Substance Abuse

Posted: December 22nd, 2022

Substance Abuse

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Abstract

The report looks into the issue of substance abuse from a broader perspective by dwelling on the causes, effects, and proper ways of preventing further use. The study elaborates the need to embrace proper mechanisms such as counseling and rehabilitation and education to regulate the increasing cases of abuse among Americans. It emerges that dealing with the problem would be easier when one understands the risk factors such as mental health, family history and genetics, and trauma that one can encounter at particular times of their lives. Environmental factors such as friend groups, social media, and geographical area could also put one at a higher risk of becoming an abuser. The analysis elaborates why it is necessary to deal with substance abuse to prevent addiction-related problems such as health, global, and economic impacts, and other effects such as overdose, death, and violence. Stakeholders learn the importance of counseling affected persons and the value of education in regulating the problem.

Substance Abuse

Introduction of Substance Abuse – Epidemiologic Findings

Even though scholars would use different terms to describe substance abuse, they all usually develop the same meaning and impression. Substance abuse according to the description by National Institute on Drug Abuse refers to the hazardous or harmful utilization of psychoactive substances, including illegal drugs and alcohol. Continuous use of psychoactive substances can result in dependence syndrome – a collection of physiological, cognitive, and behavioral condition that form after continuous substance use and that usually come with a strong urge to take alcohol or a particular drug.¹ The phenomena make it difficult to regulate usage, persisting in its utilization regardless of the destructive effects. A person reaches a point of substance abuse when they place much priority to drug use than other responsibilities and activities, thereby causing increased intolerance and physical withdrawal. A study by the Substance Abuse and Mental Health Services Administration through its yearly report, the National Survey on Drug Use and Health, the primary source of data on drugs and alcohol use, misuse, and dependence among American citizens 12 years and above, showed how substance abuse is on the rise.¹ The almost 67,700 respondents reported whether they have used any substance at any particular time in their lifetime, over the past year, or month, which could be regarded as current use. The study discovered illicit drug utilization in the U.S. has been escalating. It emerged that in 2013 nearly 24.6 million American citizens aged 12 and above (9.5% of the entire population) had used an unlawful substance in the past month. The number is an increase from 8.3% in 2002.¹ The study showed how marijuana use is on the rise (19.8%) followed by prescription drugs (6.5%), cocaine (1.5%), hallucinogens (1.3%), inhalants (0.5%), and heroine (0.3%).¹ Developing more effective counseling and rehabilitative processes and educating the public on the negative effects of substance abuse will be instrumental in lowering drug dependence.   

Causes of Substance Abuse

Risk factors

Gaining tangible insight into the causes of substance abuse requires one to consider the various risks factors that could increase one’s likelihood of using drugs and alcohol beyond their regulation. The risk factors tend to vary and understanding the various possible causes that can result in substance abuse could help to deal with addiction without much constraint.

Mental health

The high occurrence of death between mental complications and other illnesses or disorders does not really imply that once instigated the other, even if one emerged first. Nonetheless, investigations now reveal how particular mental problems act as risk factors for generating substance use health problem or disorder. A report by the National Institute on Drug Abuse hypothesizes that people with serious or mild mental issues may utilize drugs as a way of taking medication.¹ Even though some drugs may momentarily lower symptoms of mental complications, they can also worsen the effects, both in the short and long run. For instance, evidences indicate that continued use of cocaine could worsen the effects of bipolar disease and cause a progression of the ailment. It is happens that when a person develops a mental problem, associated alterations in brain operations may heighten the vulnerability for problematic utilization of drugs and alcohol by magnifying their adverse effects, or doing away with the unpleasant effects of the mental problem or the side effects of the medicines used to address the issue.¹ Neuroimaging, for instance, indicates that attention hyperactivity disorder (ADHD) is connected neurobiological alterations in the brain that are also connected with desire for drug use, perhaps partly describing why patients with substance abuse issues report more desire when they have attention hyperactivity disorder.¹

