Final Curriculum Opposing Opioids

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Opposing Opioids:
An opioid abuse prevention curriculum for high school students
Jeanne Hoang, Courtney Jarvis, Wendy Pirir, and Bryant Rueda
HSC 440: Section 3
Spring 2018
Professor Mara Bird

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Table of Contents
Introduction………………………………………………………………………………………..2
Group Philosophy…………………………………………………………………………………6
Justification………………………………………………………………………………………..8
Scope and Sequence….…………………………………………………………………………..31
Content Outline…………………………………………………………………………………..35
Sample Learning
Opportunities……………………………………………………………………………………..54
Curricular
Resources………………………………………………………………………………………...81
Exam Checklist……………………………………………………………………………..……96
Evaluation Techniques………………………………………………………………………….104
References………………………………………………………………………………………133
Appendix………………………………………………………………………………………..124
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Introduction
Opposing Opioids is a curriculum meant to bring awareness about the prevalence of
opioid abuse among high school students, the risks associated with use, steps toward prevention,
and what treatment options and locations exist. Opposing Opioids first addresses the health risks
associated with opioid use including the signs of abuse and why they are so addictive. It then
addresses the risk factors associated with opioid abuse. This includes looking at high-risk
populations and dangerous behaviors. Opposing Opioids then teaches skills on proper
prescription use and disposal. This involves learning to read prescription drug labels and finding
the optimal way to discard of old prescription drugs. Next, Opposing Opioids discusses a number
of refusal skills that may be used to avoid opioid misuse. Lastly, Opposing Opioids provides a
number of available opioid abuse prevention and treatment resources. Students will also learn the
benefits of seeking professional help.
The specific needs and interests of the target population played a critical role in the
development of the Opposing Opioid curriculum. The goal for the curriculum is to develop the
knowledge, skills, behaviors, and attitudes to prevent opioid and prescription drug abuse.
Strategic planning and formative research have been incorporated into the curriculum in order to
address the dangers and concerns of opioid use/abuse. Opposing Opioid highlights concepts that
appear to be relatable and approachable for high school students. After assessing our survey to
our participated population, the data concludes that the curriculum should work to address some
of the beliefs and attitudes student have towards opioids such as how susceptible one is to
addiction and how dangerous they are. Many will find this curriculum helpful in their desire to
furthermore their knowledge about opioids and the consumption of opioids. It is crucial for the
Opposing Opioid curriculum to highlight areas of concerns, needs, and interests in an appropriate
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manner, being that high school students are the target population. Opposing Opioid strives to
bring value to students by providing up-to-date information and to instructors by providing tools
to successfully assess knowledge gained in measurable terms.
The Opposing Opioid curriculum is fueled by information from multiple sources and
influences. This dynamic curriculum provides information necessary to reduce the risk of opioid
misuse. The Opposing Opioid curriculum is intended to inform and educate teens about the
dangers of opioid abuse and misuse. This curriculum is designed to change attitudes and
behaviors. Youth can gain knowledge and skills to make educated and informed decisions which
can prevent and reduce the risk of prescription medication misuse. This curriculum influence
teens towards a healthy path and in return, these teens may influence others, those who may want
to engage in misuse behaviors. Participation in school programs has been associated with
reduced drug use (Cunha & Heckman, 2006) and criminal behavior (UCLA National Center for
Research on Evaluation, Standards and Student Testing, 2007) . The Opposing Opioid
curriculum is intended to avoid or delay opioid misuse, which benefits teens, their families and
communities. This educational curriculum can prevent communities from economic burden of
prescription opioids misuse and abuse.
Opposing Opioids is a curriculum which can be used for the benefit of all high school
students. This topic is relevant for teens living in and witnessing the nationwide opioid epidemic;
according to Strum and Pasquantonio (2017), “education programs that build students’ decision-
making skills and teach them about the dangers of opioid addiction” have contributed to the
decline of teens who misuse drugs. Opposing Opioids goal of raising awareness of the
prevalence of opioid abuse among high school students, risks associated with use, steps toward
prevention, and availability treatment options and locations will be achieved by presenting the
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five units of the curriculum (Health Risks Related to Opioid Use and Abuse, Understand Risk
Factors Associated with Opioid Use, Proper Prescription Use and Disposal, Refusal Skills,
Resources Available for Treatment and Prevention of Opioid Abuse) in a vertical sequence of
topics to help learners use previous unit knowledge to help guide learners in the following unit.
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Group Philosophy
Health can be defined as an overall sense of well-being from all aspects of one’s life. A
great number of factors can influence this sense of well-being. On an individual level, genetics,
communication skills, and behavior play a significant role on one’s health. On a community
level, one’s socioeconomic status, access to healthcare, relationships, and language barriers
greatly influence one’s overall health. Measurements of health are dependent upon the type of
health one is looking at. Physical health tends to be measured using clinical testing; for example,
using scans and blood tests are ways to prevent illnesses. Meanwhile, mental health is highly
dependent upon self-reports. Environmental health may be looked at using various models and
frameworks in order to look at any contributing factors, as well as current resources available.
Principles of the Ethical Practice of Public Health states “People depend upon the resources of
their natural and constructed environments for life itself. A damaged or unbalanced natural
environment, and a constructed environment of poor design or in poor condition, will have an
adverse effect on the health of people” (Public Health Leadership Society, 2002, para. 2).
Health education is the knowledge, behavior, attitudes, and skills gained from the
information provided by health educators. Health education is defined as “any combination of
learning experiences designed to facilitate voluntary actions conductive to health” (Auld &
Gambescia, 2011). Some topics that should be included in health education are infectious
diseases, substance and drug abuse, personal hygiene, and relationships, among others. Being
informed in these topics can help communities successfully become health literate in all aspects.
Health education is a key factor in preventing outbreaks and decreasing barriers. There is
evidence of a relationship between higher levels of maternal education and lower maternal
mortality (McAlister & Baskett, 2006). Health education should be intended for every one of all
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ages, gender, race, and religion. With the proper health education, mortality/morbidity rates can
change drastically.
The desire and motivation to be a health educator/health professional is to serve the
community. It is a meaningful career which allows one to mentor and provide academic support.
Targeting minority communities who experience health disparities is a major reason for entering
this field. Minority communities often experience disconnect to health services due to many
barriers, like language and cultural insensitivity. Being a voice for those who are unable to speak
up is a positive aspect of this field, which will help in closing disparity gaps within communities
who are most in need. Lastly, addressing diversity is imperative in this field to be able to connect
with individuals one may not have come across before. Empathizing, sympathizing, and learning
from others’ experiences and norms can help gain insight on how to help similar populations
while learning to be culturally competent. Also, interacting with a wide variety of populations
assists in learning to respect differences in thought. In health education, it is important to
understand cultural competence to be able to improve health care outcomes and quality of care,
which can contribute to the elimination of racial and ethnic health disparities.
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Justification
A. Survey of Experts and Curricular Resources
1. Learner Oriented Goals
Based upon the Survey of Experts and Curricular Resources, the learner oriented goals
for opioid abuse prevention among high school students are as follows:
According to Lorson, Meeting the HB 367 requirement for opioid abuse prevention
education, the goals for opioid abuse prevention among high school students are:
Goal #1: To develop the knowledge, skills, behaviors, and attitudes to prevent opioid and
prescription drug abuse.
Goal #2: Learn how to seek accredited information about prescription medication.
Goal #3: Learn how to deal with addiction problems.
Goal #4: Learn how to make healthier decisions.
According to the Action Guide to Address Opioid Abuse (Governor’s Cabinet
Opiate Action Team, 2017), the goals for opioid abuse prevention among high school
students are:
Goal #5: Help kids start conversations with caring adults.
Goal #6: Implement screening, brief interventions, and referral to treatment.
Goal #7: Understand who is at increased risk and target resources towards them.
According to Operation Prevention (Drug Enforcement Administration, &
Discovery Education, 2017), the goals for opioid abuse prevention among high
school students are:
Goal #8: Examine public health’s role in the opioid epidemic.

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Goal #9: Explore how opioid misuse has grown from an individual health issue to a
public health crisis to an epidemic.
Goal #10: Identify the ways the opioid epidemic impacts families and the community.
According to the Heroin and Opioid Awareness and Prevention Toolkit
(Maryland’s State Department of Education, 2017), the goals for opioid abuse
prevention among high school students are:
Goal #11: Understand the physical, psychological, social, and legal consequences of
opioids, including fentanyl and the factors that influence a person’s use of opioids.
Goal #12: Know how to apply appropriate strategies to intervene and help a friend or
family member.
According to Opioid Heroin Prevention Education School Youth Program
(Overdose Lifeline, Inc., 2018), the goals for opioid abuse prevention among high
school students are:
Goal #13: Raise awareness of the risk factors associated with misusing prescription
opioids.
Goal #14: Explain how misusing prescription opioids can lead to addiction, heroin use
and overdose.
Goal #15: Provide the student with skills to combat peer pressure, gain support, and
resources for making decisions about their own body and health.
2. Health Curriculum
Four different health education curricula focused on opioid abuse among high school
students are:
1. State of Ohio. (2017). The Health and Opioid-Abuse Prevention Education

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Curriculum. Retrieved from http://starttalking.ohio.gov/Schools/The-HOPE-
Curriculum
2. Drug Enforcement Administration, & Discovery Education. (2017). Operation
Prevention. Retrieved from https://www.operationprevention.com/
3. Overdose Lifeline, Inc. (2018). Opioid Heroin Prevention Education School Youth
Program. Retrieved from https://www.overdose-lifeline.org/opioid-heroin-
prevention-education-program.html
4. California Department of Education. (2003) Health Framework for California Public
Schools: Kindergarten through grade twelve. Sacramento, CA: US Department of
Education.
3. Community Resources
The three community resources for opioid abuse in high school students include:
a) Los Angeles Ambulatory Care Clinic (LAACC) VA Opioid treatment
Program
351 East Temple St.
Mail code 11-C,
Los Angeles CA, 90012-3328
(213)-253-2677
https://www.losangeles.va.gov
Contact Name: N/A
List and description of materials and services related to topic
Cost of materials/services
Restrictions: N/A
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b) Clear Treatment: Clear Detox Center
546 Hamilton Street
Costa Mesa, CA 92627
(949)-200-7555
http://www.cleartreatment.org
Contact name: N/A
Toll Free: 800-871-2020
Related Services:
- Help for Alcoholism
- Benzodiazepine Dependence
- Cocaine Addiction Treatment
- Meth Addiction Help
-Opiate Addiction Help
Cost of materials/services: N/A
Restrictions: N/A
c) Roots: Through Recovery
3939 Atlantic Ave, Suite 102
Long Beach, CA 90807
(855) 892-9379
https://roots-recovery.com/get-help-now/
Contact Name: N/A
Related services:
-Heroin Treatment
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-Opiate Treatment
-Stimulant Treatment
-Benzodiazepines
-Painkiller Treatment
Cost of materials/Services: N/A
Restrictions: N/A
B. Study of Contemporary Society and Learners
1. Prevalent Health Problems in Society
Based upon the Study of Contemporary Society and Learners, the prevalent health
problems in society related to opioid abuse include:
1. Addiction: In the United States, addiction to opioids is a serious issue with
approximately 2.1 million people suffering from addiction to prescription opioid
pain relievers and approximately 467,000 people suffering from addiction to
heroin (NIDA, 2014a).
2. Overdose deaths: Since 1999, unintentional overdose deaths from prescription
opioids have more than quadrupled (NIDA, 2014a).
3. Neonatal abstinence syndrome: According to the National Institute of Health,
“neonatal abstinence syndrome (NAS) is a group of problems that occur in a
newborn who was exposed to addictive opiate drugs while in the mother’s womb”
(2018). Rates of neonatal abstinence syndrome tripled between the years of 2000
and 2009 (NIDA, 2014a).

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4. Soft tissue infections: Contaminated injection sites may cause soft tissue
infections such as abscesses and cellulitis (Centers for Substance Abuse
Treatment, 2005).
5. Hepatitis A: Hepatitis A is more common among people who abuse drugs than
among the general public (Centers for Substance Abuse, 2005).
6. Hepatitis B: “Fifty to seventy percent of people who begin injecting drugs
contract hepatitis B within 5 years” (Centers for Substance Abuse, 2005).
7. Hepatitis C: Rates of Hepatitis C have quadrupled in young adults ages 18-29
from 2004 to 2014 following the trend of opioid abuse (CDC, 2017a).
8. HIV infection: Individuals who are injection drug users are 28 times more likely
to have HIV. As heroin and other opioid drugs are commonly injected, opioid use
is commonly attached to contraction of HIV (Henry, 2016).
9. Endocarditis: Endocarditis is a bacterial infection that should be checked for in
patients with recent injection marks (Centers for Substance Abuse, 2005).
10. Necrotizing Fasciitis: Necrotizing fasciitis is a flesh-eating bacteria that may be
introduced to the body via an injectatory needle (Centers for Substance Abuse,
2005).
2. Health Problems in the Population
Based upon the Study of Contemporary Society and Learners, the prevalent health
problems in high schoolers related to opioid abuse includes:
1. Commonly abused: Besides marijuana and alcohol, prescription drugs are the
most commonly abused drugs by Americans 14 and older (National Institute on
Drug Abuse [NIDA], 2018a).

