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Welcome to Our Generation USA!
This Page covers
Addictions
to nicotine, caffeine, alcohol, drugs and other substances (e.g., opioids) -- but also other forms of cultural dependency (e.g., gambling). Also included are recovery programs or groups, e.g. "Alcoholics Anonymous"
Addictions including Compulsive Behaviors (e.g., Gambling)
YouTube Video about The Betty Ford Center for Addiction Treatment*
*- The Betty Ford Center
Addiction is a brain disease that is characterized by compulsive engagement in rewarding stimuli, despite adverse consequences.
Despite the involvement of a number of psychosocial factors, a biological process – one which is induced by repeated exposure to an addictive stimulus – is the core pathology that drives the development and maintenance of an addiction.
The two properties that characterize all addictive stimuli are that they are reinforcing (i.e., they increase the likelihood that a person will seek repeated exposure to them) and intrinsically rewarding (i.e., perceived as being positive or desirable).
Addiction is a disorder of the brain's reward system which arises through transcriptional and epigenetic mechanisms and occurs over time from chronically high levels of exposure to an addictive stimulus (e.g., morphine, cocaine, sexual intercourse, gambling, etc.).
Addiction exacts a high toll on individuals and society as a whole through the direct adverse effects of drugs, associated healthcare costs, long-term complications (e.g., lung cancer with smoking tobacco, liver cirrhosis with drinking alcohol, or meth mouth from intravenous methamphetamine), the functional consequences of altered neural plasticity in the brain, and the consequent loss of productivity.
Classic hallmarks of addiction include impaired control over substances or behavior, preoccupation with substance or behavior, and continued use despite consequences. Habits and patterns associated with addiction are typically characterized by immediate gratification (short-term reward), coupled with delayed deleterious effects (long-term costs).
Examples of drug and behavioral addictions include:
The only behavioral addiction recognized by the DSM-5 is gambling addiction. The term addiction is misused frequently to refer to other compulsive behaviors or disorders, particularly dependence, in news media.
For further amplification, click on any of the following hyperlinks:
Despite the involvement of a number of psychosocial factors, a biological process – one which is induced by repeated exposure to an addictive stimulus – is the core pathology that drives the development and maintenance of an addiction.
The two properties that characterize all addictive stimuli are that they are reinforcing (i.e., they increase the likelihood that a person will seek repeated exposure to them) and intrinsically rewarding (i.e., perceived as being positive or desirable).
Addiction is a disorder of the brain's reward system which arises through transcriptional and epigenetic mechanisms and occurs over time from chronically high levels of exposure to an addictive stimulus (e.g., morphine, cocaine, sexual intercourse, gambling, etc.).
Addiction exacts a high toll on individuals and society as a whole through the direct adverse effects of drugs, associated healthcare costs, long-term complications (e.g., lung cancer with smoking tobacco, liver cirrhosis with drinking alcohol, or meth mouth from intravenous methamphetamine), the functional consequences of altered neural plasticity in the brain, and the consequent loss of productivity.
Classic hallmarks of addiction include impaired control over substances or behavior, preoccupation with substance or behavior, and continued use despite consequences. Habits and patterns associated with addiction are typically characterized by immediate gratification (short-term reward), coupled with delayed deleterious effects (long-term costs).
Examples of drug and behavioral addictions include:
- alcoholism,
- amphetamine addiction,
- cocaine addiction,
- nicotine addiction,
- opiate addiction,
- food addiction,
- gambling addiction,
- and sexual addiction.
The only behavioral addiction recognized by the DSM-5 is gambling addiction. The term addiction is misused frequently to refer to other compulsive behaviors or disorders, particularly dependence, in news media.
For further amplification, click on any of the following hyperlinks:
- Neuropsychology
- Behavioral addiction
- Risk factors
- Mechanisms
- Diagnosis
- Treatment
- Epidemiology
- Personality theories of addiction
- Notes
- References
- External links
Addictive Personality
YouTube Video: 9 Signs of an Addictive Personality
An addictive personality refers to a particular set of personality traits that make an individual predisposed to developing addictions.
This hypothesis states that there are common elements among people with varying addictions that relates to personality traits. People who are substance dependent are characterized by: a physical or psychological dependency that negatively affects their quality of life.
They are frequently connected with substance abuse; however, people with addictive personalities are also highly at risk of becoming addicted to:
Scientists have been better able to understand addictive personalities as researchers delve further into understanding the chemistry of addiction. Alan R. Lang of Florida State University, author of an addiction study prepared for the United States National Academy of Sciences, said, "If we can better identify the personality factors, they can help us devise better treatment and can open up new strategies to intervene and break the patterns of addiction.
Click on any of the following blue hyperlinks for further amplification:
This hypothesis states that there are common elements among people with varying addictions that relates to personality traits. People who are substance dependent are characterized by: a physical or psychological dependency that negatively affects their quality of life.
They are frequently connected with substance abuse; however, people with addictive personalities are also highly at risk of becoming addicted to:
- gambling,
- food,
- pornography,
- exercise,
- work,
- and codependency.
Scientists have been better able to understand addictive personalities as researchers delve further into understanding the chemistry of addiction. Alan R. Lang of Florida State University, author of an addiction study prepared for the United States National Academy of Sciences, said, "If we can better identify the personality factors, they can help us devise better treatment and can open up new strategies to intervene and break the patterns of addiction.
Click on any of the following blue hyperlinks for further amplification:
- Description
- Biopsychosocial causes
- Signs and symptoms
- Personality traits and addiction
- Common forms of addictive behavior include:
- Relation to leadership
- Treatment
- Controversy
[Your Web Host: I lost my wife to lung cancer in 2008. Tobacco addiction is awful and difficult to overcome once addicted.]
American Tobacco Industry and Their Political Lobbying
YouTube Video about the Dangers of Smoking
YouTube Video 5 Ways to Resist the Urge to Smoke by the American Lung Association
YouTube Video of How Addiction Changes Your Brain by CNN
Tobacco has a long history in the United States. An estimated 45.3 million people, or 19.3% of all adults (aged 18 years or older), in the United States smoke cigarettes in 2010.
By state, in 2010, smoking prevalence ranged from 9.1% in Utah to 26.8% in West Virginia.
By region, in 2010, smoking prevalence was highest in the Midwest (21.8%) and South (21.0%) and lowest in the West (15.9%). In 2009 46.6 million, or 20.6 percent of adults 18 and older were current smokers. Men tend to smoke more than women. In 2009 23.5 percent of men smoked compared to 17.9 percent women.
Cigarette smoking is the leading cause of preventable death in the United States, accounting for approximately 443,000 deaths, or 1 of every 5 deaths, in the United States each year. Cigarette smoking alone has cost the United States $96 billion in direct medical expenses and $97 billion in lost productivity per year or an average of $4,260 per adult smoker.
Click on any of the following blue hyperlinks for more about Tobacco use in the United States:
Tobacco Political Lobbying:
This sub-topic covers the politics of Tobacco lobbying:
Taxation: See also Cigarette taxes in the United States
Tobacco has been taxed by state governments in the United States for decades. The cumulative revenue of US tobacco taxation exceeded $32 billion in 2010, creating a major source of income for government.
The Contraband Cigarette Trafficking Act of 1978, a law which makes cigarette smuggling a felony punishable by up to 5 years in federal prison, is used to prosecute smugglers who avoid paying the taxes on cigarettes.
The proposed Stop Tobacco Smuggling in the Territories Act of 2013 (H.R. 338; 113th Congress), if it passes during the 113th United States Congress, would update the Contraband Cigarette Trafficking Act to include American Samoa, the Commonwealth of the Northern Mariana Islands, and Guam, which were previously not covered by the law.
Lobby:
In 2010, the tobacco industry spent $16.6 million on lobbyists to represent the industry to Congress.
Major big tobacco lobbying companies include (in order of U.S. market share) Philip Morris, R. J. Reynolds Tobacco Company, and Lorillard Tobacco Co. The tobacco lobby lost a chunk of its support when the U.S. National Association of Attorneys General (NAAG) filed charges against the Tobacco Institute, a tobacco industry advocacy group.
This resulted in the Tobacco Master Settlement Agreement, which forced the organization to disband and place all records on a website.
Litigation:
The lawsuits brought against various tobacco manufacturers, attempting to hold them responsible for wrongful death, injury, or medical expenses related to cigarette smoking and other tobacco use. Cases have been brought both by individual plaintiffs and by government officials, including U.S. State Attorney General. Punitive damages for the plaintiff have often been awarded as a result of a successful litigation. However, the vast majority of court decisions have been in favor of the defendant tobacco companies.
Click on any of the following blue hyperlinks for more about Tobacco Lobbying:
By state, in 2010, smoking prevalence ranged from 9.1% in Utah to 26.8% in West Virginia.
