Welcome to Introduction to Substance Use and Misuse
|
Textbook Introduction Introduction to Substance Use and Misuse Understanding the scope, impacts, and interventions of substance-related issues across individual, family, and systems contexts. |
Overview
Why this course matters
Substance use and misuse become most visible where stability is already under strain. The scope of the problem is defined not only by prevalence, but by the persistent gap between need and response, a gap that shows up within families, communities, courtrooms, and clinical settings alike.
The chapters that follow build a shared analytic foundation, moving from the biological and psychological dimensions of substance use through the social, structural, and policy contexts that shape both risk and response. From there it turns to research literacy, then to the clinical work of screening, assessment, treatment, and coordinated care, and closes with the evaluation, ethics, and reflective practice that sustain a career in this profession.
In 2021, 39.1% of children placed in out-of-home care had parental alcohol or other drug use identified as a condition associated with their removal, reflecting how substance use alters attachment, stability, and long-term outcomes for children.
National Center on Substance Abuse and Child Welfare (n.d.)
The economic burden of opioid use disorder and fatal overdose was estimated at $1.02 trillion in 2017 alone (Florence et al., 2021). More than half of state prisoners and sentenced jail inmates met criteria for drug dependence or abuse in the year before admission (Bronson et al., 2017). These conditions show why the study of substance use requires understanding that can move across contexts while remaining grounded in lived experience.
Systems of impact
Where substance use intersects with practice
|
Family systems
Parental substance use is a leading condition contributing to child welfare involvement, affecting attachment and out-of-home placement decisions.
|
|
Public health
After exceeding 100,000 deaths a year from 2021 through 2023, overdose deaths fell to about 79,000 in 2024 (Garnett & Miniño, 2026). The decline is real, but substance use remains a sustained national mortality crisis requiring coordinated public health response.
|
|
Justice system
More than half of state prisoners (58%) and sentenced jail inmates (63%) met criteria for drug dependence or abuse in the year before admission, and about 4 in 10 used drugs at the time of their offense (Bronson et al., 2017). A later prison survey, which used substance use disorder criteria rather than the language of dependence and abuse, put the state figure at 49% (Maruschak et al., 2021).
|
|
Economic burden
Estimated $1.02 trillion cost in 2017 from opioid use disorder and fatal overdose, capturing lost life, productivity, and system involvement (Florence et al., 2021).
|
Course structure
Five modules, one progression
The text moves from foundational understanding through contextual analysis, research literacy, clinical application, and professional growth, building knowledge that is both broad and grounded.
|
M1 — Foundations
|
|
M2 — Context and Environment
|
|
M3 — Research and Evidence
|
|
M4 — Assessment and Support
|
|
M5 — Evaluation and Growth
|
Modules 1–2 build shared understanding. Module 3 grounds practice in evidence. Modules 4–5 move into clinical and professional application. Each module prepares the practitioner to operate across the systems where substance use intersects with real lives.
Student learning outcomes
What this course prepares you to do
The five student learning outcomes below are the approved outcomes for SW 4050 and SW 5050. They govern the course as a whole, and the textbook is built to support them.
|
Outcome 1 Apply ethical standards, professional values, and communication skills to engage individuals, families, and communities affected by substance use and misuse, demonstrating an understanding of the neurobiological and biopsychosocial foundations that inform professional practice. |
|
Outcome 2 Utilize evidence-informed screening and motivational interviewing techniques to identify substance use patterns, assess readiness for change, and ensure fair access to care across varied populations and policy systems. |
|
Outcome 3 Integrate research literacy and evidence-informed frameworks to design individualized and group intervention strategies that address co-occurring disorders, recovery needs, and systemic barriers to treatment. |
|
Outcome 4 Apply collaborative, strengths-based assessment and planning methods to coordinate care across health, justice, and social systems, incorporating family and community engagement as essential components of recovery-oriented practice. |
|
Outcome 5 Evaluate outcomes and prevention efforts through reflective, data-informed, and ethically grounded approaches that strengthen professional competence, promote sustainability, and foster recovery-focused and culturally informed systems of care. |
Each chapter names the outcome or outcomes it supports as its course objective. The objectives listed beneath it identify which elements of that outcome the chapter addresses.
On the design of this textbook
Why concepts recur across the modules
Substance use is a complex and interconnected subject, and there is no single correct way to organize an introductory course around it. The same core material could be sequenced in many defensible ways. This textbook is built around chapters within the modules that address a set of core, related elements either through a shared theory or common application. That structure is a deliberate choice, and it shapes how the content is meant to be read.
One consequence of this design is that certain terms and concepts will appear more than once across the chapters. At times this may read as repetition. It is not. Each chapter and section introduces or revisits a concept for a specific reason, either to build on an idea presented earlier or to apply it in a new context. A concept introduced in one module as theory may return in a later module as a matter of assessment, coordination, or practice. The recurrence is intentional, and the meaning of a concept often deepens each time it reappears.
Readers are encouraged to treat these moments of overlap as reinforcement rather than redundancy. Encountering a concept in more than one setting is part of how the material is designed to take hold. Substance use practice requires the ability to hold several perspectives at once, and a textbook built to teach that ability will return to its central ideas from more than one direction.
