Understanding And Responding To Drug Use

Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.

Drug abuse persists as one of the most costly and contentious problems on the nation's agenda. Pathways of Addiction meets the need for a clear and thoughtful national research agenda that will yield the greatest benefit from today's limited resources. The committee makes its recommendations within the public health framework and incorporates diverse fields of inquiry and a range of policy positions. It examines both the demand and supply aspects of drug abuse. Pathways of Addiction offers a fact-filled, highly readable examination of drug abuse issues in the United States, describing findings and outlining research needs in the areas of behavioral and neurobiological foundations of drug abuse. The book covers the epidemiology and etiology of drug abuse and discusses several of its most troubling health and social consequences, including HIV, violence, and harm to children. Pathways of Addiction looks at the efficacy of different prevention interventions and the many advances that have been made in treatment research in the past 20 years. The book also examines drug treatment in the criminal justice setting and the effectiveness of drug treatment under managed care. The committee advocates systematic study of the laws by which the nation attempts to control drug use and identifies the research questions most germane to public policy. Pathways of Addiction provides a strategic outline for wise investment of the nation's research resources in drug abuse. This comprehensive and accessible volume will have widespread relevanceâ€"to policymakers, researchers, research administrators, foundation decisionmakers, healthcare professionals, faculty and students, and concerned individuals.

This monograph is the product of the decision of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) to launch a project in 1996 to obtain a comprehensive overview of qualitative research on drugs in Europe. The opening section highlights the multiple roles of qualitative research in understanding and responding to drug use. Part II addresses the impact of qualitative research on policy-making. Part III provides examples of research conducted in European Union cities that has been specifically designed to identify and verify new trends in drug use. Part IV on risk behaviour demonstrates how qualitative research methods have made a considerable contribution to the knowledge and understanding of health risks associated with drug injecting. Subsequent sections consider the theme of social exclusion, drug markets, and drug services evaluation. The final section is given over to qualitative research on drug use within a global research agenda. It reveals the scale of qualitative drug research varies greatly between countries, that little is published in the drug-specific scientific journals and that high quality work often appears to fail to influence policy. The monograph concludes that a comprehensive approach should include the training of individual experts and research teams and exchanges of experience between researchers across and beyond Europe.

Sets out clear recommendations, based on the best available evidence, for healthcare staff on how to work with people who misuse drugs (specifically opioids, stimulants and cannabis) to significantly improve their treatment and care.

Understanding and Working with Substance Misusers explores the complex nature of addiction and the challenges involved in responding effectively through policy and practice. It examines the biopyschosocial elements of addiction to substances (including alcohol) and, draws together key research findings from these fields to present a new framework for integrating theory and practice. The book argues that the best way to understand addictions is as examples of "complex self organising systems", which comprise many interacting component parts. In so doing, it addresses the problem of service users presenting with multiple needs (including poly drug use, mental health problems, criminal behaviour, unemployment and relationship difficulties) and the challenges that this poses for policy makers, services commissioners and practitioners alike. This book fills the need for a text which makes the complex issues surrounding substance misuse accessible to both students and practitioners. As such, it fosters a multidisciplinary and critically reflective approach to policy and practice.