Course: Substance Use and Public Health

General

General
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Substance Use and Public Health Homepage
This course provides a comprehensive introduction to substance use disorders and public health. It addresses the risk factors associated with developing substance use disorders (SUDs), the burden of SUDs, the role that public health plays in lessening the burden of substance use disorders, the impact of prevention strategies, interventions, and control programs, and ethical practices in SUD care to ensure effective positive health outcomes. By the end of this course, students will be able to use appropriate screening tools to assess substance use disorders and identify prevention and treatment protocols to reduce the impact of substance use disorders within a population.
The SUD and Public Health course is sponsored by the Annenberg Physician Training Program (APTP). Like all NextGenU.org courses, it is competency-based; competencies were developed in collaboration with subject matter experts and take into consideration Tap 21 Addiction Counseling Competencies from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), which benchmark how curricula, educational programs, and professional standards are measured in the U.S. SUD treatment field, the Principles of General Care (GPC) for people with Mental, Neurological and Substance Use Disorders (MNS) conditions developed by the World Health Organization’s (WHO) Mental Health Gap Action Programme (mhGAP), and the WHO and United Nations (UN) International Standards for the Treatment of Drug Use Disorders.
The course uses learning resources from accredited, world-class organizations such as the Joint United Nations Programme on HIV/AIDS, Substance Abuse and Mental Health Services Administration, U.S. Centers for Disease Control and Prevention (CDC), the U.S. National Institutes of Health, and the World Health Organization.
The course was designed by Hugo Rojas, MD, MSc; Juan Jose Pemintel, MD; Leohrandra Graham, MSc; Margaret Niles, PhD, MEd, DipID; Valeria Reynolds, MD; Pablo Baldiviezo, MD. It was later reviewed by Magali Collonnaz MD, MPH, MSc; Anthony Schlaff MD, MPH; Reisha Narine, BSc, MSc, and Rhonda Prudent, BSc.
For publications on NextGenU.org’s courses’ efficacy, see NextGenU.org’s publication page. Subscribe to our newsletter to be notified of future updates, new courses and to be part of our community.
There are five Substance Use Disorder (SUD) modules to complete, which include:
Module 1: Introduction to SUD in Public Health
Module 2: Identifying SUD
Module 3: SUD Interventions and Control
Module 4: SUD Prevention Strategies
Module 5: Ethics and Research in SUD Care

The completion time for this course is estimated at 123 hours, comprising 19 hours of learning resources, 37 hours of time to study content and assimilation, and 67 hours of participating in learning activities and quizzes to assist the learners in the synthesis of learning materials. This course is equivalent to 3 credit hours.
Upon completing the training (5 modules), participants will need to complete a final exam”. The final exam will be designed so that participants can have three opportunities to answer correctly until the required score of 70% or higher is obtained.
At the end of each module, there is a practice quiz of multiple-choice questions. At the end of the course, after you’ve completed each module, quiz, and learning activity, you’ll have access to a final exam of forty multiple-choice questions and a chance to evaluate this course. Once you’ve passed that last test, you will be able to download a certificate of completion from NextGenU.org and our course’s co-sponsoring organization, the Annenberg Physician Training Program. We keep all of your personal information confidential, never sell any of your information, and only use anonymized data for research purposes. We are happy to report your testing information and share your work with anyone (your school, employer, etc.) at your request.
Engaging with this Course:
This free course is primarily intended for public health students, public health professionals, or people working with patients suffering from substance use disorders (non-clinicians) who would like to learn more about the risk and protective factors of substance use disorders, prevention and intervention strategies, and the different treatment modalities. However, the course can be taken by both clinicians and non-clinicians as they are resources listed as suitable for BOTH audiences and other titles or resources specifically listed for clinicians or non-clinicians ONLY.
To obtain a certificate, a learner must successfully complete:
All the reading requirements.
All quizzes and pass with 70% having unlimited attempts.
All case studies.
The final exam with a minimum of 70% and a maximum of 3 attempts, and
The self and course evaluation forms.

NextGenU.org is happy to provide your institution with:
A link to and description of the course training so they can see all its components, including the cosponsoring universities and other professional organization cosponsors;
Your grade on the final exam;
Your work products (e.g. case study activities), and any other required or optional shared materials that you produce and authorize to share with them;
Your evaluations -- course and self-assessments;
A copy of your certificate of completion, with the co-sponsoring universities and other organizations listed.

To obtain a degree, NextGenU.org co-sponsors degree programs with institutional partners. To obtain a full degree co-sponsored with NextGenU.org, registrants must be enrolled in a degree program as a student of a NextGenU.org institutional partner. If you think that your institution might be interested in offering a degree with NextGenU.org, contact us.
We hope that you will find this a rewarding learning experience, and we count on your assessment and feedback to help us improve this training for future students.
Here are the next steps to take the course for credit:
Complete the registration form.
Take the pre-test.
Begin the course with Module One. In each lesson, read the description, complete all required readings and any required activity, and take the corresponding quizzes.

