Integrating Substance Use Disorder ( Sud ) And Healthcare Services

There are some barriers or weaknesses common to most interventions that target addictive behaviors in the community. Heterogeneity in the population and cultural barriers has contributed to the lack of knowledge regarding substance use and its effects. Issues related to taboo, denial and loss of face mask understanding of the extent of the problem. Institutional barriers and lack of community infrastructure make treatment efforts difficult in serving a diverse population (Ja, 1993). In addition to the psychological barriers, other physical problems also exist. Most primary care physicians do not feel competent to treat alcohol and drug related disorders. Physicians generally do not like to work with patients with these disorders and do not find treating them rewarding. There is substantial evidence that physicians fail even to identify a large percentage of patients with these disorders (Miller, Sheppard, Colenda, & Magen, 2001). Financial barriers include inability to access treatment services by addicted individuals as indicated in various studies. There is also a competition for resources that has to be considered. Local governments allocate some part of their funding for specific issues and there is a competition among several stakeholders to ensure that their cause is represented. Research shows that prevention programs in the community on the issues of substance abuse, risky sexual behavior, school failure, juvenile delinquency and violence have to be

There is no doubt that there is a prevalence of substance abuse throughout several age groups. To a certain extent, a society is faced with the reality of controlling substance abuse. Or allow it run rampant throughout the community. Often times, we hear and read about the level of substance abuse among teen, young adults and mid-aged

According to the SAMHSA (2010) report on the national survey on drug use and health almost 22.5 million people are reported to be associated with substance abuse disorder (SAMHSA, 2010). This illness was found to be very common in all age groups, both sex, and seniors. There are several effects on these individuals and their families. Many people who suffer from substance abuse disorders fail to acknowledge these serious consequences. First of all, no response of pain relief can be seen with smaller doses of pain medications, as their bodies are used to high levels of various substances at the same time. Nurses become frustrated when they try to treat and help these patients with pain. Sometimes it is difficult to think about ethical principles when nurses have to deal with such patients with pain and suffering.

Practice models used in treatment of substance abuse have up until recently only been recommended for the intervention of younger addicts. As a result, treatment approaches for older adults are lacking in evidence. However, screening for substance abuse is the first step towards determining if a more thorough assessment is needed. Cook et al. (1998) reported that it is necessary to take a holistic approach to treatment, and take a broader focus than just the chemical abuse because as people age their psychological and health problems become more complex (p. 146). Older adults face life changes and lack of poor support networks are more deeply felt. Bogunovic (2012) answered that, “A comprehensive evaluation should include a thorough physical examination and laboratory analysis and psychiatric, neurological, and social evaluation.” Such measures are effective when paired with screening

Abuse and SUD can be separated by categories. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), define substance use disorders that are mild, moderate, or severe. It is within these levels that certain criteria’s are meet Substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home (“Substance use disorder”, 2015). Other determining factors that define substance use disorder in the DSM-5 manual is the impaired control, social impairment,

Substance abuse has been a known topic which has not been recognized and fully treated the way it should. Unlike general medicine, substance abuse treatments have their own facility and services apart from general settings, making it harder to get the recognition and the assistance needed to help the individuals in need. Both the Affordable Care Act and the Substance Abuse and Mental Health Service Administration (SAMHSA), which is a part of the US Department of Health and Human Services have promoted and established ways to enhance the quality of the treatment and the amount of treatment given.

New Horizons Community Mental Health Center offers is outpatient substance abuse intervention. The Substance Abuse Program (SAP) attempts to assist clients with an insight of what has lead to their addiction as well as skills to remain sober (New Horizons Community Mental Health Center, 2014).

Individuals with substance use disorders (SUDs) are difficult to treat due to the high prevalence of relapse, with an average of 50% relapsing within the first year (Bowen et al., 2014). Research has shown that current relapse prevention therapy is ineffective and other techniques are needed for effective treatment. To decrease the incidence of relapse, Bowen et al. (2014) set out to assess the effectiveness of mindfulness-based relapse prevention (MBRP) compared with standard relapse prevention (RP) and treatment as usual (TAU) in a randomized clinical trial during a 12-month follow-up period. Bowen et al. (2014) hypothesized that MBRP would significantly decrease the risk of relapse and participants would stay sober longer compared with RP and TAU. The study included 286 participants between the ages of 18 and 70, which were selected from a SUD treatment facility and randomly assigned to into the MBRP, RP, or TAU group. The MBRP group included eight weekly 2-hour group sessions with two therapists. The RP intervention, followed the same format, but instead utilized cognitive behavioral therapy. The TAU program was formatted around Alcoholics Anonymous (AA) 12-step program and included 1.5-hour groups 1 to 2 times per week. All participants were assessed at baseline, 3 months, 6 months, and 12 months after the interventions. The study found that MBRP and RP significantly lowered the risk of relapsing and decreased the days of substance use compared with the TAU.

