitude of this issue will help us better

analyze the efforts and support that is needed to help reduce opioid use.

How will findings from the evaluation be used?

The findings from our evaluation will be used to develop more resilient communities and

neighborhoods throughout Utah. The results and findings will help us be better aware of social

issues that college aged students face and understand what is needed to combat these issues.

Further education programs can be developed based on our outcomes. We can use the data that

we gather to benefit different age demographics that may face similar issues with opioid abuse.

The data can be used to identify effective opioid prevention techniques that may be scaled and

incorporated in future prevention programs. As the program continues, we will work with CAPS

and various stakeholders to decide what was working well throughout the program and decide

what to keep and change.

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 Health issue

What, who, where, why of issue:

Opioid abuse is a serious public health issue in today’s society and throughout the state of

Utah. College aged students are an especially at-risk demographic due to higher rates of stress,

anxiety, and depression. Many college aged students use drugs recreationally. Opioid abuse

impacts people mentally leading to further anxiety, depression, and other serious addictions

(Mccabe, S. E., et al., 2005). Opioid addiction destroys families, weakens community resilience,

and increases crime (Rosenblum, A., et al., 2008).

Background Information:

Part of the issue with opioid addiction in Utah is the fact that opioids are readily

available. In 2015, Utah medical providers wrote 73.1 prescriptions per 100 persons. Many of

these prescriptions go unfinished and aren’t properly discarded. Recent studies have shown that

87% of opioids are obtained from a friend or relative (Utah.gov, n.d.). Part of the problem is a

lack of education and understanding of how to properly discard opioids and the importance of

keeping track of prescriptions (Donroe, J. H., Holt, S. R., & Tetrault, J. M., 2016).

For many college aged students in Utah, opioids are a common means to get “high”

recreationally and cope with anxiety, stress, and depression. Studies show that 10% of

Americans between the ages of 18 and 25 have reported nonmedical use of opioids (Compton,

W. M., & Volkow, N. D, 2006). Opioid use is an extremely effective way to reduce pain,

suffering, and fulfill a number of different medical needs. Common opioids include; oxycodone,

hydrocodone, codeine, fentanyl, morphine, and heroin. For the exception of the more serious

drug heroin, most opioids are prescribed under the direction of a doctor and pharmacist. Within

just two weeks, people can become addicted to opioids (Birnbaum, H. G., et al., 2011). The

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availability of these drugs and their addictive nature make opioid abuse a serious threat to

college aged students and a danger to Utah’s public health.

Causes & effects/ consequences:

While opioids are associated with abuse and addiction, they are also essential prescription

medications that help everyday people recover from surgery, illness, and chronic pain

(Birnbaum, H. G., et al., 2011). After prolonged use, many individuals become addicted to

opioids as the body develops dependence. Opioids interact with the brain's pleasure and pain

systems by dulling the perception of each nerve ending and causing a euphoric high (Morgan, M.

M., & Christie, M. J, 2011). These feelings, although temporary, cause the body to endure

uncontrollable cravings for more opiates. Common side effects of opioids include drowsiness,

confusion, slow breathing, constipation, and euphoria. Other short term effects include, reduced

sex drive, muscle and bone pain, insomnia, and a number of chronic diseases that affect the body

physically (Walley, A, et al., 2012). Long term use of opioids often results in heart infections,

collapsed veins, bacterial infections, a number of other chronic diseases, and death (Birnbaum,

H. G., et al., 2011).

Opioid dependence can lead to many consequences that affect daily life. Friend and

family relationships can be destroyed as well as employment relationships. Opioid misusers

often lose their jobs, cars, and homes as their priorities shift toward accessing more opioids and

gaining the next “high” (Birnbaum, H. G., et al., 2011). College aged students who struggle with

opioid addiction often struggle to finish school and enter into the job market (Mccabe, S. E., et

al., 2005).

Need for Research & Evaluation:

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 As a state and community, it's our responsibility to address the opioid epidemic within all

members of the community, especially in college aged students. Through working closely with

CAPS we can design an intervention to help college aged students gain the knowledge they need

concerning opioids and provide resources to positively influence health behavior change. The

Provo/Orem does not currently have resources readily available to assist the needs of students in

the area. High rates of opioid use indicate the need for research. More needs to be done to

improve this public health issue.

Stakeholders

Brief description (including mission & focus):

A major stakeholder involved in building the intended coalition will be Intermountain

Healthcare (IHC). Intermountain Healthcare’s mission is to help people live the healthiest lives

possible. They work hard to be a model health system by providing extraordinary care and

superior service at an affordable cost. We believe that their values of integrity, excellence, trust,

mutual respect and accountability align well with what we will try to accomplish as a coalition

(Intermountain Healthcare, 2018). They have built trust in the community over the last several

decades as they have strived to improve prevention and wellness for all those living within their

reach.