By region, in 2010, smoking prevalence was highest in the Midwest (21.8%) and South (21.0%) and lowest in the West (15.9%). In 2009 46.6 million, or 20.6 percent of adults 18 and older were current smokers. Men tend to smoke more than women. In 2009 23.5 percent of men smoked compared to 17.9 percent women.
Cigarette smoking is the leading cause of preventable death in the United States, accounting for approximately 443,000 deaths, or 1 of every 5 deaths, in the United States each year. Cigarette smoking alone has cost the United States $96 billion in direct medical expenses and $97 billion in lost productivity per year or an average of $4,260 per adult smoker.
Click on any of the following blue hyperlinks for more about Tobacco use in the United States:
- History of commercial tobacco
- Economic impact of the early tobacco industry
- Legislation
- Costs
- Companies and products
- Lobbying and organizations
- Critics
- See also:
- Prevalence of tobacco consumption#United States
- List of smoking bans in the United States
- Smoker Protection Law
- Steven C. Parrish, the Senior Vice President of Philip Morris
- C. C. Little - tobacco researcher
- Tobacco-Free Pharmacies
- Supreme Court Cases on Cigarettes, Smoking and Tobacco
Tobacco Political Lobbying:
This sub-topic covers the politics of Tobacco lobbying:
Taxation: See also Cigarette taxes in the United States
Tobacco has been taxed by state governments in the United States for decades. The cumulative revenue of US tobacco taxation exceeded $32 billion in 2010, creating a major source of income for government.
The Contraband Cigarette Trafficking Act of 1978, a law which makes cigarette smuggling a felony punishable by up to 5 years in federal prison, is used to prosecute smugglers who avoid paying the taxes on cigarettes.
The proposed Stop Tobacco Smuggling in the Territories Act of 2013 (H.R. 338; 113th Congress), if it passes during the 113th United States Congress, would update the Contraband Cigarette Trafficking Act to include American Samoa, the Commonwealth of the Northern Mariana Islands, and Guam, which were previously not covered by the law.
Lobby:
In 2010, the tobacco industry spent $16.6 million on lobbyists to represent the industry to Congress.
Major big tobacco lobbying companies include (in order of U.S. market share) Philip Morris, R. J. Reynolds Tobacco Company, and Lorillard Tobacco Co. The tobacco lobby lost a chunk of its support when the U.S. National Association of Attorneys General (NAAG) filed charges against the Tobacco Institute, a tobacco industry advocacy group.
This resulted in the Tobacco Master Settlement Agreement, which forced the organization to disband and place all records on a website.
Litigation:
The lawsuits brought against various tobacco manufacturers, attempting to hold them responsible for wrongful death, injury, or medical expenses related to cigarette smoking and other tobacco use. Cases have been brought both by individual plaintiffs and by government officials, including U.S. State Attorney General. Punitive damages for the plaintiff have often been awarded as a result of a successful litigation. However, the vast majority of court decisions have been in favor of the defendant tobacco companies.
Click on any of the following blue hyperlinks for more about Tobacco Lobbying:
- History
- See also:
- A Frank Statement
- Operation Berkshire
- Tobacco Master Settlement Agreement
- Tobacco MSA (Alabama)
- Tobacco MSA (Hawaii)
- Tobacco MSA (New York)
- Merchants of Doubt and 2014 film Merchants of Doubt based on the 2010 book.
- No-Smoking.org
- Tobacco Institute Documents-Part of Master Settlement Agreement
- UCSF Tobacco Industry Videos Collection
- UCSF Tobacco Industry Audio Recordings Collection
- State and Local Tax Revenue, Selected Years 1977-2006
Substance Abuse
YouTube Video: 6 Signs of Substance Abuse and Addiction
YouTube Video: Teen Rx Drug Addiction by CBS News
Picture Below: The Physical harm, Dependence liability, and Social harm scores were each computed from the average of three distinct ratings. The highest possible harm rating for each rating scale is 3.0.
Physical harm is the average rating of the scores for acute binge use, chronic use, and intravenous use.
Dependence liability is the average rating of the scores for intensity of pleasure, psychological dependence, and physical dependence.
Social harm is the average rating of the scores for drug intoxication, health-care costs, and other social harms.
Total harm was computed as the average of the Physical harm, Dependence liability, and Social harm scores.
Substance abuse, also known as drug abuse, is a patterned use of a drug in which the user consumes the substance in amounts or with methods which are harmful to themselves or others, and is a form of substance-related disorder.
Widely differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases criminal or anti-social behavior occurs when the person is under the influence of a drug, and long term personality changes in individuals may occur as well.
In addition to possible physical, social, and psychological harm, use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.
Drugs most often associated with this term include the following:
The exact cause of substance abuse is not clear, with the two predominant theories being: either a genetic disposition which is learned from others, or a habit which if addiction develops, manifests itself as a chronic debilitating disease.
In 2010 about 5% of people (230 million) used an illicit substance. Of these 27 million have high-risk drug use otherwise known as recurrent drug use causing harm to their health, psychological problems, or social problems or puts them at risk of those dangers.
In 2015 substance use disorders resulted in 307,400 deaths, up from 165,000 deaths in 1990. Of these, the highest numbers are from the following:
Classifications:
Public health definitions:
Public health practitioners have attempted to look at substance use from a broader perspective than the individual, emphasizing the role of society, culture, and availability. Some health professionals choose to avoid the terms alcohol or drug "abuse" in favor of language they consider more objective, such as "substance and alcohol type problems" or "harmful/problematic use" of drugs.
The Health Officers Council of British Columbia — in their 2005 policy discussion paper, A Public Health Approach to Drug Control in Canada] — has adopted a public health model of psychoactive substance use that challenges the simplistic black-and-white construction of the binary (or complementary) antonyms"use" vs. "abuse". This model explicitly recognizes a spectrum of use, ranging from beneficial use to chronic dependence.
Medical definitions:
'Drug abuse' is no longer a current medical diagnosis in either of the most used diagnostic tools in the world, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), and the World Health Organization's International Statistical Classification of Diseases (ICD).
Substance abuse has been adopted by the DSM as a blanket term to include 10 separate classes of drugs, including alcohol; caffeine; cannabis; hallucinogens; inhalants; opioids; sedatives, hypnotics, and anxiolytics; stimulants; tobacco; and other substances.
The ICD uses the term Harmful use to cover physical or psychological harm to the user from use.
Physical dependence, abuse of, and withdrawal from drugs and other miscellaneous substances is outlined in the DSM:
However, other definitions differ; they may entail psychological or physical dependence, and may focus on treatment and prevention in terms of the social consequences of substance uses.
Value Judgment:
Philip Jenkins suggests that there are two issues with the term "drug abuse". First, what constitutes a "drug" is debatable. For instance, GHB, a naturally occurring substance in the central nervous system is considered a drug, and is illegal in many countries, while nicotine is not officially considered a drug in most countries.
Second, the word "abuse" implies a recognized standard of use for any substance. Drinking an occasional glass of wine is considered acceptable in most Western countries, while drinking several bottles is seen as an abuse. Strict temperance advocates, who may or may not be religiously motivated, would see drinking even one glass as an abuse. Some groups even condemn caffeine use in any quantity.
Similarly, adopting the view that any (recreational) use of cannabis or substituted amphetamines constitutes drug abuse implies a decision made that the substance is harmful, even in minute quantities.
In the U.S., drugs have been legally classified into five categories, schedule I, II, III, IV, or V in the Controlled Substances Act. The drugs are classified on their deemed potential for abuse.
Usage of some drugs is strongly correlated. For example, the consumption of seven illicit drugs (amphetamines, cannabis, cocaine, ecstasy, legal highs, LSD, and magic mushrooms) is correlated and the Pearson correlation coefficient r>0.4 in every pair of them; consumption of cannabis is strongly correlated (r>0.5) with usage of nicotine (tobacco), heroin is correlated with cocaine (r>0.4), methadone (r>0.45), and strongly correlated with crack (r>0.5)
Drug Misuse:
Drug misuse is a term used commonly when prescription medication with sedative, anxiolytic, analgesic, or stimulant properties are used for mood alteration or intoxication ignoring the fact that overdose of such medicines can sometimes have serious adverse effects. It sometimes involves drug diversion from the individual for whom it was prescribed.
Prescription misuse has been defined differently and rather inconsistently based on status of drug prescription, the uses without a prescription, intentional use to achieve intoxicating effects, route of administration, co-ingestion with alcohol, and the presence or absence of dependence symptoms.
Chronic use of certain substances leads to a change in the central nervous system known as a 'tolerance' to the medicine such that more of the substance is needed in order to produce desired effects. With some substances, stopping or reducing use can cause withdrawal symptoms to occur, but this is highly dependent on the specific substance in question.
The rate of prescription drug use is fast overtaking illegal drug use in the United States. According to the National Institute of Drug Abuse, 7 million people were taking prescription drugs for non-medical use in 2010. Among 12th graders, non-medical prescription drug use is now second only to cannabis. "Nearly 1 in 12 high school seniors reported non-medical use of Vicodin; 1 in 20 reported such use of OxyContin." Both of these drugs contain opioids.
