No one would classify diabetes, HIV or cancer as crimes. We all know they’re diseases brought on by a combination of societal, behavioral and genetic factors. So why is society’s attitude toward drug addiction different?
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President Donald Trump recently declared the opioid crisis in the United States a public health emergency. Although the declaration itself doesn't provide any money to fight the issue, it allows for existing grants to be redirected toward the problem, according to NBC News.
To put the severity of the situation into perspective, past public health emergencies include the H1N1 influenza outbreak in 2009 and extreme weather events like Hurricane Harvey.
Last November, United States Surgeon General Dr. Vivek H. Murthy released the first-ever Surgeon General's report on the science behind preventing and treating substance-use disorders to change the the conversation surrounding addiction.
Although most of us aren’t going to go out and read Murthy’s book-length report, there’s a lot we can learn about addiction. Here are some shocking facts about the substance-use disorder crisis that’s plaguing America.
1. 20.8 million Americans are currently struggling with substance-use disorders.
That number is similar to the number of Americans who have diabetes. It’s also more than 1.5 times the number of people who suffer from every kind of cancer combined (14 million in 2013), Dr. Murthy reports.
2. Addiction is a chronic brain disease.
Substance-use disorder causes changes in a person’s brain, according the Surgeon General’s report. When a person becomes addicted to drugs or alcohol, the brain circuits involved in pleasure, learning, stress, decision-making and self-control are altered.
When taking drugs, a surge of dopamine — a neurotransmitter responsible for pleasure — happens in a region of the brain called the basal ganglia, which is responsible for controlling our rewards.
As drug use continues, the basal ganglia becomes less sensitive to dopamine, building a tolerance. This means that people who are addicted to drugs have to continually increase their intake to experience the “high” they used to get with less. In the process, they become increasingly numb to everyday experiences that used to bring them joy.
Disruption to the extended amygdala — the stress center of the brain — makes a person feel emotional distress, or withdrawal, when they are not on drugs. Drug use also alters the prefrontal cortex, which is responsible for decision-making, so that a person is less able to control their impulses.
While these disruptions in the brain don’t override people’s autonomy, they do alter their ability to control desires, making it difficult to stop drug use.
3. One in seven Americans is expected to develop a substance-use disorder at some point in their life.
Forty to 70 percent of a person’s risk of becoming addicted to drugs is genetic. Other factors include home life, neighborhood, peers and age.
A person has a substance-use disorder when they use drugs or alcohol to the extent that it causes “clinically significant impairments in health, social functioning and voluntary control over substance use,” Dr. Murthy reports.
Most people who misuse substances don’t develop a disorder, and a disorder can be diagnosed as mild, moderate or severe.
4. Prescription drug and heroin overdose is the leading cause of unintentional death in the U.S.
It’s also the second leading cause of death among people under the age of 35, according to a Facing Addiction press release.
According to the Surgeon General’s report, 350 people die from drug and alcohol use every day in the United States. Seventy-eight of those deaths are from opioid overdose, quadruple the number of opioid deaths in 1999.
Almost 23 percent of people ages 18 to 20 use illicit (i.e., illegal) drugs, and about one in 10 adults (12.8 percent of men and 7.3 percent of women) report illicit drug use, according to the Substance Abuse and Mental Health Services Administration.
5. Substance-use disorders cost the U.S. $442 billion every year.
That’s more than the entire state of Massachusetts earned in personal income last year. The number includes health care costs, lost economic productivity and criminal justice system costs.
Murthy’s solution to the problem is to invest in treatment and prevention programs.
“Investing in treatment programs saves us $4 in health care costs and $7 in criminal justice costs for every $1 invested in treatment,” Murthy tells LIVESTRONG.COM.
6. Only one in 10 people with a substance-use disorder receives any type of specialty treatment.
Even though more than 20 million people are in need of treatment for a substance-use disorder, many only receive treatment after a crisis occurs (such as an overdose), and that typically comes with the involvement of the criminal justice system.
The Surgeon General’s report calls for an integrated, multistep health care model, one in which substance-use disorders and other behavioral disorders are treated like physical diseases.
In this model, people would be screened in general health care settings. If diagnosed with mild to moderate disorders, they’d be treated in general care. People with severe disorders would be treated by specialists. They’d also receive continual care coordinated with their primary care doctors.
So during your next appointment help to push the system along by asking your doctor why he or she didn’t screen you for a substance-use disorder.
7. More than 25 million people who have had substance-use disorders are in remission.
The Surgeon General’s report emphasizes that there is hope to end America’s addiction crisis. Murthy urges institutions, schools and communities to implement evidence-based strategies for prevention and treatment.
Research-based programs boost protective factors, or resources that help a person to avoid substance use. For example, feeling that adults and peers at school care about them as individuals is the strongest protective factor for both boys and girls to decrease substance use. So teachers in preventative programs might dedicate extra time, interest and emotional support to their students in order to bolster their sense of school connectedness.
Evidence-based programs also teach people to manage their stress in healthy ways, rather than self-medicating.
“All across our country we have example communities that are starting to set up and implement prevention programs and treatment programs,” Murthy tells NPR. “And people’s lives are changing as a result of that. We’ve been dealing with substance disorders for centuries. What’s different now is that we have solutions that work.”
To learn more, or to find help for you or someone you know who might be suffering from a substance use disorder, visit samhsa.gov.
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