Skip to main content
Full access
From the Guest Editor
Published Online: 11 April 2019

Progress and Future: Meeting the Needs of the Nation’s Substance Use Crisis

Publication: FOCUS, A Journal of the American Psychiatric Association
Drug overdoses are now one of the leading causes of injury and mortality in the United States. Similar to the U.S. strategy for the AIDS epidemic, the country needs a highly coordinated response to combat increasing rates of substance use. Unfortunately, many underserved areas still lack access to evidence-based treatments. Important questions about substance-related treatment strategies also remain unanswered, such as how long to leave individuals on medication-assisted treatment and whether certain formulations of buprenorphine work better for specific patient populations. This issue of Focus explores a range of substance-related topics that are clinically relevant to the practicing psychiatrist. The articles are written by some of the leading experts in the areas of clinical treatment, research, and drug related-policy. We thank Focus’s editor, Mark Rapaport, M.D., for encouraging us to highlight such an important topic.
On the opioid front, Bertha Madras, Ph.D., a member of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, and her colleague, Hilary Connery, M.D., Ph.D., provide an insightful analysis of the scope of the opioid crisis and governmental efforts to combat the growing epidemic (1). They also propose roles that psychiatrists could take in advocating for change and providing high-quality treatment of patients with substance use disorders. Richard Rosenthal, M.D., carries the theme of opioid-related disorders and offers a review of various delivery systems for intermediate- to long-acting buprenorphine maintenance treatment options, some of which are novel solutions to reduce issues related to diversion and nonadherence (2). Finally, Joji Suzuki, M.D., as a co-guest editor of this issue, discusses the approach to general hospital treatment of endocarditis that is associated with injection drug use (3).
However, we also need to be careful not to have the opioid epidemic overshadow the demand for more effective treatment strategies for all substance use disorders. Co-guest editor Justine Welsh, M.D., examines the use of substances on college campuses, as well as some of the specific challenges and approaches to treatment in this population (4). Despite significant gains across the field, training in addictions remains limited not only in the medical community, but also in general psychiatry. In this issue, John Renner, M.D., provides a review of the inadequacy of addiction training among psychiatric residents and the stigma associated with substance use treatment (5). To overcome such challenges, he proposes ways to incorporate additional training into the psychiatric curriculum based on his experience working with the Boston University/Veterans Affairs training model. Amid the changing political landscape, Arthur Williams, M.D., and Kevin Hill, M.D., M.H.S., offer insight into cannabis policy and provide a comprehensive review on the epidemiology and treatment of cannabis use disorder (6). Muhammad Iqbal, M.D., and colleagues explore treatment recommendations for co-occurring substance use disorders and other psychiatric conditions (7). We hope that these articles provide much-needed insights into the significant progress our field has made and where we hope to go in our ability to provide tailored treatment options to individuals with substance use disorders.

References

1.
Madras BK, Connery H: Psychiatry and the opioid overdose crisis. Focus 2019; 17:128–133
2.
Rosenthal R: Novel formulations of buprenorphine for treatment of opioid use disorder. Focus 2019; 17:104–109
3.
Suzuki J: Assessment and management of endocarditis among people who inject drugs in the general hospital setting. Focus 2019; 17:110–116
4.
Welsh JW, Shentu Y, Sarvey DB: Substance use among college students. Focus 2019; 17:117–127
5.
Renner JA: Counteracting the effect of stigma on education for substance use disorders. Focus 2019; 17:134–140
6.
Williams AR, Hill KP: Cannabis and the current state of treatment for cannabis use disorder. Focus 2019; 17:98–103
7.
Iqbal MN, Levin CJ, Levin FR: Treatment for substance use disorder with co-occurring mental illness. Focus 2019; 17:88–97

Information & Authors

Information

Published In

Go to Focus
Go to Focus
FOCUS, A Journal of the American Psychiatric Association
Pages: 87

History

Published in print: Spring 2019
Published online: 11 April 2019

Keywords

  1. Administration
  2. Drug/Substance Abuse

Authors

Details

Justine W. Welsh, M.D.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Welsh); Department of Psychiatry, Brigham and Women’s Hospital, and Harvard Medical School, Boston (Suzuki).
Joji Suzuki, M.D.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Welsh); Department of Psychiatry, Brigham and Women’s Hospital, and Harvard Medical School, Boston (Suzuki).

Metrics & Citations

Metrics

Citations

Export Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Format
Citation style
Style
Copy to clipboard

View Options

View options

PDF/EPUB

View PDF/EPUB

Login options

Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.

Personal login Institutional Login Open Athens login

Not a subscriber?

Subscribe Now / Learn More

PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.

Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).

Media

Figures

Other

Tables

Share

Share

Share article link

Share