BYU’s Counseling and Psychological Services (CAPS) will also be a major contributor

to the overall success of the coalition. The overall mission of the CAPS program is to provide

confidential counseling services aimed at helping students achieve their personal and academic

goals (Counseling and Psychological Services, 2018). Within the CAPS organization, they have

options for students who are struggling with substance abuse. They work with students to help

them understand the impact of substance abuse on their lives and the lives of those around them.

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CAPS offers services to students who wish to explore and potentially change their current

substance use patterns and gain assistance with maintaining their recovery from addition.

United Way will serve as an additional stakeholder that comprises the coalition. The

vision of United Way is to create a community where all individuals achieve their human

potential through education, financial stability and healthy lives. They work in partnerships with

other community organizations to provide welfare and assistance to differing vulnerable

populations. United Way’s mission is to improve the lives of individuals by mobilizing the

caring power of the community to advance the common good (United Way, n.d.).

Interest in the program/ evaluation:

CAPS will play an integral part in evaluating the effectiveness of the program. CAPS will

be most interested in how students are benefiting from the efforts of the coalition. They work

closely with students through counseling sessions and will be able to determine if students are

receiving the desired effects from the program. United way will also be interested in the

effectiveness of the CAPS-O coalition. United Way will want to see how community resilience

is increased as more opioid awareness is brought to the residents. United Way will also be

interested in the financial aspects of CAPS-O. They will provide resources in order to help

facilitate the activities of the CAPS-O and will want to know if those resources are producing

positive results and contributing to the coalitions goals and objectives. Intermountain Healthcare

will be most interested in the financial aspect as well as serve as a critic to the CAPS-O.

Role of stakeholders:

Members from CAPS will serve as part of the planning team. Staff members from the

CAPS program have expertise in counseling and mental health/substance abuse awareness that

will be beneficial to the planning stage. They will be able to identify topics of focus that the

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CAPS-O program should incorporate when trying to increase opioid awareness among college

aged students. CAPS will also receive results and encourage students to take the post survey in

order to evaluate their knowledge of opioids.

United Way will also serve as part of the planning team. They have members in their

organization who will be able to provide connections to opioid abuse support systems within the

community that will be beneficial for scheduled Awareness Fairs. United Way will also help to

interpret the findings from the post surveys collected after the Awareness Fairs and the on-

campus forums. Intermountain Healthcare will serve as an external reviewer and critic to the

efforts of CAPS-O. IHC will review the findings from the post surveys and evaluate if the goals

of the CAPS-O program are being met.

Engaging stakeholders:

The CAPS program is a well-respected service that BYU students can access for free.

They have confidential services offered to all students. They see the underlying issues leading to

opioid abuse on a daily basis and will be able to offer a perspective different than United Way

and IHC. United Way will serve as an integral part in making connections to local organizations

to be involved with the Awareness Fairs. They have a track record of working with various

community outreach groups and will be very valuable in making these connections. IHC has

interests in both prevention and tertiary care efforts for those experiencing opioid abuse. They

will be able to offer a clinical approach that will differ from the view of United Way and CAPS.

IHC will be able to supply the forums with guest speakers such as doctors and physicians who

have seen the effects of opioid abuse.

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 Description of Program

Background for the project:

In joining forces with Brigham Young Universities CAPS program our drug awareness

and resource program will meet the need of college student’s lack of understanding opioid

prevalence and dangers. BYU students are affected by opioids in direct and indirect ways and

after conducting a survey we found that many of the students surveyed lacked a complete

understanding of what opioids are and the dangers they pose. Our partnership with CAPS in

creation of a CAPS-O coalition (O for opioids) will meet the needs of education and providing

resources for those affected by opioids and other drugs. Our focus is to meet needs concerning

the growing epidemic of opioids in our community. This includes education on the epidemic and

the impact it has had and is currently having on members of campus community. Educational

efforts will meet needs of students and faculty to better understand the need for addressing this

issue.

Our program is not just aimed at educating but also providing resources to those who

need counseling, support groups, treatment/detox, and recovery maintenance. Resources serve to

meet the needs of students who are actively struggling with substance misuse and need assistance

battling potential addictions.

