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Scenario-Tailored Opioid Messaging Program (STOMP)

Primary prevention strategies in Michigan targeted towards children and adolescents to promote cautious opioid prescribing and increase appropriate disposal of unused prescription opioid medications

Recognizing that legitimate prescription opioid use during adolescence has been associated with later prescription opioid misuse in adulthood, the Scenario-Tailored Opioid Messaging Program (STOMP) is a project by the University of Michigan aimed at primary prevention in youth. 

The ultimate goal of the program is to improve prescription opioid safety and efficacy in children and adolescents. This is done by optimizing three areas:

  • opioid risk recognition
  • informed analgesic decision-making
  • drug storage/disposal among parents of youth for home use

One current strategy of STOMP that is currently being investigated in a clinical trial is to offer an educational intervention to youth undergoing elective surgical procedures. Researchers are hopeful that this intervention will increase opioid risk recognition and decrease future prescription opioid misuse.  

Another strategy that is being supported by a grant from the National Institute on Drug Abuse is an educational intervention that, in addition to increasing parental knowledge, will facilitate the appropriate disposal of unused prescription opioids.

Previous work by STOMP has shown that poor parental understanding leads to risky and potentially dangerous prescription opioid-related decisions. In response to this finding, STOMP also has a strategy tailored to parental education for youth who are prescribed prescription opioids, which has shown promising results. 

More information on STOMP interventions can be found in the peer-reviewed literature here and here. Preliminary results are promising. 

STOMP has shown promising results for increasing both parental knowledge and appropriate disposal of unused prescription opioids.

Continuum of Care
Prevention
Type of Evidence
Peer-reviewed
Response Approach
Cautious Opioid Prescribing
Educational
Family Support
Peer-reviewed Article
Effect of a Scenario-Tailored Opioid Messaging Program on Parents’ Risk Perceptions and Opioid Decision-Making
Behavioral Intervention and Disposal of Leftover Opioids: A Randomized Trial
Effect of a brief scenario-tailored educational program on parents' risk knowledge, perceptions and decisions to administer prescribed opioids: a randomized controlled trial
Enhancing risk perception may be insufficient to curtail prescription opioid use and misuse among youth after surgery: A randomized controlled trial
A Risk Education Program Decreases Leftover Prescription Opioid Retention: An RCT
Related Resources
Prescription Drug Community Action Kit: Safe Medication Disposal Guide
The Prescription Opioid and Heroin Crisis: A Public Health Approach to an Epidemic of Addiction
Mandatory Drug Stewardship Programs in States and Municipalities across the United States
Prescriber Education Interventions to Optimize Opioid Prescribing in Acute Care: A Systematic Review
Evidence-Based Interventions for Adolescent Opioid Use Disorder: What Might Work for High-Risk Ohio Counties?
A Nation in Crisis: A Health Education Approach to Preventing Opioid Misuse and Addiction
The Opioid Use Disorder Prevention Playbook

Evidence of Program Effectiveness

STOMP has shown promising results in increasing both parental knowledge and unused prescription drug disposal:

"Following the intervention, the STOMP™ group became more risk avoidant and gained higher perceptions of the critical risk, excessive sedation. STOMP™ parents were less likely than Controls to give a prescribed opioid in the High Risk situation. The STOMP™ intervention enhanced risk perceptions, shifted preferences toward opioid risk avoidance, and led to better decisions regarding when to give or withhold an opioid for pain management." (Voepel-Lewis et al., 2018)

"Prompt (unused prescription drug) disposal behavior was higher for parents who received both the STOMP and Nudge interventions (38.5%), Nudge alone (33.3%), or STOMP alone (31%) compared with controls (19.2%)...Such strategies can reduce the presence of risky leftover medications in the home and decrease the risks posed to children and adolescents." (Voepel-Lewis et al., 2020)

However, the STOMP intervention may not translate into reducing opioid use and misuse in youth who are prescribed opioids for acute pain relief after surgery:

"Compared to Controls, STOMP was associated with stable but higher risk perceptions on day 14 and month 3. There was no effect of STOMP or analgesic misuse risk perceptions on days of opioid use or subsequent misuse intentions/behavior. The degree to which participants valued pain relief over analgesic risk (trade-off preference) was, however, associated with prolonged postoperative opioid use and later misuse...Education emphasizing the risks of opioids was insufficient in reducing opioid use and misuse in youth who were prescribed these analgesics for acute pain relief." (Voepel-Lewis et al., 2022)