Skip to main content

Shifts at The Helm: gratitude, re-commitment to our work, and a call for addictions disparities research

In 2011, Addiction Science & Clinical Practice (ASCP) Editor-in-Chief Jeffrey Samet (with the late Editor Emeritus Richard Saitz) took the reins of our journal from the National Institute on Drug Abuse to usher it into a new era as an open-access forum for clinically relevant research and perspectives that contribute to improving the quality of care (prevention and treatment) for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviors across a spectrum of settings. Now, as we begin our 11th year, we can look back at our accomplishments over the last decade: we have published 766 articles (44% from outside the US, 26% from Europe); produced 5 thematic series, 1 special issue, and 10 supplements; and forged lasting partnerships with the International Network on Brief Interventions for Alcohol and Drugs (INEBRIA) and the Addictions Health Services Research (AHSR) Conference. ASCP has been cited 7277 times with a yearly average 12% increase that jumped to 28% in the last year. Notably in 2020, we received a first-time Journal Impact Factor of 3.088, 7th of 20 addiction journals (it has since climbed to 3.544 in 2021). We are proud of these accomplishments and grateful to our team of outstanding associate editors, our editorial board and managing editor, our contributors, and all of you who contribute your time to review articles for us.

The work of our ASCP community has never been more relevant. Though addiction is a consistent and ubiquitous threat to public health across cultures and societies globally, roughly over the same period as our journal was gaining momentum, substance use reached an all-time high. The US opioid overdose crisis hit peak levels of deaths and increasingly became characterized by polysubstance use with particularly large increases in methamphetamine use among people who use opioids [1]. Overdose deaths from cocaine and methamphetamine increased 3- and 13-fold, respectively [2, 3]. Unhealthy alcohol use increased substantially, particularly in women; alcohol-related deaths doubled between 1999 and 2017 and served as a major contributor to the decline in overall US life expectancy observed between 2015 and 2017 [4]. Though tobacco use has declined overall worldwide, use has increased among men; 45% of adults in South East Asia use tobacco [5], and vaping among youth increased ~ 75% between 2017 and 2018 with greater increases expected annually [6]. Finally, both medical and recreational cannabis use have become increasingly legal and accessible, creating a need for studies about its epidemiology and treatment, particularly its longitudinal health impacts [7]. This time was also marked by new funding mechanisms and multiple innovative and rigorous efforts to implement evidence-based care for substance use in medical settings [8,9,10,11] and innovative clinical trials [12,13,14] the results of which have informed clinical guidelines [15] and ongoing conversations about best practices [16,17,18]. Despite these innovations, the majority of persons with unhealthy substance use, substance use disorders, and/or other addictive disorders do not receive evidence-based care [19, 20].

Likely stemming from structural fundamental causes, adverse social and health consequences from substance use and barriers to care disproportionately impact Black, Indigenous, and other Persons of Color (BIPOC); persons with minoritized sexual and gender identities; persons living with HIV and Hepatitis-C; and other groups with lived experiences that increase risk for lower access to resources [21,22,23,24,25]. Syndemic public health crises—structural racism and the novel Coronavirus (COVID-19)—have together and exacerbated and highlighted the needed work toward treating and preventing substance use disorders. Structural racism, or historically-rooted and culturally reinforced discrimination through mutually reinforcing systems (e.g., in housing, education, employment, credit, income, and criminal justice), shapes access to resources and has specifically fundamentally shaped responses to substance use. This is particularly true in the US, where structural racism has influenced addictions stigma and treatment through differential enforcement of substance use policy (disproportionate arrest, incarceration, and mandatory substance use treatment of BIPOC folks for drug-related charges), greater stigma and criminalization of substance use when it occurs in non-White communities, and racially-patterned substance regulation and discrimination [26]. The introduction of the COVID-19 pandemic has generated a “perfect storm” with regard to substance use—both consequences and its treatment, particularly for BIPOC and individuals from other marginalized groups. Existing research on COVID-19 suggests that living in the context of a global pandemic with related healthcare and social restrictions has been associated with increased use and severity of substances [27], increased overdose deaths [28, 29], and less access to syringe service programs and other community treatment resources that serve large populations of those most affected by structural racism and its sequelae [30]. Tangential but related to addictions, COVID-19 has also contributed to peak levels of comorbid mental health disorders [31], disproportionately killed BIPOC populations, and compounded pre-existing health disparities along racial lines related to systematic societal disadvantage [32]. Changes to the healthcare system resulting from the pandemic (including those focused specifically on addictions health services, such as federal relaxation of buprenorphine induction standards) hold potential to permanently and dramatically reshape US addiction healthcare. The consequences of such policy changes are unknown—they could ameliorate or exacerbate existing health and healthcare disparities in addictions [33, 34].

