Mary Stevens-Krogh has a big鈥攁nd unique鈥攋ob as the district coordinator of substance use supports for Portland Public Schools.
In Oregon鈥檚 largest city, Stevens-Krogh is responsible for managing the logistics of the district鈥檚 response to student drug use, at a time when overdose deaths are on the rise nationally.
Monthly overdose deaths among people aged 10 to 19 years old increased 109 percent between July and December 2019 to July to December 2021, . Deaths involving illicitly manufactured fentanyl increased by 182 percent during that same time period.
The increase poses a complex problem for districts, which are tasked with figuring out how to prevent drug use among students, address infractions given that drug use is prohibited on school campuses, and provide support to the community when tragedy strikes.
Stevens-Krogh鈥檚 position focusing specifically on substance use is uncommon. School districts more commonly have health directors who focus more generally on student wellness鈥攁 position that Portland schools also have.
In an interview with 澳门跑狗论坛, Stevens-Krogh talked about her job, the prevalence of adolescent drug use nationally, and offered advice for districts as they work to combat the problem. This interview has been edited for length and clarity.
What exactly are the responsibilities of your role, and where did the idea for your position come from?
My role is really focused on the coordination of substance use supports for students, as opposed to the delivery of services. I supervise three certified alcohol and drug counselors, and manage funds to work with contractors to provide and expand services in the district. I also do a lot with developing and implementing discipline policy around drug and alcohol supports. And I鈥檓 kind of the face of the district around substance-related issues, both good things like prevention efforts and also when we have tragedies. Oftentimes, people are looking to me to respond to that stuff.
The idea for the position came from a senior administrator we had at the time who has since left the district, who had a real passion for the delivery of substance use supports. In her role, she was seeing that the efforts weren鈥檛 cohesive. Some things were happening in health classes, there was a smattering of discipline things in other departments, and there weren鈥檛 really any supports or partnerships with community-based organizations.
So her vision was that there would be one person that would work to address those gaps, coordinate, and expand on all of these things.
I have never found a peer [with the same position in other school districts]. When I鈥檝e been lucky enough to go to national conferences, I鈥檝e found a couple of drug and alcohol counselors that are employed by school districts, but I鈥檝e never found anybody else in a coordination or administrative role.
How prevalent are adolescent drug use and deaths now, compared to previous years?
I think an important piece of context is that I don鈥檛 think either nationally or in Oregon adolescent substance use is up. It鈥檚 been steady for a long time, but where you see the increase is that overdose deaths are up. That is tied directly to the presence of fentanyl in the drug supply and people either seeking it out or using it by accident because it has totally infiltrated the illicit drug market.
It鈥檚 important to note that the overall leading cause of death right now for 18- to 45-year-olds is overdoses. It鈥檚 more than car accidents.
My one word of caution is you have to be careful because percentages of overdose deaths are terrifying when you see them, and some text or headline says there鈥檚 been a 500 percent increase. But if, for example, you had one minor who died one year and then five the next, that鈥檚 a 400 percent increase, but it鈥檚 not 400 kids. So, whenever possible, ask for more context if you see a number that鈥檚 particularly shocking.
What are some of the most impactful initiatives you鈥檝e worked on in Portland schools?
We redid the district鈥檚 drug and alcohol policy. We revised it to be the 鈥渉ealthy substance-free learning environment policy,鈥� and we really focused on what we did want to see, which is students and adults鈥攅verybody in the building鈥攂eing healthy.
The most important piece of that policy that we redid is, now our primary response to substance use violations is connecting kids with interventions, education, and supports. It鈥檚 not enough to just say, 鈥淭his is not acceptable and here鈥檚 your punishment.鈥� You鈥檝e got to have something to refer students to.
How important is the approach of offering services and education as opposed to discipline?
It鈥檚 everything. By and large, the primary form of discipline for drug and alcohol violations is out-of-school discipline. Out-of-school discipline for drug and alcohol violations is especially problematic because then we鈥檙e setting students up to have more unstructured, unsupervised time to use, instead of pulling them in closer and connecting them with supports.
One of our biggest interventions is, PPS has a long-standing six hours of psychoeducation that we offer to families that have the lowest-level drug and alcohol violation. So basically the first time kids get in trouble, they get referred to this class called Insight. And I manage that, and it鈥檚 four classes. Each is 90 minutes long, and students have to come with a parent or a caring adult. And it鈥檚, you know, we鈥檙e doing activities, we鈥檙e giving a lot of baseline information. We鈥檙e talking about the substances that both most often trip students up, and we also now talk about fentanyl because it鈥檚 so dangerous. And then we talk about skills around refusal, how to ask for help if you need it, decision-making risk, and protective factors.
How effective has your work been? Are you seeing tangible impacts in your schools?
We have 41,000 students, and then we have about 400 to 450 that have a low-level drug and alcohol violation every year. And then from that group of students, the group that goes on to get in trouble again is less than 100. And then the group that goes on to get in trouble a third time is really small, probably about 20. So I think the thing that we鈥檙e seeing is that education and linkages to supports work.
It鈥檚 tricky because schools are in communities, so as long as substance use is an issue in the community鈥攁nd it鈥檚 a big issue in the Portland community鈥攖hat鈥檚 going to impact our students. So the things that we control are the supports that we offer once kids are in our buildings.
What advice do you have for other district leaders who are faced with this problem?
In education, we鈥檙e all enamored with the MTSS (multi-tiered system of supports) triangle.
I love thinking about tier one interventions for substance use, because that is really where you have the most impact. So, focus on comprehensive health education for all students.
Think about skills-based health education where you鈥檙e not saying, 鈥淵ou won鈥檛 ever be in this situation,鈥� but teaching them how to navigate it once there鈥攚hat decisionmaking skills are you using for yourself when you鈥檙e in these hard situations?
Then, do some strategic planning about how you鈥檙e going to address this throughout the school year. Make a plan to talk about drug and alcohol supports once a month in your school newsletter, then figure out what you want to talk about each month and just keep it part of the conversation consistently.
Most districts don鈥檛 have a me, so find your community partner you can invite in when you need extra help. Figure out who that is and nurture that relationship.
I think that type of planning can take schools a really long way.
What else do districts need to fight this issue, from either the state or federal level?
I think one of the things that gets missed a lot is adolescent drug and alcohol treatment often gets placed outside of schools. That in and of itself is an automatic barrier for students accessing it.
Any time we can think about and fund partnerships between health authorities and school districts so that kids can access some of those services during the school day, we鈥檙e setting ourselves and our kids up for success.
The more barriers that a family has鈥攊f English isn鈥檛 their first language, if they don鈥檛 have a car, if the parent works odd hours鈥攖he harder it鈥檚 going to be for them to access treatment in the community. Anything we can do to fund treatment in schools, because the kids are already there, is really effective programming.
