Substance Use Disorder Toolkit

Overview

Overview

Substance Use Disorder

The American Society Addiction Medicine (ASAM) defines addiction as a primary, chronic disease of brain reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations.

Substance use—involving drugs, alcohol, or both—is a complex public health issue associated with a range of destructive social conditions, including family disruptions, financial problems, lost productivity, failure in school, domestic violence, child abuse, and crime.

PAs should be specifically attuned to addressing substance use disorders with their patients since it can be spotted throughout all specialties and can affect ongoing treatment plans and overall health outcomes.

The Substance Use Disorder Toolkit aims to help PAs practicing in all specialties address substance use disorders in their patients by providing tools, resources, and techniques to help identify these disorders, create treatment plans, and provide appropriate patient resources.

 


 

Opioids

The epidemic of overdoses and deaths from the abuse of prescription opioids has devastated countless families and communities. Preventing individuals from abusing and becoming dependent on opioids will save lives and preserve the health and vibrancy of communities. To combat the opioid crisis, AAPA provides several CME activities promoting the appropriate, safe, and effective use of opioids to manage chronic pain many Americans.

At present there are too few addiction specialists to meet the growing demand for medication assisted treatment (MAT) programs. Since 2016, the Comprehensive Addiction Recovery Act (CARA) permits PAs to become waivered to prescribe buprenorphine for the treatment of opioid addiction. AAPA is an approved provider by CSAT/SAMHSA DATA 2000 training. Training of PAs in primary care in prescribing and managing patients on one of the drugs used in MAT will increase the availability of providers in the care of patients with an opioid use disorder.

For additional information about PAs and Buprenorphine Waivers, see AAPA’s 2020 report.

 


 

High-Risk Substance Use Among Adolescents

The majority of adults who meet the criteria for having a substance use disorder started using substances during their teen and young adult years. Youth with substance use disorders also experience higher rates of physical and mental illnesses, diminished overall health and well-being, and potential progression to addiction.

High-risk substance use is any use by adolescents of substances with a high risk of adverse outcomes (i.e., injury, criminal justice involvement, school dropout, loss of life). This includes misuse of prescription drugs and use of illicit drugs. In addition, use of injection drugs increases the risks of acquisition of HIV and hepatitis.

 


 

Alcohol

According to the Centers for Disease Control and Prevention (CDC), excessive alcohol use leads to approximately 95,000 deaths in the United States each year and is a leading cause of preventable death.

Excessive alcohol use has both short-term and long-term effects:

Short-term effects

  • Injuries, such as motor vehicle crashes, falls, drownings, and burns
  • Violence, including homicide, suicide, sexual assault, and intimate partner violence
  • Risky sexual behaviors which can result in unintended pregnancy or sexually transmitted diseases, including HIV
  • Miscarriage and stillbirth or fetal alcohol spectrum disorders (FASDs)

Long-term effects

  • High blood pressure, heart disease, stroke, liver disease, and digestive problems
  • Cancer of the breast, mouth, throat, esophagus, liver, and colon
  • Cognitive impairment
  • Psychosocial issues such as depression, anxiety, lost productivity, family disruption, and unemployment
  • Alcohol use disorders or alcohol dependence

 


 

Tobacco

Tobacco use is the single most preventable cause of disease, disability, and death in the United States.   According to the Centers for Disease Control and Prevention, in 2019, 14.0% of all adults (34.1 million people) currently smoked cigarettes: 15.3% of men and 12.7% of women.

Patient Education Resources

Patient Education Resources

Opioids

CDC Helpful Materials for Patients: Opioid Overdose

Partnership to End Addiction: Heroin & the Opioid Epidemic: From Understanding to Action

Practice Resources

Practice Resources

Substance Use Disorder

Federal

Professional Societies


Practice Resources

 


 

Opioids

Federal


Professional Societies

 


 

High-Risk Substance Use Among Adolescents

Federal

American Society of Pediatrics

CDC

Healthy People 2020

National Institute of Drug Abuse

U.S. Surgeon General


Practice Guidelines

U.S. Preventive Services Task Force

 


 

Alcohol

Federal

CDC

U.S. Surgeon General

Practice Guidelines

 


 

Tobacco

E-cigarettes & Vaping


Marijuana


Federal

CDC

National Institute on Drug Abuse

Healthy People 2030

U.S. Surgeon General

Practice Guidelines

U.S. Preventive Services Task Force

U.S. Surgeon General

Webinars

Webinars

National Academy of Medicine Stigma of Addiction Summit

Join the National Academy of Medicine, Dell Medical School at The University of Texas at Austin, and Shatterproof on June 10 at 12 PM ET for the Stigma of Addiction Summit, a free, virtual, half-day symposium that will focus entirely on understanding, addressing, and eliminating the harmful impacts of stigma on people who use drugs and experience addiction.

National Academy of Medicine Tapering Guidance for Opioids: Existing Best Practices and Evidence Standards

The Action Collaborative on Countering the U.S. Opioid Epidemic hosted a free public webinar on opioid tapering, utilizing experts in the field who discussed current guidance for opioid tapering, how it is applied in practice, and the strength of the evidence behind it.