Running head: SUBSTANCE ABUSE: AN EPIDEMIC

Substance Abuse: An Epidemic

Keely Sopko
Wayne State University

SUBSTANCE ABUSE: AN EPIDEMIC

2
Abstract

Substance abuse is an issue that affects many individuals from all different areas. Many of those
addicted to substances believe that they are only harming themselves. However, there are many
others who suffer in the aftermath that addiction creates. Addiction affects people on a micro
level of practice, a mezzo level of practice and lastly institutions on a macro level of practice. It
has a huge impact on social welfare and social policies. According to a study done by the
Substance Abuse and Mental Health Services Administration (SAMSHA) (2013), individuals
between the ages of eighteen and twenty-five are the most common abusers of illicit substances
(p. 29). In this demographic group, American Indians or Alaskan Natives have the highest
proportion of individuals that abuse alcohol or illicit drugs (SAMHSA, 2013, p. 29). Whites
come in second to Native Americans (SAMHSA, 2013, p. 29). This research will explore
aspects of substance abuse that include; the effects it has on its demographic population and what
services or policies are in place to help those facing substance abuse problems. It will also
explore the individuals who receive these services, how it was treated historically along with the
social stigma and discrimination that are surrounded by it. The researchers personal beliefs on
substance abuse will also be discussed, along with how it pertains to social work values and
ethics. Substance abuse has a negative impact on the demographic population that it affects.

SUBSTANCE ABUSE: AN EPIDEMIC

Health Risks Associated with Substance Abuse

There are many consequences involved for people that suffer from drug or alcohol abuse.
Some of these include greater health risks, higher rate of crime and death by overdose. A health
risk associated with substance abuse is exposure to sexually transmitted diseases through
unprotected sex. Exposure may also occur when addicts exchange dirty needles leading to the
spread of HIV, AIDS or hepatitis B. The findings of Majer, Rodriguez, Bloomer and Jason
predict that (2014), recent substance use and current psychiatric problem severity are greater
risk factors for HIV-risk sexual behavior than lifetime abuse histories among persons who have
substance abuse disorders (p. 138). Other health risks include high crime rates associated with
individuals using controlled substances.
Approximately twenty-three million Americans struggle with addiction to controlled
substances (Day & Schiele, 2013, p. 446). In 2013, Day and Schiele found Criminalization and
incarceration of the mentally ill is a growing and ominous trend (p. 446). An addict's desire for
the controlled substances may guide them in poor decision-making. These actions lead them to
jails, institutions and if they are lucky substance abuse treatment centers. These crimes pose
health risks for the victims and the offenders. According to Kuhns, Maguire, and Cox (2007),
drug-related crimes ranked second only to property crimes. For this reason, it is a main concern
for public safety by police agencies serving populations of 50,000 or less (p. 438). Other health
risks that directly involve the substance abuser are an overdose, whether intentional or
accidental.
Overdoses as a result of heroin use have risen in the United States, making it much more
likely for drug abusers to die as a result of their addiction (Otto, 2014, para.1). Heroin and other
opiates slow down the respiratory system often making it so that the user stops breathing.

SUBSTANCE ABUSE: AN EPIDEMIC

Research by Otto (2014), states fatal heroin overdoses doubled in the United States from 2010
to 2012 . . . . the Northeastern states have increased 211.2% (para. 2). This research supports
that it is much more common for a heroin abuser to die of an overdose today than before the year
of 2010. Although substance abuse has negative health risks, there are services and policies in
place to assist those struggling with these issues.
Services and Policies
There are many services in place to assist those struggling with addiction. According to
the Macomb County Community Mental Health Office of Substance Abuse (MCOSA) (2005),
they offer services that include outpatient, intensive outpatient, Methadone assisted treatment
and residential treatment services including detoxification (para. 1). The people that receive
these services usually have to be able to provide some payment for them. MCOSA authorizes
funds for individuals with state-funded health insurance (para. 3,4). There are also various selfhelp groups such as Narcotics Anonymous and Alcoholics Anonymous. There are groups for
family members of addicts as well, such as Nar-Anon Family Groups. The people who receive
these services vary. Anyone can join a self-help group, it is free and available to anyone. These
services help to alleviate the substance abuse epidemic in Macomb County. MCOSA has
funding programs for people that have state-funded insurance and are considered to be
vulnerable populations because of their poverty level. These policies and services have a
positive impact on the demographic population that is affected by substance abuse. There are
many other prevention programs put in place by various police agencies to prevent addiction to
substance abuse. Programs such as DARE (Drug Abuse Resistance Education) offer education
about controlled substances to prevent children from experimenting with drugs. Scared Straight

