Hilary S Connery1, R Kathryn McHugh, Meghan Reilly, Sonya Shin, Shelly F Greenfield. 1. From the Departments of Psychiatry (Drs. Connery, McHugh, and Greenfield) and Global Health and Social Medicine (Dr. Shin), Harvard Medical School; Divisions of Alcohol, Drugs, and Addiction (Drs. Connery, McHugh, and Greenfield, and Ms. Reilly), and of Women's Mental Health (Ms. Reilly and Dr. Greenfield), McLean Hospital, Belmont, MA; Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA (Dr. Shin); Gallup Indian Health Center, Gallup, NM (Dr. Shin).
Abstract
LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Assess the treatment gap for patients with substance use disorders• Evaluate treatments and models of implementation for substance use disorders ABSTRACT: Substance use disorders (SUDs) account for substantial global morbidity, mortality, and financial and social burden, yet the majority of those suffering with SUDs in both low- and middle-income (LMICs) and high-income countries (HICs) never receive SUD treatment. Evidence-based SUD treatments are available, but access to treatment is severely limited. Stigma and legal discrimination against persons with SUDs continue to hinder public understanding of SUDs as treatable health conditions, and to impede global health efforts to improve treatment access and to reduce SUD prevalence and costs. Implementing SUD treatment in LMICs and HICs requires developing workforce capacity for treatment delivery. Capacity building is optimized when clinical expertise is partnered with regional community stakeholders and government in the context of a unified strategy to expand SUD treatment services. Workforce expansion for SUD treatment delivery harnesses community stakeholders to participate actively as family and peer supports, and as trained lay health workers. Longitudinal supervision of the workforce and appropriate incentives for service are required components of a sustainable, community-based model for SUD treatment. Implementation would benefit from research investigating the most effective and culturally adaptable models that can be delivered in diverse settings.
LEARNING OBJECTIVES: After participating in this activity, learners should be better able to:• Assess the treatment gap for patients with substance use disorders• Evaluate treatments and models of implementation for substance use disorders ABSTRACT: Substance use disorders (SUDs) account for substantial global morbidity, mortality, and financial and social burden, yet the majority of those suffering with SUDs in both low- and middle-income (LMICs) and high-income countries (HICs) never receive SUD treatment. Evidence-based SUD treatments are available, but access to treatment is severely limited. Stigma and legal discrimination against persons with SUDs continue to hinder public understanding of SUDs as treatable health conditions, and to impede global health efforts to improve treatment access and to reduce SUD prevalence and costs. Implementing SUD treatment in LMICs and HICs requires developing workforce capacity for treatment delivery. Capacity building is optimized when clinical expertise is partnered with regional community stakeholders and government in the context of a unified strategy to expand SUD treatment services. Workforce expansion for SUD treatment delivery harnesses community stakeholders to participate actively as family and peer supports, and as trained lay health workers. Longitudinal supervision of the workforce and appropriate incentives for service are required components of a sustainable, community-based model for SUD treatment. Implementation would benefit from research investigating the most effective and culturally adaptable models that can be delivered in diverse settings.
Authors: R Louise Floyd; Mark Sobell; Mary M Velasquez; Karen Ingersoll; Mary Nettleman; Linda Sobell; Patricia Dolan Mullen; Sherry Ceperich; Kirk von Sternberg; Burt Bolton; Kenneth Johnson; Bradley Skarpness; Jyothi Nagaraja Journal: Am J Prev Med Date: 2007-01 Impact factor: 5.043
Authors: Shelly F Greenfield; Alan Shields; Hilary Smith Connery; Viktoriya Livchits; Sergey A Yanov; Charmaine S Lastimoso; Aivar K Strelis; Sergey P Mishustin; Garrett Fitzmaurice; Trini A Mathew; Sonya Shin Journal: Alcohol Clin Exp Res Date: 2009-11-20 Impact factor: 3.455
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