Family History/Genetics

The National Institute on Drug Abuse estimates that 40-60% of a person’s vulnerability to substance abuse disorders is traceable to genetics. Most researchers in the area tend to look for that might prompt people to generate both a substance abuse complication and other mental ailments, or to have a higher risk of a second disease emerging after the initial appears.¹ Most of these vulnerabilities, the National Institute on Drug Abuse explains, emanate from intricate interactions among numerous genes and genetic interrelations with environmental factors.¹ Regular use of marijuana at the adolescent stage, for instance, is linked to increased chances developing psychosis when they become adults, especially among users who have a specific gene type.

In some situations, a gene variant may act straightforwardly, in the way protein determines how a person reacts to a drug (as it would appear with whether they experience pleasure or not from a substance) or the duration which the drug remains active in the body. Certain genetic components have been recognized that put an individual at high risk of taking cigarette or becoming an alcoholic and researchers have embarked on uncovering the connection between high risk of drug dependency and genetic composition.¹ The genes can also act in indifferently by changing how a person reacts to depression or by heightening the chances of taking risks, which could hasten the beginning of substance use as well as the acquisition of illnesses and other substance use mental complications.¹ Studies indicate that there are a number of genes that could contribute to the risk for both addiction and mental illnesses, including those that have effect on the actions of components carrying information from one neuron to the other that are damaged by illicit substance.

Environment Influences

Child Abuse/Trauma

Several environment influences may push someone into substance abuse, a process that may start so easily but end up being complicated. A person’s work experiences, for example, may drive them into substance use and abuse as it appears with the military personnel. The report by National Institute on Drug Abuse demonstrates how members of the armed forces are not resistant to the substance use issues that affect other members of the society.¹ Even though the use of illicit substances is relatively low among military officers than among civilians, heavy usage of alcohol and tobacco, more so prescription drug misuse, are on the rise. Usually, the stress and depression associated with deployment during conflicts and the unique culture associated with the military contribute to some of the variations.¹ The problem continues to affect many military personnel because of the zero-tolerance regulations and stigma, issues that derail the efforts to treat or deal with the condition.

Apart from the work environment, other environmental factors can increase one’s chances of becoming an addict. Stress or trauma during childhood, for example, is a well known risk factor for a wide array of mental problems, thereby offers one probable common neurobiological connection between the illness processes of substance abuse disorders and mental complications.² It is clear exposure to factors or situations that cause stress may return one to drug use even after recovering for some period. Usually, stress reactors are controlled by the hypothalamic-pituitary-adrenal axis, which can impact on brain connections that regulate inspiration or motivation. Higher amounts of stress tend to slow down activities in the prefrontal cortex and heighten response in the striatum, which results in escalated impulsivity and lowered behavioral regulation.² Furthermore, experiencing stress early in life could cause long-term changes in the hypothalamic-pituitary-adrenal axis, which tamper with limbic brain operations that are in charge of adaptation, learning, and motivation, thus increasing one’s likelihood of entering into substance use.² However, other environmental factors such as adverse childhood encounters and trauma among others could increase one’s possibility of becoming a drug and alcohol user.

Friend groups

Failing to consider the type of friends one keep could put one at a higher risk of becoming a drug or alcohol user thereby making it necessary to always choose friends who may not lead one into adverse or destructive behavior. Some friends could lead someone into inappropriate use of drugs when they interact with non-users.² Such friends could try to convince the non-user to try a particular substance to achieve particular feelings. The non-user may easily give in to their friends’ peer pressure to avoid feeling neglected.

Social media

Social media users should be very careful to avoid contracting habits that could foster substance abuse considering the nature of these interactive platforms where people express their perceptions freely without the fear of contradiction. Individuals watch videos and see images of others using illicit substance and in so doing develops the desire to practice such acts.² Social medial links a person to friends from all over the world and when someone meets people from nations that permit the use of certain drugs as it happens with marijuana in some American states. Such interactions put individuals at a high risk of developing behaviors they did not have.

