Substance Abuse Plagues Nation as Health Problem

Substance Abuse Plagues Nation as Health Problem
Posted by FoM on March 09, 2001 at 18:28:22 PT
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Source: St. Louis Post-Dispatch
A new report released today finds that young people are experimenting with drugs, alcohol, and tobacco at early ages. The report also finds that illicit drug and tobacco use increased dramatically among youth through the mid-1990s. But since then, these trends in use have shifted downward, although the new drug, ecstacy, is on the rise.The comprehensive report, commissioned by The Robert Wood Johnson Foundation and prepared by the Schneider Institute for Health Policy at Brandeis University, tracks positive and negative trends in smoking, drinking, and illicit drug use over several decades. 
The report substantiates its title, Substance Abuse: The Nation's Number One Health Problem, by documenting that substance abuse causes more deaths, illnesses, and disabilities than any other preventable health problem today. The report can be found under, ``Substance Abuse Chartbook,'' at -- -- the new Substance Abuse Resource Center of The Robert Wood Johnson Foundation Web site designed for community leaders, researchers, and professionals who deal with substance abuse issues.Today's report contains data from several hundred public and private sources, reporting snapshots and long-term trends over the previous three decades in patterns of substance use, consequences to society, and approaches for combating the problem. Among other findings, the report discusses the role that media have played in influencing teens' substance use and looks at how treatment, though shown to be effective by numerous scientific studies, is severely underutilized.It also reports that the economic cost of substance abuse is staggering, estimated at more than $414 billion in 1995. Of the more than two million deaths each year in the U.S., one in four is attributable to alcohol, tobacco, and illicit drug use. In 1995, health care spending associated with alcohol, tobacco, and drug abuse was estimated at more than $114 billion. ``This report demonstrates that there is a gap between what we know about prevention and treatment, and what we actually do to prevent and treat this enormous problem,'' said J. Michael McGinnis, M.D., senior vice president and director of the Health Group at The Robert Wood Johnson Foundation, the nation's largest health and health care philanthropy.``This report provides a complete picture of substance use, abuse, and dependence over a span of years,'' said Connie Horgan, principal investigator at Brandeis University. ``Our conclusion overall is that society continues to pay the price for a problem that is largely preventable and treatable.''Implications of Early Use:By the 8th grade, 52 percent of adolescents have consumed alcohol, 41 percent have smoked cigarettes, and 20 percent have used marijuana. According to the report, young people account for the majority of increases in the numbers of new initiates for many substances. The rising prevalence of marijuana use during the first half of the 1990s was driven, in large part, by the increasing rates of new use among youths aged 12 to 17. Declines in the mean age of first use of cocaine and heroin were accompanied by an upward trend in the rates of new cocaine and heroin users among the 12- to 17-year-old age group.``The younger use begins, the more likely the users are to have substance abuse problems later in life, especially if use begins before age 15,'' said Horgan. ``Just when they are beginning to assume more mature responsibilities in society, young adults aged 18 to 34 are more likely than any other age group to drink heavily, smoke cigarettes, and use illicit drugs.''More than 40 percent of those who started drinking at age 14 or younger developed alcohol dependence, compared with 10 percent of those who began drinking at age 20 or older. High school students who use illicit drugs are also more likely to experience difficulties in school, in their personal relationships, and in their mental and physical health.A critical aspect of substance use is the perception of risk. Young people may use substances at an early age because of their perception that many of these substances will not harm them. ``The relationship between perception of risk and use of substances is particularly important for young people who generally believe there is less risk in using substances than