Drug and alcohol use, abuse, and addiction continue to be among the nation’s leading public health problems.
"The human brain is the most complex organ in the body—you need it to drive a car, to enjoy a meal, to breathe, to create an artistic masterpiece, and to enjoy everyday activities. In brief, the brain regulates your body’s basic functions; enables you to interpret and respond to everything you experience; and shapes your thoughts, emotions, and behavior. Drugs, however, can alter important brain areas that are necessary for life-sustaining functions and can drive the compulsive drug abuse that marks addiction." -National Institute on Drug Abuse
Nearly 1 in 10 Americans, over the age of 12 years old, have a substance use problem.
Drug and alcohol addiction varies from early teen years to 60 years and older.
Over 23 million Americans currently struggle with alcohol or drug addictions, but only 11% of those with an addiction actually receive treatment.
In 2013, 8.6% of Americans needed treatment for a "problem related to drugs or alcohol", but only 0.9% percent received that treatment.
Abuse of tobacco, alcohol, and illicit drugs is very costly to America - with more than $700 billion spent annually in costs related to crimes, lost work productivity, and health care.
Nearly $223 billion in health care costs and lost productivity are attributable to alcohol use disorders.
From 2001 to 2014, there was a 2.8-fold increase in the total number of deaths caused by prescription drug overdose.
Although drug use has significantly increased, alcohol is still linked to 23% of treatment admissions in the United States.
Every day in the United States, 114 people die as a result of drug overdose, and another 6,748 are treated in emergency departments (ED) for the misuse or abuse of drugs.
How do you diagnose a substance use problem?
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) identifies nine (9) types of Substance-Related Disorders:
Opioids (Pain Killers, Heroin)
Hallucinogens (LSD, MDMA, Ecstacy)
Stimulants (Cocaine, Ritalin, Methamphetamine)
Sedatives, Hypnotics, or Anyxiolytics (Valium, Xanax, "Qualudes")
Regardless of the particular substance, the diagnosis of a substance use disorder is based upon a pathological set of behaviors related to the use of that substance.
These behaviors fall into FOUR main categories listed below.
Four Main Categories:
1. IMPAIRED CONTROL
Impaired control may be evidenced in several different ways:
- Using for longer periods of time than intended, or using larger amounts than intended.
- Wanting to reduce use, yet being unsuccessful in doing so.
- Spending excessive time getting/using/recovering from drug or alcohol use.
- Cravings that are so intense it is difficult to think about anything else.
2. SOCIAL IMPAIRMENT
Social impairment is one type of substantial harm (or consequence) caused by the repeated
use of a substance
- People may continue to use despite problems with work, school, or family/social obligations. This may include repeated work absences, poor school performance, neglect of children, or failure to meet household responsibilities.
- People may continue to use despite having interpersonal problems because of their use. This could include arguments with family members about the use or losing relationships because of continued use.
- Important and meaninful social and recreational activities may be given up or reduced because of their continued use. A person may spend less time with their family or friends, or even engaging in personal hobbies, due to their use.
3. RISKY USE
The key issue of this criteria is the failure to refrain from using the substance despite the
harm it causes
- Addiction may be indicated when someone repeatedly uses substances in physically dangerous situations including operating machinery or driving a vehicle.
- Some individuals continue to use substances even though they are aware it is causing or worsening physical or psychological problems.
4. PHARMALOGICAL INDICATORS (TOLERANCE/WITHDRAWAL)
Tolerance and withdrawal can be classic indicators of an advanced substance abuse
problem which also makes them important concepts.
- Tolerance occurs when people need to increase the amount of a substance they are using to achieve the same desired effect. In other words: once someone has been using a substance repeatedely for an extended period of time they begin to build a tolerance for that substance which in return creates the need and desire to use more. People experience tolerance differently depending on the amount of use, length of use, and substance being used.
- Withdrawal is the cluster of symptoms that occur when an individual suddently stops using or decreases their intake of substances. Withdrawal symptoms can very significantly depending on the individuals tolerance and the substance being used. Withdrawal symptoms can be very unpleasant and depending on the drug (including alcohol), withdrawals can be fatal. Therefore, it is important to consult with a medical professional before attempting to stop drug or alcohol use after a period of heavy, continuous use.
The DSM-5 States That:
- A mild substance use disorder is a presence of 2-3 symptoms listed above
- A moderate substance use disorder is a presence of 4-5 symptoms listed above
- A severe substance use disoder is a presence of 6+ symptoms listed above
What does treatment and recovery consist of?
Treatment for substance use disorders consists of multiple components including:
Intensive Outpatient Treatment
Inpatient Residential Treatment
Medication-Assisted Therapy (Vivitrol, Antabuse, Naltrexone)
Peer Support (Family, Friends, Fellowship)
Spirituality/Faith Related Activities