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2. “Safer”: Many teenagers believe prescription are “safer” than street drugs. Some
reasons for this reasoning is because they are medications, are prescribed by
doctors or pharmacies, and are not necessary to buy from traditional “drug
dealers” (Drug Enforcement Administration [DEA], 2012).
3. Misuse: Teenagers misuse prescription drugs for a variety of reasons, which
include to get high, escape boredom, academic stress, or to stop pain (NIDA,
2018a).
4. Easy access: Many teens get prescription drugs they misuse from friends and
relatives; more than half of 12th graders who reported misusing prescription
opioids said they got the drugs from a friend or relative (NIDA, 2018a).
5. Prevalence: About one in five teens (17%) have reported using prescription drugs
at least once to get high (DEA, 2012).
6. Prevalence: Nearly one in ten teenagers (10%) report using pain medications
(OxyContin and Vicodin) to get high within the past year, while six percent report
using in the last 30 days to get high (DEA, 2012).
7. Risk of overdose: Seven out of ten teens who abuse prescription opioids combine
these medications with alcohol and/or other drugs, which puts them at a higher
risk of overdose. “Marijuana and alcohol were the most common (58.5% and
52.1%), followed by cocaine, tranquilizers, and amphetamines (10.6%, 10.3%,
and 9.5%)” (NIDA, 2013).
8. Exposure: Teenagers who are spending a lot of time on social media are more
likely to use drugs, smoke cigarettes, and drink alcohol. “The survey of 12 to 17
year olds found that 70% spent time on social networking sites. Of the 70%, 40%
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have seen pictures on the sites of teens getting drunk, passed out, or using drugs.
Half of these teens saw these pictures when they were 13 years of age or younger;
90% saw them when they were 15 or younger” (DEA, 2012).
9. Researching effects: The internet is used by many teenagers to research how
these drugs feel, how much of a drug they can take, what combinations work well,
and what they are supposed to experience (DEA, 2012).
10. Risk factors: There are many factors which can increase a teenagers risk for
abusing opioids. These can include acute and chronic pain, history of mental
illness, physical health problems, witnessing an overdose, and having friends who
abuse these kinds of drugs (U.S. Department of Health & Human Services, 2017).
3. Religious, Cultural, and/or Ethnic Beliefs
a. Religious belief:
There is a relationship between religion and opioid abuse. Specifically
according to a study done by Puffer, Skalski, and Meade (2012), found a
relationship between religious coping and opioid use. Religious coping in known
as the main resource affecting how individuals cope with stressors. “Positive
religious coping is thought to be associated with benefits in psychosocial
adjustment, meanwhile negative religious coping leads to poorer consequences
and in therefore considered maladaptive.” They found that increased positive
religious coping was associated with less frequent opioid use prior to inpatient
treatment and a history of 12-step participation. They found that the reduction in
in negative religious coping predicted less opioid use after discharge and more
positive religious coping was associated with more frequent participation in 12-
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step programs as well. Results concluded that increased positive religious coping
was associated with less frequent opioid use and more frequent 12-step
participation, and decreased negative religious coping was associated with less
relapse. Religious coping had a great impact in treatment outcome.
b. Cultural and/or ethnic group beliefs:
There is a relationship between ethnic beliefs of high school students who
use opioids for “pain relief” and other motives to use prescription opioids on their
own is not dangerous. Teens do not see the risk in using prescription medication
on their own. Teens tend to mix drugs without knowing the consequences and
health risks. Their belief is that they will not be victims of addiction by taking a
few pills for pain without a prescription from a health provider. Teens are
unaware of risks to physical, and mental health due to prescription medication
use. According to a study done by McCabe, Boyd, Cranford, and Teter, “ There
are health risks to those who use prescription opioids on their own, without a
physician’s order, regardless of motive. Nonmedical users of prescription opioids
do not benefit from clinical assessments and monitoring nor do they receive
important medical information that accompanies appropriate pain management.
Thus, nonmedical users are likely unaware of the medication’s proper use,
contraindications, or potential for interaction with other drugs” (McCabe, Boyd,
Cranford, and Teter, 2009).
4. Myths and Facts
MYTH #1: Opioid addiction is just a psychological disorder and people who are
dependent simply need better willpower. (Chen, 2017)

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FACT: Opioid addiction is in fact not just a psychological disorder. For instance, opioid
users who are prescribed medication for pain relief can simply build up tolerance over
time and when they are off of the medication they can experience major withdrawal
symptoms. These symptoms alone are not considered to be a disorder. Many mistaken the
fact that opioid addiction is a sign of weakness and lack of willpower but it’s not exactly
the case. When we have someone who is highly addicted to opioid use, there will be a
result in alteration of brain functions. It tricks the brain into pleasure and reward cycle
that causes that addictive use of opioid.
MYTH #2: The best way to combat an opioid addiction is without medication.
(Chen, 2017)
FACT: Although the idea of combating opioid addiction without use of medication
sounds nice, it actually isn’t an effective method to approach sobriety. Research have
shown that the right treatment(s) for opioid users include medication and counseling.
Two popular medications used are buprenorphine and methadone. Both of these
medication can act as a blocker for receiving the “high” that some opioid users crave.
Surprisingly most users actually don’t use opioids for the “high” but instead to avoid
withdrawal symptoms such as vomiting, cramping, insomnia, body aches and etc. These
two opioid agonist, help patients become less addictive to the drug and prevent them
from getting withdrawal symptoms. Buprenorphine and methadone medications has
proved to be effective in treatment programs directed to opioid users.
MYTH #3: It’s ok if we call people with opioid use disorder “addicts,” “users,” or
“junkies.” (Chen, 2017)

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FACT: Calling people with an addiction names such as “addicts,” “users,” or “junkies”
can leave a negative impact. People with opioid use disorder should not be defined by
their addiction/disease. Using such negative terms can create barriers for these users to
seek treatment and that’s not what we want. Users should feel encouraged to seek help
and to focus on measurable changes;rather then feeling threaten to approach the idea of
professional help and or treatment.
MYTH #4: Addiction to prescribed opioids occurs only in patients who are already
addicts. (Berman, 2018)
FACT: Unfortunately this is not true, addiction to prescribed opioids can happen to
anyone and not just patients who are already addicted. Having personal or family history
of addiction does not mean you have a higher chance of addiction and vice versa. People
who have no trace of opioid abuse can actually end up becoming addicted through their
doctor’s prescription. It is important to correctly get prescribed and identify any peculiar
indications and signs of addiction early on.
MYTH #5: Opioids are the most effective drugs for chronic pain. (Berman, 2018)
FACT: Opioids are in fact not the best drug form to reduce chronic pain. Using opioids
to reduce pain can increase the users tolerance which results in addiction. There are better
methods such as acupuncture or simply exercising and other forms of therapies that can
help with this problem.
5. Physical, Mental-Emotional, Social, Growth/Development, and Learning
Characteristics
a. Physical growth and development characteristics:

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According to Sutter Health (2013), the physical growth and development
characteristics of high school students include:
Girls: Typically, girls reach the peak of their physical
development. During this time, many struggle with their weight and
experience the release of hormonal activities.
Boys: Adolescent boys during this period, they have not fully reach their
full physical development. Some knowledgeable changes include facial
hair, lowering of the voice, and increase in muscle and or height growth
spurt. Both will experience a trigger in sexual arousal and will be intrigued
with the concept.
b. Mental/emotional characteristics:
According to Sutter Health (2013), the mental/emotional characteristics of high
school students including teen boys and girls will often have them feel unassured
and constantly peer pressured; whether it be succeeding in school, fitting in with
their peers, and etc. Teens also often feel sadness or depression and should
definitely reach out if it last more than two weeks. The emotional strain on the
pressure of succeeding in school while fitting in with their peers can affect their
attitudes and behaviors.
c. Social characteristics:
According to Sutter Health (2013), the social characteristics of high school
students including teen boys and girls prefer to spend less time with their families
and more time alone or with their friends. They usually find embarrassment from
the interactions with their family members and not with friends from school.Some
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teens will try to find peers according to similar interests. Use of and
acknowledgement of alcohol,tobacco, and other drugs are common and will often
typically contribute to occasional participation especially during social gatherings.
d. Learning characteristics:
According to Sutter Health (2013), the learning characteristics of high school
students including both teen boys and girls improving their overall skill in
organization. During this time, it is crucial for teens to begin thinking about their
future plans after high school. At the same time for some teens, they struggle to
think before they act and this results in making the wrong decision. Teenagers are
constantly trying to learn how to adapt quickly to certain situations and gain more
insight about themselves and the world around them.
6. Needs and Interests (5N+5I)
a. Topics students are interested to know are:
1. The risk factors for nonmedical use of opioids and heroin use particular to their age group
(Palamar, Shearston, Dawson, Mateu-Gelabert, & Ompad, 2016)
2. How careful assessment, appropriate prescribing, monitoring, and referral for substance
abuse treatment when indicated can reduce addiction among their age group (Mccabe,
West, & Boyd, 2013).
3. Education aimed at preventing nonmedical use & learning how to safely store, secure,
and dispose of prescribed opioids (Mccabe et al., 2013).
4. Reducing the amount of leftover prescribed medication from previous prescriptions,
which is a major contributing factor for nonmedical use of prescription opioids among
high school seniors in the United States (Mccabe et al., 2013).

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5. Reducing the amount of “experimentation” of opioids, which can increase odds of
lifetime heroin use (Palamar et al., 2016).
b. The health interests for opioid abuse among high school students are:
1. Prevention efforts to divert students from engaging in non-medical use of prescription
opioids in order to prevent possible future heroin use (Palamar et al., 2016).
2. Prevention efforts that consider race/ethnicity (Palamar et al., 2016).
3. How to help a friend who may be becoming addicted (Palamar et al., 2016).
4. Reducing the use of prescription opioids among students with higher income (Palamar et
al., 2016).
5. Steps they can take to prevent addiction (Palamar et al., 2016).
7. Survey of Health Needs and Interests of Target Population
a. Needs assessment survey: For survey see Appendix
Frequency of Responses
Total number of surveys: 13
Age: 15 n= 1 Gender: Males n= 9
16 n= 3 Females n= 4
17 n= 7
18 n= 2
Do you think your community members know how to safely dispose of prescription drugs?
Yes n= 2
No n= 11
Are you familiar with what opioid drugs are?
Yes n= 11
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No n= 2
Do you know anyone who has used opioids for other than prescribed use?
Yes n= 9
No n= 4
How much of a problem do you think opioid abuse is in your community?
Big problem n= 3
Average problem n= 8
Small problem n= 2
Not a problem at all n= 0
Are there any places in or around your community where people can get treatment for a drug
abuse problem?
Yes n= 1 Name(s) of Reported Place(s): Balboa Horizon
No n= 12
I feel confident in refusing opioids from my peers.
Strongly Agree n= 1
Agree n= 5
Neutral n= 3
Disagree n= 3
Strongly Disagree n= 1
Is it very easy to obtain opioids that are not prescribed to me.
Strongly Agree n= 3
Agree n= 6
Neutral n= 2
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Disagree n= 1
Opioids make you feel good.
Strongly Agree n= 3
Agree n= 7
Neutral n= 2
Disagree n= 1
Opioid abuse is common.
Strongly Agree n= 0
Agree n= 10
Neutral n= 2
Disagree n= 1
Risk of addiction to opioids is low.
Strongly Agree n= 0
Agree n= 4
Neutral n= 0
Disagree n= 8
I feel pressured to try opioids.
Strongly Agree n= 1
Agree n= 2
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Neutral n= 2
Disagree n= 7
It is dangerous to take prescription drugs for non-medical purposes.
Strongly Agree n= 4
Agree n= 4
Neutral n= 2
Disagree n= 1
Summary of Findings
A health needs assessment survey was conducted to determine the needs of high school
students aged 15-18 in relation to opioid abuse prevention. The data collected from this survey
will be used when developing a health education curriculum for high school students.
The health needs assessment survey was completed by 13 students attending Millikan
High School in Long Beach. These participants ranged from 15 to 18 years old. More males
(n=9, 69%) than females (n=4, 31%) participated in the survey. Seventeen students declined to
take the survey.
This survey was administered on March 2, 2018 outside of Millikan High School.
Students were asked if they were willing to help with a school assignment. If they agreed, they
were asked to anonymously fill out a paper survey. Paper surveys were collected and inputted
into excel.
According to the survey, a majority of the students (n=11, 85%) believed that community
members do not know how to properly dispose of prescription drugs. A majority of the students
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(n=11, 85%) said they were familiar with what opioid drugs were and another majority (n=9,
69%) stated they knew someone who had used opioids for other than prescription use. All of the
students surveyed (n=18) believed that opioid abuse in their community was an issue, but the
extent of the issue varied. While only 23% believed opioid abuse was a big problem, 62%
believed it was an average problem, and 15% believed it was only a small problem. Of the 13
students surveyed, only 1 was aware of any available resources for drug abuse problems.
When questioned on their beliefs towards various opioid related statements, some
answers varied greatly. For example, when asked how comfortable they felt refusing opioids
from their peers, 8% strongly agreed, 38% agreed, 23% were neutral, another 23% disagreed,
and another 8% strongly disagreed. On the other end, when asked if they believed opioid drugs
could be obtained easily, 69% stated they either agreed or strongly agreed. Participants were then
asked if they believed opioids make you feel good and 77% agreed or strongly agreed. When
asked if opioid abuse is common a strong 77% said they agreed that it was. When asked whether
they believed risk of addiction to opioids was low, a majority (62%) said they disagreed. This
was followed by a varied response in whether they felt pressured to try opioids. Of the
participants, 8% said they strongly agreed, 15% said they agreed, 15% said they felt neutral, 54%
said they disagreed, and 8% said they strongly disagreed. Lastly, participants were asked if they
felt it was dangerous to take prescription drugs for non-medical purposes. A majority (62%) did
either strongly agree or agree that it was dangerous, yet nearly one-fourth (23%) of the
participants stated that they disagreed or strongly disagreed.
Overall, the survey indicated various areas that should be addressed within the health
education curriculum. First of all, the curriculum should address how easy it is for opioids to be
obtained. It also became apparent that the curriculum should work to address some of the beliefs
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and attitudes student have towards opioids such as how susceptible one is to addiction and how
dangerous they are. Lastly, although not a majority, a significant amount of students felt
pressured to try opioids suggesting the curriculum should involve drug refusal skills.
C. Foundations Factors, Laws, Mandates, Codes or Initiatives
1. As reported by SAMHSA, the Opioid State Targeted Response (STR) grants, a two year
program authorized by the 21st Century Cures Act (P.L. 114-255).
a. This measure provides $485 million to states and U.S. territories in fiscal year 2017,
and the program allows states to focus on areas of greatest need, including increasing
access to treatment, reducing unmet treatment need, and reducing opioid overdose related
deaths through the provision of the full range of prevention, treatment and recovery
services for opioid disorders. The President’s budget requests $500 million for this
program in fiscal year 2018, the full level authorized by congress.
b. This measure could affect a curriculum on opioid abuse/overdose in a positive way
among high school students by making more resources available to them for prevention
and treatment.
c. Based on this measure, topics of a curriculum on opioid abuse/overdose among high
school students should include the awareness of different resources available to them
within their community for opioids. The increased awareness of different resources will
help students in a positive way.
2. As reported by California Legislature, AB-182 Heroin and Opioid Public Education
(HOPE) Act was approved in 2017.