Program context:

Our program will be provided as a campus wide service that is for all members of

Brigham Young University including faculty and students and any employed staff of the

university. The context of Brigham Young University is a private college with over 33,000

students with close to 4,000 faculty and staff (Facts and Figures, n.d.). The predominant faith

among the community is The Church of Jesus Christ of Latter-Day Saints and over 62% of

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students have served as a missionary for the church. Students admitted to the university also

averaged a 3.86 GPA and 29 ACT score from high school, which helps cultivate an academically

rigorous student body (Facts and Figures, n.d.). However, the contextual and cultural practices

lead to high stress environments where students are pressured with religious and academic

beliefs and expectations. Because of a religious belief to abstain from drug use and an honor

code that students abide to live by, we foresee some difficulty in implementing a program where

students can feel protected by sharing such personal behaviors. We acknowledged the role that

religious practice plays in student’s openness on behaviors they perceive as sinful. This

perception may influence how open students and staff are with counselors as they may fear their

academic standing being jeopardizes/being reported to honor code office. Our program hopes to

effectively educate BYU campus on the growing opioid epidemic, especially as it relates to Utah

County and campus life.

Target population:

For this program our target population is college students specifically students on BYU

campus. We are also making our services available to faculty and staff at BYU. We want to

make college students the target recipients of our services, as opioid abuse is continually rising

among college students. Our program, however, is intended as a whole to educate the entire

campus community on opioid misuse and substance abuse.

Stages of development:

The CAPS program has been a part of BYU campus for several years as a counseling

service and for psychological services. Because CAPS is already an established program run on

campus, our program will just need to be integrated into the services already provided. CAPS

already offers some services for drug and substance abuse (Counseling and Psychological

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Services, 2018). Counseling and psychological services are offered for those who have substance

abuse issues to understand the impact of their substance misuse. However, the program does not

offer services to educate the entire student body on substance misuse, specifically addressing the

opioid epidemic.

The first major stage in development would be creating educational material and a

compilation of resources the CAPS program can use for students. Marketing material for the

vamped-up service would also be created. After all necessary materials have been created, they

will be presented to CAPS counselors/staff and other stakeholders to get feedback on

adjustments and additional resources needed.

The second major stage is implementing the program with a big marketing campaign

across campus. Posters and flyers would be spread across campus. An announcement would be

included in the weekly campus email that goes out to students and staff. Social media

announcements would be published on Twitter, Instagram, and Facebook CAPS and BYU pages.

During this stage a campus wide survey would be sent out to gain a baseline knowledge of

opioids and substance misuse.

The third major stage of development is holding a kick-off event where we have guest

speakers and a presentation on services offered and the scope of the opioid epidemic among our

community. Events similar to this will be held twice in a semester, but on a smaller scale.

The final stage of development will be maintaining services for students by administering

surveys at the beginning and end of each semester to rate how effective program is for those who

use the service and to gain general knowledge campus wide on opioids.

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Resources/ Inputs:

Staff and counselors are available for the program through a partnership with the CAPS

program at BYU. The space to hold counselling and one-on-one services is available in CAPS

offices in the Wilkinson Center on BYU campus. The CAPS website and various social media

accounts for CAPS are available to promote and give information. Overall, the program has a

solid base of resources to start servicing and educating campus on substance misuse.

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Logic model:

Opioid CAPS Program: CAPS-O

INPUTS ACTIVITES OUTPUTS IMPACT LONG TERM OUTCOMES

Over 200 fliers Increased

Opioid abuse CAPS Displaying
posted on campus knowledge of CAPS-
promotion CAPS-O information about
about CAPS-O O on campus
club and emailing
students about new 1 email sent to all Increased
Materials for
resource student and faculty awareness of
participants:
- Information about about new CAPS resources for drug
Meeting at beginning resource, CAPS-O related issues , INCREASE
opioid disposal
of semester specifically opioids AWARENESS OF
- Outline of plan to
Completion of 1st RESOURCES
cope with drug
semester meeting AVAILABLE FOR
addiction (12 week Meeting at end of Increase in OPIOID ISSUES
program) semester knowledge of
- Guides to talking Completion of 2nd opioids (what they
about opioids with semester meeting are and do)
others Administer surveys at
- List of treatment beginning and end of
Increase in open
centers semester over Administer over conversations with
Offices and facilities to email/at meetings 1,000 surveys others concerning
hold meetings 2x about opioid
opioids
semester knowledge and INTERVENTION
Completion of at
knowledge of new STRATEGY KEY:
Surveys for participants CAPS -O least 500 surveys
to take (50%) Established trust MATERIALS
75% of attendance between students
CAPS, Counselors/ Plan/Attend semester is students at and CAPS
ACTIVITY
staff meetings meetings Increasing # of
student participants PARTICIPANT
Student participants Engaging with 40 students actively each semester
resources engaged in CAPS-O

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 Evaluation Design
Type of evaluation:

