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COMMONLY MISUSED SUBSTANCES

• When substance use begins...
• The numbers...
• Commonly Misused Substances - Chart
• Emerging trends
• The health effects...
• The Health Effects of Commonly Misused Substances - Chart
• The consequences...
• Getting help...

Millions of people who once suffered from a substance use disorder have reclaimed their lives through treatment and long-term recovery. Across the country, people are learning how the destructive power of alcohol and drug addiction can negatively affect lives, families, and communities.

Overall, use rates for alcohol, tobacco, and illicit drugs among America's adolescents aged 12 to 17 have declined since 2002; this includes a significant drop in drug use within the past month (11.6 percent in 2002 versus 9.8 percent in 2006).^1,2 However, while signs of healthier behavior exist, steps must continue to be taken to assist and encourage those in need to turn to treatment and seek recovery.

A substance use disorder means that a person is dependent on or abuses alcohol and/or drugs, including prescription drugs.³ Substance use disorders affect people nationwide, regardless of race, class, gender, ethnicity, or employment status.⁴ It is important to recognize that, like other mental disorders and chronic ailments, substance use disorders are medical conditions that can be treated.⁵

Raising awareness of the true stories of treatment and long-term recovery can influence those currently struggling with addiction. In 2006, of the 22.6 million people in need of treatment for an alcohol and/or drug use problem in the past year, only 4 million received some form of treatment.⁶ To bridge this gap, it is necessary to raise awareness and expand the dialogue about substance use disorders, as well as about the substances that are commonly misused.

There is still much work to be done to increase awareness of treatment and recovery. As individuals and communities, you have an opportunity to participate in this call to action. You can help by showing support for people with substance use disorders and offering forums where people can share their stories in your community. As you read the following facts about alcohol and drug abuse in the United States, consider the consequences on families, neighbors, and society as a whole.

When substance use begins...

Substance use can occur at any age and at any time. In 2006:

• The average age of first-time use of inhalants was nearly 16 (among people aged 12 to 49).⁷
• An estimated 2.8 million people aged 12 or older used an illicit drug for the first time within the past 12 months; this is an average of nearly 8,000 new users each day.
• The largest number of recent new users aged 12 or older appeared in the nonmedical use of pain relievers (2.2 million) and marijuana (2.1 million).⁸
  - The average age of first use of pain relievers among people 12 to 49 was 21.9 years. ⁹
  - The average age of first use of marijuana among people 12 to 49 was 17.4 years.¹⁰
• 4.4 million people aged 12 or older used alcohol for the first time in the past 12 months - approximately 12,000 new users per day. Of these, 89.2 percent were under age 21 at the time of initiation.¹¹

These alarming numbers serve as an indicator of emerging patterns in substance use disorders.¹²

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The numbers...

Today, there are a variety of commonly misused substances. The following chart is a reflection of the 218.3 million illicit drug, alcohol, and tobacco users aged 12 or older in 2006. It is broken down by each substance, the numbers of people using each, and, when applicable, common "street" names.^13,14

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Commonly Misused Substances

218.3 Million Current Users (Aged 12 or over)

Substance	Street Slang
Alcohol 125 million people
Tobacco Products 72.9 million people
Marijuana 14.8 million people	Pot, weed, Mary Jane, reefer, ganja, hash
Prescription-type Drugs 7 million people Pain Relievers 5.2 million people
Cocaine 2.4 million people Crack 702,000 people	Coke, C, blow, crack
Hallucinogens 1 million people Ecstasy (MDMA) 528,000 people	LSD, acid, boomers, yellow
Inhalants 761,000 people	Whippets, laughing gas, poppers
Methamphetamine 731,000 people	Crank, meth, speed, ice
Heroin 338,000 people	Captain cody (codeine), H, smack, dope, white horse

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Emerging trends: prescription drugs, methamphetamine, and alcohol

