Hidden Impact of Substance Abuse

When you turn on the news channel or read a newspaper you might come across a title like “Bronx bust uncover packaging mill with $7.5M in drugs: authorities” or “Police arrest three people during Weslaco drug raid,” or even “Border Patrol agents bust teen with meth and black tar heroin”.

Drugs are a large problem in America today, I believe the general public would agree with that statement. Drugs can cause serious medical complications for users, and can cause emotional pain for both the abuser and related family. When people think of the effects from substance abuse the two previous examples are the most commonly brought up effects, however there are many more issues.

Substance abuse impacts health care costs, loss of productivity, costs of fighting war on drugs, and rehabilitation program costs. As a police lieutenant for the PSJA police department substance abuse has always intrigued me due to seeing the effects drug addiction has on people up close. I have seen how people that constantly use drugs have allowed them to control their lives up to the point where the drug is more important to them than food. The World Health Organization defines substance abuse as “the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs.

In 2014 the National Survey on Drug Use and Health concluded that more than 7 million Americans were battling a drug abuse disorder. The same report concluded that the highest percentage of illicit drug users were in the age range of 18 to 25 at 22%, more than 1 in every 5. The next largest age group were ages 12 to 17 stating that 11.6% of adolescents used an illicit drug in the past month. This was a surprising revelation to me, adolescents were more likely to use illicit drugs than adults aged 26 or older (8.3%).

Data that was much less shocking was that marijuana was the most commonly used illicit drug concluded from the survey. As a police officer marijuana was the most common drug we arrested individuals for, in twenty years marijuana arrests over time became a “norm.” I never arrested an individual carrying methamphetamine or heroin.

In 2014 an estimated 1.8 million adolescents around 7.4% of all adolescents in the United States had used Marijuana in the past month. 19.6% of young adults (18-25) had used Marijuana in the past month, and all three age groups had shown increases in usage rates compared to the previous year. Heroin, methamphetamine, and cocaine were all below 1% in all three age groups with the exception of cocaine use in young adults (18-25) being measured at 1.4% within the previous month. The National Institute on Drug Abuse published a 2017 study titled “Monitoring the Future (NIDA 2017).”

The goal of the survey was to collect data about the drug trends in adolescents today, the key finding in the survey was that “nearly 1 in 3 students in 12th grade has used some kind of vaping device in the past year.” Vaping devices can contain nicotine, marijuana, flavoring juices, or synthetic drugs. That same study showed that 33% of those students who used a vape pen stated they used it to smoke nicotine. Imagine a graduating class of 500 students, about 46 students of that class have smoked nicotine through a vape pen in the last year.

Vaping is certainly a trend that has become more popular in recent years and now that popularity is spreading from young adults to adolescents. Some would argue that vaping is a “safer method,” however ingesting nicotine into your body is never safe no matter what method is being used. The National Council on Alcoholism and Drug Dependence Inc. (NCADD) estimated that drug abuse costs employers $81 billion annually.

The 4 main effects of alcohol and drug abuse in the work environment are Premature death/fatal accidents, injuries/accident rates, excessive absences/sick leave, and loss of production. Being under the influence of substances in the workplace can have the same fatal impact as drunk driving, for people that work in construction, oil fields, drivers, or other professions that involve the use of heavy machinery. Fatal accidents can result from a work under the influence of alcohol or drugs, falling asleep or not being completely aware of surroundings.

The NCADD has measured that workers with alcohol or drug abuse issues were 2.7 more likely than workers without drinking problems to have injury-related absences. It’s not just those using the drugs or alcohol that are at risk, their coworkers risk of injury also rises. a worker is operating a fork lift just 30 minutes after getting high from smoking marijuana their senses might not be sharp, they could lose focus and potentially drop the heavy load they are operating causing injury or even death to their coworkers. One workers poor decision could possibly impact multiples lives, the lives of his coworker and that coworker’s family could all be affected in one incident.

NCADD statistics also report that workplace fatalities show 11% of victims having alcohol in their system at the time of death. Workers dealing with substance abuse tend to have higher absences/sick leave counts than their coworkers that don’t abuse alcohol or drugs. Substance abusers are 2.2 times more likely to request early dismal or time off, and 2.5 times more likely to have absences of eight days or more.

This may be due to serious health issues and complications stemming from substance abuse, fatigue from a long night of drinking and drug use, or possibly the worker “needing a fix” so bad that they decide to take a whole day off to fulfill their addiction. All three scenarios have the same result, lost production in the workplace this can affect the employee when they come back “needing to catch up” or their coworkers that must pick up the pace to make up for workers absence. These statistics and scenarios show that substance abuse not only affects the user but their coworkers as well.

ou may be a victim of this issue without even knowing it having to complete work for coworkers that are always absent despite constantly inviting people in your office for happy hour. The impact of substance abuse on the health care industry is financially more substantial than its lost production in the workplace impact. The estimated health care costs of tobacco ($168 billion), alcohol ($27 billion), illicit drugs ($11 billion) and prescription opioids ($26 billion) add up to $232 billion dollars annually.

