If you are caught in the throes of dealing with a loved one who is struggling with a substance abuse issue, it is challenging to look at the bigger picture and consider the social problems caused by drug addiction. Drug abuse is a major public health issue that spills over into criminal justice and economics. With all of these different facets, it is no wonder this issue has been so difficult to address.
Is Drug Abuse a Social Problem?
Drug abuse is a social problem, and it is one whose face is changing with time. Researchers have traditionally observed that men have had higher rates of substance use and abuse than women. Over the past few decades, the gap has narrowed, however. Surveys conducted in the 1980s found the ratio of male to female alcohol abuse disorders was 5:1. By 2007, this gap had shrunk to 3:1.
Noted in that same study, the National Epidemiologic Survey on Alcohol and Related Conditions has published survey results of substance abuse and psychiatric disorders that found men were more than twice as likely as women to abuse drugs and 1.9 times more likely to develop a dependence on drugs.
Studies have shown women have a different experience with substance abuse than men. When women start using drugs such as alcohol, cannabis and opioids, they tend to become dependent much more quickly than men. The natural hormones produced in the ovaries, including estrogen and progesterone, may have an influence over the behavioral effects of drugs for women.
This change in the profile of the typical person using drugs has a social impact as well. Women tend to be more involved in child rearing and in the home, but they also hold down jobs and wield power in the business world. All of this is further impacted by substance abuse.
Causes and Effects of Drug Addiction
There is no single cause of drug addiction. Some people can be exposed to addictive substances and use them on a casual basis and not develop an addiction, while others can develop an addiction after just one use. No one decides they want to become an addict, and for those who do become addicted, it’s not a matter of lack of willpower.
Causes of Addiction
Several risk factors contribute to whether a particular person develops a drug addiction:
• Environmental factors play a significant role. If a person grows up in a family where they see parents or other family members using drugs, they come to understand this type of behavior as being acceptable. In a situation where family members are not using drugs but friends are involved in drug use, the likelihood of experimentation with drugs increases.
• Psychological components come into play when looking at why some people develop addictions. Researchers have not been able to determine whether there is a direct link between specific personality traits and addiction. People who have grown up without feeling they had a sense of love and security may be more likely to develop an addiction. Often, traumatic events during youth, such as physical or sexual abuse, play a role as well.
• A person who is living with a mental illness may be at a higher risk for developing an addiction. They may start using drugs or alcohol as a way to treat their symptoms through self-medicating. In the short term, the person using drugs may feel as though the drugs are offering some symptom relief. Unfortunately, the drug or alcohol use can have the opposite effect and increase the severity or symptoms of the mental illness.
• Genetics also influence whether someone becomes addicted to a substance. Once they start using drugs, the speed at which an addiction develops may be influenced by genetic traits. These inherited qualities also determine how slowly or quickly a person develops a drug addiction.
• Prenatal alcohol exposure is another cause of substance abuse. A person who has been born with one of the fetal alcohol spectrum disorders, or FASDs, will likely have permanent alcohol-related birth defects. People born with FASD are also at high risk for developing substance abuse issues.
• Age of first exposure to drugs is another risk factor for addiction. The younger a person is the first time he or she uses drugs, the more likely they are to become addicted. Drug use at a young age can have an effect on brain development, which can make a young person more susceptible to mental health issues as their addiction progresses during their lifetime.
• A person’s drug of choice has an impact on the likelihood of an addiction developing and how quickly one occurs. Addictions to marijuana and alcohol are likely to take time to develop, while addictions to other drugs such as methamphetamine, heroin or cocaine tend to develop more quickly. Withdrawal symptoms from drugs like heroin, cocaine or alcohol can be physically painful, and users are more likely to use the drug often to avoid this situation.
• The method of ingesting drugs can have a bearing on whether a person becomes addicted. Injecting or smoking allows a drug to get into the bloodstream and brain faster than taking it in a pill form. The user gets to experience a more intense high more quickly by injecting or smoking their drug of choice and also may become addicted more quickly, since the drug is introduced to the brain without being filtered by the liver or any other organs first.
Societal Problems Caused by Drug Addiction
Drug addiction is responsible for a number of problems plaguing society. It is linked to various types of crime, a strain on the health care system and lack of productivity and other problems in the workplace.