their older counterparts,'' said Horgan.Media Depictions of Substance Use:The media play a critical role in shaping the perception of risk. Increases in substance use among youth between the early 1990s and 1996 were linked to decreases in the perception of potential harm from using many substances, particularly marijuana. This period also saw a decline in the prevalence of warning and anti-drug messages from the media, parents, and schools; the proliferation of pro-use messages from the entertainment world; and high levels of tobacco and alcohol product advertising and promotion.According to the report, movies and popular songs-media forms particularly favored by teenagers- frequently depict the use of alcohol, tobacco, and illicit drugs. In the 200 most popular movie rentals in 1996 and 1997, alcohol appeared in 93 percent and tobacco in 89 percent of the movies. Illicit drugs appeared in 22 percent of movie rentals in 1996 and 1997, with marijuana and cocaine depicted most often. Findings from an analysis of the 1,000 most popular songs in 1996 and 1997 revealed that 27 percent of the songs referred to either alcohol or illicit drugs.``For parents, it must seem that everywhere they turn, there's a movie, song, music video, or television ad that showcases the use of substances,'' said Horgan. ``With this kind of competition from popular culture and mass media, it's even more of a challenge for parents to show their children that the dangers of substance use are very real.''In 1999, 44 percent of non-news programs aired by the four major television networks portrayed tobacco use in at least one episode. In 1998, the tobacco industry spent $6.7 billion for advertising and product promotions, and the alcohol industry spent more than $1 billion on television, radio, print, and outdoor advertising in 1997.Proven Treatment Options Underutilized:More than 18 million people who use alcohol and almost five million who use illicit drugs need treatment. Fewer than one-fourth of those in need get treatment. On the federal level, spending on the criminal justice system and interdiction takes up 60 percent of the federal drug control budget, while only 18 percent is devoted to treatment.A major question asked about drug and alcohol abuse treatment is, ``Does it work?'' The report documents that it does. Recent studies show that after six months, treatment for alcoholism is successful for 40 to 70 percent of patients, cocaine treatment is successful for 50 to 60 percent and opiate treatment for 50 to 80 percent, with effectiveness defined as a 50 percent reduction in substance use after six months.According to the report, addiction is a chronic, relapsing health condition. Substance abusers may, therefore, be in treatment multiple times-or make repeated attempts to quit on their own-before they are successful.``Perhaps we haven't been asking ourselves the right questions about substance abuse treatment,'' said Horgan. ``The improvement rate for people completing substance abuse treatment is comparable to that of people treated for asthma and other chronic, relapsing health conditions. Treatment is a wise public investment.''Overall, according to the report, treatment-even with multiple treatment episodes-is less expensive than the alternatives of incarceration and untreated addiction. The benefits of treatment include reduced crime, enhanced productivity, and lower health care use. Yet, it is surprising that many newer treatment options are not being used. For example, naltrexone-a medication used to treat dependence on drugs like heroin-was approved in 1994 to treat alcohol dependence, as well, but is not widely prescribed.Similarly, many current smokers want to quit, but treatment is underutilized, despite recent pharmacological advances in treating tobacco addiction, such as the nicotine patch. Health plans typically do not cover cessation services, and relatively few doctors provide even brief counseling. Yet, physician advice has been shown to increase long-term abstinence rates by 30 percent.Other Trends and Findings from the Report:-- Substance Abuse and Violence: At least half of adults arrested for major crimes-including homicide, theft, and assault-tested positive for drugs at the time of their arrest. Among those convicted of violent crimes, approximately half of state prison inmates and 40 percent of federal prisoners had been drinking or using drugs at the time of their offense. Alcohol is more likely to be involved in crimes against people than property. Up to 60 percent of sexual offenders were drinking at the time of their offense. More than 75 percent of female victims of non-fatal domestic violence report that their assailant had been drinking or using drugs.