Drug Abuse




A significant portion of the population engages in drug consumption, encompassing a range of substances. From everyday items like caffeinated soft drinks and aspirin to prescribed medications, individuals across all age groups partake in these substances. Furthermore, certain substances, such as alcohol and cigarettes, are consumed by both adults and even some underage individuals, despite being legally restricted to adults only. Beyond legal boundaries, some individuals opt for illegal substances like cocaine or methamphetamine. Regrettably, a notable portion of drug users also misuse and abuse these substances, which poses a concerning issue.

Drug Abuse Defined

In drug abuse, the social and health-related costs are greater than the benefits. By this definition, much drug use is abusive.

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Social costs of drug abuse include the deterioration of relations with other persons such as failure to carry out responsibilities, arguments, abuse, lost income, and time spent in jail or drug treatment.

Health-related costs of drug use include addiction, a physiological or psychological need for the drug. Other health-related costs include diminished physiological capacity, illness, and death. In 1998, 19,277 deaths were caused by the use of illegal drugs.

Social benefits of drug use include enhanced capacity in relations with others, as with psychotropic drugs that reduce symptoms of mental illness. Health benefits of drugs include regulation of bodily functions, as with thyroid hormone that controls metabolism. Health benefits of drugs also include management of disease agents such as fungi, bacteria, or viruses. Studies show that for every passing year, life expectancy increases 3 months. Most of this increase is due to the effectiveness of drugs in treating disease.

Drug abuse is characterized by a situation where the negative social and health-related consequences outweigh any potential benefits derived from drug use. Under this definition, a considerable portion of drug consumption can be classified as abusive.

The social costs associated with drug abuse encompass a range of adverse impacts on interpersonal relationships. This includes the failure to fulfill responsibilities, engaging in arguments, experiencing abuse, losing income, and facing legal consequences, such as incarceration or compulsory drug treatment.

Health-related costs stemming from drug use primarily revolve around addiction—a condition marked by a strong physiological or psychological dependency on the substance. Additionally, drug abuse can lead to diminished physical well-being, illnesses, and even fatalities. Notably, in 1998, the use of illegal drugs was responsible for causing 19,277 deaths.

Despite the negative connotations, drug use can also offer some social and health-related benefits. For instance, certain psychotropic drugs can improve individuals’ capacity to interact with others, particularly by alleviating symptoms of mental disorders. Moreover, drugs can play a crucial role in regulating bodily functions—thyroid hormones, for example, help control metabolism. Additionally, drugs aid in managing disease agents, such as bacteria, fungi, or viruses. Extensive research indicates that the steady increase in life expectancy, with a rise of 3 months each passing year, is largely attributed to the efficacy of drugs in treating various medical conditions.

The Drug Industry

Globally, the pharmaceutical sector manufactures an extensive array of over 400,000 products. When combined with the alcohol and tobacco industries, the collective worth of the global drug trade is estimated to be in the vicinity of a trillion dollars annually. Presently, international organizations are raising concerns about the adverse effects on public health due to the extensive marketing of cigarettes to children. Additionally, there is growing alarm over the prohibitively high costs of prescription medications, which hinder impoverished nations from addressing widespread health crises, such as the acquired immunodeficiency syndrome (AIDS) pandemic.

Regulation Of Drug Use

Throughout history, regulations pertaining to the production, distribution, and consumption of alcohol, tobacco, and various drugs were largely absent until the advent of the 20th century. In contemporary times, a comprehensive framework of regulations governs the entire lifecycle of most drugs. This includes the production, marketing, distribution, and utilization of these substances. For instance, alcohol and tobacco products are subjected to taxation, and stringent legal repercussions are imposed on the use of illegal drugs.

Rates Of Drug Use And Abuse

The origins of most drug abuse can be traced back to the experimental phase of adolescents engaging with alcohol, tobacco, and other substances. In the United States, the Monitoring the Future project has been instrumental in monitoring the prevalence of alcohol, tobacco, and drug use and abuse. Notably, the rates of alcohol consumption, tobacco use, and drug experimentation have undergone changes over the years. For instance, in 2003, around 48% of high school seniors reported alcohol consumption within the past month, a decrease from the 68% reported in 1975. Similarly, marijuana use was reported by 21% of individuals in 2003, down from 27% in 1975. In terms of cigarette smoking among adolescents, the rate was 24% in 2003, compared to 37% in 1975.

In 1998, approximately 3.3 million individuals in the United States were identified as hard-core users of heroin and cocaine, with an estimated 7 million individuals potentially in need of drug treatment. Among adults, cigarette smoking remains prevalent, with 25% of adults being smokers. The gender breakdown of this statistic is roughly equal between men and women. Alcohol consumption is also widespread, with about half of individuals aged 12 and older reporting alcohol use. In terms of heavy drinking, nearly 7% of the population aged 12 and older engage in this behavior, consuming five or more drinks on at least five days per month.

