Substance Use
Substance use refers to the consumption of psychoactive substances, including alcohol, tobacco, prescription medications, and illicit drugs. It encompasses a spectrum of behaviors, from occasional recreational use to dependency and addiction. Substance use can be voluntary or compulsive, and is influenced by genetic, social, and environmental factors. While not all substance use leads to harm, misuse and dependency can have serious health and social consequences.
Addressing substance use is critical for preventing addiction, reducing associated health risks, and supporting social stability. The opioid crisis, increasing rates of alcohol-related deaths, and rising use of synthetic drugs highlight the urgency of addressing substance use disorders as a public health issue.
Substance use disorders affect millions of people globally. In the United States alone, over 22 million individuals struggle with substance use disorders each year. The COVID-19 pandemic intensified this crisis by increasing stress, social isolation, and limited access to support and treatment services. At the same time, there is growing momentum to expand the use of evidence-based treatment, prevention, and harm-reduction strategies.
Cultural factors, including Prohibition, the War on Drugs, and changing pharmaceutical regulations have shaped policies and stigmas. Racial and socioeconomic disparities in drug enforcement and treatment access continue to influence outcomes for individuals and communities. Certain populations are disproportionately affected by substance use and its consequences. Marginalized communities, including low-income individuals and people with co-occurring mental health disorders, face higher risks of substance use disorders. Adolescents and young adults are particularly vulnerable due to peer influence and developmental factors.
Factors such as mental health crises, availability of substances, and healthcare accessibility shape current substance use behaviors. Substance use has broad implications for healthcare, criminal justice, and social services systems. Addressing substance use effectively can reduce healthcare costs, decrease incarceration rates, and improve economic productivity.
Large-scale change can come from expanding Medicaid coverage, regulating pharmaceutical distribution, investing in early intervention, harm reduction, recovery and treatment facilities, and decriminalizing substance use. Federal, state, and local investments in mental health services and recovery infrastructure are also essential to establishing systems of care.
Local responses are vital in addressing substance use. Community-based efforts, like peer recovery networks, public education campaigns, and harm reduction programs, offer culturally responsive, person-centered approaches to care. These efforts foster connection and belonging while reducing stigma and supporting long-term healing.
Resources & Tools
Prison Alternatives Boosted by Health Impact Assessment
Resource
Brought to you by Health Impact Project
Navigating the Opioid and Substance Use Data Landscape: Strategies to Assemble Data and Bridge Gaps
Resource - Guide/handbook
Brought to you by IP3
Published on 03/07/2022
Grade Retention: A Case Study in Cincinnati Public Schools
Resource - Assessment
Brought to you by Health Impact Project
Published on 03/01/2013
Chukchi Sea Planning Area-Oil and Gas Lease Sale 193 and Seismic Surveying Activities
Resource - Assessment
Brought to you by Health Impact Project
Published on 12/31/2006
Basic Needs For Health and Safety: Freedom From Trauma, Violence, and Addiction
Resource - Website/webpage
Brought to you by Well Being Trust
Alcohol Retail Outlet Density Policy in Utah
Resource - Assessment
Brought to you by Health Impact Project
Downtown-Westside Baltimore
Resource - Assessment
Brought to you by Health Impact Project
Published on 05/31/2013
Overview of Opioid Treatment Program Regulations by State
Resource - Policy Brief
Brought to you by The Pew Charitable Trusts
Retail Cannabis Regulation in Los Angeles County
Resource - Assessment
Brought to you by Health Impact Project
Published on 07/14/2019
Tackling America’s Mental Health and Addiction Crisis Through Primary Care Integration
Resource - Report
Brought to you by Bipartisan Policy Center Inc.
Deviancy, Dependency, and Disability: The Forgotten History of Eugenics and Mass Incarceration
Resource - Journal Article
Fort McPherson Interim Zoning
Resource - Assessment
Brought to you by Health Impact Project
Published on 12/31/2009
Effects of Substance Use Disorder Criminalization on American Indian Pregnant Individuals
Resource - Journal Article
Brought to you by AMA
Legalizing Medical Marijuana Through the Utah Medical Cannabis Act
Resource - Assessment
Brought to you by Health Impact Project
Published on 11/30/2017
Potential Health Effects of Changes to the Kansas Liquor Control Act
Resource - Assessment
Brought to you by Health Impact Project
The Layoff and Bumping Process in Cincinnati
Resource - Assessment
Brought to you by Health Impact Project
Small Area Estimates For Cancer-Related Measures
Resource - Data Bank/repository
Brought to you by NCI
School Discipline Policies
Resource - Assessment
Brought to you by Health Impact Project
Published on 04/30/2012
Proposed Opioid Pre-Authorization Policy in Utah
Resource - Assessment
Brought to you by Health Impact Project
Published on 11/30/2017
Eugene-Springfield Consolidated Plan and the Impact of Housing on Children's Health
Resource - Assessment
Brought to you by Health Impact Project
Published on 07/31/2014
Association of Firearm Access, Use, and Victimization During Adolescence With Firearm Perpetration During Adulthood in a 16-Year Longitudinal Study of Youth Involved in the Juvenile Justice System
Resource - Journal Article
Brought to you by JAMA
Marijuana Policies Related to Child Abuse and Neglect in the State of Colorado
Resource - Assessment
Brought to you by Health Impact Project
Published on 10/31/2016
Rural Community Action Guide Promising Practices Supplement
Resource - Guide/handbook
Brought to you by USDA
