Alcohol and Substance Abuse in the United States: Evermore Grave

by Kay Hurlock, Psy.D.*

Clinical Psychology Associates of North Central Florida

When we examine health care costs, mortality, violence rates, lost workdays, or workplace accidents, it soon becomes apparent alcohol and substance abuse, and dependency are major contributors.  News headlines have now faded since it was first announced that for the first time in 2009 drugs caused more deaths (37,485) than motor vehicle accidents. That was double the rate of drug-related deaths in 1999. A steep rise in deaths from overdoses of prescription narcotics contributes to this ongoing trend. 

Substance abuse remains an omnipresent problem in the United States. According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) drug statistic trends, 20.4 million Americans aged 12 or older were current illicit drug users in 2006.  The most commonly used illicit drug is marijuana, with nearly 10 million current users.An estimated 5.2 million persons were current nonmedical users of prescription pain relievers in 2006, which is more than the estimated 4.7 million in 2005.

Substance use rates are higher in persons 26 years of age or older than in any other age group.  An estimated 125 million people of Americans aged 12 or older reported being current drinkers of alcohol in the 2006 survey. More than 57 million persons aged 12 or older participated in binge drinking at least once in the 30 days prior to the survey in 2006. In 2006, heavy drinking was reported by approximately 17 million of the population aged 12 or older.

Working with patients who deny having a problem presents a challenging task.  Individuals may delude themselves into thinking that they are not drinking too much or that they can control their use. When drinking, they create an illusion of normalcy and believe they need alcohol or illicit drugs to cope with daily life stressors.  To imagine life without using seems impossible. 

Substance abuse and dependency crosses all age groups and socioeconomic margins.  From the 42-year old male mechanic to the 72-year old female retired university professor, medical professionals need to be prepared to screen for alcohol and illicit drug abuse as part of their routine questioning.  Family physicians can play a vital role in recognizing an at risk patient, determining the significance of the problem, providing support and making the appropriate referral for treatment.  Often a patient’s perception of a physician’s recognition of substance abuse problems affects one’s prognosis. 

Once an individual is identified at significant risk of alcohol or substance abuse the next step is how to help the individual.  Approximately 2/3 of physicians will provide some sort of counseling within their office.  Often due to time-constraints, more formal counseling is not practical within a primary care setting where the average office visit seems to trend evermore less than 17.4 minutes.  Psychologists and other addiction professionals offer a range of assessment and treatment services for individuals with alcohol or drug problems.  Self-help groups such as AA or NA groups can be helpful, though many individuals need more formal assessment of co-existing psychiatric disorders, individual and/or group therapy, medical follow up and possibly pharmacotherapy to reduce craving or forestall withdrawal symptoms.

For more on Alcohol and Drug Assessment and Treatment Services click here.

If you have any further questions or comments regarding the treatment of alcohol and substance abuse within an outpatient setting, contact Clinical Psychology Associates of North Central Florida at (352) 366-2888.

Kay Hurlock, Psy.D. wrote this article while a  psychology resident with Clinical Psychology Associates of North Central Florida.  She is now in private practice as a licensed psychologist in Humble, Texas.

Contact: Kay Brumbaugh, Psy.D., 18321 W. Lake Houston Suite 310, Humble, TX, 77346, Ph. (832) 800-9558.  Website: http://www.drkbrumbaugh.com