Addiction is a global problem. Over 3 million people die of alcohol related deaths each year. It’s estimated that 31 million people have a drug use disorder. 11 million of those are intravenous drug users. In 2015, 450,000 people died as a result of drug use. In 2016, 275 million people used drugs at least once.
The World Health Organization (WHO) uses a metric called the disability-adjusted life-year (DALY) to quantify the overall societal burden of a particular disease. It uses time as a measurement of the effects of a chronic illness in terms of premature death and years lived with a resulting disability. These numbers are then factored against life expectancy. Basically, one DALY equals one year of healthy life lost. According to the National Institutes of Health, in 2015, illegal drug use cost 27.8 million DALYs. In other words, the global population lost 27.8 million years of healthy human life. Include tobacco and alcohol to that number and it jumps to 283 million.
Substance Abuse Stats: America vs. The World
Although addiction is a problem all around the world, America seems to have it the worst in many ways.
- In 2016, approximately 5.4% of the American population had a substance use disorder. Only Russia has a higher percentage at 6% and while that number has been declining since 2000, ours has continued to climb. Those percentages include alcohol abuse. When you look strictly at drugs, as of 2017, America is by far the global leader at 3.4% of the population. The United Arab Emirates follows at 2.9%.
- We have the highest DALY percentage in terms of total disease burden. We also have the highest DALY score, at 1,695 healthy years lost per every 100,000 people (2017). With a population of about 327 million, that’s around 5.5 million years.
- The direct death rate from drug use disorders in America is more than double the rates in any other country. We lose about 18 people in 100,000 with Libya next at 8 per 100,000 (2017). The U.S. has about 4% of the world’s population but 27% of the world’s overdose deaths
Contributors to the Drug Problem in America
So why is this the case with America? There is a complex web of societal and economic reasons but experts cite several reasons that have to do with the opioid situation in this country.
Per every 1 million people, the U.S. daily opioid use is about 20,000 people higher than the country with the second highest rate, Canada. As an example, West Virginia has one of the worst problems with opioid abuse in the U.S. There’s a town called Kermit there with a population of about 400. Over the course of two years, the residents there received 9 million prescription opioid pills.
Lack of Strict Prescription Laws
- Most other countries have stricter prescription laws than us. The U.S. and New Zealand are the only two nations in the world that allow direct-to-consumer (DTC) marketing of prescription medications. Opponents of this practice say that prescription ads prompt people to go see doctors asking for those medications when they may not need them. This creates a culture of wanting immediate fixes for almost every ailment and often, normal bodily conditions and this, in turn, gets people wanting more pain medication. Ads come out for drugs before long-term safety information is known. Opponents also say that these ads overemphasize the benefits of the drugs and are misleading which leads to misinformed patients.
Marketing of Opioids
- Then there is the relentless marketing of opioid pain medication by the pharmaceutical companies to doctors. In 2016, these companies spent $8 billion pushing their products on doctors and teaching hospitals. Pharma company salespeople do things like host fancy dinners and symposiums for doctors. A 2016 study found that these techniques increase the likelihood of their medications being prescribed.
Pain Management Issues
- There is also a pain management issue here in America. Health insurance often covers pain medications but won’t cover alternative methods like physical therapy. Experts say that doctors don’t get enough training in pain management. This is changing for younger doctors entering the medical field but older doctors didn’t learn enough about it when they were in med school. One comparison in a 2016 study showed that in 97% of acute pain cases in the U.S. were treated with opioids while in Japan it was only 47%.
Not Enough Treatment Options
- In 2015, the Centers for Disease Control found that prescription opioid addicts are 40% more likely to become heroin addicts. There is a shortage of treatment options in this country and health care is harder to access compared to many other nations. A surgeon general’s report in 2015 showed that only 10% of addicts in America get into specialized drug treatment.
Looking to The Future
Hopefully, with all the attention that the opioid crisis is receiving in America, meaningful changes in how we deal with it will start to happen. Hopefully, we will start to see a drop in the overdose death rate and an increase in treatment options. Public awareness and acceptance of addiction as a disease is certainly on the rise and that is a good start.
Thankfully there is an upside here. Alcoholics Anonymous and Narcotics Anonymous offer people hope and a solution to their drug problems and these organizations are everywhere. Almost anywhere you go in the world, you will find AA and NA. There are 118,000 weekly AA meetings across 180 countries and about 70,000 NA meetings in 144 different countries. The Big Book and Basic Text are translated into dozens of languages. These organizations are free to join for anyone. They are helping millions of people. Their programs are proven to work for people who want them and apply them.
We will probably never eradicate addiction and may never come up with a cure but as individuals, we do have a surefire way through AA and NA to get into recovery if we truly want it and are willing to put in the work.