*The previous version of this course is also available here for your reference but is not available for registration. Only students that were registered before can complete it
Module 1: Introduction to Substance Use Disorder in Public Health
Instructional Goals covered in this module:
- Understand different models of addiction and the impact of substance abuse on individuals and public health.
Module1: Lesson 1: Introduction to Substance Use Disorders
Student Learning Outcomes:
Upon completion of this module, students should be able to:
- Define key terms associated with substance use.
- Describe different models of addiction.
- Examine substance use as a chronic relapsing disorder.
- Explain what substances are used and abused and their effect on an indivudual's health and social functoning.
Approximate time required for the readings for this lesson (at 144 words/minute): 3 hours and 57 minutes.

Click here to start this lesson
9 URLs
- Required Learning Resources and Activities
- What Is a Substance Use Disorder? URL
  Read the entire webpage. (11 minutes)
  American Psychiatric Association - 2020
- Addictionary URL
  Lookup the definition of the terms "Withdrawal" and "relapse" in this special dictionary about substance use. Additionally, you may search any other unfamiliar terms to improve your understanding. (2 minutes)
  Recovery Research Institute - 2017
- Is Addiction a Disease? URL
  Read the entire webpage. (7 minutes)
  Partnership to End Addiction - 2017
- Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health: Chapter 2 :The Neurobiology of Substance Use, Misuse, and Addiction. URL
  Read the content under the heading "Preview", "Conducting Research on Neurobiology...", "The Addiction Cycle", "Different Classes of ...", "Different Classes of Substances Affect the Brain and Behavior in Different Ways" and "Factors that Increase ...". (28 minutes)
  NCBI - 2016
- Commonly Used Drugs Charts URL
  Click on "Cocaine," "Marijuana (Cannabis)," "Heroin," "Inhalants," "Prescription Opioids," "Tobacco/Nicotine," and "Methamphetamine" and read the section "Possible Health Effects" for each. (7 minutes)
  National Institute on Drug Abuse - 2020
- Abuse of Over-the-counter Medicines: A Pharmacist’s Perspective URL
  Read the entire article. (21 minutes)
  Integrated Pharmacy Research and Practice - 2017
- Family and Social Aspects of Substance Use Disorders and Treatment URL
  Read content under “Effects of Substance Use Disorders on the Family” and “Social Effects of Substance Use Disorders” (3 minutes)
  NCBI - 2014
- Recommended Additional Readings
- Substance-related Disorders URL
  Read the entire webpage. (4 minutes)
  DSM-5
- Alcohol's Effects on Health. Research-based Information on Drinking and its Impact. URL
  Read the following subsections in this order: (26 minutes)
  Alcohol Facts and Statistics
  Binge Drinking
  Alcohol Use Disorder
  Alcohol and the Brain
  Alcohol’s Effects on the Body.
  National Institute on Alcohol Abuse and Alcoholism - 2013
Module 1: Lesson 2: The global impact of Substance Use Disorders
Student Learning Outcomes:
Upon completion of this module, students should be able to:
- Explore trends in the global burden of mental, neurological, and substance use disorders (MNS).
- Review the UNGASS 2016 position regarding the role of public health in addressing substance use disorders.
Approximate time required for the readings for this lesson (at 144 words/minute): 9 hours and 46 minutes.

Click here to start this lesson
2 URLs, 1 Forum, 1 Quiz
- Required Learning Resources and Activities
- The Global Burden of Mental, Neurological and Substance Use Disorders: An Analysis from the Global Burden of Disease Study 2010 URL
  While this article is somewhat outdated, it still provides an excellent overview of the global burden of disease, which is still accurate today" Read the entire article. (44 minutes)
  PLOS - 2015
- Drug Use Disorders: Impact of a Public Health Rather than a Criminal Justice Approach URL
  Read the entire page. (8 minutes)
  World Psychiatry - 2017
- Discussion Forum Activity 1: Addressing Substance Use Disorders in Public Health (420 minutes)
  In this activity, you will examine how substance use disorders have shaped global positions on substance abuse.
  
  Step 1: Read Outcome Document of the 2016 United Nations General Assembly Special Session on drugs (UNGASS 2016). You can access the document here. Select one (1) of the topics discussed in the module, i.e., Models of addiction, substance use as a chronic relapsing disorder, commonly used drugs/consequences of substance abuse, or the trends in the global burden of mental, neurological, or substance use disorders (MNS).
  
  Step 2: Prepare a 300 – 750 word discussion post that summarizes your reflections on how the selected topic has influenced the position taken by UNGASS on substance abuse.
  
  Step 3: To share your work in Moodle, click on the “Add a New Post” button under this post and paste your work in the “message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting; see the resource on the Himmelfarb Health Sciences Library for instructions: APA citation resource (N.B. references are excluded from word counts).
  Step 4: To complete the activity, you will need to reply to at least one post made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to the forum.”
- Quiz: Module 1
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to view the case studies and respond to the questions.
Module 2: Identifying Substance Use Disorders
Instructional Goals covered in this module:
- Describe the established diagnostic criteria for substance use disorders.
- Explain the socioeconomic, political, and cultural factors that influence substance use risk and resiliency among individuals and groups.
Module 2: Lesson 1: Assessment of Substance Use Disorders
Student Learning Outcomes:
Upon completion of this module, students should be able to:
- Differentiate among the main categories of substance use disorder behaviors.
- Explore commonly used substance use disorder screening instruments/tools.
Approximate time required for the readings for this lesson (at 144 words/minute): 9 hours and 33 minutes.

