Swimming Against the Current: Addressing Community Needs and Establishing Partnerships for the Prevention of Opioid and Methamphetamine use Among Parents.

The opioid and methamphetamine crises in Oregon have a consequential impact on young families, as an increasing number of parents experience substance use disorder (SUD). As parental substance use escalates, the child welfare system (CWS) becomes overwrought with families who have complex needs. The burden placed on families and on the CWS indicates a need for prevention and treatment interventions for parental SUDs. In response to the worst statewide opioid and methamphetamine epidemics in the USA, a Hybrid Type 2 trial of PRE-FAIR-a prevention intervention for parents-is being implemented in five Oregon counties. Establishing strong partnerships within the communities helped identify the need to implement the evidence-based FAIR treatment model alongside PRE-FAIR. A strong focus on implementation includes meeting the needs of communities and establishing the infrastructure necessary for sustainment of the FAIR programs at the provider agencies. Despite implementation efforts to direct toward PRE-FAIR referrals, parents in need of treatment are being referred at a disproportionate rate, as are older parents who fall outside of study-eligibility. Both challenges have delayed the ability to enroll a sufficient number of participants for the prevention trial. This commentary describes the impact of the opioid and methamphetamine epidemics in Oregon as the crises relate to implementing prevention versus treatment interventions-highlighting the importance of addressing community needs and establishing strong partnerships, which has allowed creative strategies to increase PRE-FAIR recruitment.