It is estimated that one out of every five deaths in America is thought to be associated with the use of tobacco and smoking is believed to be the leading cause of premature death in this country (U.S. Department of Health and Human Services, 2014). Aside from the emotional trauma, the monetary cost for the years between 2009 and 2012 are believed to be between $289 billion and $332.5 billion which include figures for lost productivity of workers in addition to expenses for medical care. Smoking, drinking alcohol, and the inappropriate use of legal and illegal drugs impacts society substantially through decreased health, death, loss of employment, and criminal activity. The cost of addiction in the United States is approximately $400 billion every year (McGinnis & Foege, 1999). It is clear that the influence of substance abuse on American society as a result of the ingestion of substances by adolescents and adults that are known to be detrimental to their health is profound. A brief overview of the topic will strive to demonstrate how important it is to address substance abuse as a psychological and physiological detriment to the user and a negative impact on society as a whole.
The American Psychological Association (2016) defines psychopharmacology as the study of the effects of medications on the human mind and subsequent behavior. The field is a professional branch of psychology that applies scientific principles and information to clinical therapies across a number of populations. The behavioral and social effects of substance abuse are related to psychopharmacologic drugs such as alcohol, antidepressants, antipsychotics, benzodiazepines, hallucinogens, hypnotics, opiates, stimulants, and marijuana and cannaboids. In terms of consequences, there are three categories of inappropriate use of medications that determine the total negative impact: the immediate physical harm to the user, the ability of the drug to create addiction, and the ultimate affect on friends, families, communities, and society at large (Gable, Reis, Impett, & Asher, 2004). While research in the field of psychopharmacology also deals with the physiologic effect of drugs on behavior and cognition including therapeutic treatment for mental disorders, the scope of this paper deals with the impact the harmful use of psychopharmacologic substances has on individuals and society.
Research
Symptoms of Abuse
According to Fox, Oliver, and Ellis (2013), the possible ability of a drug to cause injury to a person physically is relative to toxicity; overdose may result in immediate death or in long-term health problems. An overdose is defined as the amount of a drug taken in one or more exposures within 24 hours. Medications are generally prescribed with specific doses for therapeutic treatments, but lethal doses are far more than those recommended (except in the case of an allergic reaction). The effect of toxic doses is individualized, but they result in changes in cognition and behavior. For instance, relatively low doses of cocaine make the user feel mentally sharp, euphoric, and full of energy, which is the appeal of the drug. However, higher and prolonged doses may result in rapid heart rate, sweating, irritability, repetitive actions, paranoid behavior, seizures, or stroke (Antai-Otong, 2006).
Should the individual survive into a habit of chronic use, either the drug itself or the method of administration may lead to lasting health issues. Smoking substances such as marijuana or tobacco increase the risk of persistent coughing, bronchitis, emphysema, and cancer (U.S. Department of Health and Human Services, 2014). Injection of drugs directly into the veins promote thrombosis, abscesses, lung conditions such as pneumonia, cardiac conditions such as heart infections, passage of infectious diseases from sharing needles such as HIV and hepatitis, and filtration diseases of the kidneys and liver (Lingford-Hughes, Welch, Peters, & Nutt, 2012). Pairing ingested medications with other drugs have resulted in numerous deaths of celebrities and in the general public as prescribed medications negatively interact with ones that are not recommended by a physician. Doctors prescribe dosages of pain or anti-anxiety drugs that are suitable, but patients may take more than the amount indicated, resulting in overdose or addiction. Patients and other users develop a tolerance to initial dosages and may take more than the recommended amount on a regular basis, requiring continually higher dosages for the desired effect. Recreational alcohol, for instance, has the ability to evolve into a dependency that manifests in withdrawal symptoms on cessation and unacceptable behavior.