In short, our addiction field is ripe for new and innovative studies focused on understanding disparities and their structural origins; development of new and innovative clinical practices to address old and emerging challenges in addictions treatment; and rigorous evaluations of policies ushered in as a result of the global pandemic that has disproportionately influenced vulnerable and historically stigmatized populations.

ASCP is excited to usher in this new era of high-quality addictions disparities research. To help steward that work, we are delighted to introduce our new co-Editor-in-Chief, Emily Williams, PhD, MPH. Dr. Williams is a mixed-methods implementation scientist and disparities researcher whose portfolio focuses on increasing access to evidence-based treatment and prevention for unhealthy alcohol and opioid use in medical and community-settings. She is a professor at the University of Washington School of Public Health within the Department of Health Services and has been serving as an Associate Editor of ASCP since Drs. Samet and Saitz assumed editorial control of the journal in 2011. Defining, understanding, and addressing disparities in addictions outcomes and treatments is a substantial focus of her work.

To promote rigorous addiction health services disparities work that focuses on structural racism, white supremacy, and stigma as fundamental causes of inequalities in substance use and its treatment [35, 36], we are strongly encouraging new submissions of manuscripts reporting clinically-relevant epidemiologic, intervention, and evaluation research that focuses on the broader social forces that shape disparities in the treatment or prevention of substance use disorders. We aim to increase our publication of research focused on structures (e.g., racism or gender discrimination) instead of minoritized identities or individual characteristics (e.g., race or gender) [36] and research that draws on sound theory (e.g., Critical Race Theory [37] and the Public Health Critical Race Praxis [38, 39]) and recommended equity approaches to knowledge production (e.g., community-based participatory research) [40]. Though ASCP’s decisions to publish manuscripts are solely based on research and not the researchers, we strongly support diversification of the field of addictions researchers and encourage submissions from diverse investigators in and out of the US [41].

We are excited to move this work forward together, and to be recommitting to providing a top-notch forum for clinically relevant research and perspectives that contribute to improving both the quality and equity of addictions care.


  1. Cicero TJ, Ellis MS, Kasper ZA. Polysubstance use: a broader understanding of substance use during the opioid crisis. Am J Public Health. 2020;110(2):244–50.

    Article  Google Scholar 

  2. Hedegaard HSM, Garnett MF. Increase in drug overdose deaths involving cocaine: United States, 2009–2018, NCHS Data Brief: No. 384. 2020. Accessed 9 Dec 2020.

  3. Das LT, Kutscher E. Stimulant use disorders in the United States—is another epidemic on the horizon? JAMA Health Forum. 2020;1(12):e201486–e201486.

    Article  Google Scholar 

  4. White AM, Castle IP, Hingson RW, Powell PA. Using death certificates to explore changes in alcohol related mortality in the United States, 1999 to 2017. Alcohol Clin Exp Res. 2020;44(1):178–87.

    Article  Google Scholar 

  5. World Health Organization. WHO Report on the global tobacco epidemic, 2019. 2019. Accessed 30 March 2020.

  6. U.S. Food and Drug Administration. 2018 NYTS Data: a startling rise in Youth E-cigarette use. 2020. Accessed 29 March 2021.