Over a span of six years, deaths attributed to the abuse of illegal drugs declined from 24,000 to 19,000 between 1992 and 1998. However, other substances continue to pose significant risks. In the year 2000, alcohol abuse led to over 2,500 deaths and was a contributing factor in more than 13,000 traffic-related fatalities. Nevertheless, tobacco remains the most lethal contributor, claiming the lives of over 440,000 individuals due to smoking-related causes in 1999.

Monetary Costs Of Drug Abuse

Between 1988 and 2000, the cost of purchasing illegal drugs in the United States experienced a decline from $116 billion to $63 billion. However, the actual financial toll of drug abuse goes far beyond these figures, encompassing significant indirect costs. In the year 2000, these indirect costs reached an astonishing $167 billion annually. These indirect costs encompass a wide range of factors, including healthcare expenses (such as drug treatment, addressing violent crimes stemming from drug abuse, and managing illnesses resulting from drug-exposed infants, HIV/AIDS, and tuberculosis). Additionally, these costs account for lost productivity due to premature death, illnesses, hospitalizations, and incarceration. Further, they include other expenses like police protection, efforts to reduce drug supply, and legal fees.

It’s important to note that the indirect costs associated with alcohol abuse are one and a half times greater than those linked to illegal drug abuse. Similarly, the costs related to tobacco abuse rival those of alcohol abuse. When considering both the purchasing costs of these substances and their associated indirect costs, the combined monetary impact is immense—reaching around a trillion dollars annually. This translates to approximately $3,500 per citizen or roughly half of the federal budget.

Abuse Of Prescription Drugs

The abuse of prescription drugs has undergone a dramatic surge over the last two years, with instances of this type of abuse tripling within that time frame. In the present moment, this form of abuse has even surpassed the utilization of all illegal drugs except for marijuana. In cases of prescription drug abuse, individuals often acquire these medications through various means, such as placing orders through online platforms situated outside of the United States where regulations are comparatively lax. Additionally, a practice known as “doctor shopping” has become prevalent, wherein individuals who are not genuinely in need of the medication seek out physicians willing to prescribe drugs that aren’t suitable for their medical condition. This pattern exploits the flexibility of prescription practices and regulatory gaps to gain access to these substances for non-medical purposes.

Moral And Attitudinal Issues

Survey results reveal a distinct dichotomy in drug use patterns, divided into two contrasting groups: abstainers or occasional users, and heavy or problem users. This division has played a significant role in shaping a moral atmosphere characterized by condemnation and a lack of empathy toward those struggling with drug abuse. Consequently, this division has influenced the formulation of laws and policies surrounding drug abuse, with a pronounced emphasis on punitive measures rather than treatment and support.

This phenomenon is particularly evident when examining the response to tobacco smoking. Efforts to counter the health risks of secondhand smoke and the negative social perception associated with smoking have led to widespread bans on smoking in public places. Tobacco smokers are increasingly marginalized in society, and successful legal actions against tobacco companies for marketing hazardous products have resulted in substantial monetary settlements to state governments. These funds are intended to offset the costs linked to smoking-related issues, yet their allocation varies, including their use for balancing state budgets. It is noteworthy that tobacco sales have expanded significantly in economically disadvantaged countries where regulations are less stringent.

Policies On Illegal Drugs

Initiated in the 1980s, the War on Drugs emerged as a response to combat drug abuse issues. The primary objective was to limit the availability of illegal drugs within the United States, whether they were imported or produced domestically. To achieve this goal, measures were implemented, including the recruitment of additional law enforcement officers and the introduction of stricter penalties for drug-related offenses. The financial commitment to these initiatives reached $5.5 billion by the year 2000.

Furthermore, the War on Drugs sought to decrease the demand for illicit drugs through educational efforts and the imposition of jail sentences for drug users. It is estimated that approximately 30% of incarcerated individuals are serving sentences for drug-related convictions. While the War on Drugs yielded some reduction in drug use and abuse, its impact was modest. Moreover, the focus on supply control seems to have prompted a shift in drug preferences, with domestically manufactured substances like methamphetamine becoming more prominent choices for users, as opposed to imported drugs like cocaine.

Drug Education

Since the 1980s, drug education initiatives have predominantly targeted young people. Beginning in elementary school, programs like the 17-week Drug Abuse Resistance Education (D.A.R.E.) have been implemented with the goal of delaying the initiation of alcohol, tobacco, and drug experimentation. The underlying principle is that the later individuals start experimenting with substances, the less likely they are to develop substance abuse issues.

D.A.R.E. employs uniformed police officers as instructors in classrooms to convey the message that using alcohol, tobacco, and drugs carries adverse consequences. These officers also provide instruction on resisting peer pressure to engage in substance use. Evaluations of the D.A.R.E. program have revealed short-term benefits such as improved social skills, more negative attitudes toward drug use, and increased positive perceptions of law enforcement. However, the program’s long-term effectiveness remains unproven.

Drug Treatment Strategies

Drug treatment strategies play a crucial role in addressing the significant challenge of substance abuse. In the United States, around seven million individuals require drug treatment, yet only one million receive it annually, at a cost exceeding $6,000 per case. Many individuals cycle through multiple treatment programs in their pursuit of recovery.

