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Rx for Addiction and Medication Safety (RAMS-PEER)

A school-based youth prevention program developed in Rhode Island to increase knowledge of opioids and decrease opioid use and misuse

More than 1 in 8 students in Rhode Island reported having used a prescription medication non-medically. In response to this, the University of Rhode Island College of Pharmacy developed Rx for Addiction and Medication Safety (RAMS-PEER), which is an educational intervention for high school students to increase knowledge about opioids, ultimately leading to decreased opioid use and misuse. 

Initially, a pilot project (called RAMS) consisted of a four-week, three-hour curriculum delivered by trained pharmacy students and college faculty which targeted 9th grade students in eight public schools in Rhode Island. The curriculum is divided into four components:

  • Medication safety, such as safe use and storage and disposal education
  • Signs and symptoms and risk factors for opioid misuse and withdrawal
  • Opioid overdose identification and response
  • Treatment and recovery resources

The RAMS program initiated a booster online educational intervention for students in 10th grade. Collectively, this model is called RAMS-PEER and is a publicly available educational curriculum. This model would be considered a universal prevention program for opioid misuse in adolescents. 

More detailed information about RAMS-PEER can be found in the presentation here. A comprehensive presentation on nonmedical use of prescription opioids by youth, which discusses RAMS-PEER, can be found here. The program has been highlighted by the CDC. 

Ninth grade student knowledge of opioid misuse improved...confidence to refer someone to treatment improved.

Continuum of Care
Prevention
Type of Evidence
Peer-reviewed
Response Approach
Early Intervention
Educational
Peer-reviewed Article
Rx for Addiction and Medication Safety (RAMS-PEER): Evaluation of an Education and Peer Program on Opioid Misuse
Rx for addiction and medication safety: An evaluation of teen education for opioid misuse prevention
Related Resources
Awareness, Education, and Collaboration: Promising School-based Opioid Prevention Approaches
Management of Opioid Misuse and Opioid Use Disorders Among Youth
Targeting Youth to Prevent Later Substance Use Disorder: An Underutilized Response to the US Opioid Crisis
Evidence-Based Interventions for Adolescent Opioid Use Disorder: What Might Work for High-Risk Ohio Counties?
Addressing a Crisis: Cross-Sector Strategies to Prevent Adolescent Substance Use and Suicide
The Opioid Use Disorder Prevention Playbook
A Nation in Crisis: A Health Education Approach to Preventing Opioid Misuse and Addiction
Addressing the Opioid Crisis through Community Prevention: An Application of the Seven Strategies for Community Change
Prescription Drug Community Action Kit: Safe Medication Disposal Guide

Evidence of Program Effectiveness

"After the RAMS-PEER program, during the 2017 through 2018 academic year, ninth grade student knowledge of opioid misuse improved. The percentage of correct answers increased significantly from preintervention to postintervention for questions on knowledge of opioid misuse (from 76.2% correct to 84.4% correct), and perceptions of people who use drugs (from 27.4% correct to 33.9% correct)...Improvement was observed among matched ninth graders regarding their knowledge that accepting a prescription medication from a friend was drug misuse. After receiving the intervention, among the matched students, we observed an 8% increase in knowledge of identifying addiction as a chronic brain disorder, a 26% increase in understanding of reasons people use drugs, and a 78% increase in knowledge that nonmedical use is using a prescription medication without a prescription. Knowledge improvement, however, was not significantly higher among ninth graders in the returning schools versus ninth graders in the new schools." (Sun et al., 2020)

"Significantly more students identified that addiction is a chronic brain disease, drug users are not responsible for their addiction, and that non-medical use of a prescription medication is use without a prescription. Improved confidence was also reported in identifying opioid withdrawal symptoms, identifying signs of an opioid overdose, and knowing when to administer naloxone. Confidence to refer someone to treatment improved from 31% to 45%." (Paltry et al., 2018)