Substance Use Disorders in Global Mental Health Delivery: Epidemiology, Treatment Gap, and Implementation of Evidence-Based Treatments

Eating disorders (ED) and substance use disorders (SUD) frequently co-occur but are rarely treated in a comprehensive integrated manner. This chapter elucidates the complex relationship between ED and SUD to help the treating professional create an integrated treatment plan that addresses both disorders and any other co-occurring conditions. Evidence-based treatments for each disorder are discussed, and recommendations on how to take “best practices” from both fields to formulate a treatment plan that addresses the specific needs of the patient are presented. The chapter includes case examples that demonstrate the importance of understanding the adaptive function of both disorders when developing an effective intervention.

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Closing the treatment gap for mental, neurological and substance use disorders by strengthening existing health care platforms: strategies for delivery and integration of evidence-based interventions

International Journal of Mental Health Systems ◽

10.1186/s13033-015-0031-9 ◽

2015 ◽

Vol 9 (1) ◽

Cited By ~ 46

Author(s):

Rahul Shidhaye ◽

Crick Lund ◽

Dan Chisholm

Keyword(s):

Health Care ◽

Substance Use ◽

Substance Use Disorders ◽

Evidence Based ◽

Treatment Gap

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Evidence-Based Treatments for Substance Use Disorders

FOCUS The Journal of Lifelong Learning in Psychiatry ◽

10.1176/foc.1.2.115 ◽

2003 ◽

Vol 1 (2) ◽

pp. 115-122 ◽

Cited By ~ 3

Author(s):

Paul B. Gold ◽

Kathleen T. Brady

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Evidence Based ◽

Evidence Based Treatments

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Evidence-Based Alcohol and Substance Use Disorder Treatment with Sexual and Gender Minorities

Handbook of Evidence-Based Mental Health Practice with Sexual and Gender Minorities ◽

10.1093/med-psych/9780190669300.003.0010 ◽

2019 ◽

pp. 222-243

Author(s):

Adam W. Carrico ◽

Walter Gómez ◽

Cathy J. Reback

Keyword(s):

Substance Use ◽

Clinical Research ◽

Substance Use Disorders ◽

Substance Use Disorder ◽

Evidence Based ◽

Sexual Minority Women ◽

Substance Use Disorder Treatment ◽

Evidence Based Treatments ◽

Disorder Treatment ◽

And Gender

Although sexual and gender minority (SGM) populations remain at markedly elevated risk for developing alcohol and substance use disorders, relatively few substance use disorder treatment programs provide culturally tailored services. This chapter provides an overview of alcohol and substance use disparities as well as reviews evidence-based interventions in distinct SGM populations. In general, clinical research has focused on culturally tailoring evidence-based substance use disorder treatments such as cognitive–behavioral therapy and motivational interviewing with modest success. Further clinical research should develop and test novel substance use disorder intervention approaches that address minority stress processes as key triggers for unhealthy alcohol consumption and substance use. Clinical research is also needed to address the disparities in unhealthy drinking among sexual minority women as well as alcohol and substance use disparities in transgender individuals. Recommendations are provided to optimize the effectiveness and scalability of existing evidence-based treatments targeting alcohol and substance use disorders in SGM populations.

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Substance Use Disorders

10.1093/med/9780190920197.001.0001 ◽

2020 ◽

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Evidence Based ◽

Need For Treatment ◽

The Past ◽

The Us ◽

Evidence Based Treatments ◽

Behavioral Therapies ◽

Illegal Activities ◽

Lay Public

Over the past few years there has been an increased interest in the identification and treatment of substance use disorders, due at least in part to the widespread drug overdose epidemic. Clinicians and the lay public have gained a greater understanding of the need for treatment of substance use disorders and the consequences of avoiding treatment. In addition, there has been a growing understanding of substance use disorders as medical or mental health disorders, rather than as character flaws or merely illegal activities. This book builds on this nascent understanding and presents epidemiology, basic science, and treatment from the perspective of a clinician who wants to gain the knowledge and background needed to work with this patient population. The overall theme of the book is to discuss evidence-based rather than anecdotal or unproved treatments. Section I begins with the epidemiology, etiology, and neurobiology of substance use disorders, including preclinical data. Section II discusses pharmacotherapy for substance use disorders, focusing on medications approved by the US Food and Drug Administration (FDA). Section III focuses on other evidence-based treatments for substance use disorders, including behavioral therapies, and ends with potential future treatments.

