Estimates indicate that as many as 1 in 4 Americans will experience a mental health problem or will misuse alcohol or drugs in their lifetimes. These disorders are among the most highly stigmatized health conditions in the United States, and they remain barriers to full participation in society in areas as basic as education, housing, and employment. Improving the lives of people with mental health and substance abuse disorders has been a priority in the United States for more than 50 years. The Community Mental Health Act of 1963 is considered a major turning point in America's efforts to improve behavioral healthcare. It ushered in an era of optimism and hope and laid the groundwork for the consumer movement and new models of recovery. The consumer movement gave voice to people with mental and substance use disorders and brought their perspectives and experience into national discussions about mental health. However over the same 50-year period, positive change in American public attitudes and beliefs about mental and substance use disorders has lagged behind these advances. Stigma is a complex social phenomenon based on a relationship between an attribute and a stereotype that assigns undesirable labels, qualities, and behaviors to a person with that attribute. Labeled individuals are then socially devalued, which leads to inequality and discrimination. This report contributes to national efforts to understand and change attitudes, beliefs and behaviors that can lead to stigma and discrimination. Changing stigma in a lasting way will require coordinated efforts, which are based on the best possible evidence, supported at the national level with multiyear funding, and planned and implemented by an effective coalition of representative stakeholders. Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change explores stigma and discrimination faced by individuals with mental or substance use disorders and recommends effective strategies for reducing stigma and encouraging people to seek treatment and other supportive services. It offers a set of conclusions and recommendations about successful stigma change strategies and the research needed to inform and evaluate these efforts in the United States.

This wide-ranging handbook brings together experts in the sociology of drug abuse prevention. Providing a comprehensive overview of the accumulated knowledge on prevention theory, intervention design, and development and prevention research methodology, this work also promotes prevention science as an evolving field in the practice and policy of drug abuse prevention.

All across the United States, individuals, families, communities, and health care systems are struggling to cope with substance use, misuse, and substance use disorders. Substance misuse and substance use disorders have devastating effects, disrupt the future plans of too many young people, and all too often, end lives prematurely and tragically. Substance misuse is a major public health challenge and a priority for our nation to address. The effects of substance use are cumulative and costly for our society, placing burdens on workplaces, the health care system, families, states, and communities. The Report discusses opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person's overall health, rather than a substance misuse or a physical health condition alone or in isolation. It also provides suggestions and recommendations for action that everyone-individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers-can take to prevent substance misuse and reduce its consequences.

Harm Reduction is a philosophy of public health intended as a progressive alternative to the prohibition of certain potentially dangerous lifestyle choices. Recognising that certain people always have and always will engage in behaviours which carry risks, the aim of harm reduction is to mitigate the potential dangers and health risks associated with those behaviours. Harm Reduction in Substance Use and High-Risk Behaviour offers a comprehensive exploration of the policy, practice and evidence base of harm reduction. Starting with a history of harm reduction, the book addresses key ethical and legal issues central to the debates and developments in the field. It discusses the full range of psychoactive substances, behaviours and communities with chapters on injecting, dance drugs, stimulant use, tobacco harm reduction, alcohol use and sex work. Written by an international team of contributors, this text provides an essential panorama of harm reduction in the 21st century for educators and researchers in addiction and public health, postgraduate students and policy makers.

Disorders of anxiety and substance use are, for some reason, rarely treated in an integrated fashion by professionals. This timely volume addresses this glaring omission with dispatches from the frontlines of research and treatment. Thirty-four international experts offer findings, theories, and intervention strategies for this common form of dual disorder, across a range of substances and of anxiety disorders, to give the reader comprehensive knowledge in a practical format.

Clinicians are now facing new substance use-related challenges such as the opioid crisis, a changing political landscape regarding marijuana, and the emergence of new delivery devices such as e-cigarettes. Unfortunately, it is more critical than ever that clinicians caring for adolescents have a proficiency in treating substance use. This book is a comprehensive clinical guide that discusses the prevalence of substance use among adolescents and young adults, as well as prevention strategies, available screening methods, practical treatment applications and their outcomes. Using a multidisciplinary approach with inclusion of authors from diverse clinical backgrounds, this definitive guide provides the best practices for treating adolescent substance use disorders from medical, behavioral, and social standpoints. Supplemented with case examples and written by experts in the field, Treating Adolescent Substance Use appeals to all clinicians that treat adolescent patients.

This guide was created to promote the early identification of children and adolescents with mental health and substance use problems as well as to provide guidance, tools, and resources for early identification--including a compendium of the most developmentally, culturally, and environmentally appropriate screening instruments. SAMHSA developed the guide using the input of the members of the Federal/National Partnership* (FNP) Early Identification Workgroup, chaired by representatives from the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA).

Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.

Adolescent substance abuse is the nation's #1 public health problem. It originates out of a developmental era where experimentation with the world is increasingly taking place, and where major changes in physical self and social relationships are taking place. These changes cannot be understood by any one discipline nor can they be described by focusing only on the behavioral and social problems of this age period, the characteristics of normal development, or the pharmacology and addictive potential of specific drugs. They require knowledge of the brain's systems of reward and control, genetics, psychopharmacology, personality, child development, psychopathology, family dynamics, peer group relationships, culture, social policy, and more. Drawing on the expertise of the leading researchers in this field, this Handbook provides the most comprehensive summarization of current knowledge about adolescent substance abuse. The Handbook is organized into eight sections covering the literature on the developmental context of this life period, the epidemiology of adolescent use and abuse, similarities and differences in use, addictive potential, and consequences of use for different drugs; etiology and course as characterized at different levels of mechanistic analysis ranging from the genetic and neural to the behavioural and social. Two sections cover the clinical ramifications of abuse, and prevention and intervention strategies to most effectively deal with these problems. The Handbook's last section addresses the role of social policy in framing the problem, in addressing it, and explores its potential role in alleviating it.