Introduction
The World Health Organization (n.d) defines substance abuse as the harmful or hazardous uptake of psychoactive chemicals, including illicit drugs and alcohol. According to the National Institute on Drug Abuse (2014), substance abuse refers to the use of legal or illegal drugs inappropriately. This term includes the repeated use of drugs for pleasure, stress alleviation or reality alteration as well as the use of prescription medicines in other ways than prescribed (NIDA, 2014). Substance abuse and addiction can lead to potentially fatal diseases such as lung disease, HIV/AIDS, cardiovascular problems, cancer, and hepatitis (Marsiglia et al., 2014). People who are high on drugs are likely to cause accidents in whatever environment they may be in. They are also prone to anger and violence that causes them to hurt themselves and others. Apart from overdose mortalities, substance abuse also leads to suicide deaths. Although anyone can abuse drugs, certain populations are prone to misusing substances. These groups include teenagers and young adults, commercial sex workers, veterans, LGBT individuals, and racial minority populations. Low-income communities are particularly vulnerable to drug abuse.
Drug Abuse in Hudson County
Substance abuse is a major public health issue in New Jersey, with Hudson being the most affected County. In 2014, Hudson registered 3,516 hospital admissions due to substance abuse (Zhu, 2015). Seventy-four percent of these cases involved males while twenty-six percent involved females. Zhu (2015) reports that Hispanics were the most affected racial group (38%) followed by Blacks (31%) and Whites (27%). According to Zhu (2014), the highest incidence of drug misuse was among adults (25-59 yrs) at 73% followed by young adults (18-25yrs) at 12%. This report by the Health and Human Services Department indicates that 87% of the persons treated for substance use illnesses lived below the Federal Poverty level (Zhu, 2015).
Risk Factors for Substance Abuse
Individual Risk Factors
The genetic constitution of a person can predispose him or her to drug abuse. Biological and psychological characteristics can make a person venerable to or resilient in the face of narcotics exposure. Studies show that adopted children whose biological parents have a history of substance abuse are at high risk of abusing psychoactive agents (Kendler et al., 2012). Scientific evidence also shows significant resemblance in drug use disorders among adopted same-gender siblings (Kendler et al., 2012). Sweden researchers found that adopted children who had at least one parent diagnosed with substance abuse had an 8.6% higher risk of suffering from drug addiction compared to those children whose parents did not abuse psychoactive chemicals (Kendler et al., 2012). Kendler et al. (2012) also indicate that individuals with high genetic risks are more likely to succumb to environmental and community risk factors unlike persons with a low genetic risk.
Research shows that people who experienced an early life exposure (before 14 years of age) to drugs are highly likely to abuse substances (Valentine & Dejong, 2014). In addition, personal life events such as divorce, bankruptcy, job loss, and bereavement among others can drive a person to abuse alcohol or drugs abuse.
Persons who suffer from mental illnesses such as anxiety and depression are at a high risk of experimenting with drugs in a bid to experience pleasure or alleviate stress or the feeling of helplessness. For Example, 62% of the persons treated for substance abuse in 2014 were diagnosed with mental illness as a co-occurring condition (Zhu, 2015). Individuals who suffer from chronic illnesses or injury have a high likelihood of abusing prescription drugs. For Instance, older adults who suffer from arthritis, back pain, insomnia, anxiety, and cognitive decline among others have a high tendency of misusing medicines or have a combination of alcohol and medication abuse (Substance Abuse and Mental Health Services Administration, 2015).
Environmental or Community Risk Factors
The social environment forms a significant element in the prevention or propagation of substance abuse. According to Valentine & Dejong (2014), the family setting is a crucial determinant of an individual’s likelihood to abuse psychoactive agents. Family problems such as divorce and separation, parental drug abuse, as well as parental mental illness increase the risk of drug addiction in children (Valentine & Dejong, 2014). Similarly, Kendler et al. (2012) indicate that poor patent-child relationships, reduced parental supervision, marital tension, alcoholism, criminal behavior, and increased medical hospitalizations in the family have a tendency of promoting substance abuse. In fact, these familiar factors increase the probability of individuals with a genetic predisposition to get into substance abuse (Kendler et al., 2012). In Hudson, 5% of the substance abuse admission cases involved individuals whose parents had abused drugs while 4% of the patients experienced parental neglect or physical abuse in their childhood (Zhu, 2015).
