What is a public health approach to substance use? A qualitative systematic review and thematic synthesis

被引：12

作者：

Crepault, Jean-Francois ^{[1
,2
]}

Russell, Cayley ^{[1
,3
]}

Watson, Tara Marie ^{[1
]}

Strike, Carol ^{[2
]}

Bonato, Sarah ^{[1
]}

Rehm, Juergen ^{[1
,2
,3
,4
,5
,6
,7
]}

机构：

[1] CAMH, 1001 Queen St, Toronto, ON M6J 1H4, Canada

[2] Univ Toronto, Dalla Lana Sch Publ Hlth, 6th Floor,155 Coll St, Toronto, ON M5T 3M7, Canada

[3] Univ Toronto, Inst Med Sci, 1 Kings Coll Circle, Toronto, ON M5S 1A8, Canada

[4] Univ Toronto, Dept Psychiat, 8th Floor,250 Coll St, Toronto, ON M5T 1R8, Canada

[5] Tech Univ Dresden, Inst Clin Psychol & Psychotherapy, Chemnitzer Str 46, D-01187 Dresden, Germany

[6] Tech Univ Dresden, Ctr Clin Epidemiol & Longitudinal Studies, Chemnitzer Str 46, D-01187 Dresden, Germany

[7] Univ Med Ctr Hamburg Eppendorf UKE, Ctr Interdisciplinary Addict Res ZIS, Dept Psychiat & Psychotherapy, Martinistr 52, D-20246 Hamburg, Germany

来源：

INTERNATIONAL JOURNAL OF DRUG POLICY | 2023年 / 112卷

关键词：

Public health approach; Public policy; Drug policy; Substance use; Systematic review; Thematic synthesis; HARM REDUCTION; ALCOHOL; DRUG; DRINKING; POLICY; ABUSE;

D O I：

10.1016/j.drugpo.2023.103958

中图分类号：

R194 [卫生标准、卫生检查、医药管理];

学科分类号：

摘要：

Background: Psychoactive substance use and the regulations that govern it both have the potential to lead to harm. A 'public health approach' (PHA) is frequently invoked as a means of addressing these harms, but the term is used in inconsistent and contradictory ways. This study systematically reviewed the English-language academic literature to understand how a public health approach to substance use is defined and described.Methods: This review employed thematic synthesis, a methodology designed to rigorously synthesize qualitative evidence. Eligible articles were published in peer-reviewed journals, in the English language, with full text avail-able, and focused primarily on substance use. There were no limits on year of publication. Original research, opinion/commentary, and reviews were included. The searches were conducted in October 2021 in CINAHL, Embase, Medline, PAIS Index, PsycINFO, Scopus, Sociological Abstracts, and Web of Science.Results: 272 articles from 25 countries, published between 1950 and 2021, were synthesized. Definitions of a PHA have changed over time and differ by substance. The most commonly cited characteristics of a PHA were: for alcohol, regulation, e.g. of price and availability (54% of articles); for cannabis: regulation (68%); for illicit drugs: that a PHA is distinct from a criminal justice approach (63%); for opioids: substance use disorder treatment (55%); and for tobacco: regulation (62%).Conclusion: There is no consensus on the definition of a public health approach to substance use, but there is substantial agreement when it comes to PHAs to specific substances. There are also similarities in how they are described for legal substances versus illicit ones. This review found areas of disagreement regarding the extent to which PHAs should focus on individual-level factors. Policymakers, academics, and others developing or implementing PHAs to substance use should be explicit about their aims and objectives - as well as the premises and assumptions underlying them.

引用

页数：12

共 76 条

[1] The 2014 Surgeon Generals Report: Commemorating the 50th Anniversary of the 1964 Report of the Advisory Committee to the US Surgeon General and Updating the Evidence on the Health Consequences of Cigarette Smoking [J].