In 1989, National Recovery Month was started during the month of September. The purpose of Recovery Month is to raise awareness and promote evidence-based treatment and recovery practices, celebrate the recovery community, and acknowledge service providers and communities that assist individuals with their recovery. Recovery Month provides continued education and encouragement around recovery, elevating accomplishments and reaffirming the possibility of recovery.

SAMHSA defines recovery as a process of change through which individuals improve their health and wellness, live self-directed lives and strive to reach their full potential. Social workers provide counseling and psychotherapy services to patients in recovery.  Social workers help patients eliminate psychosocial stressors such as homelessness, loss of job, divorce, and loneliness that may have led to their use of substances. They walk patients through their journey of recovery providing supportive services that lead them to a healthier and rewarding lifestyle.

NASW celebrates Recovery Month and congratulates those in recovery for their resiliency and tenacity. The association shares the following resources with members who work with patients in recovery.

NASW Resources

New Messaging from Faces & Voices of Recovery for Talking About Recovery
Faces & Voices of Recovery (FAVOR) is a national campaign of individuals and organizations joining together with a united voice to advocate for public action to deliver the power, possibility, and proof of recovery from substance-use disorders. FAVOR has developed a language that social workers and others can use to talk with the public and policymakers about recovery from addiction to alcohol and other drugs.

Facing the Opioid Crisis (podcast episode)
David Stoecker, LCSW, is founder and director of Better Life in Recovery. He recommends that we look at the opioid addiction pandemic through a harm-reduction lens, rather than a punitive one. He argues that abstinence is not the only path to recovery and that we need to create healthy communities and to provide recovery support to those who need it.

Additional Resources

Centers for Disease Control and Prevention,
Recovery Is for Everyone: Understanding Treatment of Substance Use Disorders. The CDC explains what substance use disorders are along with different treatment and recovery options and the importance of reducing stigma.

National Center on Substance Abuse and Child Welfare

• Disrupting Stigma: How Understanding, Empathy, and Connection Can Improve Outcomes for Families Affect by Substance Use and Mental Disorders. Brief created to support collaboration amongst teams in their efforts to help reduce stigmas. The brief provides strategies and best practices when working with individuals affected by substance use and mental disorders.

• Understanding Substance Use Disorder Treatment: A Resource Guide for Professionals Referring to Treatment. Resource which provides tools for providers to utilize when working with individuals and families affected by substance use.

• Online Tutorials, for Substance Use Treatment Professionals, Child Welfare Professionals and Legal Professionals.

National Institute on Drug Abuse (NIDA)
NIDA defines recovery and provides descriptions of different types of recovery programs and provides two tools providers can use when working with individuals who are entering recovery.

Online Treatment Locator, the confidential and anonymous resource for individuals seeking treatment for mental and substance use disorders in the United States and its territories.

Substance Abuse Mental Health Services Administration (SAMHSA):

• SAMHSA’s National Helpline, is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English andSpanish) for individuals and families facing mental and/or substance use disorders.

• SAMHSA’s Evidence-Based Practices Resource Center, SAMHSA has compiled a list of resources that can help communities, providers and policymakers incorporate evidence-based practices into their work and settings.

• Recovery from Substance Use and Mental Health Problems Among Adults in the United States, recent brief report released in 2023 of self-reports of recovery among adults aged 18 and older in the United States. The findings provide information regarding reasons connected with recovery and how efforts can be made to assist with sustaining recovery.

• Recovery is Real & Holistic, infographic regarding persons in recovery.

Social Media Toolkits

National Recovery Month Partner Toolkit, CDC toolkit which provides social media content to help raise awareness regarding National Recovery Month.

2023 Toolkit for Recovery Month, toolkit which can be used to help with raising awareness through social media, hashtags, and other ideas related to hosting community events to celebrate Recovery Month.

National Recovery Month Events

Faces and Voices of Recovery, list of events during the month of September for Recovery Month.

Drinking during pregnancy is more common than you might think. About one in 20 pregnant people report binge drinking in the past 30 days, and up to five percent of school children in the U.S. may have fetal alcohol spectrum disorders (FASDs), a range of lifelong behavioral, intellectual, and physical disabilities that can occur in a baby exposed to alcohol before birth. People with FASDs may be at high risk for school challenges, criminal justice issues, substance use disorders, and mental health disorders.