Geographical area

The place a person comes from may either increase or decrease a person’s likelihood of becoming a substance user. An individual, for example, is highly likely to enter into drug and alcohol use when they come from an area where most of the people use or abuse drugs, or where it is easy to access the various substances. It appears that more people in urban areas have higher chances of using drugs and alcohol than people in rural areas because of the rampancy of these products in relatively developed and highly populated places.¹ It is also easier for a person to become a substance user when they come from the shanties or ghetto where life is quite difficult, and some perceive drug use as a way of dealing with the stressors they experience in the community or neighborhood. A study by National Institute on Drug Abuse illustrates how most studies on substance abuse among Latinas and Hispanics in the U.S. has paid attention alcohol, and has affirmed the widely held perception that, in spite of of the national origin, Latinas and Hispanics normally record higher levels of, especially among men.¹ The finding affirms the view that people from Latin and Spanish speaking nations are heavy drinkers compared with women. The phenomenon further illustrates the strict adherence to cultural norms by Hispanic and Latino women who adhere to the sanctions against taking alcohol and other related substances.

Effects of substance abuse

Addiction

One of the major effects of substance abuse is addiction. Unfortunately, addition or substance dependence causes a wide range of negative effects, including health, global, and economic impacts. Stakeholders must act very fast to address addiction to prevent the many adversities that could affect not only the user but the society at large.

Health impact

Individuals who use drugs are at a higher risk of developing health problems that could result in fatal consequences. A person who frequently uses drugs has higher chances of developing drug use disorder, which might be regarded as the sum of drug and alcohol use disorders. High incidences of substance abuse disorders are reported in the U.S. and Eastern Europe where the health problem occurs in 6-7% of the entire population.³ The data implies that 1 in 21 suffers from substance use disorder. Whereas the prevalence is higher in the Americas, Oceania, and Western Europe, across Asia, the Middle East and Africa the prevalence is relatively lower at 1-2% with more men suffering from the condition than men.³ Heavy alcohol users are at a higher risk of developing alcohol use disorders, and it is approximated that nearly 1.5% of the global population struggles with alcohol use disorder while about 0.5-4% of the American population live with alcohol use disorder.³

Unfortunately, even as the health effects associated with substance abuse continue to take toll on many drug users, the process of getting medical attention is usually low, and not widely covered. An estimation by the Office of Applied Studies, which is part of the Substance Abuse and Mental Health Services Administration shows that more than 4 million people who attain the diagnostic level for addiction and require addiction-related treatment do not get it.³ Since the approximation acquired from the National Household Survey on Drug Abuse, does not encompass individuals in correctional facilities or those who are homeless, it should not be perceived as enlightening and one that gives appropriate guidance. The state estimates of treatment of addicted persons range from 8 to 16% for adults, and from 10 to 24% for youth.³ Although the estimates indicating the number of individuals requiring treatment but are unable to pay for their medication lack, it can be ruled out that the number of people needing treatment for addition-related problems continues to escalate as more individuals and families become uninsured.³ Furthermore, the estimates showing the number of people getting treatment does not cover those affected by other’s substance abuse, who would likely gain from services such as counseling. Seemingly, the approximations do not include people who may not have to take a DSM IV diagnosis, but would gain from intervention at an early stage, thus showing how many people are cut out of the health program.

Many American states acknowledge that the amount of funding needed to meet these and other treatment-connected requirements would amount hundreds of millions of dollars. President Bush while addressing the congregation during the installation of John Walters as the chair of the Office of National Drug Control Policy showed interest in lowering the treatment gap, and promised to add $1.7 billion over the next half a decade.³ Hopefully, Bush’s addition to the kitty and the adoption of the techniques by the Office of National Drug Control Policy National Drug Control Strategy such as the enlargement of treatment capacities via federal financial aid and enlargement of treatment capacities through the withdrawal of legislative barriers will narrow the gap.³ Stakeholders concerned dealing with the health problems emanating from substance abuse also believe that the other approaches such as expansion of treatment avenues through Medicaid, advancement of workforce, strengthening of publicly aided addiction treatment programs through advanced cooperation at the federal stage, and developing policies that do not divert funding from a specific area of treatment to another segment, thus favoring particular populations, will address the treatment gap that is wide now.

