"Among the synthesized articles, the five most frequently cited characteristics and components of a PHA were the following (also see Table 6 for illustrative quotes):

  • "A PHA includes regulation (n=70). Some articles simply mentioned that a PHA involves regulating psychoactive substances, while others gave specific examples; the most commonly cited types of regulation were price controls (n=36), limits on availability (n=33), and advertising restrictions (n=29).
  • "A PHA includes substance use disorder treatment (n=63). Most articles mentioned that treatment generally is a part of PHAs, but others specified certain types, e.g. medication-assisted or psychosocial treatment.
  • "A PHA includes education (n=58). This category consists of interventions intended to communicate information to the public, for example through media campaigns, public service announcements, or school-based education. Most often the desired content of this education was not discussed, but 21 articles stated that PHAs involve targeting social norms around substance use and promoting “healthy behaviours.”
  • "Prevention efforts are part of a PHA (n=55). Prevention is a broad category.5 Most articles mentioned only broad types of prevention (e.g. primary or secondary) that they envision as part of a PHA, but a few also offered examples, e.g. early detection of substance use disorders as a form of secondary prevention.
  • "A PHA is distinct from a criminal justice approach (n=54). Here, articles presented PHAs as a contrast or alternative to drug policies that are centred around criminalization and incarceration."

Crépault JF, Russell C, Watson TM, Strike C, Bonato S, Rehm J. What is a public health approach to substance use? A qualitative systematic review and thematic synthesis. Int J Drug Policy. 2023;112:103958. doi:10.1016/j.drugpo.2023.103958