Social Acceptance of Substance Abuse
Few people will argue that news stories concerning drunk drivers and out-of-control drug addicts are offensive and socially unacceptable. However, smoking and drinking alcohol are considered to be appropriate in certain circumstances. During World War I, cigarettes were included in kits for the soldiers as a way to relax from combat and smoking was present in many movies as the practice was thought to be sexually attractive. However, when research proclaimed the dangers of using tobacco in any form, fewer and fewer people started smoking and larger portions of smokers took steps to stop. At that time, it was discovered how addictive cigarettes are and national organizations dedicate themselves to cessation programs. In the last few years, it has become forbidden to smoke in most public places. As the use of another substance, drinking alcohol is encouraged in many social settings and being the “designated driver” for inebriated friends meant he was going to miss out on much of the night’s entertainment. Drinking is still promoted in many public places such as restaurants, bars, night clubs, and social settings. Drinking on the job or while operating an automobile has severe penalties, however. Individuals who cannot “hold their liquor” are looked upon with disapproval and those who are labeled as alcoholics garner actual disdain. Even the use of marijuana has gained approval with approximately 56 percent of the participants in a poll taken in 2013 (Gallup, Inc., 2015). As more and more states legalize marijuana for medicinal and recreational purposes, cannabis is becoming more socially acceptable as a recreational drug. Although there are no articles noted concerning marijuana as a risk for overdose or as a potential hazard for interactions with other medications, the smoking of the drug carries the same health dangers as smoking tobacco in terms of respiratory illnesses and the promotion of cancer.
Impact of Substance Abuse on Families
The family unit remains the most basic source of support and nurturing in society. The member or members of the family that misuse substances create hardships based on money, emotional detachment, legal issues, social embarrassment, and sometimes violence. Perhaps one of the most significant impacts of substance abuse is on the dependents of the user. The Department of Health and Human Services (2007) reported that a survey conducted between 2002 and 2007 reported 8.3 million children ages 17 and younger reside in a home with at least one parent abusing substances. Kelleher, Chaffin, Hollenberg, and Fischer (1994) state that when children live in a household where drugs and alcohol are abused, they are three times more likely to suffer from child abuse and four times more likely to suffer neglect than children without substance-abusing parents. Many times, as the parent is unable to perform his or her responsibilities, a child is forced to parent himself and possibly younger siblings. In addition, pregnancy is affected by drug, alcohol, and tobacco abuse with complications during and after term (Bateman & Chiriboga, 2000). Miscarriages, premature births, low birth weight, learning disabilities, cerebral palsy, attention deficit disorders, childhood behavioral problems, and even death are some of the complications demonstrated when mothers abuse substances while carrying a child. There are also indications that children of substance abusers become substance abusers themselves (Zimić & Jukić, 2012).
Sometimes the substance abuser is not the parent, but the child. As a natural reaction to the negative consequences a child experiences as a result of the disorder, other family members develop enabling patterns of behavior in an attempt to help him (Lander, Howsare, & Byrne, 2013). Hiding evidence of use, providing bail when arrested, allowing the adult child to remain in the home, and offering financial assistance are examples of how a family will protect a user from the consequences of his actions. Parents may even sabotage their child’s recovery to rationalize their own use, such as when the parent and child drink together on occasion. The impact of a child who uses substances inappropriately creates conflict within the family as parents frequently blame themselves for the situation and counseling or support groups may be indicated as part of the recovery process of both the user and the family members.
Impact of Substance Abuse on Society
One impact of substance abuse on society is costs that include health care services to the user or others, damage to property, expenses within the legal system, and loss of productivity (Fox, Oliver, & Ellis, 2013). The National Institute on Drug Abuse (2015) estimates the United States spends over $700 billion each year related to substance abuse. Seven million adults were involved in the judicial system in 2012 related to crimes committed while intoxicated on drugs and/or alcohol (Glaze & Herberman, 2013) while a survey by the United States Department of Justice in 2004 reported that 64 percent of convicts in federal prisons and 70 percent of adults incarcerated in state penitentiaries used drugs on a regular basis before conviction (Mumola & Karberg, 2004).