Global Impact

Abusing drugs could have far reaching repercussions that could be global in nature. Misuse could affect business with other nations due to the fears that brining in certain drugs could push people into inappropriate use. Other than affecting business dealings at the global level, substance abuse has negative effects on other cultures that are not accustomed to rampant drug use.¹ People in countries that do not take illicit substances are likely to learn of such acts from societies that encounter high incidences of misuse.

Economic Impact

Substance abuse imparts immeasurable damage on public safety and health around the globe every year, and threatens the peaceful growth and smooth operation of many societies. Acquiring the economic costs of substance misuse is vital to create legislations that lower such costs. The government used nearly $250 billion in 2010 to treat addiction-related disorders, which represents about 0.4% of the country’s GDP.¹ The government also uses a lot of money to save the environment from destruction owing to the unlawful production and disposal of pharmaceuticals and drugs.¹ Drug use relationship with crime further pushes the state to invest so much in beefing up security. Users too, must spend a lot of money to acquire the substance of their choice, thus further showing how drug dependence has adverse economic effects.

Other effects of Substance Abuse

Overdose

Overdose is an effect of substance abuse that requires so much attention now that the problem is becoming rampant. The National Institute on Drug Abuse while describing substance utilization in the American military develops an image of how sometimes incidences of overdose are reported, especially for prescription drugs. The National Institute on Drug Abuse informs that in 2008, 11% of active officers reported cases of overdose, up from 2% in 2002 and 5% in 2005.¹ The ease of access to these drugs and increase in prescriptions may add to their widening misuse by officers. Overdose is not only a problem among military officers but also among civilians who continue to develop health problems due to inappropriate use.^{8, 9}

Death

Death is a serious consequence of substance abuse that could occur due to a number of reasons. The American government does not trace the death rates of each substance, but the National Center for Health Statistics gathers information about the widely utilized drugs. The Centers for Disease Control and Prevention has developed a database (CDC Wonder) through which members of the public can access data regarding deaths occurring from substance-abuse cases.¹ Data by the National Institute on Drug Abuse detailing the nationwide drug overdose deaths (1999-2017) shows how more than 70,300 Americans succumbed to excessive use of drugs in 2017, including prescription opioids and unlawful drugs, almost a 2-fold rise in ten years.¹ Earlier in 1999 the number of those who died from overdose was 16,849, but shot to 70,238 in 2017.¹  

Other than the natural death addicts may encounter after contracting adverse health problems, substance abuse is associated with high incidences of suicide. The National Institute on Drug Abuse an example of the U.S. military where suicide levels have always maintained lower levels than among civilians in the same age group other than in 2004 when cases of suicide started to escalate, surpassing civilian occurrences in 2008.^1,7 Other than the high rate of suicide among the military, it is common knowledge that a person with psychostimulant, opioid, or alcohol dependence has an escalated risk of committing suicide of 8, 7, and ten respectively compared to a person who does not take such substances.¹ All over the world, it is estimated that about 318,000 deaths recorded in 2016 directly related substance abuse illness.¹

Violence

It is now proven that people who take drugs and alcohol on regular basis are more violent compared with individuals who hardly take these substances. Someone is likely to resort to violent approaches of settling disputes when they are under the influence of alcohol or any other substance than when they are sober.⁴ It is vital, therefore, to regulate substance abuse to avoid cases of violence that seem to increase with more drug use.

