CE26-0220 - no stigma warrior: a community-driven approach to prevent prescription opioid and youth alcohol misuse in ST

The Centers for Disease Control and Prevention awarded the Sickle Cell Association $125,000 on July 1, 2026, under the Drug-Free Communities Support Program (CFDA 93.276) to implement the No Stigma Warrior Initiative, a community-driven strategy to prevent prescription opioid misuse and underage alcohol use among youth in the St. Louis metropolitan area.

The coalition will deliver prevention services aligned with the DFC Seven Strategies for Community Change. Core activities include disseminating context-based prevention messaging on safe medication practices and underage drinking through schools, healthcare providers, faith-based institutions, youth-serving agencies, and digital platforms, with youth listening sessions and youth-led campaigns to ensure messaging reflects local norms and lived experiences. The initiative will deliver evidence-based workshops for youth and caregivers to support youth mental health, strengthen refusal skills, decision-making, parental monitoring, and communication related to alcohol use and prescription medications, while training providers and educators in delivering consistent guidance on safe medication use, storage, and disposal. The project will also promote safe medication storage and disposal access within the community.

The coalition identifies youth ages 12 to 18 as the primary population, with adolescents affected by sickle cell disease designated as a high-risk subpopulation due to increased exposure to prescription pain medications and stigma associated with chronic pain and substance use. The project operates across Missouri with a period of performance from July 1, 2026, through June 30, 2031.

Louis metropolitan - the no stigma warrior initiative coalition (EST. 2025) proposes a comprehensive, community-driven strategy to reduce youth substance use in the ST. Louis metropolitan area, with a primary focus on prescription opioid misuse and a secondary focus on underage alcohol use. The initiative is led by the sickle cell association (SCA) as fiscal agent. Youth ages 12-18 are the primary population of focus. Adolescents affected by sickle cell disease (SCD) are identified as a high-risk subpopulation due to increased exposure to prescription pain medications for recurrent pain management and the stigma associated with chronic pain and substance use. While this subpopulation informs strategy design, the project addresses community-wide conditions influencing substance use behaviors among all youth. Aligning with the DFC seven strategies for community change, the coalition will implement a coordinated approach that emphasizes environmental and systems-level change rather than clinical or treatment services. Core strategies include: (1) providing information by disseminating context-based prevention messaging on safe medication practices and underage drinking through schools, healthcare providers, faith-based institutions, youth-serving agencies, and digital platforms. Youth listening sessions and youth-led campaigns will ensure messaging reflects local norms and lived experiences; (2) building skills through evidence-based workshops for youth and caregivers to support youth mental health, strengthen refusal skills, decision-making, parental monitoring, and communication related to alcohol use and prescription medications. Training will also support providers and educators in delivering consistent guidance on safe medication use, storage, and disposal; (3) improving access and reducing barriers by promoting safe medication storage and disposal through community events, partnerships with pharmacies and law enforcement, and distribution of safe storage tools to reduce youth access to unused prescription medications; and (4) changing consequences and policies by supporting restorative school responses to underage substance use, reinforcing positive community norms, improving mental health, recognizing prevention-supportive behaviors, and collaborating with healthcare partners to promote consistent prescribing and disposal guidance. Over the five-year project period, the coalition will strengthen cross-sector collaboration and build sustainable prevention infrastructure while achieving measurable reductions in youth substance use. Short-term outcomes include increased youth perception of risk and increased parental and peer disapproval of alcohol and prescription drug misuse. Intermediate outcomes include reduced reported ease of access to alcohol and unused medications. Long-term outcomes include measurable declines in past 30-day alcohol use and nonmedical use of prescription pain relievers among youth. By integrating youth voice, leveraging strong healthcare and school partnerships, and embedding prevention strategies within existing community systems, the no stigma warrior initiative coalition will create sustained, community-level change that reduces stigma, strengthens protective factors, and promotes healthier futures for youth across ST. Louis metropolitan.