Click here to start this lesson
5 URLs, 1 Forum
- Required Learning Resources and Activities
- The Diagnostic Criteria for Substance Use Disorders (Addiction) URL
  Read the content on the main page and click on the headings "Alcohol," "Cannabis," "Hallucinogens," "Inhalants," "Opioid," "Sedatives, Hypnotics, or Anxiolytics," "Stimulants," and "Tobacco" and read the content for each. (38 minutes)
  MentalHelp.net - 2020
- Commonly Used Substance Use Disorder Screening Instruments. URL
  Read the content in the table. (4 minutes)
  MassHealth PCC Plan MBHP - 2020
- The Surgeon General’s Report on Alcohol, Drugs, and Health Chapter URL
  Read the content under the heading " Vulnerability to Substance Misuse Problems and Disorders. (3 minutes)
  NCBI - 2017
- Risk and Protective Factors URL
  Read the complete article. (6 minutes)
  SAMHSA - 2019
- Discussion Forum Activity 2: Epidemiology of Substance Use Disorders in the student’s country of practice (420 minutes)
  In this learning activity, you will study and share the epidemiology of substance use disorders in the country in which you reside or work.
  Step 1: Search online for a scientific publication on Substance Use Disorders in the country where you reside. Study the epidemiological aspects of SUD such as models of addiction, substance use as a chronic relapsing disorder, commonly used drugs, consequences of substance abuse, or the trends in the burden of mental, neurological, or substance use disorders (MNS). Make sure to include and reference the link you have used to obtain your data.
  Step 2: Prepare a 250 – 400 word discussion post that summarizes your reflections on how the epidemiology substance use disorder in your country of residence compares to the global trends.
  Step 3: To share your work in Moodle, click on the “Add a New Post” button under this post and paste your work in the “message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting; see the resource on the Himmelfarb Health Sciences Library for instructions: APA citation resource (N.B. references are excluded from word counts).
  Step 4: To complete the activity, you will need to reply to at least one post made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to the forum.”
- Recommended Additional Readings
- DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale URL
  Read the content under the heading "Overarching Issues" (33 minutes)
  NCBI - 2013
Module 2: Lesson 2: The Social Determinants of Substance Use Disorders
Student Learning Outcomes:
Upon completion of this module, students should be able to:
- Correlate the social determinants of health to the risk of individual and group development and sustenance of substance use disorders.
- Analyze the factors that can contribute positively to individual and group resiliency to substance use.
Approximate time required for the readings for this lesson (at 144 words/minute): 9 hours and 26 minutes.

Click here to start this lesson
3 URLs, 1 Forum
- Required Learning Resources and Activities
- Addressing the Opioid Crisis through Social Determinants of Health: What Are Communities Doing? URL
  Read the entire document. (16 minutes)
  Brandeis Opioid Resource Connector - 2013
- Women and Drugs Drug Use, Drug Supply and Their Consequences URL
  Read the content under the headings "Health and social consequences of drug use among women" and "Access to treatment and care for drug use disorders," on pages 20-23. (12 minutes)
  UNODC - 2018
- Facing Addiction in America: The Surgeon General's Report on Alcohol, Drugs, and Health URL
  Read the entire page. (2 minutes)
  NIH - 2016
- Creative Peer Activity 1: Addressing the comorbidities associated with substance use abuse and other medical conditions. (480 minutes) Forum
  In this activity you will examine the challenges faced in treating substance use disorders and associated mental and medical conditions in public health settings.
  Step 1: Explore online to see the various examples of infographics. Become familiar with what infographics are and what they look like.
  A good basic overview of the history and use of information graphics is available on Wikipedia: http://en.wikipedia.org/wiki/Information_graphics
  Step 2: Review the material on comorbidities associated with substance use disorders and the attendant challenges they pose in the public health setting. Use the literature (i.e., journals and other professional resources) and reputable websites, to gather information to include data, statistics, and pertinent facts.
  Step 3: Using a web design application* of your choice, create an infographic that addresses the comorbidities associated with substance use abuse and other medical and mental conditions. Be sure that your analysis and insight into the data are represented to tell the story so the intended message(s) are communicated.
  Step 4: Remember to proofread and refine your infographic. Make sure your infographic can be viewed easily in full screen mode.
  Step 5: To share your work in Moodle, click on the “Add a New Post” button under this post and paste the link to your infographic in the “message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting; see the resource on the Himmelfarb Health Sciences Library for instructions: APA citation resource (N.B. references are excluded from word counts).
  Step 6: Evaluate the work of one of your peers based on items in the rubric below. Provide a rationale for the grade you provided, as well as comments or suggestions for improvement. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You can use the list below as a guide:
  Item A is .…. because…. My suggestions for improvement are….
  Item B is .…. because…. My suggestions for improvement are….
  Item C is .…. because…. My suggestions for improvement are….
  Item D is .…. because…. My suggestions for improvement are….
  *Examples of free design applications include Google Charts, Easel.ly, Visme, Infogram, Canva, Snappa, Piktochart, and PowerPoint.
Module 2: Lesson 3: Identifying the comorbidities of substance use and medical and mental disorders
Student Learning Outcomes:
Upon completion of this module, students should be able to:
- Examine the co-occurrence of substance use and mental health disorders.
- Examine substance use and associated health conditions that are feature throughout the lifespan including HIV, diabetes, hepatitis, depression, psychosis.
- Examine special reproductive health issues for women in relation to substance use, comorbidity, and pharmacological treatment.
Approximate time required for the readings for this lesson (at 144 words/minute): 3 hours and 7 minutes.