SUBSTANCE ABUSE: AN EPIDEMIC

programs are in jails and prisons. They help to prevent at-risk youths from using controlled
substances or committing other various crimes.
Historical Treatment
Historically speaking substance abuse problems began by being treated as a personal
problem. Society perceived individuals who suffered from substance abuse as deviant or noncontributing members of the community. Day and Schiele (2013), explained that some
individuals immediately began overindulging in alcohol upon its introduction in the 1500 to
1600s (p. 125). This excessive use of alcohol led to individuals believing they were not
responsible for their actions when they consumed the beverage, and it transformed their
personalities into something undesirable (Day & Schiele, p. 125). Alcohol abuse posed a
problem because men were killing each other, husbands burning wives, wives were dishonoring
husbands, and fathers putting their children into cauldrons (Day & Schiele, p. 125). It was
occurrences like these that eventually led to the problem of addiction becoming addressed.
Although substance abuse has been in existence much longer, society had no interest in
recognizing it as a social issue. Substance abuse was not focused on until the social work
profession emerged around 1917 with the social worker Mary Richmond declaring inebriety is a
disease (Richmond, as cited in Dulmus & Sowers, 2012, p. 113). Richmond was referring
primarily to alcoholics when she made her statement (Dulmus & Sowers, p. 113). Additionally,
Richmond declared inebriety is a disease before the implementation of twelve-step programs
(Dulmus & Sowers, p 113). Not until decades later did professionals from the World Health
Organization, American Medical Association, and the American Psychiatric Association came to
recognize alcoholism as disease, illness, or serious medical problem (Dulmus & Sowers, p. 113).

SUBSTANCE ABUSE: AN EPIDEMIC

Identification of Substance Abuse

The identification of substance abuse has changed over time. Just like any other disease
or illness, research and education have given professionals a better understanding of substance
abuse. The myth surrounding this illness is those who have it are viewed as having a lack of
will power or moral weakness (Dulmus & Sowers, 2012, p. 114). These myths contributed to
societys perception of substance abuse years ago, and they are still currently maintained by
some. The historical definition of substance abuse is consistent with these myths. Lack of
education on substance abuse contributed to this definition for decades and possibly even
centuries. Over time, the definition has evolved from something that was believed to be a moral
deficiency to a serious medical condition, illness, or disease (Dulmus & Sowers, p. 113). The
definitions differ because professionals like social workers have taken into consideration other
factors such as the environment. For this reason, the perception of substance abuse over time,
has evolved from being a personal issue to being more of a social problem (Dulmus & Sowers, p.
113-115).
Treatment of Substance Abuse
Substance abuse treatment has varied throughout the years. According to The History of
Drug Abuse in America, 2009, for a long period, alcoholics and illicit drug users were going
untreated (para. 3). In the 1970s, the mental health profession did not have an opinion on
treating substance abusers and for this reason did not help with the treatment of this disease
(History of Drug, para. 2). In 1963, Rockefeller Institute published the first study in treating
heroin withdrawal with methadone hydrochloride maintenance programs (History of Drug, para.
3). The promoters of methadone maintenance changed the research paradigm around addiction
and redefined treatment effective in terms of: (1) reduction in drug use, (2) reduction in criminal

SUBSTANCE ABUSE: AN EPIDEMIC

activity, and (3) increase in social productive activities (History of Drug Abuse, para. 3). The
handling of substance abuse has grown significantly since the absence of treatment program
availability back in the early to mid-1900s.
Today, the treatment of substance abusers has evolved and manifested many more
resources for people that suffer from this disease. Some of the services that are available to
people seeking treatment for substance abuse can be found in community behavioral health
centers, inpatient substance abuse centers, independent providers, hospitals, community health
centers, support groups and peer-run organizations, schools, jails, prisons, and a variety of other
locations (SAMSHA, 2013, para. 4). According to White (2007), the most recent shift in
treatment for addiction went from a long-standing pathology and intervention paradigm to a
solution focused recovery paradigm (p. 229). This shift explains that it has been proven to be
more effective to focus on the recovery aspect of a substance abusers disease (White, p. 229).
The recovery paradigm is manifesting unconventional solutions that include peer recovery
coaches, personal recovery assistants, recovery advocacy organizations, recovery support
specialists, and peer-based recovery support centers (White, p. 229). In the last five years, many
of these supports were implemented in hopes of helping recovering addicts maintain sobriety.
Stigma of Substance Abuse
The stigma, discrimination, and societal prejudices have negatively impacted the
definition of substance abuse. These aspects have also negatively impacted policy solutions.
However, the treatment of substance abuse has come a long way since knowledge on the topic
has been researched extensively. Although the stigma still has an effect on those suffering from
the disease today, substance abuse is a problem that is prevalent with many clients who seek
services from social workers. Every social worker should gain knowledge about substance

