In managing or preventing substance use disorders, nothing should occur in isolation. People and systems of care are complex. They require frequent observation, assessment and understanding. To this end, systems focused on medical models, statistics and abstract ideas do not take fully into account the reality of a patient’s situation and place too great an emphasis on the individual as being the source of their own suffering. Such paradigms, while accepting that individuals must make their own health decisions, perhaps negate the influence of social systems and existing policy on health outcomes. In working towards the prevention of substance use disorders, it is important to appreciate those social determinants of health, policies and actions that precipitate adverse outcomes. Furthermore, empowering stakeholders to engage with clinicians and policy makers on issues related to treatment and prevention, is an essential step in understanding what is needed, and how best practices might be implemented.
At SAMHSA’s Center for Substance Abuse Treatment (CSAT) we value the importance of not only providing evidence-based treatments for substance misuse, but also in treating ‘the whole person’. This means that our grantees and partners are encouraged to engage the assistance of counseling, behavioral therapies, case managers, vocational coaches, and peer-support networks, to name but a few, in assisting clients. This approach has been shown to augment the treatment experience and to maintain clients in long-term recovery. It also helps address the biologic, psychological and sociocultural factors that underlie substance misuse.
Preventative strategies also draw on biopsychosocial principles not only to warn against the harmful effects of those substances prone to misuse, but also in promoting systems of change. In this way, preventative and treatment strategies are aligned, while differing in their focus. A striking example of how alignment of these principals can produce an impact might be found in the opioid crisis.