The use of alcohol or illicit substances has a negative impact on the health and well-being of individuals, their families, and society.¹⁵ Each year, new trends emerge about the use of specific drugs. In 2006, reports including the Substance Abuse and Mental Health Services Administration's (SAMHSA's) 2006 National Survey on Drug Use and Health noted the alarming increase in the abuse of prescription drugs.^16,17 Also in 2006, the National Drug Intelligence Center's National Drug Threat Survey (NDTS) revealed that 78.8 percent of state and local law enforcement agencies reported either high or moderate availability of illegally diverted pharmaceuticals.¹⁸ More than half of the people who use prescription-type psychotherapeutics (pain relievers, sedatives, tranquilizers, stimulants) nonmedically obtained the drugs "from a friend or relative for free."¹⁹

Even though the past month use of all drugs by teens has dropped by 18 percent between 2002 and 2006, reports indicate a growing concern about teens intentionally using prescription medicines to get high.^20,21 Behind marijuana, prescription drugs have become the second most abused drug among young people ages 12 to 17; but for those aged 12 and 13, they are abused the most.²²

In 2006, an estimated 7 million people aged 12 or older, or 2.8 percent of the population, had used prescription psychotherapeutic medications nonmedically in the past month.²³

• Between 2005 and 2006, the use of pain relievers increased by 11 percent, from 4.7 million in 2005 to 5.2 million in 2006.²⁴
• Four in 10 teens aged 12 to 17 agree with the misconception that, even if prescription medicines are not prescribed by a doctor, they are much safer to use than illegal drugs.²⁵

Opioids, a type of narcotic, are among the most addictive pain medications, and some that are commonly prescribed include hydrocodone (Vicodin®) and oxycodone (OxyContin®, Percocet®).²⁶ Pain relievers are the most abused type of prescription drug among those aged 12 to 17. Since 2005, there has been an increase in the use of OxyContin by 8^th and 10^th graders.²⁷

Just as people often don't recognize the risks of misusing prescription drugs, nearly 1 in 7 youths between ages 12 and 17 believe that there is little or no risk in taking methamphetamine (meth) on a regular basis.²⁸

• On average, teens were 12 or older when they first used meth, with the majority, 77 percent, aged 15 or younger at the time.²⁹
• The rate of lifetime use of methamphetamine for people aged 12 or older increased from 5.2 percent in 2005 to 5.8 percent in 2006.³⁰

The use of alcohol has always caused concern, with more than half of people aged 12 or older (50.9 percent) reporting that they were current alcohol drinkers in 2006.³¹ Among those aged 12 to 20, nearly 10.8 million reported using alcohol in the past month.³² Each day, there were an estimated 12,000 new alcohol users aged 12 or older, translating to approximately 4.4 million people who used alcohol for the first time in the past 12 months. Perhaps most alarming is that the vast majority (89.2 percent) of new users were younger than 21 when they first consumed alcohol.³³

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The health effects...

Substance misuse has serious and potentially deadly consequences. For example, drugs such as heroin, cocaine, steroids, and methamphetamines provoke risky behaviors (needle sharing and unsafe sex) that increase a person's chances of acquiring HIV, hepatitis, and other infectious diseases.³⁴ Substance misuse takes a gradual, yet powerful, toll on the human body, affecting a person's brain and motor functions, in addition to a number of other health consequences. The following diagram and chart outline the body organs and systems impacted by drug use, as well as other potential side effects that are harmful to a person's health.³⁵

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The Health Effects of Commonly Misused Substances ^36,37

Number used in organ chart	Impacted Organ/System	Substances that Impact It	Health Effects
1	Respiratory system, lungs	Tobacco products, marijuana, inhalants, methamphetamines	Lung and esophagus damage, coughing, infections
2	Liver	Steroids, heroin,  methamphetamines, alcohol	Liver damage, tumors
3	Kidneys	MDMA,  methamphetamines, tobacco products	Kidney damage/failure, kidney infections
4	Bones, muscles	Heroin, opioids, steroids	Stunted growth, poor muscle control, bone pain
5	Brain, memory, pleasure circuit/ emotional limbic system, senses (sight, smell, taste), sensory system, mood	Opioids, CNS depressants, cocaine, marijuana,  methamphetamines, inhalants, LSD, alcohol, stimulants, MDMA, hallucinogens, heroin	Seizures, brain damage, memory loss, hallucination Flushing of skin, dry mouth, blurred vision, narcolepsy, tiredness Euphoria, anger, panic, paranoia, aggression, depression
6	Chest, heart	Tobacco products, inhalants, cocaine, marijuana, MDMA, hallucinogens, heroin/opioids, stimulants	Increased heart rate, irregular heart rhythm, heart disease, chest pain, collapsed veins
7	Stomach, gastrointestinal system	Heroin, tobacco products, cocaine	Infertility, vomiting, nausea
8	Circulatory system, blood pressure	Cocaine, MDMA, tobacco products	Constricted blood vessels

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The consequences...