-- Education, Income, and Substance Abuse: People with more education are more likely to drink, but those with less education are more likely to drink heavily. Rates of heavy alcohol use are highest among those with less than a college degree. Among people with less education, smoking is more common, and smoking cessation less likely. In addition, heavy smoking is higher among those without a high school diploma. Similarly, current illicit drug use is twice as high among those aged 26 to 34 who have not completed high school than among those in the same age group with a college degree. Use of multiple drugs, including alcohol and tobacco, is common among substance abusers, particularly among the economically disadvantaged.-- Gender Differences in Substance Abuse: Gender differences are most apparent among heavy users. Males are almost four times as likely as females to be heavy drinkers, nearly one and a half times as likely to smoke a pack or more of cigarettes a day, and twice as likely to smoke marijuana weekly.-- Regulation on Smoking and Alcohol Use: In the past decade, tax increases and regulatory strategies have been an increasing focus of efforts to further reduce alcohol and tobacco use. It is estimated that a 50 percent increase in cigarette prices would result in a 12.5 percent reduction in the number of smokers, or 3.5 million fewer smokers nationwide. Although some states have raised excise taxes, the U.S. cigarette tax remains among the lowest in the developed world. Clean indoor air laws and legislation lowering the legal drunk driving limits for adults and youth are increasingly popular ways of reducing tobacco and alcohol use.-- Costs of Substance Abuse: The economic cost of substance abuse to the U.S. is staggering. Alcohol abuse is the most costly at $166.5 billion, followed by smoking at $138 billion and drug abuse at nearly $110 billion. The major burden of alcohol abuse is related to productivity losses associated with illness and death; for smoking, the most significant losses are associated with health care costs for myriad adverse health effects and productivity losses due to premature deaths; and for drug-related costs, crime plays the major role.To order hard copies of Substance Abuse: The Nation's Number One Health Problem, please either write to The Robert Wood Johnson Foundation; Attn: Substance Abuse Chartbook, Route 1 and College Road East, P.O. Box 2316, Princeton, NJ 08543-2316, or visit: Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation's largest philanthropy devoted exclusively to health and health care. It concentrates its grantmaking in three goal areas: to assure that all Americans have access to basic health care at reasonable cost; to improve care and support for people with chronic health conditions; and to reduce the personal, social, and economic harm caused by substance abuse-tobacco, alcohol, and illicit drugs. For more information, check the Web site at: http://www.rwjf.orgThe Schneider Institute for Health Policy (SIHP) located in the Heller School at Brandeis University has achieved national recognition as a leading health care policy and research institution. SIHP examines health and the health care system from a variety of perspectives including questions of access to and quality of care, how health care is financed, delivered, and utilized, and the cost of such care. In many of its studies, SIHP focuses on the special problems of our most vulnerable populations, including the elderly, individuals with chronic illness, those with substance abuse problems, and mental illness. For more information check the SIHP Web site at: http://sihp.brandeis.eduSubstance Abuse Resource Center An on-line resource from The Robert Wood Johnson Foundationhttp://substanceabuse.rwjf.orgBackground: To coincide with the release of Substance Abuse: The Nation's Number One Health Problem - Key Indicators for Policy. The Robert Wood Johnson Foundation has created an online Substance Abuse Resource Center, located at: This free resource consolidates a wealth of information generated by RWJF National Program Offices, grantees and other sources about the abuse of alcohol, tobacco, and illicit drugs and efforts to prevent harm from their use. The Web site is designed for policy makers, community