September is Fetal Alcohol Spectrum Disorders Awareness Month. As providers of mental and behavioral health services, social workers play a critical role in preventing FASDs by sharing these key messages with clients who are pregnant or may become pregnant:

• There is no known safe amount of alcohol use or safe time to drink during pregnancy.
• There is also no safe type of alcohol to drink while pregnant, since all types of alcohol can be harmful, including wine, beer, and liquor.
• If you become pregnant, stop drinking alcohol. Every day matters. The sooner you stop drinking, the less health risks your newborn baby may encounter.

Stigma related to alcohol use during pregnancy can make discussing these topics with clients difficult. The good news is that universal alcohol screening, brief intervention, and referral to treatment (SBIRT) offers a non-stigmatizing, evidence-based tool to address risky drinking, including any alcohol use during pregnancy. It is relatively simple to do, and using a validated screening instrument takes just a few minutes. Alcohol SBI is also recommended by the U.S. Preventive Services Task Force and endorsed by major medical professional organizations as well as the Centers for Disease Control and Prevention (CDC).

Since 2014, NASW and the NASW Foundation have partnered with the Health Behavior Research and Training Institute at The University of Texas at Austin Steve Hicks School of Social Work in the Collaborative for Alcohol-Free Pregnancy. This CDC initiative supports health professionals across disciplines working together to promote primary prevention of alcohol-exposed pregnancies.

To learn more, visit NASW’s Behavioral Health page. Additional resources are also available:

• Centers for Disease Control and Prevention, Fetal Alcohol Spectrum Disorders Training and Resources
• NASW Practice Perspectives: Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT)
• Reducing and Preventing Alcohol Misuse and Its Consequences: A Grand Challenge for Social Work

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This initiative, Engaging Social Workers in Preventing Alcohol- and Other Substance-Exposed Pregnancies, is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services as part of a financial assistance award totaling $280,000 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, CDC/HHS, or the U.S. Government.

1. Drinking among women has increased substantially over the last 20 years.

Though men still drink more overall than women do, gender gaps in drinking patterns are shrinking. Between 2000 and 2016, the number of women ages 18 and older who drink rose by 6 percent (while falling by 0.2 percent among men). Women’s binge drinking has also increased significantly (by 14 percent, compared to a 0.5 percent increase among men). Moreover, girls and young women ages 12 to 20 are now drinking more alcohol than same-aged males.

2. Women face greater health risks from drinking than men do.

Due to gender differences in body structure and chemistry, women experience more severe health risks from drinking compared to men, including blackouts, liver disease, faster progression of alcohol use disorder, and certain cancers – even when they consume less alcohol. Those who are pregnant or can become pregnant also risk alcohol-exposed pregnancy and fetal alcohol spectrum disorders (FASDs), a range of lifelong behavioral, intellectual, and physical disabilities that affect an estimated 1-5% of school children in the U.S.

3. Drinking during pregnancy often occurs with marijuana and tobacco use, and all pose risks to both mother and baby.

About 1 in 20 pregnant people report binge drinking in the past 30 days and 40% of those who drink during pregnancy say they also use one or more other substances, most frequently tobacco and marijuana. Prenatal alcohol exposure has been linked to increased risk of miscarriage, stillbirth, premature birth, and sudden infant death syndrome (SIDS). People with FASDs are at high risk for trouble in school, trouble with the law, alcohol and drug abuse, and mental health disorders. Using tobacco and marijuana during pregnancy have also been linked to health risks for both the mother and developing baby.

4. There is no safe type, no safe time and no safe amount of alcohol to drink while pregnant.

There is no known safe amount of alcohol use during pregnancy. There is also no safe time during pregnancy to drink. All types of alcohol can be harmful, including wine, beer, and liquor. Although some babies may not be affected by alcohol exposure during pregnancy, others may have lifelong effects. The safest thing to do to is to avoid any type of alcohol use throughout pregnancy.

