Opioid-related deaths by overdoses quadrupled in the United States from the years 1999 to 2015. This rise in mortality predominately occurred in the wake of historic changes in pain management practices and aggressive marketing of opioid medications such as oxycontin. Prescription opioid misuse and subsequent addiction spilled over to heroin and fentanyl for many. This drug epidemic differed from others in its impact among non-Hispanic whites, leading to drastic changes in how the United States views addiction and chooses to respond. This article offers an overview of opioid use disorder (OUD), its treatment and its relationship with pain. It also discusses special populations affected and provides insight into future directions for research and social work practice surrounding opioid management in the United States. Because of the profession’s emphasis on the person and social environment as well as its focus on vulnerable and oppressed populations, social work plays a critical role in addressing the crisis.
M. Aryana Bryan, Valerie Hruschak, Cory Dennis, Daniel Rosen, and Gerald Cochran
Lori K. Holleran Steiker
This article provides an overview of screening adolescents for substance use, misuse, and substance use disorders. It covers the practical and empirical considerations when working with youth around issues of drugs and alcohol. Four reliable and valid screening tools are discussed: Alcohol Use Disorders Identification Test (AUDIT), CRAFFT, Rutgers Alcohol Problem Index (RAPI), and Problem-Oriented Screening Instrument for Teenagers (POSIT). The tools and techniques are drawn from evidence-based theoretical frames and practices, including close attention to the recent adolescent (Screening, Brief Intervention, Referral, and Treatment (SBIRT) resources.
Jessica M. Black
Scientific findings from social sciences, neurobiology, endocrinology, and immunology highlight the adaptive benefits of positive emotion and activity to both mental and physical health. Positive activity, such as engagement with music and exercise, can also contribute to favorable health outcomes. This article reviews scientific evidence of the adaptive benefits of positive emotion and activity throughout the life course, with examples drawn from the fetal environment through late adulthood. Specifically, the text weaves together theory and empirical findings from an interdisciplinary literature to describe how positive emotion and activity help to build important cognitive, social, and physical resources throughout the life course.
Julie Schroeder and Bridgette Harris
Drug courts were developed to facilitate treatment for criminal offenders with substance abuse problems. Drug courts operate using dual paradigms of healing and discipline via treatment, social service resources, and case management for healing, and judicial sanctions and criminal justice interventions in efforts to initiate change resulting in sobriety and no further criminal behavior. The key goals of most drug courts are to reduce drug use and associated criminal behavior by engaging and retaining drug-involved offenders in programs and treatment services; to concentrate expertise about drug cases into a single courtroom; to address other defendant needs through clinical assessment and effective case management; and to free judicial, prosecutorial and public defense resources for adjudicating non-drug cases. It is vital that social work students be introduced to drug courts and how they function for students to gain better understanding of how addiction can bring their clients into contact with the criminal justice system. Drug courts are ideal settings for internship placements so that students can get hands-on experience in a court setting and assist clients using a therapeutic jurisprudence model.
Shaun M. Eack
Mental health research is the study of the causes and correlates of mental health and illness, approaches to improve mental well-being, and the delivery of effective mental health services to those in need. Social workers have been leading researchers in each of these areas of inquiry, and this article provides an overview of the broad field of mental health research, with particular emphasis on the contributions of social work. A biopsychosocial review of research on the correlates of mental health and illness is provided, followed by a synthesis of studies examining pharmacological and psychosocial approaches to improving mental health. Research on mental health services is then presented, with a focus on studies seeking to improve access to quality care and reduce service disparities. Key directions for future mental health research include identifying specific causal predictors of mental illness, improving existing treatments, and disseminating advances to the community.
Lia Nower and Kyle Caler
Gambling disorder is a significant public health concern. The recent and continued proliferation of land-based and interactive gambling opportunities has increased both accessibility and acceptability of gambling in the United States and abroad, resulting in greater and more varied participation. However, there is currently no designated federal funding for prevention, intervention, treatment, or research, and states are left to adopt varying standards on an ad hoc basis. Social workers receive little or no training in screening or treating problem gamblers, though research suggests that a significant proportion of those with mental health and other addictive disorders also gamble excessively. Raising awareness about the nature and scope of gambling disorder and its devastating implications for families and children is a first-step toward integrating gambling into prevention, assessment and treatment education in social work. This, in turn, will increase the chances of early identification and intervention across settings and insure that social workers can lend a knowledgeable and credible voice to addressing this hidden addiction.
Tonya Edmond and Karen Lawrence
Since its inception in 1987, eye movement desensitization and reprocessing (EMDR) therapy has been the subject of lively debate and controversy, rigorous research both nationally and internationally, and is now used by licensed practitioners across six continents as an effective treatment of trauma symptoms and posttraumatic stress disorder (PTSD). The aim of this entry is to provide social work practitioners and researchers with a description of the treatment approach for adults and children, EMDR’s development and theoretical basis, a review of controversial issues, and an overview of the evidence of effectiveness of EMDR across trauma types and populations.
Since the start of the human immunodeficiency virus (HIV) pandemic, numerous biomedical advances have caused the social-work response to shift from management of a crisis to prevention of an incurable, but treatable chronic disease. About 1.3 million people in the United States and more than 33 million people worldwide are estimated to be living with HIV. Rates of incidence in impoverished, marginalized communities are highest, with the rates continuing to increase among young African American gay and bisexual men. Other communities at high risk are people who are incarcerated, engage in sex work or other kinds of exchange sex, and participate in risky injection-drug use. Minority groups are often impacted because of reduced access to quality medical care and HIV testing. Social workers in HIV prevention work are challenged to educate clients and communities on the sexual risk continuum, provide more interventions that are culturally tailored for disadvantaged at-risk groups, and implement evidence-based HIV prevention and testing programs worldwide. The National HIV/AIDS Strategy now provides structure to funding opportunities for HIV prevention programs, and there is disparate access to effective treatments worldwide for those living with HIV.
This entry presents an overview of prison violence and how issues such as overcrowding and scarcity of resources may contribute. Exploring both collective and interpersonal levels of violence, issues such as incidents between inmates and those between inmates and staff are examined. This entry looks at the issues facing males, females, juveniles, and the mentally ill as they contend with correctional institutions and violence within these institutions. The potential effects of violent victimization are also examined, as well as potential interventions and solutions to reduce violence.
Continuing a history of inequity, private insurers have placed restrictions and limitations on coverage for mental health conditions making access to treatment services increasingly more challenging. A state-by-state advocacy movement has led to the enactment of various state laws to require mental health parity. With the Clinton Administration’s attempt at health care reform, mental health parity became part of the health reform debate and led to the passage of the Mental Health Parity Act of 1996. The inadequacies of this law were partially corrected in the Mental Health Parity and Addiction Equity Act of 2008, which included mandated coverage for substance use conditions. The Obama Administration in 2011 included these provisions in the Patient Protection and Affordable Care Act, which does not require compliance monitoring nor does it provide a definition for “mental health,” which leaves insurers to define it and hence determine what coverage will actually be available.