If it seems like the addiction problem in America is getting worse, that’s because it is. Despite countless awareness campaigns, legal regulations, and public health initiatives, the rates of substance abuse disorders are increasing.
This is counterintuitive. The more we know about an illness, the easier it should be to prevent it. After all, people can take the necessary steps to prepare and protect themselves.
However, the reality is that the rates of many illnesses, both physical and mental, are increasing. Cancers and diabetes caused by bad eating habits are prevalent despite access to a glut of information about healthy eating. There are more mental health crises caused by overworking than ever before in spite of the recognition of the dangers of chronic stress.
When it comes to prevention, there is simply a lot that cannot be controlled. Human nature and environmental factors get in the way of prevention campaigns working flawlessly.
Here are some of the factors that are contributing to the rise of substance abuse disorders.
The Role of Mental Health and Stress
One of the primary drivers behind the rise in substance abuse disorders is the mental health crisis. Rates of anxiety, depression, and other mental health disorders have been steadily increasing, and many individuals turn to substances as a way to cope. Substances like alcohol, opioids, and stimulants might offer relief but it is temporary. They ultimately exacerbate the problem, creating a vicious cycle of dependence and mental health decline.
For many people, mental health issues stem from Adverse Childhood Experiences (ACEs), such as abuse, neglect, and household dysfunction. ACEs impact brain development and coping mechanisms, making it harder for individuals to handle stress and emotions in healthy ways. Unfortunately, in spite of advances being made in how we see childcare, there is still major dysfunction in many households in the US. Rising crime rates and school shootings also mean that violent trauma is becoming more common among children.
As is the case with mental illness, chronic stress is another major contributor to substance use. Work pressures, financial insecurity, and the breakdown of social support systems are all functions of modern society. For relief from these daily stressors, more people are turning to substance use as a form of escape.
Socioeconomic Factors
The gap between the haves and have nots is growing with the decline of the middle class. More people are struggling financially. Socioeconomic struggles have long been connected to the development of substance abuse disorders.
People in low-income communities are often exposed to higher levels of stress and trauma, with limited access to healthcare, mental health services, and addiction treatment. This gap in healthcare access exacerbates the issue, as individuals in poverty may use substances to cope with their difficult circumstances, creating a cycle of dependency.
The problem is exacerbated by the rising costs of healthcare. Many people struggling with addiction do not have access to affordable healthcare, particularly when it comes to mental health services and rehabilitation programs. The lack of affordable, accessible addiction treatment often results in untreated conditions, allowing addiction to spiral further out of control. This is particularly true for individuals in rural and underserved areas, where healthcare options are limited.
Cultural and Social Influences
In many societies, alcohol and drug use are becoming more normalized in social settings. Drinking alcohol, for instance, is often considered a socially acceptable way to relax or have fun, despite its potential for abuse. This normalization can lead individuals to underestimate the risks of substances.
Social media plays a part in this normalization – but not because of its organic use. Rather, celebrities and influencers are now using platforms like Instagram and TikTok to promote their own brands of alcohol or brands which pay them to do so. Because social media appears to bridge the gap between celebrities and fans, these promotions appear organic and have a significant impact.
Peer pressure on social media also plays a role. Adolescents and young adults have always been vulnerable to trying drugs due to peer influence. The desire to fit in, coupled with the availability of substances in social environments like parties or concerts, increases the likelihood of first-time use. These early experiences can sometimes lead to long-term addiction. Now, with people sharing photos and videos of their experiences on social media platforms, peer pressure is more powerful than ever.
Availability and Accessibility of Drugs
Drugs have also become increasingly available and accessible. Prescription medications, particularly opioids, are one of the leading drivers of addiction in the country. Over-prescription of painkillers during the early 2000s created a crisis where many individuals became dependent on these medications, leading to widespread opioid addiction. Despite efforts to regulate opioid prescriptions, many individuals still find ways to access these drugs illegally.
Additionally, the availability of illicit drugs has expanded significantly in recent years. Drugs like heroin, cocaine, and methamphetamine are often readily accessible in many communities, with street-level dealers making it easier to purchase these substances. The ease of access, combined with the high purity of certain drugs, increases the risk of addiction. In particular, the rise of synthetic opioids like fentanyl, which is far more potent than heroin, has caused a spike in overdose deaths and addiction rates.
Technological Advances and the Dark Web
Modern technology has significantly contributed to the growing accessibility of drugs, fueling the rise of substance abuse disorders. One of the most concerning developments has been the emergence of the dark web, a part of the internet that is hidden from search engines and accessible only through special browsers. The dark web allows individuals to buy illegal drugs anonymously, making it easier for users to access substances without the risk of being caught by law enforcement. This has led to a surge in the availability of drugs such as fentanyl, heroin, and synthetic cannabinoids.
The Impact of the COVID-19 Pandemic
The COVID-19 pandemic affected all parts of our lives, but was perhaps most significant when it came to mental health and substance abuse. The increased isolation, economic uncertainty, and existential stress all contributed to a rise in depression and anxiety. Since people were cut off from their usual support systems, including friends, family, and recovery groups, they turned to substances to cope.
Moreover, access to addiction treatment services became more limited during the pandemic. Many rehabilitation centers closed or reduced their capacity to prevent the spread of the virus, leaving individuals with fewer options for help. Telehealth services tried to fill the gap, but for many people, especially those without reliable internet access, these services were not a feasible solution. As a result, substance use increased, and the rates of overdose deaths surged during the pandemic, particularly with opioids like fentanyl.
The pandemic highlighted the need for robust mental health and addiction treatment infrastructures, as the strain caused by such crises can exacerbate underlying issues and lead to more widespread substance abuse.
Failure of Public Health Approaches
It’s clear that public health approaches have not managed to prevent the rise in substance use disorders. The question of why they failed is complex, but there are certain factors that precipitated this failure
One of the major issues these approaches have not sufficiently addressed the stigma surrounding addiction. Addiction is often seen as a moral failing rather than a medical condition, which discourages individuals from seeking help. The fear of judgment or legal repercussions prevents many from accessing treatment until their condition has worsened.
But, more importantly, awareness campaigns often focus on the dangers of the drugs themselves rather than addressing the underlying causes of addiction, such as mental health issues, trauma, or socioeconomic struggles. While these campaigns can deter some from experimenting with drugs, they do little to counter the systematic nature of the problem. Furthermore, punitive measures, such as criminalizing drug use, have proven ineffective in curbing addiction rates and often lead to incarceration rather than rehabilitation.
Another critical issue is the lack of funding for comprehensive addiction treatment programs. Many communities, particularly in rural areas, do not have access to sufficient mental health or rehabilitation services. Even in areas where these services are available, they are often expensive and inaccessible to those without adequate insurance. Without adequate funding and support, public health approaches will remain ineffective at addressing the root causes of addiction
Conclusion
Substance abuse disorders are rising in number in spite of decades of work in raising awareness. It’s clear that the public health approaches have not met the needs of society. Considering the systemic issues that lead to substance abuse, this is not surprising. Awareness is simply not enough to counter the day-to-day struggles that cause people to turn to drugs.
That does not mean that awareness campaigns are futile. They do deter some people from using drugs and make it easier to identify when there is a problem. They can also help get people into treatment. However, to solve the addiction problem, we need far more robust solutions.
Sources
- SAMHSA: National Survey on Drug Use and Health (NSDUH). Accessed 22 October 2024.
- Psychoactives: A Multi-Level Analysis of Biological, Social, and Psychological Determinants of Substance Use Disorder and Co-Occurring Mental Health Outcomes. Accessed 22 October 2024.
- PLOS Medicine: Addressing the context and consequences of substance use, misuse, and dependence: A global imperative. Accessed 22 October 2024.