The health complications from substance abuse can lead to multiple doctor visits, medication costs, and even expensive surgery to correct severe complications from substance abuse. As we begin to better understand mental health and the impact of substance abuse on mental health issues we expect to see these healthcare costs raise even higher. When a person recovers from substance abuse and all the challenges that come with it in order to better themselves and their families it is an inspiring story. These stories unfortunately are not as often as we would like, and substance abusers more likely face death than a storybook ending.

In 2016 the United States had more than 63,600 drug overdose deaths, opioid overdose deaths are five times higher in 2016 than 1999. 27 states saw statistically significant drug overdose rate increases from 2015 to 2016 (CDC) The three states with the highest drug overdose death rates are West Virginia (52 deaths per 100,000), Ohio (39.1 deaths per 100,000), and New Hampshire (39.0 deaths per 100,000). Ohio and West Virginia saw statistically significant overdose rate increases of at least 25% from 2015 to 2016. We are seeing overdose rates increase in over half of all states, not including those states where the rates were estimated to increase but not found to be statistically significant.

The knowledge of opioids and other substances is preached in schools, workplaces, churches, and even in television commercials. This knowledge may be helping to reduce the amount of users but so far it hasn’t impacted overdose rates as we would hope. The opioid epidemic is finally getting the attention it needs with national news outlets and politicians, hopefully laws can be put in place to help reduce overdose rates in the coming years. Imagine going out with your coworkers for drinks at your bar and after hours of good times you witness a man at the bar who has been heavily drinking start saying inappropriate comments to other patrons. The man is asked by the staff to leave and the man instead starts shouting and getting aggressive with a member of the staff before having to be physically escorted out of the bar. This is one example of how substance abuse can lead to aggression, the “drunk and abusive” dad role is played out quite commonly in TV shows or movies today.

In one of my personal favorite movies of all time “The Dark Knight” the iconic batman villain the joker tells batman about how he got the scars that go around the outline of his mouth. “My father was a drinker…and one night he goes off crazier than usual he takes the blade to my mouth and says let’s put a smile on that face.” It seems to be common knowledge that substance abuse, can lead to increased aggression and as a result violence. Alcohol and illicit drugs are present in both offenders and victims in many violent events. The central theme of this paper is to shine light on the far reaching impact of substance abuse on everyone in our nation. We have seen how substance abuse impacts our workplace, healthcare system, and violence.

In my opinion the most devastating impact of substance abuse is on the family members of the abuser. The people with substance abuse problems rarely recognize their problem until it starts to have a commanding presence and control over their everyday lives. Many will deny the issue if they are told they have an addiction problem by a family member or friend. The stigma of being a “druggie” or an “alcoholic” is damaging to a person’s mind and thus they insist that they don’t have a problem, or they have it “under control.” Recognizing signs of substance abuse are key to recovering or helping someone recover, recover cannot take place until the person realizes they have substance abuse issues.

Addiction symptoms include loss of control, neglecting other daily life activities, risk taking, relationship issues, secrecy, family history, tolerance, withdrawal symptoms, continued use despite negative consequences. Abusers lose control when they keep using a substance for longer doses and periods of time than they originally planned. They may lose track of time and even though they told themselves they would only use “one dose for a quick 15 minutes” 2 hours have now past and they have gone past 3 doses.

Alcohol is a substance which the amount of alcohol drank can quickly add up before the user realizes it. Other times users are aware that they have already taken the amount they planned on using but cannot control themselves and instead continue using the substance. As mentioned earlier in the impact of substance abuse on the economy, abusers can start to neglect activities such as work, school, family functions all because of “the need” to use. Alcohol and drugs affect the brains decision making processes which can have negative impacts on school and work.

We have discussed how substance abuse affects the loved ones of abusers showing just how far the impact of substance abuse reaches beyond the abuser. Some of the most common symptoms are temporary blackouts, arguments with family and friends, depression, mood swings, the need of substance use to “cheer up, sleep, cope with issues, or feel normal.” Other symptoms include using the substance in the morning or in secrecy. Drug abusers may feel ashamed about their drug use but the constant need of the substance in their life leads them to acting in ways to cover up their use such as finding isolated areas to use in order to keep their secret.

