Substance Use Disorder (2)

Part
01
of one
Part
01

Substance Use Disorder (2)

Key Takeaways

  • Over 20.4 million people in the US suffer from substance use disorders, with alcohol-related issues being the most prevalent.
  • One in 12 people that have a stable job have reported suffering from a substance use disorder.
  • Age, race, educational level, marital status, and employment level are some of the biggest contributors to the development of a SUD

Introduction

The opioid epidemic has become a big hurdle for the US health system. Of the 165 million people that have reported substance use, 20.4 million suffer from substance use disorders (SUDs). Alcohol, illegal drugs, and prescription medicine are the three predominant substances related to SUDs. The overall death rate related to SUDs has also been increasing, reaching over 70,000 deaths in 2019. The unemployment rate has been a crucial factor for the increase of illegal substances prevalence and addiction. However, employed people have not been immune either, with one in 12 reporting having a substance abuse disorder.

General Statistics

  • According to the most recent National Survey on Drug Use and Health, approximately 20.4 million people suffered from substance use disorders.
  • In total, over 60% of the US population uses some kind of substance, be it tobacco, alcohol, or opioids.
  • Alcohol is the most common type of substance use, with over 139.7 million people drinking alcohol every month in 2019. Of those, 65.8 million were considered binge drinkers and 16 million were heavy alcohol users.
  • About 14.8 million, or 5.3% of the US population, alcohol drinkers were considered as having a SUD.
  • However, alcohol use and people that identify as having a SUD as a result of alcohol drinking have been generally on the decline since 2002.
  • There has been a 2.4% decline in the recorded alcohol use disorder cases between 2002 and 2019, resulting in a drop of 3.6 million cases in the specific time frame.
  • Illicit drug use is the second-highest source of addiction and substance misuse.
  • In 2019, 31.9 million people were using illegal drugs. Of those, 8.1 million were considered to have a SUD.
  • Marijuana (4.8 million), cocaine (1.5 million) and pain reliever medications (1.4 million) were the substances that were used the most by SUD users.
  • Marijuana use, along with prescription medications, has also been on the rise, despite other illegal drugs decreasing in prevalence in the last 15-20 years.
  • The frequent marijuana use increased by 6.5% between 2002 and 2019.
  • A big reason for the increase in SUD cases can be attributed to the sudden rise in the number of medical prescriptions since the early 2010s.
  • In 2012, the rate of drug prescriptions stood at 81.3 per 100 people, reaching 255 million prescriptions issued that year.
  • While the rate has steadily decreased since then, the rate of prescription in the US is still alarmingly high. In several US counties, there were enough opioid prescriptions for every person to have one.
  • By the end of 2017, the prescription rate stood at 59 per 100, with 191.2 million issued prescriptions.
  • The latest data from the CDC indicates that the prescription rate has decreased further by another 12.3%, reaching a rate of 46.7 per 100, with 153.2 million dispensed prescriptions in 2019.

The Demographics of Substance Use Disorder

  • In general, younger people, specifically those between 18 and 29, are more prone to substance abuse.
  • About 73% of all the people with a substance use disorder were between 18 and 29 years old.
  • A big contributor to the development of SUD is the presence of illegal substances at a younger age.
  • 70% of people that try drugs or other illegal substances by age 13 develop a SUD within 7 years, while only 27% of those that try illegal substances after they turn 17 develop the substance use disorder.
  • Substance misuse is also generally more prominent in males compared to females and is more prevalent in larger cities than in rural environments.

SUD-related Deaths

  • There are over 70,000 deaths related to substance abuse in the US on an annual basis.
  • The mortality rate related to SUD increased to 20.7 deaths per 100,000 in 2018, with "West Virginia (51.5), Delaware (43.8), Maryland (37.2), Pennsylvania (36.1), Ohio (35.9), and New Hampshire (35.8), having the highest mortality rates."
  • SUD-related deaths were more prevalent in White males, but death rates in Black people have increased tremendously (over 104%) in the last few years.
  • In comparison, the mortality rate for White males increased only about 50%, going from 26.46 in 2014 to 39.77 per 100,000 in 2017.
  • According to Hernandez et al., age, race, educational level, marital status, and employment level are some of the biggest contributors to death.
  • Individuals between 25 and 29 were most at risk of dying.
  • White, single people that had at least a secondary education were also more at risk of dying from SUD-related causes.
  • In 2019, clinics that deal with people that suffer from SUD have noted that the urine samples that contain fatal substances have increased several times compared to data from 2013.
  • People that have taken fatal amounts of meth increased from 1.4% in 2013 to 4% in 2019, while urine samples that had fatal amounts of fentanyl increased from 1% to 5%.
  • Poverty and non-insurance have also been related to the increase in the development of SUDs and the eventual deaths of the affected people.

SUD in Employed People

SUD and Unemployment

  • According to data from the 2013 National Survey on Drug Use and Health survey, 16.8% of the unemployed people, or 2.2 million, suffer from a SUD.
  • More recent reports have noted that the correlation between the unemployment rate and SUD is not clear, which is probably why recent results are not available.
  • According to Azagba et al., an increase in unemployment rates increased opioid and other substance admissions by a few percent.
  • The HHS has also noted that limited work experience and job prospects are factors that increase the likelihood of people increasing the use of different substances.
  • Several studies have shown that an economic downturn can cause people to increase their use of alcohol and drugs.
  • A more recent study conducted in Milwaukee noted that unemployed and part-time employees tested positive for cocaine and other harmful substances more often than full-time employees.

Research Strategy

Throughout our research, we focused mainly on data reported either by government agencies like NCDAS, NORC, and the National Survey on Drug Use and Health. We also looked through several recent research articles on the topic to complement our data. While information about the subject was generally abundant, the specific prevalence of people with SUDs that are unemployed was scarce, with most of the data coming from 2013. Several research reports that have analyzed the effects of unemployment on the development of SUDs have also noted that the relationship between substance abuse and unemployment is complex and often unclear. Data about prevalence in unemployment was missing from the last National Survey and many of the other authorities in substance abuse, notably the American Addiction Center uses data that is from 2013, suggesting that a more accurate representation of the figure has not been provided in recent survey responses.

It is also important to note that some of the data we used in this report may be similar to the data used in the previous iteration of the project. The main reason for that is that we strove to provide the most up-to-date information related to the subject in question.
Sources
Sources