Mental Health, Brain Health and Substance Use

Beyond the financial costs, mental health and substance use conditions interfere with young people’s ability to accomplish developmental tasks, such as establishing healthy interpersonal re­lationships, succeeding in school, and making their way in the workforce. Primary prevention using a socioecological framework seeks to prevent the onset of disease and acknowledges that an individual’s risk of developing OUD is shaped by a combination of intersecting biopsychosocial and environmental risk and protective factors, as outlined in Figure 2. Evidence-based primary prevention interventions address both biopsychosocial and environmental risk and protective factors at the individual, interpersonal, and macro levels to prevent the onset of OUD (Office of the Surgeon General, 2016). According to the 2022 National Survey on Drug Use and Health, approximately 48.7 million Americans aged 12 or older had a SUD in the past year, yet only about 6% received treatment.

Psychosocial interventions

In complex cases where diagnostic ambiguity exists, referring the individual to a psychiatrist with expertise in addiction can be particularly beneficial. This specialized assessment can help untangle intricate diagnostic scenarios and guide treatment decisions effectively. However, what makes this analogy particularly insightful is the realization that much like the original Trojan Horse, the situation can be more complex. As the ‘horse’ (psychiatric treatment) enters, it may indeed address and alleviate the psychiatric symptoms, but it does not necessarily guarantee the complete resolution of substance use issues. This unfolding scenario emphasizes the need for a comprehensive and nuanced approach to treating concurrent disorders, acknowledging that these conditions may coexist independently rather than one being solely responsible for the other. Culturally and linguistically diverse populations face greater challenges to accessing OUD treatment (Gainsbury, 2016).

FIGURE 3. Secondary Prevention: Examples of Risks and Protective Factors for Those with Opioid Use Disorder.

Community coalitions are composed of diverse organizations that form an alliance in order to pursue a common goal. The activities of community coalitions include outreach, education, prevention, service delivery, capacity building, empowerment, community action, and systems change. The presumption is that successful community coalitions are able to identify new resources to continue their activities and sustain their impact in the community over time. Given the large investment in community coalitions, researchers are beginning to systematically explore the factors that affect the sustainability of community coalitions once their initial funding ends. Treatment may save a life and can help people struggling with opioid addiction get their lives back on track by allowing them to counteract addiction’s powerful effects on their brain and behavior.

• Prevention strategies have often relied on harsh criminal legal actions and fear-based educational campaigns, ostensibly to send a warning to individuals who might sell or use drugs.
• Community coalitions are composed of diverse organizations that form an alliance in order to pursue a common goal.
• Also 15.7 million adults (aged 18 or older) and 2.8 million youth (aged 12 to 17) had a major depressive episode during the past year.
• Mental health, neurological and substance use(MNS) conditions represent a major global health and development challenge.This document sets out WHO’s…

Research Funded by NIMH

The authors hope to expand the purview of action and responsibility beyond the individual, encourage an expanded lens for those who ascribe only to the biomedical approach to health and well-being, and promote an evergreen focus on SUD prevention that elevates the conversation beyond any particular drug. Leveraging a socioecological approach empowers leaders to champion prevention strategies that address health equity and amend the nation’s historically unjust practices, some of which persist today. With health equity in mind, the authors encourage US leaders to sharpen their attention toward macro-level solutions for prevention; these hold the greatest potential for sustainably improving health for all citizens across a broad set of health outcomes.

In the realm of comorbid SUDs and psychiatric conditions, harm reduction strategies emerge as a pragmatic and compassionate approach to care. This dual-diagnosis population faces unique challenges, often influenced by social determinants of health, pervasive stigma, and limited access to comprehensive care. In this context, harm reduction strategies offer a holistic prevention of substance use and mental disorders approach that prioritizes safety and well-being over immediate abstinence, recognizing that complete sobriety may not always be immediately achievable or realistic. In essence, the “Trojan Horse” concept highlights the importance of individualized treatment approaches that acknowledge the multifaceted nature of concurrent disorders.