Through the CAPS-O program we intend to increase awareness and knowledge about

opioids. We will conduct both a formative and summative evaluation to ensure that we are

meeting our objectives and increasing awareness about opioids among our target population. For

our formative evaluation, we plan to conduct an online survey with participants who are

attending the forums and open discussion on campus. We will encourage everyone in attendance

to take a quick 5-minute survey after the duration of the forum. We anticipate that 70% of

members who attended the forum will complete the online survey. We will remind the attendees

once at the beginning of the meeting and immediately following the termination of the forum

that there will be an online link posted where they can complete the survey. In addition to the

online surveys, we will conduct in person interviews that will help determine the effectiveness of

our program and gain a general knowledge and the perceived value that the CAPS-O program is

offering to our target audience. We will solicit 4-5 volunteers to participate in the interviews and

offer a 5-dollar gift card to encourage participation. We will conduct two sessions of interviews

each semester. Each forum we will pass out a sign-up sheet for those willing to participate in

interviews. If we receive a number higher than the planned 4-5 participants, we will randomly

select from the willing volunteers. The summative evaluation will be done through a campus

wide online survey. We will administer the survey to all students at the beginning of the semester

and then again and the termination of the semester. We anticipate a lower response rate towards

the end of the semester due to finals and the workload placed on students.

We have chosen to use an online survey as our evaluation tool because our target

audience will respond well to the electronic version as opposed to a paper copy. Our target

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audience is comprised of younger adults who are more technologically inclined. The quick

access to the online survey through mobile devices, laptops or tablets creates an opportunity for a

high number of responses at a minimal cost to the CAPS-O coalition. The interviews will allow

us to get an overall perception of how the CAPS-O coalition efforts are being received by our

target audience. From the information received in the interviews, we will be able to implement

changes in the future guest speakers about what topics need to be addressed and how they should

be presented to the students and faculty.

Timeframe for data collection:

At the beginning of the semester we will allow a two-week period for students to

complete the initial survey. The online survey following each forum will be open for one hour

after the forum has ended. The interviews will take no longer than 20 minutes and will be

conducted after the first forum. The final survey will be administered two weeks before finals

week to not impede on students’ academic endeavors.

Evaluation Plan
Intended outcomes:

The goal of the CAPS-O coalition is to increase awareness about opioids and the

resources available to those struggling with addiction. One intended outcome is that following

the forums and discussions, students will be able to identify the 3 most common opioids from

other illicit substances. We also wish that following the termination of the forums that students

will be able to identify various professionals and organizations that are available to them as a

resource. CAPS-O wants to establish trust between students and counselors. We want them to

feel safe about their addiction problems and be able to seek help without fear of honor code

repercussions.

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Long-term outcomes:

We ultimately want to increase awareness of the resources available to resolve opioid

misuse issues. The community is rich with opportunities and resources for our target audience,

but many students do not seek help because they are unaware of the resources available to them.

We will mitigate the responses from the surveys and use percentages to determine if our

objectives and overall outcomes are being met. If the majority of students are answering

negatively to questions that assess their knowledge about local resources available to them, we

will be able to determine that our goals are not being met. Conversely, through the surveys we

can measure the increase of knowledge and awareness surrounding opioids and resource centers.

The percentage increase will be our measure to evaluate if the efforts by the CAPS-O coalition

are meeting the intending outcomes. We will be able to evaluate if trust is being established

between the CAPS-O program and the students by the number of students enrolled in the CAPS

substance abuse program. Attendance logs will help to identify if more students are reaching out

to resources available to them on campus.

Examples of specific questions:

1- Which of the following are opioids? (check all that apply)

Speed, oxycontin, marijuana, cocaine, heroin, percocet, vicodin, codeine and LSD.

2- What do you think are the greatest challenges that college aged individuals face?

3- In your opinion, what do you think should be done to help people with drug addictions?

4- Do you currently know that _______ and _______ are places you can get professional help?

a. Do you think these agencies and professionals are well known in the community?

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These questions will assess if the students are learning about opioids and local resources

available to them. From these questions we will be able to gain an overall consensus on whether

or not students are becoming more knowledgeable about opioids. The questions from the

interview will help us to know what students perceive as the greatest challenges that face

collegiate individuals. We will be able to take their responses and structure our forums and guest

speakers to answer their specific concerns and questions.

Data Collection

In order to better understand how opioids, affect college aged students and staff

members, researchers will conduct an anonymous survey (see appendices) in which participants

will be asked various questions that will test their knowledge on the subject of opioids. This will

in turn give researchers telling information on where they can help the stakeholders focus their

efforts in order to help those who struggle with opioid/substance abuse and addiction. The survey

will be created and distributed by the researchers using a survey software such as Qualtrics or

Google Forms. By doing a survey, it will give the researchers a lot of quick, easy data and

information that they can use. It is inexpensive to administer digital surveys and with the help of

Qualtrics or Google Forms data can be exported into Microsoft Excel to compare and analyze

when that time comes.