  7. National Academies of Science Evidence and Medicine. The health effects of cannabis and cannabinoids: the current state of the evidence and recommendations for research. 2017.

  8. Agency for Healthcare Research and Quality. Topic: substance abuse. Accessed 16 April 2021.

  9. Bobb JF, Lee AK, Lapham GT, et al. Evaluation of a pilot implementation to integrate alcohol-related care within primary care. Int J Environ Res Public Health. 2017;14(9):1030.

    Article  Google Scholar 

  10. Korthuis PT, McCarty D, Weimer M, et al. Primary care-based models for the treatment of opioid use disorder: a scoping review. Ann Intern Med. 2017;166(4):268–78.

    Article  Google Scholar 

  11. Chang ET, Oberman RS, Cohen AN, et al. Increasing access to medications for opioid use disorder and complementary and integrative health services in primary care. J Gen Intern Med. 2020;35(Suppl 3):918–26.

    Article  Google Scholar 

  12. Saitz R, Palfai TP, Cheng DM, et al. Screening and brief intervention for drug use in primary care: the ASPIRE randomized clinical trial. JAMA. 2014;312(5):502–13.

    Article  Google Scholar 

  13. O’Connor EA, Perdue LA, Senger CA, et al. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: updated evidence report and systematic review for the US preventive services task force. JAMA. 2018;320(18):1910–28.

    Article  Google Scholar 

  14. Roy-Byrne P, Bumgardner K, Krupski A, et al. Brief intervention for problem drug use in safety-net primary care settings: a randomized clinical trial. JAMA. 2014;312(5):492–501.

    Article  Google Scholar 

  15. Curry SJ, Krist AH, Owens DK, et al. Screening and behavioral counseling interventions to reduce unhealthy alcohol use in adolescents and adults: US preventive services task force recommendation statement. JAMA. 2018;320(18):1899–909.

    Article  Google Scholar 

  16. Krist AH, Davidson KW, Mangione CM, et al. Screening for unhealthy drug use: US preventive services task force recommendation statement. JAMA. 2020;323(22):2301–9.

    Article  Google Scholar 

  17. Saitz R. Screening for unhealthy drug use: neither an unreasonable idea nor an evidence-based practice. JAMA. 2020;323(22):2263–5.

    Article  Google Scholar 

  18. Bradley KA, Lapham GT, Lee AK. Screening for drug use in primary care: practical implications of the new USPSTF recommendation. JAMA Intern Med. 2020;180(8):1050–1.

    Article  Google Scholar 

  19. Connery HS, McHugh RK, Reilly M, Shin S, Greenfield SF. Substance use disorders in global mental health delivery: epidemiology, treatment gap, and implementation of evidence-based treatments. Harv Rev Psychiatry. 2020;28(5):316–27.

    Article  Google Scholar 

  20. Park-Lee E, Lipari RN, Hedden SL, Kroutil LA, Porter JD. Receipt of services for substance use and mental health issues among adults: results from the 2016 National Survey on Drug Use and Health. CBHSQ Data Review. 2017. Accessed 30 Jan 2022

  21. Jordan A, Mathis ML, Isom J. Achieving mental health equity: addictions. Psychiatr Clin North Am. 2020;43(3):487–500.

    Article  Google Scholar 

  22. Keyes KM, Liu XC, Cerda M. The role of race/ethnicity in alcohol-attributable injury in the United States. Epidemiol Rev. 2012;34(1):89–102.

    Article  Google Scholar 

  23. James K, Jordan A. The Opioid crisis in black communities. J Law Med Ethics. 2018;46(2):404–21.

    Article  Google Scholar 

  24. Priester MA, Browne T, Iachini A, Clone S, DeHart D, Seay KD. Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: an integrative literature review. J Subst Abuse Treat. 2016;61:47–59.

