Alcohol and Drug Use Disorders

Abstract

Alcohol and drug use exist on a spectrum ranging from occasional use without consequences to a devastating chronic illness. A history of systemic inequities and racism has contributed to poorer outcomes regarding substance use, treatment, and consequences among minoritized groups. Substance use disorders may exist on their own, exacerbate chronic conditions, or cause other chronic illnesses. Addiction stigma remains a barrier to care for patients including lack of access to treatment, particularly in rural settings. Use of non-stigmatizing, person-first language can improve quality of care and should be emphasized in all healthcare settings. Screening for unhealthy alcohol and drug use is part of obtaining a comprehensive medical history and has implications for the diagnosis and management of numerous medical and psychiatric conditions. Effective, comprehensive substance use disorder treatment plans include pharmacotherapy, behavioral interventions, and recovery support. Medications should not be withheld from those not engaging in counseling. Telehealth promotes engagement and increases access to treatment.