Researchers will also conduct interviews with students and staff to get a full range and

more in-depth understanding of the subject. This will help the researchers to develop a

relationship with the participants which will in turn allow the participant to feel more

comfortable to open up with counselors. The interview is also a good data collection method

17
because the researcher can be flexible with the participant as opposed to them filling out a

survey.

Research would be done using reliable, valid methods that would account for cultural and

socio-economic factors. Instead of reinventing the wheel, researchers will find best practice

studies, interviews, etc. and use those to conduct their research and modify where needed. We

were able to collect data from 30 surveys as our sample size for our pilot/trial run. Ideally,

researchers would be able to collect data from 1000+ surveys via an anonymous survey link. The

CAPS-O staff/members would be responsible for collecting the information. Researchers would

also ideally be able to interview 10-20 different students/staff.

Data Analysis

There will be multiple data analysis approaches that will be used to address the research

questions. One method that will be used will be descriptive statistics which will provide simple

summaries about the data that has been collected. This combined with some simple graphics

analysis will form the basis of a quantitative analysis. In addition, by doing a pre and post

survey--once at the beginning of the semester and another one at the end of the semester--there

will be another quantitative method that will be used to measure how effective the CAPS-O

program was as far as student and staff knowledge on the subject of opioids. Analysis will

hopefully show improvements in knowledge and decision making based on the questions in the

survey. Microsoft Excel, among other analytic tool options will be used to analyze and portray

the findings. An example of a specific test that will be conducted will be looking at whether the

students and staff involved in the CAPS-O program can identify what is and is not an opioid. For

example, 20% of the people that completed the survey rated themselves as being “very

knowledgeable” about opioids, yet 83% of those that rated themselves as “very knowledgeable”

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failed to be able to identify what opioids are or aren’t. Most of the participants that completed the

survey were not able to correctly identify what was and wasn’t an opioid. In fact, only 10% of

those that completed the survey could correctly identify what was and wasn’t an opioid from a

list of 9 different drugs (see appendices for graphic representation of these results).

Qualitative analysis will also be used to gain insightful information and data. The

interviews that the researchers will perform will be an effective way to capture direct quotations

about the participant's personal perspectives and actual lived experiences. Researchers will look

for common patterns and themes that emerge around different questions throughout the

interview. They will also look to see if the patterns that they find support the findings of other

studies done and look for ways that may suggest that additional data needs to be collected.

Interpretation

In short, and based on the results we have found, there is a lot of work to be done in

educating students and even staff on what opioids are, why they are dangerous and how to

prevent substance abuse and addiction.

All of these evaluation findings will be used to figure out a way to best combat this

opioid epidemic that is currently flooding the nation--including our own state and university here

at BYU. The CAPS and CAPS-O program at Brigham Young University will use these findings

along with the stakeholders that are involved--Intermountain Healthcare and United Way--to

hopefully expand efforts to reach those not only on campus and BYU, but also throughout the

state and ideally, the whole nation with time.

If the CAPS-O program is indeed successful, Intermountain Healthcare will be able to

use the same principles to help educate their staff which includes doctors, nurses, etc. to in turn

help patients that they see. If the people that are prescribing opioids in the first place are more

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aware of the lack of knowledge that their patients have, they can help them to become more

informed on how to properly use opioids, dispose of them, etc. This, combined with other laws

and guidelines on how much doctors can prescribe opioids will help to combat the current opioid

epidemic.

United Way can also use the findings to help fulfil their whole purpose and mission

which is to assist in creating communities where all individuals achieve their potential through

education, financial stability and healthy lives. They can also use the same principles from the

CAPS-O program in creating their own interventions and programs in the communities in which

they focus their efforts (United Way, n.d.).

The CAPS and CAPS-O program at BYU will also be able to use these findings to help

educate their instructors on how they can best be of assistance to those they teach that struggle

with opioid or substance abuse/addiction.

An effective way to share these findings would be to require instructors on campus to

dedicate a class period to go over the results of the research and help the students be aware that

help is available and where they can go to get that help. A social media campaign would also be

an effective way in today's day and age to share information. Finding those that have a lot of

influence on others (athletes, well known professors, community leaders, etc.) and getting them

on board and sharing the information will be key reaching as many people as possible.

In order to stay in contact with, and keep the stakeholders up to date on findings, results,

etc., the CAPS-O program will hold a meeting once a month with the stakeholders. In these

meetings, all parties will exchange information and data that they have found and gathered over

the month and talk about what went well, what didn’t go so well and what they can do to best

move forward with the program. By implementing this program in different settings, it will

20
hopefully lead to more ways and ideas to better reach the target population. Because the

education aspect of opioids is clearly lacking, it will be most helpful to start by effectively

educating the target population on what opioids actually are. Then, after there is an increase in

basic knowledge, move into why opioids are harmful and dangerous when used improperly.