Treatment

Now that we have identified the major issues arising from substance abuse let’s explore the current treatment options for substance abusers. A survey performed from 2004-2013 by the National Survey of Drug Use and Health focused on identifying people with opioid use disorder, they were able to find 6770 respondents. The percentage of respondents receiving treatment for opioid use disorder was 16.6% from 2004-2008. There was a significant jump from 16.6% to 21.5% of users in 2009-2013 receiving some form of treatment.

Drug addiction is classified as a brain disease that affects behavior, the chemicals in drugs can cause major changes in the brain’s chemistry. The effects of substance abuse on the brain can impact a person long after they have stopped taking the drug typically months possibly even years. The chemical changes in the brain and the still present effects could cause a person to suffer a relapse even after months of sobriety. The national institute of drugs treatment principles recommended principles include “Recovery from drug addiction requires effective treatment, followed by management of the problem over time.”

Treatment is one part of the process but even the most effective treatment and long periods of abstinence will not help if the participant does not have support systems helping them to monitor and deal with the withdrawal side effects. Support groups encourage participation in treatment and can lead to higher success rates. Treatments typically last a minimum of 3 months; every person is different and substance abuse treatment lengths must be altered to fit with the observed progress of the participant. Treatments usually center around teaching the participant to break away from their old behaviors and ways of thinking, they learn how to avoid finding themselves in positions to relapse.

One treatment program I found interesting is the “Beating the Scene: A Re-Offense Prevention Program for Delinquents Suffering from Substance Use Disorders” program. The program works in 5 phases, treating it somewhat like a school course giving participants assignments to work on in group with their fellow participants. Phase 1 prepares participants in the program by helping them understand the goals of the program, allowing them to get to know their fellow participants and plan of building a pro-social network. It describes the traits of prosocial people as those who “don’t do drugs, don’t abuse alcohol, help others, are trustworthy, don’t do crime, and respect others and their opinions.” The program tries to help participants understand that they need to avoid antisocial people those whose relationships could cause harm to the participant.

Antisocial people traits include “Do drugs, abuse alcohol, commit crime, think of only themselves, don’t care for others, and can’t be trusted.” I believe that the key highlight of those is “trust” in my experiences as an officer dealing with adolescents using drugs I find that they do it in order to “gain friends or cheer themselves up.” Adolescents are still developing their own thoughts, goals, desires and they look for other individuals they trust to reaffirm their direction. In the section on substance abuse and families we see how children look up to their parents and often times follow in their footsteps, if that means using drugs they see it as a way to get “closer” to their family. So making sure they grasp the concept of prosocial people in their life is an important aspect at the beginning of the program.

Phase 2 focuses on participants becoming aware of the influences of their social network on thoughts, substance abuse, and behavior. They also understand how the type of relationship (family, friend), length, and closeness affect the strength of that relationship over decision making. Most often adolescents are introduced to a harmful substance by a family member or friend and are not alone when they first use that substance. The participants are asked to create a sociogram, a graphical representation of social links that person has to those “major relationships” in their lives. Once the network is drawn participants explore those relationships by determining the nature and quality of the relationships and determining whether that relationship is prosocial (helpful) or antisocial (harmful) to the participant. This also allows the participant to trace their substance abuse to sources of the problem such as the introduction to the substance and those promoting the use of the substance.

Antisocial people should be avoided no matter their relationship to the participant throughout the time they are in the treatment program. Once participants have identified prosocial and antisocial relationships in their current life and have a better understanding of the corresponding traits they focus on the ability to recognize prosocial people. It can be difficult for adolescents to go away from antisocial relationships that have lasted years and attempt to make new relationships with prosocial people. The program helps adolescents identify different types of places that contain prosocial people, the program makes sure to help identify these places and match them to the interests of each individual participant.

The next phases focus on helping participants see the advantages of a prosocial network, how prosocial relationships can help them “control their addiction, stay out of trouble with the law, improve work and income, maintain friendships and intimate relationships, develop new skills and interests, and attain a better quality of life. The assignment in this phase challenges participants to ask themselves “how would my life be different than it is now? Would I still abuse substances? Would I be happier?” This phase reinforces the benefits of prosocial relationships and helps participants make real life connections on how their lives could benefit from these relationships.

Phase 5 focuses on designing a prosocial network that matches the individual’s personality, needs, and preferences. The focus is on participants creating their “ideal” prosocial relationships to give them a starting point on what to look for when they start to build their network. Participants are also taught valuable social skills in order to create new prosocial relationships and are given a buddy I would like to implement a similar program into the PSJA police department for young repeat drug offenders at schools. I feel this program could be beneficial for participants as currently the amount of public abuse treatment programs for youth in our city is zero.

Drug abusers have a much higher chance of encountering legal issues, and many drug abusers are currently incarcerated due to crimes committed under the influence. If the goal of prison is truly to reform inmates to help them improve their lives than those substance abusers in prison cannot be ignored.