• Notably, the review highlighted that males were more likely to experience dual diagnoses, and affective disorders emerged as the most prevalent psychiatric diagnoses among this group.
• OUD is a treatable, chronic disease that can affect anyone – regardless of race, sex, income level, or social class.
• In turn, this broader focus on prevention and treatment can also contribute significantly to promoting overall health and well-being.
• One significant challenge arises from the difficulty in accurately identifying specific subgroups within this population.
• Social epidemiologic research supports the assertion that the context in which individuals make health-related choices serves as a barrier to or facilitates health (Galea, Nandi, and Vlahov, 2004; DuBois, 2003).
• This dual-diagnosis population faces unique challenges, often influenced by social determinants of health, pervasive stigma, and limited access to comprehensive care.

Notably, the review highlighted that males were more likely to experience dual diagnoses, and affective disorders emerged as the most prevalent psychiatric diagnoses among this group. Accurate diagnosis is key for treating co-occurring substance use and mental disorders, since symptoms may overlap. Health care providers with experience in both substance use disorders and mental disorders can use comprehensive assessment tools to reduce the chance of a missed diagnosis and create an effective treatment plan.

Overdose Prevention

This integrated operational framework provides an overview of the connections between mental health, neurological and substance use (MNS) conditions, and… You can discuss your specific circumstances and situation to find treatments that are effective for your body. Share your concerns about the benefits and risks of prescription opioids and other pain treatment strategies.

For instance, primary care-based buprenorphine treatment has previously been shown to be effective in treatment patients with OUD with similar outcomes in terms of treatment engagement to subspecialty care.4 All health care providers can help reduce the burden of substance use disorders. Universal screening, empathetic communication, and medical treatment can save lives and transform the trajectory of patients struggling with substance use. While there are a variety of evidence-based and promising practices related to SUD and overdose prevention, there remain significant gaps in researchers’ and practitioners’ understanding. Public funds addressing overdose trends should ensure individual-, interpersonal-, and macro-level investments across the primary, secondary, and tertiary prevention spectrum and support continued research on intended and unintended health outcomes of all funded interventions.

Data have shown that early intervention following the first episode of a serious mental illness can make an impact. Coordinated, specialized services offered during or shortly after the first episode of psychosis are effective for improving clinical and functional outcomes. For instance, if a patient reports underlying depression or anxiety, they might initiate antidepressant treatment and closely monitor the patient’s progress over time. However, what is particularly insightful is how this approach unfolds when the client’s depression or anxiety begins to improve, as indicated by standardized rating scales and clinical evaluations, yet their alcohol use persists. During such diagnostic evaluations, psychiatrists and other clinicians face the complex task of disentangling these relationships.

Prenatal and antenatal interventions

Substance use disorders exist on a spectrum, ranging from mild to severe, but it’s important to remember that substance use disorders are treatable. Updates about mental health topics, including NIMH news, upcoming events, mental disorders, funding opportunities, and research. The conversation needs to be elevated beyond individual positions on the matter to include structural and societal factors. Here, the authors seek not to discredit the biomedical view but merely to provide support for more inclusive problem statements and solutions.

Strategies to prevent substance use — especially in adolescents — and help people get treatment can reduce drug and alcohol misuse, related health problems, and deaths. The outlined interventions and strategies can serve as a starting point and inspiration for stakeholders interested in addressing OUD and other related SUDs. The tables do not prioritize specific interventions, since each advocate operates within a unique context. Therefore, when determining which strategies and interventions to adopt, advocates should consider their target population and sphere of influence, and the resources they have at their disposal. The definitions of recovery and remission are hotly debated topics that involve differing schools of thought (Office of the Surgeon General, 2016).

Applying a Socioecological Framework for a More Nuanced View of OUD and Public Health Prevention

These disorders involve patterns of behaviors that might include using more of the substance than planned, finding it difficult to stop, or continuing to use despite knowing it’s causing harm. Use these free digital, outreach materials in your community and on social media to spread the word about mental health. Use these free education and outreach materials in your community and on social media to spread the word about mental health and related topics.