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a. This measure requires the State Department of Health to develop a comprehensive
education program on heroin and opioid abuse to help the public identify danger signs
and find the resources to get needed help.
b. This measure could affect a curriculum on opioids among high schools in a positive way
by providing a framework for teacher to include this educational program in their
teaching curriculum for student to be well informed.
c. Based on this measure, topics of a curriculum on the dangers of opioids and recognition
of opioids key danger signs would increase reduction of accidental overdoses in high
schools and the knowledge of resources and how to find them will reduce incidence of
opioid abuse/overdose among high school students.
D. Summary
1. Summarize
The survey and curricula resources stress the need for information to increase the
knowledge and awareness of the risks related to opioid use in high school populations. Some of
the important concepts include health risks, consequences, resources available, and
understanding social risks factors that increase opioid use. Other concepts include providing
knowledge and skills to change behaviors and attitudes to prevent opioid and prescription drug
abuse.
The Health and Opioid-Abuse Prevention education curriculum (HOPE, 2017) was
developed to meet the requirements of House Bill 367. The HOPE curriculum is compiled of a
series of lessons, assessments and learning activities to develop students’ functional knowledge,
attitudes and necessary skills to prevent drug use. This curriculum is design to cover K-12. The
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high school curriculum includes 11 lessons to be covered in health education during a drug abuse
prevention unit.
There are many community resources available to adolescents. Some include Los
Angeles Ambulatory Care Clinic (LAACC), the Clear Treatment: Clear Detox Center, and Roots
Through Recovery. All provide opioid education, prevention, and treatment. These programs are
available to adolescents who need help.
The study of contemporary society and learners revealed that prevalent health problems
in society related to opioid abuse include addiction, overdose deaths, Neonatal abstinence
syndrome, soft tissue infections, Hepatitis, HIV infection, and Endocarditis. Health problems
within the population that are attributed to opioid use include commonly abused, “safer”, misuse,
easy access, prevalence of exposure, risk of overdose, exposure through media, researching
effects, and risk factors associated particular to youth. The opioid crisis continues to increase and
youth are particularly at risk because of the lack of awareness and knowledge. There are many
resources available but schools, teachers, and students need to be active and seek resources.
The opioid crisis conflicts with cultural and religious belief. According to Puffer,
Skalski, and Meade (2012), there is a correlation between positive religious coping and the
reduction of opioid use and the increase participation in the 12-step program. In the high school
population, there is a cultural belief that self-prescribing is not dangerous, which is incorrect.
Self-prescribing increases health risks and the risk of overdose.
There are many myths and misconceptions regarding opioid use, some being addiction is
a psychological disorder and people who suffer from addiction need more willpower, combating
opioid addiction without medication is effective, and the normalizing of calling addicts junkies.
These myths have detrimental effect on individuals who are experience addiction. Addiction is a
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disease, yet these myths continue the stigma and negative perceptions of substance abuse. This
stigma can potentially harm the addict even more, and may result in more drug use and to not
seek treatment.
Adolescents go through many changes during this time period. Physically, boys and girls
go through characteristic changes in high school. Mentally, they constantly feel peer pressure,
which causes stress. Socially, they are in their rebellious years, where friends are more important
than family. Learning wise, they should improve their organizational and critical thinking skills,
which will improve their success in college.
The survey on opioids was a useful assessment; it was insightful to learn more about
attitudes in high school students toward opioids. The survey indicated various areas that should
be addressed within the health education curriculum. First of all, the curriculum should address
opioid easy access, beliefs and attitudes student have towards opioids, and refusal skills because
significant amount of students felt pressured to try opioids.
The Opioid State Targeted Response (STR) grants, a two year program authorized by the
21st Century Cures Act (P.L. 114-255), is a measure that provides funding to opioid reduction
programs, Thus funding allows states to focus on areas of greatest need, including increasing
access to treatment, reducing unmet treatment need, and reducing opioid overdose-related deaths
through the provision of the full range of prevention, treatment and recovery services for opioid
disorders. Heroin and Opioid Public Education (HOPE) Act is a measure that requires the State
Department of Health to develop a comprehensive education program on heroin and opioid
abuse. These laws were created to help address the opioid crisis in California.
2. Important topics
Findings suggest the following five topics should be included in the curriculum:
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A. Health Risks Related to Opioid Use and Abuse
B. Understand Risk Factors Associated with Opioid Use
C. Proper Prescription Use and Disposal
D. Refusal Skills
E. Resources Available for Treatment and Prevention of Opioid Abuse
3. Inclusive goal statement, Based on the Justification is:
Goal: To raise awareness of the prevalence of opioid abuse among high school students,
risks associated with use, steps toward prevention, and availability treatment options and
locations.
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Scope and Sequence

1. Goal: To raise awareness of the prevalence of opioid abuse among high school students,
locations.
A. Unit I: Health Risks Related to Opioid Use and Abuse
a. Unit Objective: Upon completion of the unit, the learner will be able to recognize health risks
related to opioid use/abuse. (Cognitive, Remembering)
b. Instructional Objectives: By the end of the lesson, the learner will be able to…
1. List two health risks of long-term opioid use/abuse. (Cognitive, Remembering)
2. Provide three examples of signs of an overdose. (Affective, Responding)
3. Present five symptoms of opioid use/abuse. (Affective, Responding)
4. Describe two side effects of opioid use/abuse that affects the body. (Cognitive, Remembering)
5. Explain one reason why one might choose to consume opioid for their health. (Cognitive,
Applying)
6. Demonstrate the ability to identify three different opioids. (Psychomotor, Precision)
7. Explain one reason why opioids are addictive. (Cognitive, Applying).
8. Discuss two different types of opioids that are commonly misused. (Cognitive,
Understanding)
B. Unit 2: Understand Risk Factors Associated with Opioid Use
a. Unit Objective: Upon completion of the unit, the learner will be able to examine behaviors
which can increase the use of opioids.
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9. Identify personal risk factors which may increase the likelihood of drug abuse. (Affective,
Organizing)
10. Argue the reasons why the opioid epidemic is primarily affecting the White population of the
United States. (Affective, Valuing)
11. Summarize populations with a higher risk of opioid misuse. (Cognitive, Understanding)
12. Provide examples of how individuals with substance abuse disorders are at higher risk for an
opioid overdose. (Affective, Responding)
13. Justify how prescription opioid use is a risk factor for heroin use. (Cognitive, Evaluating)
14. Investigate how higher rates of prescribed opioids can lead to abuse of opioids. (Cognitive,
Evaluating)
15. Relate how obtaining prescriptions from multiple providers can lead to abuse of opioids.
(Cognitive, Analyzing)
16. Develop methods to reduce risk factors among high-risk populations. (Psychomotor,
Articulation)
C. Unit 3: Proper Prescription Use and Disposal
a. Unit Objective: Upon completion of the unit, the learner will be able to summarize proper
prescription use including disposal. (Cognitive, Understanding)
17. Identify proper dosage amounts on prescription labels. (Cognitive, Remembering)
18. List three aspects of a prescription label. (Cognitive, Remembering)
19. Explain one importance of properly reading prescription labels. (Cognitive, Understanding)
20. Criticize one issue with current prescription label formatting. (Affective, Valuing)
21. List two ways to dispose of prescription drugs properly. (Cognitive, Remembering)
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22. Explain one reason why proper prescription disposal is important. (Cognitive,
Understanding)
23. Identify one local prescription disposal site. (Cognitive, Remembering)
24. Practice safely disposing of prescription drugs. (Affective, Internalizing Values)
D. Unit 4: Refusal Skills
a. Unit Objective: Upon completion of the unit, the learner will be able recall the importance of
refusal skills to reduce, prevent, and avoid drug use. (Cognitive, Remembering)
25. List the five steps of refusal skills. (Cognitive, Remembering)
26. Analyze two strategies to resist unhealthy choices. (Cognitive, Analyzing)
27. Recognize at least one risky situation that requires strong refusal skills. (Cognitive,
Remembering)
28. Discuss two non-verbal measures of refusing prescription drugs. (Affective, Receiving)
29. Repeat three verbal measures for refusing prescription drugs. (Psychomotor, Imitation)
30. Construct three go-to refusals to never get caught off guard. (Psychomotor, Naturalization)
31. Act out one ‘triggered’ conversation to feel prepared to say no under peer pressure.
(Affective, Internalizing Values)
32. Create one poster to advocate the use of refusal skills. (Cognitive, Creating)
E. Unit 5: Resources Available for Treatment and Prevention of Opioid Abuse
a. Unit Objective: Upon completion of the unit, the learner will be able to justify the importance
of local resources available to teen in their community to treat, prevent, and educate about the
use/misuse of prescription drugs. (Cognitive, Evaluating)
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33. List two local treatment facilities for opioid abuse. (Cognitive, Remembering)
34. Repeat one national helpline phone number for substance abuse. (Psychomotor, Imitation)
35. List signs and symptoms of addiction. (Cognitive, Remembering)
36. Summarize one reason it is important to find networks of support. (Cognitive,
Remembering)
37. Discuss three benefits associated with seeking professional treatment for opioid abuse.
(Affective, Receiving)
38. Criticize the weaknesses of one prevention program. (Affective, Valuing)
39. Investigate barriers for reasons why an individual would not seek treatment. (Cognitive,
Evaluating)
40. Create a poster ad that promotes opioid users/abusers to seek treatment. (Affective,
Responding)
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Content Outline
locations.
Unit Objective: Upon completion of the unit, the learner will be able to recognize health
risks related to opioid use/abuse. (Cognitive, Remembering)
Instructional Objectives: By the end of the lesson, the learner will be able to…
4. Describe two side effects of opioid use/abuse that affects the body. (Cognitive,
Remembering)
5. Explain one reason why one might choose to consume opioid for their health.
(Cognitive, Applying)
6. Demonstrate the ability to identify three different opioids. (Psychomotor,
Precision)
Understanding)
1. List two health risks of long-term opioid use/abuse. (Weber, 2017)
a. Hormonal dysfunction: This causes hormonal effects that can affect the
menstrual period, fertility, as well as sex drive.

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b. Immunosuppression: This causes your immune system to become weak that
could potentially lead to infections, cancer, HIV, etc.
2. Provide three examples of signs of an overdose. (Harm Reduction Coalition, 2018)
a. Loss of consciousness
b. Unresponsive to outside stimulus
c. Awake, but unable to talk
3. Present five symptoms of opioid use/abuse. (American Addiction Centers, 2018)
a. Nausea
b. Muscle cramping
c. Depression
d. Anxiety
e. Agitation
4. Describe two side effects of opioid use/abuse that affects the body. (Weber, 2017)
a. Gastroparesis: Paralysis of the gastrointestinal tract that slows the movement of
food
b. Muscle rigidity: Muscles stay contracted and is unable to relax normally.
5. Explain one reason why one might choose to consume opioid for their health. (Weber,
2017)
a. A reason for someone to choose to consume opioid for their health could be for
chronic pain. The use of opioids can relief the pain that they’re feeling.
6. Demonstrate the ability to identify three different opioids. (Utah Department of
Health, 2016)
a. Oxycodone/ Acetaminophen
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b. Codeine
c. Alternative form
d. Acetaminophen (Tylenol®)
7. Explain one reason why opioids are addictive. (Utah Department of Health, 2016)
a. One reason why opioids are addictive is because our body will build tolerance
for it over time.
8. Discuss two different types of opioids that are commonly misused. (The National
Center on Addiction and Substance Abuse, 2017)
a. Codeine:
Examples: (commercial and street names): Empirin with Codeine, Fiorinal with
Codeine, Robitussin A-C, Tylenol with Codeine: Captain Cody, Cody, schoolboy
b. Morphine:
Examples: (commercial and street names): Roxanol, Duramorph, M, Miss Emma,
monkey, white stuff
B. Unit II: Understand Risk Factors Associated with Opioid Use
Unit Objective: Upon completion of the unit, the learner will be able to examine
behaviors which can increase the use of opioids.
9. Identify personal risk factors which may increase the likelihood of drug abuse.
(Affective, Organizing)
10. Argue the reasons why the opioid epidemic is primarily affecting the rural
population of the United States. (Affective, Valuing)

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11. Summarize populations with a higher risk of opioid misuse. (Cognitive,
Understanding)
12. Provide examples of how individuals with substance abuse disorders are at
higher risk for an opioid overdose. (Affective, Responding)
13. Justify how prescription opioid use is a risk factor for heroin use. (Cognitive,
Evaluating)
14. Investigate how higher rates of prescribed opioids can lead to abuse of
opioids and other drugs. (Cognitive, Evaluating)
15. Relate how obtaining prescriptions from multiple providers can lead to abuse
of opioids. (Cognitive, Analyzing)
16. Develop methods to reduce risk factors among high-risk populations.
(Cognitive, Create)
A. Identify personal risk factors which may increase the likelihood of drug abuse.
(SAMHSA, 2016)
a. Age
b. Education
c. Income
d. Health
e. Psychosocial problems
B. Argue the reasons why the opioid epidemic is primarily affecting the rural
population of the United States. (USDA, 2018)
1. When there is a lack of treatment options in a rural area, alternatives like
physical therapy are out of the question and drugs are a prime option.
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2. Medication-assisted treatment is rare in these areas.
3. Jobs like manufacturing, farming and mining, tend to have higher injury
rate, which can lead to more pain and use of painkillers.
C. Summarize populations with a higher risk of opioid misuse. (WHO, 2018)
1. Populations with high risk of misuse and abuse include people:
 with opioid dependence
 who inject opioids
 who use prescription opioids
 who combine opioids with other sedatives
 who use opioids and have medical conditions such as HIV, liver or
lung disease
 suffer from depression
 with household members that possess opioids or prescription opioids
D. Provide examples of how individuals with substance abuse disorders are at higher
risk for an opioid overdose. (WHO, 2018)
1. Combining opioids with alcohol and sedative medication increases the
chance of dying.
2. Combinations of opioids, alcohol and sedatives usually are found in
overdoses that kill individuals.
3. People who are dependent on opioids are more likely to succumb to an
overdose.
4. Drug addiction is a brain disorder. Not everyone who uses drugs will
become addicted. The effects of addiction range from individual to individual.

