Changing the Conversation

Why a Public Health Approach? There are many reasons to learn about the impact of trauma and untreated trauma on individuals, families, and communities. Trauma and untreated trauma are common in all socioeconomic groups and are often misunderstood. For example, people experiencing opioid addiction, other substance use conditions, mental illness, and homelessness may shy away from treatment because of stigma in communities and treatment settings.

The symptoms of trauma and its under-treatment are evident more and more everyday. Early childhood and adult trauma are implicated in the onset of addictions and the comorbidity of post-traumatic stress disorders and mood-related psychopathology.

I recently spent my day writing final project reports. I wrote about how our project helped one state place peer recovery coaches in hospital emergency rooms to support people recovering from opioid overdoses. Another state expanded supported employment opportunities for transition-age youth. Several states created training and credentialing programs for peer recovery support specialists to help people enter and sustain recovery from mental health conditions and substance use disorders. Another state is re-examining and re-engineering their entire behavioral health crisis response system. We helped a U.S. Territory experiencing a substance use crisis take steps to establish their first-ever recovery community organization. We brought together adults in recovery with family members of adults with behavioral health disorders to discuss ways to improve supports for people in crisis.

Human connection is an integral part of social and emotional health and well-being. Think about the many connections, friendships, and relationships that shape your daily life. When you are in need of support, these relationships are key to providing guidance, happiness, and stability.

Social supports act as a crucial determinant for shaping health outcomes. Research suggests relationships are a significant factor in determining substance use and recovery outcomes. Studies of adolescents suggest that family support and involvement acts as a protective factor against substance use. A study of women experiencing homeless found that those who had less social support were more likely to engage in illicit substance use. A common affirmation in the recovery community— people, places, things—points to how important people can be in impacting one’s journey to recovery. Social networks, including family, friends, community and kinship ties, can act as risk or protective factors in determining an individuals’ path toward recovery.

The opioid crisis has reached epidemic levels, with nearly half of Americans now reporting they personally know someone who has been addicted to prescription painkillers. Despite growing recognition of the problem and concerted efforts to drive practice and policy solutions, significant challenges remain.

While people often begin using alcohol or other drugs during adolescence and young adulthood, only 10 percent of 12-17 year olds who need substance use treatment actually receive services. When they do, they are much more likely to receive services while in the criminal justice system rather than through other avenues, such as their school or health care provider. These sobering statistics speak to the difficulty of identifying and helping at-risk teens before their substance use becomes a problem.