California Proposition 47: The Safe Neighborhoods and Schools Act
Resource - Assessment
Brought to you by Health Impact Project
Published on 09/03/2014
Colorado Statewide Regulatory Structure for Retail Marijuana
Resource - Assessment
Brought to you by Health Impact Project
Worksite Wellness in Davidson, NC
Resource - Assessment
Brought to you by Health Impact Project
Published on 11/01/2014
Transforming the Narrative: Health Equity and the Community – A Toolkit
Resource
Brought to you by NNPHI
Minnesota Drug Sentencing Reform
Resource - Assessment
Brought to you by Health Impact Project
Published on 01/31/2016
Bright Spot: Clinical Integration of Fax Referrals to Quitlines
Resource - Model Policy
Brought to you by 100MHL
In Support of Maximum Diversion of Persons With Serious Mental Illness From the Criminal Justice System
Resource - Model Policy
Brought to you by MHA
Colorado SB 18-024: Expanding Access to Behavioral Health Care Providers
Resource - Report
Brought to you by Health Impact Project
Legalizing Medical Marijuana in Kansas
Resource - Assessment
Brought to you by Health Impact Project
Published on 08/31/2015
Outer Continental Shelf Oil and Gas Leasing Program
Resource - Assessment
Brought to you by Health Impact Project
Published on 12/31/2006
Alcohol Outlet Density in the Greenbush-Vilas Neighborhood, Madison, Wisconsin
Resource - Assessment
Brought to you by Health Impact Project
Medicaid Coverage For Residential Substance Use Disorder Treatment: Addressing The Institution For Mental Disease Exclusion Policy
Resource - Blog
Brought to you by Project HOPE
Transitional Jobs Program
Resource - Assessment
Brought to you by Health Impact Project
Published on 12/31/2012
Raising the Legal Tobacco Purchase and Use Age to 21 in Utah
Resource - Assessment
Brought to you by Health Impact Project
Mojave Desert Utility-Scale Solar Project
Resource - Assessment
Brought to you by Health Impact Project
Published on 12/31/2013
Basic Needs: Freedom from Trauma, Violence, and Addiction
Resource - Report
Brought to you by Well Being Trust
Hartford Neighborhood Revitalization and Sustainability Plan
Resource - Assessment
Brought to you by Health Impact Project
Alcohol Outlet Density-Marathon County, Wisconsin
Resource - Assessment
Brought to you by Health Impact Project
Toxic Stress, Behavioral Health, and the Next Major Era in Public Health
Resource - Report
Brought to you by MHA
Washington State Substance Use Disorder Prevention and Mental Health Promotion
Resource - Report
Brought to you by Washington State Health Care Authority
Implementing State and Local Overdose Prevention Policies: A Resource for Navigating the Policy Process
Resource - Guide/handbook
Brought to you by ChangeLab Solutions
Legal Interventions to Reduce Overdose Mortality: Naloxone Access and Overdose Good Samaritan Laws
Resource - Fact Sheet
Brought to you by Public Health Law Center
After-School Programs - Proposition 49
Resource - Assessment
Brought to you by Health Impact Project
Replacing Public Housing Units Destroyed by Hurricane Ike
Resource - Assessment
Brought to you by Health Impact Project
Alcohol Outlet Density in Mendocino County
Resource - Assessment
Brought to you by Health Impact Project
Published on 12/31/2012
City Residents Support Public Health Approaches to Drug Use, Homelessness: A Messaging Playbook
Resource - Guide/handbook
Brought to you by BCHC
Preventing Overdose and Reducing Drug-Related Harm: A Policy Guide For State and Local Change
Resource - Guide/handbook
Brought to you by ChangeLab Solutions
Substance Abuse and Homelessness: Statistics and Rehab Treatment
Resource - Guide/handbook
Brought to you by American Addiction Centers
Bright Spot: Prize Incentives Contingency Management for Substance Abuse
Resource - Model Policy
Brought to you by 100MHL
Baltimore City's Comprehensive Zoning Code Rewrite
Resource - Assessment
Brought to you by Health Impact Project
Published on 01/02/2010
This E.R. Treats Opioid Addiction on Demand. That's Very Rare.
Story - Written
Brought to you by NYT
An Introduction to the Opioid and Substance Use Framework
Story
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Original
Brought to you by Community Commons
Published on 05/21/2024
Public Transit Agencies Join the Fight to Curb Overdose Deaths
Story - Written
Brought to you by Bloomberg L.P.
Published on 01/18/2024
A Collision of Epidemics: Coronavirus Disrupts Addiction Treatment
Story - Written
Brought to you by CalMatters
For The Babies Of The Opioid Crisis, The Best Care May Be Mom’s Recovery
Story
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Original
Brought to you by Community Commons
Published on 05/15/2018
A Rural Community Decided To Treat Its Opioid Problem Like A Natural Disaster
Story - Written
Brought to you by NPR
How Does Our Sense of Belonging Shape our Mental Health?
Story
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Original
Brought to you by Community Commons
Taking Action to End Overdose Deaths
Story
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Original
Brought to you by Community Commons
Published on 09/16/2025
Caritas of Austin Uses Multi-Solving and Non-Traditional Partnerships to Decrease Veteran Homelessness
Story
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Original
Published on 11/29/2023
E-cigarettes and Vaping: The New Tobacco Battleground
Story
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Original
Brought to you by Community Commons
Published on 01/30/2020
Our Need for a National Resilience Strategy
Story
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Original
Brought to you by Community Commons
Published on 11/21/2017
Holistic Health and Wellness Expo
Story - Written
Brought to you by KU Center for Community Health and Development: Community Tool Box
Safe Medication Collection
Story - Written
Brought to you by KU Center for Community Health and Development: Community Tool Box
Opioid Antidote Can Save Lives, But Deciding When To Use It Can Be Challenging
Story - Written
Brought to you by NPR
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