Illegal drug use in the U.S. and worldwide is predicted to rise by nearly 25 percent between 2018 and 2028 as industrialization, population growth and expedited urbanization fuels demand for all types of non-prescription drugs. The United Nations Office on Drugs and Crime also reports that over 220 million people have used at least one illegal drug since 2010 and that heroin and cocaine abusers comprise 0.6 percent of the world’s adult population. Each year, an estimated 200,000 people globally will die from abusing or overdosing on drugs.

The increasing rate of deaths in the US through 2016

Most Drugs are Addictive and Habit-forming

What is an SUD?

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines substance abuse disorders (SUDs) as a dependence on prescription medications or certain drugs. An SUD may be diagnosed when the dependence causes an inability for the person to “experience and fulfill normal responsibilities and activities”, such as school, family and work responsibilities. SAMHSA further states that over 21 million U.S citizens above the age of 12 could be classified as suffering an SUD at any given time.

What is an AUD?

An AUD is an alcohol use disorder characterized by continued drinking that causes harm or distress to the user and those around them. The National Institute on Alcohol Abuse and Alcoholism reports over 16 million adults and 700,000 teenagers have an AUD in the U.S. The CDC states excessive alcohol consumption causes nearly 100,000 deaths each year, making AUD the 4th leading preventable death in the U.S.

Diagnosing AUD and SUD

What are the Effects of Drugs?

Depending on whether the drug is sedative or stimulating, drugs can exert a wide range of physical and psychological effects that can have long-term consequences on your overall health. Some of these effects include:

  • Feeling anxious, paranoid or fearful for no reason
  • Severe changes in sleep and appetite/weight loss/insomnia
  • Mood swings
  • Dangerously impulsive behaviors
  • Deteriorating physical appearance/lack of interest in personal hygiene
  • Regular encounters with law enforcement
  • Inability to maintain relationships with family and friends
  • Inability to remain employed
  • Lying about drug/alcohol use
  • Stealing from family and friends to fund their addiction
  • Developing a behavioral addiction (gambling, Internet, sex)

What is an Addictive Substance?

Addiction results from any drug that abnormally influences the release of neurotransmitters in the brain implicated in motivation, reward, and pleasure (specifically dopamine, serotonin, and norepinephrine).

Substance abusers experiencing daily or near-daily drug-induced states of pleasure and arousal will ultimately be unable to resist taking drugs as tolerance builds and withdrawal symptoms make them feel physically sick, agitated and mentally unwell.

What is the Difference Between a Chemical Dependency and a Behavioral Dependency?

A chemical dependency is a physical and psychological dependence on a legal or illegal drug. Alcohol abuse may also be considered a chemical dependency. A chemical dependency often requires a medically-supervised detox process to end, otherwise, it may cause life-threatening health effects and highly increase chances of relapse. 

A behavioral dependency is a dependency on a behavior. Gambling, sex, Internet or eating addictions are considered behavioral dependencies. People become addicted to behaviors because engaging repetitively in these actions exerts the same kind of influence on the brain’s reward system that drugs do. In other words, spending all your time on the Internet or in casinos floods the brain with the same neurotransmitters involved in drug addiction. Trying to abstain from gambling or having one-night stands with strangers causes withdrawal symptoms similar to drug withdrawal symptoms.

Is There a 'Most' Addictive Substance?
Due to its ability to impact the brain’s “pleasure center” so quickly and so powerfully, heroin is considered the most addictive substance among all legal and illegal substances. When addiction scientists determine the addictive properties of any drug, five components of that drug are considered: intoxication, reinforcement, dependence, tolerance and withdrawal. Other highly addictive drugs include crack cocaine, methamphetamine and opioids.

Legal/Illicit Drugs

Alcohol and prescription drugs are legal drugs. Examples of abused prescription drugs:

  • Ativan
  • Oxycontin
  • Percocet (oxycodone with acetaminophen)
  • Vicodin (hydrocodone)
  • Codeine
  • Tramadol (opioid pain reliever)
  • Valium
  • Xanax

Examples of commonly abused, addictive illegal drugs are:

  • Marijuana (legal in some states)
  • Alcohol
  • Cocaine
  • Crystal methamphetamine
  • Bath salts, Ecstasy, synthetic marijuana and other “club” drugs
  • Heroin/fentanyl

Inhalants

Inhalants are legal substances that are abused for their psychological effects. Airplane glue, gasoline, paint thinner and paint are commonly abused inhalants.

