Consideration of Social Determinants Risks in Substance Use Disorder Assessment and Treatment Plan Formulation

Substance use disorders continue to trend as an increasingly pervasive public health problem in the United States. Substance use disorders are recognized as a global health problem by the World Health Organization. It is imperative to explore all opportunities to improve outcomes of substance use disorder treatment. Consideration of social determinant risks in assessment, treatment planning, and treatment implementation is one such opportunity. Social determinant conditions can be conceptualized along a continuum of primary categories. Developing methods to help clinicians understand and incorporate social determinants into assessment and treatment plan formulation processes may help improve outcomes for those who are experiencing one or more substance use disorders. This column includes a proposal for a framework of primary categories of social determinants and offers a definition for each. The categories are identified as basic needs insecurity, past trauma, historical oppression, current/ongoing severe distress and layered/compounded risks. These categories and definitions are developed in the context of practical application for clinical assessment and treatment plan formulation.