Substance Abuse and Addictions in Adults

by Katie A. McGravey, MA, CAGS candidate at the Massachusetts School of Professional Psychology

Substance Abuse refers to the pathological use of drugs or alcohol, characterized by daily intoxication, inability to reduce consumption, and/or impairment in social or occupational functioning. In the United States, abused substances range from cigarettes and alcohol to cocaine and heroin. Painkillers and marijuana are also commonly abused.

Substance abuse is sometimes viewed primarily as a social problem. However, it can develop into a complex disease or addiction. Substance Dependency indicates a more serious condition, with abuse lasting for a longer period of time. Long-term substance abuse can lead to changes in the chemical properties of the brain.

According to the 2001 National Household Survey on Drug Abuse (NHSDA), about half of all individuals in the U.S. who abuse drugs or alcohol are considered dependent. Many factors can influence whether or not a person becomes addicted, including the environment, development, mental illness, and biology. According to the National Institute on Drug Abuse (NIDA), genetics and environment together account for about half of a person’s likelihood of becoming addicted to drugs or alcohol. For example, someone who grows up in a home where drugs or alcohol are abused is more likely to abuse substances. In addition, development plays a role in dependency. For instance, the younger a person is when he begins abusing drugs, the more likely that person is to become dependent. In addition, emotional disorders put individuals at greater risk for substance abuse; severe depression or anxiety may lead some to abuse drugs or alcohol. Individuals with Attention Deficit Hyperactivity Disorder (ADHD) may also turn to drugs or alcohol to treat their own symptoms. Biology can play a part as well, since men are more likely to abuse alcohol than women.

Preventative programs that involve families, schools, and the community have proven effective in preventing drug abuse and addiction. Since the age at which abuse begins has a major impact on whether or not it will become an addiction, many school districts implement prevention programs in an effort to deter students from using drugs and/or alcohol. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the Granite Falls School District in Washington State is a leader in such programs. The District uses a Life Skills training program that includes promoting anti-drug use as the norm, along with teaching refusal behaviors and social skills, such as coping with anger and anxiety (samhsa.gov).

Many substance abuse prevention programs incorporate features of the Granite Falls model. For instance, social skills training is an important element, since substance abuse has been linked to other behaviors, such as delinquency and low academic achievement. By teaching teenagers how to cope with stress, anxiety, and peer pressure, prevention programs can help students use other strategies to deal with difficult issues, rather than turning to drugs or alcohol.

 Substance abuse and dependency are treatable. However, treatment must be comprehensive and it usually occurs over time. Addiction is considered to be a chronic condition, so relapses are common. Therefore, it is important for substance abuse and dependency treatment programs to be long-term and involve multiple interventions. According to NIDA, the most effective programs include a combination of therapies plus other services, all of which address the individual needs of a client.

While treatment can be successful, there remains a considerable discrepancy between the number of people with a substance abuse problem and the number of people in treatment. In an attempt to improve this situation, programs must become less costly and more accessible.

NIDA encourages mental health professionals to screen for substance abuse and dependency, and then refer those who need help to treatment centers. Family members can play important roles in the process. They may assist in convincing a person struggling with substance abuse or dependency to enter into treatment, and/or to remain in treatment. In addition, many treatment programs include individual and group therapy along with family therapy.

For information specifically on substance abuse in older adults, please see our article on Substance Abuse in Older Adults.

The information in the article above was drawn from the following sources:

• The Mayo Clinic. Alcoholism Risk Factors. Retrieved July 22, 2009.
• National Institute on Drug Abuse (NIDA). (2009).  NIDA InfoFacts: Understanding Drug Abuse and Addiction. Retrieved July 20, 2009.
• National Institute on Drug Abuse (NIDA). (2009).  Principles of Drug Addiction Treatment: A Research Based Guide. Retrieved July 20, 2009.
• Substance Abuse and Mental Health Services Administration (SAMHSA). (2009). Center for Substance Abuse Prevention.  Retrieved July 22, 2009.
• Substance Abuse and Mental Health Services Administration (SAMHSA). (2009). Substance Dependence, Abuse, and Treatment. Retrieved July 22, 2009.

Additional Sources of Information

• Promoting Older Adult Health: Aging Network Partnerships to Address Medication, Alcohol, and Mental Health Problems, from the National Council on Aging.
• Rethinking the Demographics of Addiction: Helping Older Adults Find Recovery, a webcast addressing alcohol and aging from the National Alcohol & Drug Recovery Month, an initiative of the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.

• As You Age: A Guide to Aging, Medicines, and Alcohol, a public education campaign to warn older adults about the dangers of misusing medications or mixing them with alcohol developed by the U.S. Department of Health and Human Services, the Substance Abuse and Mental Health Services Administration, and the Food and Drug Administration.

General Resources on Aging and Wellness

• From Project INTERFACE: Caregiver Resources.
• Geriatric Mental Health Foundation.
• “Older Adults and Mental Health,” from Mental Health: A Report of the Surgeon General.
• PubMed, a collaboration of the U. S. National Library of Medicine and the National Institute of Health, provides a comprehensive list of journal articles regarding mental health and older adults.