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E. Justify how prescription opioid use is a risk factor for heroin use. (Muhuri et al,
2013)
1. The incidence of heroin was 19 times higher among those who reported
prior nonmedical pain reliever use than those who did not.
2. A number of studies have suggested people transitioning from prescription
opioids abuse to heroin cite that heroin is cheaper while providing a better high.
3. About four to six percent who abuse prescription opioids will eventually
switch to heroin.
F. Investigate how higher rates of prescribed opioids can lead to abuse of opioids.
(CDCb, 2017)
1. The amount of opioids prescribed in the United States began to decrease in
2011. However, in 2015, it remains approximately three times as high as in 1999,
and about four times as high than prescription rates in Europe.
2. Sales of prescription opioids in the U.S. nearly quadrupled from 1999 to
2014, but the amount of pain people are in has not changed.
3. There is not enough evidence to prove that opioids improve chronic pain,
function, and quality of life.
4. Using opioids for a long period of time can be linked to abuse and
overdose.
G. Relate how obtaining prescriptions from multiple providers can lead to abuse of
opioids. (NIDA, 2014b)
1. One out of every 143 U.S. patients who was prescribed an opioid in 2008
obtained them from multiple doctors.

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2. While these “doctor shoppers” were only 0.7 percent of patients with
opioid prescriptions, they were prescribed two percent of all prescribed opioids.
H. Develop methods to reduce risk factors among high-risk populations. (NIDA, 2018b)
1. Using the National Institute of Health’s five priority areas, students can
create their own ideas for methods to reduce risk factors.
Five Priority Areas:
1. Improve access to treatment and recovery services
2. Promote use of overdose-reversing drugs
3. Strengthen understanding of epidemic through better public health
surveillance
4. Provide support for cutting-edge research on pain and addiction
5. Advance better practices for pain management
C. Unit III: Proper Prescription Use and Disposal
Unit Objective: Upon completion of the unit, the learner will be able to summarize
proper prescription use including disposal. (Cognitive, Understanding)
17. Explain one importance of properly reading prescription labels. (Cognitive,
Understanding)
18. Identify proper dosage amounts on prescription labels. (Cognitive,
Remembering)
19. List three key points of information on a prescription label. (Cognitive,
Remembering)
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20. Criticize one issue with current prescription label formatting. (Affective,
Valuing)
21. List two ways to dispose of prescription drugs properly. (Cognitive,
Remembering)
Understanding)
24. Practice safely disposing of prescription drugs. (Affective, Internalizing
Values)
A. Explain one importance of properly reading prescription labels. (Queensland
Government, 2017)
1. Directions- All medications come with directions for use and they should
be read. These directions tell one when or how frequently the medication
should be taken. They also tell one how much of the medication should be
taken and for how long. Following these directions may be essential to the
effectivity of the medication. Taking the wrong dosage of a medication or
taking it longer than intended for can be harmful to the body. Every
medication is different so it is essential to read the directions and contact a
pharmacist or doctor for anything you don’t understand.
2. Warnings- Medications can have numerous side effects associated with
them. The warning section included on prescription labels or the
instructions leaflet list these side effects, as well as what to do if one
occurs. The warnings should also include things one shouldn’t do while
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taking the medication. For example, certain medications should not be
combined with alcohol as it may alter the effects of the medication.
3. Expiration Date- Using medications past their expiration date may not
only be ineffective in treatment, but can lead to unwanted and potentially
dangerous side effects.
B. Identify proper dosage amounts on prescription labels. (Queensland Government,
2017)
1. Proper dosage amounts will be written below the patient’s name and drug
name
a. Ex: Take two tablets every four to six hours for pain
C. List three key points of information on a prescription label. (Queensland Government,
2017)
1. How often the medication should be used or what time(s) it should be
taken
2. How much medication should be taken and for what time duration
3. Side effects associated with the medication
4. Warnings against things that should not be done while taking the
medication
5. The expiration date of the medication
D. Criticize one issue with current prescription label formatting. (Jeetu & Girish, 2010)
1. The Institute of Medicine reported that poor labeling on prescription drugs
is a main cause for medication errors in the U.S.

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a. Formatting on prescription labels is most frequently
adjusted to highlight the information most valuable to the
pharmacists.
i.Eighty-four percent of the time, pharmacy names or logos
are the largest item on a prescription label.
ii.Font sizes consistently decrease for medication
instructions, medication names, and warning and
instruction sticker.
(LaRue, 2005)
E. List two ways to dispose of prescription drugs properly. (FDA, 2018)
1. Optimal disposal of prescription drugs involves turning them in to an
authorized drug collector site for disposal.
2. You may dispose of medication in a household trash.
3. Although not optimal, some medications may be flushed down the toilet.
F. Explain one reason why proper prescription disposal is important. (FDA, 2018)
1. Disposal of unused prescriptions is important in reducing the rates of
accidental exposure or intentional misuse.
2. Disposal through sanitation system may lead to groundwater causing soil
contamination.
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G. Identify one local prescription disposal site. (National Community Pharmacists
Association, 2018)
1. Walgreens
3339 E Anaheim St.
562-597-5338
2. The Medicine Shoppe
17623 Pioneer Blvd.
Artesia, CA 90701
(562) 402-1000
3. Golden Cove Pharmacy
31238 Palos Verdes Drive West
Rancho Palos Verdes, CA 90275
H. Practice safely disposing of prescription drugs. (FDA, 2018)
1. Optimal disposal of prescription drugs involves turning them in to an
authorized drug collector site for disposal.
a. The U.S. Drug Enforcement Administration, as well as
other local law enforcement agencies, host medicine take-back
programs that help communities safely dispose of prescription
drugs.
2. You may dispose of medication in a household trash.
b. To dispose of medications in a household trash:

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i.Mix the medication with an unpalatable substance such as
dirt, kitty litter, or used coffee grounds
ii.Place the mixture in a container
iii.Throw in to the household trash
iv.Scratch out all personal information on the empty pill bottle
before throwing it out
3. Although not optimal, some medications may be flushed down the toilet.
c. Certain medications can be extremely harmful or deadly if taken
by anyone they are not prescribed to. If other disposal options are
not available, they may be flushed down the toilet.
D. Unit IV: Refusal Skills
Unit Objective: Upon completion of the unit, the learner will be able recall the
importance of refusal skills to reduce, prevent, and avoid drug use. (Cognitive,
Remembering)
25. List the 5 steps of refusal skills. (Cognitive, Remembering)
27. Recognize at least one risky situation that requires strong refusal skills.
(Cognitive, Remembering)
28. Discuss two non-verbal measures of refusing prescription drugs. (Affective,
Receiving)
29. Repeat three verbal measures for refusing prescription drugs. (Psychomotor,
Imitation)
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30. Construct three go-to refusals to never get caught off guard. (Psychomotor,
Naturalization)
31. Act out one ‘triggered’ conversation to feel prepared to say no under peer
pressure. (Affective, Internalizing Values)
A. List the 5 steps of refusal skills. (UEN, 2004)
Step 1: Ask Question to assess the situation
Step 2: Explain the trouble of involvement
Step 3: Explain the Consequences (“If i do that…”)
Step 4: Advocate an Alternative activity ( “instead why don’t we…”)
Step 5: Leave the situation or Sell the alternative and maintain the
relationship. (“if you change your mind..”)
a. Analyze two strategy to resist unhealthy choices. (CMICH, 2009)
1. “Know the facts.”
2. Search consequences that can occur if actions are taken
3. Differentiate between “right” and “wrong.”
4. “Recognize the positive and negative influences that pressure you.”
5. “Stand up to negative peer pressure.”
6. Have friends who support healthy choices
B. Recognize at least one risky situation that requires strong refusal skills.
(Recovery, 2017)
When you find yourself in a “using: environment”- when you find yourself in a
situation in which people around you are offering you drugs or are using drugs,
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It’s okay to leave without saying anything. The most important thing is to leave
and keep your sobriety.
C. Discuss two non-verbal measures of refusing prescription drugs. (Department of
Health, 2003)
1. Make a direct eye contact with the other person to increase the
effectiveness of your message
2. Stand or sit up straight to create a confident air.
D. Repeat three verbal measures for refusing prescription drugs. (Department of
Health, 2003)
1. Use a clear, firm, confident and unhesitating tone of voice.
2. “No” should be the first word out of your mouth. A direct statement is
more effective when refusing the offer.
3. Change the subject to something else to avoid getting involved in a drawn
out debate about using.
E. Construct three go-to refusals to never get caught off guard. (CMICH, 2009)
1. Say a direct “No”
2. Say the same phrase over and over again, such as “no thank you. I don’t
want to”
3. Walk away and say “I will see you tomorrow”
F. Act out one ‘triggered’ conversation to feel prepared to say no under peer
pressure. (CMICH, 2009)
Scenario: You are at a house party with no adult supervision. Your friend shows
you an unmarked bottle of pills, and suggest each of you take two or three pills.
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Your friend tells you, “They will give you a nice high.” You are not aware of
what type of drug are in the pills and you don’t want to take any. How do you
react?
H. Create one poster to advocate the use of refusal skills. ( CMICH, 2009)
1. By creating a poster students will advocate and inform others about health
practices and encouraging healthful behaviors. Posters can increase
knowledge, change attitudes, and alter behavior. One or more refusal skills
should be depicted by the poster.
E. Unit V: Resources Available for Treatment and Prevention of Opioid Abuse
Unit Objective: Upon completion of the unit, the learner will be able to justify the
importance of local resources available to teens in their community to treat, prevent, and
educate about the use/misuse of prescription drugs. (Cognitive, Evaluating)
33. List two local treatment facilities for opioid abuse. (Cognitive, Remembering)
34. Repeat one national helpline phone number for substance abuse.
(Psychomotor, Imitation)
35. List signs and symptoms of addiction. (Cognitive, Remembering)
36. Summarize one reason it is important to find networks of support. (Cognitive,
Remembering)
37. Discuss three benefits associated with seeking professional treatment for
opioid abuse. (Affective, Receiving)
38. Criticize the weaknesses of one prevention program. (Affective, Valuing)

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39. Investigate barriers for reasons why an individual would not seek treatment.
(Cognitive, Evaluating)
40. Create a poster ad that promotes opioid users/abusers to seek treatment.
(Affective, Responding)
A. List two local treatment facilities for opioid abuse. (SAMHSA, 2018)
1. Twin Towers Treatment Centers
4388 Katella Ave.
Los Alamitos, CA 90720
(562) 594-8844
2. Safe Refuge
3111 East 7th St.
(562) 987-5722
3. Roots Through Recovery
3939 Atlantic Ave.
Suite 102
(562) 473-0827
B. Repeat one national helpline phone number for substance abuse. (SAMHSA,
2018)
1. 1-800-662-HELP (4357),(also known as the Treatment Referral Routing
Service)
Hours of Operation: 24-hour-a-day, 365-day-a-year

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i. Free service
ii. Confidential
iii. English and Spanish speakers
C. List at least three signs of addiction. (Drug Abuse, 2017)
1. Physical Signs:
2. Noticeable Euphoria
3. Constipation
4. Confusion
Other signs:
1. Extra pill bottles turning up in the trash
2. Social withdrawal
3. Sudden financial problems
4. Summarize one reason it is important to find networks of support. (Recovery, 2017)
1. Support systems are important in maintaining sobriety. When you have
sober friends they lend a hand in keeping you in track. “Sober peers can
talk you through risky situations”. They can remind you of consequences,
what you are risking, and what your goal is. They provide support and
guidance when you are at risk of relapse.
5. Discuss three benefits associated with seeking professional treatment for opioid abuse.
(Dual Diagnosis, 2018)
1. Medical Stabilization
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When one stops using opioids after abusing them, they will often
experience withdrawal symptoms. Seeking professional treatment allows
them to have medical monitoring to make sure the patient remains safe.
2. Peer Support
Other residents of a professional treatment facility may provide a unique
form of support for those addicted to opioids.
3. Family Support
The families of those addicted to opioids also greatly benefit from
professional treatment. It is useful for family members to learn how to be a
solid support system for someone dealing with addiction.
4. Aftercare
Professional treatment facilities commonly provide aftercare support
following the patient’s recovery. Recovery is a process and it may be
essential for many to have this continuous support.
6. Criticize the weaknesses of one prevention program. (APHA, 2015)
1. Depending on the program, a few general weaknesses of a prevention
program can be:
a. Restricting access to pain medications through legislative or
criminal justice actions to prevent doctor shopping or close “pill mills”
can further decrease legitimate pain medication access.
b. Failure to adequately medicate a patient.