5. Alcohol screening and brief intervention (SBI) is effective and relatively simple to do.

Alcohol SBI has been proven to reduce risky alcohol use, and is recommended by the U.S. Preventive Services Task Force for use with all adults served in primary healthcare settings. Alcohol SBI is also endorsed by major medical professional organizations as well as the Centers for Disease Control and Prevention (CDC). Screening with a validated instrument takes just a few minutes, followed by a brief conversation with those who are drinking too much, and referral to treatment when appropriate

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Since 2014, NASW, the NASW Foundation and the Health Behavior Research and Training Institute at The University of Texas at Austin Steve Hicks School of Social Work, have teamed-up with leading health workforce organizations and the CDC in a comprehensive national initiative to encourage health professionals to help prevent prenatal alcohol use. NASW is the only mental health workforce organization participating in this initiative.

Visit NASW’s Behavioral Health page for resources. Additional resources are also available:

• NASW Practice Perspectives: Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT): Best Practices for the Prevention and Treatment of Risky Drinking in Girls/Women of Childbearing Age
• Reducing and Preventing Alcohol Misuse and Its Consequences: A Grand Challenge for Social Work
• American College of Obstetricians and Gynecologists: Alcohol and Pregnancy, Tobacco and Pregnancy, and Marijuana and Pregnancy

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Article by Diana Ling, MA, Program Manager; and Anna Mangum, MSW, MPH, Senior Health Strategist; Health Behavior Research and Training Institute, Steve Hicks School of Social Work, The University of Texas at Austin.

Traditionally, loneliness research has focused primarily on older adult populations. There is limited research on how loneliness and social support impact young people’s mental health and mental health services use.

In the May 2023 issue of the journal Health & Social Work, which is co-published by NASW and Oxford University Press, an article looks at loneliness among emerging adults. (The article defines “emerging adults” as persons aged 18 to 29 years old.)

This article reports an assessment of whether loneliness and social support are associated with the use of mental health services, and with mental health symptoms (psychological distress and suicidal ideation) among emerging adults.

A subsample of emerging adults ages 18 to 29 was drawn from the 2017 Survey of Police-Public Encounters, a cross-sectional, general population survey administered to residents of New York City and Baltimore. The authors performed various statistical analyses to model associations between loneliness and mental health symptoms and services use outcomes.

Some findings:

• Emerging adults with higher levels of loneliness reported higher levels of distress and suicidal ideation. Having more social support, experiencing higher levels of distress, and suicidal ideation were associated with increased odds for using services.
• First-generation American emerging adults and Black emerging adults were less likely to use services than their U.S.-born and non-Black counterparts.

The authors conclude that the significant impact of loneliness on mental health symptoms and the effect of social support on service use highlight the importance of developing interventions to prevent and reduce loneliness over the life course.

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Study Authors

• Melissa Bessaha, PhD, LMSW, associate professor, School of Social Welfare, Stony Brook University
• Dawnsha Mushonga, PhD, assistant professor, School of Health and Human Services, University of Baltimore
• Lisa Fedina, PhD, assistant professor, School of Social Work, University of Michigan,
• Jordan DeVylder, PhD, associate professor, Graduate School of Social Service, Fordham University

This work was supported by internal funding from the University of Maryland School of Social Work, through the Competitive and Innovative Research Award to Jordan DeVylder.

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NASW journals are co-published by NASW Press and Oxford University Press. The journal Social Work is a benefit of NASW membership. It is available online or, at a member’s request, in print. Children & Schools, Health & Social Work and Social Work Research are available by subscription at a discounted rate for NASW members, either online or in print. Learn more about the journals and subscriptions.

If you’re not sure how to answer these questions, you’re not alone. Recent communication research shows that many healthcare professionals are surprised to learn how few drinks per week are considered excessive.

Excessive drinking includes heavy drinking (eight or more drinks a week for women, and 15 or more a week for men) and binge drinking (four or more drinks on one occasion for women, and five or more for men). In addition, there is no known safe amount of alcohol use or safe time to drink during pregnancy. There is also no safe type of alcohol to drink while pregnant, since all types of alcohol can be harmful, including wine, beer, and liquor.