Click here to start this lesson
4 URLs, 1 Quiz
- Required Learning Resources and Activities
- Comorbidity of Substance Use and Mental Health Disorders in Europe URL
  Read the entire document. (25 minutes)
  European Monitoring Centre for Drugs and Drug Addiction - 2016
- Substance Use and Associated Health Conditions Throughout the Lifespan URL
  Read the content under the heading "Discussion". (25 minutes)
  NCBI - 2017
- Substance Use During Pregnancy URL
  Read the entire article. (9 minutes)
  Centers for Disease Control and Prevention - 2022
- Quiz: Module 2
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to view the case studies and respond to the questions.
- Recommended Additional Readings
- Common Comorbidities with Substance Use Disorders Research Report URL
  Read the content from the heading "Part 1: The Connection Between Substance Use Disorders and Mental Illness," on page 4 to the end of page 15. (21 minutes)
  National Institute on Drug Abuse - 2020
Module 3: Substance Use Disorder Prevention Strategies
Instructional Goals covered in this module:
- Articulate a range of substance use disorder prevention strategies across the socio-ecological spectrum, and identify the role of healthcare providers is participating in or supporting these strategies.
Module 3: Lesson 1: Prevention Programs and Policies
Student Learning Outcomes:
Upon completion of this module, students should be able to:
- Investigate the range of policy options used to prevent alcohol, tobacco, and other substance use problems in the society.
- Analyze the impact of policy and environmental interventions on the prevention of substance use disorders.
Approximate time required for the readings for this lesson (at 144 words/minute): 15 hours and 3 minutes.

Click here to start this lesson
3 URLs, 1 Forum
- Required Learning Resources and Activities
- Chapter 3. Prevention Programs and Policies URL
  Read to pages 3-4 to 29 (From "Risk and Protective Factors" until "Maximizing Prevention Program and Policy Effectiveness" excluded).
  Surgeon General’s Report on Alcohol, Drugs, and Health - 2016
- Environmental substance use prevention interventions in Europe URL
  Read the content under the heading "1. Prevention traditions and environmental prevention" on pages 9 -16.
  Read table 2. Environmental prevention measures covered in the survey on pp 19-20. (27 minutes)
  European Monitoring Centre for Drugs and Drugs Addiction - 2018
- Reflective Peer Activity 1: Impact of Policies and Regulations on Substance Use Disorders (480 minutes) Forum
  In this activity, you will analyze the impact of prevention policies and regulations related to reducing substance use disorders in your local community.
  Step 1: Research and review the policy and environmental strategies introduced during the lesson.
  Step 2: Prepare a 300 – 750 word letter to the editor of your local newspaper analyzing the impact of policies and regulations enacted to reduce the prevalence of substance use abuse and disorders in your community. In your letter, you are encouraged to offer strategies to assist with the implementation of these policies and the expected results of the adoption of said policies. Here the rubric for this activity.
  Step 3: To share your work in Moodle, click on the “Add a New Post” button under this post and paste your work in the “message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting; see the resource on the Himmelfarb Health Sciences Library for instructions: APA citation resource (N.B. references are excluded from word counts).
  Step 4: Evaluate the work of one of your peers based on items in the rubric below. Provide a rationale for the grade you provided, as well as comments or suggestions for improvement. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You can use the list below as a guide:
  
  Item A is .…. because…. My suggestions for improvement are….
  Item B is .…. because…. My suggestions for improvement are….
  Item C is .…. because…. My suggestions for improvement are….
  Item D is .…. because…. My suggestions for improvement are….
- Recommended Additional Readings
- A Guide to SAMHSA’s Strategic Prevention Framework URL
  Read from pages 4 to 31 in the guide.
  This is a generic planning model and students who have completed a core MPH curriculum may be familiar with it. (65 minutes)
  Substance Abuse and Mental Health Services Administration - 2019
Module 3: Lesson 2: The role of healthcare workers and social and community support in preventing substance use disorders
Student Learning Outcomes:
Upon completion of this module, students should be able to:
- Examine the role played by family, social networks, and other community systems in the prevention of substance use disorders.
- Explore addiction prevention strategies such as social and community support, including educational, housing, and vocational support.
- Describe the role of healthcare workers in the prevention of substance use disorders.
Approximate time required for the readings for this lesson (at 144 words/minute): 5 hours and 27 minutes.