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c. Objections to distributing naloxone (aka Narcan, a medication used
to block the effects of opioids, especially in overdose) to nonmedical
personnel.
7. Investigate barriers for reasons why an individual would not seek treatment. (Rapp,
Xu, Carr, Lane, Wang, & Carlson, 2006)
1. “Privacy concerns”
2. Belief that treatment is not needed or not beneficial
3. Practical and economic barriers
8. Create a poster ad that promotes opioid users/abusers to seek treatment. (CMICH,
2009)
1. By creating a poster students will advocate local treatment location, where
students can seek help if needed.

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Sample Learning Opportunities
Learning Opportunity #1
A. Name: What are opioids?
B. Domain: Cognitive, Remembering
C. Target Population: High School students
D. Unit Objective: Upon completion of the unit, the learner will be able to recognize health
risks related to opioid use/abuse.
E. Enabling Objectives: Following instruction, the student will:
1. Demonstrate the ability to identify three different opioids.
2. Explain one reason why opioids are addictive.
3. Discuss two different types of opioids that are commonly misused.
F. Introduction:
Start off with an introduction by using the PowerPoint. The slides that should be covered are
slides 1-11. Ask if the students have any questions afterwards.
G. Description of implementation procedure:
Next, we will begin the activity. Students will first be given a printed worksheet. With this
worksheet students will be able to do more research on three kinds of opioids of their choice.
They will be given about 15 minutes to do research via Internet. Students will get into groups
and choose one of the three opioids to present to the class by making an informational poster.
For the conclusion part, a video will be shown to the class. This video will help students better
understand why opioids are addictive. Discuss this video as a class after.
H. List of materials and equipment needed:
 Computer/Lap-Projector with sound system

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 PowerPoint (USDHHS,SAMHSA,n.d.)
 Worksheet (Discovery Education,2016)
 Poster paper
 Markers/Crayons
I. Examples of material:
Intro-
https://www.drugabuse.gov/news-events/nida-notes/2017/04/nonmedical-opioid-heroin-
use-mong-hh-school-seniors
Procedure:
Activity:Operation Prevention: Information on Opioid Worksheet
https://www.operationprevention.com/sites/operationprevention.com/files/PDFs/Operatio
n%20Prevention_VFT_Classroom_Activity.pdf
Video: Why are Opioids so Addictive?
https://www.youtube.com/watch?v=nIx0zT0fc2A 1:09 mins
J. Time (Total and Distribution):
Introduction: 20 minutes
Activity: 20 minutes
Operation Prevention: 15 minutes
Video: 1.09 minutes
Discussion 4 minutes
Conclusion: 5 minutes
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Total Time: 55 minutes

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1. Name: Learning About Opioids
2. Domain: Cognitive, Analyzing
3. Target population: High school students
4. Unit II: Upon completion of the unit, the learner will be able to examine behaviors which
can increase the use of opioids.
5. Enabling objectives:
15. By the end of the lesson, the learner will be able to relate how obtaining
prescriptions from multiple providers can lead to abuse of opioids.
13. By the end of the lesson, the learner will be able to investigate how higher
rates of prescribed opioids can lead to abuse of opioids and other drugs.
(Cognitive, Evaluating)
6. Introduction: Instructor introduces the topic of opioids and prescription pill abuse by
way of lecture. Instructor will ask various questions to gauge learners’ knowledge of
opioids. Questions may include, “Who has heard of opioids?”, “What are different kinds
of opioids?’’, “Are opioids dangerous?”, and/or “Are opioids legal?” Learners will be
expected to answer in a call-and-response format.
7. Lesson Implementation Format:
The instructor will introduce the topic of painkiller addiction by showing students
segments from Tragedy and Hope: Stories of Painkiller Addiction (PBS, 2018), titled
“The Science of Addiction”, “Accessibility”, and “Signs & Symptoms”. After viewing
the videos, the instructor will distribute the Opioid Information Sheet. After reviewing for
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some time, the instructor will answer any questions the students may have. Students
should take notes on opioids and topics of discussion. After, allow students to discuss
what they learned in the video. The instructor will call on individuals to share what they
took from the segments. Students will then brainstorm ideas for their homework
assignment, which is to write a five-paragraph essay on how obtaining prescriptions from
multiple providers can lead to abuse of opioids and how higher rates of prescribed
opioids can lead to abuse of opioids and other drugs.
Conclusion: Students will brainstorm the essay in class, but will turn in the assignment
the following class meeting.
8. Materials needed:
o Computer with access to Internet to load Tragedy and Hope: Stories of Painkiller
Addiction
o Projector and screen
o Cables
o Opioid Information Sheet
9. Examples of materials: Refer to Appendices
10. Time allotment: 55 minutes
o Introduction: 3 minutes
o The Science of Addiction: 7 minutes
o Accessibility 8 minutes
o Signs and Symptoms 3 minutes
o Questions from students: 3 minutes
o Group discussion: 15 minutes

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o Brainstorm: 15 minutes
o Remind students of assignment at end of class: 1 minute
Total time: 55 minutes

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Tragedy and Hope: Stories of Painkiller Addiction

Opioid Information Sheet
The following are some of the most common opioid prescriptions abused.
Generic
Brand Name Side Effects
Name
slow heart rate, weak or shallow breathing, sighing; confusion,
hallucinations, unusual thoughts or behavior; severe weakness,
feeling like you might pass out; cold, clammy skin; or pale skin,
Actiq® Fentora®
easy bruising or bleeding; fever; constipation, diar- rhea; dry
Onsolis® Abstral®
Fentanyl mouth, nausea, vomiting, upset stomach; headache; drowsiness,
Lazanda® Subsys®
weak ness, tired feeling; feeling anxious or nervous; cold
Durgesic®
symptoms such as stuffy nose, sneezing, sore throat; sweating, skin
rash; or itching, blistering, redness, or swelling where the patch was
worn
shallow breathing, slow heartbeat; feeling lightheaded, fainting;
confusion, fear, unusual thoughts or behavior; seizure
(convulsions); problems with urination; or nausea, upper stomach
pain, itching, loss of appetite, dark urine, clay-colored stools,
Hydrocodone Lorcet® Vicodin®
jaundice (yellowing of the skin or eyes); anxiety, dizziness,
drowsiness; mild nausea, vomiting, upset stomach, constipation;
headache, mood changes; blurred vision; ringing in your ears; or
dry mouth
abdominal or stomach pain; blurred vision; burning, crawling,
itching, numbness, prickling, “pins and needles,” or tingling
feelings; chest pain or discomfort; confusion; cough; decreased
urination; dizziness, faintness, or lightheadedness when getting up
suddenly from a lying or sitting position; fainting; fast, pounding,
RMS® MS Contin® or irregular heartbeat or pulse; headache; increased sweating;
Morphine
Avinza® nausea or vomiting; nervousness; pounding in the ears; puffiness or
swelling of the eyelids or around the eyes, face, lips, or tongue;
severe constipation; severe vomiting; shakiness in the legs, arms,
hands, or feet; shortness of breath; slow heartbeat; sweating or
chills; wheezing; absent, missed, or irregular menstrual periods;
agitation; change in vision; or depression
shallow breathing, slow heartbeat; seizure (convulsions); cold,
Oxycontin®
clammy skin; confusion; severe weakness or dizziness; feeling
Percodan®
Oxycodone like you might pass out; nausea, vomiting, constipation, loss of
Roxicodone®
appetite; dizziness, headache, tired feeling; dry mouth; sweating; or
Percocet® Roxicet®
itching
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This is the Opioid Information Sheet which gives examples of common prescription opioids. This will be
distributed after viewing Tragedy and Hope: Stories of Painkiller Addiction.

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1. Name: Understanding Prescription Labels
2. Domain: Cognitive, Remembering
3. Target Population: High school students
4. Unit Objective: Upon completion of the unit, the learner will be able to summarize proper
prescription use, including disposal.
5. Enabling Objective(s):
1. By the end of the lesson, the learner will be able to identify proper dosage amounts on
prescription labels.
2. By the end of the lesson, the learner will be able to list three aspects of a prescription
label.
6. Introduction: Instructor will provide the students with a brief explanation as to why it is
important to comprehend prescription drug labels. (Queensland Health, 2017)
1. Directions- All medications come with directions for use and they should be read.
These directions tell one when or how frequently the medication should be taken. They
also tell one how much of the medication should be taken and for how long. Following
these directions may be essential to the effectiveness of the medication. Taking the wrong
dosage of a medication or taking it longer than intended for can be harmful to the body.
Every medication is different so it is essential to read the directions and contact a
pharmacist or doctor for anything you don’t understand.
2. Warnings- Medications can have numerous side effects associated with them. The
warning section included on prescription labels or the instructions leaflet list these side
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effects, as well as what to do if one occurs. The warnings should also include things one
shouldn’t do while taking the medication. For example, certain medications should not be
combined with alcohol as it may alter the effects of the medication.
3. Expiration Date- Using medications past their expiration date may not only be
ineffective in treatment, but can lead to unwanted and potentially dangerous side effects.
7. Description of implementation procedure: The instructor will pass out the prescription
labels handout. (LaRue, 2005) Students will be instructed to read over the handout in groups of
four. The instructor will then hold a class discussion summarizing all of the prescription label
components while writing them up on the draw erase board. The instructor will then pass out the
prescription labels practice quiz #1 to the class to be completed individually. Once completed,
students will then be given time to go over their answers with a partner. Then, the instructor will
then go over the answers to prescription labels practice quiz #1 as a class.
Conclusion: Instructor will pass out prescription labels practice quiz #2 as homework to be
turned in the following session.
8. List of materials and equipment needed:
-Prescription Labels handouts
-Whiteboard
-Dry erase marker
-Prescription Labels practice quiz #1
-Prescription Labels practice quiz #2
9. Examples of materials: (On following page)
10. Time (Total and Distribution): 40 min. total
-Introduction: 2 min.
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-Reading of prescription label handouts in groups: 8 min.
-Class discussion on components of prescription labels: 10 min.
-Work of prescription label practice quiz #1 individually: 6 min.
-Discuss practice quiz #1 answers with partners: 6 min.
-Go over answers to practice quiz #1 as class: 5 min.
-Pass out practice quiz #2 as homework: 3 min.
Prescription Labels
When you go to a doctor, for a check-up, or because you are sick, the doctor may decide that you
need prescription medicine.
The label on your prescription has important information. This information will be on the label.
Some labels may have it in a different order.

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Number 1 is the name, address and phone number of the pharmacy that filled the prescription.
This is from "Main Street Pharmacy".
Number 2 is the name of the doctor. Doctor R. Wilson prescribed this medicine.
Number 3 is the prescription number, which begins with the abbreviation "Rx" or "No".
This prescription number is 300443.
Number 4 is the name of the patient. This medicine is for John Johnson. No one else should take
this medicine.
Number 5 tells how much medicine to take and when to take it. This may be written after the
word "Dose". John should take 1 tablet once a day.
Number 6 is the name of medicine, and the name of the company that manufactured it. This
medicine is called "Zocor", and Merck makes it.
Number 7 is the number of tablets. This may be written after the abbreviation "Qty" or the word
"Quantity". This prescription is for 30 pills.
Number 8 is the number of refills available. When no refills are available the number will be "0".
Number 9 is the expiration date of the prescription. This may be written after "refill before" or
the abbreviation "Exp". This is the last date the pharmacy can refill the prescription.
For more information about OTC medicine labels see OTC Labels. For more information about
warning labels see Warning Labels.
For more information about the side effects of medicine see Side Effects.
The LaRue Medical Literacy Exercises were created by Charles LaRue through a grant from the Minnesota Department of Education under the
supervision of the Minnesota Literacy Council.

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©2005 MN Dept of Education
Prescription Labels - Quiz 1

LaRue Medical Literacy Exercises
1. Who is this prescription for?

A. Main Street Pharmacy
B. Dr. R Wilson
C. Zocor Tabs
D. John Johnson
2. What is the prescription number?

A. 30
B. 300443
C. 01/04/2005
D. (612) 555-1234
3. How many pills should John take each day?

A. 2
B. 1
C. 3
D. 30
4. Where did John get this prescription?

A. John Johnson
B. Mfg Merck
C. Dr. R Wilson
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D. Main Street Pharmacy
5. How many pills came in this prescription?

A. 30
B. 3
C. One tablet
D. 01/04/2005

A. Dr. S Stevens
B. Sue Çhong
C. Glucophage Tablets
D. Central Avenue Pharmacy

A. 60
B. One tablet
C. 01/11/2005
D. 454009
8. How many pills should Sue take each day?

A. 1
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B. 60
C. 2
D. 01/11/2005
9. When does this prescription expire?

A. 01/11/2005
B. 7/27/2005
C. 7000 Central Avenue
D. Twice Daily
10. How many refills are available?

A. One tablet
B. 60
C. 2
D. 7/27/2005
The LaRue Medical Literacy Exercises were created by Charles LaRue through a grant from the Minnesota
Department of Education under the supervision of the Minnesota Literacy Council. © MN Dept of Education
Available online at www.mcedservices.com
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Prescription Labels - Quiz 2
LaRue Medical Literacy Exercises

A. Dr. C Chan
B. Richard Barber
C. University Pharmacy
D. Xanax Tabs
2. Where did he get this prescription?

A. Dr. C Chan
B. 01/09/2005
C. Three times daily
D. University Pharmacy
3. How many pills does he take every day?

A. 1
B. 3
C. 90
D. Richard Barber
4. How many times can this be refilled?

A. One tablet
B. Three times
C. 0
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D. 90
5. How many pills are in this prescription?