Prenatal alcohol exposure has been linked to increased risk of miscarriage, stillbirth, premature birth, and sudden infant death syndrome (SIDS). Alcohol-exposed pregnancies may also lead to fetal alcohol spectrum disorders (FASDs), a range of lifelong behavioral, intellectual, and physical disabilities that affects an estimated 2-5% of schoolchildren in the U.S.

Screening, Brief Intervention, and Referral to Treatment (SBIRT)

April is Alcohol Awareness Month—a call for social workers to learn about risky drinking, including any alcohol use during pregnancy. Social workers are uniquely positioned to discuss alcohol use with all clients and incorporate alcohol screening, brief intervention, and referral to treatment (SBIRT) into routine care. Alcohol screening and brief intervention is an evidence-based practice that is recommended by the U.S. Preventive Services Task Force and endorsed by major medical professional organizations, as well as the Centers for Disease Control and Prevention (CDC).

Using a validated screening instrument takes just a few minutes, followed by a brief conversation with those who are drinking too much, and referral to treatment when appropriate. Simply raising the topic and asking clients about their alcohol use can have a significant impact, and research has found that 83% of healthcare professionals who routinely conduct screening and brief intervention (SBI) have seen positive behavior change in their patients.

Since 2014, NASW and the NASW Foundation have partnered with the Health Behavior Research and Training Institute at The University of Texas at Austin Steve Hicks School of Social Work and the Collaborative for Alcohol-Free Pregnancy. This CDC initiative encourages health professionals across disciplines to conduct alcohol screening for all adults, including those who may be pregnant.

Resources

To learn more, visit NASW’s Behavioral Health page.

Winter Practice Perspectives (2020): Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT): Best Practices for the Prevention and Treatment of Risky Drinking in Girls/Women of Childbearing Age

American Academy of Social Work & Social Welfare: Reducing and Preventing Alcohol Misuse and Its Consequences: A Grand Challenge for Social Work (November 2015)

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By Diana Ling, MA, Program Manager; and Anna Mangum, MSW, MPH, Senior Health Strategist; Health Behavior Research and Training Institute, Steve Hicks School of Social Work, The University of Texas at Austin.

Binge drinking and heavy alcohol use during pregnancy have increased over the past decade, according to a new study in JAMA Network Open. In fact, from 2011 to 2020, binge drinking among pregnant women increased nearly 9 percent a year, while heavy drinking increased by more than 11 percent a year, study authors found. For women, binge drinking means four or more drinks on one occasion; heavy alcohol use is defined as eight or more drinks a week.

Any alcohol use during pregnancy can cause a range of physical, behavioral, and learning problems in the baby known as fetal alcohol spectrum disorders (FASDs). These issues can include speech and language delays, hyperactivity, and vision problems. FASDs may affect up to 1 in 20 schoolchildren in the U.S. and are the leading preventable cause of developmental disabilities.

September is Fetal Alcohol Spectrum Disorders Awareness Month—a reminder that there is no known safe amount, no safe time, and no safe type of alcohol to drink while pregnant or trying to get pregnant. Social workers can make a difference by sharing this key message with clients—and by screening all adults for risky alcohol use. Alcohol screening and brief intervention (SBI) is supported by more than 30 years of research showing its effectiveness in reducing prenatal alcohol use and FASDs. Based on this evidence, the U.S. Preventive Services Task Force recommends the use of alcohol SBI for all adults in primary healthcare settings.

The National Association of Social Workers (NASW), the NASW Foundation and the Health Behavior Research and Training Institute at The University of Texas at Austin Steve Hicks School of Social Work are partners in the Collaborative for Alcohol-Free Pregnancy, a Centers for Disease Control and Prevention initiative to encourage primary health professionals, including social workers, to use proven practice in routine care.

