Introduction
Most Americans from rural, urban, and suburban areas overwhelmingly consider drug addiction as a problem within their local community (Gramlich, 2018). The public's concern is not ill-advised since there has been a steady increase in the rate and number of fatal drug overdoses cutting across the three different community types. According to a Pew study, nine out of ten Americans in rural areas have cited drug addiction as a major or minor problem. 86% of suburban residents and 87% of urban residents have also singled out addiction as a critical issue. The drug problem in America involves many substances, but it is clear that some are more severe than others. This paper will consider the problem of opioids and alcohol in America.
Opioids
A record 63,300 Americans were reported to have died of a drug overdose in 2016 with about 52,000 dying the previous year. It represents an almost 21% increase from 2015 with preliminary reports showing that the number will be higher in 2017. The figures represent the most drug overdose deaths of any other period in American history- even more than the crack and heroin epidemic.
Opioids were directly responsible for 66% of the drug overdose deaths recorded in 2016 (Gramlich, 2018). More people died from overdosing than from pneumonia, influenza, kidney disorders, as well as firearm and motor vehicle accidents. Drug overdose deaths almost tripled between 1999 and 2014 with opioids being a significant causal factor. As a result, the life expectancy of Americans decreased in comparison to other developed countries for the first time since 1999 (Rummans et al., 2018). When looking at these numbers, it is evident that the US is in the midst of an opioid epidemic. Statistics from the Center for Disease Control and Prevention underline the deadly toll caused by opioids, and President Trump even declared it a national public health emergency (Gramlich, 2018).
The use and misuse of opioids has become prevalent today due to medical prescriptions. Earlier on, opioids were only prescribed to patients who were suffering from acute pain caused by surgery, injury, cancer, or terminal illnesses. In the 70s, opioids like hydrocodone and oxycodone were developed to help patients in relieving acute cancer pain (Rummans et al., 2018). Physicians were cautious about handing out opioid prescriptions since they feared addiction, government repercussions, and there was insufficient evidence, at the time, to support prescribing practices. Aggressive lobbying from physician and bodies like the World Health Organization led the steady expansion in opioid use recorded in the 80s (Rummans et al., 2018). Opioids were seen as an alternative to surgery and significant relief of chronic pain. This lobbying led to the reduced restrictions surrounding the acquisition and use of opioids in America. When the restrictions were lifted, opioid prescriptions increased by about 2-3 million every year from 1990 to 1995 reaching 11 million in 1999. In 2016, roughly 62 million patients had received a prescription (Rummans et al., 2018).
The actions of insurance agencies, pharmaceutical companies, government medical agencies, and retail pharmacies contributed directly to the current opioid epidemic in the US. Dentists and physicians prescribed large quantities of opioids while insurance firms and retail pharmacies charged less for large prescriptions. As a result, many patients had vast amounts of potent opioids when none or a few would have sufficed. The ready access and availability of the opioids led to dependability, and a study has shown that 80% of abusers had an opioid prescription before addiction (Rummans et al., 2018). When patients could no longer get prescription refills, they resulted in cheap and potent agents like heroin and fentanyl that are sold illegally. These drugs are highly addictive, and hence the people continued using and misusing the opioids even after the treatment period was over. The increased prescription rates contributed to the dependability and addiction issues that have led to many overdose deaths. Although the crisis was initially fuelled by prescription medication, there was an equal number of deaths due to illicit synthetic opioids.
The use of opioids impacts all sexes, ages, and socioeconomic backgrounds in society. A third of all American adults currently use some kind of opioid according to Annals of Internal Medicine (Rummans et al., 2018). More people are using prescription opioids today than are using tobacco. Considering the widespread use of tobacco and its products, the use of opioids is a clear danger that needs to be addressed. Substance abuse costs the government roughly $442 billion annually in lost productivity, healthcare, and criminal justice with the opioid crisis alone accounting for $78 billion (Rummans et al., 2018). With the increasing use of opioids, drug overdoses have become the primary cause of death for Americans below the age of 50, and a growing issue for those between ages 15-24.
Interventions
Prescription drug misuse and illicit opioids are closely linked. Many who use heroin or illegal fentanyl start with misusing opioid prescriptions. There is an urgent need to solve the crisis since it is a significant problem in American society. The president's move to declare it a national emergency is one way of intervening since it avails funds needed to help the hardest hit communities (Zolot, 2017). Fighting addiction is expensive, and hence the federal government's intervention will be a massive advantage.
Another solution would involve reducing the number of opioids produced. The DEA is proposing a reduction in the manufacture of controlled substances (Zolot, 2017). This idea may be challenging to implement since each opioid is originally designed to treat pain legally.