Avenues of obtaining prescription drugs for misuse are varied: sharing between family and friends, illegally buying medications at school or work, and often "doctor shopping" to find multiple physicians to prescribe the same medication, without knowledge of other prescribers.
Increasingly, law enforcement is holding physicians responsible for prescribing controlled substances without fully establishing patient controls, such as a patient "drug contract." Concerned physicians are educating themselves on how to identify medication-seeking behavior in their patients, and are becoming familiar with "red flags" that would alert them to potential prescription drug abuse.
Click on any of the following blue hyperlinks for more about Substance Abuse:
Widely differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases criminal or anti-social behavior occurs when the person is under the influence of a drug, and long term personality changes in individuals may occur as well.
In addition to possible physical, social, and psychological harm, use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.
Drugs most often associated with this term include the following:
- alcohol,
- cannabis,
- barbiturates,
- benzodiazepines,
- cocaine,
- methaqualone,
- opioids,
- and some substituted amphetamines.
The exact cause of substance abuse is not clear, with the two predominant theories being: either a genetic disposition which is learned from others, or a habit which if addiction develops, manifests itself as a chronic debilitating disease.
In 2010 about 5% of people (230 million) used an illicit substance. Of these 27 million have high-risk drug use otherwise known as recurrent drug use causing harm to their health, psychological problems, or social problems or puts them at risk of those dangers.
In 2015 substance use disorders resulted in 307,400 deaths, up from 165,000 deaths in 1990. Of these, the highest numbers are from the following:
- alcohol use disorders at 137,500 deaths,
- opioid use disorders at 122,100 deaths,
- amphetamine use disorders at 12,200 deaths,
- and cocaine use disorders at 11,100.
Classifications:
Public health definitions:
Public health practitioners have attempted to look at substance use from a broader perspective than the individual, emphasizing the role of society, culture, and availability. Some health professionals choose to avoid the terms alcohol or drug "abuse" in favor of language they consider more objective, such as "substance and alcohol type problems" or "harmful/problematic use" of drugs.
The Health Officers Council of British Columbia — in their 2005 policy discussion paper, A Public Health Approach to Drug Control in Canada] — has adopted a public health model of psychoactive substance use that challenges the simplistic black-and-white construction of the binary (or complementary) antonyms"use" vs. "abuse". This model explicitly recognizes a spectrum of use, ranging from beneficial use to chronic dependence.
Medical definitions:
'Drug abuse' is no longer a current medical diagnosis in either of the most used diagnostic tools in the world, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), and the World Health Organization's International Statistical Classification of Diseases (ICD).
Substance abuse has been adopted by the DSM as a blanket term to include 10 separate classes of drugs, including alcohol; caffeine; cannabis; hallucinogens; inhalants; opioids; sedatives, hypnotics, and anxiolytics; stimulants; tobacco; and other substances.
The ICD uses the term Harmful use to cover physical or psychological harm to the user from use.
Physical dependence, abuse of, and withdrawal from drugs and other miscellaneous substances is outlined in the DSM:
- When an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed. Compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped.
However, other definitions differ; they may entail psychological or physical dependence, and may focus on treatment and prevention in terms of the social consequences of substance uses.
Value Judgment:
Philip Jenkins suggests that there are two issues with the term "drug abuse". First, what constitutes a "drug" is debatable. For instance, GHB, a naturally occurring substance in the central nervous system is considered a drug, and is illegal in many countries, while nicotine is not officially considered a drug in most countries.
Second, the word "abuse" implies a recognized standard of use for any substance. Drinking an occasional glass of wine is considered acceptable in most Western countries, while drinking several bottles is seen as an abuse. Strict temperance advocates, who may or may not be religiously motivated, would see drinking even one glass as an abuse. Some groups even condemn caffeine use in any quantity.
Similarly, adopting the view that any (recreational) use of cannabis or substituted amphetamines constitutes drug abuse implies a decision made that the substance is harmful, even in minute quantities.
In the U.S., drugs have been legally classified into five categories, schedule I, II, III, IV, or V in the Controlled Substances Act. The drugs are classified on their deemed potential for abuse.
Usage of some drugs is strongly correlated. For example, the consumption of seven illicit drugs (amphetamines, cannabis, cocaine, ecstasy, legal highs, LSD, and magic mushrooms) is correlated and the Pearson correlation coefficient r>0.4 in every pair of them; consumption of cannabis is strongly correlated (r>0.5) with usage of nicotine (tobacco), heroin is correlated with cocaine (r>0.4), methadone (r>0.45), and strongly correlated with crack (r>0.5)
Drug Misuse:
Drug misuse is a term used commonly when prescription medication with sedative, anxiolytic, analgesic, or stimulant properties are used for mood alteration or intoxication ignoring the fact that overdose of such medicines can sometimes have serious adverse effects. It sometimes involves drug diversion from the individual for whom it was prescribed.
Prescription misuse has been defined differently and rather inconsistently based on status of drug prescription, the uses without a prescription, intentional use to achieve intoxicating effects, route of administration, co-ingestion with alcohol, and the presence or absence of dependence symptoms.
Chronic use of certain substances leads to a change in the central nervous system known as a 'tolerance' to the medicine such that more of the substance is needed in order to produce desired effects. With some substances, stopping or reducing use can cause withdrawal symptoms to occur, but this is highly dependent on the specific substance in question.
The rate of prescription drug use is fast overtaking illegal drug use in the United States. According to the National Institute of Drug Abuse, 7 million people were taking prescription drugs for non-medical use in 2010. Among 12th graders, non-medical prescription drug use is now second only to cannabis. "Nearly 1 in 12 high school seniors reported non-medical use of Vicodin; 1 in 20 reported such use of OxyContin." Both of these drugs contain opioids.
Avenues of obtaining prescription drugs for misuse are varied: sharing between family and friends, illegally buying medications at school or work, and often "doctor shopping" to find multiple physicians to prescribe the same medication, without knowledge of other prescribers.
Increasingly, law enforcement is holding physicians responsible for prescribing controlled substances without fully establishing patient controls, such as a patient "drug contract." Concerned physicians are educating themselves on how to identify medication-seeking behavior in their patients, and are becoming familiar with "red flags" that would alert them to potential prescription drug abuse.
Click on any of the following blue hyperlinks for more about Substance Abuse:
- Signs and symptoms
- Treatment Psychological
- Epidemiology
- History
- Society and culture
- Special populations
- See also:
- ΔFosB
- Addictive personality
- Alcohol abuse
- Combined drug intoxication
- Controlled Substances Act
- Drug addiction
- Drug overdose
- List of controlled drugs in the United Kingdom
- List of deaths from drug overdose and intoxication
- Harm reduction
- Low-threshold treatment programs
- Needle-exchange programme
- Poly drug use
- Polysubstance abuse
- Substance use disorder
- Adverse Childhood Experiences: Risk Factors for Substance Misuse and Mental Health Dr. Robert Anda of the U.S. Centers for Disease Control describes the relation between childhood adversity and later ill-health, including substance abuse (video)
- The National Institute on Drug Abuse
The Opioid Epidemic focusing on the United States
Pictured below: Overdose Deaths Involving Opioids, United States, 2000–2015. Deaths per 100,000 population.
- YouTube Video: The new face of fentanyl addiction: Kati's story
- YouTube Video: One Nation, Overdosed: Documentary On The Deadliest Drug Crisis In American History (Full) by MSNBC
- YouTube Video: Boundaries in Recovery - Betty Ford* Center
Pictured below: Overdose Deaths Involving Opioids, United States, 2000–2015. Deaths per 100,000 population.
The opioid epidemic or opioid crisis is the rapid increase in the use of prescription and non-prescription opioid drugs in the United States and Canada beginning in the late 1990s and continuing throughout the first two decades of the 2000s.
Opioids are a diverse class of moderately strong painkillers, including oxycodone (commonly sold under the trade names OxyContin and Percocet), hydrocodone (Vicodin), and a very strong painkiller, fentanyl, which is synthesized to resemble other opiates such as opium-derived morphine and heroin.
The potency and availability of these substances, despite their high risk of addiction and overdose, have made them popular both as formal medical treatments and as recreational drugs. Due to their sedative effects on the part of the brain which regulates breathing, opioids in high doses present the potential for respiratory depression, and may cause respiratory failure and death.
According to the U.S. Drug Enforcement Administration, "overdose deaths, particularly from prescription drugs and heroin, have reached epidemic levels". Nearly half of all opioid overdose deaths in 2016 involved prescription opioids. From 1999 to 2008, overdose death rates, sales, and substance abuse treatment admissions related to opioid pain relievers all increased substantially. By 2015, annual overdose deaths from heroin alone surpassed deaths from both car accidents and guns, with other opioid overdose deaths also on the rise.