Controlling and Preventing Substance Abuse

Applying suitable policies, which impact the patterns and levels of substance and related effects, can largely lower the public health issues related to inappropriate utilization of illicit drugs and alcohol. It is upon legislators and policy makers to identify the most appropriate means of controlling and preventing substance abuse and work towards making these approaches more impactful.⁴ The adopted mechanisms should be able to yield the anticipated results, and should not be difficult to implement.

Counseling and Rehabilitation

A suitable way to control and prevent substance abuse is to place much emphasis on counseling and rehabilitation practices. Counselors should try to address the various effects of drug and alcohol use, especially after prolonged period. Counselors while providing their services need to understand that other than cravings and the possible effects of withdrawal symptoms, they need to offer services that would help deal with escalated anxiety, loneliness, depression and increased stress.⁴ Highly qualified counselors should take into account the possible contribution of the environmental and genetic causes of substance abuse while providing their services to achieve the most effective outcome.⁴ Counselors should remind their clients the importance of detox during withdrawal as this helps to keep the patient comfortable and physically safe as they try to quit the drug.

Other than counselors who might set up their private ventures, it is vital to consider the functions of rehabilitators who play critical roles in helping substance abusers regain good health and behavior. Today, rehabilitative programs are available in several settings, including outpatient rehab initiatives, inpatient residential rehabilitation, and private ventures offering such services.^{1, 4} The objective of therapeutic intervention during a rehab initiative is to prepare individuals to attain long-term recovery after a series of treatment plans even though some interventions could last several years.⁴ Rehabilitative therapy is essential because it lowers the duration and frequency a person spends taking drugs or alcohol as an individual learns to put up with the causes of his additive behavior and to deal with stressors in life.

Even as many experts share the opinion that rehabilitation may not yield the best outcome such as completely withdrawing the user from the substance, especially among individuals who encounter traumatic experiences, the various therapeutic interventions applied by service providers have tremendous impact on those undergoing withdrawal. The National Survey of Substance Abuse Treatment Services conducted a survey in 2014 and revealed how addiction treatment facilities in the U.S. apply behavioral therapeutic approaches more than any other intervention method.¹ Behavioral therapeutic methods allow patients to know the origin of high-risk behaviors and develop mechanism for putting up or avoiding situations that increase risk. Taking substance abusers through rehabilitative programs is essential and likely to lower cases of dependence because of the cognitive behavioral therapeutic (CBT) methods therapists use to transform users’ perception.⁴ Cognitive behavioral therapy pays attention on learning activities to lower problematic behaviors linked with substance misuse. A key aspect of operation while using CBT is predict risky situations and employing coping mechanisms such as self-regulation and avoidance to avoid reentry.⁴ Other than behavioral therapy, researchers rank CBT as one of the widely applied therapies in addition treatment, and therapists use it to manage a variety of cases such as cocaine, marijuana, nicotine, alcohol, and methamphetamine. CBT is helpful to patients because it helps them modify and recognize risky behaviors by utilizing a number of skills.⁴ Recovering addicts get to understand the underlying causes of risky acts so they can fix the issue more easily. More importantly, rehabilitation may be a suitable solution to substance abuse because of the use of matrix model, which offers people in recovery from stimulant abuse a structure for upholding abstinence.⁴ The numerous advantages that come with rehabilitation should be a motivating factor to take users through such programs to achieve a sober nation.

Already, the U.S. has invested in a number of rehabilitative programs aimed at sensitizing affected persons on the need to shun behaviors that put them at the risk of continued use. Most of these rehabilitation centers aim at helping the patient become stronger and sober, emotionally, mentally, and physically.^4,6 These facilities also teach users how to lead a drug-free life and to assist them develop stronger relationships at all aspects. Examples of renowned facilities include the Alo House Recovery Center in California, the Ascension Brighton Center for Recovery in Michigan, and the Ashley Addition Treatment in Maryland all which provide residential and outpatient treatment to its patients.¹

