essay on effects of substance abuse

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What are the effects of drug misuse?

Substance use disorder can lead to short- and long-term negative health effects. These can be physical and mental, ranging from moderate to severe. They will depend on the substance a person had been using.

Drug abuse vs. substance use disorder

This article does not reference the term “drug abuse,” which is a stigmatizing term. Instead, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) uses the term substance use disorder (SUD). The manual defines SUD as a disorder involving the continued use of substances despite personal, professional, and health-related problems caused by the usage that negatively affects a person’s day-to-day life.

Generally, drug misuse or SUD refers to the use of psychoactive drugs , which are substances that affect the brain. The effects on the body depend on the type of substance a person uses and their health history.

Examples of common psychoactive drugs include:

• hallucinogens
• prescription opioids
• prescription stimulants
• methamphetamine
• tobacco or nicotine

This article discusses the physical and mental effects of substance use disorder.

Physical effects of drug misuse

Psychoactive drugs are chemical compounds that affect the mind and body.

Taking different drugs may cause :

• changes in coordination
• blood pressure and heart rate changes
• feelings of being more awake or sleepy
• improved sociability
• pain relief
• changes in the appearance of a person’s body

When chronic substance use occurs over a long period, these short-term physical effects may cause long-term changes to a person’s brain and body.

The specific physical effects of substance use may vary among individuals and depend on the substance, dosage, delivery method, and length of use.

Substance use can sometimes lead to serious health consequences, including overdose and death.

Short-term physical effects

Using any drug can cause short-term physical effects. The following are examples of common drugs, their short-term physical effects, and potential health risks due to SUD.

• deficits in coordination
• a quickened heartbeat
• reddening of the skin or face
• nausea and vomiting
• potential hypothermia
• potential coma
• increased wakefulness and physical activity
• decreased appetite
• increased breathing
• increased or irregular heart rate
• increased blood pressure
• increased temperature
• narrowed blood vessels
• enlarged pupils
• increased body temperature, heart rate, and blood pressure
• abdominal pain and nausea
• erratic and violent behavior
• heart attack
• slurred speech
• problems with movement
• slowed breathing
• lowered blood pressure
• slowed breathing and heart rate
• increased heart rate
• greatly increased risk of cancer — lung cancer due to smoking or oral cancer due to chewing
• chronic bronchitis
• heart disease

Long-term physical effects

Using substances for an extended time may have long-term health consequences. These lasting effects depend on multiple factors, including the substance, the amount, and how long a person has used it.

Examples of commonly used drugs and potential long-term physical effects of SUD include:

• liver disease and inflammation ( alcoholic liver disease )
• pancreatitis
• digestive problems
• cancer of breast, mouth, throat, esophagus, voice box, liver, colon, and rectum
• weakened immune system
• alcohol use disorder or alcohol dependence
• severe dental problems
• weight loss
• intense itching leading to skin sores
• risk of HIV , hepatitis , and other diseases from shared needles
• loss of sense of smell
• nasal damage and trouble swallowing
• infection and death of bowel tissue from decreased blood flow
• inadequate nutrition and weight loss
• collapsed veins
• infection of the lining and valves of the heart
• constipation and stomach cramps
• liver or kidney disease
• fatal overdose

Mental effects of drug misuse

Long-term SUD may affect a person’s memory, behavior, learning, consciousness, and concentration.

Substances, such as alcohol, cannabis, stimulants, and opioids, are psychoactive drugs that may change an individual’s brain function and structure after chronic use. This can resul t in cognitive and behavioral changes and deficits that may remain even after someone stops using.

The exact mental or cognitive effects of SUD may vary depending on the type of drug and the duration of use.

SUD may also exacerbate symptoms of other mental disorders , and early drug use is a strong risk factor for the later development of substance use disorders. It may also be a risk factor for developing other mental illnesses.

For example, frequent cannabis use in adolescents can increase the risk of psychosis in adulthood in individuals who carry a particular gene variant.

Short-term mental effects

Examples of common drugs and their short-term mental effects include:

• feelings of euphoria
• reduced anxiety
• easing of social interactions
• irritability and anxiety upon withdrawal
• enhanced sensory perception
• feelings of euphoria and relaxation
• irritability upon withdrawal
• concentration issues
• problems with memory
• restlessness upon withdrawal
• increased wakefulness
• anxiety upon withdrawal

Long-term mental effects

Examples of common drugs and mental effects associated with long-term SUD include:

• learning and memory problems
• social problems
• increased risk of overdose
• mood problems
• violent behavior
• hallucinations
• risk of overdose
• in teens, they can affect the development of brain circuits that control attention and learning
• irritability, attention and sleep problems, and depression upon withdrawal
• mental health problems
• irritability, trouble sleeping, anxiety upon withdrawal

What is substance use disorder?

To get a diagnosis of SUD, a person has to qualify for 11 criteria that the DSM-5 outlines.

These include:

• using more of a substance than a person intends or using it for longer than they mean to
• trying to cut down or stop using the substance but being unable to
• experiencing intense cravings or urges to use the substance
• needing more of the substance to get the desired effects (tolerance)
• developing withdrawal symptoms when not using the substance
• spending more time getting and using drugs and recovering from substance misuse
• continuing to use even when it causes relationship problems
• giving up important or desirable social and recreational activities due to substance use
• using substances in potentially harmful settings that put a person in danger
• continuing to use despite the substance causing problems to physical and mental health

SUD prevalence

Government data shows that SUD tends to be more common among Black people than Hispanics, Asians, and people who are white. SUD is more common in males among people who are white, Black or African Americans, American Indians or Alaska Natives, and those who identify as two or more races.

However, it is difficult to determine the accuracy of data on racial disparities. In the United States, historically, the “war on drugs” has meant that Black Americans are 6–10 times more likely to be incarcerated for drug offenses even though they are not necessarily more likely to use illegal drugs. This imbalance may impact prevalence data.

In addition, SUD from illegal opioids is a large public health problem in the U.S. that can lead to overdose and death. In some cases, SUD can result from prescription opioids, but the bulk of the crisis stems from illegal or “street” drugs.

More than 760,000 people have died since 1999 from opioid overdoses. In 2018, two out of three overdoses had links to opioid use.

How to get help

Finding the right treatment program may feel overwhelming. Here are a few things a person can consider when seeking treatment for SUD.

• Consider whether inpatient or outpatient services would be most suitable.
• Find local treatment centers using the Substance Abuse and Mental Health Services Administration’s treatment finder tool.
• Know that state-run treatment centers and programs may be free of charge.
• Look for programs that use evidence-based treatment strategies.

SUD is a complex but treatable disease that affects a person’s cognitive function and behavior. No single treatment is right for everyone.

However, effective treatment for SUD should address all of a person’s mental and physical health needs.

Treatment aims to help individuals develop a healthier relationship with drugs, helping them live productive lives in relationships with their family, work, and society.

Treatment may involve some of the following components:

• Medications: Can help minimize withdrawal symptoms and prevent the return to unsafe use.
• Behavioral counseling : Helps individuals modify their attitudes and behaviors related to substance use, increase healthy life skills, develop problem-solving skills, and stick to treatment plans.
• Group therapy: Gives people the chance to acknowledge, share, and work through the psychological aspects of recovery with a group of peers under professional guidance.
• Additional support: May include vocational training and other resources that address problems associated with SUD, such as mental health conditions, unemployment, and medical conditions.

Frequently asked questions

Here are some common questions and answers regarding SUDs.

How do I know if I or someone I know is misusing drugs?

Healthcare professionals use 11 criteria to determine if an individual has SUD. Some of them include:

• using more of a substance than a person intends
• using it for longer than they mean to
• needing more of the substance to get the desired effects

What are the risk factors for drug misuse?

Certain factors may increase an individual’s risk for SUD. These risk factors include:

• family history of substance use
• difficulties with parental monitoring
• parents substance use
• family rejection of sexual orientation or gender identity
• association with substance-using peers
• lack of school connectedness
• academic achievement difficulties
• childhood sexual abuse
• mental health issues

SUD can affect several aspects of a person’s physical and psychological health.

Certain substances may lead to drowsiness and slow breathing, while others may cause insomnia, paranoia, or hallucinations. Chronic substance use has links to cardiovascular, kidney, and liver disease.

In addition to physical and mental effects, substance use can adversely affect a person’s relationships, home and work life, and mental health.

Care providers should tailor treatment to a person’s needs. Community-based organizations and state-funded treatment programs usually involve a combination of behavioral therapy, group therapy, and medication.

Last medically reviewed on June 20, 2022

• Alcohol / Addiction / Illegal Drugs
• Psychology / Psychiatry

How we reviewed this article:

• Addiction and health. (2020). https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/addiction-health
• Alcohol’s effects on the body. (n.d.). https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body
• Alcohol use and your health. (2022). https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm
• Bruijnen, C.,  et al.  (2019). Prevalence of cognitive impairment in patients with substance use disorder. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6593747/
• Common comorbidities with substance use disorder research report. (2020). https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness
• Commonly used drugs charts. (2020). https://nida.nih.gov/drug-topics/commonly-used-drugs-charts
• DSM-5 criteria for substance use disorders. (n.d.) https://www.gatewayfoundation.org/addiction-blog/dsm-5-substance-use-disorder/
• High-risk substance use among youth. (2020). https://www.cdc.gov/healthyyouth/substance-use/index.htm
• Lung cancer. (2021). https://www.cdc.gov/cancer/lung/index.htm
• Netherland, J., et al. (2017). White opioids: Pharmaceutical race and the war on drugs that wasn’t. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501419/
• Opioid crisis statistics. (2021). https://www.hhs.gov/opioids/about-the-epidemic/opioid-crisis-statistics/index.html
• Opioid overdose. (2022). https://www.cdc.gov/drugoverdose/index.html
• Prescription medicines. (n.d.) https://teens.drugabuse.gov/drug-facts/prescription-drugs
• Principles of drug addiction treatment: A research-based guide (Third edition). (2018). https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
• Racial/ethnic differences In substance use, substance use disorders, and substance use treatment utilization among people aged 12 or older (2015-2019). (2021). https://www.samhsa.gov/data/sites/default/files/reports/rpt35326/2021NSDUHSUChartbook102221B.pdf
• Substance use and co-occurring mental disorders. (2021). https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health

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The Effects of Drug Addiction on the Brain and Body

Signs of drug addiction, effects of drug addiction.

Drug addiction is a treatable, chronic medical disease that involves complex interactions between a person’s environment, brain circuits, genetics, and life experiences.

People with drug addictions continue to use drugs compulsively, despite the negative effects.

Substance abuse has many potential consequences, including overdose and death. Learn about the effects of drug addiction on the mind and body and treatment options that can help.

Verywell / Theresa Chiechi

Drug Abuse vs. Drug Addiction

While the terms “drug abuse” and “drug addiction” are often used interchangeably, they're different. Someone who abuses drugs uses a substance too much, too frequently, or in otherwise unhealthy ways. However, they ultimately have control over their substance use.

Someone with a drug addiction uses drugs in a way that affects many parts of their life and causes major disruptions. They can't stop using drugs, even if they want to.

The signs of drug abuse and addiction include changes in behavior, personality, and physical appearance. If you’re concerned about a loved one’s substance use, here are some of the red flags to watch out for:

• Changes in school or work performance
• Secretiveness 
• Relationship problems
• Risk-taking behavior
• Legal problems
• Aggression 
• Mood swings
• Changes in hobbies or friends
• Sudden weight loss or gain
• Unexplained odors on the body or clothing

Drug Addiction in Men and Women

Men and women are equally likely to develop drug addictions. However, men are more likely than women to use illicit drugs, die from a drug overdose, and visit an emergency room for addiction-related health reasons. Women are more susceptible to intense cravings and repeated relapses.

People can become addicted to any psychoactive ("mind-altering") substance. Common addictive substances include alcohol , tobacco ( nicotine ), stimulants, hallucinogens, and opioids .

Many of the effects of drug addiction are similar, no matter what substance someone uses. The following are some of the most common effects of drug addiction.

Effects of Drug Addiction on the Body

Drug addiction can lead to a variety of physical consequences ranging in seriousness from drowsiness to organ damage and death:

• Shallow breathing
• Elevated body temperature
• Rapid heart rate
• Increased blood pressure
• Impaired coordination and slurred speech
• Decreased or increased appetite
• Tooth decay
• Skin damage
• Sexual dysfunction
• Infertility
• Kidney damage
• Liver damage and cirrhosis
• Various forms of cancer
• Cardiovascular problems
• Lung problems
• Overdose and death

If left untreated drug addiction can lead to serious, life-altering effects on the body.

Dependence and withdrawal also affect the body:

• Physical dependence : Refers to the reliance on a substance to function day to day. People can become physically dependent on a substance fairly quickly. Dependence does not always mean someone is addicted, but the longer someone uses drugs, the more likely their dependency is to become an addiction.
• Withdrawal : When someone with a dependence stops using a drug, they can experience withdrawal symptoms like excessive sweating, tremors, panic, difficulty breathing, fatigue , irritability, and flu-like symptoms.

Overdose Deaths in the United States

According to the Centers for Disease Control and Prevention (CDC), over 100,000 people in the U.S. died from a drug overdose in 2021.

Effects of Drug Addiction on the Brain

All basic functions in the body are regulated by the brain. But, more than that, your brain is who you are. It controls how you interpret and respond to life experiences and the ways you behave as a result of undergoing those experiences.

Drugs alter important areas of the brain. When someone continues to use drugs, their health can deteriorate both psychologically and neurologically.

Some of the most common mental effects of drug addiction are:

• Cognitive decline
• Memory loss
• Mood changes and paranoia
• Poor self/impulse control
• Disruption to areas of the brain controlling basic functions (heart rate, breathing, sleep, etc.)

Effects of Drug Addiction on Behavior

Psychoactive substances affect the parts of the brain that involve reward, pleasure, and risk. They produce a sense of euphoria and well-being by flooding the brain with dopamine .

This leads people to compulsively use drugs in search of another euphoric “high.” The consequences of these neurological changes can be either temporary or permanent. 

• Difficulty concentrating
• Irritability 
• Angry outbursts
• Lack of inhibition 
• Decreased pleasure/enjoyment in daily life (e.g., eating, socializing, and sex)
• Hallucinations

Help Someone With Drug Addiction

If you suspect that a loved one is experiencing drug addiction, address your concerns honestly, non-confrontationally, and without judgment. Focus on building trust and maintaining an open line of communication while setting healthy boundaries to keep yourself and others safe. If you need help, contact the SAMHSA National Helpline at 1-800-662-4357.

Effects of Drug Addiction on an Unborn Child

Drug addiction during pregnancy can cause serious negative outcomes for both mother and child, including:

• Preterm birth
• Maternal mortality

Drug addiction during pregnancy can lead to neonatal abstinence syndrome (NAS) . Essentially, the baby goes into withdrawal after birth. Symptoms of NAS differ depending on which drug has been used but can include:

• Excessive crying
• Sleeping and feeding issues

Children exposed to drugs before birth may go on to develop issues with behavior, attention, and thinking. It's unclear whether prenatal drug exposure continues to affect behavior and the brain beyond adolescence.  

While there is no single “cure” for drug addiction, there are ways to treat it. Treatment can help you control your addiction and stay drug-free. The primary methods of treating drug addiction include:

• Psychotherapy : Psychotherapy, such as cognitive behavioral therapy (CBT) or family therapy , can help someone with a drug addiction develop healthier ways of thinking and behaving.
• Behavioral therapy : Common behavioral therapies for drug addiction include motivational enhancement therapy (MET) and contingency management (CM). These therapy approaches build coping skills and provide positive reinforcement.
• Medication : Certain prescribed medications help to ease withdrawal symptoms. Some examples are naltrexone (for alcohol), bupropion (for nicotine), and methadone (for opioids).
• Hospitalization : Some people with drug addiction might need to be hospitalized to detox from a substance before beginning long-term treatment.
• Support groups : Peer support and self-help groups, such as 12-step programs like Alcoholics Anonymous, can help people with drug addictions find support, resources, and accountability.

A combination of medication and behavioral therapy has been found to have the highest success rates in preventing relapse and promoting recovery. Forming an individualized treatment plan with your healthcare provider's help is likely to be the most effective approach.

Drug addiction is a complex, chronic medical disease that causes someone to compulsively use psychoactive substances despite the negative consequences.

Some effects of drug abuse and addiction include changes in appetite, mood, and sleep patterns. More serious health issues such as cognitive decline, major organ damage, overdose, and death are also risks. Addiction to drugs while pregnant can lead to serious outcomes for both mother and child.

