If Substance Abuse Were Eliminated, What American Problems Would Disappear? 

American large family

Most people realize that heavy or lengthy substance abuse is associated with serious physical, mental, or social problems. What may not be realized, however, is the expensive and heart-breaking burden imposed on this country by alcohol or drug abuse. This is a burden borne by all Americans, either as we watch our friends or family suffer, or as our taxes increase to cover the cost of the wreckage that results.

Perhaps the most tragic aspect of injuries, illnesses, or problems arising from substance abuse is that they are 100% preventable and unnecessary. Every drunk driving accident or fatality, every cannabis-related psychotic break that lands a young person in the emergency room, every baby sick with the effects of prenatal exposure to drugs—these problems would disappear entirely. Many other personal and social problems would be reduced to much lower numbers.

A review of the many types of burdens we suffer from substance abuse might help motivate us to do more and to take more action to fight drug and alcohol use in our towns and cities. We have compiled a list of some of the most serious of these burdens.

Health Effects: Adults

The health effects of drug or alcohol abuse can impact either the person using drugs or, when the user is pregnant, their baby. Here are some of the adverse health effects of drug or alcohol abuse:

  • Heart infections or damage
  • High blood pressure or heart failure
  • Liver inflammation, infection, or failure
  • Brain damage
  • Cancers of the mouth, throat, voice box, esophagus, liver, breast, colon, and rectum
  • Strokes
  • Exposure to diseases like HIV, hepatitis B, or C

Of course, the most tragic health effect of drug or alcohol abuse is death. Every year, more than 100,000 Americans lose their lives to drug overdoses. It’s also estimated that 178,000 people die from the effects of excessive alcohol use each year. The deaths from alcohol are harder to detect, however, because in most cases, they occur more slowly.

Health Effects: Infants and Children

Woman having problem with her newborn

Alcohol and drugs can directly impact one’s health and the health of the children exposed to them. Exposure can take place prenatally or after birth due to accidental ingestion. Children are also exposed to drugs when parents manufacture, store, or sell drugs out of the home.

Prenatal exposure can result in fetal alcohol syndrome disorder (FASD) or neonatal abstinence syndrome (NAS). FASD encompasses a wide range of physical, behavioral, and cognitive impairments that result from exposure to alcohol birth. FASD effects include learning and memory problems, difficulty communicating, controlling emotions, and performing daily life skills. It’s estimated that 40,000 children a year are born with FASD.

NAS is a group of symptoms suffered by a baby exposed to drugs before birth. After birth, the baby is essentially in withdrawal from these drugs and struggles with tremors, ceaseless crying, sleep problems, seizures, and much more. Each year, more than 20,000 babies suffer from NAS.

Social Problems

As a person’s moral, mental, and physical conditions deteriorate as a result of heavy drug or alcohol use, that person has an adverse effect on their environment. The resulting problems are well-known to law enforcement and social services agencies such as foster care networks.

The National Institute on Drug Abuse notes that an estimated 65% percent of those in prison in the U.S. have active substance use disorders. Another 20% that did not meet the criteria for substance use disorder were under the influence of drugs or alcohol at the time they committed a crime.

Drug dealing sign: shoes on a pool.
Photo by RacheeLynn/Shutterstock.com
Major criminal groups transport drugs across our borders and distribute their products into our communities. Foreign and domestic criminal organizations work together to create demand for methamphetamine, fentanyl, heroin, cocaine, marijuana, and other drugs and keep a steady supply flowing in every corner of our country.

In 2022, an estimated 13,524 people lost their lives in drunk driving crashes involving a driver with an illegal blood alcohol concentration of .08 or greater. Many more have suffered injuries that may be permanent.

Children may suffer more ill effects due to parental drug or alcohol abuse than any other demographic. Many statistics illustrate the dangerous environment created by substance abuse. For example, of children one year old or younger who were removed from a home, 51% were taken into care because of a parent’s substance abuse problems. For children aged one to five years, 45% were removed from the home for this reason. Once these kids are out of the home, they are typically in care for longer periods than kids whose parents are not abusing drugs or alcohol.