Education

Educating people on the dangers of substance abuse will be instrumental in regulating the problem, which is not only becoming a menace in the U.S. but also in other parts of the globe. The educational activities aimed at enlightening on the dangers of substance abuse should not only address the common aspects, but should dig dipper into facts that would completely transform individual’s perception about entering or continuing with drug use. The education process should not only take the form of the traditional classroom setting but should diversify into developing a coordinated structure that focus on public awareness through campaigns that identify substance abuse as a disease that is possible to prevent and treat.³ The educational plans should inform people that whereas the entering into substance use may appear to be a voluntary act based on the individual’s views, research has reinstated that addiction is a result of intricate neurobiological and neurochemical interactions.^3,9 The learners or audience should understand that depending on a person’s internal vulnerabilities, initial or early usage can turn out into addiction so fast, an illness that entails irreversible and permanent alterations in the biochemical processes of the addict’s brain.^5,10 The educators should enlighten trainees and learners about the various researches aimed at addressing substance abuse, as well as inform on the importance of bridging the denial gap that the Office of National Drug Control Policy consider to be a factor hindering many abusers from quitting the habit.⁵

Conclusion

The report elaborates how enlightening the public about the dangers of substance abuse will help reduce the negative effects associated with the practice. Substance abuse, which refer to a situation where a person takes more drugs or alcohol than required, is becoming rampant, an indication that more needs to happen to deal with the situation. Dealing with substance abuse requires adequate insight on risk factors such as mental health, family history and genetics, and stressful encounters during childhood. Other environmental factors such as friend groups, social media, and geographical area also put one at the risk of becoming an abuser. Abusing drugs and alcohol could have more devastating effects ranging from addition that could have severe health, global, and economic impacts to other effects such as overdose, death, and increased violence. The study elaborates the essence of embracing mechanisms that would regulate substance abuse including adopting effective therapeutic measures such as counseling and rehabilitation and education.

References

1. National Institute on Drug Abuse. National Institute on Drug Abuse. https://www.drugabuse.gov/. Published 2019. Accessed September 19, 2019.
2. Substance Use Disorders. American Academy of Family Physicians. https://www.aafp.org/about/policies/all/substance-abuse.html. Published 2016. Accessed September 19, 2019.
3. National Association of State Alcohol and Drug Abuse Directors. Policy Position Paper: Recommendations Related to Closing the Treatment Gap. June 2003. More information available at www.nasadad.org/resource.php?base_id=37. Accessed September 19, 2019.
4. Office on Women’s Health. Alcohol use Disorder, Substance Use Disorder, and Addiction. https://www.womenshealth.gov/mental-health/mental-health-conditions/alcohol-use-disorder-substance-use-disorder-and-addiction. Published 2018. Accessed September 19, 2019.
5. Substance Abuse | Healthy People 2020. Healthypeople.gov. https://www.healthypeople.gov/2020/topics-objectives/topic/substance-abuse. Published 2019. Accessed September 19, 2019.
6. US Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2010 midcourse review: Focus area 26, substance abuse [Internet]. Washington: HHS; 2006. Available from: http://www.healthypeople.gov/2010/Data/midcourse/pdf/FA26.pdf
7. Volk K. Teen Prescription Drug Misuse and Abuse. Samhsa.gov. https://www.samhsa.gov/homelessness-programs-resources/hpr-resources/teen-prescription-drug-misuse-abuse. Published 2014. Accessed September 20, 2019.
8. National Institutes of Health, National Institute on Drug Abuse (NIDA). NIDA topics in brief: Substance abuse among the military, veterans, and their families. Bethesda, MD: NIDA; 2009 Available from: http://www.drugabuse.gov/tib/vet.html
9. Addressing Fetal Alcohol Spectrum Disorders (FASD). Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/system/files/sma13-4803.pdf. Published 2014. Accessed August 29, 2019.
10. Russell H. Veterans and Opioid Addiction. Military Officers Association of America. https://www.moaa.org/content/publications-and-media/features-and-columns/health-features/veterans-and-opioid-addiction/. Published 2017. Accessed August 30, 2019.