Public health approaches to substance misuse
In the current climate of alcohol drinking and drug-taking behaviours, health promotion, education, prevention and harm-reduction are increasingly part of the role of the health and social care professionals. From the late ’80s, prevention and treatment have become much higher on the political and service agendas. Public health campaigns have been introduced that maximise awareness of the risks of tobacco smoking, of drunk-driving and of the misuse of over-the-counter drugs, alcohol, prescribed drugs and illicit drugs. As a result, the public health triangular model, which involves interaction between the host (the individual), the agent and the environment, has become more prominent. The Prevention, Treatment, Enforcement and Harm Reduction (Four Pillars Model) approaches have been implemented in many countries. The programme is a balancing act between prevention and health promotion providing both harm reduction programmes for those who continue to use drugs and treatment options for the drug users who want to quit. Every encounter with a patient affords an opportunity to transmit knowledge about health care and harm reduction in relation to tobacco smoking, alcohol, psychoactive drugs and sexual health.