The term “substance abuse” is defined as conditions associated with the consumption of mind- and behavior-altering substances that have negative behavioral and health outcomes. Because of social attitudes as well as political and legal response to the use of alcohol and drugs, it is a complex public issue. Not only does it have considerable health implications, but it has far-ranging effects of the U.S. criminal justice system. Society cannot agree whether it is a disease or a matter of personal choice. All can agree, though, that it takes a toll on Americans who abuse, their families and the health care system. About 22 million Americans struggle with a drug or alcohol problem. Nearly all of them, approximately 95 percent, are unaware of their problem. Of those who acknowledge the problem, 273,000 have made at least one unsuccessful effort to obtain treatment. Those who study it say that the low rate of recovery means that prevention is essential to curbing substance abuse.
Drug and alcohol abuse has a profound effect on families and communities. These effects are cumulative, significantly contributing to social, physical, mental and public health problems. These problems include domestic violence, child abuse, teen pregnancy, HIV/AIDS, other sexually transmitted diseases, vehicle accidents, physical violence, crime, suicide and murder.
There is a difference between substance abuse and addiction. Addiction is a dependence on the substance which happens after repeated substance abuse. Addiction is a strong desire to take the drug, despite its consequences. An addict will have difficulties controlling use, and will make the substance the number one priority over family, friends, work or other obligations. Sometimes addicts will have an increased tolerance to the substance and will go through withdrawal if it is taken away.
Maraijuana is the most common illegal drug used in the U.S., with more 15 million users in the last month. In 2008, marijuana was used by more than 75 percent of people who used street drugs. Most pot is smoked by adolescents and young adults. Marijuana use among teens had declined over the last five years, but now is on the rise. Almost 12 percent of 8th graders smoked pot in the last year. About 27 percent of 10th graders used pot in the last year and nearly a third of all high school seniors. Pot is thought to be a contributing factor in more than 374,000 emergency room visits in the U.S. People who smoke pot before age 17 have elevated rates of drug use and problems later in life. Nine percent of pot smokers will become addicted.
Alcohol although a legal substance, costs the U.S. the most in terms of related health problems. The effects of alcoholism are widespread. They range from fetal alcohol syndrome, a birth defect caused by mothers drinking, to terminal liver disease. Domestic violence is often fueled by alcohol, and drunk driving still takes a toll on U.S. highways. Fortunately, drinking statistics are down with young teens, which researchers hope will lower statistics for alcoholism in the future.
Methamphetamine use has been on the rise in the U.S. over the last decade but is now dropping in use among teens. Cheaper than cocaine, meth affects users as a stimulant. Highly addictive and potentially deadly, meth causes a wide variety of issues, including dental problems, hallucinations and violence. Long-term users have trouble thinking and can have psychiatric disorders. Meth users are more likely to participate in risky behavior, like using dirty needles or having unprotected sex, which means they can be exposed to HIV.
Club drugs, which include GHB, Rohypnol and ketamine, have declined in use in recent years. However ecstasy use is on the rise with teens in 8th through 10th grade. Ecstasy is hard on the body, especially the circulatory system, and can be lethal.
Cocaine, which made headlines 30 years ago when a crack epidemic hit the U.S., is down in use among adolescents. One study found that cocaine and amphetamine use in high school seniors dropped from four percent to three percent in recent years.
LSD, heroin, steroids, cigarettes, smokeless tobacco, cocaine, inhalants and opiates are other illicit drugs that are in use. Like most drugs, their popularity grows and then decreases with each generation. For example, heroin addiction rose in the 1990s and then decreased in the 2000s.
One area that needs to be addressed is the abuse of prescription medication. Adolescent abuse of prescription drugs continued to increase over the past five years. A recent survey found high rates of recreational use of the prescription pain relievers Vicodin and OxyContin. Researchers believe a couple of factors have led to the increase in prescription drug abuse. One is that teens believe they are safer than street drugs. The second is the easy availability of prescription drugs. Teens can get the drugs from doctors, the internet and even their parents’ medicine cabinet.
War has increased drug abuse among members of the military. Operations in the Middle East create stress and anxiety on military personnel and their families. This can lead to family problems, mental health issues, and even suicide. Some military personnel resort to drugs. One study found that over 7 percent of veterans, or 1.8 million people, suffer from substance abuse.
Policy makers and researchers have struggled to determine the best ways to decrease substance abuse. However, research advancements have led to the development of proven strategies to effectively address this issue. Better brain-imaging technologies and the development of medications that help in treatment have gradually shifted the research community’s perspective on substance abuse. Researchers now understand that it is a disorder that begins in adolescence and, for some, will develop into a chronic disease that will require lifelong monitoring and care. Researchers have improved evaluation methods when they study community-level prevention. Now they understand the environmental and social factors that contribute to the kids using and abusing alcohol and illicit drugs. This knowledge has led to a better understanding of how to implement proven prevention techniques in specific social and cultural settings. A stronger emphasis on studying drug and alcohol treatment is also helping people recover from addiction.
The Substance Abuse and Data Archive has links to studies and information on an array of substance abuse issues:
The National Institutes of Health features information on many aspects of substance abuse:
The World Health Organization has information on substance abuse worldwide:
The Substance Abuse and Mental Health Services Association provides a map of treatment facilities:
Information from the National Institutes of Health on drug abuse:
Department of Health and Human Services goals to prevent substance abuse: