Author: Sara Habibipour
According to the National Survey on Drug Use and Health, 19.7 million American adults (aged 12 and older) battled a Substance Use Disorder in 2017.
That’s a lot of people. In fact, maybe you know someone who suffers from Substance Use Disorder.
In the discussion of health disparities, Substance Use Disorder is an interesting case to look at because there are so many social factors that can lead someone down the path of drugs and alcohol.
Let’s first understand what this condition is.
What is Substance Use Disorder?
Substance Use Disorder occurs when a person's use of alcohol or drugs leads to health issues or problems at work, school, or home (also known as substance abuse) (MedLine Plus).
The exact cause of Substance Use Disorder is unknown, as there are so many factors that can influence its development.
Many who develop a Substance Use Disorder have depression, attention deficit disorder (ADD), post-traumatic stress disorder (PTSD), or another mental illness. Children who grow up seeing their parents using drugs may have a higher risk of developing Substance Use Disorder as well for reasons we’ll discuss later. Commonly used substances that can lead to addiction include:
Opiates and other narcotics due to their pain-killing effect
Stimulants (ex: cocaine, Ritalin, meth): A person can start needing higher amounts of these drugs over time to feel the same effect.
Depressants (ex: alcohol and Xanax) for their abilities to reduce anxiety.
Hallucinogenics (ex: LSD, "mushrooms", PCP) can cause a person to see things that are not there (hallucinations) and can lead to psychological addiction.
Marijuana (cannabis, or hashish)
The Role of Criminal History and Socioeconomic Status
A study was conducted by Benjamin Le Cook, PhD, MPH and Margarita Alegria, PhD of Harvard University and Massachusetts General Hospital (respectively) that assessed the role of criminal history and socioeconomic status in Substance Use Disorders.
Racial disparities in any substance abuse treatment were measured among adults with substance use disorders from the 2005–2009 National Survey on Drug Use and Health. Three staged models were used to measure the extent to which criminal history and socioeconomic indicators contributed to disparities, and identify any correlation in treatment.
Treatment was rare (about 10%) for all racial groups. However, higher rates of criminal history among Blacks and Latinos, and those of lower income, seemed to influence changes in estimates of disparities across models.
“The greater likelihood of treatment receipt among persons with a criminal history and lower socioeconomic status is a pattern unlike those seen in most other areas of medical treatment and important to the understanding of substance abuse treatment disparities” (Le Cook et. al). Those in the criminal justice system may forcibly provide access to individuals, even if they’re resistant to care, leading those in the system to be more likely to receive treatment.
The Role of Environment and Genetics
According to the American Addiction Centers, genetics are 50 percent of the underlying reason for alcohol use disorder. If a person is genetically predisposed to metabolize alcohol in a way that the pleasurable effects are more prominent than the negative effects (ex: nausea, vomiting, mood swings), the person may be more likely to develop a Substance Use Disorder.
Genes that influence drug use may be expressed in different ways:
Studies have shown that people who have a family history of drug use have been shown to have a smaller than average amygdala, the part of the brain responsible for emotions associated with cravings.
People who have a genetic predisposition to alcohol use disorder may experience fewer or different warning signals from their nervous system when they physically need to stop using the substance.
Unusual levels of serotonin, key mood-regulating neurotransmitters, have also been associated with people who are genetically predisposed to Substance Use Disorder
Going hand-in-hand with genetic factors, a child’s environment can also heavily influence their future with substance use. Environmental factors that may increase a person’s risk of addiction include a chaotic home environment surrounded by their parent’s use of drugs, peer influences, etc, especially if they’re already genetically predisposed.
If you’re struggling with addiction and need help, call this hotline: 888-971-2516
I've heard that another thing which contributed to the opiate crisis was aggressive marketing by drug companies. Two of my older relatives who were working in medicine a few decades ago remember the staff being given lunchtime lectures by drug representatives who gave out free sandwiches, being told that there were no long-term addictive qualities and that they should prescribe as many opiates as they can. I have a suspicion that that might have been a contributing factor in starting this whole mess.