Georgia BASICS: Brief assessment, screening, intervention, and continuum of services project: A public health approach to substance use services

IntroductionThe concept of a ‘public health approach’ to substance use is frequently but inconsistently invoked. This inconsistency is reflected in public policy, with governments using the term ‘public health approach’ in contradictory ways. This aim of this study is to clarify what is meant and understood when the term ‘public health approach’ is used in the context of substance use.Methods and analysisWe will conduct a systematic search of Medline, Embase, Scopus, CINAHL, PsycINFO, Sociological Abstracts and PAIS Index. Eligible articles will be from peer-reviewed journals, in English, with full text available. There will be no limits on year of publication. Substance use must be the primary topic of the article. Editorials, commentaries and letters to the editor will be included, but not commentaries on other articles, unless the definition of a public health approach is central to the commentary. Data selection and collection will be conducted independently by two researchers, with a third separately resolving any disagreement. To answer the research question, we will extract authors’ definitions of a public health approach to substance use as well as any descriptions of the central principles, characteristics and components of such an approach. To synthesise the data, we will employ thematic synthesis. Coding will be conducted by one researcher and verified by a second; two researchers will then group the codes into themes using an inductive process. Finally, the full research team will develop a set of analytic themes, which will be presented as a narrative.Ethics and disseminationEthics approval is not needed since the research will only involve published work. Our findings will be disseminated in a peer-reviewed journal and, if possible, at conferences.PROSPERO registration numberCRD42021270632.

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The Prevalence Of Binge Eating Disorder And Associated Psychiatric And Substance Use Disorders In A Student Population In Kenya – Towards A Public Health Approach

10.21203/rs.3.rs-222582/v1 ◽

2021 ◽

Author(s):

Victoria N. Mutiso ◽

Prof. David M. Ndetei ◽

Esther N. Muia ◽

Rita K. Alietsi ◽

Lydia Onsinyo ◽

...

Keyword(s):

Public Health ◽

Substance Use ◽

Eating Disorder ◽

Binge Eating ◽

Psychiatric Disorders ◽

Substance Use Disorders ◽

Binge Eating Disorder ◽

Student Population ◽

Public Health Approach ◽

Dsm Iv

Abstract Background: Changing lifestyles in Kenya can lead to eating related behaviors and problems. The more severe problems are likely to manifest in clinical settings, but the majority and less severe forms will remain unrecognized. There is therefore the need to take a public health awareness approach to identify cases at community level and initiate appropriate intervention. This requires characterization of Eating Disorders (ED) and its associations in the local context. Our focus will be on the more common Binge Eating Disorder (BED). The overarching objective of this study is to generate Kenyan data on BED and fill a gap that exists not only in Kenya but Africa in general. The specific aims are: (1) To document the patterns and prevalence of different symptoms of BED in a student population whose age range represents a significant proportion of the population. (2) To determine associated psychiatric and substance use disorders (3) To determine independent predictors of BED. Method: We administered to a total of 9742 participants following tools: A researcher designed socio-demographic and economic indicators questionnaire; an instrument on DSM-IV diagnosis of BED and its various symptoms; instruments to determine DSM-IV psychiatric disorders, substance abuse, affectivity, psychosis and stress indicators. The participants were high school, college and university students in four out of the 47 counties in Kenya. We used descriptive and inferential analysis to determine prevalence and association of the different variables. The independent predictors of BED were generated from the generalized linear model (p<0.05). Results: We found a prevalence of 3.2% of BED and a wide range of BED symptoms varying from 8.1% to 19.0%. There were significant (p<0.05) associations between BED with various socio-demographic variables and psychiatric and substance use disorders. However, only some of these disorders were independent predictors of BED. Conclusion: Our findings on prevalence of BED and significant associations with various psychiatric disorders and substance use disorders are similar to those obtained in HICs using similar large scale samples in non-clinical populations. Economic status is not a predictor of BED. Our findings suggest a public health approach to awareness and management.

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Screening, Brief Intervention, and Referral to Treatment (SBIRT) as a Public Health and Prevention Strategy to Address Substance Misuse and Addiction

A Public Health Guide to Ending the Opioid Epidemic ◽

10.1093/oso/9780190056810.003.0009 ◽

2019 ◽

pp. 77-94 ◽

Cited By ~ 1

Author(s):

Alexandra Nowalk ◽

Janice Pringle

Keyword(s):

Public Health ◽

Substance Use ◽

Brief Intervention ◽

Substance Misuse ◽

High Risk Patient ◽

Public Health Approach ◽

Medical Settings ◽

Risk Levels ◽

Treatment And Prevention ◽

Increasing Risk

SBIRT (screening, brief intervention, and referral to treatment) is a comprehensive and integrated public health approach that aims to address hazardous and harmful substance use in patients through universal screening for substance misuse risk and the subsequent delivery of appropriate evidence-based interventions to reduce this risk. SBIRT has been implemented throughout all 50 states in a wide variety of medical settings. Thus far, over one million people across the country have been screened for substance use using SBIRT practices. SBIRT has also been implemented internationally. SBIRT is predicated on the premise that, like other chronic diseases, substance use falls along a clinical spectrum ranging from low to high risk. Patient substance use can be stratified across increasing risk levels that correlate with an appropriate disease state extending from abstinence to a diagnosable substance use disorder. Implications for treatment and prevention programs are discussed.

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Stigma and the Language of Addiction

A Public Health Guide to Ending the Opioid Epidemic ◽

10.1093/oso/9780190056810.003.0005 ◽

2019 ◽

pp. 33-44

Author(s):

Michael Botticelli ◽

Colleen L. Barry

Keyword(s):

Public Health ◽

Mental Health ◽

Substance Use ◽

Public Attitudes ◽

Opioid Use Disorder ◽

Health Conditions ◽

Public Health Approach ◽

Opioid Use ◽

Policy Changes ◽

Opioid Crisis

Stigma influences attitudes toward individuals and groups, and these attitudes are expressed in how we as a nation have dealt with addiction in general and the opioid crisis in particular. Stigma is defined as a strong lack of respect for a person or a group of people or a bad opinion of them because they have done something or have traits of which society disapproves. Stigma creates misperceptions about how to end the opioid crisis and acts as a barrier for individuals with opioid use disorder to seek treatment and engage in recovery. Public attitudes toward addiction need to be changed to effectively end the epidemic, as does the language used to describe individuals who misuse drugs. Misperceptions and lack of understanding of addiction as a chronic disease have promoted the criminalization of individuals with substance use disorder rather than a public health approach. The case is made for policy changes that support new policy directions that stress parity in treatment for mental health and substance misuse with other “physical health” conditions as well as suggestions for better communications strategies to reduce stigma.

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