As substance abusers negatively impact society, so too might society promote abusers. Aside from social acceptance of adults using tobacco and alcohol, studies have shown that smoking is more prominent in teenagers who experience lower levels of parental involvement, who leave home before the age of 18, if smoking was present by family members, if they lived with lower income levels in the home, and if there was lower parental education (Conwell et al., 2003; Juon, Ensminger, & Sydnor, 2002). Social relationships are important, but it is crucial for society that they promote healthy behavior. The quality of a social network has a strong influence on the actions of an individual of any age; friends and family have the ability to create a strong support group that recognizes risks and through concern for the individual, encourage safe behavior. The reason for social promotion of unhealthy behavior may lie in the tolerance of one person in comparison to the tolerance of another; in other words, one person may have the ability to drink a large amount of alcohol and continue to function normally while a friend may drink the same amount and become inebriated to the point where his behavior is unacceptable. It has also been shown that when the behavior of an individual in a group becomes unacceptable to society, it affects all the members of the group; for instance, if a parent becomes caught up in using substances inappropriately, the mental health of the spouse and children also suffers and behavior is negatively impacted.
Opinions
The problems within society concerning substance abuse are a result of the cultural acceptance of use. Alcohol, tobacco, and illicit drug use stem from a society looking for chemical relief from stress and seeking ever-higher levels of entertainment. A growing population of social circles identify with the use of substances that are commonly known to be a health risk. The use of any harmful substance can only cease when it is no longer socially acceptable. The period of alcohol prohibition in America’s past has proven that making substances illegal is not the answer. It would appear that as long as friends and family accept an individual’s use of a chemical substance, there will be those that will cross the line into abuse. As a result, it becomes the responsibility of the same friends and family and of the community to assist them in fighting their addiction. It becomes a cycle that costs billions of dollars every year in addition to the trauma of illness and death that ride the coat tails of substance abuse.
Changes in public education, vocal social lack of approval, and modifications in public policy are actions that may decrease levels of substance abuse. Public awareness campaigns on the benefits of a healthy marriage may encourage couples experiencing marital problems to seek help and encourage other couples cohabitating to recognize the attributes of making a legal commitment to each other. The topic of same-sex marriages falls into the same category for change. Decreasing the financial pressure on low-income parents to allocate funds allows for the enrollment of children in activities such as sports and school- or church-related programs foster healthy relationships for young people. Community organizations need to reach out to socially isolated individuals not only with food and shelter, but with companionship even when it is difficult to establish. Support groups for those who have lost a spouse or single parents struggling to find the time and money for friendships should reach out aggressively to locate people without family or concerned neighbors. Many times, an individual may appear to be involved with a social circle when in reality, they are functioning on the outside of it. Acquaintances do not have the same positive influences as friends.
While there appears to be a sufficient body of research on the familial and societal influence on the initiation of smoking with teenagers, there seems to be a need for further investigation into the influence of the family on starting to use illegal drugs (Galea, 2004). As marijuana becomes legal in more areas and teens find ways to obtain it, encouragement by society may increase. However, there is a demand for more psychopharmacological research into the area of initiation of illegal substances for young adults.
There is also a significant gap in research within the field of psychopharmacology concerning substance abuse and gender. According to Suzette Evans, the editor of Experimental and Clinical Psychopharmacology, out of 54 articles published in the journal concerning substance abuse, only one dealt with the variable of gender (Munsey, 2010). In addition, a significant amount of the research on humans was conducted in a laboratory and not in a clinical setting. Therefore, additional research is needed to address the impact of gender differences in drug abuse and outside the controlled environment of a laboratory.
Conclusion
Individuals who abuse substances negatively impact themselves and their society. The process of individual use creates problems through their health issues, economic impact, behavior, and psychological consequences on family. When a member of the household is abusing alcohol or drugs, the other family members experience a sense of loss, emotional upset, fear, isolation, internal strife, misplacement of responsibilities, and perhaps violence. Strong socioeconomic influences have been shown to significantly promote the initiation of harmful substances which may ultimately lead to abuse and social circles have to potential to encourage either healthy or unhealthy mental states and behavior. Psychopharmacologists continue to study the complex relationships between substances and behavior. The chronic harm generated from the inappropriate use of drugs, alcohol, and tobacco demand that research and public policy develop new avenues for prevention and treatment.
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