leaders, prevention and treatment professionals, educators, researches, media and others interested in substance abuse issues.Content Overview: The Substance Abuse Resource Center home page features breaking news and information on issues relating to substance abuse, updated daily. It also links to Funding News, with information on current substance abuse funding opportunities from a variety of grant making organizations. The home page is a gateway to the following main content areas:1. Statistics & Solutions Access free publications that focus on the context of substance abuse, patterns and consequences of use and ways to combat the problem. Publications can be viewed on-line (available in PDF format -- requires Adobe Acrobat Reader). Or, request a hard copy using the on-line Order Publication Form. From here, preview an outline of the Substance Abuse Chartbook topics and charts, download the entire Chartbook or individual sections, and order a copy.2. Projects We Fund: View a list of active grants awarded by RWJF to combat substance abuse. Includes descriptions of the National Programs receiving grants, contact information for the organization and, if available, a link to the program's Web site. Single-site grantees are listed, with a brief description of the funded project. From here, access Open Calls for (grant) Proposals relating to substance abuse, comprehensive information on how to apply for a grant, FAQ's and on-line forms for submitting questions regarding specific proposals or the overall grant application process.3. What We've Learned: Read grant result reports of selected substance abuse programs and projects funded by RWJF. Each report describes the problem addressed, objectives and strategies, results or findings, communications efforts, any next steps, and (usually) a bibliography. The reports also includes contact information for the program director.4. Media Services Access RWJF media releases, webcasts, and other substance abuse resources for journalists and others.5. Web DirectoryAn annotated directory of over 100 Web resources on issues related to substance abuse, reviewed and selected by RWJF editors. The Directory is searchable by audience, topic or focus.Media Contact: Ellen Wilson or Dionne Dougall, Burness Communications, 301-652-1558Complete Title: Comprehensive Report Illustrates How Substance Abuse Plagues Nation as Number One Health Problem Source: St. Louis Post-Dispatch (MO)Published: March 9, 2001Copyright: 2001 St. Louis Post-DispatchAddress: 900 North Tucker Boulevard, St. Louis, Missouri 63101Contact: letters post-dispatch.comWebsite: Article:Fighting Cheech & Chong Medicine
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Comment #7 posted by FoM on March 11, 2001 at 10:05:35 PT:
USA Today - News Brief
Study: Drugs Cost U.S. $400B 1 in 4 Deaths Linked to Alcohol, Tobacco, Controlled Substances Source: USA Today (US)Author: Donna Leinwand, USA TodayPublished: March 9, 2001Copyright: 2001 USA TODAY, a division of Gannett Co. Inc.Address: 1000 Wilson Blvd., Arlington VA 22229Fax: (703) 247-3108Contact: editor usatoday.comWebsite: people are beginning to use drugs earlier and are increasingly likely to choose Ecstasy and hallucinogens over marijuana and cocaine, according to a report to be released today by Brandeis University.The report, which tracks drug- and alcohol-use trends over several decades, also indicates that drug use, alcohol consumption and smoking cost the USA more than $400 billion a year in health-care claims, lost productivity and criminal justice expenses.The report was funded by the Robert Wood Johnson Foundation, a philanthropic group in Princeton, N.J., that supports health-care research. Analysts who reviewed hundreds of substance-abuse studies linked one in four U.S. deaths to tobacco, alcohol or drug use.Although overall levels of drug and alcohol use peaked in the 1970s and 1980s and have fallen substantially, some substances favored by teens are bucking the trend, the report says.Alcohol remains the most commonly used substance among teens. Marijuana use, which rose among teens in the early 1990s, began to drop in 1996. And cocaine use, which peaked in the 1980s, also is down. The study calls Ecstasy a ''notable exception.'' It links the overall rise in heroin and hallucinogen use with the drugs' popularity among those younger than 26.A decade ago, 14% of eighth-graders had tried illicit drugs other than marijuana. That percentage had risen to 16% by 2000, the report says. 
