Get the Facts on Substance Abuse
Introduction to Substance Abuse
Substance abuse is a major issues in the United States. According to the National Survey on Drug Use and Health, approximately 20.3 million people aged 12 or older had a substance use disorder (SUD) in 2018—with 14.8 million struggling with an alcohol use disorder (AUD) and 8.1 million dealing with an illicit drug use disorder (DUD).1
Substance misuse and SUDs greatly impact the nation economically, with a price tag of more than $400 billion each year in crime, health, and lost productivity.2 It’s not surprising that substance abuse comes with such a high price tag when you consider all the health, legal, criminal, and personal issues that often come in its wake.
Substance misuse costs individuals substantially, and it costs the nation as a whole.
In 2018, 1 in 5 people age 12 and older used an illicit drug in the past year—19.4% of the population.1 Although many states have legalized marijuana for both recreational and medical purposes, it remains illegal at the federal level, and marijuana is still the most frequently used illicit drug, with 43.5 million Americans identified as current users in 2018.1 As for alcohol, in 2018 there were 139.8 million current alcohol drinkers aged 12 and older—slightly more than 50%.1
Prescription Drug Abuse
While street drugs are known to be dangerous, such as heroin and crystal meth, prescription drugs are often viewed in a more favorable light, due to their status as being doctor prescribed. Though many believe these drugs are “safer” as a result, they can be as addictive as heroin.
Prescription drugs are often misused in the United States. in 2018, around 9.9 million people aged 12 or older abused those medicines at least once in the past year.3
Opioids—including morphine, OxyContin (oxycodone), and Vicodin (hydrocodone)—killed more than 47,000 Americans as a result of an overdose in 2017.4
Short- and Long-Term Effects
Drugs work by stimulating various parts of the human body, including certain areas of the brain. The many different types and classifications of drugs that produce a variety of short-term effects, but the most common ones may include increased heart rate, high blood pressure, dizziness, tremors, mood changes and paranoia. In high dosages, the risk for more dangerous effects increases, and the potential for heart attack, stroke, respiratory failure and coma increase.
In the long-term, substance abuse may lead to mental and physical effects that will require treatment to resolve. These effects may include paranoia, psychosis, immune deficiencies, and organ damage.
Tolerance, Dependence, and Addiction
While substance abuse comes with a great many side effects, ranging from mild physical side effects like nausea and dehydration to work-related consequences such as reduced productivity, some of the greater risks of substance use include tolerance, dependence, and addiction.
When a person continues to take a drug, they can reach a point where they no longer respond to the drug as they did previously, and so they need to increase the dosage of the drug to experience the same effect as they did before—this is known as "tolerance."5,6
When a person experiences withdrawal symptoms when they stop using a drug, this is identified as "dependence."5,7 Withdrawal symptoms can be mild or even life threatening.5,7 To avoid discomfort from withdrawal, users need to stop using the drug gradually. It is important to note that just because a person is dependent on a drug does not necessarily mean they are addicted.5 It is important to note that just because a person is dependent on a drug does not necessarily mean they are addicted.5
Even when the effects of drugs are damaging to a person’s health and harms their relationships with friends, family members and coworkers, the constant need for a substance may overcome any rational thinking.
Even when the effects of drugs are damaging to a person’s health and harms their relationships with friends, family members and coworkers, the constant need for a substance may overcome any rational thinking—this is known as "addiction."8 Addiction is a chronic disease identified by compulsive drug seeking despite harmful consequences.8,9
Per the National Institute of Drug Abuse, addiction is a persisting disease that requires ongoing management. Individuals are never “cured” of addictions; instead, they learn how to manage their disease so they can lead healthy, balanced lives.9
If the body receives a level of drugs that it cannot tolerate, this leads to an overdose. While some overdoses occur after continuous use, they can also happen after one single use of a drug.
Symptoms of a drug overdose may include:10,11
- Difficulty breathing.
- Nausea and vomiting.
- Unsteady gait.
- Violent or aggressive behavior.
If any of these signs are present, or if you believe a person might be having an overdose, seek life-saving medical attention immediately.
Getting Clean and Sober
The decision to seek out a clean and sober lifestyle is one of the most important steps in the recovery process. Since addiction is such a widespread condition, anyone seeking help will find numerous options for treatment.
These treatment options are designed to help people begin on their journey of sobriety, which can make the transition easier.
How an Intervention Works
Deciding to stop using drugs may be a difficult decision for a person to make. Even if drugs are causing a disruption in a person’s life, the compulsion to abuse substances habitually often overcomes any desire to quit. In some cases, the family and friends of an addict may consider holding an intervention.
