Authors: Jenna Little and Rachel Luzer
Substance abuse is a major issue in America, affecting millions of people across all age groups. According to the National Institute on Drug Abuse, about 19.3 million adults aged 18 and older reported having a substance use disorder in 2021. The most commonly abused substances include alcohol, nicotine, marijuana, opioids, and inhalants. Alcohol use disorder (AUD) is the most prevalent, with around 28.3 million people affected, while nicotine addiction impacts 23.6 million people, many of them suffering because of the rise of e-cigarettes. The opioid epidemic continues to worsen, with 2.7 million people struggling with opioid use disorder. Marijuana is another widely used substance, with 50 million people reporting use in the past year. Adolescents are heavily impacted, with about 1 in 7 teens (ages 12-17) facing some form of substance use disorder. Overall, the incidence of substance abuse continues to grow, fueled by easier access to substances, social pressures, and the ongoing opioid epidemic.
The most commonly abused substances in the U.S. are alcohol, nicotine, marijuana, opioids, and inhalants, each affecting different groups in various ways. Alcohol is the top contender, with about 28.3 million people over the age of 12 struggling with alcohol use disorder (AUD). It's especially common among young adults (ages 18-25), who are influenced by social pressures, peer groups, and the challenges of transitioning into adulthood. Nicotine use is also widespread, with around 23.6 million Americans addicted to it. While cigarette smoking has declined, vaping has surged, particularly among 18-24 year olds. Nicotine misuse is more common in areas with lower socioeconomic status, where healthcare access and anti-smoking programs are often lacking. Nicotine-related deaths still number around 480,000 each year in the U.S., showing just how significant the impact is.
Marijuana is another substance with high usage rates, with around 50 million people using it over the past year, particularly among 18-25 year olds. It's also heavily used by high school seniors (about 30.5% of 12th graders), and the rates continue to rise. Opioid misuse has become a major public health crisis, affecting 2.7 million people, especially among young adults who often have easy access to prescription painkillers and are influenced by peer and social pressures. Lastly, inhalant abuse, while less common overall, is highest among adolescents (ages 12-13), with some young adults also using inhalants to manage stress. There's no significant difference in inhalant use between rural and urban areas. In the end, young adults and those in lower-income areas are the groups most at risk for substance misuse across these various drugs.
Individuals suffering from alcohol abuse disorder can face various physical and mental health problems. Alcohol can alter both the structure and function of the brain, which will impact mood and behavior. The heart can face damage, fighting problems like cardiomyopathy, arrhythmias, strokes and hypertension. Heavy drinking may impact the liver, causing conditions like steatosis (a fatty liver which can lead to liver failure or cancer), alcoholic hepatitis, fibrosis or cirrhosis. Additionally, alcohol can cause swelling and pain of the pancreas, or pancreatitis, which makes it difficult to produce enzymes and hormones for digestion. Furthermore, excessive alcohol consumption is linked to an increased risk of different types of cancers, including head and neck, liver, breast, or colorectal cancer.
Smoking tobacco is the most preventable cause of death and disability in America. Cigarette smoke contains different chemicals that affect the health of humans, such as arsenic, benzene, formaldehyde, and tar, most of which contribute to cancer. Smoking raises cholesterol levels, leading to the hardening of arteries and increasing the risk of heart disease, artery disease, and possibly a heart attack. Nicotine in cigarettes causes an elevation in blood pressure, heart rate, and flow of blood which narrows the arteries, making it more difficult for blood to reach your heart. Additionally, nicotine has addictive properties making withdrawal extremely challenging for individuals trying to quit.
Consistent marijuana use can lead to tolerance or dependence, making it necessary for users to use larger amounts to achieve the same result. Adolescents are a vulnerable population, as marijuana usage during this stage of brain development is linked to increased risk of mental health disorders. Long term use of marijuana can damage the lungs and impairments to cognitive functions like memory and attention.
Common side effects of opioid misuse include nausea, vomiting, constipation, pruritus (itchiness or feeling the need to scratch skin), dizziness, dry mouth, and sedation. Many opioid users may experience respiratory problems such as sleep apnea, asthma, or chronic obstructive pulmonary disease (COPD). Mental health side effects include depression, anxiety, and post-traumatic stress disorder. The constant use of opioids long term can lead to misuse, addiction, overdose and even death.
Inhalants are highly toxic chemicals and can have severe, or even fatal, effects. Short term consequences include impaired judgment, nausea, vomiting, confusion, dizziness, drowsiness, lethargy, and muscle weakness. Fatal consequences include irregular heartbeat which leads to heart failure, and “sudden sniffing death” which occurs after just one use of the drug. Long term side effects include damage to the brain and nervous system making it difficult to control thinking, moving, seeing, and hearing. They can also cause damage to organs like the heart, lungs, liver, and kidneys, and the effects are not always reversible. Lastly, mental health disorders can occur due to the use of inhalants including major depression.
While there is a blurry line when it comes to prescription specific controlled substances, there are laws in place that were formed to regulate these medications for safety concerns and prevention. The Controlled Substance Act (CSA), a law controlled closely by the Drug Enforcement Administration (DEA) and Department of Health and Human Services (HHS), enforces 5 divisions of schedules for substances based on the potential for abuse or dependency. For example, for schedules 3 and 4, these controlled substances are limited to be refilled only 5 times or within 6 months after the issuing date.
There are many resources available, both online and in communities, for those with loves ones experiencing a substance use disorder. Many of these resources are supported by insurance companies for multidisciplinary treatment. Having the conversation with a loves one is hard, here are some recommendations from the Substance Abuse and Mental Health Services Administration.
Choose an appropriate time and place to have the conversation. This can be in the privacy of ones home or outside in nature.
Relay concerns in a direct manner that are backed by evidence and not accusational.
Reassure their loved one’s feelings on the matter and actively listen while avoiding judgement.
Connect their love one with resources for help and provide emotional, mental and physical support to reassure them that they are not tackling this alone.
Practice patience with the process and understand that recovery takes time, commitment, and discipline.
Substance use has become an epidemic in America that can be scary for the individual with the disorder and the families involved. There are many prevention efforts in place, but these efforts need to begin early in middle school including education on use and misuse of medications and other uncontrolled substances in an age appropriate manner. Schools can play an important role in this primary prevention process. Outside of academic settings, religious institutions, local community centers, and other public facilities should be encouraged to continue these prevention efforts by utilizing resources and education, inviting professionals within the field to speak, and encouraging those who had a history of substance use disorder to talk about it.
Substance use disorder is an epidemic in the United States. Substances can be provided from a number of locations including the streets or even the doctor. Since this disease is preventable, it is our responsibility without our society to bring awareness and education to the consequences of long term substance use and the toll it can take on an individual and their family. Take precautions, see the signs, and help us make the world a better and safer place. If you, or someone you know, struggles with alcohol use or substance use disorder, please call 1-800-662-HELP (4357) to get guidance and help. You are not alone.
Resources:
コメント