INTRODUCTION
Research shows that key risk periods for SUD occur during life transitions, such as adolescence. The psychological development of adolescence focuses on socialization. Peer pressure can be especially intense. If peers are using substances, the adolescent may feel obligated to also use substances to “belong” and make/keep friends (Meadows-Oliver, 2019).
Problem behavior in early adolescence may identify a subset of youth who are at an especially high and generalized risk for developing adult psychopathology. Therefore, substance use assessment and intervention are particularly critical for adolescents. To be comprehensive, treatments should encompass the physical, mental, emotional, social, cultural, cognitive, and behavioral aspects of the adolescent (National Institute on Drug Abuse, 2020).
INCIDENCE AND PREVALENCE
The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the wellness of millions of Americans. The Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2019 National Survey on Drug Use Alcohol Abuse of alcohol is quite prevalent in the U.S. Data show that (SAMHSA, 2021a): ● About 139.7 million Americans 12 years of age or older were past month alcohol users; 65.8 million people were binge drinkers in the past month; and 16 million were heavy drinkers in the past month. ● ●About 2.3 million adolescents aged 12 to 17 in 2019 drank alcohol in the past month, and 1.2 million of these adolescents binge drank during that period. ● About 14.5 million people 12 years of age or older have had an alcohol use disorder. ● Excessive alcohol use can lead to risk-taking behavior such as driving while impaired. In fact, research shows that every day, 29 people in the U.S. die in motor vehicle crashes that involve an alcohol-impaired driver. ● Excessive alcohol use can increase the risk of stroke, liver cirrhosis, alcoholic hepatitis, and cancer. Healthcare Professional Consideration: Since the onslaught of COVID-19, social isolation, unemployment, restricted community events, and family distancing have all created stresses that have increased the abuse of alcohol and other substances. Electronic Cigarette (E-Cigarette) According to data from the Centers for Disease Control and Prevention’s (CDC) 2020 National Youth Tobacco Survey (CDC, 2020), use of e-cigarettes declined from 2019 to 2020 among both middle and high school students. This is a reversal of previous trends. E-cigarettes contain nicotine and various other chemicals. This means that their use is especially unsafe for youth, young adults, and pregnant women (CDC, 2020). Opioids An average of 128 Americans die every day from an opioid overdose (CDC, 2021a). Data concerning opioid use indicates the following (SAMHSA, 2021a). ● There were 10.1 million people age 12 or older who misused opioids in 2020. Most of these people misused prescription pain relievers. Marijuana According to 2019 data (SAMHSA, 2021a): ● An estimated 48.2 million Americans 12 years of age or older (17.5% of the population) used marijuana in the past year. Emerging Trends in Substance Misuse Several troubling emerging trends have also been identified by SAMHSA. These include the following (SAMHSA, 2021a). ● Methamphetamine: In 2019, almost 2 million people had used methamphetamine in the past year. An estimated
and Health reports that about 19.3 million people 18 years of age and older had a substance use disorder in the past year (SAMHSA, 2021a). Key findings from SAMHSA’s 2019 survey include the following (SAMHSA, 2021a). Tobacco Data from the 2019 SAMHSA report shows that 58.1 million people were tobacco users in the past month. Additionally, 45.9 million people age 12 or older in 2019 were cigarette smokers in the past month (SAMHSA, 2021a). Tobacco use is the leading cause of preventable death. It often results in lung cancer, respiratory disorders, heart disease, and stroke. An estimated 480,000 deaths in the U.S. are related to cigarette smoking every year (SAMHSA, 2021a). Children raised in households with smokers are at increased risk of asthma and respiratory illnesses. Individuals who work in restaurants, bars, or offices where secondhand smoke is a hazard are also at risk of the consequences of smoke inhalation. Evidence-Based Practice Research indicates that more than 16 million Americans are living with a disease caused by smoking cigarettes (SAMHSA, 2021a). Healthcare professionals must be alert to the impact of smoking tobacco and work to help patients stop using tobacco products or, just as importantly, to prevent their use in the first place. Healthcare Professional Consideration: The CDC (2021b) reports that 99% of e-cigarettes sold in the U.S. contain nicotine. Furthermore, some e-cigarette labels fail to disclose that the product contains nicotine. Some are marketed as containing 0% nicotine but, in fact, have been found to contain nicotine. ● An estimated 1.6 million people age 12 or older had an opioid use disorder. ● An average of 128 Americans die every day from an opioid overdose. ● About 745,000 people used heroin during 2020. ● Opioid use, specifically injection drug use, is a risk factor for contracting HIV, hepatitis B, and hepatitis C. ● About 4.8 million people 12 years of age or older had a marijuana use disorder in the past year. ● Research indicates that marijuana can impair judgment and distort perception in the short term and can lead to memory impairment in the long term. 1 million people had a methamphetamine use disorder, which was higher than the percentage in 2016, but similar to percentages in 2015 and 2018. Overdose death rates involving methamphetamine quadrupled from 2011 to 2017.
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