Treatment for drug addiction may involve psychotherapy , medication, hospitalization, support groups, or a combination.

If you or someone you know is experiencing substance abuse or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357.

American Society of Addiction Medicine. Definition of addiction .

HelpGuide.org. Drug Abuse and Addiction .

Tennessee Department of Mental Health & Substance Abuse Services. Warning signs of drug abuse .

National Institute on Drug Abuse. Sex and gender differences in substance use .

Cleveland Clinic. Drug addiction .

National Institute on Drug Abuse. Drugs, Brains, and Behavior: The Science of Addiction Drugs and the Brain .

American Heart Association. Illegal Drugs and Heart Disease .

American Addiction Centers. Get the facts on substance abuse .

Szalavitz M, Rigg KK, Wakeman SE. Drug dependence is not addiction-and it matters . Ann Med . 2021;53(1):1989-1992. doi:10.1080/07853890.2021.1995623

Centers for Disease Control and Prevention. Drug overdose deaths in the U.S. top 100,000 annually .

American Psychological Association. Cognition is central to drug addiction .

National Institute on Drug Abuse. Understanding Drug Use and Addiction DrugFacts .

MedlinePlus. Neonatal abstinence syndrome .

National Institute on Drug Abuse. Treatment and recovery .

Grella CE, Stein JA.  Remission from substance dependence: differences between individuals in a general population longitudinal survey who do and do not seek help . Drug and Alcohol Dependence.  2013;133(1):146-153. doi:10.1016/j.drugalcdep.2013.05.019

By Laura Dorwart Dr. Dorwart has a Ph.D. from UC San Diego and is a health journalist interested in mental health, pregnancy, and disability rights.

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Substance Use Disorders and Addiction: Mechanisms, Trends, and Treatment Implications

• Ned H. Kalin , M.D.

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The numbers for substance use disorders are large, and we need to pay attention to them. Data from the 2018 National Survey on Drug Use and Health ( 1 ) suggest that, over the preceding year, 20.3 million people age 12 or older had substance use disorders, and 14.8 million of these cases were attributed to alcohol. When considering other substances, the report estimated that 4.4 million individuals had a marijuana use disorder and that 2 million people suffered from an opiate use disorder. It is well known that stress is associated with an increase in the use of alcohol and other substances, and this is particularly relevant today in relation to the chronic uncertainty and distress associated with the COVID-19 pandemic along with the traumatic effects of racism and social injustice. In part related to stress, substance use disorders are highly comorbid with other psychiatric illnesses: 9.2 million adults were estimated to have a 1-year prevalence of both a mental illness and at least one substance use disorder. Although they may not necessarily meet criteria for a substance use disorder, it is well known that psychiatric patients have increased usage of alcohol, cigarettes, and other illicit substances. As an example, the survey estimated that over the preceding month, 37.2% of individuals with serious mental illnesses were cigarette smokers, compared with 16.3% of individuals without mental illnesses. Substance use frequently accompanies suicide and suicide attempts, and substance use disorders are associated with a long-term increased risk of suicide.

Addiction is the key process that underlies substance use disorders, and research using animal models and humans has revealed important insights into the neural circuits and molecules that mediate addiction. More specifically, research has shed light onto mechanisms underlying the critical components of addiction and relapse: reinforcement and reward, tolerance, withdrawal, negative affect, craving, and stress sensitization. In addition, clinical research has been instrumental in developing an evidence base for the use of pharmacological agents in the treatment of substance use disorders, which, in combination with psychosocial approaches, can provide effective treatments. However, despite the existence of therapeutic tools, relapse is common, and substance use disorders remain grossly undertreated. For example, whether at an inpatient hospital treatment facility or at a drug or alcohol rehabilitation program, it was estimated that only 11% of individuals needing treatment for substance use received appropriate care in 2018. Additionally, it is worth emphasizing that current practice frequently does not effectively integrate dual diagnosis treatment approaches, which is important because psychiatric and substance use disorders are highly comorbid. The barriers to receiving treatment are numerous and directly interact with existing health care inequities. It is imperative that as a field we overcome the obstacles to treatment, including the lack of resources at the individual level, a dearth of trained providers and appropriate treatment facilities, racial biases, and the marked stigmatization that is focused on individuals with addictions.

This issue of the Journal is focused on understanding factors contributing to substance use disorders and their comorbidity with psychiatric disorders, the effects of prenatal alcohol use on preadolescents, and brain mechanisms that are associated with addiction and relapse. An important theme that emerges from this issue is the necessity for understanding maladaptive substance use and its treatment in relation to health care inequities. This highlights the imperative to focus resources and treatment efforts on underprivileged and marginalized populations. The centerpiece of this issue is an overview on addiction written by Dr. George Koob, the director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and coauthors Drs. Patricia Powell (NIAAA deputy director) and Aaron White ( 2 ). This outstanding article will serve as a foundational knowledge base for those interested in understanding the complex factors that mediate drug addiction. Of particular interest to the practice of psychiatry is the emphasis on the negative affect state “hyperkatifeia” as a major driver of addictive behavior and relapse. This places the dysphoria and psychological distress that are associated with prolonged withdrawal at the heart of treatment and underscores the importance of treating not only maladaptive drug-related behaviors but also the prolonged dysphoria and negative affect associated with addiction. It also speaks to why it is crucial to concurrently treat psychiatric comorbidities that commonly accompany substance use disorders.

Insights Into Mechanisms Related to Cocaine Addiction Using a Novel Imaging Method for Dopamine Neurons

Cassidy et al. ( 3 ) introduce a relatively new imaging technique that allows for an estimation of dopamine integrity and function in the substantia nigra, the site of origin of dopamine neurons that project to the striatum. Capitalizing on the high levels of neuromelanin that are found in substantia nigra dopamine neurons and the interaction between neuromelanin and intracellular iron, this MRI technique, termed neuromelanin-sensitive MRI (NM-MRI), shows promise in studying the involvement of substantia nigra dopamine neurons in neurodegenerative diseases and psychiatric illnesses. The authors used this technique to assess dopamine function in active cocaine users with the aim of exploring the hypothesis that cocaine use disorder is associated with blunted presynaptic striatal dopamine function that would be reflected in decreased “integrity” of the substantia nigra dopamine system. Surprisingly, NM-MRI revealed evidence for increased dopamine in the substantia nigra of individuals using cocaine. The authors suggest that this finding, in conjunction with prior work suggesting a blunted dopamine response, points to the possibility that cocaine use is associated with an altered intracellular distribution of dopamine. Specifically, the idea is that dopamine is shifted from being concentrated in releasable, functional vesicles at the synapse to a nonreleasable cytosolic pool. In addition to providing an intriguing alternative hypothesis underlying the cocaine-related alterations observed in substantia nigra dopamine function, this article highlights an innovative imaging method that can be used in further investigations involving the role of substantia nigra dopamine systems in neuropsychiatric disorders. Dr. Charles Bradberry, chief of the Preclinical Pharmacology Section at the National Institute on Drug Abuse, contributes an editorial that further explains the use of NM-MRI and discusses the theoretical implications of these unexpected findings in relation to cocaine use ( 4 ).

Treatment Implications of Understanding Brain Function During Early Abstinence in Patients With Alcohol Use Disorder

Developing a better understanding of the neural processes that are associated with substance use disorders is critical for conceptualizing improved treatment approaches. Blaine et al. ( 5 ) present neuroimaging data collected during early abstinence in patients with alcohol use disorder and link these data to relapses occurring during treatment. Of note, the findings from this study dovetail with the neural circuit schema Koob et al. provide in this issue’s overview on addiction ( 2 ). The first study in the Blaine et al. article uses 44 patients and 43 control subjects to demonstrate that patients with alcohol use disorder have a blunted neural response to the presentation of stress- and alcohol-related cues. This blunting was observed mainly in the ventromedial prefrontal cortex, a key prefrontal regulatory region, as well as in subcortical regions associated with reward processing, specifically the ventral striatum. Importantly, this finding was replicated in a second study in which 69 patients were studied in relation to their length of abstinence prior to treatment and treatment outcomes. The results demonstrated that individuals with the shortest abstinence times had greater alterations in neural responses to stress and alcohol cues. The authors also found that an individual’s length of abstinence prior to treatment, independent of the number of days of abstinence, was a predictor of relapse and that the magnitude of an individual’s neural alterations predicted the amount of heavy drinking occurring early in treatment. Although relapse is an all too common outcome in patients with substance use disorders, this study highlights an approach that has the potential to refine and develop new treatments that are based on addiction- and abstinence-related brain changes. In her thoughtful editorial, Dr. Edith Sullivan from Stanford University comments on the details of the study, the value of studying patients during early abstinence, and the implications of these findings for new treatment development ( 6 ).

Relatively Low Amounts of Alcohol Intake During Pregnancy Are Associated With Subtle Neurodevelopmental Effects in Preadolescent Offspring

Excessive substance use not only affects the user and their immediate family but also has transgenerational effects that can be mediated in utero. Lees et al. ( 7 ) present data suggesting that even the consumption of relatively low amounts of alcohol by expectant mothers can affect brain development, cognition, and emotion in their offspring. The researchers used data from the Adolescent Brain Cognitive Development Study, a large national community-based study, which allowed them to assess brain structure and function as well as behavioral, cognitive, and psychological outcomes in 9,719 preadolescents. The mothers of 2,518 of the subjects in this study reported some alcohol use during pregnancy, albeit at relatively low levels (0 to 80 drinks throughout pregnancy). Interestingly, and opposite of that expected in relation to data from individuals with fetal alcohol spectrum disorders, increases in brain volume and surface area were found in offspring of mothers who consumed the relatively low amounts of alcohol. Notably, any prenatal alcohol exposure was associated with small but significant increases in psychological problems that included increases in separation anxiety disorder and oppositional defiant disorder. Additionally, a dose-response effect was found for internalizing psychopathology, somatic complaints, and attentional deficits. While subtle, these findings point to neurodevelopmental alterations that may be mediated by even small amounts of prenatal alcohol consumption. Drs. Clare McCormack and Catherine Monk from Columbia University contribute an editorial that provides an in-depth assessment of these findings in relation to other studies, including those assessing severe deficits in individuals with fetal alcohol syndrome ( 8 ). McCormack and Monk emphasize that the behavioral and psychological effects reported in the Lees et al. article would not be clinically meaningful. However, it is feasible that the influences of these low amounts of alcohol could interact with other predisposing factors that might lead to more substantial negative outcomes.

Increased Comorbidity Between Substance Use and Psychiatric Disorders in Sexual Identity Minorities

There is no question that victims of societal marginalization experience disproportionate adversity and stress. Evans-Polce et al. ( 9 ) focus on this concern in relation to individuals who identify as sexual minorities by comparing their incidence of comorbid substance use and psychiatric disorders with that of individuals who identify as heterosexual. By using 2012−2013 data from 36,309 participants in the National Epidemiologic Study on Alcohol and Related Conditions–III, the authors examine the incidence of comorbid alcohol and tobacco use disorders with anxiety, mood disorders, and posttraumatic stress disorder (PTSD). The findings demonstrate increased incidences of substance use and psychiatric disorders in individuals who identified as bisexual or as gay or lesbian compared with those who identified as heterosexual. For example, a fourfold increase in the prevalence of PTSD was found in bisexual individuals compared with heterosexual individuals. In addition, the authors found an increased prevalence of substance use and psychiatric comorbidities in individuals who identified as bisexual and as gay or lesbian compared with individuals who identified as heterosexual. This was most prominent in women who identified as bisexual. For example, of the bisexual women who had an alcohol use disorder, 60.5% also had a psychiatric comorbidity, compared with 44.6% of heterosexual women. Additionally, the amount of reported sexual orientation discrimination and number of lifetime stressful events were associated with a greater likelihood of having comorbid substance use and psychiatric disorders. These findings are important but not surprising, as sexual minority individuals have a history of increased early-life trauma and throughout their lives may experience the painful and unwarranted consequences of bias and denigration. Nonetheless, these findings underscore the strong negative societal impacts experienced by minority groups and should sensitize providers to the additional needs of these individuals.

Trends in Nicotine Use and Dependence From 2001–2002 to 2012–2013

Although considerable efforts over earlier years have curbed the use of tobacco and nicotine, the use of these substances continues to be a significant public health problem. As noted above, individuals with psychiatric disorders are particularly vulnerable. Grant et al. ( 10 ) use data from the National Epidemiologic Survey on Alcohol and Related Conditions collected from a very large cohort to characterize trends in nicotine use and dependence over time. Results from their analysis support the so-called hardening hypothesis, which posits that although intervention-related reductions in nicotine use may have occurred over time, the impact of these interventions is less potent in individuals with more severe addictive behavior (i.e., nicotine dependence). When adjusted for sociodemographic factors, the results demonstrated a small but significant increase in nicotine use from 2001–2002 to 2012–2013. However, a much greater increase in nicotine dependence (46.1% to 52%) was observed over this time frame in individuals who had used nicotine during the preceding 12 months. The increases in nicotine use and dependence were associated with factors related to socioeconomic status, such as lower income and lower educational attainment. The authors interpret these findings as evidence for the hardening hypothesis, suggesting that despite the impression that nicotine use has plateaued, there is a growing number of highly dependent nicotine users who would benefit from nicotine dependence intervention programs. Dr. Kathleen Brady, from the Medical University of South Carolina, provides an editorial ( 11 ) that reviews the consequences of tobacco use and the history of the public measures that were initially taken to combat its use. Importantly, her editorial emphasizes the need to address health care inequity issues that affect individuals of lower socioeconomic status by devoting resources to develop and deploy effective smoking cessation interventions for at-risk and underresourced populations.

Conclusions

Maladaptive substance use and substance use disorders are highly prevalent and are among the most significant public health problems. Substance use is commonly comorbid with psychiatric disorders, and treatment efforts need to concurrently address both. The papers in this issue highlight new findings that are directly relevant to understanding, treating, and developing policies to better serve those afflicted with addictions. While treatments exist, the need for more effective treatments is clear, especially those focused on decreasing relapse rates. The negative affective state, hyperkatifeia, that accompanies longer-term abstinence is an important treatment target that should be emphasized in current practice as well as in new treatment development. In addition to developing a better understanding of the neurobiology of addictions and abstinence, it is necessary to ensure that there is equitable access to currently available treatments and treatment programs. Additional resources must be allocated to this cause. This depends on the recognition that health care inequities and societal barriers are major contributors to the continued high prevalence of substance use disorders, the individual suffering they inflict, and the huge toll that they incur at a societal level.

Disclosures of Editors’ financial relationships appear in the April 2020 issue of the Journal .

1 US Department of Health and Human Services: Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality: National Survey on Drug Use and Health 2018. Rockville, Md, SAMHSA, 2019 ( https://www.samhsa.gov/data/nsduh/reports-detailed-tables-2018-NSDUH ) Google Scholar

2 Koob GF, Powell P, White A : Addiction as a coping response: hyperkatifeia, deaths of despair, and COVID-19 . Am J Psychiatry 2020 ; 177:1031–1037 Link ,  Google Scholar

3 Cassidy CM, Carpenter KM, Konova AB, et al. : Evidence for dopamine abnormalities in the substantia nigra in cocaine addiction revealed by neuromelanin-sensitive MRI . Am J Psychiatry 2020 ; 177:1038–1047 Link ,  Google Scholar

4 Bradberry CW : Neuromelanin MRI: dark substance shines a light on dopamine dysfunction and cocaine use (editorial). Am J Psychiatry 2020 ; 177:1019–1021 Abstract ,  Google Scholar

5 Blaine SK, Wemm S, Fogelman N, et al. : Association of prefrontal-striatal functional pathology with alcohol abstinence days at treatment initiation and heavy drinking after treatment initiation . Am J Psychiatry 2020 ; 177:1048–1059 Abstract ,  Google Scholar

6 Sullivan EV : Why timing matters in alcohol use disorder recovery (editorial). Am J Psychiatry 2020 ; 177:1022–1024 Abstract ,  Google Scholar

7 Lees B, Mewton L, Jacobus J, et al. : Association of prenatal alcohol exposure with psychological, behavioral, and neurodevelopmental outcomes in children from the Adolescent Brain Cognitive Development Study . Am J Psychiatry 2020 ; 177:1060–1072 Link ,  Google Scholar

8 McCormack C, Monk C : Considering prenatal alcohol exposure in a developmental origins of health and disease framework (editorial). Am J Psychiatry 2020 ; 177:1025–1028 Abstract ,  Google Scholar

9 Evans-Polce RJ, Kcomt L, Veliz PT, et al. : Alcohol, tobacco, and comorbid psychiatric disorders and associations with sexual identity and stress-related correlates . Am J Psychiatry 2020 ; 177:1073–1081 Abstract ,  Google Scholar

10 Grant BF, Shmulewitz D, Compton WM : Nicotine use and DSM-IV nicotine dependence in the United States, 2001–2002 and 2012–2013 . Am J Psychiatry 2020 ; 177:1082–1090 Link ,  Google Scholar

11 Brady KT : Social determinants of health and smoking cessation: a challenge (editorial). Am J Psychiatry 2020 ; 177:1029–1030 Abstract ,  Google Scholar

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The Impact of Substance Use Disorders on Families and Children: From Theory to Practice

The effects of a substance use disorder (SUD) are felt by the whole family. The family context holds information about how SUDs develop, are maintained, and what can positively or negatively influence the treatment of the disorder. Family systems theory and attachment theory are theoretical models that provide a framework for understanding how SUDs affect the family. In addition, understanding the current developmental stage a family is in helps inform assessment of impairment and determination of appropriate interventions. SUDs negatively affect emotional and behavioral patterns from the inception of the family, resulting in poor outcomes for the children and adults with SUDs. Social workers can help address SUDs in multiple ways, which are summarized in this article.