Crime and Violence
The link between drug addiction and crime is not difficult to fathom. It includes the following:
• Crimes related to abusing drugs, such as stealing money or property to get money for drugs
• Crimes related to selling or possessing drugs
• Crimes stemming from associating with others involved in illegal activity, such as organized crime or gangs
Violent crimes are associated with drug use and activity, and it is common for a person to use drugs or alcohol before committing a crime or to have been using at the time the crime was committed. The Bureau of Justice Statistics from the Department of Justice states that the U.S. correction system population includes just over 6.9 million inmates and the majority of them — nearly 4.8 million inmates — are either on probation or on parole.
Drug law violations are the most common offenses being committed. The Bureau of Justice Statistics estimates that approximately half of state and federal prisoners meet the DSM (Diagnostic and Statistical Manual for Mental Disorders) definitions for either drug dependence or abuse, and unfortunately, prison has not traditionally been the best environment to find effective treatment.
Treatment availability has improved for those presently serving sentences, but many times there are few choices in the types of programs being offered. Treatment that is available may not be of the highest quality or rigorous enough to fully address an inmate’s substance abuse and the underlying issues feeding it. Offenders who don’t receive drug abuse treatment are at higher risk of having a relapse once they are released from custody and returning to their previous criminal behavior to support their addiction. They are at higher risk for being arrested and re-sentenced to federal or state custody. Effective treatment is the best way to stop this cycle.
Drug abuse treatment could be offered in the prison system in a number of ways.
1. Start more drug court programs that focus on offering offenders the option of going to treatment instead of imposing a jail sentence. The court would follow up with offenders regularly throughout their court-imposed treatment program to ensure that the offender is clean and sober. The judge can impose the original jail sentence if the offender fails a drug test or does not comply with any of the conditions set by the court.
2. Offer treatment to offenders while they are serving their sentences, and follow up with community-based programs after their release.
3. Make attending a drug abuse treatment program regularly a condition of probation.
Dating Violence and Prescription Drugs
The results of a study conducted by the University of Michigan Addiction Research Center found there is also a connection between dating violence and prescription drugs for young people. Many youth who abuse prescription drugs do not see a link between their use for non-medical reasons and an increase in violent behavior. 575 participants between the ages of 14-24 tracked and reported their sedative and opioid use, along with incidents of any violent conflict, over 12 months.
The results of the study found that in a total of 1,262 violent occurrences, substance use had occurred immediately prior to the conflict 44 percent of the time. The study also found that men were associated with non-dating violence, while women were more often associated with violence in connection with dating relationships.
Based on the results of their study, the researchers stressed the need for helping young people learn to deal with anger and conflict in their relationships. Education on the possibility of conflict escalation when drug use is a factor was also recommended.
Higher Health Care Costs Resulting From Drug Abuse
The costs of drug and alcohol abuse — including tobacco — account for a significant percentage of health care costs. Direct spending for treatment is only one small part of this amount. The total cost to the health care system is $166 billion annually, according to the National Institute on Drug Abuse.
The health care system must deal with treating patients living with the consequences of using their drug of choice. They may be at higher risk for certain diseases or conditions due to damage caused by their substance abuse, such as certain forms of cancer, liver damage, kidney disease, HIV, stroke, hepatitis B and C and more. The longer someone is addicted, the more likely they are to develop a serious health concern, which will be more difficult — and expensive — to treat.
Increased Visits to Emergency Rooms for Acute Treatment
The Drug Abuse Warning Network, or DAWN, reports the number of drug-related emergency department visits involving illicit drugs increased by 29 percent between 2009 and 2011. During the same period, increases in visits involving legal stimulant-type drugs were noted.
In 2011, more than 125 million visits were made to emergency departments in general hospitals operating 24 hours per day across the United States. DAWN says more than five million of these visits were related to drugs, a figure representing a 100 percent increase over the previous eight years.
DAWN estimated approximately 2.5 million visits to emergency rooms were the result of medical emergencies involving either drug misuse or abuse. A visit may appear in more than one group for statistical purposes, and DAWN tracked the numbers as follows:
• 1.25 million visits involved the use of illicit drugs
• 1.24 million involved the non-medical use of prescription drugs
• 0.61 million visits involved the ingestion of drugs and alcohol
There were also more than 200,000 visits to emergency departments as the result of drug-related suicide attempts in 2011. The vast majority of these attempts involved either an over-the-counter or a prescription drug. More than 80 percent of these patients received some type of follow-up care after their visit to the emergency department.
Approximately 250,000 drug-related visits to the emergency department were from patients seeking substance abuse or detox services in 2011. Approximately 60 percent of those who sought detox obtained services based on their visit. Nearly a third of them were admitted to the hospital, and 20 percent were referred to detox and treatment services. Seven percent were transferred elsewhere.