Hallucinogens

All hallucinogens are illegal to make, grow purchase and consume (LSD, mescaline, psilocybin, peyote), but are not considered addictive because they do not act on the brain’s reward and pleasure center. Instead, hallucinogens act specifically on serotonin receptors and the amygdala, a brain organelle regulating fear and anxiety.

Statistics on Abuse of Prescription Drugs

  • In the U.S., over 50 million adolescents and adults have taken a prescription drug for a “non-medical” reason at least once in their lifetime.
  • Abused prescription medications generally come under four separate categories: painkillers (3.4 million users and abusers); tranquilizers (two million users/abusers); stimulants (nearly two million users/abusers) and sedatives (one million users/abusers).
  • More people in the U.S. report using prescription drugs than methamphetamine, heroin or cocaine.
  • Prescription drugs are only second behind marijuana in terms of illegal drug use.

Abuse of Over-the-Counter Drugs

OTC drugs are generally not addicting but they are still abused. People making methamphetamine may be said to abuse OTC drugs because they purchase certain cold medicines, specifically medications containing pseudoephedrine, which is used to make meth. Alcohol abusers may also resort to drinking mouthwash containing as high as 14 percent alcohol for antibacterial purposes. Others may combine night-time cold medicine or OTC sleeping pills with alcohol to intensify the effects of alcohol and the drug.

Drug Poisoning Deaths - Medication leading

How Does the U.S. Regulate Drugs?

The Drug Enforcement Administration (DEA) determines a drug’s potential for abuse and harmfulness by listing drugs in five different “schedules”:

Example of drug schedulesSchedule I

Drugs under this schedule have a high potential for abuse and no accepted medical use. They include heroid, LSD, cannabis, peyote and Ecstacy.

Schedule II

Schedule II drugs have a high abuse potential that could lead to severe physical or psychological dependence. They include cocaine, Dilaudid, Vicodin, Demerol, OxyContin, Adderall and fentanyl.

Schedule III

Drugs listed as Schedule III substances have a low to moderate potential for dependence. They include codeine, anabolic steroids and ketamine.

Schedule IV

Schedule IV drugs have a low abuse and dependence potential. They include Valium, Xanax, Tramadol and Ativan.

Schedule V

Schedule V drugs have the lowest potential abuse among all other scheduled drugs. Most of these drugs are used as analgesics, antitussives or antidiarrheals like Lyrica or Robitussin AC.

The Disease of Addiction

Addiction used to be viewed as a “personality flaw” that people could change if they wanted to. Ongoing research has changed that view, however, by discovering the psychobiosocial model of addiction and developing treatment modalities to address the psychological, biological and social causes of addiction.

Addiction is a disease, much like diabetes or high blood pressure are both diseases. They require professional treatment provided by addiction specialists, prescription medications to reduce cravings and ease withdrawal symptoms and proactively addressing problems before they arise. Abusing drugs is not something anyone wants to do, just like no one wishes to suffer from a chronic disease. Learn more about the Disease of Addiction

Statistics on Overdose Rates in the U.S.

Nearly 64,000 overdose deaths occurred in the U.S. in 2016. Age-adjusted rates of overdose deaths significantly increased by 22 percent from 2015 to 2016. Currently, the primary driver of deaths by drug overdose is opioids–both illegal and legal. In fact, heroin and prescription painkillers were involved in 42,000 deaths in 2016 (almost 67 percent of all overdose deaths in the U.S.).

States presenting the highest drug overdose death rates in 2016 were Ohio, West Virginia, Washington D.C, New Hampshire and Pennsylvania.

Dramatic increases in overdose death rates between 2015 to 2016 happened in the Midwest, Southern and Northeast regions of the U.S. States like Kentucky, Indiana, Rhode Island, Tennessee, Vermont, Pennsylvania and South Carolina saw unprecedented rises in drug abuse and overdose rates among 30 to 45 year old adults. State and local governments attribute the increase of drug overdose deaths to heroin laced with fentanyl and the cheap availability of over-the-counter products needed to make methamphetamine.

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