INTRODUCTION AND THEORETICAL FRAMEWORK

The family remains the primary source of attachment, nurturing, and socialization for humans in our current society. Therefore, the impact of substance use disorders (SUDs) on the family and individual family members merits attention. Each family and each family member is uniquely affected by the individual using substances including but not limited to having unmet developmental needs, impaired attachment, economic hardship, legal problems, emotional distress, and sometimes violence being perpetrated against him or her. For children there is also an increased risk of developing an SUD themselves ( Zimic & Jakic, 2012 ). Thus, treating only the individual with the active disease of addiction is limited in effectiveness. The social work profession more than any other health care profession has historically recognized the importance of assessing the individual in the context of his or her family environment. Social work education and training emphasizes the significant impact the environment has on the individual and vice versa. This topic was chosen to illustrate how involving the family in the treatment of an SUD in an individual is an effective way to help the family and the individual. The utilization of evidence-based family approaches has demonstrated superiority over individual or group-based treatments ( Baldwin, Christian, Berkeljon, & Shandish, 2012 ). Treating the individual without family involvement may limit the effectiveness of treatment for two main reasons: it ignores the devastating impact of SUDs on the family system leaving family members untreated, and it does not recognize the family as a potential system of support for change. Two theories important to understanding how and why SUDs impact the family are attachment theory and systems theory.

Attachment Theory

It is estimated that more than eight million children younger than age 18 live with at least one adult who has a SUD that is a rate of more than one in 10 children. The majority of these children are younger than age 5 (U.S. Department of Health and Human Services [USDHHS], 2010). The studies of families with SUDs reveal patterns that significantly influence child development and the likelihood that a child will struggle with emotional, behavioral, or substance use problems ( Substance Abuse and Mental Health Services Administration [SAMHSA], 2003 ). The negative impacts of parental SUDs on the family include disruption of attachment, rituals, roles, routines, communication, social life, and finances. Families in which there is a parental SUD are characterized by an environment of secrecy, loss, conflict, violence or abuse, emotional chaos, role reversal, and fear.

Relationships serve as the communication conduits that connect family members to each other. Attachment theory provides a way of understanding the development and quality of relationships between family members. John Bowlby (1988) developed attachment theory through the clinical study of mammalian species and humans. He postulated that at the time of an infant's birth, the primary relationship, usually with the mother but not always, serves as the template for all subsequent relationships throughout the life cycle. This relationship forms a subsystem within the larger family system. It is through this relationship, at a prelanguage level, that infants learn to communicate and relate to their environment. They do this through crying, cooing, rooting, and clinging. The way in which the primary caretaker responds to these cues will establish the quality of the attachment. Generally, if the child experiences the primary caretaker as responsive and nurturing, a secure attachment will form. If the child experiences the primary caretaker as unresponsive or inconsistently responsive, an insecure attachment may form that can result in a variety of problems including anxiety, depression, and failure to thrive.

A parent with a SUD, who is mood altered, preoccupied with getting high or spending significant amounts of time recovering from the effects of substances, may miss the opportunities to foster healthy attachment. Consequently, the intricate attachment system that is built on hundreds of thousands of reciprocal and implicit interactions between infant and attachment figure will be affected. Eye contact, tone, volume and rhythm of voice, soothing touch, and the ability to read the needs of the infant are all intricate building blocks of attachment. Healthy attachment is a psychological immune system of sorts. Just as humans need a physiological immune system to fight off disease and illness, likewise, the relational attachment system provides protection against psychological problems and illness. Without a healthy attachment system, a child is much more vulnerable to stress and therefore more susceptible to having problems with trauma, anxiety, depression, and other mental illness. Attachment theory posits that the quality of the parents' attachment system that developed in infancy will affect their ability to form healthy attachments to their own children and with other adults.

Family Systems Theory

Family systems theory grew out of the biologically based general systems theory. General systems theory focuses on how the parts of a system interact with one another. In general systems theory an individual cell is one example of a system, and in family systems theory the family is essentially its own system. Key concepts in both theories are feedback, homeostasis and boundaries that are defined and operationalized in this section. Family systems theory was developed in the late 1960s and early 1970s. Nathan Ackerman, Jay Haley, Murray Bowen, Salvadore Minuchin, Virginia Satir, and Carl Witaker, among others were highly influential figures in this movement and developed its applications to psychiatric treatment. Out of this theory multiple models of family therapy developed including but not limited to strategic, structural, experiential, and more recently the multisystemic family systems therapy (MFT) model. All the family therapy models share the basic principal of family systems theory that is that the individual cannot be fully understood or successfully treated without first understanding how that individual functions in his or her family system. Individuals who present in our clinical settings can be seen as “symptomatic,” and their pathology can be viewed as an attempt adapt to their family system so as to maintain homeostasis.

Homeostasis refers to the idea that it is the tendency of a system to seek stability and equilibrium ( Brown & Christensen, 1986 ). The idea of homeostasis is key to understanding the effect of SUDs on the family in that each family member tends to function in such a way that keeps the whole system in balance even if it is not healthy for specific individuals. For example, a latency-age child may cover up her father's drinking by cleaning up after him if he is sick, getting him into bed after he passes out, and minimizing his drinking to her mother. Her efforts allow his SUD to continue with limited consequence and keep the family system at relative equilibrium by reducing fighting between the mother and father. Although that adaptation may keep the family system in a state of equilibrium, it also serves to maintain the problem. Feedback refers to the circular way in which parts of a system communicate with each other. The process of feedback is how the parent–child attachment relationship is formed. In a family system, a wife may identify that she abuses pain pills because her husband ignores her and she is depressed. The husband may in turn state that he avoids his wife because she is always morose and high on pain pills. Each person's behavior becomes reinforcing feedback for the other. Boundaries define internal and external limits of a system and are established to conserve energy by creating a protective barrier around a system. In a family they regulate interpersonal contact. In a healthy family, boundaries surround the parental subsystem and the child subsystem by keeping them separate. In a family with a parent who has a SUD, boundaries around the parental and child subsystems are typically permeable as the parental subsystem does not function well as a cohesive unit. Boundaries around the family itself are rigid to maintain the family secret of substance abuse. Healthy boundaries are important in the normal development of a family and children.

FAMILY IMPACT

Genetic and environmental factors contribute to the development of SUDs. Given that the family in which one is raised influences both of these, it is important to explore the impact of SUDs on the family. Studies looking at the relative weight of these influences show that both add contribution and impact ( Haber et al., 2010 ). The impact will vary depending on the role and gender that the individual with the SUD has in the family. For example, if an adolescent child is identified as having a SUD, this will affect the family differently than if a parent has an SUD. The attitudes and beliefs that family members have about SUDs are also of importance as these will influence the individuals as they try to get sober and will influence the efficacy of treatment interventions. For example, if a parent sees a SUD as a moral failing and thinks his or her adolescent child should just use “will power” to quit, this will be important to know if the treating therapist is working from a disease model of addiction. Education with the family about SUDs, their development, progression, and treatment will be needed. When family members have appropriate education and treatment for themselves they can play a significant role in the abusers' recognition of the problem and acceptance of treatment. The evidence-based family treatment Community Reinforcement And Family Training (CRAFT) has demonstrated its effectiveness in increasing the rate at which abusers enter treatment ( Roozen, de Waart, & van der Kroft, 2010 ).

When one person in a family begins to change his or her behavior, the change will affect the entire family system. It is helpful to think of the family system as a mobile: when one part in a hanging mobile moves, this affects all parts of the mobile but in different ways, and each part adjusts to maintain a balance in the system. One consequence of this accommodation can be that various family members may inadvertently sabotage treatment with their own behaviors as they respond to the change in the individual using substances. For example, if an adult son tries to get sober and his retired father feels as if he has lost his “drinking buddy,” he might express to his son that he can have “just a couple beers at the game.” This will put pressure on the son to continue his use so as not to disappoint his father. These behaviors can be seen as an attempt to maintain the comfortable equilibrium of the system because as one person changes it upsets the equilibrium of the whole family system including extended family relationships. Family therapy can be a useful intervention where the therapist can assist and support the son in setting limits with the father saying he does not want to drink at all and suggesting alternative non-drinking-related activities. Individual therapy can be used with the son to affirm his decision to remain sober and reinforce the importance of his establishing his own identity as a nondrinking person.

We know that individuals who grow up in a family where there is an SUD are at significantly higher risk to develop SUDs due to genetic and environmental factors ( Hawkins, Catalano, & Miller, 1992 ). It is essential to assess for active substance abuse in the immediate and extended family. Knowing that an individual with an SUD grew up in a family with an SUD has significant implications in treatment. Active substance abuse in the family of a client who is trying to get clean will also put that client at risk for relapse.

Developmental Stages of the Family

Understanding the family's specific developmental stage can help with assessing the interventional needs of a family. Carter and McGoldrick (1989) identify eight stages of the family life cycle and corresponding developmental tasks. SUDs can disrupt these developmental tasks depending on who has the SUD and at what developmental stage the family is in when the SUD develops. Table 1 is an adaptation of Carter and McGoldrick's family life cycle stages as applied to families with SUDs. When families do not move through the life cycle and get stuck, individual members can exhibit clinical symptoms. It should be noted that blended families with stepparents and stepchildren have their own developmental needs that are impaired by SUDs as well, but those are not detailed in this table.

Impact of SUD on Family Life Cycle Stages

Note . This table has been adapted from Carter and McGoldrick's (1989) model of the stages of the family life cycle. Modifications have been made to Column 2 to identify concepts relevant to the family with a SUD, and Columns 3 and 4 are contributions of the authors of this article.

SUD = substance use disorder; AA = Alcoholics Anonymous; NA = Narcotics Anonymous.

Impact of Parental Substance Abuse on Children

Clinicians have speculated that what are called “attachment disorders” may occur at elevated rates among children affected by alcohol, in part due to abuse and neglect (when these have happened), and in part because of alcohol-related deficits in cognitive and social-emotional functioning that lead to less resilience ( Coles et al., 1997 ). Studies indicate that between one third and two thirds of child maltreatment cases involve some degree of substance use ( U.S. Department of Health and Human Services [USDHHS], 1996 ). The negative consequences of having one or both parents with a SUD ranges from covert damage that is mild and may play out when a child or adolescent is having difficulty establishing trusting relationships with people, to being overly emotionally responsible in relationships and taking on adult roles much younger than developmentally appropriate. An even more severe impact can begin in utero with maternal substance abuse that causes damage to the growing fetus resulting in birth defects, fetal alcohol syndrome, and/or fetal alcohol effects. These difficulties may cause disabilities that require early intervention and often ongoing and social and mental health services. Social workers can help by encouraging their clients who abuse substances to use precautions to prevent pregnancy and providing education about the risks of maternal drug use on the developing fetus. If a social worker is working with a pregnant client with an SUD, referral to a Perinatal Addiction Clinic and/or high-risk pregnancy OB/GYN clinic is indicated.

As previously mentioned, all primates learn how to regulate their affect from their primary attachment figures through the attachment system and modeling. Parents who have substance use problems will likely have their own affect dysregulation that may have preceded or resulted from their substance use. Consequently, development of healthy affect regulation will be difficult for children and adolescents to achieve. This can result in children and adolescents having an increased risk for internalizing problems such as depression, anxiety, substance abuse, and so on or externalizing problems such as opposition, conduct problems (stealing, lying, and truancy), anger outbursts, aggressivity, impulsivity, and again substance abuse. Children may present to a social worker in direct practice at community mental health center or a school setting. Social workers can assist these clients by looking for signs and symptoms of parental substance use while observing the child's behavior in social settings and in play behavior. Social workers should look for how the child's presenting symptoms serve a function in the family system to maintain homeostasis. Providing family therapy, parent training and education, play therapy, social skills training, and coping skills training either in individual or group therapy in an outpatient, school or in-home therapy setting are ways that social workers can be helpful. Sometimes a referral to Child Protective Services will be indicated.

Parental Substance Abuse and Child Abuse and Neglect

A parent with a SUD is 3 times more likely to physically or sexually abuse their child. The sequalae of this is that these children are more than 50% more likely to be arrested as juveniles, and 40% more likely to commit a violent crime ( USDHHS, 1996 ). Children who have experienced abuse are more likely to have the externalizing disorders such as anger, aggression, conduct, and behavioral problems whereas children who experience neglect are more likely to have internalizing disorders (depression, anxiety, social withdrawal, poor peer relations). Incest has a very high association with parental substance abuse as do all types of sexual abuse. About two thirds of incest perpetrators report using alcohol directly before the offending incident ( USDHHS, 1996 ).

Although active substance abuse can impair attachment and healthy modeling for affect regulation, sometimes the consequences of severe and ongoing substance abuse on the part of a parent can result in parent and child separation. This separation could be because of parental incarceration, long-term treatment or an intervention on the part of child protective services that removes the child from an unsafe or high-risk home environment and places him or her in an out-of-home placement such as foster care, relative placement, or a group or residential home. In extreme cases, the separation may be due to the substance-related death of the parent from overdose, motor vehicle accident, or medical complications due to substance abuse. The significant increase in out-of-home child placements in the 1980s and 1990s closely paralleled the pandemic drug addiction in the United States during those decades ( Jaudes & Edwo, 1997 ). Any long-term separation will have a negative impact on the child's ability to attach, regulate affect, and can lead to a trauma response of numbing or hyperarousal (inability to discriminate and respond appropriately to stimulus). These impairments in the psychological emergency response system are directly related to, and substantially increase, subsequent traumatic victimization. Maltreated children of parents with a SUD are more likely to have poorer physical, intellectual, social, and emotional outcomes and are at greater risk of developing substance abuse problems themselves ( USDHHS, 2003 ).

Social workers can help by using trauma-informed, attachment-informed, and systems-based approaches to direct practice in individual therapy and family therapy with special attention to multigenerational trauma and substance abuse. The role of the social worker may include providing in-home therapy supporting parents in being more effective with parental supervision, providing structure, and facilitating healthy caring communication. Social workers may serve on multidisciplinary teams to advocate for a child who is adjudicated, abused, and/or neglected. In addition, social workers may provide expert testimony in courts and participate in permanency planning for children in out-of-home placements. Lastly, social workers play an essential role in specialized courts (family courts, mental health courts, adult drug courts, and juvenile drug courts), providing a unique person in environment and multisystems lens to helping children and families. Specialized drug courts have been shown to produce favorable outcomes for the whole family ( Burns, Pullman, Weathers, Wirschem, & Murphy, 2012 ).

Parental Substance Abuse and Child Social and Emotional Functioning

Many children living in a home where there is an addiction develop into “parentified children.” This occurs when the caretaker is unable to meet the developmental needs of the child, and the child begins to parent themselves and perhaps younger siblings earlier than developmentally appropriate. In a phenomenon called “reversal of dependence needs” the child actually begins to parent the parent.

Case Example

Ashley was a 15-year-old female who was referred to treatment by her school counselor for self-injury. She is a classic “hero” child who has excellent grades and is well liked by her peers. Her parents separated when she was age 5, and she lived with her biological mother until she was 12. Her father obtained full custody of her after being contacted by the domestic violence shelter where she was living with her mother and younger brother. They had moved to the shelter after a domestic violence incident involving her mother's boyfriend. Her biological mother was alcohol dependent; she had difficulty keeping a job and moved frequently. In fifth grade, Ashley changed schools 7 times in a single academic year. Her mother worked as a waitress and a bartender and would often go out drinking after her evening shifts. Ashley then became the caregiver to her younger brother. From age 9 she remembers her mother coming home, being intoxicated sometimes in a black-out, and Ashley helping her into bed. She remembers caring for her mother at night, cleaning up her vomit, wiping her face, and tending to her younger brother in the mornings by getting his breakfast and helping him get ready for school. She stated to her therapist that she remembers thinking, “If only I take really good care of her, maybe she'll be able to take care of me someday.”