A. 01/09/2005
B. 882456
C. One tablet
D. 90

A. Mary Smith
B. Restatis
C. Dr. V Nguyen
D. Northern Pharmacy
7. How many drops does she put in each eye every day?
A. One drop
B. Two drops
C. Both eyes
D. 32
8. How many times can she refill this prescription?

A. Twice
B. 565449
C. One time
D. 32
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9. When does this prescription expire?

A. 02/04/2005
B. Northern Pharmacy
C. 3/09/05
D. Dr. V Nguyen

A. 02/04/2005
B. 750 1st Street
C. 763 222-1234
D. 565499
The LaRue Medical Literacy Exercises were created by Charles LaRue through a grant from the Minnesota
Department of Education under the supervision of the Minnesota Literacy Council. © MN Dept of Education
Available online at www.mcedservices.com
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(Adapted From HOPE, 2018)
Name: Ways to say “No!”
Domain: Psychomotor, Imitation
Target Population: High School Students
Unit Objective: Upon completion of the unit, the learner will be able recall the importance of
refusal skills to reduce, prevent, and avoid drug use.
Enabling objective: Following Instructions, the student will be able to
1. Repeat three verbal measures for refusing prescription drugs
Introduction: In this activity the student will see scenarios regarding drug use and have the
opportunity to practice peer resistance skills using effective communication skills. Practicing
communication skills to avoid prescription drugs in a safe classroom environment will help to
build confidence if ever faced with these pressures.
Description of Implement Procedure:
 To prepare for the activity students should of gone over the Lead the Scene PowerPoint
(Generation RX): http://generationrx.org/take -action/teen/ . After the lesson students
should watch Theatrical performance Vimeo: https://player.vimeo.com/video/161513021.
 After the lesson and video, students should have time to put their skills to the test.
Students will break into small groups and write down/perform a more positive outcome.
Follow the steps below:
o Randomly assign groups scenario 1-3. If needed, advance the presentation to slide
12 so groups can review the original scenario.

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o Ensure groups understand they are traveling back in time and exchanging any
negative choices in the scenario for more positive choices. In their skit, they are
demonstrating how to implement more positive choices as well as demonstrating
effective refusal skills. Each group has the opportunity to essentially change the
scenario to ensure a more positive outcome.
*Each group or student has the opportunity to make a choice to demonstrate the refusal
skills on paper or demonstrate it in the given scenario.
 Closure: Today we reviewed strategies for saying no to drugs and practiced effective
communication skills by working through various scenarios involving decisions around
prescription drug use.
 Ask students, “how would you rate your level of confidence on a scale of 1-5 (1 being not
at all to most confident) for saying no to drugs?” Explain your answer on a half sheet of
paper.
Materials and equipment needed:
1. PowerPoint (Generation RX): http://generationrx.org/take -action/teen/

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2. Theatrical performance Vimeo: https://player.vimeo.com/video/161513021
Theatrical performance Vimeo is a short Film depicting different scenarios that students might
be peer pressured into drug use. Scenarios showcase different high risk situations in which strong
refusal skills are needed.
3. “Time To Practice!” Worksheet
4. Half sheet of paper
5. Computer
6. Projector
7. Projector screen
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8. Audio cable
Examples of materials needed: “Time to Practice!” Worksheet
Time allotment:
Introduction: 5 minutes
Activity:
PowerPoint: 10 min
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Video: 6 min
Activity: 30 min
Conclusion:
Closure: 10 min
Total time: 61 min

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Curricular Resources
locations.
Unit Objective: Upon completion of the unit, the learner will be able to recognize health risks
related to opioid use/abuse. (Cognitive, Remembering)
4. Describe two side effects of opioid use/abuse that affects the body. (Cognitive, Remembering)
5. Explain one reason why one might choose to consume opioid for their health. (Cognitive,
Applying)
6. Demonstrate the ability to identify three different opioids.(Psychomotor, Precision)
Understanding)
Instructor:
1. Classroom Resources to Help Combat the Opioid Crisis. (n.d.). Retrieved from
http://blog.discoveryeducation.com/blog/2017/10/27/classroom-resources-to-help-combat-the-
opioid-crisis/
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This source provides teachers guidance to teach about the opioid crisis within their classrooms. It
gives the amenities of services and programs associated with opioid use that both teachers,
parents, and student can easily navigate and become educated.
2. Solutions, L. W. (n.d.). Retrieved from
https://www.prevention.org/Professional-Resources/Opioid-Education-Resources/
This source gives teachers and mentors the opportunity in learning a different method in teaching
opioid use/abuse. Training webinar are provided to help teachers and assist schools in educating
in substance abuse.
3. Opioid Abuse Prevention. (n.d.). Retrieved from http://education.ohio.gov/Topics/Learning-
in-Ohio/Health-Education/Opioid-Abuse-Prevention
The Department of Education of Ohio provides additional resources for opioid abuse prevention.
They provided a list of additional resources they have found helpful in approaching this topic
from grades kindergarten up till twelfth grade.
4. National Institute on Drug Abuse. (n.d.). Parents & Educators. Retrieved from
https://www.drugabuse.gov/parents-educators
This site provides an overview of drug abuse. There are classroom materials including lesson
plans and classroom activities that the instructor can use.Other content includes video segments
and drug fact articles.
5. Classroom Resources. (n.d.). Retrieved from
https://www.operationprevention.com/classroom
This source includes classroom resources that get students to get active and involved. The site
provides a series of hands-on investigations, and the information on how opioids affect our brain
and body.
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Student:
1. How to Avoid Drug & Alcohol Abuse in College. (n.d.). Retrieved from
https://www.accreditedschoolsonline.org/resources/avoiding-substance-abuse/
This source provides a guide on how to avoid substance abuse. Some background information
will be introduced as it leads into the different signs and tools students can use to identify
substance abuse.
2. Search and Rescue. (n.d.). Retrieved from https://www.searchandrescueusa.org
The Search and Rescue source provides tools in reducing opioid addiction. Some tools indicated
on the site were guidelines, evaluation, and strategies that could be implemented.
3. National Institute on Drug Abuse. (2014, May 14). America's Addiction to Opioids: Heroin
and Prescription Drug Abuse. Retrieved from https://www.drugabuse.gov/about-nida/legislative-
activities/testimony-to-congress/2016/americas-addiction-to-opioids-heroin-prescription-drug-
abuse
This source includes many aspects that come along with the abuse of opioids. It goes into depth
about the scope and impact of substance abuse here in the United States and gives background
data for supporting evidence.
4. Opioid Abuse and Addiction. (2018, April 30). Retrieved from
https://medlineplus.gov/opioidabuseandaddiction.html
Medicine Plus includes the basic information, latest news, research and more on opioid abuse
and addiction. There are also handouts, videos, and other toolkits for parents interested.
5. Painkillers and Opioid Use Disorder. (n.d.). Retrieved from https://www.webmd.com/mental-
health/addiction/painkillers-and-addiction-narcotic-abuse#1
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WebMD goes over the effects of opioid misuse and how it affects the body. They go over many
aspects like conditions and disorders that may occur for opioid users.
B. Unit 2: Understand Risk Factors Associated with Opioid Use
Unit Objective: Upon completion of the unit, the learner will be able to examine behaviors
Organizing)
10. Argue the reasons why the opioid epidemic is primarily affecting the White population of the
United States. (Affective, Valuing)
11. Summarize populations with a higher risk of opioid misuse. (Cognitive, Understanding)
12. Provide examples of how individuals with substance abuse disorders are at higher risk for an
opioid overdose. (Affective, Responding)
13. Justify how prescription opioid use is a risk factor for heroin use. (Cognitive, Evaluating)
14. Investigate how higher rates of prescribed opioids can lead to abuse of opioids. (Cognitive,
Evaluating)
15. Relate how obtaining prescriptions from multiple providers can lead to abuse of opioids.
16. Develop methods to reduce risk factors among high-risk populations. (Psychomotor,
Articulation)
Instructor:
1. Public Broad Casting Service. [PBS]. (2018). Learning about Opioids Lesson | Tragedy &
Hope: Stories of Painkiller Addiction. Retrieved from

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https://www.pbslearningmedia.org/resource/7f567e4a-0572-4c69-a25c-
8d7e4b77b69d/learning-about-opioids/#.WtXkei_MyRt
This website from PBS gives the instructor videos for an opioid lesson plan. Also provided is a
worksheet for students.
2. Palamar, J. J., Shearston, J. A., Dawson, E. W., Mateu-Gelabert, P., & Ompad, D. C. (2016).
Nonmedical opioid use and heroin use in a nationally representative sample of us high school
seniors. Drug and Alcohol Dependence, 158, 132-138. doi:10.1016/j.drugalcdep.2015.11.005
This journal will give the instructor an idea of opioid use and heroin use in high school students.
3. Substance Abuse and Mental Health Services Administration. [SAMHSA]. (2017). State
Targeted Response to the Opioid Crisis Grants. Retrieved, from
https://www.samhsa.gov/grants/grant-announcements/ti-17-014
This resource will help the instructor learn about what their state is doing in regards to the
Opioid Crisis.
4. Substance Abuse and Mental Health Services Administration. [SAMHSA]. (2016). Preventing
prescription drug misuse: Understanding who is at risk. Retrieved april 9, 2018. From
https://www.samhsa.gov/capt/sites/default/files/resources/preventing-prescription-drug-misuse-
understanding.pdf
This resource will aid the instructor in identifying who is at risk for the abuse of prescription
opioids.
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5. United States Department of Agriculture. [USDA]. (2018). Opioid Misuse in Rural America.
Retrieved from https://www.usda.gov/topics/opioids
This resource will help the instructor learn the differences in reasons why rural America abuses
opioids.
Students:
1. World Health Organization. [WHO]. (2018). Information sheet on opioid overdose. Retrieved
from http://www.who.int/substance_abuse/information-sheet/en/
This website can help students learn general information on the signs of opioid overdose.
2. NIDA (National Institute on drug abuse) for Teens. (2018). 6 Tactical tips for resisting peer
pressure to use drugs and alcohol. Retrieved from https://teens.drugabuse.gov/blog/post/6-
tactful-tips-resisting-peer-pressure-to-use-drugs-and-alcohol
This website helps students learn resourceful methods on how to say no to opioids.
3. DoSomething. (n.d). 11 facts About Teens and Drug Use. Retrieved from
https://www.dosomething.org/us/about/who-we-are
This website aids teens in learning how their peers and teens in general use drugs.
4. Partnership for drug-free kids. (2018). Drug Prevention Tips for Every Age. Retrieved from
https://drugfree.org/article/prevention-tips-for-every-age/
This resource informs children of every age of prevention strategies.
5. Abovetheinfluence. (n.d). Friends & Peers Above the Crowd. Retrieved from
http://abovetheinfluence.com/about/
This website also helps teens stay clear of drug use.
C. Unit III: Proper Prescription Use and Disposal

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Unit Objective: Upon completion of the unit, the learner will be able to summarize proper
prescription use including disposal. (Cognitive, Understanding)
17. Explain one importance of properly reading prescription labels. (Cognitive, Understanding)
18. Identify proper dosage amounts on prescription labels. (Cognitive, Remembering)
19. List three key points of information on a prescription label. (Cognitive, Remembering)
20. Criticize one issue with current prescription label formatting. (Affective, Valuing)
21. List two ways to dispose of prescription drugs properly. (Cognitive, Remembering)
Understanding)
24. Practice safely disposing of prescription drugs. (Affective, Internalizing Values)
Instructor:
1. LaRue Medical Literacy Exercises provides worksheets and quizzes on reading
prescription drug labels. It is addressed to instructors to be used as teaching material in
the classroom. (LaRue, 2005)
2. Rx for Understanding: Preventing Prescription Drug Abuse provided by the National
Education Association of the Health Information Network includes ten lesson plans for
high school students. These lesson plans all deal preventing prescription drug abuse.
Teachers may use the entire curriculum or some of the lesson plans individually.
(National Education Association Health Information Network, n.d.)
3. The journal article, “Prescription drug labeling medications errors: a big deal for
pharmacists”, discusses the correlation between prescription drug labels and drug misuse.
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Numerous factors of current prescription label formatting can lead to difficulties in
reading and understanding them. Instructors may integrate this article as evidence for the
4th objective. (Jeetu & Girish, 2010)
4. “The battle against prescription drug abuse: medication return collection units”
discusses the issue of accumulated unused prescription drugs. The study seeks to find a
solution to this over-accumulation in properly disposing of these unused medication.
Instructors may integrate this article into the lesson plans for objectives 5 and 6. (Smith,
Burns, Fraino, & Kisiel, 2015)
5. This policy statement by the Association for Accessible Medicines discusses how
prescription adherence, safe storage, and proper disposal play a role in reducing drug
abuse. Instructor may integrate this policy statement into teaching objectives 1 and 6.
(Association for Accessible Medicines, 2018)
Student:
1. Rx Outreach provides a full list of all the information that may be found on a drug
prescription label. All of this information is provided with a sample label for better
understanding. This source is intended for consumers of prescription drugs. (Rx
Outreach, 2017)
2. This article from the Queensland Government shares what main components make up
a drug prescription label, as well as a further explanation as to why each is important. The
purpose of this article is to explain the importance of reading prescription drug labels to
consumers. (Queensland Health, 2017)
3. This guide posted by Carrington College helps to provide a further understanding of
how prescriptions work. This is executed by providing a background on prescription