The continuous misuse of substances can produce unfortunate situations that can put individuals in danger of hurting themselves and others. While the following statistics are only a mere glimpse of the reality, these data reflect the serious impact that alcohol- and drug-related emergencies have on public health, as well as the influence substance use can have on a family.³⁸

In 2006, the rippling effect of alcohol could be seen in the 17,590 fatalities from alcohol-related traffic crashes and the 13,470 people who were killed in crashes involving drunk drivers.³⁹

Often, families living with a substance user face certain consequences, including:

• Financial Struggles - Financial pressures can put an immense amount of stress on families, sometimes causing relatives to work harder to compensate for the substance user's lost wages due to job loss, drug habits, incarceration, or hospitalization.⁴⁰
• Marital Problems - Substance use can affect the quality of marriages and increase the risk of divorce.⁴¹
• Partner Violence - Increased levels of drug and alcohol use in both the aggressor and victim of partner violence can interfere with effective communication and increase aggressive tendencies.⁴²
• Child Abuse and Neglect - According to a report by Columbia University's National Center on Addiction and Substance Abuse, nearly 70 percent of all reported child-maltreatment cases involve substance abuse.⁴³
• Exposure to Crime - Exposing children of illicit drug users to high levels of drug use and criminal activity can hinder their moral development, while increasing their chances of also using drugs and/or alcohol.⁴⁴

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Getting help...

In 2006, while 22.6 million people aged 12 or older met the criteria for a substance use disorder in the past year, only 4 million people (1.6 percent of the population) actually received treatment for it.⁴⁵ This is troubling due to the positive impact treatment can have on people in need, their family members, and entire communities.

Substance use disorders are treatable diseases. Up to 70 percent of patients in treatment for alcohol dependence are successful, cocaine treatment is successful for 60 percent, and opiate treatment is successful for up to 80 percent of those in treatment. People make substantial progress through treatment and recovery, and success can be compared with that of other chronic, relapsing conditions, such as asthma, diabetes, and hypertension.⁴⁶ Since substance use disorders can be a recurring, chronic disease, a person might experience more than one round of intense treatment before long-term recovery is possible.

Substance use disorders are a reality in the United States. However, treatment is available and recovery is possible. By encouraging and publicizing the discussion of substance use disorders and sharing stories of real people in long-term recovery, communities and family members can support and encourage those with substance use disorders to get better. In doing so, people are helping to enrich lives, while improving health and celebrating the real recovery of addicted individuals and their families throughout the country.

For more resources and organizations that can help provide treatment, visit the Recovery Month Web site at www.recoverymonth.gov. Information on treatment options in your area and the special services available can be found at www.findtreatment.samhsa.gov, a searchable database of more than 11,000 U.S. treatment facilities. For additional Recovery Month materials, visit www.recoverymonth.gov or call 1-800-662-HELP.

