ALCOHOL & OTHER DRUGS

The National Survey on Drug Use & Health reports extensively on the substance use issues in America. Not only do they study those with any use of substances year over year, but also the number of people newly exposed to substances each year. The results are staggering. Perhaps the most troubling are their statistics for how many people in our country meet criteria for an actual substance use disorder (i.e. not just illicit use, abuse or misuse).

From their report, there are 20.3 million people in America 12 and older who met criteria for substance use disorder in 2018. Alcohol remains the leading substance use disorder with 14.8 million people affected. Of those, 12.2 million “just” have an alcohol problem with the other 2.7 million also meeting criteria for an illicit drug use disorder. There are 5.4 million people, then, who “just” have an illicit drug use disorder.

Of those people struggling with an illicit drug use disorder in 2018, here are the most prevalent substances:

• 4.4 million = marijuana

• 1.7 million = prescription pain medications

• 1.1 million = methamphetamine

• 977,000 = cocaine

• 561,000 = prescription stimulant medications

• 526,000 = heroin

Though there are some medication-assisted treatment options to directly impact alcohol use disorder, they are not as effective as the options currently available for opioid use disorder. For any of these other illicit drug use disorders, researchers have yet to develop any FDA-approved medication-assisted interventions, so providers are relegated to using other medications off-label to help.

Absent such modalities, many people have been and can be helped with these substance use disorders on an outpatient basis with a combination of therapeutic individual counseling, group activities, case management, crisis intervention and peer support. There are some medications that can be used for minor detoxification and withdrawal management, but that would be on a case-by-case basis.