To learn more, visit NASW’s page on Behavioral Health. Additional clinical resources from Collaborative members are also available:

• Centers for Disease Control and Prevention, Fetal Alcohol Spectrum Disorders Training and Resources
• American College of Obstetricians and Gynecologists, Fetal Alcohol Spectrum Disorders Prevention Program
• Velasquez, M. M., Ingersoll, K., Sobell, M., & Sobell, L.C. (2015), Women and Drinking:  Preventing Alcohol-Exposed Pregnancies

By Diana Ling, MA, Program Manager; and Leslie Sirrianni, LCSW, Senior Research Project and Training Coordinator; Health Behavior Research and Training Institute, Steve Hicks School of Social Work, The University of Texas at Austin

When students leave the halls of academia and decide to venture on their first social work job, there is trepidation. Will I be able to cut it? Do my skills align with the amount of knowledge I gained in school?

Students must decide what type of social worker they want to become, and where they would like to work. There are clinical, military, hospital, school social work, and other options.

Addiction is one route that a social worker can pursue, and it typically requires a Licensed Master Social Work (LMSW) certification. This simply means that an individual can marry various systems, schools of thoughts, and theories, and apply them to real-life scenarios. It also is a great selling point for large institutions that have prestigious names to carry. Large hospital systems typically employ LMSW social workers because they have demonstrated clinical acumen and the ability to navigate practice scenarios.

So why should  students enter the realm of clinical social work in addiction? Well, for one, addiction is serious societal issue. There are two main  types of addiction – behavioral and chemical. Common behavioral addictions include food addiction, gambling addiction, gaming addiction, and hoarding. Chemical addiction involves substances, most notably alcohol, opioids, cannabis, nicotine, amphetamines, cocaine, and methamphetamines.

One can be diagnosed with a substance use disorder if he or she meets a certain criterion determined by the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Here are some sobering statistics: In 2022 in New York (including New York City), 1,131,000 adults and 52,000 young people were diagnosed with a substance use disorder.

What are Opiates?

One form of substance is opiates. Opiates are a type of drug used to treat pain, but oftentimes these drugs are abused because of their addictive qualities.

There are natural opiates, like codeine, morphine, and heroin (heroin is made from morphine). These drugs are used after surgeries and used on an as-needed basis. There are also semi-synthetic opiates, which are part naturally producing and part manufactured drugs. One of the biggest and well-known semi-synthetic opiates is OxyContin.

A drug prescribed for serious pain in the 1990s, oxycontin is highly addictive, and has come under major media scrutiny due to its makers’ (Sackler family and Purdue Pharma) unsavory marketing strategies as ‘non-addictive’ opioids. This could not be farther from the truth, and most patients seeking help from drug use start their stories with “I got into an accident in high school and was prescribed oxycontin.” It is downhill from there.

There are also synthetic opiates, a dangerous, man-made class of drugs manufactured in laboratories. These drugs include Demerol, methadone, and fentanyl, and represent lethal classes of drugs due to their potency. According to the National Institute of Drug Abuse (NIDA), because of fentanyl’s extremely high potency (it is 50 to 100 times more potent than morphine) and its ability to readily enter brain tissue, it can be lethal to breathe air with atomized fentanyl in it or touch a contaminated surface.

In other words, if someone ingests fentanyl or uses heroin, cocaine, or cannabinoid laced with fentanyl, he or she can die. Right on the spot. The Covid-19 pandemic exacerbated the fentanyl crisis: in 2020, there was an estimated 30 percent increase of overdose deaths related to opiate use, with a growing amount due to the drug fentanyl. The number is higher today, as the pandemic has lasted two plus years and is still part of the fabric of our lives.

Those entering addiction field must ask themselves, “Am I ready to see a client overdose or even die?”

Why would a social work student decide to enter this field?  It could be because they have a passion for social justice and a commitment to ending pain and suffering.

Those contemplating working in this field should also ask themselves, “Is this a field that I can realistically go into, knowing that my patients might overdose, or worse, die?” It is not an unfair question. Social workers in schools,  nonprofit organizations, research, and mental health settings are likely to see their clients or patients the following day. The same cannot be said of working in a methadone clinic. Patients seeking help for opioid addiction go through phases of change, one of them being relapse. A relapse episode is the most dangerous as a patient might overdose and not be able to call 911 in time.