Alcohol
Alcoholism refers to a severe drinking pattern where an individual persistently drinks despite the apparent social, physical, and mental problems caused by alcohol (Ringold et al., 2006). It is involved with an inability to stop drinking, severe withdrawal symptoms, and increased tolerance. Individuals need higher amounts to avoid the awful effects like sweating, shaking, nausea, and anxiety that come with withdrawals. Alcoholism is a severe problem in American society today as it leads to roughly 88,000 deaths per year (Maldonado & Buffo, 2018). Alcohol-related deaths are the fourth leading causes of preventable death in the country. Understanding the dangers of alcoholism can play a significant part in reducing the mortality rate and risk of harm.
Approximately 16 million adults had an alcohol use disorder in 2014 with 5 million partaking in risky habits like binge drinking. Taking alcohol seems rather ubiquitous, but the majority of the consumption happens among a small portion of the entire drinking population. In any given year, more than half of the alcohol is consumed by 10% of the drinking population (Maldonado & Buffo, 2018). A significant number of Americans start drinking at an early age, and this poses the danger of developing dependence. Research shows that 8 million people had taken more than a few sips of alcohol between the ages of 12-20. Starting early means that they will spend long periods of their lives drinking which could lead to addiction. When people drink at a young age, they increase the likelihood of engaging in harmful behavior.
According to the Substance Abuse and Mental Health Services Administration, 7% (16.3 million) of the American population has a drinking problem with 6% considered heavy alcohol users (Maldonado & Buffo, 2018). Alcohol-related problems are prevalent among people of all ages as long as there is a heavy indulgence. These numbers show that alcohol and alcohol abuse and alcoholism are serious problems that require the society's attention.
Binge drinking is a pattern that brings the blood alcohol concentration level to 0.08g/dL and above within two hours. Binge drinking is common between the ages of 18-34 with 90% of underage drinkers engaging in the practice. Such drinkers perform poorly in school, fall back on assignments, and end up dropping out. They are also likely to engage in other destructive behaviors like assault and drunk driving. 85% of the alcohol-impaired driving cases were associated with binge drinking (Maldonado & Buffo, 2018). Alcohol leads to numerous other problems like police arrests, vandalism, and sexual crimes. Alcohol abuse and alcoholism are twice as prevalent among men than women.
Alcoholism and alcohol abuse exert a heavy toll on Americans today. The health effects of alcohol are well documented with liver cirrhosis top of the list. It also increases the chances of developing certain cancers and diseases like tuberculosis and pneumonia. Approximately 73,000 of the liver disease deaths in 2013 involved alcohol (Maldonado & Buffo, 2018). Alcohol addiction is also a serious threat since it becomes difficult to drop the habit when one becomes addicted. 30% of the traffic accidents were connected to alcohol-impaired driving. The economic impact of alcoholism reached $249 billion in 2010 in the form of medical costs and lost productivity (Maldonado & Buffo, 2018).
Intervention
One of the ways to help victims is by detoxification and acute withdrawal. It helps alcoholics since it is designed to prevent the withdrawal symptoms which can be so severe as to be life-threatening (Ringold et al., 2006). This treatment requires the patient to spend time in a facility.
There are medications to help relapsing addicts.
Group or individual counseling can also help the addict to recover and quit the habit (Ringold et al., 2006). Counseling is important because alcoholism often coexists with mental illnesses like depression.
Conclusion
The American public is increasingly concerned about the issue of drug abuse and addiction. The country has a drug problem since the substances consumed have far-reaching effects on society. Opioids are a national epidemic since they are legal prescriptions that have been turned into an addictive drug. Opioids are the leading cause of preventable deaths, and hence it is a severe problem. Alcohol is well-known as a contributor to many bad decisions and destructive behavior. These drugs cost the government billions annually as well as killing thousands, and hence interventions are necessary.
References
Gramlich, J. (2018). Many in the US say drug addiction is a major problem in their community. Retrieved from http://www.pewresearch.org/fact-tank/2018/05/30/as-fatal-overdoses-rise-many-americans-see-drug-addiction-as-a-major-problem-in-their-community/
Maldonado, E., & Buffo, J. (2018). Alcoholism & Drug Addiction Stats in the United States. Retrieved from https://www.projectknow.com/research/alcohol-and-drugs/
Ringold, S., Rynm, C., & Glass, R. (2006). Alcohol Abuse and Alcoholism. The Journal Of The American Medical Association, 295(17). doi: 10.1001/jama.295.17.2100
Rummans, T., Burton, M., & Dawson, N. (2018). How Good Intentions Contributed to Bad Outcomes: The Opioid Crisis. Mayo Clinic Proceedings, 93(3), 344-350. doi: 10.1016/j.mayocp.2017.12.020
Zolot, J. (2017). A Worsening Opioid Epidemic Prompts Action. AJN, American Journal Of Nursing, 117(10), 15. doi: 10.1097/01.naj.0000525858.52569.e6
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