Drug overdoses have since become the leading cause of death of Americans under 50, with two-thirds of those deaths from opioids. In 2016, the crisis decreased overall life expectancy of Americans for the second consecutive year.
Overall life expectancy fell from 78.7 to 78.6 years. Men were disproportionally more affected due to higher overdose death rates, with life expectancy declining from 76.3 to 76.1 years. Women’s life expectancy remained stable at 81.1 years.
In 2016, over 64,000 Americans died from overdoses, 21 percent more than the almost 53,000 in 2015. By comparison, the figure was 16,000 in 2010, and 4,000 in 1999.
While death rates varied by state, public health experts estimate that nationwide over 500,000 people could die from the epidemic over the next 10 years. In Canada, half of the overdoses were accidental, while a third was intentional. The remainder were unknown. Many of the deaths are from an extremely potent opioid, fentanyl, which is trafficked from Mexico.
The epidemic cost the United States an estimated $504 billion in 2015.
CDC director Thomas Frieden said that "America is awash in opioids; urgent action is critical." The crisis has changed moral, social, and cultural resistance to street drug alternatives such as heroin.
In March 2017, Larry Hogan, the governor of Maryland, declared a state of emergency to combat the opioid epidemic, and in July 2017 opioid addiction was cited as the "FDA's biggest crisis." On October 26, 2017, President Donald Trump concurred with his Commission's report and declared the country's opioid crisis a "public health emergency."
Click on any of the following blue hyperlinks for more about the Opioid Epidemic:
Opioids are a diverse class of moderately strong painkillers, including oxycodone (commonly sold under the trade names OxyContin and Percocet), hydrocodone (Vicodin), and a very strong painkiller, fentanyl, which is synthesized to resemble other opiates such as opium-derived morphine and heroin.
The potency and availability of these substances, despite their high risk of addiction and overdose, have made them popular both as formal medical treatments and as recreational drugs. Due to their sedative effects on the part of the brain which regulates breathing, opioids in high doses present the potential for respiratory depression, and may cause respiratory failure and death.
According to the U.S. Drug Enforcement Administration, "overdose deaths, particularly from prescription drugs and heroin, have reached epidemic levels". Nearly half of all opioid overdose deaths in 2016 involved prescription opioids. From 1999 to 2008, overdose death rates, sales, and substance abuse treatment admissions related to opioid pain relievers all increased substantially. By 2015, annual overdose deaths from heroin alone surpassed deaths from both car accidents and guns, with other opioid overdose deaths also on the rise.
Drug overdoses have since become the leading cause of death of Americans under 50, with two-thirds of those deaths from opioids. In 2016, the crisis decreased overall life expectancy of Americans for the second consecutive year.
Overall life expectancy fell from 78.7 to 78.6 years. Men were disproportionally more affected due to higher overdose death rates, with life expectancy declining from 76.3 to 76.1 years. Women’s life expectancy remained stable at 81.1 years.
In 2016, over 64,000 Americans died from overdoses, 21 percent more than the almost 53,000 in 2015. By comparison, the figure was 16,000 in 2010, and 4,000 in 1999.
While death rates varied by state, public health experts estimate that nationwide over 500,000 people could die from the epidemic over the next 10 years. In Canada, half of the overdoses were accidental, while a third was intentional. The remainder were unknown. Many of the deaths are from an extremely potent opioid, fentanyl, which is trafficked from Mexico.
The epidemic cost the United States an estimated $504 billion in 2015.
CDC director Thomas Frieden said that "America is awash in opioids; urgent action is critical." The crisis has changed moral, social, and cultural resistance to street drug alternatives such as heroin.
In March 2017, Larry Hogan, the governor of Maryland, declared a state of emergency to combat the opioid epidemic, and in July 2017 opioid addiction was cited as the "FDA's biggest crisis." On October 26, 2017, President Donald Trump concurred with his Commission's report and declared the country's opioid crisis a "public health emergency."
Click on any of the following blue hyperlinks for more about the Opioid Epidemic:
Alcoholism, Alcohol Abuse and Alcohol Dependence
YouTube Video of the Effects of Binge Drinking by CDC
YouTube Video: Why Does Alcoholics Anonymous Work?
Alcoholism:
Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems. The disorder was previously divided into two types: alcohol abuse and alcohol dependence: see later herein for each.
In a medical context, alcoholism is said to exist when two or more of the following conditions are present: a person drinks large amounts over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.
Risky situations include drinking and driving or having unsafe sex, among other things. Alcohol use can affect all parts of the body, but it particularly affects the brain, heart, liver, pancreas and immune system.This can result in mental illness, Wernicke–Korsakoff syndrome, irregular heartbeat, liver cirrhosis and increased cancer risk, among other diseases. Drinking during pregnancy can cause damage to the baby resulting in fetal alcohol spectrum disorders.
Women are generally more sensitive than men to the harmful physical and mental effects of alcohol.
Environmental factors and genetics are two components associated with alcoholism, with about half the risk attributed to each. Someone with a parent or sibling with alcoholism is three to four times more likely to become an alcoholic themselves. Environmental factors include social, cultural and behavioral influences. High stress levels and anxiety, as well as alcohol's inexpensive cost and easy accessibility, increase the risk.
People may continue to drink partly to prevent or improve symptoms of withdrawal. After a person stops drinking alcohol, they may experience a low level of withdrawal lasting for months.
Medically, alcoholism is considered both a physical and mental illness. Questionnaires and certain blood tests may both detect people with possible alcoholism. Further information is then collected to confirm the diagnosis.
Prevention of alcoholism may be attempted by regulating and limiting the sale of alcohol, taxing alcohol to increase its cost, and providing inexpensive treatment. Treatment may take several steps. Due to medical problems that can occur during withdrawal, alcohol detoxification should be carefully controlled.
One common method involves the use of benzodiazepine medications, such as diazepam. These can be either given while admitted to a health care institution or occasionally while a person remains in the community with close supervision.
Mental illness or other addictions may complicate treatment. After detoxification, support such as group therapy or support groups are used to help keep a person from returning to drinking. One commonly used form of support is the group Alcoholics Anonymous.(See above YouTube Video) The medications acamprosate, disulfiram or naltrexone may also be used to help prevent further drinking.
The World Health Organization estimates that as of 2010 there were 208 million people with alcoholism worldwide (4.1% of the population over 15 years of age).
In the United States, about 17 million (7%) of adults and 0.7 million (2.8%) of those age 12 to 17 years of age are affected. It is more common among males and young adults, becoming less common in middle and old age.
It is the least common in Africa, at 1.1%, and has the highest rates in Eastern Europe, at 11%. Alcoholism directly resulted in 139,000 deaths in 2013, up from 112,000 deaths in 1990.
A total of 3.3 million deaths (5.9% of all deaths) are believed to be due to alcohol. It often reduces a person's life expectancy by around ten years.
In the United States, it resulted in economic costs of $224 billion USD in 2006. Many terms, some insulting and others informal, have been used to refer to people affected by alcoholism; the expressions include tippler, drunkard, dipsomaniac and souse. In 1979, the World Health Organization discouraged the use of "alcoholism" due to its inexact meaning, preferring "alcohol dependence syndrome".
Click on any of the following blue hyperlinks for more about alcoholism:
Alcohol abuse encompasses a spectrum of unhealthy alcohol drinking behaviors, ranging from risky drinking to alcohol abuse to alcohol dependence. This includes binge drinking and alcohol dependence. It is a psychiatric diagnosis as classified by DSM-5 (DSM-5).
Globally, alcohol consumption is the seventh leading risk factor for both death and the burden of disease and injury. In short, except for tobacco, alcohol accounts for a higher burden of disease than any other drug.
Alcohol use is a major cause of preventable liver disease worldwide, and alcoholic liver disease is the main alcohol-related chronic medical illness. Millions of men and women of all ages, from adolescents to the elderly, engage in unhealthy drinking in the United States. AUD reportedly most often affects young men (aged 18-24 years) of lower socioeconomic status.
There are two types of alcohol abuse, those who have anti-social and pleasure-seeking tendencies, and those who are anxiety-ridden people who are able to go without drinking for long periods of time but are unable to control themselves once they start.
Alcoholism Definitions:
Main article: Binge drinking
Risky drinking (also called hazardous drinking) is defined by drinking above the recommended limits:
Binge drinking is a pattern of alcohol consumption that brings blood alcohol concentration ≥ 0.08%, usually corresponds to
A patient meets criteria for the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of alcohol use disorder if ≥ 2 of the following behaviors or symptoms have been present within the past 12 months:
Alcohol misuse is a term used by United States Preventive Services Task Force to describe a spectrum of drinking behaviors that encompass risky drinking, alcohol abuse, and alcohol dependence (similar meaning to alcohol use disorder but not a term used in DSM).
