Addiction in America

Clinically Reviewed by Claire Pinelli LADC, ICAADC, CCS, MCAP

It doesn’t matter what you call it: drug dependence, addiction or substance use disorder. The problem is essentially the same. A person has used enough of a substance to make the body and mind dependent on that substance. The physical and psychological dependence and cravings keep them tied to its use.

To a greater or lesser degree, once a person loses control of this aspect of their life, they begin to lose control of other aspects. They might begin to neglect their own health or their job or school performance. If the addiction creates mental changes, they may begin to abuse their spouse or children. Alcohol and most drugs have a severe effect on the body so their health will begin to deteriorate.

A very few people become what is sometimes referred to as “functional addicts” which means they can’t stop relying on the drug but somehow they manage to maintain a viable lifestyle.

As many people make one unethical compromise after another to maintain their access to drugs or drinks, it’s far more common for their lifestyles to deteriorate. Marriages often split up, children are taken away, jobs or businesses are lost. Those who are the worst off become homeless, end up in jail or lose their lives.

How Many Americans Suffer?

It’s terrible to think that more than 40 million of our fellow Americans struggle this way every day. Here’s how that number breaks down.

• 21.9 million have alcohol use disorder only
• 11.9 million have an illicit drug use disorder only
• 6.5 million people have an illicit drug use disorder plus an alcohol use disorder

Therefore, one in eight Americans struggles with problematic and damaging drug or alcohol abuse or both.

Polydrug Drug Use

Actually, the separation between these categories is not as clear-cut as those numbers from the Substance Abuse and Mental Health Services Administration might make you think. For example, in a report on concurrent drug use (polydrug use), SAMHSA notes that among those that used methamphetamine:

• 68.1 percent also used marijuana
• 43.7 percent also used opioids
• 32.2 percent also used cocaine
• 13.4 percent reported heavy alcohol use in the past month

To clarify the way this works, when a person arrives at a rehab or otherwise contacts medical professionals about their addiction, they may report that they are addicted to methamphetamine but also drink from time to time. Depending on the severity of the substance use, the individual may only be listed as addicted to methamphetamine.

Age Groupings

Of course, individuals with drug or alcohol problems tend to fall into specific patterns and categories. Certain ages have heavier rates of addiction. The age group from 18 to 25 is generally the most common group to struggle with drugs and alcohol. The age group from 12 to 17 is the lowest. Problems drop significantly after age 25.

Geographic Groupings

Drug and alcohol problems also vary by region. But there are so many ways to rate these problems. One way is to compare overdose death rates per 100,000 population.

In 2018, the states with the worst drug overdose death rate were:

• West Virginia
• Delaware
• Maryland
• New Hampshire

All four of these states lost more than 30 people per 100,000 population in 2018.

The best states were:

• Nebraska
• Montana
• South Dakota
• Hawaii
• Texas
• Iowa

These states all lost fewer than five people per 100,000 population.

According to the 2019 National Survey on Drug Use and Health, here are the states with the highest rates of illicit drug use:

• Vermont 21.12%
• Oregon 19.84%
• Colorado 19.24%
• District of Columbia 19.06%
• Alaska 18.87%
• Nevada 17.59%
• Rhode Island 17.35%

And the lowest rates:

• South Dakota 7.52%
• Utah 8.14%
• Wyoming 8.68%
• Texas 8.75%
• North Dakota 9.09%
• Mississippi 9.17%
• Iowa 9.17%

Recovery from Addiction

Some people manage to recover from addiction on their own. Anyone who has tried it knows that it’s an extremely difficult task. For some people, like those coming off high doses of alcohol or benzodiazepines, recovery is best started with the help of professionals. Withdrawal from alcohol or benzodiazepines often requires medical support. Professional help is always wise no matter what drug you are withdrawing from.

For most people, it takes the help of a group or professionals to make it all the way to lasting sobriety. The group could consist of other people in recovery working cooperatively and looking out for each other. Professionals could refer to the staff of a full-time residential rehab. There are many people who have needed around-the-clock supervision to ensure that they make it all the way through the cravings and lifestyle changes needed to reach stable rehabilitation.

How many drug rehab centers are there for these people? According to SAMHSA, there are more than 14,500 specialized rehabilitation centers in the U.S. SAMHSA recommends rehab programs of three months or more for the best effectiveness.

When to Choose the Support of a Specialized Rehab Facility

How can you tell the difference between a person who can get sober without the support of a rehab and one who definitely needs that support? If they promise to stop using drugs or drinking and then fail—or if they start taking action to get sober or attend meetings and then relapse or quit, they need the support of a well-rounded program.

In today’s world, there are too many deadly drugs for it to be safe to fail at recovery. There are life-threatening ailments or injuries that can be suffered as a result of heavy drinking or using drugs. A person intoxicated with drugs or alcohol is out of control of their actions and survival. That intoxication could result in an accident or an overdose. The next time this person relapses to either drugs or alcohol could be fatal.

Finding a Solution

With fewer than 15,000 rehab centers, we don’t have enough beds to support all 40 million people with a substance use disorder. There must be other measures implemented.

One of the most important aspects of a solution to this problem must be implemented at the entrance point to addiction—preventing youth and young adults from starting to use drugs or drink excessively. This means there must be more action, education and awareness created in schools, families, clubs, communities, YMCAs and similar groups, youth and sports programs.

Helping youth steer themselves onto a healthy, drug-free path will begin to reduce the number of adults that need full-fledged rehab. It will take time to see these results, but the benefits are worth the investment.

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