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drugs, as well as a list of common prescription abbreviations. This guide is addressed to
the consumer population. (Carrington College, 2016)
4. The U.S. Food and Drug Administration provides a full page regarding the disposal of
unused prescription drugs. The page encompasses how to dispose of unused drugs, the
impact of flushing medicines on the environment, and a list of medicines recommended
for disposal by flushing. This page is addressed to all consumers of prescription drugs.
(FDA, 2018)
5. The website provided by the National Community Pharmacists Association is
dedicated to helping individuals find local sites to safely drop off their unused
prescription medications. (National Community Pharmacists Association, 2018)
Local Resource Agency (for disposal of unused prescription drugs):
The Medicine Shoppe
17623 Pioneer Blvd
Artesia, CA 90701
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D. UNIT IV: Refusal Skills
Unit Objective: Upon completion of the unit, the learner will be able recall the importance of
refusal skills to reduce, prevent, and avoid drug use. (Cognitive, Remembering)
Instructional Objectives: By the end of the lesson, the learner will be able to...
25. List the five steps of refusal skills. (Cognitive, Remembering)
27. Recognize at least one risky situation that requires strong refusal skills. (Cognitive,
Remembering)
28. Discuss two non-verbal measures of refusing prescription drugs. (Affective, Receiving)
29. Repeat three verbal measures for refusing prescription drugs. (Psychomotor, Imitation)
30. Construct three go-to refusals to never get caught off guard. (Psychomotor, Naturalization)
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31. Act out one ‘triggered’ conversation to feel prepared to say no under peer pressure.
(Affective, Internalizing Values)
Instructor:
1. Poe Center for Health Education Substance Use Prevention. (2018). For the Health of It!
Retrieved from http://www.poehealth.org/educational-topics/drug-prevention/
This lesson plan helps students discover how using drugs and alcohol can impact their
bodies and brains in a negative way. This class includes interactive activities that focus on
“showing and not telling” kids how their brains are affected by drug use. Real life scenarios are
used to aid students analyze how a “drugged” brain affects their actions and decision making
skills. Students will also engage in Role-Play reinforcing refusal skills.
2. Health & Opioid Prevention Education (HOPE). (n.d). Meeting the BH 367 Requirement for
Opioid Abuse Prevention Education. Retrieved from
http://www.mcesc.org/userfiles/14/my%20files/mcdfc%20-
%20%20esc%20meeting%20opioid%20education%20requirement%20dr.%20kevin%20lorson%
2010-26-16.pdf?id=1022
This curriculum is for High schools, it aligns with the national standards. It includes
Standard 4: Interpersonal Communication, which teaches students effective verbal and non-
verbal communication skills to avoid drug use. Standard 5: Decision-Making, which includes
examining circumstances that help or hinder making decisions to be drug free. It analyzes the
interpersonal and intrapersonal beliefs affecting drug-free decisions, generate alternatives to drug
use, predict short and long term effects of drug use, choose healthy alternatives, analyze the
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effectiveness of a final outcome related to drug use decision. Standard 8: Advocating for drug-
Abuse prevention, which persuades and supports others to be alcohol and other drug-free.
3. Generation Rx. (n.d.). Teen. Retrieved from https://www.generationrx.org/take-action/teen/
Rx includes many resources for teachers/instructors to educate teens about the
importance of using medication safely, as well as teaching teens key skills to turn down
invitations to misuse and positive alternatives to cope with the demands of life. Activity 3: “Lead
the Scene” Skit-based Activity includes viewing a theatrical performance, then identify different
choices characters could have made to ensure more positive outcomes.
4. DACCO Behavioral Health. (2016). Prescription Drug Abuse Prevention for High School.
Retrieved from https://www.dacco.org/application/themes/dacco/docs/Presciption_DACCO.pdf
DACCO provides a digital course that aims to arm high school students with the
knowledge and tools to make healthy, informed decisions when it comes to making healthy,
informed decisions when it comes to prescription medications. Though interactive scenarios and
self-guided activities, students learn facts about drugs, how to properly use and dispose of them,
and how to step in when faced with a situation involving misuse wich includes simulations:
refusal and bystander skills.
5. New York State Education Department (NYSED). (n.d.) Health Education Standards
Modernization Supplement Guidance Document: Instructional Resource Packet for Heroin &
Opioids. Retrieved from http://www.p12.nysed.gov/sss/documents/FinalNYSEDHeroin-
OpioidsInstructionalResourcePacket6.16docx.pdf
This resource packet aligns with the NYS Learning Standards. It provides Health
Education instructional prevention framework visual and opioids functional knowledge and
skills. The key idea is for students to demonstrate personal and social responsible behaviors.
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They will care for and respect themselves and others. They will recognize threats to the
environment and offer appropriate strategies to minimize them. They will have the skills
necessary to demonstrate the ability to apply decision-making to enhance their personal health.
Student:
1. NIDA (National Institute on drug abuse) for Teens. (2018). 6 Tactical tips for resisting peer
pressure to use drugs and alcohol. Retrieved from https://teens.drugabuse.gov/blog/post/6-
tactful-tips-resisting-peer-pressure-to-use-drugs-and-alcohol
This is a website where teens can get the latest on how drugs affect the brain and body.
Featuring videos, games, blog posts and more. The blog post is a tool where teens can read a
blog post and are free to reply to the blog post and express their opinion. This helps teens
communicate their feelings and attitudes about the blog. They are also free to reply to other
comments connecting teens to one another. This site offers different videos depicting different
scenarios in which teens can find themselves and explain different ways they can improve the
outcome of each scenario.
2. Abovetheinfluence. (n.d). Friends & Peers Above the Crowd. Retrieved from
This site helps teens deal with pressure. The goal of this resource is to help teens stand up
to negative pressure, or influences. The more aware teens are of different influences around
them, the better they are prepare to face them, including pressure to use drugs and alcohol. They
give other perspectives and the latest facts to make it easier for teens to make their own smart
decisions. The site ultimately helps teens be aware of influences around them and carefully
consider risks when faced with tough decisions.

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3. TeensHealth from Nemours. (2018). Peer Pressure. Retrieved from
http://kidshealth.org/en/teens/peer-pressure.html
This is an interactive website where teens can learn about drug and alcohol facts.
Educational videos are provided to teens to explain health concepts, offer personal perspectives,
and more. There is an Expert Answers (Q&A), where teens are encouraged to ask any questions
they have. There is a variety of articles with information and prevention methods like
understanding the different types of peer pressure, how to speak out and take different actions to
change the situation. It provides different strategies of refusing drugs.
4. DoSomething. (n.d). 11 facts About Teens and Drug Use. Retrieved from
DoSomething.org is a website that is mobilizing young people. This website gives teens a
platform to sign up for a volunteer, social change, or civic action campaign to make real-world
impact om a cause they care about. For those teens who have the passion to transform their
communities dosomething helps them get it done. After reading different educational posts teens
are free to start a campaign where they can advocate for something that they are really passionate
about, like the importance of refusal skills. Not only will they be able to raise awareness but they
can help other teens take actions in their own communities.
5. Partnership for drug-free kids. (2018). Drug Prevention Tips for Every Age. Retrieved from
This website provides a series of scenarios about drug use and abuse. It explains correct
ways of handling tough situations. It gives tips to teens to increase their refusal skills. Partners
for drug-free kids helps families struggling with substance abuse. They empower families with
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information, support and guidance to get their loved ones needs and deserved. They advocate for
a greater understanding and more effective programs to treat the disease of addiction.
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Exam Checklist
Evaluation Matrix
Evaluative Techniques
Test Items
OBJ Fill in Short Role

# List Blank T/F MC Match Answer Essay Play Other (Specify)
1 16
Poster- Eval
2 Technique #2
Poster- Eval
3 Technique #2
4 18
5 5
Poster- Eval
6 Technique #2
7 26
8 4
Essay- Eval
9 x Technique #3
10 11
11 31
12 13
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13 20
14 32
15 19
16 12
17 7
Poster- Eval
18 6 x Technique #4
Poster- Eval
19 2 x Technique #4
OBJ Fill in Short Role

# List Blank T/F MC Match Answer Essay Play Other (Specify)
20 28
21 1
22 8
23 29
24 9
25 22
26 23
27 24
28 14
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29 15
30 25
31 X
Poster-Eval
32 Technique #5
33 30
34
35 27
36 17
37 10
38 21
39 3
40 33
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Exam
Multiple Choice:
Directions: Please circle the answer that best matches the question.
1. Which of the following is the BEST way to dispose of prescription drugs? (21)
A. Flush them down the toilet
B. Turn them in to an authorized drug collector site
C. Throw them in the trash
D. Bury them outside
2. Which of the following is NOT found on a drug prescription label? (19)

A. Expiration date
B. Possible side effects
C. Patient’s birth date
D. Pharmacy’s phone number
3. Which of the following is NOT a barrier for reasons why an individual would not seek
treatment? (39)
A. “Privacy Concerns”
B. Belief the treatment is not needed
C. Economic barriers
D. Fear and Shame
4. Which of the following are considered a commonly misused opioid? (8)

A. Codeine, Morphine
B. Prescription, Over-the-counter drugs
C. Aspirin, Ibuprofen
D. Massages, Acupuncture
5. Which of the following is a reason why one might choose to consume opioids for their
health? (5)
A. Urinary tract
B. Bowel movements
C. Digestion
D. Chronic pain
6. Which of the following represents a proper dosage amount? (18)

A. 30 pills
B. May 20, 2019
C. Rx # 0187392
D. Take 1 pill every 4 hours
7. Which of the following is NOT a reason why it is important to properly read prescription
labels? (17)
A. To know how to properly dispose of them
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B. To see the directions for proper dosage

C. To see warnings for common side effects
D. To avoid using them past the expiration date
8. Which of the following is the main reason why proper prescription disposal is important?
(22)
A. It is bad for the environment
B. It provides a good example for children
C. It prevents accidental and intentional misuse
D. It gets rid of clutter in the medicine cabinet
9. Which of the following is NOT a safe prescription disposal technique you would practice
at home? (24)
A. Flushing them down the toilet
B. Bury them outside
C. Dispose of them in a household trash
D. Scratch out personal information on old prescription bottles
10. Which of the following is NOT a benefit of seeking professional treatment for opioid
abuse? (37)
A. Peer support
B. Trying other drug options
C. Aftercare
D. Medical stabilization
11. What is one reason opioid abuse more prevalent in rural areas? (10)
A. The rural population prefer opioids
B. There are a high amount of opioids in these areas
C. The type of jobs in these areas are more injury prone
D. Opioids are primarily manufactured in rural areas
12. Which of the following is not a method to reduce risk factors among high risk
populations? (16)
A. Provide support for cutting-edge research on pain and addiction
B. Improve access to recovery and treatment services
C. Prescribing less opioids with a high-risk of abuse
D. Promote use of overdose-reversing drugs
13. Which of the following is not an example of how individuals with substance abuse issues
are at a higher risk to abuse opioids? (12)
A. Drug addiction is a choice and it the users fault if they overdose
B. People who are dependent on opioids will likely suffer an overdose
C. The combination of alcohol and other sedatives can be fatal
D. Combination of multiple drugs are usually present in cases of overdose
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True/False:
Directions: For each question below, circle T if the statement is true or F if the statement if false.
14. T/F: Standing and sitting up straight are non-verbal measures to refuse prescription drugs.
(28)
15. T/F: Using a clear, firm, confident and unhesitating tone of voice is a verbal tactic to
refuse prescription drugs. (29)
16. T/F: Hormonal dysfunction and immunosuppression are two health risks of long-term
opioid use/abuse. (1)
17. T/F: It is Important to find networks of support to maintain ongoing sobriety, because
sober friends can talk you through risky situations. (36)
18. T/F: Gastroparesis and muscle rigidity are NOT two side effects of opioid use that affects
the body. (4)
19. T/F: “Doctor shopping” can lead to abuse of opioids. (15)
20. T/F: Four to six percent of prescription opioid abusers will eventually use heroin. (13)
21. T/F: Failure to medicate a patient properly can weaken a prevention program (38)
Short Answer, Fill-In:

Directions: Read each question carefully. Write the answer(s) to the best of your ability in the
space provided.
22. List the 5 steps of Refusal Skills (5pts). (25)

a. ________________________________
b. ________________________________
c. ________________________________
d. ________________________________
e. ________________________________
23. What are two strategies you can use to resist unhealthy choices? (2pts). (26)
a. _____________________________________________________________
_____________________________________________________________
_____________________________________________________________
b. _____________________________________________________________
_____________________________________________________________
_____________________________________________________________
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24. John is at a party with his two friends. One friend offers him medication pills. John does
not know what kind of pills they are, or what they do. Is John in a risky situation, yes or
no? Explain your answer (2pts). (27)
a. ___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
25. Mandy is offering you pills. Construct three refusal sentences to prescription
medication Mandy is offering you using these phrases: “No” , “I don’t want to”, “ I have to
go”, “ Instead of _________ let’s do this __________” , “ It’s bad for you” (3pts). (30)
a. __________________________________________________________________
__________________________________________________________________
b. __________________________________________________________________
__________________________________________________________________
c. __________________________________________________________________
__________________________________________________________________
26. Explain one reason why opioids are addictive (1pt). (7)
a. __________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
27. List three signs of addiction (3pts): (35)

1. _____________________________________________
2. _____________________________________________
3. _____________________________________________
28. Criticize one issue with current prescription label formatting. (20)
a. Name one possible issue (2 pts.)
b. Describe why it is an issue (4 pts.)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
29. List one local prescription disposal site. (23)

a. Name location (1 pt.)
b. Name city of location (2 pt.)
____________________________
____________________________
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30. List two local treatment facilities for opioid abuse. (33)
a. Name two locations (2 pt.)
b. Name cities of two location (4 pt.)
1. ____________________________
____________________________
2. ____________________________
____________________________
31. Summarize which populations have a higher risk of opioid misuse (2pts). (11)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
32. Investigate how higher rates of prescribed opioids can lead to abuse of opioids (2pts). (14)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
33. Give examples of what should be included in a poster to advertise treatment to opioid abusers
(2pts). (40)
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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Evaluation Techniques
Evaluation Technique #1
Evaluation Technique: Poster
Unit I: Health Risks Related to Opioid Use and Abuse
a. Unit Objective: Upon completion of the unit, the learner will be able to recognize health risks
related to opioid use/abuse.
Enabling objective(s):
#2. Provide three examples of signs of an overdose.