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Smartphone Applications for Mindfulness Training in the Treatment of Substance Use Disorders

The Oxford Handbook of Digital Technologies and Mental Health ◽

10.1093/oxfordhb/9780190218058.013.36 ◽

2020 ◽

pp. 428-438

Author(s):

Kathleen A. Garrison ◽

Stephanie S. O'Malley ◽

Judson A. Brewer ◽

Marc N. Potenza

Keyword(s):

Mental Health ◽

Substance Use ◽

Substance Use Disorders ◽

Mindfulness Training ◽

Mobile Technologies ◽

Substance Use Treatment ◽

Smartphone App ◽

Evidence Based ◽

Clinical Testing ◽

Smartphone Apps

There are presently more than 1,000 smartphone apps offering mindfulness or meditation in some form, marketed largely to improving one’s health and well-being. At the same time, scientific credibility of most available mindfulness and meditation apps is considered low, and clinical testing of these apps is only in beginning stages. Nevertheless, initial work is under way and suggests that evidence-based mindfulness apps may have clinical benefits for mental health. This chapter reviews the state of the science of mindfulness apps, with a focus on the treatment of substance use disorders. Mindfulness training, in person, has been shown to be effective in the treatment of substance use disorders. Mobile technologies such as smartphone apps offer numerous advantages to delivering mindfulness training, conducting clinical studies, and potentially improving clinical outcomes in substance use treatment over in-person mindfulness training. This chapter outlines the advantages and some possible limitations of delivering mindfulness training via smartphone app, reviews available mindfulness apps for mental health, reviews scientific literature supporting these apps, and proposes areas of focus for further development of mindfulness apps. Findings indicate that mindfulness training is feasible to deliver by smartphone app and other mobile technologies, initial clinical testing of mindfulness apps for substance use treatment is promising, and larger randomized controlled trials are under way. Importantly, more mindfulness apps and trials are utilizing evidence-based clinical practice guidelines.

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Mental health treatment outcome expectancies in Burundi

Transcultural Psychiatry ◽

10.1177/1363461516652302 ◽

2016 ◽

Vol 54 (1) ◽

pp. 46-65 ◽

Cited By ~ 4

Author(s):

Pacifique Irankunda ◽

Laurie Heatherington

Keyword(s):

Mental Health ◽

Mental Health Treatment ◽

Global Mental Health ◽

Spiritual Healing ◽

Traditional Healing ◽

Future Research ◽

Evidence Based ◽

Treatment Expectancies ◽

Values And Beliefs ◽

Evidence Based Treatments

Best practices in global mental health stress the importance of understanding local values and beliefs. Research demonstrates that expectancies about the effectiveness of a given treatment significantly predicts outcome, beyond the treatment effect itself. To help inform the development of mental health interventions in Burundi, we studied expectancies about the effectiveness of four treatments: spiritual healing, traditional healing, medication, and selected evidence-based psychosocial treatments widely used in the US. Treatment expectancies were assessed for each of three key syndromes identified by previous research: akabonge (a set of depression-like symptoms), guhahamuka (a set of trauma-related symptoms), and ibisigo (a set of psychosis-like symptoms) . In individual interviews or written surveys in French or Kirundi with patients ( N = 198) awaiting treatment at the clinic, we described each disorder and the treatments in everyday language, asking standard efficacy expectations questions about each (“Would it work?” “Why or why not?”). Findings indicated uniformly high expectancies about the efficacy of spiritual treatment, relatively high expectancies for western evidence-based treatments (especially cognitive behavior therapy [CBT] for depression-like symptoms), lower expectancies for medicine, and especially low expectancies for traditional healing (except for traditional healing for psychosis-like symptoms). There were significant effects of gender but not of education level. Qualitative analyses of explanations provide insight into the basis of people’s beliefs, their explanations about why a given treatment would or would not work varied by type of disorder, and reflected beliefs about underlying causes. Implications for program development and future research are discussed.

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