Another principle the program will stress, is to share what they learn with family and friends in

hopes that we can reach even more people that aren’t directly involved with the program.

Limitations
The quantitative evaluation method we used in our program made it difficult to apply our

evaluation findings to the general public. It’s important to be aware of these issues as we analyze

data and draw conclusions from our findings. The surveys we used had questions that tested the

participant’s knowledge and understanding of opioid use. Individual biases may have prevented

these surveys from being accurate and precise. Although relatively accurate, quantitative data

may not be specific enough to explain complex issues or root causes in a larger population.

To account for these biases we allowed open participation and access through survey data

collection. Surveys are posted on citywide social media platforms and researchers survey people

door to door. No demographic requirements are necessary for participation.

A person’s inability to answer questions honestly and openly may have prevented

accurate data collection during in-person interviews. Participation in the survey questionnaire is

another large limitation to our study because many participants failed to complete the entire

questionnaire. A large portion of people that completed the surveys were college aged

individuals from ages 18-25. The data is limited to specific demographics.

Conclusion

Opioids are a growing epidemic that affect a large portion of our population. Among

college students there is a growing trend of opioid misuse and misunderstanding of the harms of

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opioids as compared to illicit drugs. Our partnership with BYU CAPS and other community

organizations will help foster a greater understanding among BYU students and faculty

concerning opioids. The opioid epidemic is a preventable problem when education and resources

are available. After gathering survey responses and looking at results we learned many important

things. Among the most important things learned, a few things stood out. First, that many people

do not have a clear understanding of what opioids are. Second, that a fair portion of respondents

did not perceive opioids as harmful as illicit drugs. Finally, that education is a key step in

preventing and controlling the opioid epidemic, especially when done with a large body of

participants.

Because of the stigma in Utah County surrounding addiction and opioids there is

a more reserved approach to talking about the problem. Religious practice, social structure and

an illusion of everyone else being perfect greatly contributes to the lack of open discourse

surrounding opioids and how to avoid them or get help if you or someone you know has become

addicted. Because of this and the important points learned from our results--this matters because

people die daily directly because of opioids in Utah. College students are the next generation of

leaders and with knowledge and comfort to discuss hard topics they can change the way opioids

are viewed and discussed, instead of keeping it a quiet issue.

Our results in this area can be helpful for future research into college counselling services

(specifically tailored to drug education and addiction services) and the impact/effectiveness they

have on students’ behaviors and attitudes. Although, many campuses have counselling and

psychological services available our program can be evaluated to see if there is a need for more

tailored counselling services.

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References:

1) Mccabe, S. E., Teter, C. J., Boyd, C. J., Knight, J. R., & Wechsler, H. (2005). Nonmedical use
of prescription opioids among U.S. college students: Prevalence and correlates from a national
survey. Addictive Behaviors, 30(4), 789-805. doi:10.1016/j.addbeh.2004.08.024

2) Rosenblum, A., Marsch, L. A., Joseph, H., & Portenoy, R. K. (2008). Opioids and the
treatment of chronic pain: Controversies, current status, and future directions. Experimental and
Clinical Psychopharmacology, 16(5), 405-416. doi:10.1037/a0013628

3) Utah.gov: The Official Website of the State of Utah. (n.d.). Retrieved from
http://www.utah.gov/

4) Donroe, J. H., Holt, S. R., & Tetrault, J. M. (2016). Caring for patients with opioid use
disorder in the hospital. Canadian Medical Association Journal, 188(17-18), 1232-1239.
doi:10.1503/cmaj.160290

5) Compton, W. M., & Volkow, N. D. (2006). Major increases in opioid analgesic abuse in the
United States: Concerns and strategies. Drug and Alcohol Dependence, 81(2), 103-107.
doi:10.1016/j.drugalcdep.2005.05.009

6) Birnbaum, H. G., White, A. G., Schiller, M., Waldman, T., Cleveland, J. M., & Roland, C. L.
(2011). Societal Costs of Prescription Opioid Abuse, Dependence, and Misuse in the United
States. Pain Medicine, 12(4), 657-667. doi:10.1111/j.1526-4637.2011.01075.x

7) Morgan, M. M., & Christie, M. J. (2011). Analysis of opioid efficacy, tolerance, addiction and
dependence from cell culture to human. British Journal of Pharmacology, 164(4), 1322-1334.
doi:10.1111/j.1476-5381.2011.01335.x

8) Walley, A. Y., Paasche-Orlow, M., Lee, E. C., Forsythe, S., Chetty, V. K., Mitchell, S., &
Jack, B. W. (2012). Acute Care Hospital Utilization Among Medical Inpatients Discharged With
a Substance Use Disorder Diagnosis. Journal of Addiction Medicine, 6(1), 50-56.
doi:10.1097/adm.0b013e318231de51

9) Intermountain Healthcare. (2018). Our Vision. Retrieved Dec 1, 2018 from

https://intermountainhealthcare.org/about/who-we-are/mission-vision-values/.