Click here to start this lesson
7 URLs, 1 Quiz
- Required Learning Resources and Activities
- Role of Social Support in Relapse Prevention for Drug Addicts URL
  Read from "Role of Social Support in Preventing Relapse" in page 917 to "Conclusion",page 921. (12 minutes)
  International Journal of Innovation, Creativity and Change - 2020
- Individualized Approach to Primary Prevention of Substance Use Disorder: Age-related Risks URL
  Read the entire article. (25 minutes)
  Springer - 2020
- SAMHSA Opioid Overdose Prevention TOOLKIT URL
  Read the content under the heading " STRATEGIES TO PREVENT OVERDOSE DEATHS " on page 2-3. (7 minutes)
  SAMHSA - 2018
- Substance Misuse Prevention for Young Adults URL
  Read Chapter 2 (pages 19 –24) of the document. (13 minutes)
  SAMHSA - 2019
- Preventing Marijuana Use Among Youth URL
  Read Chapter 2 (pages 21 – 32) of the document. (37 minutes)
  SAMHSA - 2021
- Prescription Drug Monitoring Programs: A Guide for Healthcare Providers URL
  Read pages 1 to 8 of the document. (35 minutes)
  SAMHSA - 2017
- Quiz: Module 3
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
- Recommended Additional Readings
- School-Based Drug Abuse Prevention: Promising and Successful Programs URL
  Read from "Chapter 2" until "Conclusion'. (24 minutes)
  Government of Canada - 2022
Module 4: Intervention and Control
Instructional Goals covered in this module:
- Understand models of treatment, recovery, and relapse prevention for addiction and related problems.
- Propose strategies to reduce negative effects of substance abuse according to different states of change and cultural identities.
Module 4: Lesson 1 : Substance Use Disorders Treatment and Relapse Prevention
Student Learning Outcomes:
Upon completion of this module, students should be able to:
- Describe the components of comprehensive substance abuse treatment.
- Explain models and effectiveness of relapse prevention.
- Discuss recommendations for public health interventions to promote treatment, recovery, and relapse prevention of addiction.
- Compare and contrast autonomy and independent living with institutionalization of persons coping with substance use disorders.
Approximate time required for the readings for this lesson (at 144 words/minute): 8 hours and 49 minutes.

Click here to start this lesson
9 URLs
- Required Learning Resources and Activities
- Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition) URL
  Read from the heading "Principles of Effective Treatment" until the heading "Adolescent Community Reinforcement Approach and Assertive
  Continuing Care" to end of the document (pages 3 to 52). (84 minutes)
  NIH - 2018
- Relapse Prevention: Clinical Models and Intervention Strategies URL
  Read Introduction; “Lapse, Relapse, and Recovery”; “Effectiveness and Efficacy of RP" and the first two subsections of "Models of RP": “The Cognitive–Behavioral Model of Relapse” and “The Cognitive–Behavioral Model of Relapse, Revised”. (30 minutes)
  Doctor - 2019
- Vision for the Future: A Public Health Approach URL
  Read the following: CHAPTER 7: VISION FOR THE FUTURE: A PUBLIC HEALTH APPROACH. (50 minutes)
  NCBI - 2016
- Affording Housing Models and Recovery URL
  Read the entire article. (5 minutes)
  Substance Abuse and Mental Health Services Administration - 2021
- COVID-19 and Substance Use Disorders: Recommendations to a Comprehensive Healthcare Response. An International Society of Addiction Medicine Practice and Policy Interest Group Position Paper URL
  Read the content under the heading "1. Introduction", "2. Early Detection and Referral Systems and Linkages to Other Community-based Services", and "3. Specific Concerns Around Opioid Substitution Therapy." (22 minutes)
  Basic & Clinical Neuroscience - 2020
- Recommended Additional Readings
- Addressing Substance Use in Behavioral Health Crisis Care: A Companion Resource to the SAMHSA Crisis Toolkit URL
  Read the entire document. (56 minutes)
  National Association of State Mental Health Program Directors - 2020
- Vision for the Future: A Public Health Approach URL
  Read the following: CHAPTER 4: EARLY INTERVENTION, TREATMENT, AND MANAGEMENT OF SUBSTANCE USE DISORDERS. (115 minutes)
  NCBI - 2016
- Vision for the Future: A Public Health Approach URL
  Read the following: CHAPTER 6: HEALTH CARE SYSTEMS AND SUBSTANCE USE DISORDERS. (144 minutes)
  NCBI - 2016
- A VA Clinician’s Guide to Identification and Management of Opioid Use Disorder URL
  Read the entire document. (22 minutes)
  US Department of Veterans Affairs - 2016
Module 4: Lesson 2: Intervention Considerations in Therapy and Control of Substance Use Disorders
Student Learning Outcomes:
Upon completion of this module, students should be able to:
- Determine the effectiveness of psychotherapeutic interventions.
- Examine the advantages and disadvantages of pharmacotherapy interventions as a treatment option for substance use disorders.
- Assess strategies to minimize the negative physical and social impact incurred by the behaviors related to drug use.
- Differentiate stages of change and processes to undertake behavior change.
- Compare different intervention strategies for substance abuse.
- Propose addiction interventions that are sensitive to different cultural identities or states of change.
Approximate time required for the readings for this lesson (at 144 words/minute): 12 hours and 49 minutes.