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Comment #6 posted by dddd on March 11, 2001 at 02:17:10 PT
Dan brings up a great item,,,food,,and food abuse.I have not been able to figure out why someone has not brought a lawsuitagainst the bacon industry....Bacon tastes good enough to become habitual.Thebacon industry,(not to mention the Surgeon General),has neglected to warn consumers that bacon can KILL!..I see no warning label on the package.***sidenote;...The food abuse concept will be another item anti-MJ propaganda will use,saying;"Marijuana use is also harmful,in that it encourages Dietary Excess Abuse Syndrome,or DEAS...Peoplewho suffer from DEAS commonly eat themselves into a stupor after smoking marijuana.This is another one of the hidden dangers of marijuana..."I also love seeing the phrase; "Plagues Nation",used in the title.As if "substance abuse",was somethingthat people "came down with".....Plague,,,it conjurs up images of bodies stacked on an oxcart in some midevil village.dddd
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Comment #5 posted by observer on March 10, 2001 at 21:35:54 PT
Pharmaceutical Industry Demonizes Cannabis Users
 Substance Abuse Plagues Nation . . . A new report released today finds that young people are experimenting with drugs . . . report, commissioned by The Robert Wood Johnson Foundation . . . "The other side would be salivating if they could hear [the] prospect of [the] Feds going against the will of the people,"-- Robert Wood Johnson Foundation vice president Dr. Paul S. Jellinek, at a meeting McCaffrey convened after California's Prop. 215 passed``Although the work of the Partnership is spread over hundreds of ad firms, the driving force behind the organization is a man named James Burke-and he is a peculiar spokesman for a "drug free" philosophy. Burke is the former CEO of Johnson & Johnson, the maker of Tylenol and other pain-relief products; Nicotrol, a nicotine-delivery device; Pepcid AC, an antacid; and various prescription medications. When he came to the Partnership, he brought with him a crucial grant of $3 million from the Robert Wood Johnson Foundation, a philanthropy tied to Johnson & Johnson stock. Having granted $24 million over the last ten years, RWJ is the Partnership's single largest funder, but the philanthropic arms of Merck, Bristol-Myers Squibb, and Hoffman-La Roche have also made sizable donations.I resist the urge to use the word "hypocrisy," from the Greek hypokrisis, "acting of a part on the stage." I don't believe James Burke is acting. Rather, he embodies a contradiction so common that few people even notice it-the idea that altering the body and mind is morally wrong when done with some substances and salutary when done with others. . .''America's Altered StatesJoshua Wolf Shenk1999 Harper's Magazine Foundation 
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Comment #4 posted by observer on March 10, 2001 at 10:12:35 PT
Johnson = Partnership = Pharmaceutical Lobby
The comprehensive report, commissioned by The Robert Wood Johnson Foundation This is another drug-war moneybag. These are the folks funding/behind the "Partnership for A Drug-Free Amerika" a front group for the pharmacuetical industry and alcohol/tobacco companies. This foundation is a front group for the Johnson & Johnson drug empire.Robert Wood Johnson / Partnership activity Wood Johnson Foundation activity A national coordinator of anti-drug user rhetoric emerged, an organization called Partnership for a Drug-Free America. Its propaganda helped convince the public that drug users are not ordinary people, that instead they are dangerous enemies who must be eliminated. Partnership rhetoric promoted a climate making brutalization of ordinary people not only acceptable but virtuous. In 1990 almost $1 million a day in free advertizing was being donated to Partnership.144Philip Morris, Anheuser-Busch, RJR Reynolds, American Brands, DuPont, Johnson & Johnson, SmithKline Beecham, Hoffman-LaRoche, the Proctor & Gamble Fund, the Bristol-Myers Squibb Foundation, and the Merck Foundation have all been important sources of money for Partnership propaganda.145 Those groups are manufacturers (and affiliated foundations) of tobacco, alcohol, and pharmaceuticals. As one student of Partnership activity notes, "Partnership advertises, in effect, against having chemical competitors to alcohol and tobacco.146 Nor does Partnership propaganda discuss the competition that could provide to expensive medical pharmaceuticals.Partnership's goal is not drug education but drug propaganda. The group states forthrightly that its purpose "is to reduce demand for illegal drugs by using media communication to help bring about public intolerance of illegal drugs, their use and users."147 In describing publicity, drug czar William Bennett's office said, "One laudable example is the Partnership for a drug-Free America's campaign to encourage negative attitudes toward drugs and to label drug users as unpopular losers."148 . . .. . . Describing the Partnership's campaign as "some of the best advertising I've seen," a Partnership spokesperson declared, "The ads really stick in your mind and get straight to the point."163A distinguished student of Nazi ways noted, "Propaganda is not a substitute for violence, but it is one of its aspects. The two have the identical purpose of making men amenable to control from above."164 Partnership's orchestrated campaign of fear propaganda was important in that respect because many persons find fear unbearable, and transform fear into the more comfortable emotion of anger. Promoting fear promotes hatred. And hatred promotes brutality.Richard L Miller, Drug Warriors and their Prey, 1996, pgs.27-28 
