Each year, millions of people suffer from substance use disorders and countless more become collateral damage as loved ones, friends, and anyone around the user. A substance use disorder is defined as a dependence on, or abuse of alcohol and/or drugs (including prescription drugs).

Specifically, in 2007 an estimated 23.2 million people aged 12 or older required treatment for a substance use disorder in the United States alone. Even though the rate of current illicit drug use among youths aged 12 to 17 has declined significantly from 2002 to 2007, it is startling to see how many young people start using substances at an early age.

For example, in 2007:

  • 85.9 percent of people aged 12 or older who initiated alcohol use within the past year did so before they reached the legal age of 21. Of those people, they average they began misusing alcohol was 15.8 years.
  • An estimated 2.7 million people aged 12 or older used an illicit drug for the first time within the past year; 60.1 percent were younger than 18 at the time. Among people ages 12 to 49, the average age of first use was:
  • Inhalants – 17.1 years
  • Marijuana – 17.6 years
  • Cocaine – 20.2 years
  • Ecstasy – 20.2 years
  • Nonmedical use of pain relievers – 21.26
  • Many young Americans began their drug use by taking pain relievers nonmedically or using Marijuana. In 2007:
  • 2.1 million people had misused pain relievers for the first time within the past year, with an average age at first use os 21.2 years.
  • 2.1 million people had used Marijuana for the first time within the past year (approximately 6,000 people per day). Most (62.2 percent) were younger than age 18 when they first used it.
  • Most people aged 12 and older who had used any illicit drug for the first time within the past year reported that their first drug was Marijuana (56.2 percent). Nearly 31 percent started with the nonmedical use of prescription drugs.

A substance use disorder does not discriminate against its victims based on age, race, gender, ethnicity, socio-economic status, or community. This disease controls people’s lives and has devastating effects on their friends and families. Substance use disorders are one of the most deadly ailments, with one in four deaths each year attributed to alcohol, tobacco, or illicit drug use. The following substances contribute to numerous negative health issues:

  • Heavy drinking contributes to illnesses associated with each of the top three causes of death: heart disease, cancer, and stroke.
  • Cocaine has been shown to contribute to deaths from heart attacks, respiratory failure, strokes, and seizures. In extremely rare occasions, sudden death can occur on the first use of cocaine.
  • Heroin is associated with fatal overdoes and infectious diseases such as HIV/AIDS and hepatitis – particularly in people who inject the drug.
  • Methamphetamine, known to many as speed or meth, can cause psychotic behavior, hallucinations, and stroke when usde over a long period of time.

These tragedies concern all of us. All Americans, not just those directly affected by substance use disorders, must commit to helping people with the disease. The Institute of Addiction Medicine seeks to raise awareness in the community to help break down the myths associated with this powerful disease and encourage support and healing.


  • From 1992 to 2003, misuse of opioid prescription painkillers increased by 140%
  • Americans, who represent less than 5% of the world’s population, are by far the largest group of opioid users; 80% of the world’s supply of opioids (and 99% of the hydrocodone available globally) are used by people in the United States.
  • The increase in the legitimate use of opioids has been paralleled by a rise in abuse of these drugs, with a 63% increase in opioid deaths during the 5-year period from 1999 to 2004.
  • Multiple investigations have shown prevalence of drug abuse around 20% and as high as 58% in patients receiving opioids for chronic pain
  • According to the 2005 National Survey on Drug Use and Health:
  • Almost 2 million Americans are opioid dependent
  • Approximately 4.7 million teenagers and adults used opioid prescription painkillers for nonmedical purposes
  • Approximately 32.7 million Americans report having used opioid prescription painkillers for nonmedical purposes at least once in their lives
  • Statistics for your state may be available at


  • Opioid dependence is recognized by the World Health Organization as a brain disease
  • Opioid dependence is a condition that involves the physical, psychological, and behavioral need for an opioid, and affects every aspect of a person’s life
  • The misuse of opioids can create euphoria of such intensity that it reinforces drugtaking behavior and resets the brain to believing that opioids are necessary to survive.
  • Opioid prescription painkillers are chemically similar to heroin and can be as addictive.
  • Adults abusing opioids typically acquire them by one of the following methods: doctor shopping — MORE NEEDED
  • Youths abusing opioids typically acquire them by: stealing them from parents or relatives; buying them from classmates who are selling legitimate prescriptions or buying them from illegal Internet pharmacies or other vendors
  • When an opioid-dependent person stops taking opioids, severe physical withdrawal symptoms occur, and he or she often develops intense cravings for the drug. These cravings can be so powerful that people find it extremely difficult to stop taking opioids.
  • The social stigma attached to opioid dependence is so strong that some people will continue using opioids than risk possible exposure by seeking treatments


  • Historically, the primary treatment option for patients with opioid dependence has been methadone, most often administered in a clinic setting
  • Psychosocial counseling is a critical component of opioid-dependence treatment
  • A new treatment option has been available since 2003, which can be prescribed by trained physicians in the privacy of an office setting
  • Opioid dependence can now be managed medically — in the same way that other chronic illnesses like diabetes and hypertension are managed.
  • Many individuals are more inclined to be treated in the privacy and convenience of a physician’s office
  • According to several conservative estimates, every dollar invested in opioid dependence treatment may yield a return of between $4 and $7 in reduced drug related crime, criminal justice costs, and theft alone. when savings related to health care costs are included, the ratio can equal 12:1 for every dollar invested

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  • Results From the 2007 National Survey on Drug Use and Health: National Findings. DHHS Publication No. (SMA) 08-4343. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, September 2008, p. 71.
  • Ibid, p. 80.
  • Ibid, p. 1.
  • Ibid, pp. 55, 56.
  • Ibid, p. 50
  • Ibid.
  • Ibid, pp. 4, 50, 52, 55.
  • Substance Abuse: The Nation’s Number One Health Problem. The Schneider Institute for Healthy Policy, Brandeis University and the Robert Wood Johnson Foundation, February 2001, p. 62.
  • “Cocaine.” National Institute on Drug Abuse Web site: Accessed August 14, 2008.
  • “Heroin.” National Institute on Drug Abuse Web site: Accessed August 14, 2008.
  • “Methamphetamine.” National Institute on Drug Abuse Web site: Accessed August 14, 2008.