Click here to start this lesson
11 URLs, 1 Forum, 1 Quiz
- Required Learning Resources and Activities
- Evidence Based Psychosocial Interventions in Substance Use URL
  Read the content under the headings "Abstract," "Treatment Approaches," "Individual Psychosocial Interventions," and "Special Populations." (22 minutes)
  NCBI - 2014
- New Buprenorphine Guidelines May Promote More Equitable Access to Effective Opioid Treatment URL
  Read the entire webpage. (8 minutes)
  Center for HealthCare Strategies - 2021
- Harm Reduction URL
  Read the entire webpage. (9 minutes)
  SAMHSA - 2022
- The Stages of Change Model of Overcoming Addiction URL
  Read the entire article. (2 minutes)
  International Society of Substance Use Professionals - 2019
- Strengthening Canada’s Approach to Substance Use Issues URL
  Read the content under the headings "3. The Canadian Drugs and Substances Strategy" and "4. How to get there - Issues for discussion". (49 minutes)
  Government of Canada - 2018
- Cultural Considerations in Addiction Treatment" The Application of Cultural Humility URL
  Read the entire document. (19 minutes)
  Advances in Addiction and Recovery - 2021
- Discussion Forum Activity 3: Discussion on intervention considerations in therapy and control of substance use disorders. (420 minutes)
  Step 1: Select a specific group or demographic of your interest that may benefit from interventions to aid on the therapy and control of substance use disorders.
  Step 2: For the selected group, prepare a 300 – 750 word proposal for an intervention strategy considering examples of best practices for adapting public health interventions explored in the lesson. The proposal should include steps to ensure adaptation of the strategy to the cultural characteristics of the group/demographic identified.
  Step 3: To share your work in Moodle, click on the “Add a New Post” button under this post and paste your work in the “message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting; see the resource on the Himmelfarb Health Sciences Library for instructions: APA citation resource (N.B. references are excluded from word counts).
  Step 4: To complete the activity, you will need to reply to at least one post made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to the forum.”
- Quiz: Module 4
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
- Recommended Additional Readings
- Principles of Harm Reduction URL
  Read the entire webpage. (3 minutes)
  National Harm Reduction Coalition
- Understanding Stages of Change and Best Interventions for Substance Use Disorders URL
  Watch the video from 36:15 to 42:45. (7 minutes)
  National Nurse-Led Care Consortium - 2021
- Substance Use Disorders in Crisis Settings: Engagement, Assessment, and Intervention Approaches URL
  Read the content under the heading "Guidelines for integrated longitudinal assessment" until the heading "CME Post-Test". (16 minutes)
  Psychiatric Times - 2019
- Cross-Cultural Issues in Recovery from Addiction URL
  Watch the entire video. (5 minutes)
  CalSouthern Psychology - 2013
- Improving Cultural Competence: Quick Guide for Clinicians URL
  Read pages 4 to 47. (47 minutes)
  SAMHSA - 2014
Module 5: Ethics and Research in SUD Care
Instructional Goals covered in this module:
- Be competent in addressing stigma, and promoting and protecting the human rights of those you serve.
Module 5: Lesson 1: Addressng Stigma in Substance Use Disorder Care Settings
Student Learning Outcomes:
Upon completion of this module, students should be able to:
- Define stigma in the substance use disorder context.
- Examine the impact of stigmatization, marginalization, and discrimination on SUD treatment /interventions.
- Compare the strategies to mitigate stigmatization, marginalization, and discrimination in SUD care settings.
Approximate time required for the readings for this lesson (at 144 words/minute): 12 hours and 51 minutes.

Click here to start this lesson
11 URLs, 1 Forum
- Required Learning Resources and Activities
- Stories of Stigma: Stephanie’s Story URL
  Watch the video and at least two other "Stories of Stigma". (3 minutes)
  Commonwealth of Massachusetts - 2015
- Human Rights, Stigma, and Substance Use URL
  Read the entire article. (31 minutes)
  Health and Human Rights Journal - 2020
- Anti-Stigma Toolkit: A Guide to Reducing Addiction-Related Stigma URL
  Read Chapter 2 on pages 15 to 48. (43 minutes)
  Central East Addiction Technology Transfer Center & The Danya Institute - 2012
- Creative Peer Activity 2: Addressing the challenges of stigma and ethical practices in treating vulnerable and marginalized populations. (540 minutes) Forum
  
  In this activity you will examine the impact of stigma on vulnerable and marginalized populations with respect to substance use disorder identification and treatment strategies.
  
  Step 1: Review the information shared during the lesson on stigma and ethical issues. Then, pick a specific population (preferably where you live or work) and examine the country’s drug use, it’s social context and apply thinking about stigma and possible remediation for that setting. You can reference Chapte 2 of the Anti-Stigma Toolkit Guide to help inform your response or possible strategies that may be appropriate for your context.
  
  Step 2: Explore online to see the various examples of free video creation applications*. Become familiar with what good and poor videos look like. View the video creation tips found at http://www.kathleenamorris.com/2020/06/01/video-tools-teachers/ .
  
  Step 3: Using the video creation tool of your choice, create a 5- 10 minute video discussing stigma and its impact on the specific population that you selected and studied with respect to Substance Use Disorders identification and treatment, along with strategies for mitigating this impact.
  
  Step 4: Remember to proofread and edit your video. Make sure your video can be viewed easily in full screen mode.
  