Among the most renowned programs for alcohol abuse treatment is Alcoholics Anonymous (AA). AA employs the power of peer support and pressure as its primary mechanisms for assisting individuals struggling with alcohol addiction. Treatment approaches for other types of substance abuse have drawn inspiration from AA’s principles. Often, these treatments are conducted within residential facilities, utilizing resocialization as a core mechanism. The treatment process, spanning several months, involves deconstructing and rebuilding the self-concept of the individual to foster responsible adult behaviors.

Another approach to drug treatment involves administering a less addictive substance, such as methadone, to individuals addicted to more harmful drugs like heroin. The aim is to gradually reduce the dosage until the person is no longer dependent. However, this method may not always prove effective, and some drugs employed in treatment are themselves addictive. Consequently, drug treatment programs can unintentionally evolve into maintenance programs for addiction rather than offering definitive cures. Despite this, maintenance programs can offer benefits such as removing addicts from the illegal drug market and contributing to improved public health outcomes by curbing practices like needle-sharing among addicts.

Success Of Treatment

The success of drug treatment programs varies, and studies provide insights into these outcomes. In Florida, for instance, a study conducted on nine medium-intensity drug treatment programs across 26 facilities focused on individuals who had previously failed outpatient treatment. Between 1991 and 1999, nearly 19,000 individuals were admitted to these programs, with a completion rate of 53% for the 6-month programs. Among those who completed the program, 54% managed to avoid recommitment to prison or supervision after two or more years.

A similar study examined data from six treatment programs lasting between 9 and 18 months, targeting individuals with a history of extreme substance abuse and multiple failed treatments. The completion rate for this group was lower, at 30%, yet 56% of those who completed the program avoided recommitment to prison or supervision after two or more years.

In the realm of smoking cessation, a significant market has emerged due to the desire of 70% of smokers to quit. Nicotine replacement products, such as chewing gum and skin patches, are marketed by drug companies, some of which also produce tobacco products. A pill designed to reduce nicotine withdrawal symptoms has also been introduced. Research from over 50 studies involving nicotine replacement or the pill has revealed that around one-fourth of the subjects who received the drug were successful in quitting for a period of six months or longer.

The Future

Looking ahead, addressing the issue of illegal drug supply is complicated by the economic incentives for poor farmers who find it more profitable to cultivate illegal crops, such as opium poppies or coca, rather than legal ones. To combat this, government programs have offered subsidies for legal crops, while corporations have encouraged alternative livelihoods like producing clothing or crafting high-end buttons from local materials.

However, controlling illegal drug production is further complicated by the fact that those involved in processing and exporting these drugs often arm themselves and gain political control over the regions where the drugs are produced, as seen in Afghanistan and Colombia.

Domestically in the United States, challenges arise from the ease of marijuana cultivation, which can be done indoors or in various locations, and the production of methamphetamine using readily available chemicals in small mobile laboratories. Instructions for both activities are easily accessible on the internet. Moreover, some individuals find selling illegal drugs more financially rewarding than engaging in legitimate work.

A trend towards the legalization of marijuana has been emerging for years in the United States, with many states reducing penalties for possessing small amounts of the substance. Medical use of marijuana has also been legalized for conditions such as appetite stimulation in chemotherapy patients. While historical lessons from the Prohibition Laws of the 1930s highlight the challenges of curbing popular illegal behavior, the implications of legalizing previously illicit drugs like marijuana for abuse remain uncertain.

References:

  1. Bouchery, E., & Harwood, H. (2001). The economic costs of drug abuse in the United States 1992–1998 (Publication No. NCJ-190636). Washington, DC: Executive Office of the President, Office of National Drug Control Policy. Available from http://www.whitehousedrugpolicy.gov
  2. Centers for Disease Control and Prev (2002). Annual smoking-attributable mortality,  years  of  potential  life lost and economic costs—United States, 1995–1999. Morbidity and Mortality Weekly Report, 51(14), 300–303. Retrieved from http://www.cdc.gov/preview/mmwrhtml/mm5114a2.htm
  3. Florida Department of Corrections. (1999). Selected community corrections residential programs. Retrieved from http://www.dc.state.fl.us/pub/rop/rop99–06/program- html
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  6. National Institute on Alcohol Abuse and (2003). Databases. Bethesda,  MD.  Retrieved  from  http://www.niaaa.nih.gov/databases/qf.htm
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  8. Rhodes, W., Layne, , Johnson, P., & Hozik, L. (2002). What America’s users spend on illegal drugs 1988–1998. Washington, DC: Office of National Drug Control Policy. Retrieved from http://www.whitehousedrugpolicy.gov/ publications/drugfact/american_users_spend2002/
  9. Substance Abuse and Mental Health (2003).Results from the 2002 national survey on drug use and health: National findings (NHSDA Series H-22, DHHS Publication No. SMA 03-3836). Rockville, MD: Office of Applied Studies. Retrieved from http://samhsa.gov/oca/ NHSDA