10) Counseling and Psychological Services. (2018) Substance Abuse Treatment and Prevention.
Retrieved Dec 1, 2018 from https://caps.byu.edu/node/955.

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11) United Way of Summit County. Mission and Vision. Retrieved Dec 2, 2018 from
http://www.uwsummit.org/mission-vision

12) Facts and Figures. (n.d.). Retrieved from https://news.byu.edu/byu-numbers

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 Appendices

Survey: Opioid Survey

Opioid Survey

Thank you for taking a few minutes to complete this short survey. This survey is sponsored by
Brigham Young University: Department of Public Health. This survey is completely
confidential. All responses are recorded in complete anonymity. No personal identifiers will be
asked and therefore cannot be linked to individual responses. Answer each question to the best of
your ability.

Section 1 includes questions about Opioid use and Section 2 includes demographic questions.

1. Which of the following is/are opioids? (Check all that apply)

❏ Speed
❏ OxyContin
❏ Marijuana
❏ Cocaine
❏ Heroin
❏ Percocet
❏ Vicodin
❏ Codeine
❏ LSD

2. Have you ever been prescribed an opioid?

❏ Yes
❏ No
3. Rate your knowledge when it comes to opioids and prescription drug use?
❏ Extremely Knowledgeable
❏ Very Knowledgeable
❏ Moderately Knowledgeable
❏ Slightly Knowledgeable
❏ Not Knowledgeable at all

4. Do you agree with the following statement? It is safer for someone to get high on opioids and
prescription drugs than on street drugs.
❏ Strongly Agree
❏ Agree

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 ❏ Somewhat Agree
❏ Disagree
❏ Strongly Disagree

5. Do you agree or disagree with the following statement? It is OK to take more than the
recommended dosage of a prescription medication if you are feeling more pain than usual.
❏ Strongly Agree
❏ Agree
❏ Somewhat Agree
❏ Disagree
❏ Strongly Disagree

6. In your opinion how do people who abuse opioids and prescriptions medication obtain it?
❏ Friends
❏ Family
❏ Internet
❏ Doctors who overprescribe
❏ Pharmacists who give or sell medications to people who don't need them for medical
purposes
❏ People who write false prescriptions

7. Have you ever been addicted to any type of drug?

❏ Yes
❏ No

8. Have you ever shared your prescribed opioids with someone else?
❏ Yes
❏ No

9. Do you know how to properly dispose of unused opioids and medications?

❏ Yes
❏ No

10. How many people do you know that are currently taking opioids?
❏ 0-2
❏ 3-4
❏ 5-6
❏ 6 or more

11. How many people do you know that have abused opioid use?

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 ❏ 0-1
❏ 1-2
❏ 2-3
❏ 3 or more

12. What would you say to a family member that struggled with opioid addiction?
Your answer .

13. Describe your personal feelings towards opioids?

Your answer .

14. How successful do you think drug recovery programs are at helping victims?
❏ I really don't think they help.
❏ I don't think they help.
❏ I don't know if they help.
❏ I think they help.
❏ I really think they help.
15. On a scale of 0-10 (0 being no at likely, and 10 being extremely likely) How likely is it that
you would recommend a recovery program to a struggling friend?
❏ 1
❏ 2
❏ 3
❏ 4
❏ 5
❏ 6
❏ 7
❏ 8
❏ 9
❏ 10

16.How likely are you to use opioids for non-prescribed methods? (1 being extremely unlikely
and 5 being extremely likely)
❏ 1
❏ 2
❏ 3
❏ 4
❏ 5

17. Regarding prescription medications, which of the following best describes you?

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 ❏ I take prescription medication occasionally when prescribed by a Doctor for temporary
illness or injury.
❏ I take prescription medication prescribed by a doctor regularly for a chronic condition.

Page 1 of 2

Demographics
The following questions are not related to opioids but will provide background and context to
help find common connections in preventing the opioid problem.
1. How old are you?
Your answer .

