Risk Factors and Warning Signs
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Drug Abuse Date: 2019 From: Gale Opposing Viewpoints Online Collection Publisher: Gale, a Cengage Company Document Type: Topic overview Length: 1,934 words Content Level: (Level 5) Lexile Measure: 1440L
Full Text: Drug abuse refers to a pattern of hazardous or harmful drug use for recreational or mood-altering purposes. It is a form of substance abuse, a term that encompasses the abuse of illegal drugs, prescription drugs, alcohol, and other intoxicating substances. Illegal drugs are substances that have not been approved for medical use and are banned by law. Prescription drugs have been approved for medical use but must be prescribed by a licensed physician. Some professionals also use the term drug misuse to describe situations in which people consume prescription drugs for off-label purposes inconsistent with their approved medical applications. Drug misuse and abuse are major social problems in the United States, largely because these behaviors can lead to physical or psychological addiction, which is defined by the National Institute on Drug Abuse as a “chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain” and considered a complex brain disorder and mental illness.
In the United States, commonly abused and misused drugs include opioids and other painkillers; illegal substances such as heroin, cocaine, methamphetamines, and hallucinogens; prescription stimulants and sedatives; marijuana; and alcohol. The distribution of marijuana is illegal under federal law. Distribution and use of marijuana for medicinal or recreational purposes are subject to individual state laws and regulations. As of June 2019, thirty-four states and several territories permit medical marijuana use. Of those states, fourteen have passed laws that allow adults to purchase marijuana and use it recreationally. Alcohol is available for purchase in all fifty states to those who meet specified age and other legal requirements. The Controlled Substances Act (1970), which was last amended in 2017, serves as the primary piece of federal drug legislation. States and municipalities also maintain their own laws related to drug possession, distribution, use, and other related matters.
Despite continuous public awareness campaigns and stiff legal penalties, drug abuse and misuse remain common in the United States. According to data published by the Substance Abuse and Mental Health Services Administration (SAMHSA), 134.7 million Americans over the age of twelve reported using illicit drugs at least once in their lives in a 2017 survey, including 51.8 million in the past year and 30.5 million in the past month. Marijuana was by far the most commonly used drug, followed by prescription painkillers, cocaine, and hallucinogens. Among survey respondents aged twelve to seventeen, 23.9 percent had used illegal drugs at least once, with 16.3 percent using within the past year and 7.9 percent within the past month. SAMHSA also reported that 2.8 percent of Americans over age twelve had an illicit drug use disorder in 2017, while 5.3 percent had alcohol dependence or an alcohol abuse disorder. As reported by the Centers for Disease Control and Prevention (CDC), 28,466 people in the United States died of a drug overdose caused by fentanyl or other synthetic narcotics (other than methadone) in 2017. The second leading cause of fatal drug overdoses was prescription opioids (17,029 deaths), followed by heroin (15,482) and cocaine (13,942).
US law bans substances that produce significant physical or psychoactive effects but have few or no legitimate medical uses. Substances with legitimate uses that have high risks of misuse are prohibited unless prescribed by a physician. Drug abuse and drug misuse are types of substance abuse characterized by a pattern of hazardous, harmful, or off-label use of illicit substances for recreational, mood-altering, or other nontherapeutic purposes. Despite decades of awareness campaigns and harsh legal penalties, drug abuse remains a major problem. Commonly abused drugs include prescription painkillers, stimulants, and sedatives; heroin, cocaine, and methamphetamines; marijuana; and alcohol. Drug abuse has significant negative effects on individuals and families. It can change a user’s brain chemistry and cause major organ damage, and it is associated with domestic violence, job loss, and arrest and imprisonment. Drug abuse also has negative effects on public health and safety. Prevention and treatment programs, high rates of hospital
visits, drug-impaired driving, and financial and compulsive crime all exert strain on public resources and services. The impact of drug abuse on the US economy—including productivity losses, hospitalization and treatment costs, and costs associated with enforcement and incarceration—was an estimated $1 trillion in 2017.
Risk Factors and Warning Signs
People use drugs for many different reasons, and drug abuse occurs in people of all ages, races and ethnicities, genders, and socioeconomic statuses. However, experts and government health agencies identify numerous risk factors that may make certain people more likely to abuse drugs. They include family dysfunction, trouble at work or school, a family history of substance abuse, an individual or family history of mental health problems, and normalized drug use in an individual’s social circles. The CDC also identifies youth high-risk substance use as a specific issue, defining it as an adolescent’s use of drugs that carries a high likelihood of causing negative health outcomes or other adverse consequences like dropping out of school, expulsion, or contact with the juvenile criminal justice system. Factors known to lead to high-risk substance abuse include a family history of drug or substance abuse, low parental involvement in the adolescent’s life, mental health problems, poor academic achievement, and disconnectedness from the school community. Teens who are the victims of previous sexual, emotional, physical, or psychological abuse are also at elevated risk, as are teens whose gender or sexual identities have been rejected by their parents or peers.
Warning signs of drug abuse cover clues and signals that a friend, family member, or loved one is using drugs. Experts frequently divide these signs into physical, behavioral, and psychological cues. Physical warning signs include bloodshot eyes; dilated pupils; changes in sleeping or eating patterns; a constant runny nose or sniffling; sudden changes in weight; and changes in speech, coordination, or balance. Behavioral signs include suspicious or secretive activity; poor performance at work or school; financial problems or a sudden need for money; run-ins with law enforcement; involvement in fights, accidents, or illegal activities; and driving under the influence. People who abuse drugs may also display an abrupt or dramatic change in friends or hobbies. Psychological cues cover warning signs such as paranoid behavior; sudden personality changes; an uncharacteristic lack of ambition or motivation; and mood swings or nervous or unstable behavior, especially when it occurs in spurts and is inconsistent with the individual’s usual disposition.