#3. Present five symptoms of opioid use/abuse.
#6. Demonstrate the ability to identify three different opioids.
Instructions:
How to administer evaluation technique:
After going over the content with the students; students should be able to demonstrate their
understanding by creating a poster. Quickly go over the directions on how the students should
create their poster to meet the point criteria. Students will be provided with poster paper, crayons
and markers to create their content.
Key/Description of criteria:
Students must meet all criteria to receive full points.
1. Include name: (1 pts.) ____

2. Correctly identify three signs of an overdose (3 pts.) ____
3. Correctly identify five symptoms of opioid use/abuse (5 pts.) ____
4. Correctly identify three different opioids (3 pts.) ____
5. Creativity (4 pts.) ____
6. Grammar, punctuation, and spelling (4 pts.) ____
Total: 20 points
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Individual Evaluation Technique #2
Evaluation Technique: Informal Essay
Unit II: Understand Risk Factors Associated with Opioid Use
Unit II Objective: Upon completion of the unit, the learner will be able to examine behaviors
Enabling Objective:
Organizing)
Implementation: Instructor will direct students to take a sheet of paper out for the purpose of
writing an informal essay. Instructor will assign students the topic of identifying any personal
risk factors which could increase the likelihood of drug abuse. Students should be able to relate
any personal experiences and/or any information learned from the curriculum to the essay. Ideas
should be clearly stated, with proper grammar and punctuation.
Criteria: Students will be evaluated according to the following criteria.
Total: 15 points
Description Excellent (4) Good (3) Basic (2) Poor (1)
Focus Text clearly states Text mostly Text barely states Text does not
focus of essay states focus of focus of essay state focus of
essay essay
Development Text presents Text presents Text presents Text presents no

multiple facts, some facts, little facts, facts, details,
details, definitions, details, details, definitions
and relates definitions definitions
personal
experiences
Cohesion Student Student skillfully Student barely Student does not

strategically uses uses phrases to uses phrases to use phrases to
phrases to link link sections of link sections of link sections of
sections of text text text text
Grammar & Student utilizes Student utilizes Student utilizes Student does not
Punctuation grammar and grammar and grammar and utilize proper
punctuation which punctuation punctuation grammar and
exceeds appropriate for which is below punctuation
expectation grade level grade level
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Evaluation Technique: Poster
Unit 3: Proper Prescription Use and Disposal
Enabling Objectives:
18. Identify proper dosage amounts on prescription labels.
19. List three key points of information on a prescription label.
Instructions: Instructor will assign students a poster project to be completed in groups of four.
Instructor will inform students that the poster should include a sample prescription label. The
students may develop their own sample prescription label or find one from an online source. This
sample prescription label should have the dosage amount identified, as well as three other
labelled components. Students will be provided with the poster paper and markers. Upon
completion, the instructor will have each group present their final product.
Total points: 10 points
-Dosage amount identified: 2 points
-Three other labelled components: 6 points
-Present to class: 2 points
Sample Product:
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Dosage amount: One pill per day
Prescription name: 800 mg Ibuprofen
Prescriber’s name: Dr. R. Smith
Expiration date: 04/07/18

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Name: Steps Of Refusal Skills
Evaluation technique: Poster
Unit IV: Refusal Skills
1. Unit Objective: Upon completion of the unit, the learner will be able recall the
Remembering)
2. Enabling Objective: By the end of the lesson, the learner will be able to create one
poster to advocate the use of refusal skills. (32)
Implementation:
The instructor will pass out markers and a poster board to each student. Each student will
create a poster board listing the five steps of refusal skills. For each refusal skill step the student
should provide an example. At the end of the activity every student will share their poster to the
class room and provide an explanation why the poster is a great way to advocate refusal skills.
The posters will then be displayed on bulletin boards around the school to raise awareness for the
use of refusal skills.
Criteria: Students will be evaluated according to the following criteria
1. Class participation 0= no participation 5= engaged in activity
2. Poster legibility 0= unable to read 5= legible
3. Poster organization 0= unorganized 5= Organized
4. All Five refusal skills are listed 1-5= 1 point for each step
5. Each refusal step has an example 1-5= 1 point for each example to each step
6. Explanation of Refusal skills advocacy 0= minimal explanation 5= excellent explanation

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7. Oral Presentation 0= poor poster presentation 5= poster well presented
TOTAL POSSIBLE POINTS: 35 PTS
The Five Steps of Refusal Skills:
Step 1: Ask Question to assess the situation
Ex: What are you doing? Why are you doing that?
Step 2: Explain the trouble of involvement
Ex: “That’s wrong”,
“I don't want to take pills”,
“That’s possession”
Step 3: Explain the Consequences
Ex: “If I engage in that …”
 I could get suspended from school
 I could get grounded by my parents
 I could get fined and end up in jail
Step 4: Advocate an Alternative activity
Ex: “On a second thought, why don’t we…”
 Play video games
 Go to the mall
 Watch a movie
 Go out to lunch
Step 5: Leave the situation or Sell the alternative and maintain the relationship
Ex: “If we do this instead...”
 I will buy us food

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 We can level up on the video game
 We can meet our friends at the mall
 Or leave, and say sorry my parents are expecting me for dinner
 And let your friend know you are accessible and still want to maintain the relationship
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Name: Just Say No
Evaluation Technique: Role Play
Unit IV: Refusal Skills
1. Unit Objective: Upon completion of the unit, the learner will be able recall the
Remembering)
2. Enabling Objective: By the end of the lesson, the learner will be able to Act out one
‘triggered’ conversation to feel prepared to say no under peer pressure. (31)
Implementation:
The instructor will pair 2 students together and pass out a scenario to each pair. Each pair
will have 10 minutes to role play the scenario, after those 10 minutes students will switch roles
and take another 10 minutes to role play again. During the activity the instructor will walk
around to ensure student participation and utilization of effective refusal skills. After the
activity students will have the opportunity to summarize why role playing triggered situation is
beneficial to enhancing their refusal skills.
Criteria: Students will be evaluated according to the following criteria
1. Recognize triggered situation 0= unable to recognize 5= recognized
2. Using a Firm No 0= Not Firm 5= Firm
3. Tactics used 0= No Tactics used 5= Tactics used
4. Realistic Response 0= not Realistic 5= realistic
5. Participation 0= no participation 5= participated
6. Summary Explanation 0= no summary 5= summary

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Total Points Possible = 25
Scenario For: Just Say No
Scenario: You are at a house party with no adult supervision. Your friend shows
you an unmarked bottle of pills, and suggest each of you take two or three pills.
Your friend tells you, “They will give you a nice high.” You are not aware of what
type of drug are in the pills and you don’t want to take any.
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Appendix
Exam Key
Answer Key:
Multiple Choice:
1.B
2.C
3.D
4.A
5.D
6.D
7.A
8.C
9. B
10. B
11. C
12. C
13. A
True or False:
14. True
15. True
16. True
17. True
18. False
P a g e | 125
19. True
20. True
21. True
22. Answer Must Include
1. Ask Question to assess the situation
2. Explain the trouble of involvement
3. Explain the Consequences
4. Advocate an Alternative activity
5. Leave the situation or Sell the alternative and maintain the relationship
23. Answers may include any of the following
1. Know the facts
2. Search consequences that can occur if actions are taken
3. Differentiate between “right” and “wrong.”
4. “Recognize the positive and negative influences that pressure you.”
5. “Stand up to negative peer pressure.”
6. Have friends who support healthy choices
24. Answer must include a general idea of the following
Yes, John is in a risky situation because he is being offered pills that are not prescribed to
him, and he does not know what they are and what they do. Hence the pills can affect his body in
a negative and may cause deathly health problems.
25. Answers must include
1. “no”
2. “I don’t want to”

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3. “ I have to go”
4. “ Instead of _________ let’s do this __________”
5. “ It’s bad for you”
26. Answer may include:
An appropriate explanation of why opioids are addictive: high tolerance over time.
1. Physical Signs:
a. Noticeable Euphoria
b. Constipation
c. Confusion
2. Other signs:
a. Extra pill bottles turning up in the trash
b. Social withdrawal
c. Sudden financial problems
a. The Institute of Medicine reported that poor labeling on prescription drugs is a main
cause for medication errors in the U.S.
b. Formatting on prescription labels is most frequently adjusted to highlight the
information most valuable to the pharmacists.
c. Eighty-four percent of the time, pharmacy names or logos are the largest item on a
prescription label.
d. Font sizes consistently decrease for medication instructions, medication names, and
warning and instruction sticker.

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1. The Medicine Shoppe
Artesia, CA
2. Golden Cove Pharmacy
Rancho Palos Verdes, CA
1. Twin Towers Treatment Centers
Los Alamitos, CA
2. Safe Refuge
Long Beach, CA
3. Roots Through Recovery
Long Beach, CA
1. People with opioid dependence
2. People who inject opioids
3. People who use prescription opioids
4. People with household members who have opioids
5. People who use opioids while having other medical conditions
1. How the rate of prescribed opioids has risen
2. Rate of sales has quadrupled
3. Long-term use can lead to abuse and addiction
4. Prescribed opioids only manages pain and does not cure pain
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33. Answer should include:
1. Treatment location
2. Phone number
3. Address of treatment location
4. Type of activities program includes

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Opioid Survey
Directions: Please fill out this survey to the best of your abilities. Place a mark using an “X” to
let us know what your answer is. You have the right to refuse to answer any item.
Gender: __________________ Age: _____________
Do you think your community members know how to safely dispose of prescription drugs?
[ ] Yes [ ] No
Are you familiar with what opioid drugs are?
[ ] Yes [ ] No
Do you know anyone who has used opioids for other than prescribed use?
[ ]Yes [ ]No
How much of a problem do you think opioid abuse is in your community?
[ ] Big problem [ ] Average problem [ ] Small problem [ ] Not a problem at all
Are there any places in or around your community where people can get treatment for a drug
abuse problem?
[ ]Yes: Name of the place: ________________

[ ]No, can’t name any place(s).
How do you feel about each statement? Bubble in a circle for each row.
Strongly Agree Neutral Disagree Strongly

Agree disagree
I feel confident in refusing opioids

from my peers.
Is it very easy to obtain opioids that

are not prescribed to me.
Opioids make you feel good.
Opioid abuse is common.
Risk of addiction to opioids is low.

P a g e | 130
I feel pressured to try opioids.
It is dangerous to take prescription

drugs for non-medical purposes.
** Thank-you for your time and participation! **

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Page |1

Jeanne Hoang, Courtney Jarvis, Wendy Pirir, and Bryant Rueda

HSC 440: Section 3

Professor Mara Bird

Scope and Sequence….…………………………………………………………………………..31

benefits of seeking professional help.

to successfully assess knowledge gained in measurable terms.

prescription opioids misuse and abuse.

information provided by health educators. Health education is defined as “any combination of

The desire and motivation to be a health educator/health professional is to serve the

assists in learning to respect differences in thought. In health education, it is important to

1. Learner Oriented Goals

prescription drug abuse.

Goal #3: Learn how to deal with addiction problems.

Goal #4: Learn how to make healthier decisions.

According to the Action Guide to Address Opioid Abuse (Governor’s Cabinet

Goal #5: Help kids start conversations with caring adults.

Goal #6: Implement screening, brief interventions, and referral to treatment.

According to Operation Prevention (Drug Enforcement Administration, &

school students are:

Goal #8: Examine public health’s role in the opioid epidemic.

public health crisis to an epidemic.

According to the Heroin and Opioid Awareness and Prevention Toolkit

prevention among high school students are:

According to Opioid Heroin Prevention Education School Youth Program

school students are:

1. State of Ohio. (2017). The Health and Opioid-Abuse Prevention Education

Curriculum. Retrieved from http://starttalking.ohio.gov/Schools/The-HOPE-

2. Drug Enforcement Administration, & Discovery Education. (2017). Operation

Prevention. Retrieved from https://www.operationprevention.com/

Program. Retrieved from https://www.overdose-lifeline.org/opioid-heroin-

4. California Department of Education. (2003) Health Framework for California Public

Schools: Kindergarten through grade twelve. Sacramento, CA: US Department of

a) Los Angeles Ambulatory Care Clinic (LAACC) VA Opioid treatment

351 East Temple St.

Mail code 11-C,

Los Angeles CA, 90012-3328

Contact Name: N/A

List and description of materials and services related to topic

b) Clear Treatment: Clear Detox Center

546 Hamilton Street

Costa Mesa, CA 92627

Contact name: N/A

Toll Free: 800-871-2020

- Help for Alcoholism

- Cocaine Addiction Treatment

- Meth Addiction Help

-Opiate Addiction Help

Cost of materials/services: N/A

c) Roots: Through Recovery

3939 Atlantic Ave, Suite 102

Long Beach, CA 90807

Contact Name: N/A

Cost of materials/Services: N/A

B. Study of Contemporary Society and Learners

1. Prevalent Health Problems in Society

problems in society related to opioid abuse include:

1. Addiction: In the United States, addiction to opioids is a serious issue with

approximately 2.1 million people suffering from addiction to prescription opioid

pain relievers and approximately 467,000 people suffering from addiction to

heroin (NIDA, 2014a).

2. Overdose deaths: Since 1999, unintentional overdose deaths from prescription

opioids have more than quadrupled (NIDA, 2014a).