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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.
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.
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 authoritative handbook reviews the most widely-used methods for studying the use and abuse of alcohol and illegal drugs. Its thorough coverage spans the range of quantitative, qualitative, and mixed-method approaches to documenting and measuring the complex psychological, behavioral, and physical experience of substance misuse and dependence, to ensure valid, useful results. Experts discuss special issues and considerations for conducting ethical research with specialized populations, including youth, inmates, and the LGBT community. Throughout these chapters, contributors demonstrate the multidisciplinary nature of substance abuse research, with emphasis on professional ethics and the critical role of research in developing best practices and effective policy for prevention and treatment. Among the topics covered: · Transdisciplinary research perspective: a theoretical framework for substance abuse research · Longitudinal methods in substance use research · Considerations in blending qualitative and quantitative components in substance abuse research · The use of biological measures in social research on drug misuse · Using surveys to study substance use behavior · Applications of GIS to inform substance abuse research and interventions · Evaluating substance use prevention and treatment programs Research Methods in the Study of Substance Abuse is an essential resource for health services and public health professionals, policymakers, and researchers working and training in the field of addiction. It encourages the rigor and understanding necessary to address widespread social and public health concerns.
Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.
Addiction Research Methods’ is a comprehensive handbook for health professionals, policy-makers and researchers working and training in the field of addiction. The book provides a clear, comprehensive and practical guide to research design, methods and analysis within the context of the field of alcohol and other drugs. The reader is introduced to fundamental principles and key issues; and is orientated to available sources of information and key literature. Written by a team of internationally acclaimed contributors, the book is divided into six major sections: Introduction; Research Design; Basic Toolbox; Biological Models; Specialist Methods; and Analytical Methods. Each chapter offers an introduction to the background and development of the discipline in question, its key features and applications, how it compares to other methods/analyses and its advantages and limitations. FEATURES List of useful websites and assistive technology. Case study examples List of useful hermeneutics Recommended reading list Contains exercises to help the reader to develop their skills.
This book assists new and experienced scholars in planning and conducting high quality, contemporary studies for knowledge building about substance use. The target audience is individuals new to substance use as a field of study, either as novice researchers or as experienced researchers in other areas who find themselves lacking experience to address overlapping issues of substance use. Organized around a translational science framework, the contents address substance use research about epidemiology, etiology, intervention efficacy and effectiveness, and implementation of evidence-informed interventions. In addition, examples and issues are drawn from social work traditions involving multiple levels of study (organisms to large social systems), integrating biopsychosocial aspects, and adopting a lifespan perspective. The authors examine the implications for research of current "great debates" in the field and present readers with a variety of specific substance use research resources and tools. This practical "how to" guide takes the reader step-by-step through issues specific to substance use research in study design, participant recruitment and retention, measurement and analysis, and the processes involved in the dissemination, diffusion, and implementation of evidence-informed innovations. A variety of technical resources and measurement tools are provided, as are references to journals for scholars to consider both as knowledge resources and as outlets for disseminating their work. In sum, this book offers a fresh approach to conducting substance use research that is not readily available in other texts.