Cherokee Nation Behavioral Health and Emory team up to prevent youth substance use

While overdose deaths in the U.S. sharply declined in 2024, they remain high. Almost 90,000 Americans died from drug overdoses between October 2023 and September 2024. Overdose death rates are particularly high in American Indian and Alaska Native (AI/AN) people.

The earlier someone starts substance use, the more likely they are to have substance use problems later in life. So, it is important to work with young people to prevent substance use early in life. Researchers at Emory's Rollins School of Public Health recently partnered with Cherokee Nation Behavioral Health to design and implement programs to help prevent youth substance use in their community. 

They created two programs. Connect Kits for Family Action delivers activity kits to families of teens in 10th to 12th grade to help strengthen family relationships. Connect Brief Intervention uses technology to deliver individualized coaching to high school students.

Testing the programs

A randomized trial of the interventions, with results published in the American Journal of Public Health, found that they worked to reduce alcohol and other substance use in high school students in rural Oklahoma.

In the trial, Cherokee Nation Behavioral Health implemented the programs at 10 high schools. Ten other schools did not receive programming to serve as a comparison. The 10 high schools that did not receive the programs during the trial received them after the study ended. Most students at participating schools were either white or AI/AN.

The trial lasted for three years, and students completed surveys every six months to report on their alcohol and substance use.

What they found

Students at the schools that received the intervention had lower alcohol and other substance use than students at the comparison schools.

Every six months, these students reported:

• 18% less alcohol use
• 26% less binge drinking
• 11% less cannabis use
• 40% less prescription opioid misuse

Why this matters

Adolescent substance use poses serious risks to health, academic achievement, and long-term well-being. Therefore, protecting teens from substance use is key to helping them thrive. Our prevention programs have demonstrated measurable success in reducing alcohol and drug use among high school students. We're proud of the results and excited to share these adaptable, effective solutions with other communities."

Kelli Komro, PhD, professor of behavioral, social, and health education sciences at Rollins and project co-lead

Juli Skinner, director of behavioral health for Cherokee Nation stresses the importance of this work.

"We believe our children are our most valuable resource," she says. "This project allowed us to work within our own reservation to find ways that affect change in our youth. Our partnership with Emory University and area high schools was vital in making this happen. We learned so much from the challenges we encountered during this trial, making it more effective and sustainable. The improved outcomes from this trial will last into the future generations of our Cherokee families and communities."