Methadone  is a treatment for opiate use disorder and has been around since the 1950s. It reduces withdrawal symptoms and cravings for opioids. Not all medical professionals embrace this model. Abstinence models would argue that it is better to curtail drug use through complete renunciation of drug use, rather than substitute one opioid (methadone) for another (heroin, fentanyl, oxycodone, morphine, codeine). Abstinence only models frown upon the use of methadone because it does not address psychosocial factors that contribute to drug use. However, a body of research indicates that methadone is an effective model to treat opiate use and opiate dependency.

The transition from study of addiction and knowledge of opiates is not seamless. Students are taught that addiction is a chronic but treatable disease rather than a moral failing. However, in practice, patients often feel stigmatized and ashamed of their drug use. In methadone clinics, patients walk around listlessly, bang on doors to be seen, and fidget in their seats trying to get rid of the goosebumps ravaging their systems. Clinical social workers in this setting must recognize the reality of such pain and manage the needs of every staff member – not an easy task.

How addiction social workers work with nurses, doctors and psychiatrists

Clinical social workers may feel the pressure to be overly sensitive to their patients’ behavior and to help nurses and doctors. Nurses monitor diversion (are clients selling methadone instead of taking it, returning a full bottle, or forgetting to return an empty bottle). Nurses can lose their licenses if patients mismanage their medication, and social workers must help nurses, especially when they have added information that can help explain unexpected drug use or relapse.

Clinical social workers help nurses by increasing patient schedules (from once a week to three times a week, for instance), providing more intensive counseling as per nursing recommendation and exploring higher levels of care like detox programs or inpatient care if a client  is struggling. There can be no egos in a methadone clinic. Everyone must work together, and there is no right way to treatment. Treatment is a collaborative effort. New clinical social workers must adapt and focus on the patient, nursing concerns, and other ad-hoc requests.

Clinical social workers also collaborate with doctors and psychiatrists who assess a patient’s overall function through dose evaluations. While a doctor’s scope is limited to chemical issues stemming from drug use, oftentimes doctors will speak with clinical social workers about changes in their patients’ lives. Did something happen at home? Did a patient lose employment and therefore resort to drug use? Is someone being abused? Social workers must be attuned to the nuances and changes in their patients’ lives to provide accurate and helpful insight into behavior changes.

A clinical social worker in addiction treatment setting is a professional juggler

This information alone is enough to make ones’ head spin. And a clinical social worker may still wonder, ‘What does it really feel like to work in such an intense environment?’ ‘Is it really for me?” Well, for one, a methadone clinic is incredibly fast paced. Everything happens in a heartbeat, and sometimes there is no downtime. Everything can feel like an emergency. It may not be possible to provide 45-minute counseling sessions to six patients in one day.

More likely a clinical social worker will see 12 to 15  patients, avert a crisis, and scramble to write up notes by end of day. The name of the game is learning the complex needs of the clinic while also considering a patient’s needs in a loving, present way. Psychodynamic therapy or looking at past traumas or family dynamics is helpful when patients are stable and can explore their urges, cravings, and needs from a more detached lens. The heart and soul of a methadone clinic is crisis management – and this can come as a shock to a bright-eyed social worker looking to be a therapist.

A clinical social worker is a professional juggler. An essential job function is to hold space for patients in crisis, to complete daily, weekly, and monthly deliverables, and to help nurses, doctors, and other key staff members stay on the same page.

This is a challenging proposition, not because clinical social work is hard, but because patients with opiate use disorder oftentimes present with other mental health issues that make treatment harder to quantify. Anxiety, depression, trauma, and personality disorders are oftentimes linked to addiction.

This level of patient complexity requires a dexterous mind. Clinical social workers are hugely integral members in the puzzle that is addiction. And stepping away is okay, too: this elevated risk, high reward environment isn’t for everyone. Practicing commitment to social justice comes in all forms. The best approach when thinking about addiction and a methadone clinic is to research, investigate, and determine a goodness of fit. If the answer is yes, working in a methadone clinic can be highly rewarding. Addiction social work is in the business of saving lives. What could be a more noble pursuit than that?