From a cost-benefit standpoint, providing treatment to people who need it is a less expensive option than paying out on claims for more serious ailments later on. Under the Affordable Care Act, treatment of substance abuse disorders is considered an essential health benefit. Insurance companies are required to provide coverage under their plans. However, exact policy terms can vary between providers. When co-payments are high for outpatient programs, some policyholders may be discouraged from seeking the help they need.
Insurers may require policyholders or a dependent who needs substance abuse treatment to have tried at least one “round” of outpatient addiction treatment and be able to show that it was not effective before they will be approved for a residential treatment program, rather than allowing an addict, along with their doctor or other support team members, choose the type of treatment they want. When insurance companies do approve substance abuse treatment, it may only be for the minimum level of treatment available — 30 days.
Often, a 30-day program is not long enough to fully address a client’s addiction issues and they need a longer stay in rehab. A client could benefit from a 60- or 90-day stay in rehab — and the longer the stay, the better the chance of achieving long-term sobriety.
Drug abuse treatment facilities are very familiar with the coverage available from various health insurance providers, since they work with these companies regularly. The treatment centers will help clients maximize their coverage to get the help they need.
Problems in the Workplace
Drug use in the workplace is a problem that can have a major impact. Its consequences can be both far-reaching and expensive, and tend to focus on these main issues:
• Loss of productivity
• Absenteeism and/or extra sick leave
• Increased occurrences of injuries or accidents
• Increased incidents of fatal accidents
Other problems that can occur in relation to drugs in the workplace include:
• Excessive tardiness
• Low employee morale
• Increased conflict between employees and supervisors, between employees and other employees or between employees and customers
• Lower job performance
• Difficulty performing tasks
• Preoccupation with obtaining and using substances at work, interfering with focus on job duties
• Selling illicit substances to fellow employees while on company property
Some employers may think that their workplace is somehow immune to the issues caused by drugs, but this is not the case. Of the 14.8 million Americans who use illegal drugs, 70 percent are employed according to the National Council on Alcoholism and Drug Dependence (NCADD).
NCADD provided the following facts about drugs and alcohol in the workplace:
• Employees who change jobs often — have had three or more jobs within the past five years — are twice as likely to be either current or former users of illegal drugs as workers who have had two jobs or less within the same period.
• The most commonly used illegal drug by employees is marijuana. Cocaine is the second most commonly used drug. Prescription drug abuse in the workplace is on the rise.
• Employees with alcohol problems are almost three times more likely to have injury-related workplace absences than workers who do not have issues with alcohol abuse.
• Just over one-third — 35 percent — of patients who sustained an on-the-job injury were “at-risk drinkers.”
• An analysis of on-the-job fatalities revealed that more than 11 percent of those killed had been drinking.
• Federal surveys have revealed that close to one-quarter — 24 percent — of workers have reported that they have been drinking during the workday on at least one occasion during the past 12 months.
• Twenty percent of managers and workers in a number of industries and business sizes state that a fellow worker’s drinking — either on or off the job — has put their own safety or productivity in jeopardy.
Employers can deal with this issue by putting a policy in place declaring their workplace, factory or job site drug-free. There should be specific written guidelines in place for employees who are found to have a substance abuse issue, including keeping the matter confidential. Employers can help employees by putting an EAP (Employee Assistance Plan) in place or directing the employee to see treatment through their family doctor or other community resources. Specific guidelines should be put in place for employees who refuse to seek help after a reasonable amount of time, including termination.
Treating Substance Abuse is Less Costly Than Dealing With Social Costs of Ignoring the Problem
Substance abuse is a serious social problem that should be treated as a public health issue instead of criminalized. Offering treatment to addicts is an investment that pays off – for each dollar spent on treating the disease, society ends up saving an average of $7.00, according to the Robert Wood Johnson Foundation. These benefits include:
• Lower crime rates stemming from substance abuse.
• A reduction in medical expenses, since there will be fewer instances of long-term health damage stemming from drug abuse.
• Employment rates will increase due to higher participation in the labor market for addicts who have been able to get and stay sober.
• On-the-job injury claims for short- and long-term disability will be reduced.
• Costs to the justice system will be lowered, since there will be fewer offenders moving through the system for drug-related offenses and lower incarceration rates.
• Productivity in the workplace will increase.
These changes will only take place if drug addiction starts to be treated more like a public health issue and less like something to be punished. When possible, people with substance abuse issues should be encouraged to seek treatment before their behavior crosses the line to illegal activities. If you are looking for help for substance abuse, contact 12 Keys Rehab today.