SUBSTANCE ABUSE: AN EPIDEMIC

abuse. Various individuals are affected by substance abuse in one form or another. Whether a
client is an addict or one of their family members, it is a widespread problem in society today.
Research shows that in the past decade, the highest percentage of substance abuse-related
studies of the total articles published in 3 core social work journals was 5.9% in 1994 (Vaughn,
et al., as cited Dulmus & Sowers, 2012, p. 114). The amount of research done in the last decade
reinforces the stigma and discrimination against substance abusers. Individuals do not want to
study substance abuse. The baffling behaviors of those engaging in the abuse of alcohol or illicit
drugs may possibly scare professionals and the rest of society away. These acts prevent effective
policy solutions from becoming implemented. They also encourage societal prejudices and
discrimination against substance abusers.
Personal Beliefs
To the researcher, the treatment of substance abuse could improve significantly.
Although, there have been beneficial developments over the last year here in Michigan. The
Medicaid expansion put into effect by Governor Rick Snyder in April 2014, was a large step
towards vulnerable populations being able to acquire substance abuse services. This
implementation allowed more individuals to qualify for Healthy Michigan Plan and, for this
reason, are now able to seek out various health care services including treatment for substance
abuse. The researcher is employed in an inpatient substance abuse facility, and she assists clients
in applying for state medical coverage. Additionally, she completes over the phone intakes with
county funders. These intakes have allowed her to witness the increased amount of admissions
into the treatment center since the Medicaid expansion came into effect. However, the researcher
does believe there are some very negative concepts surrounding substance abuse.

SUBSTANCE ABUSE: AN EPIDEMIC

The stigma encapsulating substance abusers is debilitating for many that suffer from this
disease. This stigma allows vulnerable populations to be discriminated against and prevents
them from getting the services that they so desperately need. The stigma also feeds into the
already low self-esteem that these individuals have. These circumstances can make it difficult
for anyone to recover from a mental health disorder. Additionally, the researcher believes that
the causes of substance abuse cannot be narrowed down to one simple explanation. Substance
abuse is a direct result of person-in-environment situations. Although, some have a genetic
predisposition to substance abuse, the environment can play a large role in a person becoming
chemically dependent as well. Additionally, the researcher's hopes and dreams are that the
stigmas will alleviate over time with proper education on the subject. Almost everyone has heard
of someone or knows someone that has struggled with substance abuse.
Relation to Values and Ethics
The treatment of substance abuse relates the NASW Code of Ethics significantly.
According to the NASW Code of Ethics (2008), the core values of the social work profession
include service, social justice, dignity and worth of a person, integrity, competence, and
importance of human relationships (para. 7). All of these play important roles in treating those
with mental health disorders or chemical dependency problems. Clients that suffer from these
mental health disorders already face stigmatization from society. The social work profession has
been implemented to assist clients in overcoming these obstacles. Mental health disorders affect
everyone who is associated with the diagnosed individuals. The relationships that substance
abusers have with other people can present as strained and unhealthy. The social work
profession was created to help people recover from these unbalances. Social workers must
remain objective and nonjudgmental when helping clients recover from any social problems.

SUBSTANCE ABUSE: AN EPIDEMIC

10

The values and ethics involved in social work are imperative for social workers to remain
professional and competent in their practice with substance abusers. The treatment of substance
abuse has improved significantly over time as a result of social works ethics and values that
maintain the warmth, empathetic and genuine treatment of substance abusers.

SUBSTANCE ABUSE: AN EPIDEMIC

11
References

Behavioral Health Barometer: United States 2013. (2013). In Substance Abuse and Mental
Health Services Administration. Retrieved from http://www.samhsa.gov/treatment.
Code of Ethics of the National Association of Social Workers. (2008). Washington, D.C.,
Virginia: National Association of Social Workers.
Day, P., & Schiele, J. (2013). America to the Civil War. In A new history of social welfare (p.
125-446). Upper Saddle River, NJ: Prentice Hall.
Dulmus, C., & Sowers, K. (2012). Social work fields of practice: Historical trends, professional
issues, and future opportunities (pp. 113-114). Hoboken, N.J.: John Wiley & Sons.
Kuhns III, J. B., Maguire, E. R., & Cox, S. M. (2007, December). Public-safety concerns
among law enforcement agencies in suburban and rural America. Police
Quarterly, 10(4), 429-454. doi:10.1177/1098611106289405.
Majer, J. M., Rodriguez, J., Bloomer, C., & Jason, L. A. (2014, March). Predictors of HIV-risk
sexual behavior: examining lifetime sexual and physical abuse histories in relation to
substance use and psychiatric problem severity among ex-offenders. Journal of American
Psychiatric Nurses Association, 20(2), 138-146. doi:10.1177/1078390314527552.
Otto, M. A. (2014, November). Heroin overdoses spur focus on naloxone. Clinical Psychiatry
News, 42(11), 2. Retrieved from http://go.galegroup.com.proxy.lib.wayne.edu/ps/i.do?id=
GALE%7CA392366948&v=2.1&u=lom_waynesu&it=r&p=AONE&sw=w&asid= b345
0b99f9c5c0e1c6955790a9b25123.
The History of Drug Abuse and Addiction Treatment in America: Part 9. (2009, August 17).
Retrieved from http://news.narconon.org/history-drug-abuse-treatment-america.
Treatment Information. (2005). Retrieved from http://www.mcosa.net/treatment.asp.

SUBSTANCE ABUSE: AN EPIDEMIC

White, W. (2007). Addiction recovery: its definition and conceptual boundaries. Journal of
Substance Abuse Treatment, 33(3), 229-241.

12