A recent study published in JAMA Psychiatry paints a bleak picture of the current state of drug addiction in the US.
Drug abuse in America always has been and always will be a hot topic. Its heavy impact on the individuals concerned, their family unit and society at large needs no explanation.
It is well known that a myriad of factors impact on an individual's propensity to abuse drugs.
An increase in unemployment, which has strong links to drug abuse, and the mass invasion of prescription opioid pain medication have all negatively influenced the arena of drug abuse in the US.
Bridget F. Grant, PhD, and her team at the National Institute on Alcohol Abuse and Alcoholism in Rockville, MD, investigated information taken from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III).
The team specifically looked in detail at the prevalence and treatment of drug use disorders (DUDs) as described in the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5).
They poured over data taken from interviews with 36,309 adults, and the study focused on amphetamine, cannabis, club drug, cocaine, hallucinogen, heroin, nonheroin opioid, sedative/tranquilizer or solvent/inhalant use disorders.
Results of the investigation showed a level of prevalence that might, to many, be surprising: 3.9% of Americans - around 9.1 million people - had a 12-month DUD diagnosis, and 9.1% had a lifetime diagnosis.
Most affected sections of society
Specific sections of society were found to have an increased rate of DUDs. The following groups were most affected:
- White and Native American individuals
- Young, and previously married or never married adults
- Those with lower income and education
- Individuals who live in the West of America.
The study also linked a number of other factors to 12-month DUDs, including:
- Major depressive disorder
- dysthymia (persistent mild depression)
- Post-traumatic stress disorder
- Personality disorders.
And, with lifetime DUDs, the following factors were added to that list:
The study found that individuals with a DUD diagnosis experienced lower social functioning, mental health and role emotional functioning.
Despite, or perhaps because of, the negative influence of DUDs on individuals, the research also found that the individual often went untreated.
Those with lifetime DUDs received treatment in 24.6% of cases; the 12-month DUDs received treatment in just 13.5% of cases. The average age of first treatment was 27.7 years, around 4 years after onset.
What can be taken from these findings?
The present study is the first of its kind since the 2013 update to the official DSM criteria for DUDs, and the update strengthened criteria for the diagnosis of DUDs. For instance, previously a diagnosis of substance abuse required only one symptom; in the updated version, a mild substance use disorder requires two to three symptoms.
The authors conclude:
"DSM-5 DUD is prevalent among US adults. The public is increasingly less likely to disapprove of specific types of drug use (e.g., marijuana) or to see it as risky, and consistent with these attitudes, laws governing drug use are becoming more permissive.
However, the present NESARC-III findings on disability and comorbidity indicate that DUDs, as defined by the new DSM-5 nosology, are serious conditions affecting many millions of Americans."
The figures presented by the study make sobering reading, and a final caveat deepens the sobriety. Grant and her team acknowledge a limitation of the study; institutionalized individuals, such as those in prisons and active military service, were not included in the research.
The authors fear that their results could, in fact, underrepresent the true number of DUDs.
They conclude their research with a call to action; the widespread nature of DUDs elucidates the need for further investigation into areas such as the estimated cost of DUDs, their etiology and the causal factors involved.
"Findings also indicate an urgent need to destigmatize DUD and educate the public, clinicians, and policymakers about its treatment to encourage affected individuals to obtain help," the researchers say.
Medical News Today recently published an article on the rise of prescription drug use in the US.