A more compassionate and realistic perspective puts the person at the center. It takes into account the context and why we start and continue to use drugs instead of just thinking about the drug itself. When we focus on the person, we are also reminded that we are all human beings, and any circumstance or result of substance use can just as easily become our own experience. How can we better understand this perspective? A common notion in our culture is that certain drugs are inherently dangerous and can somehow control our behavior. According to this idea, a person takes a drug until the day the drug takes the person. Once this change occurs, a person is labeled a „dependent“ and is unable to control their substance use. One image that too often comes to mind when we think of addiction in this way is that of a person who is overwhelmed by substance use, unemployed, perhaps homeless, and separated from family and friends. To what extent is this stereotype true? Recent reforms could weigh on the current workforce in an already overburdened health system working on treatment and prevention strategies. A recent study documented staffing models in GENERAL PRACTITIONER offices and found that even among those designated as patient-centred medical homes, less than 23% employed health educators, pharmacists, social workers, nutritionists or community service coordinators, and less than half of the care coordinators employed.312 The opioid epidemic has exacerbated the shortage of this type of health professional. 310 It is essential that health professionals receive comprehensive training on the prevention and treatment of substance use disorders when patients with comorbidities occur.32 There is also evidence that the use of certain medications can lead to mental illness for the first time. For example, research has shown that cannabis can increase your chances of developing psychosis or psychotic disorder. Another way to address inequalities is to ensure that substance abuse prevention, interventions, treatment and recovery services are appropriate and relevant to the populations that receive them.
Several interventions have been explicitly adapted to account for differences in specific population groups; They have been carried out in the field of health or can be implemented in these environments. The following list provides examples of such programs that have been shown to be effective in different populations: Health IT has shown benefits in improving care for patients with chronic diseases,357 and should be used due to the Affordable Care Act and related incentives, such as: Grants to support health center networks in the implementation and adoption of health informatics will increase sharply.358-361 To further increase adoption and implementation, CMS has released new rules to „reduce reporting burden for providers, support interoperability, and improve patient outcomes,“ including the fact that states and providers have more time to comply and focus on interoperability. 335.362 In addition, CMS recently published its draft Rule DE 2015 on Access to Medicare and the CHIP Reauthorization Act (MACRA). Creation of incentives to use health IT to communicate the results of quality measurement. State and municipal efforts to expand naloxone distribution are another example of building a comprehensive, multi-lane community infrastructure. Many communities have recognized the need to make this potentially life-saving drug more widely available. For example, community leaders in Wilkes County, North Carolina, implemented the Lazarus Project, a model that expands access to naloxone for law enforcement, emergency services, education, and health services, and reduces the overdose rate by half in one year. North Carolina also passed legislation in 2013 that introduced standing orders allowing for the dispensing of naloxone by a pharmacy without a prescription.375 A number of promising health facilities and funding models are currently being explored to integrate universal health coverage and substance use disorder treatment into health systems and to integrate the disorder treatment system. related to substance use throughout the health care system. As part of ongoing health care reform efforts, federal and state governments are investing in models and innovations ranging from nursing homes and COAs to managed and coordinated care organizations (COCs) to pay-for-performance and shared savings models. These new models develop and test strategies to effectively and sustainably fund high-quality care that integrates behavioral health and universal health coverage.
The National Heroin Working Group, comprised of law enforcement, physicians, public health officials and education experts, was convened to develop strategies to address the heroin problem and reduce the growing epidemic of overdoses and mortality rates.57 In 2015, the task force prepared a report outlining the measures taken to address the opioid problem. This included a multi-faceted strategy of enforcement and prevention efforts, as well as improved access to treatment and recovery services for substance use disorders. It is clear that integrating substance use disorders into universal health coverage is beneficial for individuals and communities, and that health care reform is driving this trend. However, several key challenges need to be addressed if integration is to be fully successful. Specifically, manufacturers and sellers of alcohol, legal drugs and related products play a role in reducing and preventing substance use among adolescents. They can prevent the sale and promotion of alcohol and other substances to minors and support evidence-based programs to prevent and reduce substance use among adolescents. Ultimately, health promotion is about healthy people in healthy communities. This also applies to the use of substances. People have been using psychoactive substances for millennia to promote health and well-being, but these substances cause or have the potential to harm individuals and communities.
In this context, health promotion is about helping people manage their substance use in the safest way possible. While hospitals have some flexibility in their definition of „community served by the facility“, they are expected to define community based on geographic location rather than demographic or geographic discharge patterns. Many states also have non-profit programs that need to be synchronized with the requirements of the Affordable Care Act.240 IOM`s 1997 report Improving Health in the Community highlighted how multiple stakeholders can conduct a health assessment in the community and share responsibility for the health outcomes of specific populations.241 These models, as well as recreation-based care systems, provide opportunities for Substance Use Disorders and Universal Health Coverage to participate in different types of collaborative efforts to integrate their services at all stages: prevention, treatment and recovery. It`s important to note that the models all emphasize the relationship between high-quality, person-centered care and fully integrated models. Innovative funding mechanisms currently under consideration also allow for formal agreements to implement some of the models mentioned above, including linking with external health professionals in substance-specific use disorders (and vice versa) when multiple services cannot be found in one location. Companies that manufacture and sell legal alcohol and drugs, as well as products related to the use of these substances, can demonstrate social responsibility by taking steps to prevent and prevent the abuse of their products. Companies can take steps to ensure that the public is aware of the risks associated with substance use, including the use of drugs with addictive potential alone and in combination with alcohol or other drugs. SAMHSA awarded 25 grants for the first SAMHSA harm reduction program. This funding, approved under the American Rescue Plan, will help improve access to a number of community-based harm reduction services and support harm reduction service providers while helping to prevent overdose deaths and reduce the health risks often associated with drug use. SAMHSA has accepted requests from state, local, tribal and territorial governments, tribal organizations, non-profit community organizations, and primary and behavioral health organizations.
Harm reduction measures and practices are based on a variety of evidence showing that interventions in different social, cultural and economic environments are practical, feasible, effective, safe and cost-effective.