  Step 5: To share your work in Moodle, click on the “Add a New Post” button under this post and paste the link to your Video in the “message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting; see the resource on the Himmelfarb Health Sciences Library for instructions: APA citation resource (N.B. references are excluded from word counts).
  
  Step 6: Evaluate the work of one of your peers based on items in the rubric below. Provide a rationale for the grade you provided, as well as comments or suggestions for improvement. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You can use the list below as a guide:
  
  Item A is .…. because…. My suggestions for improvement are….
  Item B is .…. because…. My suggestions for improvement are….
  Item C is .…. because…. My suggestions for improvement are….
  Item D is .…. because…. My suggestions for improvement are….
  
  *Examples of free video creation applications include iMovie, loom, WeVideo, Screencast Matic, Google Photos, Quik, Clips, Toonly and Doodly.
- Recommended Additional Readings
- Addictionary Words Matter: Judicial Language and Substance Use Disorders URL
  Browse this website that provides destigmatized language to use when talking about substance use disorders. (103 minutes)
  Recovery Research Institute
- Tell Me What to Say: How to Approach Challenging Patient Conversations URL
  Watch the video. (7 minutes)
  Office Based Addiction Treatment at Boston Medical Center's Grayken for Addiction - 2019
- Reducing Stigma Surrounding Substance Use Disorders URL
  Read the webpage and explore the various resources relating to reducing stigma against SUD by clicking on the links provided. (10 minutes)
  Curated Library about Opioid Use for Decision-makers - 2020
- Opioid Use Disorder – A Guide for Stigma Reduction Efforts URL
  Read the document. (5 minutes)
  Arizona Rethink RX Abuse
- Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change URL
  Read the "Summary" on pages 1 to 14. (30 minutes)
  National Academies of Science - 2016
- Reversing the Stigma of Opioid Addiction URL
  Watch the video. (10 minutes)
  NBC Left Field - 2018
- The Opioid Project: Changing Perceptions through Art and StoryTelling URL
  Select "Click Here for Art and Audio" and read at least one or two recovery and remembrance stories.
  Opoid Project - 2019
- MAT for Opioid Use Disorder: Overcoming Objections URL
  Read the entire document. (19 minutes)
  California HealthCare Foundation - 2019
Module 5: Lesson 2: Ethical Issues in Substance Use Disorder Treatment Settings
Student Learning Outcomes:
Upon completion of this module, students should be able to:
- Summarize the ethical dilemmas faced in substance use disorder from a clinical and public health perspective.
- Examine the relevance of the NAADAC Code of Ethics in guiding client-counselor relationships in substance use disorder treatment settings.
- Determine the appropriate response strategies to the disclosure of private and distressing information e.g., self-harm, sexual assault.
Approximate time required for the readings for this lesson (at 144 words/minute): 5 hours and 9 minutes.

Click here to start this lesson
8 URLs
- Required Learning Resources and Activities
- The ASAM Principles of Addiction Medicine - Ethical Issues in Addiction Practice URL
  Read the content under the heading "Core Ethical Principles". (27 minutes)
  The ASAM Principles of Addiction Medicine - Ethical Issues in Addiction Practice - 2019
- Public Health Code of Ethics URL
  Read the content under the heading " Section 3: Guidelines for Ethical Analysis" pgs 7-10. (15 minutes)
  American Public Health Association - 2019
- Alcohol Abuse and Other Substance Use Disorders: Ethical Issues in Obstetric and Gynecologic Practice URL
  Read the section: "Ethical Rationale for Clinical Recommendations and Guidelines Related to Substance Use Disorder" and "Ethical Approach to Common Patient-Care Issues Related to Substance Use Disorder". (15 minutes)
  The American College of Obstetricians and Gynecologists - 2015
- Code of Ethics URL
  Read the content under the heading "Introduction to NAADAC/NCC AP Ethical Standars" on page 1. (3 minutes)
  National Association for Alcoholism and Drug Abuse Counselors - 2021
- Disclosing Patients' Personal Information: A Framework URL
  Read the entire webpage. (10 minutes)
  General Medical Council - 2018
- Disclosures for the Protection of Patients and Others URL
  Read the entire webpage. (13 minutes)
  General Medical Council - 2018
- Using and Disclosing Patient Information for Secondary Purposes URL
  Read the entire webpage. (20 minutes)
  General Medical Council - 2018
- Recommended Additional Readings
- Public Health Code of Ethics URL
  Read the content under the heading "Section 4: Ethical Action Guidance for Policy and Practice in Functional Domains of Public Health " on pages 11- 30. (68 minutes)
  American Public Health Association - 2019
Module 5: Lesson 3: Challenges in Substance use Disorder Research
Student Learning Outcomes:
Upon completion of this module, students should be able to:
- Summarize the approach strategies for research involving human participants in LMICs.
- Examine the key challenges that impact substance use disorder research in LMICs.
- Explain the challenges of gaining informed consent of the persons involved in the SUD research.
Approximate time required for the readings for this lesson (at 144 words/minute): 3 hours and 43 minutes.

