Substance use disorders and the misuse of opioids, methamphetamine, alcohol, and cocaine continue to present major challenges to the wellbeing of society. Public health approaches to the prevention, treatment, and recovery of these conditions require shifting focus to “upstream” factors such as housing instability, that mediate risks for diseases in the first place. Here, we propose three ways of re-thinking prevention and treatment for substance misuse and use disorders:
1. Thinking intersectionally: Understanding the intersections among substance misuse/substance use disorders (SUDs) and housing, employment, access to quality and affordable treatment, and ongoing support is crucial in addressing prevention. Prevention efforts for substance misuse and use disorders, like such efforts for any other chronic disease, work best when people experience well-being in other aspects of their lives. Unstable housing, unemployment, and lack of social support are all associated with higher rates of substance use. Prevention efforts must address the numerous intersectional barriers to wellbeing.
2. Thinking person-centered: Prevention and treatment efforts must focus on people as people, with various struggles, fears, and strengths. Criminalizing and stigmatizing substance use and misuse as personal failures ignores the fact that SUDs are chronic diseases. A holistic, person-centered approach to prevention and treatment means framing the disease as one of many components of a person’s experience, not the defining characteristic of the people themselves, and encourages providers to be compassionate and refrain from being judgmental.