Community or societal problems such as peer deviance, gang involvement, runaway behavior, and drug availability create a high-risk environment for psychoactive substances abuse particularly for teenagers and young adults (Kendler et al., 2012). Community norms like open-air drug sales and law enforcement tolerance of public intoxication promote and normalize substance abuse (Valentine & Dejong, 2014). Low-income neighborhoods, disorganized communities, and densely populated areas tend to have a high incident rate of drug use disorders (Valentine & Dejong, 2014). These societal factors have a significant contribution to the Hudson substance abuse status. Of all the substance abuse treatment cases in the County, 87% were associated with poverty, 20% with criminal activity, 7% with runaway behavior, and 4% with homelessness (Zhu, 2015).
Prevention Measures
According to SAMHSA (2016), community coalition is becoming a widespread intervention in the promotion of community health due to its positive impacts and results. A community coalition is formed when professional, and grassroots members of the society come together with an aim and a commitment to collaborate in influencing long-term health and well-being transformation in their community. These individuals represent a variety of organizations, agencies, factions, and entities.
Low-income populations in Hudson County are affected by drug abuse adversely. The formation of a community coalition offers an effective strategy for combating the health problem. The program would bring together the federal government, schools, religious societies, local businesses, health agencies, and charity organization to reduce and prevent substance abuse disorders. The coalition will incorporate education, empowerment, outreach, service delivery, community action, capacity building, and systems change interventions. A combination of primary, secondary, and tertiary prevention measures will provide maximum benefits in fighting substance abuse.
Primary prevention interventions will aim at increasing community awareness, health literacy, as well as income generation. Increased awareness enhances healthy behaviors that reduce the risk of drug misuse and abuse (SAMHSA, 2016). Outreach programs, patient education, and media campaigns that are designed specifically for residents of low-income neighborhoods would help prevent the onset of illicit drug use by promoting the adoption of healthy habits and choices. When individual are aware of the adverse health and social effects of drug abuse, they are less likely start abusing them. Community empowerment projects aimed at skill building and promoting self-employment will enhance economic independence and reduce substance abuse.
Secondary prevention measures will aim at promoting case identification and access to treatment. Drug abuse evaluations at schools, workplaces, and community centers in encouraging affected individuals to seek help. People living in poverty-stricken areas have poor access to medical services and health insurance. Therefore, the coalition’s goal will be to enhance equality in healthcare access so that individuals suffering from substance use disorders can easily seek treatment. Also, the standardization of care practices to combine medical care, behavioral therapy, and patient education would improve patient outcomes (SAMHSA, 2016).
Tertiary strategies will involve the promotion of aftercare and recovery centers with the intention of reducing relapse and recurrence cases (SAMHSA, 2016). Initiating community rehabilitation centers and support groups that cater for persons with no or little income will go a long way in preventing relapses in patients who have received treatment.
The community coalition will take a comprehensive approach that integrates “promotion, prevention, treatment, and recovery” components offering the community multiple opportunities to address the health issue. Furthermore, this model is sustainable as the coalition partners have the capacity to mobilize resources and the locals towards reducing substance abuse.
Conclusion
Statistical reports show that poverty is a significant contributor to substance abuse in Hudson (Zhu, 2015). Homelessness, low literacy level, and poor access to healthcare propagate the drug problem in low-income areas. As such, the implementation of primary prevention strategies that will increase household income, promote health literacy, and healthy behaviors will prevent the onset of substance misuse effectively. An integrated approach offers the best plan for Hudson County.
References
Kendler, K. S., Sundquist, K., Ohlsson, H., Palmér, K., Maes, H., Winkleby, M. A., & Sundquist, J. (2012). Genetic and familial environmental influences on the risk for drug abuse: a national Swedish adoption study. Archives of general psychiatry, 69(7), 690-697.
Marsiglia, F. F., Becerra, D. & Booth, J. M. (2014). Alcohol and drug problems: Prevention. Encyclopedia of Social Work. DOI: 10.1093/acrefore/9780199975839.013517
National Institute on Drug Abuse. (2015). The science of drug abuse and addiction: The basics. Retrieved, Aug. 12, 2016, from https://www.drugabuse.gov/publications/media-guide/science-drug-abuse-addiction-basics
Substance Abuse and Mental Health Services Administration. (2016). Prevention of substance abuse and mental illness. Retrieved Aug. 12, 2016, from http://www.samhsa.gov/prevention
Substance Abuse and Mental Health Services Administration. (2016). Specific populations and prescription drug misuse and abuse. Retrieved, Aug. 12, from http://www.samhsa.gov/prescription-drug-misuse-abuse/specific-populations
Valentine, J. & Dejong, J. (2014). Substance abuse prevention in multicultural communities. New York: Routledge
World Health Organization. (n.d). Substance Abuse. Retrieved, Aug.12, 2016, from http://www.who.int/topics/substance_abuse/en/
Zhu, L. (2015). Substance abuse overview: 2014, Hudson County. Trenton, NJ: Department of Human Services
