Substance abuse
Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods that are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, medical, and criminal justice contexts. In some cases, criminal or anti-social behavior occurs when the person is under the influence of a drug, and long-term personality changes in individuals may also occur.[5] In addition to possible physical, social, and psychological harm, the use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.[6]
"Drug abuse" redirects here. For the album, see Drug Abuse (album).Substance abuse
Drug abuse, substance use disorder, substance misuse disorder
1,106,000 US residents (1968–2020)[4]
Drugs most often associated with this term include alcohol, amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, hallucinogens, methaqualone, and opioids. The exact cause of substance abuse is not clear, but there are two predominant theories: either a genetic predisposition or a habit learned from others, which, if addiction develops, manifests itself as a chronic debilitating disease.[8]
In 2010, about 5% of adults (230 million) used an illicit substance.[2] Of these, 27 million have high-risk drug use—otherwise known as recurrent drug use—causing harm to their health, causing psychological problems, and or causing social problems that put them at risk of those dangers.[2][3] In 2015, substance use disorders resulted in 307,400 deaths, up from 165,000 deaths in 1990.[9][10] Of these, the highest numbers are from alcohol use disorders at 137,500, opioid use disorders at 122,100 deaths, amphetamine use disorders at 12,200 deaths, and cocaine use disorders at 11,100.[9]
![Total recorded alcohol per capita consumption (15+), in litres of pure alcohol[72]](http://upload.wikimedia.org/wikipedia/commons/thumb/9/94/Alcohol_by_Country.png/461px-Alcohol_by_Country.png)
![Total yearly U.S. drug deaths[73]](http://upload.wikimedia.org/wikipedia/commons/thumb/1/1a/US_timeline._Number_of_overdose_deaths_from_all_drugs.jpg/280px-US_timeline._Number_of_overdose_deaths_from_all_drugs.jpg)
![U.S. yearly overdose deaths, and the drugs involved[64]](http://upload.wikimedia.org/wikipedia/commons/thumb/f/fa/US_timeline._Drugs_involved_in_overdose_deaths.jpg/280px-US_timeline._Drugs_involved_in_overdose_deaths.jpg)
The initiation of drug use including alcohol is most likely to occur during adolescence, and some experimentation with substances by older adolescents is common. For example, results from 2010 Monitoring the Future survey, a nationwide study on rates of substance use in the United States, show that 48.2% of 12th graders report having used an illicit drug at some point in their lives.[67] In the 30 days prior to the survey, 41.2% of 12th graders had consumed alcohol and 19.2% of 12th graders had smoked tobacco cigarettes.[67] In 2009 in the United States about 21% of high school students have taken prescription drugs without a prescription.[68] And earlier in 2002, the World Health Organization estimated that around 140 million people were alcohol dependent and another 400 million with alcohol-related problems.[69]
Studies have shown that the large majority of adolescents will phase out of drug use before it becomes problematic. Thus, although rates of overall use are high, the percentage of adolescents who meet criteria for substance abuse is significantly lower (close to 5%).[70] According UN estimates, there are "more than 50 million regular users of morphine diacetate (heroin), cocaine and synthetic drugs."[71]
More than 70,200 Americans died from drug overdoses in 2017.[64] Among these, the sharpest increase occurred among deaths related to fentanyl and synthetic opioids (28,466 deaths).[64] See charts below.
History[edit]
APA, AMA, and NCDA[edit]
In 1966, the American Medical Association's Committee on Alcoholism and Addiction defined abuse of stimulants (amphetamines, primarily) in terms of 'medical supervision':
Special populations[edit]
Immigrants and refugees[edit]
Immigrant and refugees have often been under great stress,[98] physical trauma and depression and anxiety due to separation from loved ones often characterize the pre-migration and transit phases, followed by "cultural dissonance", language barriers, racism, discrimination, economic adversity, overcrowding, social isolation, and loss of status and difficulty obtaining work and fears of deportation are common. Refugees frequently experience concerns about the health and safety of loved ones left behind and uncertainty regarding the possibility of returning to their country of origin.[99][100] For some, substance abuse functions as a coping mechanism to attempt to deal with these stressors.[100]
Immigrants and refugees may bring the substance use and abuse patterns and behaviors of their country of origin,[100] or adopt the attitudes, behaviors, and norms regarding substance use and abuse that exist within the dominant culture into which they are entering.[100][101]
Street children[edit]
Street children in many developing countries are a high-risk group for substance misuse, in particular solvent abuse.[102] Drawing on research in Kenya, Cottrell-Boyce argues that "drug use amongst street children is primarily functional—dulling the senses against the hardships of life on the street—but can also provide a link to the support structure of the 'street family' peer group as a potent symbol of shared experience."[103]
Musicians[edit]
In order to maintain high-quality performance, some musicians take chemical substances.[104] Some musicians take drugs such as alcohol to deal with the stress of performing. As a group they have a higher rate of substance abuse.[104] The most common chemical substance which is abused by pop musicians is cocaine,[104] because of its neurological effects. Stimulants like cocaine increase alertness and cause feelings of euphoria, and can therefore make the performer feel as though they in some ways 'own the stage'. One way in which substance abuse is harmful for a performer (musicians especially) is if the substance being abused is aspirated. The lungs are an important organ used by singers, and addiction to cigarettes may seriously harm the quality of their performance.[104] Smoking harms the alveoli, which are responsible for absorbing oxygen.
Veterans[edit]
Substance abuse can be a factor that affects the physical and mental health of veterans. Substance abuse may also harm personal and familial relationships, leading to financial difficulty. There is evidence to suggest that substance abuse disproportionately affects the homeless veteran population. A 2015 Florida study, which compared causes of homelessness between veterans and non-veteran populations in a self-reporting questionnaire, found that 17.8% of the homeless veteran participants attributed their homelessness to alcohol and other drug-related problems compared to just 3.7% of the non-veteran homeless group.[105]
A 2003 study found that homelessness was correlated with access to support from family/friends and services. However, this correlation was not true when comparing homeless participants who had a current substance-use disorders.[106] The U.S. Department of Veterans Affairs provides a summary of treatment options for veterans with substance-use disorder. For treatments that do not involve medication, they offer therapeutic options that focus on finding outside support groups and "looking at how substance use problems may relate to other problems such as PTSD and depression".[107]