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State of Substance Abuse in the United States

Substance abuse has become a serious problem in the United States, affecting people of all ages, races and education levels.

Overdoses, especially from opioid abuse, are rising at an alarming rate – in June 2017, the New York Times reported that not only are drug-related deaths increasing faster than ever before, but they are the leading cause of death for people under the age of 50. In October 2017, President Donald Trump officially declared the drug abuse and opioid crisis a “health emergency.”

Addressing the issue will require professionals that can make personal connections and used evidence-based research. A psychology degree with a concentration in addiction and substance abuse can prepare people for a career in substance abuse prevention and treatment.

The job outlook for substance abuse, behavioral disorder and mental health counselors is projected to grow 23% from 2016 to 2026, according to the U.S. Bureau of Labor Statistics.

George Bortnick, a professor at New England College and a substance abuse counselor for Keystone Hall, a nonprofit substance abuse treatment facility in Nashua, New Hampshire, said a lot of people are “self motivated” to seek out this career path. “For most people entering the addiction field, there is an underlying reason why they want to get in. The more you know individuals, the more you interact, the more you come across people who are dealing it, the more you understand it,” he said.

NEC graduate Amanda Widner’s work at an alcohol and drug rehab center in Virginia inspired her to earn a bachelor’s degree in psychology in 2016. Widner, who had experienced problems with substance abuse in the past, now shares her story with her patients.

“I started thinking about my past and my future and the type of patients I work with and this quote came to me; ‘I am who I am because of my past, but I do not let my past define who I am,’” she said.

The Extent of the Issue

Substance abuse is an umbrella term that includes the use of illicit drugs (such as cocaine), tobacco, alcohol, prescription drugs (such as opioids) and over-the-counter substances (like paint thinners and cold medicine). The National Institute on Drug Abuse tracks a number of commonly abused substances.

While there are varying estimates on the size and fiscal cost of substance use, the Surgeon General’s Report on Alcohol, Drugs and Health stated that in 2015, more than 27 million people used illicit drugs or misused prescription drugs, and more than 66 million people reported binge drinking. The economic impact was $193 billion for illicit drug use and $249 billion for alcohol abuse.

Alcohol is common “because it’s legal,” Bortnick said. “It’s the easiest one to get and it’s much easier to hide from people.”

NIDA, part of the National Institutes of Health, states that some people start using alcohol and drugs as a way to manage depression, anxiety and stress; others may begin experimenting due to peer pressure or their own interest; and still others might begin using other substances after becoming addicted to legally prescribed medication, such as painkillers.

The NIDA’s Drug Facts page states: “Many people don’t understand why or how other people become addicted to drugs. They may mistakenly think that those who use drugs lack moral principles or willpower and that they could stop their drug use simply by choosing to. In reality, drug addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to.”

Substance abuse can stimulate dopamine, the neurostimulator most commonly associated with pleasure in the brain. Psychology Today says people with low dopamine levels may be more predisposed to addiction.

What’s Being Done about Substance Abuse?

Organizations and government agencies at the local, state and federal levels have mobilized to address the causes and effects of substance abuse.

In 1992, Congress created the Substance Abuse and Mental Health Services Administration, or SAMHSA, to coordinate the efforts of the many different organizations involved in substance abuse research and treatment. SAMHSA, part of the U.S. Department of Health and Human Services, promotes the use of preventative education based on evidence and research, and has designed a continuum of care that spans promotion, prevention, treatment and recovery.

In New Hampshire, treatment options are available through the NH Alcohol and Drug Treatment Locator website. There are also two resource guides, one for treatment and the other for recovery, on the New Hampshire Department of Health and Human Services website.

One new development in the effort to reduce substance abuse is alternative sentencing. In this scenario, people accused of criminal substance abuse are redirected to dedicated courts – commonly called drug courts – that are likely to mandate treatment programs instead of incarceration. While the drug court concept is gaining favor in some states and municipalities, it is far from being accepted nationwide. The National Association of Drug Court Professionals says alternative sentencing through drug courts reduce crime and save money.

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