In reversal of dependence needs, the parent's needs are placed before the child's. This sets the child up for a potential lifetime of inability to set healthy boundaries in relationships and make the important triad connections between thoughts, feelings, and behaviors. It creates a lack of self-awareness and sometimes an over awareness of others' needs. In the literature one can find these difficulties well-documented under children of alcoholics and adult children of alcoholics research ( Berkowitz & Perkins, 1988 ; Cork, 1969 ; Hecht, 1973 ; Morehouse & Richards, 1982 ; Stroufe, Egeland, Carlson, & Collins, 2005 ; Tarter, 2002 ; Zucker, Donovan, Masten, Mattson, & Moss, 2009 ).

Communication is a significant social skill for interpersonal effectiveness. Parents with a SUD may have difficulty with assertiveness and direct communication. Many subjects are covertly “off-limits” to discuss. Children in these families also often witness the convergence of poor communication and affect dysregulation with their caregivers that frequently results in domestic violence. Although these difficulties may not be overtly diagnosable with a physical or psychological disorder, the patterns have significant developmental, social, and interpersonal consequences. Common emotions these children experience are anxiety, fear, depression guilt, shame, loneliness, confusion, and anger. They may believe that they caused their parent's SUD, or perhaps they are expected to keep the drug use a secret from others in the family or in the community. Perhaps they recognize their parent is mood altered or in withdrawal but are told that, “Your dad is just sick; he needs his medicine.” A parent's moodiness, forgetfulness, and preoccupation can create a chaotic and unstructured, unpredictable environment that leaves the child guessing and asking the questions, “What is going to happen next?” and “What is normal?” Children may present in community mental health settings with a variety of presentations. In terms of diagnosable mental and emotional disorders, children affected by parental substance abuse are virtually at higher risk for nearly every childhood disorder in the Diagnostic Statistical Manual of Mental Disorders ( DSM-IV-TR ; American Psychiatric Association, 2000 ). Of most significant correlation are the following: eating disorders, behavior disorders, anxiety disorders, depression, post-traumatic stress disorder, and SUDs. Social workers can help by evaluating the function of the presenting symptoms through a family systems perspective. Social workers can help children and families have more direct and honest, yet developmentally appropriate communications; and helping youth to deal with covert and overt emotions that are related to their parent's substance use. Social workers can achieve this through the provision of play therapy, individual therapy, family therapy, and group therapy in a variety inpatient, outpatient, in-home, and community based settings.

Parental Substance Abuse and Educational Functioning

Educational problems are also characteristic of some children affected by parental substance use. Problems with unexcused absences in childhood can turn into more serious truancy problems in adolescence and culminate in school dropout. In early childhood, parents read less and provide less learning-based stimulation to their infants and toddlers. In school-age years, parents are less available to provide assistance with homework, monitor school performance, and track assignments. These children may have difficulty with attention and concentration due to increased anxiety levels related to a chaotic home environment. Unstructured bedtimes and mealtimes as well as witnessing domestic violence and safety issues all contribute to an increase in learning problems and behavioral problems for these children at school. It is difficult for children to focus on higher order thinking and learning when basic survival needs are not met. Similar to the home environment, communication between substance abusing parents and teachers and the larger school system is poor. Many parents struggling with an SUD had difficulty with the school system in their own school-age years and avoid interacting with it due to their own anxiety or shame.

The role of the social worker may include providing school-based supportive services to the youth as well as connecting clients with afterschool care, tutoring services, or mentoring agencies such as Big Brothers Big Sisters. In-home and outpatient family therapy and education, supporting parents in being more effective with parental supervision and discipline, providing structure, rewards, and consequences for school attendance and performance and supporting parents in communicating with the school systems can help as well. Social workers can also help by participating in Individualized Education Plan (IEP) meetings, making school referrals for special education, and requesting psychoeducational and neuropsychological testing. Referral to a child and adolescent psychiatrist for a medication evaluation may also be helpful as well as assisting teachers with behavioral interventions in the classroom.

The Impact of Substance Abuse on Parents of Adult Children

As children transition into adulthood they are still strongly affected by their parents as their parents are by them. One of the factors that can perpetuate SUDs is the enabling that family members frequently engage in. Enabling is a form of accommodation that protects the individual with the SUD from fully experiencing the consequences of his or her substance use. An example of enabling is when the parents of a 25-year-old man repeatedly bail him out of jail and pay for lawyer and court fees generated as a result of drug-related arrests. The parents are attempting to help their son and maintain homeostasis in the system by preventing him from going to jail, however the secondary effect is that the son experiences no consequence to his use. As a result, his SUD is more likely to continue. Parents and grandparents do not always agree on how to “help” an adult child with an SUD. Social workers can encourage parents of adult children to seek their own help in Al-Anon and Nar-Anon. These are 12-Step programs for family members that will help them disengage with love, so that they stop enabling and begin to care for themselves. Often parents blame themselves for their children's substance use and feel responsible for fixing the problem. In Al-Anon and Nar-Anon they receive support from other family members and learn they did not cause the SUD, nor can they control it or cure it.

How Social Workers in Nonaddiction Settings Can Help

It is beyond the scope of this article to present in detail how to assess for an SUD, and social workers inexperienced in this area should refer patients to those who specialize in the treatment of SUDs. However with the prevalence of SUDs in the general population being at least 10%, and higher for those presenting with mental health problems, social workers in all settings will find themselves working with individuals with SUDs. All clients, and especially those with known or suspected SUDs, should be reassured of confidentiality. Due to the shame and stigma associated with having an SUD, this is of utmost importance to obtain accurate information. Clients should be asked if they believe they have an SUD and can be informed of how the social worker typically helps those with SUDs. Social workers need to educate themselves about the clinical and community resources in their area available for the treatment of SUD and refer to these resources when indicated. This includes outpatient substance abuse programs, methadone clinics, intensive outpatient programs, detoxification, and residential settings as well as self-help meetings.

Most social workers are mandated reporters so this can present an ethical issue for those who work with individuals with SUDs, especially those with dependent children. Many patients know this and may withhold information about their substance use out of fear of being reported to Child Protective Services. Mandated reporters should disclose this role to their clients and be specific about what circumstances require reporting, while also emphasizing they will do everything they can to assist clients in obtaining the help they need. Being honest in this way helps establish rapport. Social workers should be aware of their own biases, if any, regarding substance abuse. Only if clients feel a positive therapeutic rapport and trust the social worker will they disclose substance use.

SUDs affect families and children in every area of their development. Social workers have opportunities to intervene and change the trajectory of these potential problems at many junctions. When assessing any client is it essential to inquire about substance use history in the family, in the individual, and current use. There is a way to do this that is sensitive and does not put the person on the defensive. Motivational interviewing strategies can be employed to build rapport, increase motivation for change, and decrease resistance ( Miller & Rollnick, 2002 ; W. R. Miller & Rose, 2010). In addition a variety of objective measures can be presented as part of your normal evaluation (Michigan Alcohol Screening Test [MAST; Selzer, 1971 ], Drug Abuse Screening Test [DAST; Skinner, 1982 ], and Substance Abuse Subtle Screening Inventory for Adolescents [SASSI-A2; Miller, 1999 ]). Assessment not only of the individual in front of you but of their family members as well such as parents, siblings, and extended family members may be needed. One way to approach this is with a genogram ( McGoldrick & Gerson, 1985 ). Genograms can reveal SUD patterns in a visual way and help to obtain family details of substance use without directly asking about the problem thereby decreasing defensiveness.

Once a substance use problem has been identified, educating the client about what it means to have a SUD, the treatments available, and the stages of recovery can be useful. Clients can be encouraged to share the impact of the substance use on themselves and on their family system. Encouraging clients to share their feelings related to their experiences in the family is important as it helps them to break the silence so often associated with living with an SUD, and it can also increase their awareness about cognitive and behavioral patterns that contribute to the SUD. If through the assessment it becomes clear that your client or someone in the family would benefit from treatment specifically for his or her SUD, facilitating a formal evaluation or referral to treatment will be helpful. An undetected SUD can cause treatment of any type of problem to be ineffective.

Following are some specific steps that social workers can take to be helpful when a SUD is suspected or identified:

• Routinely assess for SUD problem and refer the individual to a specialty clinic for further assessment or treatment when indicated.
• Assess for past/present SUD in family or origin
• Explore feelings
• Explore impact on children and extended family
• Know the structure of the family that the individual you are working with comes from (i.e., blended family, single-parent family).
• Know the developmental stage of the family that the individual you are working with comes from (family with teenagers, aging family).
• Family therapy, couples therapy
• Play therapy, social skills training
• Parent training
• Psychiatric services
• Coordinate with school systems to help clients access school-based services, after-school care, and tutoring. Help parents with advocating in the school system for their children if psychoeducational/neuropsychological testing is needed or the development of an Individualized Education Plan.
• Facilitate referrals to specialized courts is indicated: adult drug court, teen drug court, family court.
• Educate clients with SUDs about pregnancy prevention and provide education about risks of drug exposure on fetus.
• Inform about AA, NA for the patient with a SUD and Al-Anon, Nar-Anon, Alateen for family members. Provide location and times of meetings in their area.
• If there are safety issues with regard to children or the elderly, Child Protective Services or Elder Protective Services referral may be needed.
• Ask questions about if the current living situation is physically safe or if there have been past or present incidences of domestic violence.

Individuals with SUDs cannot be understood and treated effectively without considering the impact on the whole family. Addictions researchers have confirmed the reciprocal relationship between the disease of addiction and the environment. All persons influence their social environment and in turn are influenced by it. The family system must be factored into the understanding of the disease development and maintenance as well as be included in the efforts necessary for successful ongoing treatment. The earlier we can intervene in the progression of an SUD, the better the outcomes for all family members. For further readings on this topic SAMHSA TIP #39 ( Center for Substance Abuse Treatment, 2004 ) provides an overview of substance abuse treatment and how to incorporate the family, and TIP #24 ( Center for Substance Abuse Treatment, 2004 ) is a guide to substance abuse services for primary care clinicians.

Publisher's Disclaimer: The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand, or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.

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Essay on Drug/ Substance Abuse

Drug and substance abuse remains one of the most challenging and destructive problems facing societies worldwide. It refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. This essay aims to delve into the complexities of drug and substance abuse, examining its causes, effects, and the crucial steps needed to address this epidemic.

Drug and Substance Abuse

Drug and Substance Abuse involves the recurrent use of drugs or substances leading to significant impairment, including health problems, disability, and failure to meet responsibilities at work, school, or home. This includes the misuse of legal substances like alcohol and prescription medications, as well as illegal substances like heroin, cocaine, and methamphetamines.

Causes of Drug and Substance Abuse

The reasons behind drug and substance abuse are multifaceted and can vary from individual to individual:

• Genetic Predisposition : Research indicates a genetic component to the susceptibility to substance abuse.
• Mental Health Disorders : Many individuals with mental health disorders such as depression, anxiety, or PTSD turn to substances as a form of self-medication.
• Peer Pressure : Particularly among adolescents and young adults, peer pressure can significantly influence substance use.
• Stressful Life Events : Traumatic experiences, chronic stress, or life-changing events can lead to substance abuse as a coping mechanism.
• Curiosity and Experimentation : Often, particularly in young individuals, there’s a desire to experiment, which can lead to misuse and addiction.

Effects of Drug and Substance Abuse

Drug and substance abuse, a major public health challenge, affects individuals, families, and communities across the globe. This essay explores the multifaceted effects of drug and substance abuse, including physical health, mental well-being, social relationships, and broader societal impacts.

Physical Health Effects

Immediate physical effects.

• Altered State of Consciousness : Substances like alcohol, marijuana, and hallucinogens alter perception, mood, and consciousness.
• Overdose Risk : Excessive consumption of drugs can lead to overdose, potentially resulting in coma or death.
• Infectious Diseases : Intravenous drug use increases the risk of diseases like HIV and Hepatitis B and C due to needle sharing.

Long-Term Health Effects

• Organ Damage : Chronic substance abuse can lead to severe damage to vital organs like the liver (cirrhosis), heart, and brain.
• Neurological Impact : Long-term effects on the brain can include memory loss, cognitive decline, and mental health disorders.
• Physical Dependency : Prolonged use leads to dependency, where the body requires the substance to function normally.

Mental Health and Psychological Effects

• Mental Health Disorders : Substance abuse can trigger or exacerbate mental health conditions like depression, anxiety, and psychosis.
• Behavioral Changes : Changes in behavior, such as increased aggression or impulsivity, are common.
• Cognitive Impairments : Drugs can impair decision-making abilities, judgment, and other cognitive functions.

Social and Relationship Impacts

• Family Dynamics : Drug abuse can strain family relationships, leading to conflict, mistrust, and breakdown of family structures.
• Workplace Issues : It affects job performance, leading to decreased productivity, absenteeism, and higher risk of accidents.
• Legal Problems : Substance abuse can result in legal issues, including arrests for possession, driving under the influence, or engaging in illegal activities to support the addiction.

Societal and Economic Impacts

• Healthcare Costs : Treating drug-related health complications burdens healthcare systems.
• Crime and Safety : There’s a correlation between substance abuse and increased crime rates, impacting community safety.
• Economic Burden : The economic impact includes loss of productivity, healthcare expenses, and law enforcement costs.

Prevention and Treatment

• Education and Awareness : Programs aimed at educating individuals about the risks of drug use are crucial.
• Rehabilitation Programs : Effective treatment programs, including therapy and medication-assisted treatment, help individuals recover.
• Support Systems : Family, community, and peer support are vital in the recovery process.

Addressing Drug and Substance Abuse

• Prevention Programs : Education and awareness programs, particularly targeting young people, are crucial in preventing substance abuse.
• Treatment and Rehabilitation : Access to effective treatment, including counseling, medication, and support groups, is vital for recovery.
• Policy and Regulation : Government policies to regulate the availability of substances, and laws to address drug trafficking and misuse, play a critical role.
• Community Support : Community-based efforts, including support from families, schools, and religious organizations, are essential in supporting those affected.

The Role of Society and Individuals

• Destigmatization : Removing the stigma around substance abuse and addiction encourages individuals to seek help.
• Educational Initiatives : Schools and universities should have programs to educate students about the dangers of substance abuse.
• Role Models : Influential figures and celebrities should promote healthy lifestyles and speak out against substance abuse.
• Supportive Environment : Creating an environment that fosters open discussion and support for those struggling with substance abuse.

In conclusion, Drug and substance abuse is a complex issue requiring a multifaceted approach. It is not just a personal problem but a societal challenge that calls for comprehensive prevention strategies, effective treatment programs, supportive policies, and community involvement. Understanding and addressing the root causes, along with providing support and care for those affected, is crucial in mitigating the impact of this global issue. For students participating in essay competitions, exploring this topic provides an opportunity to contribute to a critical dialogue, advocating for change and supporting those in need.

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When Substance Abuse and Psychiatric Issues Collide

Co-occurring disorders have taken a toll on celebrities and regular folk alike..

Updated April 5, 2024 | Reviewed by Hara Estroff Marano

• What Is Psychiatry?
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• Many people have a substance use disorder (SUD) and serious psychiatric issue at the same time.
• Experts and the public have struggled with whether drugs caused psychiatric illness or vice versa.
• Carrie Fisher and Matthew Perry may have self-medicated over distress, or SUDs triggered psychiatric ills.
• Sexual, physical, or emotional traumatic events in childhood increase risks for co-occurring disorders.

Often starting in adolescence or young adulthood, many individuals have both a substance abuse disorder and at least one psychiatric disorder, although which diagnosis came first is frequently unclear. This “double trouble” problem is also called “co-occurring disorders (CODS),” as well as “concurrent disorders” and “dual diagnosis.”

The combination of disorders has been discussed in speculative articles about celebrities like Charlie Sheen, Demi Lovato, Justin Bieber, Jhene Aiko, Britney Spears, and Russell Brand. More in-depth scientific and biographic articles about Ernest Hemingway, Carrie Fisher, and Kurt Cobain have helped explain the complexity of CODs. Some of us were mesmerized and sad watching their struggles. Kurt Cobain’s lyrics, performance, and even some of his songs (like “Lithium” and “All Apologies” ) come to my mind as both a fan and a psychiatrist.

