Course Guide

Introduction

Welcome to HLTH 4511: Introduction to Problematic Substance Use and Approaches for its Prevention and Treatment.

The Course Guide contains important information about the course structure, learning materials, and expectations for completing the course requirements. It also provides information about how and when to contact your Open Learning Faculty Member, an expert in the course content, who will guide you through the course. Take some time to read through the Course Guide to familiarize yourself with what you need to do to successfully complete your course.

Before you begin your coursework, it also is a good idea to read the Student Handbook, available at http://www.tru.ca/__shared/assets/TRU-OL-Student-Handbook-27236.pdf. The Handbook provides information about key policies and procedures, such as course withdrawals and cancellations, and how to schedule final exams. It also includes information about the various student services available to you, and telephone, email, and website contact details.

If you have any questions, please feel free to contact your Open Learning Faculty Member. We hope you enjoy the course.

Course Description

Learners review conceptual, historical, political, and societal factors that influence values, beliefs, approaches, and practices with persons with problematic substance use. Learners reflect upon their own attitudes and beliefs and consider how prior knowledge and experiences may influence their understanding of substance use disorders and their perceptions of persons experiencing problematic substance use and their families. Learners are introduced to foundational concepts and methods in prevention and treatment of problematic substance use.

Course Overview

This is the first course in a series of five that culminates in the Interprofessional Substance Use Practice Certificate. This certificate program was created in response to a recognized need for the development of competency-based training programs for workers involved in the treatment and prevention of substance use disorders. The certificate program courses are unique in that they have been developed collaboratively by academics and veteran front-line substance use prevention and treatment workers (practitioners, managers, directors, and policy makers). This means that the knowledge, skills, and attributes of course graduates should reflect those desired by employers.

The need for competency-based practice was first exemplified in the document A Systems Approach to Substance Use in Canada: Recommendations for a National Treatment Strategy published in 2008; although at that time, details about the knowledge, skills, and attributes required by members of Canada’s substance use workforce did not exist. Fortunately by 2010, the Canadian Center on Substance Abuse (CCSA), using a nation-wide consultation process, produced a document entitled Competencies for Canada’s Substance Abuse Workforce. This document defined the competencies (technical skills and behavioural attributes) expected of a person working in the field. The certificate program and this introductory course are based on these documents. Later in the Course Guide, you will find a section that describes the CCSA competencies and aligns them with the readings and assignments for this course. The demonstration of such an alignment is important because it shows potential employers that graduates of this course have achieved a level of competency in the described attributes and skills.

Throughout the course, in addition to the expressed competencies required by the CCSA, a number of concepts are interwoven. First, the course focuses on a critical examination of evidence-based practice approaches. The concept of evidence-based thinking currently underpins many disciplines, including medicine, education, criminology, nursing, and social work, and is influential in Canada, the UK, and the US. Although the concept of evidence-based practice continues to be contested by some professionals (based on various models of logic, scientific axioms, and epistemological considerations), few would argue against the need for rigorous and standardized research, which ultimately leads to meaningful policy and effective practice (Gray, Plath, & Webb, 2009). Consistent with adult learning theory and self-reflexivity, the demonstration of a critical stance in relation to evidence-based practice is crucial. A critical stance refers to a process in which practitioners engage with their practice environment. It requires an attitude or disposition towards oneself, others, and the object of inquiry that challenges and impels workers to reflect, understand, and act in a milieu of potentiality (Gray, Plath, & Webb, 2009). A combination of self-reflexivity and a transparent evidence-based method of practice decision-making ensures a conscious purposefulness with respect to professional and competent practice.

The second theme woven throughout the course is the role of stigma and how individual, agency, and institutional stigma affects how we understand substance use and the substance use disorder population.

The third and fourth themes are interrelated. The third is that substance use (and addictions) is a complex disorder that occurs as an interaction of psycho-social-behavioural processes with biological factors including brain chemistry and synaptic transmission. Consistent with a multifaceted approach to the causation and maintenance of substance use problems, it is not surprising that the fourth theme in this course relates to interprofessional practice. While social work and nursing are the two predominant professional foci within this course, other disciplines such as medicine and psychology are integrated.

At this point in the introduction, it is important to think about the language associated with substance use and the potential for stigma based on our vocabulary choices. In this field, words such as abuse, misuse, problematic use, user, addict, addiction, dependence, risk, tolerance, and harm are used and have different meanings to different people (Perry & Reist, 2006). Language such as substance “abuser” and substance “dependence” is stigmatizing and favours a moralistic perspective of substance use (Wakeman, 2013). In this course, and subsequent courses in this certificate program, the broad term substance use will be used to refer to the field, and the term substance use disorder will replace the terms substance abuse or substance dependence. Where possible the terms abuse and addiction will not be used. The term substance use disorder is now used in the Diagnostic and Statistical Manual of Mental Disorders (DSMV). The term concurrent disorder will be used to refer to a condition that indicates that a person has both a mental illness and a substance use problem. Of course, some of the publications and readings may predate this more contemporary usage of terms, and/or some countries may use different terminology. For example, the literature from the US doesn’t tend to use the term concurrent disorder. Throughout the course, we always will try to put the person ahead of the problem, which indicates that a person is much more than simply a problem. So, rather than saying addicts or cocaine users, we will say people with substance use disorders or people who are cocaine users.

Learning Outcomes

By working through the learning activities in this course, participants will:

  • Examine the perception of their attitudes and beliefs about persons engaged in problematic substance use and their families, and consider how conceptual, historical, political, personal, and societal forces may have contributed to their attitudes and beliefs.

  • Identify or describe factors (biological, psychological, and social) currently believed to be associated with the etiology of problematic substance use.

  • Recognize the impact of health-related stigma on past, current, and future approaches to the prevention and treatment of problematic substance use and mental illness.

  • Identify how conceptual, historical, political, and societal forces have shaped past and current approaches to problematic substance use prevention and treatment in North America.

  • Describe the principles of evidence-based practice (EBP) and the skills used in applying those principles, as defined by the Evidence-Based Decision Making (EBDM) process.

  • Explain the unique challenges/needs faced by evidence-based decision makers working in the field of problematic substance use.

  • Examine a range of evidence-based practices currently used in the prevention and treatment of problematic substance use.

  • Use EBDM skills to evaluate the evidence that supports long-standing and innovative practices for the prevention and treatment of problematic substance use.

  • Recognize the interprofessional nature of Canada’s substance abuse workforce.

  • Appreciate the importance of interprofessional collaboration for the planning and evaluation of programs for the problematic substance use field.

Prerequisites

The prerequisite for this course is fourth year standing or permission from the School of Nursing or School of Social Work.