Vision and Recommendations

The final chapter of this Report spells out concrete recommendations for how to achieve an equitable and effective, science-based public health approach to substance use and substance use disorders. A public health–based approach seeks to understand the broad individual, environmental, and societal factors that influence substance misuse and substance use disorders and applies that knowledge to improve the health, safety, and well-being of the entire population. It recognizes that substance misuse and its consequences are the result of multiple interacting factors and coordinates the efforts of diverse stakeholders to address substance misuse across the community. Current health reform efforts and technological advances can facilitate this—for example, advances in health information technology and data analytics enable researchers and practitioners to target the populations of greatest need, link different components of health care and the broader public health systems together (e.g., affordable housing, job training, recovery support), and address the risk and protective factors that are most actionable at the local level.

But the health care system alone cannot address all of the major determinants of health related to substance misuse. Community leaders should work together to mobilize the capacities of health care organizations, local governmental public health, environmental agencies, social service organizations, educational systems, community-based organizations, religious institutions, law enforcement, local businesses, researchers, and other public, private, and voluntary entities that are part of the broader public health system. Everyone has a role to play in addressing substance misuse and substance use disorders as a public health issue.

The concluding chapter highlights five general messages and their implications for policy and practice:

  • Both substance misuse and substance use disorders harm the health and well-being of individuals and communities. Addressing them requires implementation of effective strategies.
  • Highly effective community-based prevention programs and policies exist and should be widely implemented.
  • Full integration of the continuum of services for substance use disorders with the rest of health care could significantly improve the quality, effectiveness, and safety of all health care.
  • Coordination and implementation of recent health reform and parity laws will help ensure increased access to services for people with substance use disorders.
  • A large body of research has clarified the biological, psychological, and social underpinnings of substance misuse and related disorders and described effective prevention, treatment, and recovery support services. Future research is needed to guide the new public health approach to substance misuse and substance use disorders.

Review the full text for Vision for the Future – 2016 (PDF | 255 KB)