Click here to start this lesson
4 URLs, 1 Quiz
- Required Learning Resources and Activities
- Addiction Research Ethics and the Belmont Principles: Do Drug Users Have a Different Moral Voice? URL
  Read the content under the heading "Introduccion", and "Conclusions", (14 minutes)
  NIH - 2010
- Women and Substance Use Disorders in low- and middle-income countries: A call for Advancing Research Equity in Prevention and Treatment URL
  Read the entire article. (12 minutes)
  Taylor and Francis Online - 2019
- Challenges to Studying Illicit Drug Users URL
  Read the entire article. (34 minutes)
  US National Library of Medicine - 2019
- Ethical Issues in Research Involving Participants With Opioid Use Disorder URL
  Read the content under the heading "Informed Consent and Decision-Making Capacity", "Financial Compensation and Concerns About Undue Inducement" and "Other Threats to Voluntariness". (11 minutes)
  Sage Journals - 2018
- Quiz: Module 5
  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.
Final Assignment

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1 Forum
- Reflective Peer Activity 2: Ethical Principles and Human rights in Marginalized and Vulnerable Populations. (1200 minutes) Forum
  
  For this final assignment, you will illustrate the significance of the ethical principles and human rights protection in addressing the challenges of conducting research with substance use disorder participants in marginalized and vulnerable populations.
  Step 1: Identify two countries in the same OR different regions and examine major ethical and human rights issues that surround substance use disorder research in each of the selected countries.
  Step 2: Prepare a reflection piece of 1500-2500 words in length. Based on your findings, suggest strategies that can be used to engage marginalized and vulnerable populations so as to improve data collection and research outcomes. Ensure that your response includes the following :
  
  What strategies you would suggest and why?
  
  What you have learnt in the previous modules with regards to access to substance use disorder treatment and control services in a global setting?
  
  How would you apply this knowledge in your local context?
  
  Step 3: To share your work in Moodle, click on the “Add a New Post” button under this post and paste your work in the “message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting; see the resource on the Himmelfarb Health Sciences Library for instructions: APA citation resource (N.B. references are excluded from word counts).
  Step 4: Evaluate the work of one of your peers based on items in the rubric below. Provide a rationale for the grade you provided, as well as comments or suggestions for improvement. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You can use the list below as a guide:
  Item A is .…. because…. My suggestions for improvement are….
  Item B is .…. because…. My suggestions for improvement are….
  Item C is .…. because…. My suggestions for improvement are….
  Item D is .…. because…. My suggestions for improvement are…
  Adapted from https://web.uri.edu/assessment/files/reflection_rubric.doc.
Final Exam

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- Final Exam Quiz
  Restricted Not available unless:
  All of:
  The activity Course Registration is marked complete
  The activity Pre-Test is marked complete
  The activity Quiz: Module 1 is marked complete
  The activity Quiz: Module 2 is marked complete
  The activity Quiz: Module 3 is marked complete
  The activity Quiz: Module 4 is marked complete
  The activity Quiz: Module 5 is marked complete
  All of:
  The activity Discussion Forum Activity 1: Addressing Substance Use Disorders in Public Health (420 minutes) is marked complete
  The activity Discussion Forum Activity 2: Epidemiology of Substance Use Disorders in the student’s country of practice (420 minutes) is marked complete
  The activity Creative Peer Activity 1: Addressing the comorbidities associated with substance use abuse and other medical conditions. (480 minutes) is marked complete
  The activity Reflective Peer Activity 1: Impact of Policies and Regulations on Substance Use Disorders (480 minutes) is marked complete
  The activity Discussion Forum Activity 3: Discussion on intervention considerations in therapy and control of substance use disorders. (420 minutes) is marked complete
  The activity Creative Peer Activity 2: Addressing the challenges of stigma and ethical practices in treating vulnerable and marginalized populations. (540 minutes) is marked complete
  The activity Reflective Peer Activity 2: Ethical Principles and Human rights in Marginalized and Vulnerable Populations. (1200 minutes) is marked complete
  
  To take the final exam, you must complete all quizzes and complete all the required activities. The final exam consists of 30 questions, and you will have 30 minutes to complete it. When the time is over, you will have two minutes to submit your attempt before it expires, and your progress is discarded. You will not be able to answer additional questions in the grace period.
  To access the exam, click on the name of the exam provided above. On the following screen, click the attempt quiz button to respond to the questions.
Course and Self Evaluation & Certificate

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- Course Evaluation Questionnaire
  Restricted Not available unless: The activity Final Exam is marked complete
- Self Evaluation Questionnaire
  Restricted Not available unless: The activity Final Exam is marked complete
Course Activities

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- Activities Page

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Required Learning Resources and Activities

Recommended Additional Readings

Student Learning Outcomes:

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Instructional Goals covered in this module:

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Student Learning Outcomes:

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Student Learning Outcomes:

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Instructional Goals covered in this module:

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Student Learning Outcomes:

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Instructional Goals covered in this module:

Student Learning Outcomes:

Required Learning Resources and Activities

Recommended Additional Readings

Student Learning Outcomes:

Required Learning Resources and Activities

Recommended Additional Readings

Instructional Goals covered in this module:

Student Learning Outcomes:

Required Learning Resources and Activities

Recommended Additional Readings

Student Learning Outcomes:

Required Learning Resources and Activities

Recommended Additional Readings

Student Learning Outcomes:

Required Learning Resources and Activities