2. What county do you live in?

❏ Utah County
❏ Salt Lake County
❏ Wasatch County
❏ Other

3. Gender
❏ Male
❏ Female

4. What is your marital status?

❏ Single/ Never Married
❏ Married
❏ Divorced
❏ Separated
❏ Widowed

5. What is your ethnicity?

❏ White
❏ Black or African-American
❏ American Indian or Alaskan Native
❏ Asian
❏ Native Hawaiian or other Pacific Islander
❏ Some other race not listed

6. What is the highest level of education you have completed?

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 ❏ Did not complete high school
❏ High school or GED
❏ Some college
❏ Associates Degree
❏ Bachelor's Degree
❏ Graduate/ Professional Degree

Page 2 of 2

Interview: Interview Guide

Drug Use/Abuse Among College Aged Individuals

Purpose: To conduct a key informant interview for better understanding drug use/abuse among
college aged individuals.
Overarching Research Questions

1. What are the different factors that influence college aged individuals to become addicted
to drugs?
2. What impact do these factors have on how these individuals think and feel about
themselves? What further actions do these individuals take as a result of drug use/abuse?
3. What can be done to help these individuals avoid drug use/abuse?

Welcome: Thank you for coming to participate in this interview. My name is ______. The
reason we invited you here is that we would like you to respond to some questions regarding
drug use/abuse among college aged individuals. The information will help BYU in researching
ways to best help those struggling with this issue. This interview will last approximately 30-45
minutes.

I’d like to review a few things that are useful to know about this interview before we begin...

-First, we are audio recording the session, so we make sure that we get all the information and
exactly as you said it. This also means that I don’t have to take notes. All your comments will be
confidential, meaning no one will know if you made a specific comment
- There are not right or wrong answers. Feel free to say whatever you want. Anything you’re
thinking is important and interesting. We want to hear your opinion.
-Do you have any questions before we begin?
[Have them sign the consent form]

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Interview Questions

Opening Questions--build rapport and establish trust

Transition statement: To start off, I would just like to get to know you a little bit before we get
into the more detailed questions.

1. Tell me a little about yourself.

a. What are your hobbies/interests?
b. What do you look forward to most each day?
2. Tell me about what life is like as a college student?
a. Have you chosen a major yet? If so, what it is and why did you choose it?
b. What is your biggest strength?
c. What is your biggest challenge being a college student?
i. How do you deal with those challenges?

3. What are your plans after you graduate?

a. Where do you see yourself in 5 years?
b. What is your dream job?

Introductory Questions

Transition statement: Thank you for letting us get to know you briefly, we are now going to shift
gears and get more specific with our questions.

1. What is the first thing that comes to mind when the topic of drug use/abuse is brought
up?
2. Do you know anyone that is currently struggling with drug abuse?
a. If they answer yes, “How has that affected you?”
b. If no, “Have you ever known of anyone that has struggled with drug abuse or an
addiction to drugs?”
3. In your opinion, why do you think college aged individuals would become involved with
drugs?

Transition Questions

Transition statement: Now let’s talk more specifically about your community.

1. Are there networks of support for people in your neighborhood? (Consider neighbors,
support groups, faith community, outreach, agencies, and organizations)
a. What do you think are the strongest networks of support?

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 2. What do you think are the greatest challenges that college aged individuals face?
3. Do you feel that drug addictions such as opioid (prescription drug) abuse, alcohol, and
other substances are a problem among your peers? Explain.

Transition statement: There are obviously many ways to go about helping individuals with drug
abuse and addiction. With that being said...

1. How would you rank the following--from highest to lowest--as ways to help college aged
individuals who struggle from drug abuse?
a. Support groups (neighborhood/community)
b. Professional help
c. Private family/friend support.

[Give handout and have them rank]

Probe: You ranked ___________ as #1.

What is it about [________] that makes it the most important?

You ranked ___________ as #2.

How do you think ________ would be a better solution than #1?

You ranked ___________ as #3.

What is it about _________ that makes it the lowest rank of the three options?
Do you think there is a better or alternative solution than [#3]?

D. Key Questions

Transition statement: We appreciate your feedback thus far and value your responses. Now let's
talk a little bit more specifically about what can be done to help college aged individuals deal
with drug abuse and addiction.

1. In your opinion, what do you think should be done to help people with drug addictions?
a. What can your neighborhood or community do specifically?
b. What can different agencies or professionals do to help your
neighborhood/community?
2. What do you think the largest contributing factor to drug abuse among college aged
individuals is?
a. How do you think it came to be the largest contributing factor?

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 3. Do you currently know that ________, ________ and _______ are places you can go to
get professional help?
a. Do you think these agencies and professionals are well known in the community?
b. Do you think they are accessible enough for the public?

E. Ending Questions

Transition statement: Thank you for opening up with us and sharing your ideas and opinions
concerning drug abuse in your neighborhood/community.

1. After all we’ve talked about, what would you say is your biggest takeaway from our
conversation?
2. At the end of the day, do you feel like there is enough being done to help those who
struggle from drug abuse?
3. Do you have any other questions or suggestions for me?

Thank you for your time. We appreciate your feedback and insights. For completing this
interview, we are giving you a BYU creamery gift card (give to them now).

Survey data:

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