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Get the Facts on Substance Abuse

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Substance abuse is a major issue in the United States. According to the National Survey on Drug Use and Health, approximately 40.3 million people aged 12 or older had a substance use disorder (SUD) in 2020—with 28.3 million struggling with an alcohol use disorder (AUD) and 18.4 million dealing with an illicit drug use disorder (DUD).

Substance misuse and SUDs greatly impact the nation economically, with an estimated yearly price tag of $249 billion for alcohol misuse and $193 billion for illicit drug use.It’s not surprising that the economic effects of substance abuse are high when you consider the health, legal, criminal, and personal issues that often coincide.

In 2020, 59.3 million people aged 12 and older used an illicit drug in the past year—21.4% of the population.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 49.6 million Americans identified as current users in 2020.As for alcohol, in 2020 there were 138.5 million current alcohol drinkers aged 12 and older—50.0% of the population.1


Prescription Drug Abuse

rx bottles

While street drugs are known to be dangerous, such as heroin and crystal meth, prescription drugs are often viewed in a more favorable light, since they are prescribed by a physician. Though many believe these drugs are safer, they can be as addictive as heroin.

Prescription drugs are often misused in the United States. About 18 million people aged 12 or older abused these medications at least once in 2017.3

Opioids—including morphine, OxyContin (oxycodone), and Vicodin (hydrocodone)—killed almost 50,000 Americans as a result of an overdose in 2019.4


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 produce a variety of short-term effects, but the most common 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 addiction treatment to resolve. These effects may include paranoia, psychosis, immune deficiencies, and organ damage.


Tolerance, Dependence, and Addiction

While substance abuse comes with 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 an individual 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 sometimes 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.

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.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


What is a Drug or Alcohol Overdose?

If the body receives a level of drugs that it cannot tolerate, this can lead 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 man depressed

  • Agitation.
  • Seizures.
  • Hallucinations.
  • Difficulty breathing.
  • Nausea and vomiting.
  • Unsteady gait.
  • Violent or aggressive behavior.
  • Coma.

If any of these signs are present, or if you believe a person might be experiencing an overdose, seek life-saving medical attention immediately.


Working Toward a Life of Sobriety

The decision to seek out a sober, drug-free lifestyle is one of the most important steps in the recovery process. Anyone seeking help will be able to find numerous options for treatment.

These treatment options are designed to help individuals begin their journey of sobriety.

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

Drug Detoxification and Withdrawal Management

Before someone 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 and Treatment Options

A doctor, addiction specialist, or counselor can help people find the right rehabilitation or treatment option. The setting is determined by individual needs, so some may benefit from inpatient treatment while others may thrive in 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. group therapy

Patients recovering from opioid use or alcohol disorders may benefit from medication-assisted treatment (MAT), a combined approach that utilizes medication in concert with counseling and behavioral therapies to treat addiction.13

Types of Behavioral Therapy

There are various types of behavioral therapy available to help patients treat and manage their drug or alcohol addiction. One strategy is structured cognitive-behavioral therapy (CBT). CBT has been shown in some studies to be an effective aspect in the treatment of SUDs.14 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.

Other forms of behavioral therapy that may be included in your treatment plan include:

  • Contingency management. This type of therapy involves incentives and rewards to help motivate people to abstain from substance use.
  • Family therapy. This type of counseling involves the patient’s family members and focuses on issues that have arisen because of drug misuse.
  • Motivational interviewing. This technique involves the assessment of an individual’s willingness to begin treatment and make positive life changes.

Aftercare, Relapse Prevention, and Recovery Tools

Utilizing support groups as aftercare options may also reduce the potential for relapse.15 Having support from nonprofessional, nonclinical participants may aid in the patients finding additional motivation, support, and success in overcoming the SUDs.15 There are various support groups, therapies, and 12-Step programs—both religiously based and alternative—that may provide support in the recovery 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 where an individual resides, 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.


How to Find Help for Substance Abuse

While many people across the country are struggling with alcohol and drug abuse, substance misuse and abuse can still feel very isolating to those who are experiencing it. Know that you are not alone and that we are here to help you. Call 1-888-744-0069 to speak with an admissions navigator who is there to support you as you begin your journey toward recovery.


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Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series of in-depth articles on Community Paramedicine programs across the country that go beyond transporting patients to emergency rooms and connects specific patients, such as repeat system users, the homeless and others with behavioral health issues and substance use disorders, to definitive long-term care and treatment. In his current capacity as Medical Editor for American Addiction Centers, Ryan works to provide accurate, authoritative information to those seeking help for substance abuse and behavioral health issues.
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