But it’s not just celebrities who are suffering from both substance abuse and mental health issues. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2022 , 21.5 million people in the United States had both a substance abuse disorder and a mental illness.

In the past, experts believed it was best to treat one disorder (usually the substance issue) and assumed any psychiatric issues would sort themselves out. However, if the psychiatric issue persisted, it was eventually treated.

In contrast, current thinking is both disorders should be treated in about the same time frame, because ignoring either could be problematic for the patient. If someone is severely depressed, anxious, or has another psychiatric disorder, it may be possible for them to detoxify from a substance, but it’s very hard to develop longer-term control over substance dependence and any accompanying mental illnesses when both issues are not addressed.

For adolescents and young adults with underlying psychiatric disorders, abusing substances provides an unfortunate early opportunity for incorporating bad learning. For example, if they struggle with anxiety , teens may discover that alcohol calms their nerves, making them less anxious about meeting new people or engaging in social interactions. Early self- medication of psychiatric symptoms is double trouble, as alcohol causes brain changes and effects that can trigger alcohol use disorder (AUD.) Some people describe the first drink as magical, that first taste feeling like the key to previously locked-out relief.

More Intense Treatment Is Needed with SUDs Combined with Psychiatric Diagnoses

Individuals diagnosed with co-occurring disorders often need more intense treatment than others due to the complexity of their cases. They also may face greater consequences from their substance abuse compared to patients diagnosed with a mental illness only. Examples of such possible consequences may include a greater exacerbation of their psychiatric symptoms, hallucinations and/or suicidal thinking, an increase in aggressive and violent behaviors, concurrent medical, nutritional, and infectious issues, more emergency room visits than other patients, and a greater number of falls and injuries.

Those with CODs are also more likely to experience head injuries and physical fights with others as well as sexually transmitted infections (STIs). Some have a greater frequency of involuntary inpatient psychiatric placements. These patients need a psychiatric assessment and treatment from experts in both addictions and psychiatry.

Possible Causes of CODs

One theory to explain CODS, the self-medication theory, was developed by the late Harvard psychiatrist and psychoanalyst Ed Khantzian, M.D. He assumed anhedonia (the inability to experience pleasure) or suffering in general was the driving force behind addiction. This theory hypothesizes that underlying psychological disorders compel individuals to self-medicate their feelings with alcohol and/or drugs. In addition, patients are sometimes distinguished by their drugs of choice. For instance, patients with an alcohol use disorder might have been battling social anxiety and self-medicating with alcohol for performance anxiety, shyness, or nervousness in social settings; stimulants such as cocaine or methamphetamine often are used by those with depression or untreated attentional disorders like attention deficit hyperactivity disorder (ADHD).

The self-medication hypothesis was first put forth in a 1985 cover article in the American Journal of Psychiatry. It focused on how and why individuals are drawn to and become dependent on drugs. The self-medication hypothesis was derived from clinical evaluation and treatment of thousands of patients spanning five decades and remains a credible theory.

As I have stated in the American Journal of Psychiatry , it is one of the most “intuitively appealing theories” about addiction. But drugs of abuse and addiction can also cause psychiatric illnesses by targeting the brain’s mood and pleasure systems and inadvertently undermining them.

Neuroscientist Kenneth Blum developed the theory of reward-deficiency syndrome (RDS) as the cause for co-occurring addictive disorders and psychiatric diagnoses. In many ways, RDS is a natural extension of Khantzian’s theory, but it’s an update, attributing the cause to an underlying dopamine deficiency or neurochemical dysfunction that supports drug-seeking/self-medication.

People with RDS, which may be inherited, are miserably unhappy and their lives may be intolerable due to their inability to gain satisfaction from work, relationships, or their accomplishments.

An emerging, newer approach of “preaddiction” as an early or moderate stage of substance abuse is championed by leaders of the National Institute on Drug Abuse (NIDA), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and the National Institute of Mental Health (NIMH). Preaddiction is conceptually analogous to prediabetes, a risk factor for type-2 diabetes. Prediabetes has contributed to a quantum leap in early detection of people at risk for type-2 diabetes, shortened delays between symptom onset and treatment entry before the onset of diabetes, and overall been a remarkable success in halting progression to diabetes. Similarly, the earliest possible detection of substance abuse will save more lives as experts develop and focus on the evolving concept of preaddiction.

A Possible Environmental Cause: Adverse Childhood Events (ACEs)

In the late twentieth century, a large insurance provider in California worked with researchers to identify adverse childhood experiences (ACEs) that later reverberated in the lives of adults. The researchers found that individuals who reported the greatest numbers of ACEs—such as physical abuse, sexual abuse , loss of a biological parent, witnessing physical violence, and other severely traumatic childhood events—were significantly more likely than those with no ACEs to have psychiatric problems and substance abuse issues in adulthood. They were also at greater risk for suicidal behaviors.

Nirvana's Kurt Cobain was a person with bipolar disorder , substance use and a heroin habit, according to a cousin who described their family history in detail and noted that two uncles had killed themselves with guns. Cobain, who suicided in 1994, purportedly had at least four ACEs, including witnessing domestic violence , experiencing psychological abuse , being neglected, and suffering from his parents’ divorce . Such a score markedly increased Cobain’s risk for suicide as an adult.

Treatment of CODs Should Not Be Delayed

Although an extensive description of how CODs should best be treated is beyond the scope of this article, the key point is to not delay treatment of one disorder in favor of the other. Instead, as much of a simultaneous approach as possible is best. This often means a team of experts is needed, including a psychiatrist, psychologist, therapists, and others to assess the problem, determine whether inpatient, residential, or outpatient treatment is best, and develop a cohesive treatment plan for the patient.

In opioid use disorder treatment, the current standard of care is to focus on prevention of overdose and replacement of opioids with medication-assisted treatments (MATs.) However, detoxification from opioids or maintenance on a MAT would provide little symptomatic relief for a person with opioid use disorder, suicidal ideas, and bipolar illness.

It is also recommended to evaluate individuals for past or recent trauma and co-occurring psychiatric and medical illnesses and treat patients accordingly. Often this means psychotherapy is needed as well as psychiatric treatments. Psychotherapy may include cognitive behavioral therapy (CBT), motivation enhancement therapy (MET), dialectical behavior therapy (DBT), and other forms of therapy. Trained and experienced therapists are crucial. Depending on the substance on which patients depend, medication treatment for their detoxification, relapse prevention, and craving may or may not be available. Currently, medication treatments exist for tobacco use disorder, alcohol use disorder, and opioid use disorder.

Summing It Up

Not only celebrities but many people with a substance use disorder have at least one other psychiatric problem, and when this situation occurs, all disorders need to be identified and treated. I recommend professional help in checking for substance use disorders in psychiatric patients and also looking for psychiatric illness and a history of trauma in people with substance use disorders.

Future breakthroughs in genetic and other scientific research should make clearer why some individuals are more prone to such disorders, as well as lead experts toward the best medications, therapies, and other treatments to alleviate much more of this terrible suffering.

Cross, Charles R. Heavier than Heaven : a Biography of Kurt Cobain. New York :Hyperion, 2001.

Gold MS. Dual disorders: nosology, diagnosis, & treatment confusion--chicken or egg? Introduction. J Addict Dis. 2007;26 Suppl 1:1-3. doi: 10.1300/J069v26S01_01. PMID: 19283969.

Buckley PF, Brown ES. Prevalence and consequences of dual diagnosis. J Clin Psychiatry. 2006 Jul;67(7):e01. doi: 10.4088/jcp.0706e01. PMID: 17107226.

Mark S. Gold, M.D., is a pioneering researcher, professor, and chairman of psychiatry at Yale, the University of Florida, and Washington University in St Louis. His theories have changed the field, stimulated additional research, and led to new understanding and treatments for opioid use disorders, cocaine use disorders, overeating, smoking, and depression.

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Essay on Effects of Drugs on Society

Students are often asked to write an essay on Effects of Drugs on Society in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Effects of Drugs on Society

Introduction.

Drugs impact society in many ways. They affect individuals, families, and communities. The effects range from health issues to economic problems.

Health Consequences

Drug abuse can lead to serious health problems like heart disease, stroke, and mental disorders. These health issues increase medical costs for society.

Impact on Families

Drug abuse can break families apart. It can lead to neglect, abuse, and even death. This creates emotional trauma and financial stress.

Economic Effects

Drugs burden the economy with increased healthcare costs, crime, and lost productivity. These costs are borne by all members of society.

The effects of drugs on society are far-reaching and devastating. It’s crucial to educate ourselves and others about these impacts.

250 Words Essay on Effects of Drugs on Society

Drugs, both legal and illegal, have a profound impact on society. Their effects are multifaceted, influencing individuals, families, and communities, and even shaping policy and law.

Individual Implications

The most immediate impact of drugs is on the individual user. Drugs can lead to health problems, mental disorders, and even death. They can also affect a person’s ability to function, leading to job loss, academic failure, and broken relationships.

Family and Community Disruption

The ripple effects of drug use extend to families and communities. Families can be torn apart by a member’s addiction, while communities may experience increased crime rates and decreased social cohesion as a result of widespread drug use.

Economic Consequences

The economic impact of drugs is also significant. The cost of addiction treatment, lost productivity, and law enforcement efforts related to drugs can strain public resources and impede economic growth.

Policy and Legal Ramifications

Drugs also influence policy and law. The “war on drugs” has led to a focus on punitive measures, contributing to mass incarceration and racial disparities in the criminal justice system. At the same time, the legalization of certain drugs in some regions has raised questions about public health, safety, and morality.

In conclusion, the effects of drugs on society are far-reaching and complex, influencing individuals, families, communities, the economy, and policy. Understanding these impacts is crucial for developing effective strategies to address drug use and its consequences.

500 Words Essay on Effects of Drugs on Society

Drugs, both legal and illegal, have a significant impact on society. The effects are multifaceted, touching upon the individual, the family, and the community at large. The consequences can be both direct, such as health-related issues, and indirect, like social and economic repercussions.

Individual Health Consequences

Drugs can have profound effects on an individual’s health. They can lead to addiction, mental health problems, and even death. The addictive nature of many drugs can lead to a cycle of abuse that is difficult to break, leading to a decline in physical health and cognitive function. Mental health can also be affected, with many individuals experiencing anxiety, depression, or psychosis as a result of drug use.

Social Impact

The social impact of drugs is far-reaching. They can lead to broken relationships, domestic violence, child abuse, and neglect. The stigma associated with drug use can further isolate individuals, making it difficult for them to seek help or reintegrate into society. This isolation can lead to a cycle of poverty and crime, further exacerbating the social issues associated with drug use.

The economic consequences of drug use are also significant. The cost of healthcare for drug-related illnesses, lost productivity due to drug-related absenteeism, and the cost of law enforcement and incarceration for drug-related crimes all contribute to a substantial economic burden. Moreover, the illicit drug trade can fuel organized crime and violence, further destabilizing communities and economies.

Impact on Crime

Drug use and crime are often intertwined. Many individuals turn to crime to support their drug habit, leading to an increase in theft, violence, and other illegal activities. Furthermore, the illegal drug trade itself is a form of organized crime, leading to violence and corruption. This contributes to a sense of insecurity and fear in communities, impacting the quality of life for all residents.

The effects of drugs on society are complex and far-reaching, impacting individuals, families, communities, and economies. Addressing these effects requires a multifaceted approach, including prevention, treatment, and social support. Understanding these impacts is the first step towards developing effective strategies to mitigate the harm caused by drugs. As a society, it is crucial that we continue to work towards solutions that support individuals affected by drug use and create healthier, safer communities.

That’s it! I hope the essay helped you.

If you’re looking for more, here are essays on other interesting topics:

• Essay on Effect of Drugs on Youth
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Essay on Drug Abuse in 250 and 500 Words in English for Students

• Updated on  
• Apr 2, 2024

Drug abuse refers to the excessive and frequent consumption of drugs. Drug abuse can have several harmful effects on our mental and physical health. Ronald Reagan, the 40th President of the USA, passed the Anti-Drug Abuse Act of 1986 and initiated the War on Drugs . He said, ‘Let us not forget who we are. Drug abuse is a repudiation of everything America is.’

Consuming drugs not only harms the individual himself but also affects society as a whole. Studies have shown that people who consume drugs become addicted to it. This addiction turns into substance abuse, resulting in self-damage, behaviour changes, mood swings, unnecessary weight loss, and several other health problems. Let’s understand what drug abuse is and how to fight it.

Table of Contents

• 1 Essay on Drug Abuse in 250 Words
• 2.1 Why Do People Consume Drugs?
• 2.2 Why Is Drug Abuse Bad?
• 2.3 Laws in India Against Drug Consumption
• 2.4 Steps to Prevent Drug Addiction
• 2.5 Conclusion
• 3 10 Lines Essay on Drug Abuse

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Essay on Drug Abuse in 250 Words

‘When people consume drugs regularly and become addicted to it, it is known as drug abuse. In medical terminology, drugs means medicines. However, the consumption of drugs is for non-medical purposes. It involves the consumption of substances in illegal and harmful ways, such as swallowing, inhaling, or injecting. When drugs are consumed, they are mixed into our bloodstream, affecting our neural system and brain functioning.

The Indian government has taken significant steps to help reduce the consumption of drugs. In 1985, the Narcotics Drugs and Psychotropic Substances Act came into force. This act replaced the Opium Act of 1857, the Opium Act of 1878, and the Dangerous Drugs Act of 1930. 

Drug abuse can lead to addiction, where a person becomes physically or psychologically dependent on the substance and experiences withdrawal symptoms when attempting to stop using it. 

Drug abuse can have serious consequences for the individual and society as a whole. On an individual level, drugs can damage physical health, including organ damage, infectious diseases, and overdose fatalities. Not only this, a person already suffering from mental health disorders will face more harmful aftereffects. Addiction disrupts our cognitive functioning and impairs our decision-making abilities.

To fight drug abuse, we need collective action from all sections of society. Medical professionals say that early intervention and screening programmes can identify individuals at risk of substance misuse and provide them with the necessary support services. Educating people, especially those who are at-risk, about drug abuse and its harmful effects can significantly help reduce their consumption.

Drug abuse is serious and it must be addressed. Drug abuse is killing youth and society. Therefore, it is an urgent topic to address, and only through sustainable and collective efforts can we address this problem.

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Essay on Drug Abuse in 500 Words

Drug abuse is known as frequent consumption. In time, these people become dependent on drugs for several reasons. Curiosity drives adolescents and teenagers, who are among the most susceptible groups in our society. Cocaine, marijuana, methamphetamine, heroin, etc. are some of the popular drugs consumed. 

Why Do People Consume Drugs?

The very first question about drugs is: why do people consume drugs? Studies have shown that more than 50% of drug addicts consider drugs as a coping mechanism to alleviate emotional or psychological distress. In the beginning, drugs temporarily relieve feelings of anxiety, depression, or trauma, providing a temporary escape from difficult emotions or life circumstances. 

Some consume drugs out of curiosity, some under peer pressure, and some want to escape the painful experiences. Some people enjoy the effects drugs produce, such as euphoria, relaxation, and altered perceptions. Recreational drug use may occur in social settings or as a form of self-medication for stress relief or relaxation.

Why Is Drug Abuse Bad?

The National Institute on Drug Abuse states that drugs can worsen our eyesight and body movement, our physical growth, etc. Marijuana, one of the most popular drugs, can slow down our reaction time, affecting our time and distance judgement and decreasing coordination. Cocaine and Methamphetamine can make the consumer aggressive and careless.

Our brain is the first victim of drugs. Drugs can disorder our body in several ways, from damaging organs to messing with our brains. Drugs easily get mixed into our bloodstream, and affect our neural system. Prolonged and excessive consumption of drugs significantly harms our brain functioning.

The next target of drug abuse is our physical health and relationships. Drugs can damage our vital organs, such as the liver, heart, lungs, and brain. For example, heavy alcohol use can lead to cirrhosis of the liver, while cocaine use can increase the risk of heart attack and stroke.

Laws in India Against Drug Consumption

Here is an interesting thing; the USA has the highest number of drug addicts and also has strict laws against drug consumption. According to a report by the Narcotics Control Bureau, around 9 million people in India consume different types of drugs. The Indian government has implemented certain laws against drug consumption and production.

The Narcotic Drugs and Psychotropic Substances Act, 1985 (NDPS), prohibits the production, sale, purchase, and consumption of narcotics and other illegal substances, except for scientific and medical purposes.

Also, Article 47 of the Indian Constitution states that ‘ The State shall endeavour to bring about prohibition of the consumption, except for medicinal purposes, of intoxicating drinks and drugs which are injurious to health.’

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Steps to Prevent Drug Addiction

Several steps can be taken to prevent drug addiction. But before we start our ‘War on Drugs’ , it is crucial to understand the trigger point. Our social environment, mental health issues and sometimes genetic factors can play a role in drug abuse.

• Education and awareness are the primary weapons in the fight against drugs. 
• Keeping distance from people and places addicted to drugs.
• Encourage a healthy and active lifestyle and indulge in physical workouts.
• Watch motivating videos and listen to sound music.
• Self-motivate yourself to stop consuming drugs.
• Talk to a medical professional or a psychiatrist, who will guide you to the right path.

Drug abuse is a serious problem. The excessive and frequent consumption of drugs not only harms the individual but also affects society as a whole. Only a collective approach from lawmakers, healthcare professionals, educators, community leaders, and individuals themselves can combat drug abuse effectively. 

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10 Lines Essay on Drug Abuse

Here is a 10-line essay on drug abuse.

• Drug abuse can significantly affect our physical growth
• Drug abuse can affect our mental functioning.
• Drug abuse may provide instant pleasure, but inside, it weakens our willpower and physical strength.
• Educating people, especially those who are at-risk, about drug abuse and its harmful effects can significantly help reduce their consumption.
•  Drugs easily get mixed into our bloodstream, and affect our neural system. 
• Prolonged and excessive consumption of drugs significantly harms our brain functioning.
• In 1985, the Narcotics Drugs and Psychotropic Substances Act came into force.
• The USA has the highest number of drug addicts and also has strict laws against drug consumption.
• Drug addicts consider drugs as a coping mechanism to alleviate emotional or psychological distress.
•  Adolescents and teenagers are the most vulnerable section of our society and are driven by curiosity.

Ans: Drug abuse refers to the excessive and frequent consumption of drugs. Drug abuse can have several harmful effects on our mental and physical health.

Ans: ‘When people consume drugs regularly and become addicted to it, it is known as drug abuse. In medical terminology, drugs means medicines. However, the consumption of drugs is for non-medical purposes. It involves the consumption of substances in illegal and harmful ways, such as swallowing, inhaling, or injecting. When drugs are consumed, they are mixed into our bloodstream, affecting our neural system and brain functioning.

Ans: Drug abuse is known as frequent consumption. In time, these people become dependent on drugs for several reasons. Adolescents and teenagers are the most vulnerable section of our society who are driven by curiosity. Cocaine, marijuana, methamphetamine, heroin, etc. are some of the popular drugs consumed.  The Narcotic Drugs and Psychotropic Substances Act, 1985 (NDPS), prohibits the production, sale, purchase, and consumption of narcotics and other illegal substances, except for scientific and medical purposes.

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With an experience of over a year, I've developed a passion for writing blogs on wide range of topics. I am mostly inspired from topics related to social and environmental fields, where you come up with a positive outcome.

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Essay on Drug Abuse

Here we have shared the Essay on Drug Abuse in detail so you can use it in your exam or assignment of 150, 250, 400, 500, or 1000 words.

You can use this Essay on Drug Abuse in any assignment or project whether you are in school (class 10th or 12th), college, or preparing for answer writing in competitive exams. 

Topics covered in this article.

Essay on Drug Abuse in 150 words

Essay on drug abuse in 250-300 words, essay on drug abuse in 500-1000 words.

Drug abuse is a global issue that poses serious risks to individuals and society. It involves the harmful and excessive use of drugs, leading to physical and mental health problems. Drug abuse can result in addiction, organ damage, cognitive impairment, and social and economic difficulties. Prevention efforts should focus on education, raising awareness about the dangers of drug abuse, and promoting healthy lifestyles. Access to quality healthcare and addiction treatment services is crucial for recovery. Strengthening law enforcement measures against drug trafficking is necessary to address the supply side of the problem. Creating supportive environments and opportunities for positive engagement can help prevent drug abuse. By taking collective action, we can combat drug abuse and build healthier communities.

Drug abuse is a growing global concern that poses significant risks to individuals, families, and communities. It refers to the excessive and harmful use of drugs, both legal and illegal, that have negative effects on physical and mental health.

Drug abuse has severe consequences for individuals and society. Physically, drug abuse can lead to addiction, damage vital organs, and increase the risk of overdose. Mentally, it can cause cognitive impairment, and psychological disorders, and deteriorate overall well-being. Additionally, drug abuse often leads to social and economic problems, such as strained relationships, loss of employment, and criminal activities.

Preventing drug abuse requires a multi-faceted approach. Education and awareness programs play a crucial role in informing individuals about the dangers of drug abuse and promoting healthy lifestyle choices. Access to quality healthcare and addiction treatment services is vital to help individuals recover from substance abuse. Strengthening law enforcement efforts to curb drug trafficking and promoting international cooperation is also essential to address the supply side of the issue.

Community support and a nurturing environment are critical in preventing drug abuse. Creating opportunities for individuals, especially young people, to engage in positive activities and providing social support systems can serve as protective factors against drug abuse.

In conclusion, drug abuse is a significant societal problem with detrimental effects on individuals and communities. It requires a comprehensive approach involving education, prevention, treatment, and enforcement. By addressing the root causes, raising awareness, and providing support to those affected, we can combat drug abuse and create a healthier and safer society for all.

Title: Drug Abuse – A Global Crisis Demanding Urgent Action

Introduction :

Drug abuse is a pressing global issue that poses significant risks to individuals, families, and communities. It refers to the excessive and harmful use of drugs, both legal and illegal, that have detrimental effects on physical and mental health. This essay explores the causes and consequences of drug abuse, the social and economic impact, prevention and treatment strategies, and the importance of raising awareness and fostering supportive communities in addressing this crisis.

Causes and Factors Contributing to Drug Abuse

Several factors contribute to drug abuse. Genetic predisposition, peer pressure, stress, trauma, and environmental influences play a role in initiating substance use. The availability and accessibility of drugs, as well as societal norms and cultural acceptance, also influence drug abuse patterns. Additionally, underlying mental health issues and co-occurring disorders can drive individuals to self-medicate with drugs.

Consequences of Drug Abuse

Drug abuse has devastating consequences on individuals and society. Physically, drug abuse can lead to addiction, tolerance, and withdrawal symptoms. Substance abuse affects vital organs, impairs cognitive function, and increases the risk of accidents and injuries. Mental health disorders, such as depression, anxiety, and psychosis, are often associated with drug abuse. Substance abuse also takes a toll on relationships, leading to strained family dynamics, social isolation, and financial instability. The social and economic costs of drug abuse include increased healthcare expenses, decreased productivity, and the burden on criminal justice systems.

Prevention and Education

Preventing drug abuse requires a comprehensive and multi-faceted approach. Education and awareness programs are essential in schools, communities, and the media to inform individuals about the risks and consequences of drug abuse. Promoting healthy coping mechanisms, stress management skills, and decision-making abilities can empower individuals to resist peer pressure and make informed choices. Early intervention programs that identify at-risk individuals and provide support and resources are crucial in preventing substance abuse.

Treatment and Recovery

Access to quality healthcare and evidence-based addiction treatment is vital in addressing drug abuse. Treatment options include detoxification, counseling, behavioral therapies, and medication-assisted treatments. Rehabilitation centers, support groups, and outpatient programs provide a continuum of care for individuals seeking recovery. Holistic approaches, such as addressing co-occurring mental health disorders and promoting healthy lifestyles, contribute to successful long-term recovery. Support from family, friends, and communities plays a significant role in sustaining recovery and preventing relapse.

Law Enforcement and Drug Policies

Effective law enforcement efforts are necessary to disrupt drug trafficking and dismantle illicit drug networks. International cooperation and collaboration are crucial in combating the global drug trade. Additionally, drug policies should focus on a balanced approach that combines law enforcement with prevention, treatment, and harm reduction strategies. Shifting the emphasis from punitive measures toward prevention and rehabilitation can lead to more effective outcomes.

Creating Supportive Communities:

Fostering supportive communities is vital in addressing drug abuse. Communities should provide resources, social support networks, and opportunities for positive engagement. This includes promoting healthy recreational activities, providing vocational training, and creating safe spaces for individuals in recovery. Reducing the stigma associated with drug abuse and encouraging empathy and understanding are crucial to building a compassionate and supportive environment.

Conclusion :

Drug abuse remains a complex and multifaceted issue with far-reaching consequences. By addressing the causes, raising awareness, implementing preventive measures, providing quality treatment and support services, and fostering supportive communities, we can combat drug abuse and alleviate its impact. It requires collaboration and a collective effort from individuals, communities, governments, and organizations to build a society that is resilient against the scourge of drug abuse. Through education, prevention, treatment, and compassion, we can pave the way toward a healthier and drug-free future.

Drug Abuse and Its Negative Effects Essay

Introduction.

One of the consequences of using drugs is, eventually, an individual becoming addicted. Addiction refers to a neuropsychological disorder that involves persistently feeling an urge to engage in particular behaviors despite the significant harm or negative effects. The psychology that explains addiction covers many areas, such as an illness or personal problem, an effect of someone’s lifestyle, family history, or socioeconomic demographics. This paper aims to highlight what the field of psychology says about the negative effects of drugs and why people continue using despite the consequences.

Using drugs once does not necessarily mean someone will never consume them again. In most cases, the drugs contain elements that can cause a person to become addicted. From a psychological perspective, it is important to understand how people enter into addiction. At the root of addictive behavior is a level of emotional stress deeply hidden within someone’s subconscious mind, and addressing it becomes a challenge. To relieve stress, pleasure is discovered in excess (Bechara 100). An example is when people choose to drink alcohol to ease their pain and ultimately find fun.

Stopping the behavior is a danger to someone’s mental state as they fear returning thoughts of the initial source of emotional stress. When a person is addicted, it suggests they lack healthy coping methods for the problem. The only mechanisms are distracting as well as unhealthy such as substance usage. Individuals dealing with addiction do not care about what matters since what is important to them is the desire to do something when that stress appears (Bechara 101). Some can stop their behaviors as their emotional stress does not manifest as among the addictive behaviors. Meanwhile, for others, their drug usage indicates an issue they may not have known and needs treatment. This leads to associative learning, which refers to learning to do something according to a novel stimulus.

Associative Learning

It is regarded as associative learning when an individual finds and takes drugs and ultimately gets high. The concept can be further explained using Ivan Pavlov’s experiment, where he rang a bell to call a dog and then rewarded it with food (Fouyssac and David 3015). A specific part of the brain controls associative learning, which it does via a neurotransmitter named dopamine. Dopamine is produced naturally by the brain when an individual does something rewarding or pleasurable.

The dopamine effect is a survival mechanism whereby eating or drinking feels good. It ensures continuity of life, family, and species in general. The element’s production is among the key drivers behind sex since, as much as the act is rewarding and pleasurable simultaneously, it is needed for survival (Fouyssac and David 3015). The main effect is that it creates a memory of the experience, which pushes people to seek the feeling again. People forget about the negative effects of drugs due to the moments of pleasure. As mentioned earlier, it is most likely that someone who uses the drug once will consume it again. The feeling established, regardless of how long, is enough to convince a person to forget everything they know concerning the negative effects and pursue a minute or two of a great time.

The paper has highlighted what the field of psychology says about the negative effects of drugs and why people continue using despite the consequences. It has been established that, in most cases, individuals experience addiction due to the pursuit of stress relief. Using the logic of the dopamine effect, once someone experiences something pleasurable or rewarding to them, they are most likely to pursue that feeling again. Eventually, it becomes impossible to convince them against the drugs as their desire to end their problem is more than the need to remain healthy.

Works Cited

Bechara, Antoine, et al. “A Neurobehavioral Approach to Addiction: Implications for the Opioid Epidemic and the Psychology of Addiction.” Psychological Science in the Public Interest, vol. 20, no. 2, 2019, p. 96–127.

Fouyssac, Maxime, and David Belin. “Beyond Drug‐Induced Alteration of Glutamate Homeostasis, Astrocytes May Contribute to Dopamine‐Dependent Intrastriatal Functional Shifts That Underlie the Development of Drug Addiction: A Working Hypothesis.” European Journal of Neuroscience, vol. 50, no. 6, 2019, p. 3014-3027.

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Effects of Drug and Substance Abuse Among Youths

Drug and substances are so significant because it has become a significant problem affecting youths in both schools and out of school, and this is ahead of time to prime youths with knowledge on the effects of their use. The topic is important as drugs and substance abuse affect many youths. Usage of substance abuse and drugs has been on rising economic, socially, and public health problems, according to Lawal and Mustapha (2020). The effect of health is also related to other risky behaviours such as contracting HIV by having unprotected sex.

In studying, the rate of youths using drugs is increasing, and the leading cause is peer pressure that has resulted in poor health Chege et al. (2017). The use of Drug and substance abuse such as alcohol and illicit drugs (cocaine) is harmful, and this may lead to different changes in our body that are unhealthy (Garcia et al., 2020). Youths need to be involved in this to realize the demerits of its use. Drug and substances Abuse has become a problem that has raised concern among youth; this is why this essay is done to help youth overcome it and live a quality life.

INTRODUCTION

Adolescence is widely acknowledged as the time when a wide range of health problems, both temporary and long-term, begin, including some that will persist into adulthood. Adults who engage in unhealthy behaviors including smoking, drinking, and illegal drug use are more likely to suffer from disease and death than those who don’t engage in these activities. People who take drugs are more likely than those who don’t to be unemployed or to have an accident or to commit suicide. Drug and alcohol misuse has a significant influence on the health, well-being, and social cohesion of people, families, and communities because its consequences compound over time. SES (socio-economic level), parenting quality (including the impact of peers), and a genetic predisposition to drug addiction are all known to raise the likelihood of beginning or maintaining substance usage. This leads to a vicious cycle in which these people no longer function as productive members of society, but are instead engulfed by their addictions. The essay illustrates on the effects of drugs and substance abuse among the youth.

Drug and Substance Abuse

Adolescents are the most likely demographic to partake in alcohol use. More than 70% of teenagers have tasted alcohol by the time they reach the 12th grade, and over half of those are considered current drinkers (having consumed alcohol within the past month). Adolescents who drink excessively are also at risk of developing alcohol poisoning. Adolescents consume over 90% of their alcohol in a binge, placing them at risk for poor consequences such as car accidents, injuries, and unwanted sexual behaviour (Azpeitia et al.2019).

In the eyes of the general public and the media, it is perfectly fine to partake in alcoholic beverages. Parental control over adolescent drinking behavior can be exerted through communication, regular limitations, and close supervision. Adolescents who come from families where alcohol abuse is common may, on the other hand, view it as normal. Alcohol use disorders can emerge in adolescents who use them for the first time. Risk factors for developing a disorder include starting drinking at an early age and inheriting the condition from a parent. If a family member has an alcohol use disorder, adolescents need to know that they’re at greater risk.

A remarkable drop in adolescent smoking rates began in the 1990s and has continued ever since. This year, about 5.7 percent of 12th-graders reported current cigarette use (smoked in the previous 30 days), down from 28.3% in 1991 and 7.6% in 2018 (Schulenburg et al. 2019). Only about 2% of 12th-graders reported smoking every day, according to the National Institute on Drug Abuse at the National Institutes of Health survey. Most adult smokers first pick up the habit in their teenage years. Before the age of 19, it is quite unlikely that adolescent smokers will become adults. Children can attempt smoking as early as ten years old.

Adolescent smoking is more likely to occur if a person’s parents smoke or have friends or role models (e.g., celebrities) who smoke. High-risk behavior (e.g., excessive dieting among girls; physical fights and drunk driving, particularly among guys; use of alcohol or other substances) is another risk factor, as is a lack of problem-solving skills, access to cigarettes, and low self-esteem.

Other forms of tobacco use by teenagers are possible, as is the usage of marijuana. In the last decade, smoking tobacco use among high school students is down by a whole percentage point. Chewing, dipping, or inhaling are all methods of ingesting smoke-free products, which are less harmful than traditional cigarettes (snuff). In the United States, pipe smoking is an uncommon pastime. Cigarette smoking among persons over the age of 12 has decreased. Smoking and using smokeless tobacco products can be prevented if parents are positive role models (by not smoking or chewing). Openly address the dangers of tobacco, and encourage teenagers who already smoke or chew to stop (including supporting them in obtaining medical care if necessary) (see Smoking Cessation).

