Deeds Bethany, Goldstein Amy B, Blanco Carlos
Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland.
Focus (Am Psychiatr Publ). 2024 Oct;22(4):441-448. doi: 10.1176/appi.focus.20240019. Epub 2024 Oct 15.
The authors discuss the multidimensionality of risk factors for substance use and substance use disorder across the lifespan and the interplay between biological and environmental factors that may lead to substance use. When these underlying factors are not addressed, and usage continues, altered networks in the brain may lead to substance use disorders. Progress in prevention science, and in approaches to delay or prevent substance use initiation and progression to substance use disorder, is reviewed. Four barriers to delivering prevention approaches-unstable funding with a lack of coordination across systems, insufficient workforce capacity, states not knowing where to find evidence-based programs, and a lack of knowledge in how to adapt programs for specific settings-are identified, highlighting the need for a national prevention infrastructure. The authors conclude by providing examples and resources for mental health professionals in promoting prevention of substance use initiation and disorders.
作者探讨了一生中物质使用和物质使用障碍风险因素的多维度性,以及可能导致物质使用的生物和环境因素之间的相互作用。当这些潜在因素未得到解决且使用行为持续时,大脑中改变的网络可能会导致物质使用障碍。本文回顾了预防科学以及延迟或预防物质使用起始和发展为物质使用障碍的方法方面的进展。确定了实施预防方法的四个障碍——资金不稳定且各系统间缺乏协调、劳动力能力不足、各州不知道在哪里可以找到循证项目,以及缺乏如何针对特定环境调整项目的知识,强调了建立国家预防基础设施的必要性。作者通过为心理健康专业人员提供促进预防物质使用起始和障碍的示例及资源来得出结论。