University of Oregon Study Offers Potential to Enhance Drug Abuse Programs for Teenagers

With the help of prestigious drug abuse prevention grant, a University of Oregon graduate student is examining the long-term effects of what are known as recovery high schools, knowledge that could help inform public policy on adolescent recovery.

Lauren Berny is a doctoral candidate in prevention science and a research assistant at the Prevention Science Institute in the College of Education. She recently received a two-year, $86,412 grant from the National Institute on Drug Abuse to support her research on the effectiveness of recovery high schools.

Previous work suggests recovery high schools are one evidence-based, cost-effective way to help students with substance use disorders. Yet such schools are few and far between — only about 40 operate in the United States, including just two in Oregon, according to the Association of Recovery Schools.

An estimated 17,000 Oregon youth struggle with substance use disorders, and nine in 10 do not receive treatment. Even for those who go through treatment, relapse is common.

Recovery high schools are alternative school settings that provide education and recovery support to students following treatment for substance use disorders. Families often turn to recovery high schools as a last-ditch option after previous relapses following treatment.

Only one controlled study exists on recovery high schools, which showed they were effective in helping adolescents’ recovery. The two-year, longitudinal study compared students who attended recovery high schools against students who attended regular high schools.

It showed attending a recovery high school for at least 28 days was associated with abstinence and a reduction in substance use; improvement in attendance; increased graduation rates; less engagement in illegal activity while intoxicated; and greater life satisfaction.

And the schools were shown to be cost-effective: The net benefits range from $16,000 to $52,000 for families, communities and society, which adds up to a benefit ranging from $3 to $7 for each dollar spent.

But more research is needed.

“We don’t know why recovery high schools work,” Berny said. “Having an idea of what actually works, but particularly why something works, is important in interventions because that’s what makes them scalable. I’m interested in examining how social environments and relationships influence health outcomes.”

Berny intends to use advanced statistical modeling techniques to test her hypothesis: that the pro-recovery peer support that teens are exposed to in recovery high schools is the underlying component leading to positive outcomes.

Her research is based on the earlier study, which surveyed high school students in Minnesota, Texas and Wisconsin who had received treatment for substance use disorders. One group of 143 students had attended recovery high schools, while the second group of 117 students attended regular high schools.

The students completed questionnaires at six months, 12 months, and 24 months after treatment. At six months, students who attended recovery high schools were twice as likely to abstain from alcohol use, used cannabis less often, had fewer school absences, had higher levels of life satisfaction and were less likely to engage in intoxicated illegal activity.

After 24 months, the study found 82 percent of students who attended a recovery high school graduated, compared to 57 percent of their peers who attended a regular high school.

Tanner-Smith and Berny became acquainted when Berny was a master’s candidate at Vanderbilt. Smith-Tanner said she was “thrilled” when Berny applied to the prevention science program at the UO in 2020.

“Lauren demonstrates a true passion for prevention science and is driven by the ultimate goal of improving the health and well-being of communities,” Tanner-Smith said. “Her initiative, intellectual curiosity and dedication make her an excellent candidate for this dissertation research grant. She is an incredibly talented doctoral candidate who is well-poised to become a leading scholar in the field of adolescent substance use research.”

Recovery high schools have been around since the 1970s, but they are difficult to sustain because of lack of funding, the need for specialized staff, and small student bodies, Berny said.

Last year Oregon increased funding to establish five to six new recovery high schools around the state, she said.

“I want to use my research in a way that can inform public policy and help broaden and bolster the evidence base,” Berny said. “If we can show the mechanisms underlying recovery high schools is pro-recovery peer support, you can use that component to develop other types of treatment.”

Berny’s grant is a R36 dissertation award, funded by the National Institute of Drug Abuse, part of the National Institutes of Health, in support of “exemplary research projects” that align with the drug abuse institute’s strategic plan, and to help early career researchers in the field of substance use disorder research, Tanner-Smith said.

Berny’s award is one of just 20 R36 grants currently funded by the institute.