Effectiveness of educational interventions in United States schools to prevent opioid-related harms: A systematic review
Bibliographic record
Abstract
ISSUES: The opioid crisis in North America has increased concerns about adolescent problematic opioid use. Schools are crucial in prevention efforts, but the effectiveness of school-based educational programs is debated. This review evaluates the effectiveness of school-based opioid education programs in preventing opioid-related harms, and improving knowledge, attitudes, and beliefs about opioids among youth. APPROACH: Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, ERIC, and Web of Science databases were searched in January 2025. Included studies met the following criteria: (1) were published in English; (2) conducted in a middle or high school setting; (3) the intervention related to opioid education; (4) randomized trials or observational studies; and (5) published between January 2000 and January 2025. KEY FINDINGS: Among 1405 studies screened, eight met the inclusion criteria and evaluated seven school-based opioid education programs with participants aged between 11 and 18 years. Most studies used quasi-experimental designs, and only one was a randomized controlled trial. One study showed that combining classroom-based interventions in grade 7 with sessions that involved parents participating alongside students significantly reduced prescription opioid misuse, with effects lasting until grade 12. Four studies showed improved knowledge and attitudes towards opioid use and two showed increased understanding of opioid withdrawal and overdose management. IMPLICATIONS AND CONCLUSION: This review is the first to evaluate school-based opioid education programs for adolescents. Findings indicate that these programs effectively increase opioid knowledge and reduce problematic opioid use, though further randomized trials among diverse participant samples are needed to confirm efficacy and generalizability of findings.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".