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Comment #3 posted by Dan B on March 10, 2001 at 04:45:34 PT:
Food Abuse
The report substantiates its title, Substance Abuse: The Nation's Number One Health Problem, by documenting that substance abuse causes more deaths, illnesses, and disabilities than any other preventable health problem today. Well, that may be true, but only if you consider food as a substance. Obesity is the number one killer in America, so if we value human life at all, we must conclude that food depletes America's resources more than all of the other substances of abuse combined.Please don't misunderstand me: I do not believe in discrimination against the overweight. But if we want to enforce good public health through law enforcement, why aren't we rounding up overweight people and putting them in jail? The fact that we are not points up the hypocrisy of every other law against personal actions that potentially have negative effects on personal health.Hey, according to statistical averages, I'm overweight. The charts show that I should weigh a maximum of 170-175 pounds (I'm 5 foot 9), and I actually weigh 190. I don't look overweight, however, and I do eat right and exercise (usually walking). So, I guess that in order to enforce the laws, they'd have to set up weigh stations and have mandatory weigh-ins. And I'd end up in jail. So would every body builder in the nation. (No, I'm not a body builder).Remember that Stephen King movie Cat's Eye? It had a segment called "Quitters Inc." based on a short story in his book Night Shift. It showed a "stop smoking" program that forced people to quit by torturing their family members (placing them in a room with a high voltage electricity grid for a floor, cutting off a spouse's finger if the "quitter" didn't maintain a certain weight after quitting smoking, etc.). They had spies following the "quitter" all over the place, monitoring his activities at all times. Sound familiar?It was so obvious in that movie that the company was evil and operating far outside the law, yet Americans have allowed this kind of oppression to continue for decades. The only difference is that it is happening against illegal drug users rather than against legal drug users. The Washington Journal on CSPAN today was talking about violence in schools. Perhaps one reason why these kids have so little hope that they turn to violence is that they see what adulthood holds for them, and they can't handle the fact that they will be monitored by their government and forced to make decisions based solely on government sanctioned thought. Government enacted violence is the cause of the violent outbursts we are seeing across the country. As a whole, the American government is the enemy, the state governments are the enemies because they echo the wrongheaded ideology of the feds, the local governments are the enemies because they echo state policies, and the police are the enemies because they enforce all the bullshit that comes from above. Okay--I'll stop my rant there. I think everyone reading this gets the point. The oligarchy must fall. The war on some drugs must end. Only then will we return to sensible policies that discourage, rather than encourage, violence that comes from frustration.Dan B
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Comment #2 posted by dddd on March 10, 2001 at 01:51:38 PT
Who is responsible
Once again,no one really wants to take credit for writing this.There are many links,,and "media contact" numbers...thisarticle is a corporate product?dddd
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Comment #1 posted by topaztic on March 10, 2001 at 00:15:19 PT
oh, that study
"Costs of Substance Abuse: ... Alcohol abuse...$166.5 billion,... smoking at $138 billion...drug abuse...$110 billion. The major burden of alcohol... is productivity losses associated with illness and death; for smoking, the most significant losses are associated with health care costs for myriad adverse health effects and productivity losses due to premature deaths; and for drug-related costs, crime plays the major role" incidentally i beleive that the statistics also indicate that alcohol intoxication is more likely to be a factor in crimes than drug intoxication. and i have to wonderis the cost of drug related crime incurred by lossess by the victims of crimes i.e. burglary, assault, rape and the cost to prosecute and incarcerate these violent addicts or is the cost of prosecuting and incarcerating persons for violating only drug laws. in my opinion the drug war is a legislation inflicted disease upon our society. rather than athe vaccination against drug abuse it was supposed to be it has caused a major inflammation of our addictions (which have always been a part of our society) by telling us we can't scratch they make us want to scratch, when before we didn't know we itched.
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