Marisa Markowitz, LMSW, CASAC-T, is a Clinical Social Worker at New York Presbyterian Hospital’s Vincent P. Dole Treatment and Research Institute for Opiate Dependency. Marisa studies the relationship between technology and its adverse effects on mental health, particularly for vulnerable populations.

Disclaimer: The National Association of Social Workers invites members to share their expertise and experiences through Member Voices. This blog was prepared by Marisa Markowitz in her personal capacity and does not necessarily reflect the view of the National Association of Social Workers.

Four in five adults who reported being asked about their alcohol use at a checkup in the past two years and reported current binge drinking were not counseled to reduce their drinking, according to a recent Centers for Disease Control and Prevention (CDC) report. Looking closer at the data, just 14 percent of women who binge drink said they received advice to reduce drinking, compared to 25 percent of men.

Why aren’t these much-needed conversations happening? Some healthcare providers say they feel uncomfortable talking about alcohol use with patients. Other factors include time constraints, as well as concerns about privacy and confidentiality.

The consequences of these gaps in patient care are serious – especially for women. Studies show women are more likely to experience problems such as alcohol use disorder, liver damage and certain cancers sooner and at lower levels of drinking than men do. And alcohol-exposed pregnancies can lead to a range of lifelong physical, behavioral, and learning problems, known as fetal alcohol spectrum disorders (FASDs). There is no known safe amount, no safe time, and no safe type of alcohol use during pregnancy.

April is Alcohol Awareness Month, an opportunity for social workers to make alcohol screening and brief intervention (SBI) part of routine care. If you’re not sure how to begin, consider screening all adult patients – including those who are pregnant – as the U.S. Preventive Services Task Force recommends. Using a validated screening instrument takes just a few minutes – and should be followed by a brief conversation with those who are drinking at risky levels, and referral to treatment when applicable.

NASW and the NASW Foundation are partners with the Health Behavior Research and Training Institute at The University of Texas at Austin Steve Hicks School of Social Work in the Collaborative for Alcohol-Free Pregnancy. This CDC initiative enlists leading medical organizations in a cross-discipline effort to encourage health professionals to use proven prevention practice in routine patient care.

Visit NASW’s Behavioral Health webpage for professional development resources. Additional clinical resources are available through our Collaborative partners:

• Centers for Disease Control and Prevention, Alcohol Screening and Brief Intervention Efforts
• American College of Obstetricians and Gynecologists, Fetal Alcohol Spectrum Disorders Prevention Program

  Diana Ling, MA is Program Manager; and Leslie Sirrianni, LCSW is Senior Research Project and Training Coordinator; Health Behavior Research and Training Institute, Steve Hicks School of Social Work, The University of Texas at Austin.

Just  days after the Marijuana Opportunity Reinvestment and Expungement Act of 2021(MORE Act) was reintroduced in the U.S. House of Representatives Amazon, the nation’s second largest private employer, announced it will  no longer test most of its 1.3 million employees for marijuana. At the same time, Amazon publicly stated its support for the MORE Act. 

The company’s  decision is monumental.  It is a huge step toward eliminating one of the last vestiges of the drug war ― which was responsible for has robbing many Americans of their livelihoods. It seems clear Amazon recognized there was never empirical evidence that drug testing for marijuana had any relationship with an individual’s ability to perform his job. Unfortunately, this incredibly invasive practice has removed millions of people who use marijuana from the nation’s workforce.

There is hope this drug policy change will be the catalyst to a much larger industry-wide correction of a bad policy — ending drug testing for all drugs. Such a move will ensure a more just and equitable future for millions of people, especially Black, Brown, and Indigenous communities who have been disproportionately impacted by these employment requirements.

It is important that other large corporations follow Amazon’s lead by ending this counterproductive practice once and for all. It is equally important that the business community urges the House to swiftly pass the MORE Act― absent of a harmful provision that was added to exclude federal workers of drug testing protections. Once passed by the House, we ask the business community to join with the Marijuana Justice Coalition― of which the National Association of Social Workers is a member ― and press for Senate passage of the bill.

Kudos to Amazon for taking steps to end the injustices that drug war era policies have visited upon Black and Brown people. The time has come for national multi-sector support for eliminating drug testing and for decriminalizing marijuana.