Personal Problems

Substance abuse and addiction create a long list of personal difficulties. The following common problems associated with drug and alcohol abuse have been documented by the Office of Justice Programs and the U.S. Department of Health and Human Services:

  • Educational or professional failure
  • Driving while impaired and subsequent legal problems
  • Arrests and incarceration
  • Poor relationships
  • Motor vehicle accidents
  • Increased risk of death by suicide, homicide, and illness
  • Emotional and mental problems
  • Greater involvement in criminal activities
  • Involvement in gangs or prostitution

Business Problems

Substance abuse has a well-documented association with serious incidents costing many millions of dollars and resulting in the deaths of many individuals. From the book Under the Influence? Drugs and the American Work Force:

Marijuana use was implicated in the U.S.S. Nimitz accident in 1981, in which a Navy pilot crashed into the aircraft carrier's deck and destroyed several planes, resulting in damage estimates in excess of $100 million. Marijuana use was also implicated in several fatal train accidents, most notably the Conrail-Amtrak collision in 1987, in which 16 people died. Alcohol use is seen as an important cause of the Exxon Valdez catastrophe, one of the worst and most publicized oil spills in U.S. history.

The majority of Americans who suffer from substance use disorders are also employed, most of them full-time. These workers take nearly 50% more unscheduled time off and leave their jobs far more often than other workers.

Financial Losses

The total cost of substance abuse to America may well be incalculable. In 2022, the U.S. Congress Joint Economic Committee (JEC) released an analysis totaling the cost of just the opioid epidemic alone. Their analysis determined that the opioid epidemic cost $1.04 trillion in 2018, $985 billion in 2019, and nearly $1.5 trillion in 2020.

The U.S. Surgeon General estimated the cost of alcohol abuse to be an additional $249 billion each year.

What Can You Do About This Problem?

Sober activity, friends

Actually, there is plenty you can do to alleviate this burden on yourself, your neighbors, your community, and your country.

  1. Set a good example of a drug-free life with minimal alcohol use.
  2. Educate any youth you have a relationship with about the deadly dangers of drug abuse. Know the drugs youth are likely to encounter and the harms they cause and communicate honestly about each one. You can make a difference.
  3. Support drug-free and alcohol-free activities in your town, including opportunities for youth such as sports, arts, music, and dance.
  4. When a friend or family member loses control of their alcohol consumption or begins to use drugs, assist them in finding a support group or drug rehab.
  5. Support a drug-free workplace program in your business or industry. If you are aware of coworkers using drugs or drinking on the job, do your best to connect them with human resources programs designed to help them.
  6. Support programs for those who are incarcerated that are designed to help them break free from drugs and establish a drug-free life after their release.
  7. Volunteer your time in your community to distribute drug prevention and education materials.

You can probably develop many more ideas and opportunities.

Envision what life would be like in America if its population could magically be freed from this burden. Less crime, less misery, less illness, and trillions less in expenses. Now that you have imagined this drug-free world, go ahead and find real-world ways to help approach this goal right now.


  • Cancer Prevention and Heart Health — What Role Does Alcohol Play? Substance Abuse and Mental Health Services Administration, 2023. SAMHSA
  • What Are the Other Health Consequences of Drug Addiction? National Institute on Drug Abuse, 2020. NIDA
  • Deaths from Excessive Alcohol Use in the United States. Centers for Disease Control and Prevention, 2024. CDC
  • Pregnant Moms Still Drinking? 40,000 Babies Per Year With FASD. ABC News, 2010. ABC News
  • Neonatal Abstinence Syndrome (NAS). Boston Children’s Hospital, undated. Boston Children’s Hospital
  • New Framework to Curb Births of Babies Born Dependent to Drugs. National Institute for Children's Health Quality, 2024. NICHQ
  • Criminal Justice DrugFacts. National Institute on Drug Abuse, 2020. NIDA
  • 2020 National Drug Threat Assessment. Drug Enforcement Administration, 2020. DEA
  • Drunk Driving Fatality Statistics. Responsibility.org, undated. responsibility.org
  • Children Affected by Parental Substance Abuse. U.S. Department of Health and Human Services, 2023. HHS
  • Consequences of youth substance abuse. Office of Justice Programs, 1998. OJP
  • Substance Use/Misuse. Youth.gov, undated. youth.gov
  • Impact of Alcohol and Other Drug Use: Observational/Field Studies. National Institutes of Health, 1994. NIH
  • Benefits of Recovery-Ready Workplace Policies. Department of Labor, undated. DOL
  • JEC Analysis Finds Opioid Epidemic Cost U.S. Nearly $1.5 Trillion in 2020. Website of Congressman Don Beyer, 2022. beyer.House.Gov
  • Addiction and Substance Misuse Reports and Publications. Health and Human Services, 2023. HHS


Editorial Staff