Electronic cigarette products (vaping products)

Volatilization of an active ingredient (typically nicotine or THC) in a liquid is accomplished through the use of heat in electronic cigarettes (also known as “e-cigs,” “vapes,” and “vaporizers”). There is no combustion involved. In the beginning, e-cigarettes were marketed to adult smokers as nicotine-free alternatives. Teens of middle and upper socioeconomic status have become increasingly interested in “vapes” over the past few years due to their attractiveness and increasing popularity. According to an NIH-sponsored survey, the percentage of 12th graders who currently use e-cigarettes (nicotine vaping only, no other substances included) increased dramatically from 4.5 percent in 2013 to 25.5 percent in 2019. The use of e-cigarettes by 12th-graders is estimated to be 45.6 percent (nicotine and other substances). Electronic cigarettes have different health effects than smoking because tobacco’s no combustion products (Baiden et al.2021). As a result, other chemicals found in e-cigarettes may cause lung injury, which can be acute (fulminant), chronic (chronic), or even lethal. The high concentrations of nicotine and THC found in these products are also a big draw for many people. Addiction to THC and nicotine is possible, and both can lead to toxicity. Adolescents’ first exposure to nicotine is increasingly coming from e-cigarettes, but the impact on adult smoking rates remains unclear due to this trend. Additionally, the long-term consequences of e-cigarettes are unknown.

According to a 2019 NIH survey of high school students, the prevalence of current marijuana usage among high school students was 22.3%, up from 20.6 percent in 2009 (Zvanorev et al.2019). Students in high school reported using marijuana at least once or twice in their lifetimes. For the first time in 2010, the current rate of marijuana use topped the current rate of cigarette use.

Other substances

Adolescents are only abusing substances other than alcohol, cigarettes and marijuana at a very low rate. More than one in four high school students who said they had used drugs or alcohol at least once in the past year in the NIH survey reported using inhalants (e.g., glue or aerosols): 5.3 percent ; hallucinogenic (e.g. LSD, PCP or mescaline): 6.9 percent; anabolic steroids: 1.6 percent; methamphetamines (nonprescription): 2.1 percent; heroin: 0.06 percent.

These include opioid analgesics like oxycodone, stimulants like methylphenidate and dextroamphetamine, and tranquilizers like temazepam (eg, benzodiazepines). Young people’s use of substances is characterized by experimentation and expediency (Roxburgh et al.2017), and the use of substances is described as intermittent or intensive (binge) drinking. Adolescents’ desire for ‘cool or exciting’ activities and uncontrolled self-indulgence, as well as the approbation of their peers, are seen to be the driving forces behind their intermittent or intensive substance use (Romo-Avilés et al., 2016).

Effects of drugs and substance abuse on youths

Parent-child conflict, physical and sexual abuse of children, family disintegration, academic failure, and estrangement from teachers are more specific social correlations. Distress from these events can long-term impact children’s ability to form trusting and supportive relationships with their caregivers. In addition, they foresee involvement in deviant peer networks that serve as conduits for the introduction and distribution of illegal drugs. It’s not the same as “peer pressure.” Still, it explains a developmental trajectory that is believed to “shape” a child’s social development toward deviant peers and separate them from their parents and teachers. Youth who have identified administratively (as homeless, housed by the local authorities, or involved in criminal activity) rather than clinically as at high risk of substance misuse face similar problems.

Considering the connections between substance misuse and “a recurrent and persistent pattern of dissocial, hostile, or defiant conduct” offers a different perspective. Adolescent-limited and life-span persistent conduct problems are the two subtypes of conduct difficulties. If “life-span persistent” or “early onset,” disturbed behavior may be evident as early as preschool, linked to a wide range of neurodevelopmental vulnerabilities, learning disabilities, impairments in capacity to form social relationships, and perhaps in motor development, as well as symptoms of attention deficit hyperactivity disorder that are likely to be genetic. Many of these children suffer greatly due to worry and depression brought on by their frequently challenging circumstances. Children with more severe behavioral issues are almost always sent to pediatricians because they were born into this early-onset category. Individual susceptibility, other psychosocial difficulties, the association with deviant peers, and the high availability of drugs nearly guarantee the use and misuse of drugs. However, with the right combination of measures, such as stimulant medicine when necessary, this danger can be minimized.

Adolescent or preadolescent substance abuse may signify that something is wrong with the kid’s care and development, necessitating a child welfare inquiry. “Empowerment” and “choice” might induce physicians to accept a patient’s refusal of treatment, promise complete anonymity, or exclude parents and caregivers from the treatment process. Parental involvement may be critical to the effectiveness of therapeutic intervention, and a strong desire to exclude parents may raise alarms about possible harm. Substance abuse can be seen as an additional layer on the complicated developmental and social difficulties that many child specialists are already familiar with. Anyone who appears to be of sound mind and body is presumed to be so until proven otherwise. No new skills or retraining is required for effective intervention; instead, it frequently requires careful application of already-developed skills; controlled chances for reflection and familiarization, and, at first, supervised practice.

A view of competence that may be acceptable for all doctors who routinely treat older children or teenagers includes competent history taking, correct information and counsel, and appropriate referrals. An adequate history consists of the presenting complaint and investigation of the substances used and the development and environment, including the educational and social background of the individual. If the local authority is fulfilling its duty to educate them if there is evidence of child abuse, developmental problems, or mental disturbances, and who their peers are, then this type of system review should aim to establish rapport with a young person who is perhaps skeptical and mistrustful; who is caring for them and whether that person can function as a parent. The details of their substance use must also be obtained and validated by hair and saliva or urine analysis. In particular, is there evidence of dependency or a special risk associated with pregnancy or parenteral administration? Many people may be surprised if these data are collected first. They also provide a framework for future action and advocacy on behalf of the patient.

Adolescent and adult substance abuse can be reduced with even brief treatments characterized by accurate evaluation, knowledge, and advice to minimize intake, most likely in the setting of excellent rapport rather than lecturing. This strategy, if tweaked to include parents and referrals to local statutory and voluntary agencies, might serve as the foundation for fruitful collaboration at this level of government. For example, in general practice, community pediatrics, and ERs, this could be of particular use to the staff.

Adolescent medicine can provide more extensive intervention at a higher degree of expertise. The immediate and ongoing involvement of young people and their families and liaison with or mobilizing other organizations (such as educational institutions, child welfare or family support agencies, or the juvenile justice system) can help reduce harm and promote proper care and healthy development, and good health. A new study reveals that this bundle can help reduce substance abuse and its related comorbidities. Young people’s interaction with services may be beneficial, whether by lessening loneliness or despair or being on hand when therapy opportunities emerge.

Doctors are responsible for providing “excellent clinical care” and should never be seen as a simple prescription service; therefore, it may be important to help patients wean themselves off addictive medicines and prescribe substitutes in a few cases. In light of the limited therapeutic scope of some of the currently available medications, a collaborative consultation with an adult addictions service may be the first step toward the development of “pediatric addiction medicine,” a new specialty in addiction treatment for children. A huge number of these experts is not expected to emerge. The discipline of pediatrics as a whole would benefit greatly if pediatricians and child psychiatrists worked together regularly to contribute their time and expertise to the cause. During adolescence, a person’s physical and emotional maturation and desire for self-determination can lead to the development of substance misuse (Morojele & Ramsoomar, 2016). Human growth and psychological changes are profound during adolescence, not only in the physical body but also in the brain (Morojele & Ramsoomar, 2016).

According to Oldfield et al. (2016), adolescents turn less and less to their parents for guidance and instead look to their peers. Risky behaviors can be tried out during adolescence (Morojele & Ramsoomar, 2016). Adolescent substance abuse can persist throughout adulthood, increasing the risk of drug dependence, according to Trucco (2020). Gangs are a major source of revenue for young people who use methamphetamine, especially in economically disadvantaged areas.

What Causes Youth to Use Substances

Some people believe that substance misuse and addiction are family diseases that can be passed on through genetics or the home environment. They found that the following factors may contribute to the likelihood of a child-abusing substance: they have dropped out of school; are pregnant; have experienced school failure; are suicidal or have suicidal tendencies; have parents who use substances; have violent tendencies; are economically disadvantaged, and were abused physically, sexually, or emotively as a child.

A connection has also been found between parental substance addiction and subsequent adolescent substance abuse. According to the findings of this same study, hostile parenting methods also had an impact on their children’s behavior, with parents’ negative behavior having the most impact on a youth’s decision to use and misuse various substances (Mehra et al. 2019). For example, it was shown that children whose parents are heavy users of drugs and alcohol are more likely to develop a habit of using and abusing substances themselves. This research also found that young people who grew up in families where substance misuse was a problem were more likely than their peers who did not. However, this was only one study, and no causal link has been established statistically as of yet (Mehra et al. 2019).

In addition, the study’s researchers discovered that peer influences on young people’s substance use and abuse outweigh those of families. In addition, students who performed poorly academically were twice as likely as those who performed well academically to consume other substances (Mehra et al. 2019). There was a decrease in substance use and abuse among students who were more involved in their schools. In addition to peer pressure and social interactions, youth may misuse various substances due to boredom, curiosity, gender, the media, and low self-esteem. Pressure from friends, the availability of substances at social occasions, or boredom on the weekends can lead to a desire to experiment with drugs and alcohol.

We live in a society where the media glorifies drinking, partying, and living to the extreme. Still, many prevention and therapy programs advise children to refrain from these vices. There are many reasons why a young person can choose to use or misuse drugs or alcohol or why they might decide to abstain from them for the rest of their lives. Finding out why a young person starts abusing or using drugs can be a difficult task, and it’s unlikely that we’ll ever know why all young people engage in these behaviors. Even though there may be various reasons teenagers choose to use and misuse multiple substances, these are not the only ones. Those who use and misuse substances but don’t fit into any of the above categories should be questioned about their circumstances. It’s not clear why some youngsters abstain totally, while others engage in occasional or even frequent drug or alcohol consumption, while still others get hooked. In this review, there was no detailed data about these young people.

Media Influence on Youth and Substance Use

We live in a culture where we are continuously bombarded with all kinds of media. The media heavily influences today’s kids, even if they don’t use drugs themselves. Addiction and abuse of drugs and alcohol can be seen on television, in movies, commercials, music videos, the news, and in publications and newspapers. On the other hand, youth are rarely taught how to effectively filter information and build a defense against the allure and allurement of images like these. As a result, it is imperative that young people learn how to assess these images critically, comprehend how the media affects their daily lives, and cultivate a positive self-image.

There are very few substance preventions and treatment programs that integrate these aspects in their curricula, with little or no information about media and substance use and abuse, despite the media’s influence on our young. As a society, we’ve gotten concerned with weight, and popular periodicals, TV shows, and movies present women in unrealistic images. It affects teenage substance use and abuse. As a result, our youth feel inadequate compared to this unattainable ideal of thinness. Substance abuse is a common method of weight loss among teenagers. Tobacco, ecstasy, crystal meth, and cocaine, for example, all have appetite-suppressing properties. As a result, many young people turn to these substances as weight loss aids. However, just as many over-the-counter diet medicines are ineffective, so are these drugs, which may have harmful consequences. To be truly effective at preventing and treating substance misuse among adolescents, preventative and treatment programs must consider the media’s role in shaping the minds of today’s youth, according to the author.

The Influence of the Internet on Substance Use

North American adolescents are the largest group of people who use the internet. The internet has become a routine part of most people’s everyday lives. While the internet is a wonderful resource for finding reliable information, it is rife with errors, omissions, and outright lies. Many young people use the internet to learn about various topics. They’re also interested in learning about the wide variety of available substances. Even though many websites provide accurate information about the right effects of substances, support programs, and safe usage methods (as safe as possible), many websites are full of erroneous details—Department of Justice.

In addition, chemicals are being sold and distributed via the internet. It’s easy to find information on how to make drugs like MDMA, GHB, and LSD on the internet, as well as where to acquire them, how much they cost, and websites where you can order them for delivery right to your door. It has been estimated by Interpol that in 2000, there were more than 1,000 websites around the world that offered to sell illegal narcotics (Sacco, 2018). To make your narcotics, you can order all of the necessary equipment and paraphernalia online, and it will be delivered within 24 hours or a few days, making it immediately available to anyone with a computer and a modem. It is becoming increasingly common for young people to find information about legal and illicit Raves on the internet, in addition to learning how chemicals are made, distributed, and used (Sacco, 2018). As a result, the internet has evolved into a one-stop resource for teens seeking information on where to buy, create, and meet people who promote the use of illicit drugs, such as Raves, all under one roof.

From the research conducted it has shown that most of the teens are experimenting on drugs and substance’s. This however experimentation of drugs can led to serious problem that can affect them in the future. Statistics has also proven that the number of youths that are abusing drugs is increasing in an alarming rate. In instances when the youths are starting to abuse drugs it comes with a number of problems. The parent and child relationship is hampered a lot, while the child start developing other problems such as behavioural problems. Also in some instance substance abuse has been linked to parent, when the parent uses the drugs there is higher chances that the child gets into drugs. In recent times, technology has made the rate of drugs usage to increase immensely. The use of social media and the influence of internet has cause increased of drugs and substance abuse among the youth.

Azpeitia, J., Lopez, J. L., Ruvalcaba, S. A., & Bacio, G. A. (2019). Alcohol and Marijuana Use Behaviors among Latinx Adolescents: The Interplay of Intra-and Inter-Personal Predictive Factors Differ by Gender.  Journal of Child & Adolescent Substance Abuse ,  28 (4), 238-247.

Baiden, P., Szlyk, H. S., Cavazos-Rehg, P., Onyeaka, H. K., Peoples, J., & Kasson, E. (2021). Use of electronic vaping products and mental health among adolescent high school students in the United States: The moderating effect of sex.  Journal of psychiatric research .

Chege, R., Mungai, P., & Oresi, S. (2017). An investigation of the factors contributing to drug and substance abuse among the youth in Kenya: a survey of select rehabilitation centres in Mombasa County. International Journal of Public Health, 1(1).

Garcia, O. F., Serra, E., Zacares, J. J., Calafat, A., & Garcia, F. (2020). Alcohol use and abuse and motivations for drinking and non-drinking among Spanish adolescents: do we know enough when we know parenting style?. Psychology & health, 35(6), 645-664.

Lawal, N., & Al Mustapha, A. A. (2020). Assessment of Causes and Effects of Drugs and Substances Abuse among Youth: A Case Study of Katsina Metropolis (North West Nigeria). International Neuropsychiatric Disease Journal, 1-9.

Morojele, N. K., & Ramsoomar, L. (2016). Addressing adolescent alcohol use in South Africa.  SAMJ: South African Medical Journal ,  106 (6), 551-553.

Romo-Avilés, N., Marcos-Marcos, J., Marquina-Márquez, A., & Gil-García, E. (2016). Intensive alcohol consumption by adolescents in Southern Spain: The importance of friendship.  International Journal of Drug Policy ,  31 , 138-146.

Roxburgh, A., Hall, W. D., Dobbins, T., Gisev, N., Burns, L., Pearson, S., & Degenhardt, L. (2017). Trends in heroin and pharmaceutical opioid overdose deaths in Australia.  Drug and alcohol dependence ,  179 , 291-298.

Sacco, L. N. (2018). Federal support for drug courts: in brief.  Criminal justice: government, policies and programs. US: SNOVA , 5-22.

Schulenberg, J., Johnston, L., O’Malley, P., Bachman, J., Miech, R., & Patrick, M. (2019). Monitoring the Future national survey results on drug use, 1975-2018: Volume II, college students and adults ages 19-60.

Trucco, E. M. (2020). A review of psychosocial factors linked to adolescent substance use.  Pharmacology Biochemistry and Behavior ,  196 , 172969.

Zvonarev, V., Fatuki, T. A., & Tregubenko, P. (2019). The public health concerns of marijuana legalization: An overview of current trends.  Cureus ,  11 (9).

