The costs are staggering. More than $700 billion is spent in the United States each year for health care problems, lost work hours, and criminal activities, all because of the prevalence and use of tobacco, alcohol, and illicit drugs. The Substance Abuse and Mental Health Services Administration (SAMHSA), located in Rockville, Maryland, was established by Congress in 1992 to reduce the growing problems, including illness, death, and costs to society that result from substance abuse.
Tobacco Use and Abuse
Until well into the twentieth century, it was considered by many a sort of badge of honor to begin smoking, to take those first puffs, to prove yourself a sophisticated adult. Now that we know tobacco to be the leading preventable cause of disability, disease, and death in the United States, the new smoker is more likely to be frowned upon or advised to go smoke some other place. ‘No Smoking’ signs are everywhere. However, the effects do not go away. The Centers for Disease Control and Prevention (CDC) lists cigarette smoking as the cause of about 480,000 premature deaths in the United States each year, which makes smoking the cause in about one in every five US deaths yearly. In addition, about 16 million Americans suffer from a serious illness caused by smoking, and another 88 million non-smokers daily inhale the secondhand smoke from others.
Alcohol Use and Abuse
Unlike tobacco, the use of alcohol is still often considered an acceptable, even sophisticated part of society, so much so that it is often difficult to determine just when too much is too much. For some people, wine or beer is regarded as a “safer” drink than whiskey or scotch. Actually, it is the amount of alcohol, not the type, that defines dependence. Wine can get you just as drunk as whiskey, but you have to drink more of it.
Five stages of alcoholism. Alcohol drinkers and abusers are usually divided into five stages:
- Binge Drinking: The drinker, often a teenager or young adult, may consume a number of drinks
at one sitting, such as five in a row for men, four for women.
- Drinking More Often: Drinking increases, often because the person is bored.
- Self-Medicating: The individual may be depressed and drinks to try to numb this feeling.
- Dependence: The need to drink begins to take over.
- Physical Addiction: The drinker has now become physically dependent, and alcohol runs his or her life.
Illicit Drug Use and Abuse
According to the World Health Organization in a survey of drug use in 17 countries, the highest level of legal and illegal drug use is in the United States. The survey included countries with less stringent drug use laws than in the US. For example, New Zealand reported a 4% use of cocaine; the figure is 16% in the United States. Men are more likely than women to use illegal drugs, and younger adults are greater users than the older population. Single adults use more tobacco and cocaine, but not more alcohol than older adults. People who make more money also spend more on those items.
Tobacco products: Smokers use products that contain nicotine, which is an addictive drug that is quickly absorbed into the bloodstream. The person who smokes one pack a day, which is 20 cigarettes, will get “hit” with 200 spikes of nicotine. Once in the bloodstream, nicotine elevates blood pressure, heart rate, and respiration. Long-term use can produce changes in the brain. The smoker may need medical treatment to ease the sleep disturbances, increased appetite, and irritability that often result with withdrawal.
Alcohol and illegal drugs: Getting rid of the need to drink or the need to use cocaine or other drugs may take a lifetime. Rehab centers around the country focus on total wellness because by the time a drinker or a user has reached the stage of alcoholism or deep dependence on an illegal drug, it may be too late. There may be many physical problems in addition to the mental and psychological needs that turn many people into addicts.