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SOURCES

¹ Results from the 2006 National Survey on Drug Use and Health: National Findings. DHHS Publication No. (SMA) 07-4293. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, September 2007, p. 2.
² New National Survey Reveals Drug Use Down Among Adolescents in U.S. - Success in Substance Abuse Recovery Highlighted. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, news release, September 6, 2007.
³ The NSDUH Report: Patterns and Trends in Nonmedical Prescription Pain Reliever Use: 2002 to 2005. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Rockville, MD. April 6, 2007.
⁴ Results from the 2006 National Survey on Drug Use and Health: National Findings, pp. 23, 71-74.
⁵ Ibid, p. 69.
⁶ Ibid, pp. 6, 69.
⁷ Ibid, pp. 50, 51.
⁸ Ibid, p. 50.
⁹ Ibid.
¹⁰ Ibid.
¹¹ Ibid, p. 55.
¹² Ibid, p. 45.
¹³ Ibid, pp. 1, 3, 4, 16, 17, 18, 41.
¹⁴ NIDA: Commonly Abused Drugs Chart. Bethesda, MD: U.S. Department of Health and Human Sciences, National Institutes of Health, National Institute on Drug Abuse, updated December 2004.
¹⁵ Results from the 2006 National Survey on Drug Use and Health: National Findings, pp. 1, 16, 17, 31, 41, 232.
¹⁶ Teens Turn Away from Street Drugs, Move to Prescription Drugs, New Report Reveals. Office of National Drug Control Policy, news release. February 2007.
¹⁷ Results from the 2006 National Survey on Drug Use and Health: National Findings, pp. 1, 20, 50, 53.
¹⁸ "Drug Facts & Figures: Prescription Drugs." Office of National Drug Control Policy Web site: www.whitehousedrugpolicy.gov/drugfact/prescrptn_drgs/index.html. Accessed September 20, 2007.
¹⁹ Results from the 2006 National Survey on Drug Use and Health: National Findings, p. 29.
²⁰ The NSDUH Report: Patterns and Trends in Nonmedical Prescription Pain Reliever Use: 2002 to 2005. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Sciences, April 6, 2007.
²¹ Teens Turn Away from Street Drugs, Move to Prescription Drugs, New Report Reveals, news release, February 2007.
²² Teens and Prescription Drugs, An Analysis of Recent Trends on the Emerging Drug Threat. The Office of National Drug Control Policy, Executive Office of the President, February 2007, p. 2.
²³ Results from the 2006 National Survey on Drug Use and Health: National Findings, p. 1.
²⁴ Ibid.
²⁵ Teens and Prescription Drugs, An Analysis of Recent Trends on the Emerging Drug Threat, p. 3.
²⁶ Pain-pill addiction: What's the risk? The Mayo Clinic, Mayo Foundation for Medical Education and Research (MFMER), June 2006.
²⁷ Teens and Prescription Drugs, An Analysis of Recent Trends on the Emerging Drug Threat, p. 6.
²⁸ The Meth Project: National Use & Attitudes Survey 2007, National survey measuring attitudes and behaviors towards methamphetamine in America. The Meth Project, GfK Roper Public Affairs & Media, September 2007, p. 2.
²⁹ Ibid, p.19.
³⁰ Results from the 2006 National Survey on Drug Use and Health: National Findings, p. 18.
³¹ Ibid, p. 31.
³² Ibid, p. 33.
³³ Ibid, p. 55.
³⁴ NIDA Report: HIV, Hepatitis and Other Infectious Diseases, April 2005.
³⁵ "The Signs and Symptoms of Drug Use". The American Council for Drug Education Web site: www.acde.org/common/Symptom.htm. Accessed September 20, 2007.
³⁶ "NIDA: Commonly Abused Drugs Chart". The National Institute on Drug Abuse Web site: www.nida.nih.gov/DrugPages/DrugsofAbuse.html. Accessed September 28, 2007.
³⁷ Signs and Symptoms of Drug Use. American Council for Drug Education's Web site: www.acde.org/common/System.htm. Accessed September 28, 2007.
³⁸ "Frequently Asked Questions (FAQ)." Drug Abuse Warning Network Web site: http://dawninfo.samhsa.gov/tools/faqs.asp. Accessed November 16, 2007.
³⁹ "Fatalities". The Mothers Against Drunk Driving (MADD) Web site: http://www.madd.org/Victim-Services/Victim-Services/Statistics/AllStats.aspx#STAT_4. Accessed December 4, 2007.
⁴⁰ Family Matters: Substance Abuse and the American Family, p. 15.
⁴¹ Ibid, p. 17.
⁴² Ibid, pp. 19, 20.
⁴³ Ibid, p. 27.
⁴⁴ Ibid, p. 22.
⁴⁵ Results from the 2006 National Survey on Drug Use and Health: National Findings, pp. 6, 69, 75
⁴⁶ Substance Abuse: The Nation's Number One Health Problem. The Schneider Institute for Health Policy, Brandeis University and the Robert Wood Johnson Foundation, February 2001, pp. 109, 110.

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