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Cited by 36Substance Abuse Treatment and OutcomesOpioid Use Disorder TreatmentHIV, Drug Use, Sexual Risk

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Primary, Secondary, and Tertiary Prevention of Substance Use Disorders through Socioecological Strategies

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American Institutes for Research, Latimore, Amanda, Salisbury- Afshar, Elizabeth, University of Wisconsin–Madison, Duff, Noah, National Academy of Medicine, Freiling, Emma, National Academy of Medicine, Kellett, Brett, American Institutes for Research, Sullenger, Rebecca, Duke University School of Medicine, Salman, Aisha, National Academy of Medicine, Prevention, Treatment, and Recovery Services Working Group, National Academy of Medicine’s Action Collaborative on Countering the U.S. Opioid Epidemic·2023·NAM Perspectives
DOI 10.31478/202309bPMC PMC11114594
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Abstract

Rapidly rising drug overdose rates in the United States during the past three decades underscore the critical need to prevent overdose deaths and reduce the development of opioid and related substance use disorders (SUDs).Traditional public health models of prevention emphasize the biological and physical risks of SUDs, often neglecting to consider the broader environmental and social factors that influence health and well-being.Taking a socioecological approach, the authors aim to illustrate the complex interplay among individual, interpersonal, societal, and structural factors that contribute to the development of SUD and overdose risk.The authors propose evidence-informed strategies and interventions across primary, secondary, and tertiary levels of prevention.By doing so, the authors hope to encourage policy makers, funders, service providers, and community leaders to broaden their approaches to SUD prevention and consider how they can create and advocate for a health-promoting environment by addressing the social and structural factors that drive rising SUD and overdose trends. Glossary of Terms and Concepts Biomedical Model of HealthFocuses on the biological and physiological factors of disease and illness Harm ReductionAims to minimize the negative health, social, and legal impacts associated with drug use Individual Level of InfluenceThe biological, behavioral, and psychosocial factors within an individual that influence health and disease Interpersonal Level of InfluenceThe relationships, social dynamics, and ways of interacting between individuals, including family relationships, that influence health and disease Macro Level of InfluenceThe policies, culture, norms, laws, and systems that exist across groups of people and institutions that influence health and disease Primary PreventionApproaches that aim to prevent disease conditions from developing Secondary Prevention Approaches that seek to identify a health condition as early as possible to halt or slow its progression Socioecological Model of HealthFocuses on the interaction among the individual-, interpersonal-, and macro-level (e.g., community, social, and political) factors that influence disease and illness, and improve overall well-being Structural VulnerabilitiesThe intersecting structural and social factors (e.g., socioeconomic, political, racial, and cultural) that create and perpetuate inequalities, increase risk of experiencing negative health outcomes, and reduce opportunities for overall well-being Tertiary PreventionApproaches that strive to minimize acute negative consequences, such as death, among those who have a disease, while promoting recovery and the management of long-term effects to improve overall well-being

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Authors
Research, A. I. F., Latimore, A., Salisbury- Afshar, E., University of Wisconsin–Madison, Duff, N., National Academy of Medicine, Freiling, E., National Academy of Medicine, Kellett, B., Research, A. I. F., Sullenger, R., Duke University School of Medicine, Salman, A., National Academy of Medicine, Prevention, T., & National Academy of Medicine’s Action Collaborative on Countering the U.S. Opioid Epidemic
Affiliations
  • American Institutes for Research (US)
  • National Academy of Medicine (US)
  • Duke University (US)
ORCID
Venue
NAM Perspectives
Publisher
National Academy of Medicine
Published
2023-09-06
Volume
9
Issue
6
ISSN
2578-6865 (ISSN-L)
DOI
10.31478/202309b
PMC
PMC11114594
OpenAlex
W4386468648
Cited by
22
References
55
Citations by year
2026: 7 · 2025: 12 · 2024: 3
FWCI
4.39
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • NAM Perspectives (publishedVersion)
  • PubMed Central (publishedVersion, other-oa)
  • PubMed (publishedVersion)
Funders
  • George Mason University
  • Arizona State University
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
substance use disorders, opioid use disorder, overdose prevention, socio-ecological model, primary prevention, secondary prevention, tertiary prevention, harm reduction, structural vulnerability, social determinants of health, public health policy, health promotion

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