In medical care, alcohol abuse and alcohol dependence were used as distinct disorders from 1994 to 2013. After the publication of DSM-5 in 2013, the disorders were all categorized under alcohol use disorder. The DSM-5 combines those two disorders into one alcohol use disorder with sub-classifications of severity. The DSM-IV definition is no longer used. There is no "alcoholism" diagnosis in medical care.
Tolerance is the need for increased amounts of alcohol to achieve the same effect.
A smaller volume of consumed alcohol has a greater impact on the older adult than it does on a younger individual. As a result, the American Geriatrics Society recommends for an older adult with no known risk factors less than one drink a day or fewer than two drinks per occasion regardless of gender.
Signs and Symptoms:
Main article: Long-term effects of alcohol
Individuals with an alcohol use disorder will often complain of difficulty with interpersonal relationships, problems at work or school, and legal problems. Additionally, people may complain of irritability and insomnia. Alcohol abuse is also an important cause of chronic fatigue.
Signs of alcohol abuse are related to alcohol's effects on organ systems. However, while these findings are often present, they are not necessary to make a diagnosis of alcohol abuse. Signs of alcohol abuse show its drastic effects on the central nervous system, including inebriation and poor judgment; chronic anxiety, irritability, and insomnia.
Alcohol's effects on the liver include elevated liver function tests (classically AST is at least twice as high as ALT). Prolonged use leads to cirrhosis and liver failure. With cirrhosis, patients develop an inability to process hormones and toxins.
The skin of a patient with alcoholic cirrhosis can feature cherry angiomas, palmar erythema and — in acute liver failure — jaundice and ascites. The derangements of the endocrine system lead to the enlargement of the male breasts. The inability to process toxins leads to liver disease, such as hepatic encephalopathy.
Alcohol abuse can result in brain damage which causes impairments in executive functioning such as impairments to working memory, visuospatial skills, and can cause an abnormal personality as well as affective disorders to develop.
Binge drinking is associated with individuals reporting fair to poor health compared to non-binge drinking individuals and which may progressively worsen over time. Alcohol also causes impairment in a person's critical thinking.
A person's ability to reason in stressful situations is compromised, and they seem very inattentive to what is going on around them. Social skills are significantly impaired in people suffering from alcoholism due to the neurotoxic effects of alcohol on the brain, especially the prefrontal cortex area of the brain.
The social skills that are impaired by alcohol abuse include impairments in perceiving facial emotions, difficulty with perceiving vocal emotions and theory of mind deficits; the ability to understand humor is also impaired in alcohol abusers. Adolescent binge drinkers are most sensitive to damaging neurocognitive functions especially executive functions and memory.
People who abuse alcohol are less likely to survive critical illness with a higher risk for having sepsis and were more likely to die during hospitalization.
Violence:
Alcohol abuse is significantly associated with suicide and violence. Alcohol is the most significant health concern in Native American communities because of very high rates of alcohol dependence and abuse; up to 80 percent of suicides and 60 percent of violent acts are a result of alcohol abuse in Native American communities.
In the United States alcohol-related violence is related to more severe injuries and chronic cases.
Pregnancy:
Alcohol abuse among pregnant women causes their baby to develop fetal alcohol syndrome. Fetal alcohol syndrome is the pattern of physical abnormalities and the impairment of mental development which is seen with increasing frequency among children with alcoholic mothers.
Alcohol exposure in a developing fetus can result in slowed development of the fetal brain, resulting in severe retardation or death. Surviving infants may suffer severe abnormalities such as abnormal eyes, fissures, lips and incomplete cerebella.
Some infants may develop lung disease. It is even possible that the baby throughout pregnancy will develop heart defects such as ventricular septal defect or atrial septal defect. Experts suggest that pregnant women take no more than one unit of alcohol per day. However, other organizations advise complete abstinence from alcohol while pregnant
Adolescence:
Adolescence and the onset of puberty have both a physiological and social impact on a developing person. About half of grade 12 students have been drunk, and a third binge drink.
About 3% drink every day. One of these social impacts is the increase in risk-taking behaviors, such as the emergence of alcohol use. Children aged 16 and under who consume alcohol heavily display symptoms of conduct disorder. Its symptoms include troublesome behaviour in school, constantly lying, learning disabilities and social impairments.
Alcohol abuse during adolescence greatly increases the risk of developing an alcohol use disorder in adulthood due to changes to neurocircuitry that alcohol abuse causes in the vulnerable adolescent brain. Younger ages of initial consumption among males in recent studies has shown to be associated with increased rates of alcohol abuse within the general population.
Societal inequalities (among other factors) have influenced an adolescents decision to consume alcohol. One study suggests that girls were scrutinized for "drinking like men", whereas magazines that target the male population sent underlying messages to boys and or men that drinking alcohol was "masculine". (Bogren, 2010).
Click on any of the following blue hyperlinks for more about Alcohol Abuse:
Alcohol dependence:
Alcohol dependence is a previous psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol (also known formally as ethanol).
In 2013 it was reclassified as alcohol use disorder, or alcoholism along with alcohol abuse in DSM-5.
Click on any of the following blue hyperlinks for more about Alcohol Dependence:
Alcoholism, also known as alcohol use disorder (AUD), is a broad term for any drinking of alcohol that results in mental or physical health problems. The disorder was previously divided into two types: alcohol abuse and alcohol dependence: see later herein for each.
In a medical context, alcoholism is said to exist when two or more of the following conditions are present: a person drinks large amounts over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.
Risky situations include drinking and driving or having unsafe sex, among other things. Alcohol use can affect all parts of the body, but it particularly affects the brain, heart, liver, pancreas and immune system.This can result in mental illness, Wernicke–Korsakoff syndrome, irregular heartbeat, liver cirrhosis and increased cancer risk, among other diseases. Drinking during pregnancy can cause damage to the baby resulting in fetal alcohol spectrum disorders.
Women are generally more sensitive than men to the harmful physical and mental effects of alcohol.
Environmental factors and genetics are two components associated with alcoholism, with about half the risk attributed to each. Someone with a parent or sibling with alcoholism is three to four times more likely to become an alcoholic themselves. Environmental factors include social, cultural and behavioral influences. High stress levels and anxiety, as well as alcohol's inexpensive cost and easy accessibility, increase the risk.
People may continue to drink partly to prevent or improve symptoms of withdrawal. After a person stops drinking alcohol, they may experience a low level of withdrawal lasting for months.
Medically, alcoholism is considered both a physical and mental illness. Questionnaires and certain blood tests may both detect people with possible alcoholism. Further information is then collected to confirm the diagnosis.
Prevention of alcoholism may be attempted by regulating and limiting the sale of alcohol, taxing alcohol to increase its cost, and providing inexpensive treatment. Treatment may take several steps. Due to medical problems that can occur during withdrawal, alcohol detoxification should be carefully controlled.
One common method involves the use of benzodiazepine medications, such as diazepam. These can be either given while admitted to a health care institution or occasionally while a person remains in the community with close supervision.
Mental illness or other addictions may complicate treatment. After detoxification, support such as group therapy or support groups are used to help keep a person from returning to drinking. One commonly used form of support is the group Alcoholics Anonymous.(See above YouTube Video) The medications acamprosate, disulfiram or naltrexone may also be used to help prevent further drinking.
The World Health Organization estimates that as of 2010 there were 208 million people with alcoholism worldwide (4.1% of the population over 15 years of age).
In the United States, about 17 million (7%) of adults and 0.7 million (2.8%) of those age 12 to 17 years of age are affected. It is more common among males and young adults, becoming less common in middle and old age.
It is the least common in Africa, at 1.1%, and has the highest rates in Eastern Europe, at 11%. Alcoholism directly resulted in 139,000 deaths in 2013, up from 112,000 deaths in 1990.
A total of 3.3 million deaths (5.9% of all deaths) are believed to be due to alcohol. It often reduces a person's life expectancy by around ten years.
In the United States, it resulted in economic costs of $224 billion USD in 2006. Many terms, some insulting and others informal, have been used to refer to people affected by alcoholism; the expressions include tippler, drunkard, dipsomaniac and souse. In 1979, the World Health Organization discouraged the use of "alcoholism" due to its inexact meaning, preferring "alcohol dependence syndrome".
Click on any of the following blue hyperlinks for more about alcoholism:
- Signs and symptoms
- Causes
- Diagnosis
- Prevention
- Management
- Epidemiology
- Prognosis
- History
- Society and culture
- Research
- See also:
Alcohol abuse encompasses a spectrum of unhealthy alcohol drinking behaviors, ranging from risky drinking to alcohol abuse to alcohol dependence. This includes binge drinking and alcohol dependence. It is a psychiatric diagnosis as classified by DSM-5 (DSM-5).
Globally, alcohol consumption is the seventh leading risk factor for both death and the burden of disease and injury. In short, except for tobacco, alcohol accounts for a higher burden of disease than any other drug.
Alcohol use is a major cause of preventable liver disease worldwide, and alcoholic liver disease is the main alcohol-related chronic medical illness. Millions of men and women of all ages, from adolescents to the elderly, engage in unhealthy drinking in the United States. AUD reportedly most often affects young men (aged 18-24 years) of lower socioeconomic status.
There are two types of alcohol abuse, those who have anti-social and pleasure-seeking tendencies, and those who are anxiety-ridden people who are able to go without drinking for long periods of time but are unable to control themselves once they start.
Alcoholism Definitions:
Main article: Binge drinking
Risky drinking (also called hazardous drinking) is defined by drinking above the recommended limits:
- greater than 14 standard drinks units per week or greater than 4 standard drinks on a single occasion in men
- greater than 7 standard drinks units per week or greater than 3 standard drinks on a single occasion in women
- any drinking in pregnant women or persons < 21 years old
Binge drinking is a pattern of alcohol consumption that brings blood alcohol concentration ≥ 0.08%, usually corresponds to
- ≥ 5 standard drinks on a single occasion in men
- ≥ 4 standard drinks on a single occasion in women
A patient meets criteria for the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnosis of alcohol use disorder if ≥ 2 of the following behaviors or symptoms have been present within the past 12 months:
- drinking more or longer than intended
- more than once wanting to cut down or stop drinking and tried but unsuccessful
- spending a lot of time drinking or being sick/getting over the after-effects
- wanting a drink so badly it precluded all other thoughts
- often having drinking (or after-effects of drinking) interfere with major responsibilities or obligations including those of home, family, job, or school
- continuing to drink despite it causing trouble with family or friends
- giving up or cutting back on important/interesting/pleasurable activities in order to drink
- more than once, drinking in situations in which it was physically hazardous (including swimming, operating machinery, walking in dangerous area, or having unsafe sex)
- continuing to drink despite knowledge of having persistent or recurrent physical or psychological problems exacerbated by alcohol use
- noticing a need for increased amounts of alcohol to achieve intoxication or desired effect, or a diminished effect with continued use of the same amount of alcohol
- noticing withdrawal symptoms while alcohol effects are wearing off, including trouble sleeping, shakiness, restlessness, nausea, sweating, racing heart, seizure, or sensed things that were not there
Alcohol misuse is a term used by United States Preventive Services Task Force to describe a spectrum of drinking behaviors that encompass risky drinking, alcohol abuse, and alcohol dependence (similar meaning to alcohol use disorder but not a term used in DSM).
In medical care, alcohol abuse and alcohol dependence were used as distinct disorders from 1994 to 2013. After the publication of DSM-5 in 2013, the disorders were all categorized under alcohol use disorder. The DSM-5 combines those two disorders into one alcohol use disorder with sub-classifications of severity. The DSM-IV definition is no longer used. There is no "alcoholism" diagnosis in medical care.
Tolerance is the need for increased amounts of alcohol to achieve the same effect.
A smaller volume of consumed alcohol has a greater impact on the older adult than it does on a younger individual. As a result, the American Geriatrics Society recommends for an older adult with no known risk factors less than one drink a day or fewer than two drinks per occasion regardless of gender.
Signs and Symptoms:
Main article: Long-term effects of alcohol
Individuals with an alcohol use disorder will often complain of difficulty with interpersonal relationships, problems at work or school, and legal problems. Additionally, people may complain of irritability and insomnia. Alcohol abuse is also an important cause of chronic fatigue.
Signs of alcohol abuse are related to alcohol's effects on organ systems. However, while these findings are often present, they are not necessary to make a diagnosis of alcohol abuse. Signs of alcohol abuse show its drastic effects on the central nervous system, including inebriation and poor judgment; chronic anxiety, irritability, and insomnia.
Alcohol's effects on the liver include elevated liver function tests (classically AST is at least twice as high as ALT). Prolonged use leads to cirrhosis and liver failure. With cirrhosis, patients develop an inability to process hormones and toxins.
The skin of a patient with alcoholic cirrhosis can feature cherry angiomas, palmar erythema and — in acute liver failure — jaundice and ascites. The derangements of the endocrine system lead to the enlargement of the male breasts. The inability to process toxins leads to liver disease, such as hepatic encephalopathy.
Alcohol abuse can result in brain damage which causes impairments in executive functioning such as impairments to working memory, visuospatial skills, and can cause an abnormal personality as well as affective disorders to develop.
Binge drinking is associated with individuals reporting fair to poor health compared to non-binge drinking individuals and which may progressively worsen over time. Alcohol also causes impairment in a person's critical thinking.
A person's ability to reason in stressful situations is compromised, and they seem very inattentive to what is going on around them. Social skills are significantly impaired in people suffering from alcoholism due to the neurotoxic effects of alcohol on the brain, especially the prefrontal cortex area of the brain.
The social skills that are impaired by alcohol abuse include impairments in perceiving facial emotions, difficulty with perceiving vocal emotions and theory of mind deficits; the ability to understand humor is also impaired in alcohol abusers. Adolescent binge drinkers are most sensitive to damaging neurocognitive functions especially executive functions and memory.
People who abuse alcohol are less likely to survive critical illness with a higher risk for having sepsis and were more likely to die during hospitalization.
Violence:
Alcohol abuse is significantly associated with suicide and violence. Alcohol is the most significant health concern in Native American communities because of very high rates of alcohol dependence and abuse; up to 80 percent of suicides and 60 percent of violent acts are a result of alcohol abuse in Native American communities.
In the United States alcohol-related violence is related to more severe injuries and chronic cases.
Pregnancy:
Alcohol abuse among pregnant women causes their baby to develop fetal alcohol syndrome. Fetal alcohol syndrome is the pattern of physical abnormalities and the impairment of mental development which is seen with increasing frequency among children with alcoholic mothers.
Alcohol exposure in a developing fetus can result in slowed development of the fetal brain, resulting in severe retardation or death. Surviving infants may suffer severe abnormalities such as abnormal eyes, fissures, lips and incomplete cerebella.
Some infants may develop lung disease. It is even possible that the baby throughout pregnancy will develop heart defects such as ventricular septal defect or atrial septal defect. Experts suggest that pregnant women take no more than one unit of alcohol per day. However, other organizations advise complete abstinence from alcohol while pregnant
Adolescence:
Adolescence and the onset of puberty have both a physiological and social impact on a developing person. About half of grade 12 students have been drunk, and a third binge drink.
About 3% drink every day. One of these social impacts is the increase in risk-taking behaviors, such as the emergence of alcohol use. Children aged 16 and under who consume alcohol heavily display symptoms of conduct disorder. Its symptoms include troublesome behaviour in school, constantly lying, learning disabilities and social impairments.
Alcohol abuse during adolescence greatly increases the risk of developing an alcohol use disorder in adulthood due to changes to neurocircuitry that alcohol abuse causes in the vulnerable adolescent brain. Younger ages of initial consumption among males in recent studies has shown to be associated with increased rates of alcohol abuse within the general population.
Societal inequalities (among other factors) have influenced an adolescents decision to consume alcohol. One study suggests that girls were scrutinized for "drinking like men", whereas magazines that target the male population sent underlying messages to boys and or men that drinking alcohol was "masculine". (Bogren, 2010).
Click on any of the following blue hyperlinks for more about Alcohol Abuse:
- Causes
- Mechanisms
- Diagnosis
- Prevention
- Treatment
- Epidemiology
- Prognosis
- Society and culture
- Societal and economic costs
- See also:
- Rethinking Drinking, National Institute on Alcohol Abuse and Alcoholism
- Alcohol and Crime: Data from 2002 to 2008: Bureau of Justice Statistics
- Healthy Youth! Alcohol & Drug Abuse – U.S. Centers for Disease Control (CDC)
Alcohol dependence:
Alcohol dependence is a previous psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol (also known formally as ethanol).
In 2013 it was reclassified as alcohol use disorder, or alcoholism along with alcohol abuse in DSM-5.
Click on any of the following blue hyperlinks for more about Alcohol Dependence:
Controlled Substances Act (1970) and the Drug Enforcement Administration (DEA)
YouTube Video: Inside the DEA - Drug Enforcement Agency
YouTube Video: DEA in action busting drug traffickers
Pictured below: Map of the 21 DEA domestic field divisions: 1. Chicago, 2. Detroit, 3.Atlanta, 4. Dallas, 5. Denver, 6. Boston, 7. El Paso, 8. Houston, 9. Los Angeles, 10. Miami, 11. Newark, 12. New Orleans, 13. New York, 14. Philadelphia, 15. Phoenix, 16. San Diego, 17. San Francisco, 18. Seattle, 19. St. Louis, 20. Caribbean, 21. Washington, D.C.
The Controlled Substances Act (CSA) is the statute establishing federal U.S. drug policy under which the manufacture, importation, possession, use, and distribution of certain substances is regulated. It was passed by the 91st United States Congress as Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970 and signed into law by President Richard Nixon. The Act also served as the national implementing legislation for the Single Convention on Narcotic Drugs.
The legislation created five Schedules (classifications), with varying qualifications for a substance to be included in each. Two federal agencies, the Drug Enforcement Administration (DEA: below) and the Food and Drug Administration (FDA), determine which substances are added to or removed from the various schedules, although the statute passed by Congress created the initial listing.
Congress has sometimes scheduled other substances through legislation such as the Hillory J. Farias and Samantha Reid Date-Rape Prevention Act of 2000, which placed gamma hydroxybutyrate (GHB) in Schedule I and sodium oxybate (the isolated sodium salt in GHB) in Schedule III.
Classification decisions are required to be made on criteria including potential for abuse (an undefined term), currently accepted medical use in treatment in the United States, and international treaties.
Click here for more about the Controlled Substances Act
___________________________________________________________________________
The Drug Enforcement Administration (DEA) is a United States federal law enforcement agency under the United States Department of Justice, tasked with combating drug smuggling and distribution within the United States.
The DEA is the lead agency for domestic enforcement of the Controlled Substances Act (above), sharing concurrent jurisdiction with the following:
The DEA has sole responsibility for coordinating and pursuing US drug investigations both domestic and abroad.
Click on any of the following blue hyperlinks for more about the Drug Enforcement Administration (DEA):
The legislation created five Schedules (classifications), with varying qualifications for a substance to be included in each. Two federal agencies, the Drug Enforcement Administration (DEA: below) and the Food and Drug Administration (FDA), determine which substances are added to or removed from the various schedules, although the statute passed by Congress created the initial listing.
Congress has sometimes scheduled other substances through legislation such as the Hillory J. Farias and Samantha Reid Date-Rape Prevention Act of 2000, which placed gamma hydroxybutyrate (GHB) in Schedule I and sodium oxybate (the isolated sodium salt in GHB) in Schedule III.
Classification decisions are required to be made on criteria including potential for abuse (an undefined term), currently accepted medical use in treatment in the United States, and international treaties.
Click here for more about the Controlled Substances Act
___________________________________________________________________________
The Drug Enforcement Administration (DEA) is a United States federal law enforcement agency under the United States Department of Justice, tasked with combating drug smuggling and distribution within the United States.
The DEA is the lead agency for domestic enforcement of the Controlled Substances Act (above), sharing concurrent jurisdiction with the following:
- Federal Bureau of Investigation (FBI),
- Immigration and Customs Enforcement (ICE),
- U.S. Customs and Border Protection (CBP),
- and the Department of Homeland Security (DHS).
The DEA has sole responsibility for coordinating and pursuing US drug investigations both domestic and abroad.
Click on any of the following blue hyperlinks for more about the Drug Enforcement Administration (DEA):
- History and mandate
- Organization
- Budget
- Firearms
- Impact on the drug trade
- Criticism
- Raids on medical marijuana dispensaries
- Project Cassandra
- DEA Museum
- See also:
- Official website
- Drug Enforcement Administration in the Federal Register
- List of former DEA Administrators
- Office of Diversion Control
- A response to the DEA web site
- DEA Watch
- DrugEnforcementEdu.org
- Get Smart About Drugs – A DEA Resource for Parents
- DEA Demand Reduction – Street Smart Prevention
- DEA Museum
- Title 21 of the Code of Federal Regulations
- Diplomatic Security Service (DSS), U.S. State Department
- List of United States federal law enforcement agencies
- Operation Panama Express
- Regulation of therapeutic goods in the United States
- U.S. Customs and Border Protection (CBP)
Sexual Addiction
YouTube Video: Sharon Osbourne 'Proud' That Ozzy 'Finally' Admitted to Sex Addiction
Pictured below: This cycle describes what happens inside someone who has a sexual addiction. First a pain agent is triggered; it could be any kind of emotional discomfort (i.e.. pain, fear, shame, anger, etc.), it could be unresolved conflict (inner or outer), it could be stress, or it could be the need to connect with another.
Sexual addiction, also known as sex addiction, is characterized as a state of compulsive participation or engagement in sexual activity, particularly sexual intercourse, despite negative consequences.
Proponents of a diagnostic model for sexual addiction consider it to be one of several sex-related disorders within an umbrella concept known as hypersexual disorder. The term sexual dependence is also used to refer to people who report being unable to control their sexual urges, behaviors, or thoughts.
Related or synonymous models of pathological sexual behavior include hypersexuality (nymphomania and satyriasis), erotomania, Don Juanism (or Don Juanitaism), and paraphilia-related disorders.
The concept of sexual addiction is contentious. There is considerable debate among psychiatrists, psychologists, sexologists, and other specialists whether compulsive sexual behavior constitutes an addiction, and therefore its classification and possible diagnosis.
Animal research has been established that compulsive sexual behavior arises from the same transcriptional and epigenetic mechanisms that mediate drug addiction in laboratory animals; however, as of 2018, sexual addiction is not a clinical diagnosis in either the DSM or ICD medical classifications of diseases and medical disorders.
Some argue that applying such concepts to normal behaviors such as sex, can be problematic, and suggest that applying medical models such as addiction to human sexuality can serve to pathologise normal behavior and cause harm.
Click on any of the following blue hyperlinks for more about Sex Addiction:
Proponents of a diagnostic model for sexual addiction consider it to be one of several sex-related disorders within an umbrella concept known as hypersexual disorder. The term sexual dependence is also used to refer to people who report being unable to control their sexual urges, behaviors, or thoughts.
Related or synonymous models of pathological sexual behavior include hypersexuality (nymphomania and satyriasis), erotomania, Don Juanism (or Don Juanitaism), and paraphilia-related disorders.
The concept of sexual addiction is contentious. There is considerable debate among psychiatrists, psychologists, sexologists, and other specialists whether compulsive sexual behavior constitutes an addiction, and therefore its classification and possible diagnosis.
Animal research has been established that compulsive sexual behavior arises from the same transcriptional and epigenetic mechanisms that mediate drug addiction in laboratory animals; however, as of 2018, sexual addiction is not a clinical diagnosis in either the DSM or ICD medical classifications of diseases and medical disorders.
Some argue that applying such concepts to normal behaviors such as sex, can be problematic, and suggest that applying medical models such as addiction to human sexuality can serve to pathologise normal behavior and cause harm.
Click on any of the following blue hyperlinks for more about Sex Addiction:
Smartphone Addiction
YouTube Video of Crash Shows Dangers of Texting While Driving
Pictured below: Weber State University Students Study Smartphone Addiction
Smartphone addiction is a dependence syndrome seen among mobile phone users. Some mobile phone users exhibit problematic behaviors related to substance use disorders.
These behaviors can include preoccupation with mobile communication, excessive money or time spent on mobile phones, use of mobile phones in socially or physically inappropriate situations such as driving an automobile.
Increased use can also lead to increased time on mobile communication, adverse effects on relationships, and anxiety if separated from a mobile phone or sufficient signal.
Overuse of Smartphones is often defined as a "dependence syndrome", which is the term used by the World Health Organization (WHO Expert Committee, 1964) to replace addiction or habituation. This is categorized either as substance abuse, such as from psychoactive drugs, alcohol and tobacco under ICD-10, or a behavioral addiction, such as a mobile phone addiction.
Substance use disorders can be defined by 11 factors, according to the DSM-5, including:
Smartphone addiction can be compared to substance use disorders in that smartphones provide the drug (entertainment and connection) while acting as the means by which the drug is consumed.
A study conducted at Alabama State University on the effects of smartphones on students, defines the issue by stating that we are not addicted to smartphones themselves, but that we "are addicted to the information, entertainment, and personal connections [that a smartphone] delivers." People have an affinity for constant entertainment, and smartphones provide the quickest, most easily accessible route to it.
Prevalence:
Prevalence of mobile phone overuse depends largely on definition and thus the scales used to quantify a subject's behaviors. Two scales are in use, the 20-item self-reported Problematic Use of Mobile Phones (PUMP) scale, and the Mobile Phone Problem Use Scale (MPPUS), which have been used both with adult and adolescent populations.
There are variations in the age, gender, and percentage of the population affected problematically according to the scales and definitions used.
The prevalence among British adolescents aged 11–14 was 10%.
In India, addiction is stated at 39-44% for this age group. Under different diagnostic criteria, the estimated prevalence ranges from 0 to 38%, with self-attribution of mobile phone addiction exceeding the prevalence estimated in the studies themselves.
The prevalence of the related problem of Internet addiction was 4.9-10.7% in Korea, and is now regarded as a serious public health issue.
Behaviors associated with mobile-phone addiction differ between genders. Women are more likely to develop addictive mobile phone behavior than men. Men experience less social stress than women and use their mobile phones less for social purposes. Older people are less likely to develop addictive mobile phone behavior because of different social usage, stress, and greater self-regulation.
Click on any of the following blue hyperlinks for more about Smartphone Addiction:
These behaviors can include preoccupation with mobile communication, excessive money or time spent on mobile phones, use of mobile phones in socially or physically inappropriate situations such as driving an automobile.
Increased use can also lead to increased time on mobile communication, adverse effects on relationships, and anxiety if separated from a mobile phone or sufficient signal.
Overuse of Smartphones is often defined as a "dependence syndrome", which is the term used by the World Health Organization (WHO Expert Committee, 1964) to replace addiction or habituation. This is categorized either as substance abuse, such as from psychoactive drugs, alcohol and tobacco under ICD-10, or a behavioral addiction, such as a mobile phone addiction.
Substance use disorders can be defined by 11 factors, according to the DSM-5, including:
- use in larger quantities or for longer than initially intended,
- a desire to cut down or control use,
- spending a great deal of time obtaining, using, or recovering from the substance,
- use in situations in which it is physically hazardous,
- continued use of the substance despite adverse physical or psychological consequences associated with use,
- and withdrawal symptoms.
Smartphone addiction can be compared to substance use disorders in that smartphones provide the drug (entertainment and connection) while acting as the means by which the drug is consumed.
A study conducted at Alabama State University on the effects of smartphones on students, defines the issue by stating that we are not addicted to smartphones themselves, but that we "are addicted to the information, entertainment, and personal connections [that a smartphone] delivers." People have an affinity for constant entertainment, and smartphones provide the quickest, most easily accessible route to it.
Prevalence:
Prevalence of mobile phone overuse depends largely on definition and thus the scales used to quantify a subject's behaviors. Two scales are in use, the 20-item self-reported Problematic Use of Mobile Phones (PUMP) scale, and the Mobile Phone Problem Use Scale (MPPUS), which have been used both with adult and adolescent populations.
There are variations in the age, gender, and percentage of the population affected problematically according to the scales and definitions used.
The prevalence among British adolescents aged 11–14 was 10%.
In India, addiction is stated at 39-44% for this age group. Under different diagnostic criteria, the estimated prevalence ranges from 0 to 38%, with self-attribution of mobile phone addiction exceeding the prevalence estimated in the studies themselves.
The prevalence of the related problem of Internet addiction was 4.9-10.7% in Korea, and is now regarded as a serious public health issue.
Behaviors associated with mobile-phone addiction differ between genders. Women are more likely to develop addictive mobile phone behavior than men. Men experience less social stress than women and use their mobile phones less for social purposes. Older people are less likely to develop addictive mobile phone behavior because of different social usage, stress, and greater self-regulation.
Click on any of the following blue hyperlinks for more about Smartphone Addiction:
- Effects
- Tools
- See also:
- Smartphone
- Smartphone zombie
- Television addiction
- Underearners Anonymous
- Computer addiction
- Internet addiction disorder
- Nomophobia, a proposed name for the fear of being out of cellular phone contact
- Video game overuse
- Mobile phones and driving safety
- De Quervain syndrome
- Mobile phone radiation and health
- Digital detox, a period of time during which a person refrains from using electronic connecting devices
- Mobile phone § Health effects
Celebrities who died due to a Drug or Alcohol Overdose
YouTube Video: Top 10 Musicians Who Tragically Died Due to Drugs and Alcohol by WatchMojo
Pictured below: Notable deaths from acute drug use include (L-R):
Top Row: Judy Garland, Peaches Geldof, Philip Seymour Hoffman,
Center Row: Michael Jackson, Heath Ledger, Marilyn Monroe,
Bottom Row: Jim Morrison, Prince, and Ike Turner
For a List of Celebrities who died due to abuse of alcohol and/or drugs, click here.
Drug overdose and intoxication are significant causes of accidental death, and can also be used as a form of suicide.
Death can occur from overdosing on a single or multiple drugs, or from combined drug intoxication (CDI) due to poly drug use.
Poly drug use often carries more risk than use of a single drug, due to an increase in side effects, and drug synergy. For example, the chance of death from overdosing on opiates is greatly increased when they are consumed in conjunction with alcohol.
While they are two distinct phenomena, deaths from CDI are often misreported as overdoses. Drug overdoses and intoxication can also cause indirect deaths. For example, while marijuana does not cause fatal overdoses, being intoxicated by it can increase the chance of fatal traffic collisions.
Drug use and overdoses increased significantly in the 1800s due to the commercialization and availability of certain drugs. For example, while opium and coca had been used for centuries, their active ingredients, morphine and the cocaine alkaloid, were not isolated until 1803 and 1855 respectively.
Cocaine and various opiates were subsequently mass-produced and sold openly and legally in the Western world, resulting in widespread misuse and addiction. Drug use and addiction also increased significantly following the invention of the hypodermic syringe in 1853, with overdose being a leading cause of death among intravenous drug users.
Efforts to prohibit various drugs began to be enacted in the early 20th century, though the effectiveness of such policies is debated. Deaths from drug overdoses are increasing.
Between 2000 and 2014, fatal overdoses rose 137% in the United States, causing nearly half a million deaths in that period, and have also been continually increasing in Australia, Scotland, England, and Wales.
While prohibited drugs are generally viewed as being the most dangerous, the misuse of prescription drugs are linked to more deaths in several countries. Cocaine and heroin combined caused fewer deaths than prescriptions drugs in the United Kingdom in 2013, and fewer deaths than prescription opiates alone in the United States in 2008.
As of 2015 the drug most likely to cause fatal overdose in Australia was diazepam (Valium). While fatal overdoses are highly associated with drugs such as opiates, cocaine and alcohol, deaths from other drugs such as caffeine are extremely rare.
This alphabetical list (see above link) contains 599 notable people whose deaths can be reliably sourced to be the result of drug overdose or acute drug intoxication. Where sources indicate drug overdose or intoxication was only suspected to be the cause of death, this will be specified in the 'notes' column.
Where sources are able to indicate, deaths are specified as 'suicide', 'accidental', 'undetermined', or otherwise in the 'cause' column. Where sources do not explicitly state intent, they will be listed in this column as 'unknown'.
Deaths from accidents or misadventure caused by drug overdoses or intoxication are also included on this list.
Deaths from long-term effects of drugs, such as tobacco-related cancers and cirrhosis from alcohol, are not included, nor are deaths from lethal injection or euthanasia.
See also:
Drug overdose and intoxication are significant causes of accidental death, and can also be used as a form of suicide.
Death can occur from overdosing on a single or multiple drugs, or from combined drug intoxication (CDI) due to poly drug use.
Poly drug use often carries more risk than use of a single drug, due to an increase in side effects, and drug synergy. For example, the chance of death from overdosing on opiates is greatly increased when they are consumed in conjunction with alcohol.
While they are two distinct phenomena, deaths from CDI are often misreported as overdoses. Drug overdoses and intoxication can also cause indirect deaths. For example, while marijuana does not cause fatal overdoses, being intoxicated by it can increase the chance of fatal traffic collisions.
Drug use and overdoses increased significantly in the 1800s due to the commercialization and availability of certain drugs. For example, while opium and coca had been used for centuries, their active ingredients, morphine and the cocaine alkaloid, were not isolated until 1803 and 1855 respectively.
Cocaine and various opiates were subsequently mass-produced and sold openly and legally in the Western world, resulting in widespread misuse and addiction. Drug use and addiction also increased significantly following the invention of the hypodermic syringe in 1853, with overdose being a leading cause of death among intravenous drug users.
Efforts to prohibit various drugs began to be enacted in the early 20th century, though the effectiveness of such policies is debated. Deaths from drug overdoses are increasing.
Between 2000 and 2014, fatal overdoses rose 137% in the United States, causing nearly half a million deaths in that period, and have also been continually increasing in Australia, Scotland, England, and Wales.
While prohibited drugs are generally viewed as being the most dangerous, the misuse of prescription drugs are linked to more deaths in several countries. Cocaine and heroin combined caused fewer deaths than prescriptions drugs in the United Kingdom in 2013, and fewer deaths than prescription opiates alone in the United States in 2008.
As of 2015 the drug most likely to cause fatal overdose in Australia was diazepam (Valium). While fatal overdoses are highly associated with drugs such as opiates, cocaine and alcohol, deaths from other drugs such as caffeine are extremely rare.
This alphabetical list (see above link) contains 599 notable people whose deaths can be reliably sourced to be the result of drug overdose or acute drug intoxication. Where sources indicate drug overdose or intoxication was only suspected to be the cause of death, this will be specified in the 'notes' column.
Where sources are able to indicate, deaths are specified as 'suicide', 'accidental', 'undetermined', or otherwise in the 'cause' column. Where sources do not explicitly state intent, they will be listed in this column as 'unknown'.
Deaths from accidents or misadventure caused by drug overdoses or intoxication are also included on this list.
Deaths from long-term effects of drugs, such as tobacco-related cancers and cirrhosis from alcohol, are not included, nor are deaths from lethal injection or euthanasia.
See also:
- Lists of people by cause of death
- List of deaths from legal euthanasia and assisted suicide
- List of people executed by lethal injection
- Opioid epidemic