    Article  Google Scholar 

  25. Hagle HN, Martin M, Winograd R, et al. Dismantling racism against black, indigenous, and people of color across the substance use continuum: a position statement of the association for multidisciplinary education and research in substance use and addiction. Subst Abus. 2021;42(1):5–12.

    Article  Google Scholar 

  26. Kuehn BM. Accelerated overdose deaths linked with COVID-19. JAMA. 2021;325(6):523.

    PubMed  Google Scholar 

  27. Czeisler M, Lane RI, Wiley JF, Czeisler CA, Howard ME, Rajaratnam SMW. Follow-up survey of US adult reports of mental health, substance use, and suicidal ideation during the COVID-19 pandemic, September 2020. JAMA Netw Open. 2021;4(2):e2037665.

    Article  Google Scholar 

  28. Holland KM, Jones C, Vivolo-Kantor AM, et al. Trends in US emergency department visits for mental health, overdose, and violence outcomes before and during the COVID-19 pandemic. JAMA Psychiat. 2021;78(4):372.

    Article  Google Scholar 

  29. Jordan A, Allsop AS, Collins PY. Decriminalising being black with mental illness. Lancet Psychiatry. 2021;8(1):8–9.

    Article  Google Scholar 

  30. Glick SN, Prohaska SM, LaKosky PA, Juarez AM, Corcorran MA, Des Jarlais DC. The Impact of COVID-19 on syringe services programs in the United States. AIDS Behav. 2020;24(9):2466–8.

    Article  Google Scholar 

  31. Czeisler M, Lane RI, Petrosky E, et al. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic—United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(32):1049–57.

    Article  CAS  Google Scholar 

  32. Lopez L 3rd, Hart LH 3rd, Katz MH. Racial and ethnic health disparities related to COVID-19. JAMA. 2021;325(8):719–20.

    Article  CAS  Google Scholar 

  33. Glass JE, Williams EC. The future of research on alcohol health disparities: a health services research perspective. J Stud Alcohol Drugs. 2018;79(2):322–4.

    Article  Google Scholar 

  34. Frohlich KL, Potvin L. Transcending the known in public health practice: the inequality paradox: the population approach and vulnerable populations. Am J Public Health. 2008;98(2):216–21.

    Article  Google Scholar 

  35. Phelan JC, Link BG, Tehranifar P. Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. J Health Soc Behav. 2010;51(Supp1):S28-40.

    Article  Google Scholar 

  36. Hardeman RR, Karbeah J. Examining racism in health services research: a disciplinary self-critique. Health Serv Res. 2020;55(Suppl 2):777–80.

    Article  Google Scholar 

  37. Crenshaw KW, Gotanda N, Peller G, Thomas K. Critical race theory: the key writings that formed the movement. New York: The New Press; 1995.

    Google Scholar 

  38. Ford CL, Airhihenbuwa CO. The public health critical race methodology: praxis for antiracism research. Soc Sci Med. 2010;71(8):1390–8.

    Article  Google Scholar 

  39. Ford CL, Airhihenbuwa CO. Critical race theory, race equity, and public health: toward antiracism praxis. Am J Public Health. 2010;100(Suppl 1):S30-35.

    Article  Google Scholar 

  40. Jordan A, Mathis M, Haeny A, Funaro M, Paltin D, Ransome Y. An evaluation of opioid use in black communities: a rapid review of the literature. Harv Rev Psychiatry. 2021;29(2):108–30.

    Article  Google Scholar 

  41. McFarling U. ‘Health equity tourists’: How white scholars are colonizing research on health disparities. STAT. 2021. Accessed 28 Sept 2021.

Download references

Author information

Authors and Affiliations



All authors read and approved the final manuscript.

Corresponding author

Correspondence to Emily C. Williams.

Ethics declarations

Competing interests

The author declares that he/she has no competing interests

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Williams, E.C., Samet, J.H. Shifts at The Helm: gratitude, re-commitment to our work, and a call for addictions disparities research. Addict Sci Clin Pract 17, 12 (2022).

Download citation

  • Published:

  • DOI: