Parents’ greatest fear is that their kids will become addicted to drugs and alcohol.
According to a Parent.co survey of over 1500 participants, fear of drug and alcohol addiction vastly outweighed concerns about terrorism, economic collapse, crime, and war.
With help from AddictionWise, we set out to research the scope of addiction in America and how it impacts families
Most people in America know someone who is struggling with addiction. It may be the parent of a child in your kids’ class, someone at your church, or someone in your family. It might be your parent, or even your child. It might be you.
- 44% of Americans say they personally know someone who has been addicted to prescription painkillers, CNBC reports.
- 20% said it was a family member.
- 24.6 million Americans used drugs.
- This equates to 9.4% of the population versus 8.3% in 2002.
- That’s roughly equal to the entire population of Texas.
An introduction to drug addiction
Addiction is a complex disease that causes changes in the functioning of the brain.
The National Institute on Drug Abuse defines addiction as a “chronic, often relapsing brain disease that causes compulsive drug seeking and use.”
While a first-time user may try a substance voluntarily, chemicals contained in drugs compromise an individual’s self-control so that further use gradually becomes involuntary.
Drugs like heroin and marijuana mimic neurotransmitters, disrupting normal messages in brain chemistry. Cocaine and methamphetamine interact differently by producing dopamine, which arouses the brain’s reward center while also inducing the brain to produce less dopamine naturally. As drug use becomes more regular, the user’s tolerance increases with a need to use more qualities of drugs to attain a high.
Longer-term drug use affects glutamate, critical to both the reward center and for learning, which negatively influences certain brain functioning such as critical thinking, memory, and self-control.
Annual surveys conducted by the Substance Abuse and Mental Health Services Administration show that drug use is on the rise in America. Participants of the National Survey on Drug Use and Health, who are 12 years and older, provide critical commentary on the use of various substances for different periods, indicating weekly, monthly, or lifetime use of drugs and alcohol.
According to the 2013 results:
- 23.5 million Americans are addicted to alcohol and drugs.
- 24.6 million Americans used drugs.
- This is an increase from 8.3% in 2002 to 9.4%.
- Marijuana accounts for the majority of this increase as 19.8 million reported using this particular drug in 2013 whereas in 2007, this figure was only 14.5 million.
- Marijuana accounts for the greatest rates of dependence (after alcohol) with 4.2 million users matching standards for clinical trials for abuse
- 1.9 million met criteria for dependence on prescription painkillers and 855,000 for cocaine.
- Methamphetamine use also increased from 353,000 users in 2010 to 595,000 users in 2013.
- Cocaine however is currently trending downwards, from 2.4 million reported uses from 2002 to 2007 to 1.4 million uses in 2013.
Here in Vermont, more parents are permanently losing their children because of drug addiction.
Parents who are hooked on heroin and prescription opiates are driving an increase in child neglect cases, according to state child welfare officials and prosecutors. “It’s the drugs,” said James Hughes, state’s attorney in Franklin County, which has been swamped with juvenile cases. “Young parents are taking care of their addiction instead of taking care of their children.”
Teens and Drugs
The teenage population accounted for 54.1% of first-time drug users in 2013. Marijuana, followed by opioids then inhalants, are the most popular drugs of choice for this demographic.
Statistics show that drug use typically peaks in late teens and earlier twenties, though later generations are demonstrating a marked increase in drug use, especially for people in their 50s and 60s.
Survey results suggest that baby boomers have typically demonstrated elevated drug use compared to their predecessors.
Alcohol use tends to differ amongst the type of use and between ages and genders. Overall, underage drinking has declined from 28.8% to 22.7 % and binge drinking (5 or more drinks at the same time) from 19.3% to 14.2 % from 2002 to 2013.
Men are more likely to partake in binge drinking as 30.2 % of men and only 16% of women indicated that they had done so within in the month preceding the survey.
Heavy alcohol use (defined as binge drinking on 5 different days over the course of one month) is also more prevalent among men, with 9.5% of men versus 3.3% of women indicating this type of use.
Driving under the influence has fortunately declined from 2002 to 2013 from 14.2% down to 10.9%.
Alcohol addiction, which has the highest rate of dependence for all substances, has also declined in this timeframe, from 7.7% to 6.6% of Americans reporting alcohol dependence or related problems.
Tobacco use has also declined significantly between 2002, in which 2% of Americans reported regular cigarette use, and 2013, in which 21.3% indicated being a current cigarette smoker.
Encouragingly, the number of teenage smokers has declined between 2002 and 2013 from 13% to 5.6%.
The Monitoring the Future 2014’s survey, published by the National Institute on Drug Abuse indicates that drug use is on the decline amongst American teenagers across almost all categories of drugs (with the exception of marijuana, the use of which has stayed level from previous surveys).
From alcohol to painkillers, cigarettes to inhalants, teens are partaking in less substance abuse than previous generations.
However, this downward trend is countered by the rapid rise of e-cigarette use and a growing perception of marijuana as a less harmful substance. The Monitoring the Future survey reported that of 8th graders surveyed, 8.7% had used e-cigarettes in the past month, a percentage that only increases with each grade level up to 17.1% of 12th graders. 22.9% of 12th graders also indicated hookah use within the preceding year.
Despite the apparent decline of substance use in certain categories and demographics, a “treatment gap” persists for those suffering from addiction and substance dependence/abuse. While 8.6% Americans required professional care for substance abuse, only 0.9% obtained specialized treatment.
A recent Kaiser Family Foundation study found that “a majority of Americans say that lack of access to care for people with substance abuse issues is a problem (75 percent), including 58 percent who say it is a major problem.”
Emerging Trends and Opiate Addiction
The landscape of heroin addiction in the US has transformed over the past decades. Migrating from urban to suburban areas, lower income to more affluent neighborhoods, the profile of a heroin addict has changed from that of poor, urban, male and black users to predominantly white addicts of whom half are now women.
According to Theodore Cicero of Washington University in St Louis, first-time heroin users are typically in their mid-20s whereas decades ago, first-time users were generally around 16 years old. Between 2007 and 2013, heroin use has increased dramatically, from 370,000 to 680,000 users.
Similar patterns observed in the market for prescription painkillers like OxyContin mirror the rise of heroin addiction in recent years. The 1990s witnessed an increase in the accessibility to prescription painkillers that created a wave of addiction, surpassing the collective use of illicit drugs such as cocaine, ecstasy, LSD and methamphetamines.
In 2012, 16,000 deaths were caused by painkillers. However, medical professionals are working to combat the oversupply of prescription painkillers in the market. For example, OxyContin pills are now being manufactured in such a way that “when crushed, turn into a gloop that cannot easily be snorted or dissolved for injection”.
Foreign markets are responding to the increased American demand for heroin. Despite Afghanistan’s status as the main producer of opium globally, Mexico is America’s main supplier. Plus, Mexican heroin is cheaper than that imported from Asia or Columbia. Domestic politics also have an important function; as Mexico reorients its resources to combat primarily urban, organized crime, poppy farming goes unchecked in rural regions, thus allowing opium production to flourish.
Since Marijuana is still the most popular drug used in the US and nowadays, since many states have legalized cannabis for medical consumption or just plain legalized it, demand for Mexican marijuana is on the decline. Opium, therefore, provides a lucrative market. Moreover, heroin manufacturing has responded to users’ preferences. Brown heroin is more easily smoked or snorted and offers an alternative to the injection, rending heroin more accessible and perhaps, perceptibly less threatening.
Addiction and Overdose
The NY Times reported in early 2016 that the United States has seen a marked increase in the number of deaths from drug overdose, primarily propelled by heroin and prescription drugs.
Deaths from overdoses today are comparable to those of HIV in the 1980s and 1990s. Though deaths from HIV spiked more rapidly, Robert Anderson, CDC chief of morality statistics, has emphasized that unlike HIV, death from drug overdoses is not as localized to metropolitan areas and actually is beginning to occur with more frequency in rural regions.
Certain regions and states are experiencing the impact of opiate overdoses more acutely than others are. According to the Centers for Disease Control (CDC), the Southwest and Appalachia regions are the most affected in the United States. West Virginia has the highest number of deaths caused by overdose in the United States. In Appalachia, deaths caused by overdose are arguably connected to the use of prescription painkillers amongst particular populations of the blue-collar workforce. According to the West Virginia University School of Medicine’s director of addiction services, Dr. Carl R. Sullivan, III, this population is more likely to experience injuries on the job, which result in the initial prescription to combat chronic pain, a notion deemed “unacceptable” by pharmaceutical companies in the mid-1990s. Despite laws to combat abuse of such medications, those addicted to painkillers adopted heroin use.
Due to a fundamental lack of resources to administer treatment services and programs, deaths from overdose continue unchecked. State by state discrepancies in access to treatment and expenditures for such treatment also becoming more apparent. For example, in New Hampshire, overdose of opiates, mostly connected to fentanyl, caused 326 deaths in 2014. However, Timothy R. Rouke, New Hampshire’s chairman for the Governor’s Commission on Alcohol and Drug Abuse, cites that his state spends less per capita than all other states minus Texas in providing the necessary treatment services.
In other states, like New Mexico, deaths from heroin overdoses have persisted since the 1990s; so much that opiate addiction is almost akin to a hereditary disease.
According to the executive director of the nonprofit organization Healing Addiction in Our Community, Jennifer Weiss-Burke, heroin addiction is seemingly passed down from one generation to the next as “a way of life.”
Furthermore, Weiss-Burke has noticed that the younger generations are more difficult to treat. Some prove unwilling to get sober and “end up cycling through treatment or end up in jail.” Weiss-Burke further articulates that “when you go right back to the same environment, it’s hard to stay clean… Heroin craving continues to haunt a person for years.”
In 2014, abuse of opioids accounted for over 61% of overdose deaths,which has tripled since 2014 according to the New York Time. Almost more troubling is the rise of fentanyl, for which a greater amount of naloxene is required to resuscitate an overdose victim as compared to a heroin overdose. Naxolene is also used to reverse other opioid drug overdoses and it is not specific to fentanyl.
Combating Prescription Drug and Heroin Use in the US
In March 2016, President Obama enunciated a multifaceted plan to enhance resources and treatment facilities and provide greater access to naloxene to address what has rapidly transformed into a “national epidemic”. The Obama administration has thus far appealed for $1.1 billion to fund these new measures aimed at reducing opioid overdoses.
President Obama articulated that as the profile of heroin addiction has transformed in recent decades, experiencing a profound socioeconomic shift as discussed above, the widespread nature of current opioid addiction has altered public opinion. Heroin addiction is no longer an affliction solely of the urban poor and the result of moral failings.
The FDA has moved to strengthen warnings on immediate-release opioid prescription drugs to warn those taking these drugs about abuse and potential overdose. The FDA had previously subjected 34 brands of extended-release tablets to tougher labeling requirements back in 2013.
This time around, FDA Commissioner, Dr. Robert M. Califf, emphasized the enormity of this effort, and it will involve editing warning labels for 288 products. New Center for Diesease Control guidelines, though non-binding, will attempt to limit the prescription of opioid painkillers to cases in which no other appropriate option exists to mitigate pain.
Though the effectiveness of enhanced labeling of these drugs is perhaps debatable, Bruce Psaty at the University of Washington in Seattle emphasized that this “should help improve prescribing practices in the near term”. Thus, the new warnings and guidelines remain an integral part of a revitalized national campaign to combat drug addiction and opioid dependency.