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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.
Analyses the impact of addictive drugs (alcohol, nicotine and illegal drugs) and behaviours (gambling) on the health and wellbeing of individuals and societies based on the latest research and within an innovative new conceptual framework
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.
Presenting the findings of a five year project studying the pace and impact of addictions in Europe, this work deconstructs the failures and promises of European governance polices for reducing the harm done by legal and illegal drugs and posits a nine point plan as a way forward to redesign addictions governance
The multifaceted nature of harmful substance use and gambling requires interdisciplinary analysis to assess the underlying causes. What Determines Harm from Addictive Substances and Behaviours? draws together evidence from twelve disciplines including anthropology, genetics, neurobiology, and public policy. Using a developmental approach, the book presents evidence on the factors that influence the development of harmful substance use and gambling. The determinants of harm operate at three levels: molecular, individual, and social. This book brings to light the complex interplay between them and presents the scientific, social, economic, political, and psychological influences of harmful substance use and gambling. These individual determinants are then synthesised into an integrative heuristic model to encourage new ways of thinking. The findings from this analysis are used to elaborate key general implications for health and broader social policy, clinical practice, and future research. What Determines Harm from Addictive Substances and Behaviours? is based on research from ALICE RAP, a multidisciplinary European study of addictive substances and behaviours in contemporary society. This is an essential resource for public health professionals, stakeholders influencing policy for addictive substances and behaviours, students, and academics looking to better understand the factors influencing substance use and gambling and the implications this research has for addiction prevention policy.
Concepts of Addictive Substances and Behaviours across Time and Place presents fascinating new historical and social scientific research examining the temporal and spatial variations in the ways that addiction problems are understood and addressed in European societies. The book illustrates the changing and versatile nature of language use, of stakeholders concepts and ideas, and of the popular, professional and political discourse around addiction. The arguments that unfold concern the various cultural components invested in the ways in which the problems are viewed and addressed. A framework is presented for discussing these circumstances in view of current knowledge-based governance at a local, regional and global level. Concepts of Addictive Substances and Behaviours across Time and Place is based on research from ALICE RAP (Addiction and Lifestyles in Contemporary Europe, Reframing Addictions Project), a multidisciplinary European study of addictive substances, and behaviours in contemporary society. This is an essential resource for public health professionals, stakeholders influencing policy for addictive substances and behaviours, students, and academics looking to better understand the historical and geographical variations of addictive behaviours across in Europe and the role of stakeholder involvement in the construction of addiction prevention policy.
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.
Why is governance of addiction so difficult? What can we learn from recent experiences and efforts in Europe? Governance of Addictions analyses the multidisciplinary research which has been used as a framework for understanding how governments formulate and implement addiction policies in 27 European Union member states plus Norway, looking in detail at four substances: heroin, cannabis, alcohol and tobacco. Presenting the methodological design for the study research, this book comprehensively analysing international trends, with a special focus on the role of the EU and its governance of addictions modes, this volume sheds light on the current situation of the governance of addictive substances and behaviours and facilitate new approaches to dealing with addiction. Based on the research from ALICE RAP (Addiction and Lifestyles in Contemporary Europe, Reframing Addictions Project), a unique project studying the place of addictive substances and behaviours in contemporary European society, Governance of Addictions is essential reading for policy-makers, public managers, practitioner and stakeholders influencing policy for addictive substances and behaviours, as well as academics and public health professionals.
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.