Introduction to the Special Series on Community Approaches to Addiction


March 2 Special Series imageAdam O’Malley was at a pub in the northern English city of Leeds when something caught his attention: a coaster that read, “Is there a mate missing around this table? Reach out to him.” O’Malley flipped the coaster over to find another message: “If your mate’s acting differently, it could be a sign of a mental health problem: Reach out to him, be yourself, do what you love together.” Surprised and impressed by this approach to promoting men’s mental health, O’Malley posted photos of the coasters on Twitter, where they went viral. It turns out the coasters are part of a broader campaign called “Time to Change,” designed to encourage men to be more open with one another about their mental health problems. Hopefully, these conversations will spread knowledge about mental health, reduce stigma, and prevent terrible outcomes including suicide.

Time to Change illustrates a broader trend in healthcare. Increasingly, interventions are being delivered in diverse community settings — barber shops as a setting for managing high blood pressure, grocery stores as a setting for promoting healthier food choices, and credit counseling agencies as a setting for identifying people with gambling-related problems, to name just a few. In each of these cases, program developers realized that solutions to public health problems like heart disease, obesity, and addiction cannot be confined to doctors’ offices. Bringing interventions into the community helps overcome traditional barriers to healthcare delivery, including lack of healthcare access and hesitation about asking for help with stigmatized conditions.

In this month’s Special Series, we will spotlight innovative, community-based approaches to addiction. We at the Division on Addiction launched our own grassroots effort to alleviate gambling-related problems back in 2014, when we launched Gambling Disorder Screening Day. Every year since then, we have encouraged healthcare providers, especially those who treat people at relatively high risk for gambling problems, to screen their clients using a validated 3-question instrument. Recognizing that few people who experience gambling problems seek professional treatment for those problems, we have recruited Screening Day supporters from a variety of community settings. This year, Gambling Disorder Screening Day is on Tuesday, March 10, and anyone who wants to host a screening can find a free toolkit here.

This month, the four studies we review will share a common focus on addiction interventions that are delivered outside the doctor’s office. We’ll start by describing a family skills training program offered in rural community settings and designed to prevent alcohol use among African American youth. Next, we’ll describe the effectiveness of a videogame designed to discourage teens from starting to smoke or use other tobacco products. The third study we’ll review in this Special Series evaluated whether conversations with trained volunteers can help parents communicate better with their children who are recovering from substance use disorders. Finally, we’ll review a study that was designed to identify the best ways to encourage social service and healthcare providers to screen for gambling-related problems.

We’ll supplement these science reviews with insightful and inspiring op-eds from people who have tried to alleviate the effects of addiction within their own communities. First, Ed Talbot and Dot Duda will describe the successes and challenges they experienced in bringing the New Hampshire Council on Problem Gambling to fruition. The following week, Joanne Peterson will share her personal journey to creating Learn to Cope, a 10,000-member support network for people affected by a family member’s addiction. Kathleen Scanlan and Dr. Howard Shaffer will provide a history of the Massachusetts Council on Compulsive Gambling–an organization that, since its conception in the 1970s, has carried a message of advocacy and compassion for people experiencing problem gambling. Finally, Victor Ortiz, Director of Massachusetts Department of Public Health Office of Problem Gambling Services, will spotlight the public health response to the expansion of gambling in Massachusetts, informed by the engagement of communities and the promotion of racial equity to mitigate harms associated with problem gambling. We hope these four op-eds will inspire readers to learn more about efforts within their own communities to alleviate the effects of addiction.

As always, we hope you enjoy and learn from this Special Series. Please join the conversation by commenting below.

— Heather Gray, Director of Academic Affairs, Division on Addiction

Funding acknowledgement:
The Division on Addiction currently receives funding from The Foundation for Advancing Alcohol Responsibility (FAAR), The Healing Lodge of the Seven Nations via the Indian Health Service with funds approved by the National Institute of General Medical Sciences, National Institutes of Health; The Integrated Centre on Addiction Prevention and Treatment of the Tung Wah Group of Hospitals; the Gavin Foundation via the Substance Abuse and Mental Health Services Administration (SAMHSA); the Addiction Treatment Center of New England via SAMHSA; the University of Nevada, Las Vegas via MGM Resorts International; St. Francis House via the Massachusetts Department of Public Health Bureau of Substance Addiction Services, and GVC Holdings, PLC.

During the past 5 years, Heather Gray has served as a paid program evaluator for Duffy Health Center, served as a paid grant reviewer for the National Center for Responsible Gambling (NCRG), received travel funds from the Tung Wah Group of Hospitals/The Hong Kong Jockey Club Charities Trust, received honoraria funds for preparation of a book chapter from Universite Laval, received travel funds and honoraria from the NCRG, and received course royalty fees from the Harvard Medical School Department of Continuing Education. Dr. Gray is a non-paid member of the New Hampshire Council for Responsible Gambling.

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