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Sample Essay On Cause And Effects Of Drug Abuse

Type of paper: Essay

Topic: Law , Addiction , Human , Drug Abuse , Brain , Criminal Justice , Crime , Drugs

Published: 03/29/2020

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Many causes and effects of drug addiction are both related as to why a person is using illegal drugs and the outcome of becoming a drug addict. Being a drug addict creates a negative cycle, which undeniably precipitates some anomalies in the human brain. The process will result in strong cravings as well as involuntary inclination that prompt to use drugs. Drug addiction is a very serious threat to public safety and public health, not only in the United States, but also all over the world. Drug addiction develops in many ways. To better understand the causes of addiction, it would be essential to know how the use of illegal drugs is affecting the human brain. The human brain has its natural capability to reinforce and identify positive experiences. As an example, if a human eats his or her favorite food or puts a warm blanket during the cold winter nights, the brain will naturally release feel-good chemicals such as dopamine. By repeatedly experiencing these events, drugs will reinforce the human behavior through a process that teaches the brain to expect the positive experiences or pleasant sensations. However, none of these addiction causes will happen if there are no supporting factors that provoke people in getting addicted to drugs. Some people may not understand why other individuals are becoming addicted to drugs and how it changes the human brain’s activity to promote compulsive abuse of drugs. Sometimes, some people mistakenly observe drug addiction and abuse as one of the social problems. One of the causes of a person’s drug addiction is the surroundings. A person who lives in a community, where drug temptations are present, it is more likely that he or she may be with a group of people who use drugs. Therefore, the possibility of being in a group of drug users can be one of the causes of a person’s drug addiction. Another that factor that causes drug addiction is the person’s behavior. This normally happens to a person who normally gets along with a group of people who have similar behavior just like him. He will easily be convinced to use illegal drugs initially until he falls into addiction eventually. In some points, causes of drug abuse can be a personal or family matter. There may have a time that parents and guardian of a potential drug user may lack family openness, in which communication between family members is less. Therefore, there could be an attention deficiency, which they normally found from their peers. Experimentation many things including drug abuse could happen during the teenage years, which can worsen a person’s drug addiction in the long run. There could be hundreds of causes why a person becomes a drug addict. Along with this, there are also numerous effects that being a drug addict could provide. One of the effects of drug addiction could be a person’s attitude. A person who is addicted to drugs could turn his attitude to be a hot-tempered one. He or she tends to become irate as a response even on simple things. As a result, his or her relationship with her family and friends could become worse as his attitude becomes worse. In addition, drug addiction changes the human brain’s function. A drug addict will lose his self-control and his ability to recognize sounds. These effects could appear overtime as the person continues to use illegal drugs. The effects of being a drug user may depend on the length of time a person being into it. The longer a person uses illegal drugs, the more likely that he or she may have worse effects eventually. Besides emotional and social reasons, a person’s willingness to stop or continue using illegal drugs also contributes to being whether or not he is a drug abuser.

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The Effects of Emotional Abuse

This essay about the effects of emotional abuse sheds light on the silent suffering endured by victims in relationships and families. It explores how emotional abuse, operating stealthily and leaving invisible scars, erodes self-esteem, distorts reality, and impacts both mental and physical health. The essay emphasizes the importance of recognizing emotional abuse, breaking the silence surrounding it, and supporting survivors to seek help and healing.

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The Effect of E-cigarette Taxes on Substance Use

Public health advocates warn that the rapid growth of legal markets for electronic nicotine delivery systems (ENDS) may generate a “gateway” to marijuana and harder drug consumption, particularly among teenagers. This study is the first to explore the effects of ENDS taxes on substance use. We find that a one-dollar increase in ENDS taxes (2019$) is associated with a 1-to-2 percentage point decline in teen marijuana use and a 0.8 percentage point reduction in adult marijuana use. This result is consistent with e-cigarettes and marijuana being economic complements. We find no evidence that ENDS taxes affect drug treatment admissions or consumption of illicit drugs other than marijuana such as cocaine, methamphetamine, or opioids over this sample period.

We thank Monica Deza and Kyu Matsuzawa, and seminar participants at the University of Kentucky, Southern Economic Association Annual Conference, Western Economic Association Annual Conference, and IHEA Virtual Seminar on the Economics of Risky Health Behaviors for very helpful comments. Dr. Sabia acknowledges research support from the Center for Health Economics & Policy Studies (CHEPS) at San Diego State University, which includes grants received from the Charles Koch Foundation. All errors are the authors’. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.

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How a cheap, generic drug became a darling of longevity enthusiasts

Rapamycin, a drug for transplant patients, has extended the lives of animals but is unproven in people.

To keep himself healthy into his eighth decade, David Sandler recently decided to go beyond his regular workouts and try something experimental: taking rapamycin, an unproven but increasingly popular drug to promote longevity.

The medication has gained a large following thanks to longevity researchers and celebrity doctors who, citing animal studies, contend that rapamycin could be a game changer in the quest to fend off age-related diseases. The drug is going mainstream as an anti-aging treatment, even though rapamycin’s regulatory approval is for treating transplant patients. There is no evidence that it can extend human life.

Sandler initially dismissed the idea of rapamycin as a longevity drug, but as he read up online, he decided there might be something to it and ordered a year’s supply for about $200 from a supplier in India.

“If I was younger, I would hold off,” said Sandler, a 77-year-old retired accountant who lives in Bergen County, N.J. “But at this age, I’m making myself part of the experiment,” he said.

Researchers have found that rapamycin can modify a kind of cellular communications system that gives cells certain directions — to grow when the body has plenty of food and to slow down when nutrients are scarce. The drug can dial down the signal to grow, causing cells to clear out accumulated junk and allowing them to run more efficiently.

Despite the buzz surrounding the drug, it is unlikely that the Food and Drug Administration will ever approve it for longevity. The agency doesn’t consider aging to be a disease, and rapamycin’s generic status means there’s little financial incentive to run expensive clinical trials to test it on age-related afflictions. So doctors and entrepreneurs are increasingly marketing rapamycin beyond the scope of its regulatory label, believing a potentially life-extending drug is effectively hiding in plain sight.

More than two dozen medical practices prescribe rapamycin as an anti-aging treatment, according to a Washington Post review, and telehealth companies are bringing it to thousands of patients nationally. Prices vary widely, but some online purveyors offer a typical dose for about $10 a week or less. Alan Green, a physician in Little Neck, N.Y., says he has personally treated nearly 1,500 patients with rapamycin since 2017 and has called it “the most important drug in the history of medicine.”

Rapamycin’s promise as a longevity drug, however, remains divisive among scientists and longevity influencers.

The enthusiasm for the drug’s anti-aging properties comes from studies that repeatedly have shown benefits in animals across multiple species , including yeast, worms and mice. Some physicians and researchers believe that if taken intermittently and in low doses, rapamycin can increase human life span the way it has in animal trials. But doctors also caution that no one knows what the optimal dose might be for humans, and taking certain quantities of rapamycin can lead to reproductive harm and insulin resistance as well as making the body more susceptible to infection .

“Mice may be a little different from humans when it comes to drug tolerance, diseases and reactions,” said Elena Volpi, a professor and longevity expert at the University of Texas Health Science Center at San Antonio.

“It is a drug that I think can be taken safely under certain conditions but has enough of a side effect profile that I’m not interested in taking it for sake of increasing life span at this time,” Andrew Huberman, a neuroscientist with a large social media following, said on a podcast in October.

Brad Rosen, a doctor in Los Angeles, says he believes rapamycin’s potential is compelling enough for him to try.

“At 60, I don’t have the luxury of expecting studies to be completed that can validate the benefits of a longevity drug prior to my own steeper decline,” said Rosen, who also has prescribed the drug to about 250 patients. The promising animal studies, combined with rapamycin’s long history as an immune-suppressing drug, he said, makes it “one of few agents where taking a calculated risk can absolutely make sense.”

A drug from the ends of the earth

Rapamycin’s growing popularity mirrors the rise of longevity medicine. Altos Labs, which raised $3 billion , is aiming to reverse diseases of aging by rejuvenating cells — inspired by research that won the 2012 Nobel Prize . The Saudi-based Hevolution Foundation is pledging to spend up to $1 billion a year to accelerate research on aging. Longevity medicine practitioners like Peter Attia have amassed large followings on social media — and kindled excitement about rapamycin.

Rapamycin was collected by a scientific expedition in the 1960s from the soil of Easter Island, also known as Rapa Nui, one of the most remote inhabited places on earth. The FDA approved it in 1999 to help transplant patients tolerate their new organs. But scientists kept exploring how the drug worked and ultimately set the field of longevity medicine abuzz.

“It was uncanny,” Attia writes in his best-selling book, “Outlive: The Science and Art of Longevity.” “This exotic molecule, found only on an isolated scrap of land in the middle of the ocean, acts almost like a switch that inhibits a very specific cellular mechanism that exists in nearly everything that lives.” He added that “this fact still blows my mind every time I think about it.”

A bombshell study in 2009 found that rapamycin extended the lives of elderly mice by as much as 14 percent, the first time a drug had been shown to help a mammal live longer. Then in 2014, researchers had a revelation : Older adults who took a rapamycin-like drug had a more robust response to the flu vaccine, upending the widely held notion that rapamycin weakened the immune system.

A decade later, a low, intermittent dose used in the 2014 study — 5 milligrams a week — has remained popular for people taking rapamycin for longevity.

In a recent survey of 333 people who used rapamycin off-label, researchers found that they generally reported better quality of life since starting the drug. Compared with a cohort that didn’t take the drug, the only side effect among rapamycin users that was statistically different was mouth sores.

“I would say that rapamycin is the current best-in-class for a longevity drug that we have,” said Matt Kaeberlein, a professor the University of Washington who has researched rapamycin for two decades and is studying its anti-aging effects in dogs . In his own experience, he credited rapamycin’s anti-inflammatory properties with healing his persistent shoulder pain.

Taking rapamycin mainstream

Joan Mannick is aware of what she calls “a gold rush” in longevity medicine. As the researcher who led the 2014 study, she doesn’t exactly embrace how her work has become the basis for rapamycin dosing in people.

“I don’t know yet what’s the right dose, what’s the right duration, what are the risks, what are the benefits,” said Mannick. Now chief executive of Tornado Therapeutics, she is aiming to develop a rapamycin-like compound that could be even more effective — and patentable. “I think we’ll be able to get there, but we aren’t there yet.”

Others are not inclined to wait. “Get Rapamycin online,” AgelessRx, a longevity-focused telehealth firm, advertises on Google.

Healthspan, a telehealth service whose main offering is rapamycin, markets it predominantly for longevity but also cosmetic use, touting “the only skin cream scientifically proven to reverse skin aging at the molecular level.” On Tuesday, the company announced a new rapamycin product to stimulate hair growth.

Daniel Tawfik launched Healthspan — a term that refers to the portion of life when people are healthy — in 2022 after trying to help his wife battle cancer and observing a “chasm between what’s happening in the research community and the clinical world.” Tawfik said more than 2,000 patients have subscribed to its rapamycin service, which includes the drug and regular testing (Healthspan doesn’t prescribe the drug to between 15 and 20 percent of prospective patients, he said).

For longevity dosing, Healthspan relies on studies led by Mannick as well as research on dogs . For its skin cream, Tawfik cited a small study by Drexel University researchers and a rapamycin-like gel approved by the FDA in 2022 to treat benign facial tumors . For the hair treatment, the company highlighted a 2019 study on mice .

“The potential is enormous for patients to be able to extend their health span and quality of life as they age,” Tawfik said, adding that his firm’s experience “shows that rapamycin can be prescribed safely” with few side effects.

Attia, who has a medical practice focused on helping people live longer and healthier, dedicates a chapter of his 2023 book to rapamycin and has said he takes the drug himself. With more than 600,000 subscribers to his YouTube channel , Attia has become one of the most influential voices in longevity medicine, and many doctors say patients learn about rapamycin from him.

Bryan Johnson, who founded and sold mobile-payments firm Braintree, has also emerged as a high-profile user of rapamycin in his current project: developing a protocol to reverse the aging process.

After his team surveyed scientific literature on what can improve longevity and ranked various strategies, Johnson said rapamycin — in combination with diabetes drug metformin — “is the 10th best-performing of all time.” Johnson — whose videos of his extensive regimen have been viewed millions of times — sees his exploration of longevity on a grand historical scale, like Magellan circumnavigating the globe. He’s actively adjusting his dose of rapamycin.

“I don’t think we have any conclusive observations yet,” he said.

Eric Verdin, chief executive of the Buck Institute on Aging, says there’s a strong case to be made for rapamycin as an anti-aging drug but hastens to add: “We should not as a field recommend use on people.” He and many other doctors say rapamycin is no substitute for exercise and a healthy diet.

“People going on it, using it as a substitute for a healthy lifestyle, it’s a bridge too far for me,” Verdin said. Then he offered a disclosure: He takes rapamycin.

“I’m doing everything I can to try to maximize my longevity,” said Verdin, who is 66. Of rapamycin, he said, “I haven’t felt any difference one way or the other.”

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OU Research Contributes to National Conversation on Neuropsychiatric Side Effects in Children Taking Asthma Drug

Study sheds light on effectiveness of black box warning for Singulair

TULSA, OKLA. – A University of Oklahoma study about a “black box warning” for the asthma drug Singulair continues to influence a national conversation about the medication and its reported neuropsychiatric side effects in children and adolescents. The U.S. Food and Drug Administration assigns black box warnings, sometimes called boxed warnings, as the highest safety-related consumer warning the organization assigns to medications, intended to bring attention to the risks of taking the medication.

In 1998, the FDA approved Singulair, known as montelukast in its generic form, for treating asthma and hay fever. It became a frequently prescribed drug for children struggling with asthma and allergies because it is available in a cherry-flavored chewable pill and may decrease the need for steroids or daily inhaler use. However, in the 26 years since its approval, concerned parents have sounded the alarm about dramatic and sometimes deadly mental health changes they have seen in their children, prompting the FDA to issue a black box warning in 2020.

In their study, researchers at OU-TU School of Community Medicine on the University of Oklahoma’s Tulsa campus sought to understand whether Singulair’s reported negative side effects – including depression, aggression and suicidal thoughts – decreased after the black box warning. Researchers analyzed adverse events reported to the FDA two years before and two years after the warning was issued. In children ages one to 10, reports about most harmful side effects decreased after the warning was issued. However, for youth ages 11 to 17, the outcome was mixed. Reports about side effects actually increased for five of the eight mental health symptoms. Overall, prescriptions for Singulair have decreased only slightly since the black box warning was issued.

In February, the New York attorney general cited the OU findings among other research in a letter to the FDA urging the agency to sound a new, louder alarm about the negative side effects of Singulair in children. Families, too, continue to push for more restrictions on the drug.

A limitation of the study is that the black box warning was issued at the beginning of the COVID-19 pandemic, which had its own effect on the mental health of youth. But for OU researchers, their study

underscores the importance of conversations between doctors and families, said the study’s lead author, Samer Abdelkader, D.O., a pediatrics resident physician in the OU-TU School of Community Medicine.

“As a clinician interested in public health, I hope we can maximize the intent of these warnings and mitigate potential negative impacts on our patients,” Abdelkader said. “I think we can enhance our patient care with better conversations about the benefits and risks of this medication and come to a more informed decision on whether this is the right treatment for each patient.”

Asthma is the most common chronic disease in children, and hay fever (also known as allergic rhinitis) affects the lives of one in five young people, according to the Centers for Disease Control and Prevention. Singulair treats the inflammation and airway swelling that can be dangerous in both conditions. The FDA approved the drug for treating asthma in children as young as 12 months old and for allergies in babies as young as six months old. It is prescribed to millions of children and adolescents each year.

Parents were the first to raise awareness about mental changes they saw in their children who were taking Singulair. Aggression, anxiety, depression, hyperactivity, sleep problems and suicidal thinking were among the symptoms, and several high-profile suicides brought further attention to the drug’s reported problems. Without parents’ advocacy, issues with the drug likely would not have come to light as soon, said Amy Hendrix-Dicken, a senior research assistant and co-author of the paper.

“Parents are the greatest partners in providing health care to children,” she said. “Parents know their kids; our health care providers see them for 15 minutes, and there’s only so much you can glean from a 15-minute visit. We encourage families and patients to speak up, and if they feel like their provider isn’t listening, to find someone who will.”

New information like the black box warning can take a long time to make its way into doctors’ offices large and small, and federal agencies may communicate potential drug problems in differing ways. But health care providers should take the initiative to learn everything they can about the drugs they prescribe, the study’s authors said.

“I no longer say that a side effect cannot be from a medication,” said study co-author and pharmacist Michelle Condren, a professor and vice chair of research in the OU Department of Pediatrics. “I may say, ‘I haven’t seen this side effect before’ or ‘Let me look in the medical literature,’ but I’ll never say that a side effect isn’t possible. This has changed the way I communicate with patients and families. We never want to discount someone who is concerned that a medication could be causing a side effect, but to partner with them to figure things out.”

About the Project

The research team’s study was published in The Journal of Pediatric Pharmacology and Therapeutics and can be accessed at https://doi.org/10.5863/1551-6776-28.8.704.

About the University of Oklahoma

Founded in 1890, the University of Oklahoma is a public research university located in Norman, Oklahoma. As the state’s flagship university, OU serves the educational, cultural, economic and health care needs of the state, region and nation. OU was named the state’s highest-ranking university in  U.S. News & World Report’s  most recent Best Colleges list .  For more information about the university, visit  ou.edu .

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