Individual and Social Impacts
Drug abuse is associated with many negative individual and familial impacts. Drug abuse can lead to long-term or permanent changes in brain chemistry as well as heart, lung, stomach, kidney, and liver problems. Intravenous drug users are also at significantly increased risk for contracting HIV/AIDS and hepatitis. Drug use by pregnant women may cause harm to the fetus or lead to birth defects. Drug abuse is also associated with child abuse and neglect, domestic violence, household financial difficulties, job loss, and arrest and imprisonment. Families can also be affected in other, more complex ways. For example, non-using parents may develop overprotective or other unhealthy relationships with their children as they seek to compensate for the behavior of the other partner. Children in households affected by drug abuse may also compensate by taking on the role of parent to their younger siblings.
On a broader societal level, drug abuse also has numerous public health, public safety, and economic impacts. The costs of drug prevention and treatment programs are high and put a significant strain on public resources. Drug abuse drains finances from the health care system, given the high rate of emergency room visits for problems associated with overdoses and adverse reactions to drugs. Drug-impaired driving persists as a major public safety issue. Law enforcement has observed a link between drug abuse and crime, noting that individuals may commit crimes because they are under the influence of drugs or are seeking money for drugs. Estimates from 2017 place the total impact of drug abuse on the American economy at $1 trillion, including productivity losses and costs associated with the hospitalization of drug abusers and the incarceration of drug offenders.
Critical Thinking Questions
Critical Thinking Questions
Do you agree that society views the use of some illegal or illicit substances as less problematic than the use of others? If so, what factors do you believe contribute to this? If you disagree, explain your reasoning. Which approach to individual treatment for drug misuse and addiction do you think would be most effective: harm reduction, abstinence, or maintenance? Why? In your opinion, are the problems of drug misuse and addiction more appropriately addressed through the criminal justice system or the health care system? Explain your answer.
Treatment, Prevention, and Policy
Approaches to treating drug abuse vary, and include measures that promote harm reduction, abstinence, and maintenance. Harm reduction endeavors to reduce or neutralize the individual health impacts of drug abuse and its broader effects on society. For example, a growing number of cities in Europe, Australia, and Canada offer safe injection sites where intravenous drug users can obtain clean needles and use drugs under the supervision of health professionals who can immediately react in the event of an overdose. Efforts to establish such sites in the United States have encountered significant pushback with federal prosecutors and others expressing concern that they would normalize drug use. Abstinence treatments aim to eliminate an individual’s drug use, either abruptly or by reducing it over time. Maintenance approaches seek to minimize unpleasant withdrawal symptoms associated with the discontinuation of addictive drugs, usually by substituting the drug of abuse with another, less harmful analog administered in controlled and carefully monitored doses.
Individuals who enter drug abuse treatment programs undergo initial case assessments that evaluate their level of addiction, the underlying causes of their drug abuse, and their medical history, personal history, family situation, employment history, academic performance, job performance, and other indicators related to past substance abuse, treatment efforts, and prognosis for recovery. Care planning also considers the individual’s frequency of drug use, level of addiction or dependence, and underlying health issues, among other factors.
Public agencies like SAMHSA offer many different types of programs meant to curtail drug abuse and provide users and addicted individuals with helpful, supportive information and resources. SAMHSA supports drug-free workplace programs, criminal and juvenile justice system services, early intervention programs for students and at-risk youth, first responder training, and extensive resource centers. Another noteworthy nationwide program is National Prescription Drug Take Back Day, sponsored by the DEA, which gives people an opportunity to safely dispose of unneeded prescription drugs in an effort to prevent their misuse and abuse. Many states and municipalities offer a myriad of locally focused drug abuse prevention and treatment programs that address regional problems and trends.
The so-called War on Drugs, first declared by President Richard Nixon (1913–1994) in 1971 in response to the countercultural movements of the 1960s, persists as a major focus of federal policy. It involves a punitive approach to drug offenses, seeking to curtail drug abuse through deterrents and stiff legal penalties. Proponents of the War on Drugs also advocate the incarceration of drug offenders over addiction treatment and other behavioral interventions. Policy analysts and social justice activists widely characterize the War on Drugs as a failure, and lawmakers have moved to introduce new approaches after decades of limited results. Legislation like the 21st Century Cures Act (2016), Comprehensive Addiction and Recovery Act (2016), and Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (2018) have begun to treat drug abuse more as a public health issue than a problem to be handled solely by law enforcement. Such policies emphasize treatment and recovery over incarceration and criminalization, which many experts believe to offer a more productive and positive path forward.
Full Text: COPYRIGHT 2019 Gale, a Cengage Company Source Citation (MLA 8th Edition) “Drug Abuse.” Gale Opposing Viewpoints Online Collection, Gale, 2019. Gale In Context: Opposing Viewpoints, https://link-gale-
com.ezproxy.snhu.edu/apps/doc/PC3021900054/OVIC?u=nhc_main&sid=OVIC&xid=3e06dcda. Accessed 12 Jan. 2020. Gale Document Number: GALE|PC3021900054