The use of confrontational and forcible interventions, like what you see on TV, is not supported by any evidence as an effective strategy for making a lasting impact. There are, however, supportive interventional approaches that have been shown to be more effective in guiding a resistant loved one into acknowledging the validity and need of treatment. These approaches are typically done in concert with certified mental health professionals.12
Methods for Drug Withdrawal and Detoxing from Drugs
Before a drug user can begin a rehabilitation program, full withdrawal or detoxification may be necessary. During this process, the body adjusts to its drug-free state and rids itself of the remainder of the drug. Medically supervised withdrawal management programs may use controlled amounts of medication to help a person through this process.
Rehab Treatment Options
A doctor, addiction specialist, or counselor can help each individual find the right rehabilitation or treatment option. The setting is determined by individual needs, so some people may benefit from an inpatient rehab while others may thrive by using an outpatient program.
At the core, the goal is to help a former substance misuser assimilate into a drug-free life as easily as possible. There are various treatment therapies available to help patients, but some of the most commonly used treatment options for SUD include:
- Psychotherapy, which helps patients learn how to resist and redirect compulsions.
- Support groups
- Individual counseling
Patients recovering from opioid use or alcohol disorders may also benefit from medication-assisted treatment (MAT), a combined approach that utilizes medication in concert with counseling and behavioral therapies to treat addiction.13
Aftercare, Relapse Prevention, and Recovery Tools
One strategy for the prevention of relapse is structured cognitive-behavioral therapy (CBT). CBT has been shown in some studies to be an effective aspect in the treatment of SUDs.14 An approach to treatment, CBT focuses on awareness of your thoughts, actions, and the consequences of both. By learning about drug abuse prevention and how to avoid situations that may cause compulsions or cravings, a person has an opportunity to retain control and make the decision to not seek out or use drugs.
Utilizing support groups as aftercare options may also reduce the potential for relapse.15 Having support from nonprofessional, nonclinical participants may add in the patients finding additional motivation, support, and success in overcoming the SUDs.15 There are various support groups, 12-step programs, and therapies—both religiously based and alternative—that may provide support in the continued addressing of substance misuse.
The guidance of an experienced peer can be invaluably helpful to someone going through the initial steps of sobriety.
At times, a SUD can seem like a personal struggle that no one around you understands. For this reason, SUD support groups can help recovering patients find comfort in their peers. Depending on the person’s location, there may be a single support group for anyone recovering from an addiction, or there may be groups tailored to those recovering from a specific drug. In addition to providing support as a group, these organizations often pair up new members with existing members who have maintained sobriety for an extended amount of time. The guidance of an experienced peer can be invaluably helpful to someone going through the initial steps of sobriety.
Common Questions and Answers
While anyone who uses an addictive drug may be hooked with only a few uses, drug addictions signs generally involve continued use despite a decline in health or happiness.
Cannabis products, including marijuana and hash, are the most commonly abused drugs. Prescription drugs, cocaine and hallucinogens are also popular and addictive substances.
The answer to this is only a theory, but scientists theorize that addiction is both a genetic trait and a learned behavior. While a person’s genes may set him or her up for the potential for addiction, exposure to drugs may be the catalyst for exposing these addictive tendencies.
- Substance Abuse and Mental Health Services Administration. (2018). Key Substance Use and Mental Health Indicators in the United States: Results from the 2017 National Survey on Drug Use and Health.
- U.S. Department of Health and Human Services (HHS), Office of the Surgeon General. (2016). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health.
- National Institute on Drug Abuse. (2018). Misuse of Prescription Drugs: What is the scope of prescription drug misuse?
- National Institute on Drug Abuse. (2019). Opioid Overdose Crisis.
- National Institute on Drug Abuse for Teens. (2017). Tolerance, Dependence, Addiction: What’s the Difference?
- National Institute on Drug Abuse. (2007). The Neurobiology of Drug Addiction: 6: Definition of tolerance.
- National Institute on Drug Abuse. (2007). The Neurobiology of Drug Addiction: 8: Definition of dependence.
- National Institute on Drug Abuse. (2018). The Science of Drug Use and Addiction: The Basics.
- National Institute on Drug Abuse. (2018). DrugFacts: Understanding Drug Use and Addiction.
- U.S. National Library of Medicine. (2019). MedlinePlus: Drug Use First Aid.
- U.S. Drug Enforcement Administration. (n.d.). What Should You Do in an Overdose Situation?
- National Institute on Drug Abuse. (2016). What to Do If Your Adult Friend or Loved One Has a Problem with Drugs.
- Substance Abuse and Mental Health Services Administration. (2019). Medication and Counseling Treatment.
- Tracy, K., Wallace, S.P. (2016). Benefits of peer support groups in the treatment of addiction. Subst Abuse Rehabil, 7, 143-154.
- McHugh, R.K., Hearon, B.A., Otto, M.W. (2010). Cognitive-Behavioral Therapy for Substance Use Disorders. Psychiatr Clin North Am, 33(3), 511-525.