Clinician's Corner | By Associate Professor Frances Kay-Lambkin
Modifiable health risk behaviours and attitudes towards behaviour change of clients attending community-based substance use treatment services.
People diagnosed with substance use disorders face a wide range of challenges and stigmatisation related to their lifestyle, behaviours and effects of their condition throughout their lives. In their forthcoming paper in Drug and Alcohol Review, available on Early View, Tremain et al. highlight how health risk behaviours independent of primary substance use, such as tobacco smoking, play a key role in the experience of harm, and contribute to the 23-year life expectancy gap between people diagnosed with substance use disorders and the general population. They then explore the leading health risk behaviours exhibited by a sample of people seeking treatment for substance use disorders.
Tremain et al. show that tobacco use, insufficient fruit and vegetable intake, and insufficient physical activity form a cluster of health risk behaviours that account for the greatest risk of chronic health diseases, both in the general population and in people seeking treatment for substance use disorders. However, the authors found that these health risk behaviours are reported much more frequently by people diagnosed with substance use disorders, and within this population, young people (aged 18-34 years) are 4.4 times more likely to smoke tobacco than are people in older age groups.
The good news is that tobacco use, physical inactivity, and insufficient fruit and vegetable intake represent health behaviours that are amenable to change. Further, Tremain et al. found that up to 61% of people engaged in substance use treatment services in New South Wales have already considered modifying these behaviours, and up to 97% thought it acceptable to be provided access to preventive interventions to reduce this health risk. Younger people in the Tremain et al. sample were more interested than other age groups in increasing their fruit and vegetable intake, indicating that a potential strategy for engaging this typically challenging age group in substance use treatment services may be to offer a broader “lifestyle-focussed” intervention.
While more research is needed in this area to determine the most effective strategies for supporting people diagnosed with substance use disorders to address tobacco use, fruit and vegetable intake, and physical activity, Tremain et al. provide a compelling argument for integrating lifestyle-focussed assessment and interventions (including the integration of the many apps and online programs currently available) into substance use treatment services in Australia.
A full copy of this paper is available online.
Tremain D, Freund M, Wolfenden L, Wye P, Bowman J, Dunlop A, Gillham K, Bartlem K, McElwaine K, Gow B, Wiggers J. Modiﬁable health risk behaviours and attitudes towards behaviour change of clients attending community-based substance use treatment services. Drug Alcohol Rev 2016; Available on Early View.