John Paul Mulhern, MSW, MBA, LCSW-C, University of Maryland School of Social Work, Baltimore, and Division of Professional Studies, University of Maryland Baltimore County.
J Addict Nurs. 2022;33(3):200-202. doi: 10.1097/JAN.0000000000000473.
Substance use disorders continue to trend as an increasingly pervasive public health problem in the United States. Substance use disorders are recognized as a global health problem by the World Health Organization. It is imperative to explore all opportunities to improve outcomes of substance use disorder treatment. Consideration of social determinant risks in assessment, treatment planning, and treatment implementation is one such opportunity. Social determinant conditions can be conceptualized along a continuum of primary categories. Developing methods to help clinicians understand and incorporate social determinants into assessment and treatment plan formulation processes may help improve outcomes for those who are experiencing one or more substance use disorders. This column includes a proposal for a framework of primary categories of social determinants and offers a definition for each. The categories are identified as basic needs insecurity, past trauma, historical oppression, current/ongoing severe distress and layered/compounded risks. These categories and definitions are developed in the context of practical application for clinical assessment and treatment plan formulation.
物质使用障碍在美国继续成为一个日益普遍的公共卫生问题。世界卫生组织已将物质使用障碍确认为一个全球性的健康问题。必须探索一切机会来改善物质使用障碍治疗的结果。在评估、治疗计划和治疗实施中考虑社会决定因素风险就是这样一个机会。社会决定因素条件可以沿着主要类别连续体进行概念化。制定帮助临床医生理解和将社会决定因素纳入评估和治疗计划制定过程的方法,可能有助于改善那些患有一种或多种物质使用障碍的人的治疗效果。本专栏提出了一个社会决定因素主要类别的框架,并为每个类别提供了定义。这些类别被确定为基本需求不安全、过去的创伤、历史压迫、当前/持续的严重困扰以及分层/复合风险。这些类别和定义是在临床评估和治疗计划制定的实际应用背景下制定的。