The standardized Screening, Brief Intervention & Referral to Treatment (SBIRT) instrument form is a comprehensive, integrated tool that can enable health professionals in any setting to quickly assess persons with substance use disorders (SUDs) or at risk of developing these disorders, to deliver early intervention to at-risk substance users, and assist those in need of a brief intervention or more intensive treatment receive appropriate treatment services (SAMHSA, 2015). The SBIRT form consists of few sections. It incorporates a 10-item Alcohol Use Disorders Identification Test (AUDIT) questionnaire made of two sections: the alcohol pre-screen which is the first level screen that assesses patients or clients for alcohol use and consists of questions one to three, and the full screen which consists of questions four to 10 and identifies signs of dependence with questions four to six and related problems with questions seven to 10.

Research efforts must focus on understanding how to improve the effectiveness of primary drug abuse prevention programs. Furthermore, these programs must become more prominent throughout the country to prevent the development of addiction. Although the goal is to completely prevent abuse of prescription drugs, treatment services must be available to those who have abused or are currently abusing these drugs. Therefore, demand reduction strategies must ensure that there is an adequate supply of substance abuse treatment programs and mental health professionals to provide these services (American Public Health Association, 2015).

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is commonly used to identify, reduce, and prevent abuse and dependence on alcohol and banned drugs ("Screening, Brief Intervention, and Referral to Treatment (SBIRT) Health Professions Student Training," 2000). This assessment can be broken down simply by: a) conducting a screening where the clinician assesses a patient for risky substance use behaviors using standardized screening tools b) having a brief intervention where the clinician holds a short conversation, then provides feedback and offering advice c) lastly, the clinician can provide a referral to brief therapy or additional treatment for patients in need of the services ("Resource,"2000). Thus, making this a very useful

Substance abuse which involve drugs, alcohol, or both affects the health of individuals, families, and communities nationwide. It remains one of the most complex public health issue in the nation. According to Who’s Leading the Leading Health Indicator? Webinar on substance abuse, about 8.5 % of the population suffer from substance abuse dependence or abuse. In addition, the overall cost of substance abuse including lost productivity, health, and crime related costs the nation more than 600 billion dollars annually. Substance abuse contributes to all sort of negative consequences to individuals and society including increased morbidity and mortality, family distractions, financial issues, domestic violence, child abuse, and crime. Several intervention

Behavioral health disorders, which include substance use and mental health disorders, affect millions of adolescents and adults in the United States and contribute heavily to the burden of disease (World Health Organization, 2013). The coexistence of both a mental health issue and a substance use disorder (SUD) is referred to as a co-occurring disorder (i.e., a mental disorder and an SUD). (Center for Behavioral Health Statistics and Quality, 2015, p. 32). As reported by SAMSHA, 2017, about 3.3 percent of all adults in 2014 had both any mental illness (AMI) and an SUD in the past year, and 1.0

Statistics indicate that there are nearly 21 million Americans who have a substance abuse disorder, but only a significantly small portion of up to about ten percentage has been able to access medical help (Kelly et al. 8). Assessing the reasons why

Substance abuse is considered an epidemic throughout the country, affecting everyone involved, including health care systems, in particular emergency departments (Bernstein & D'Onofrio, 2013). Emergency departments are starting to look at different treatment modalities to improve patients’ overall outcome, hopefully guiding them to recovery, with more patients recovering from substance abuse, there is a potential to have a reduction in the number of patients utilizing the department. The literature reviewed discusses different treatment modalities that address the need for an alternative treatment modality; first brief intervention (BI) or Screening, Brief intervention, Referral and Treatment (SBIRT), second is booster calls or sessions and finally is the combination of BI with booster calls.