Alcohol and Cannabis are Top Reasons People Seek Substance Misuse Treatment

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  • A new report finds that alcohol and cannabis are the most common reasons people pursue substance misuse treatment.
  • The CDC report included data from 399 treatment centers across 37 states.
  • Alcohol was the most commonly reported substance misused during the past 30 days, followed by cannabis and prescription opioid misuse.

A recent Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report finds among U.S. adults assessed for substance use treatment in 2019, alcohol, cannabis, “multiple substances” use, and associated severe problems, were the most frequently reported.

The agency finds that in 2019, nearly 66 million U.S. adults reported drinking four or more drinks in 2 hours in the last month, and about 36 million reported illicit drug or prescription pain reliever misuse during the past month.

“Those with substance use issues are more likely facing more intense and more frequent triggers to their attempts to stay sober,” Moe Gelbart, PhD, Director, Behavioral Health, Torrance Memorial Medical Center, told Healthline.

“As the mental health crisis in our country deepens, self-medicating with alcohol or substances is often a common coping mechanism,” Dr. Gelbart said.

Data collected across 37 states

The CDC report included data from 399 treatment centers across 37 states. The centers were primarily substance use treatment centers, but data was collected from other sites, including driving while intoxicated centers, probation offices, or any site using the ASI-MV tool that agreed to share information.

Among 49,138 adults assessed for substance use treatment planning, 63.4 percent were male. About 66 percent were non-Hispanic White persons. About 67 percent were in metropolitan areas.

According to the CDC, 45.4 percent of assessed adults reported more severe problems with drugs, followed by issues involving psychiatric, legal, medical, employment, alcohol, and family problems.

Experts say the pandemic has only made things worse.

“Polysubstance abuse is not unusual among those experiencing addiction, but since the pandemic, it has certainly become more prevalent,” said Lawrence Weinstein, MD, chief medical officer at American Addiction Centers. “For many, their typical drugs of choice may not have been as easily accessible, especially during the early stages of the pandemic.

Alcohol and cannabis most commonly reported

Alcohol was the most commonly reported substance used during the past 30 days, followed by cannabis and prescription opioid misuse.

Eugene Vortsman, D.O., clinical director of addiction medicine and disease management and chair of pain committee for Long Island Jewish Medical Center, said cannabis has become a prevalent form of drug misuse in the U.S. for multiple reasons.

“Some of which are due to its availability as well as shifting views on the appropriateness of its usage,” Dr. Vortsman said. “’ Partaking’ in cannabis has become mainstream, and cannabis is barely considered an illicit drug by youth today.”

According to Vortsman, frequent cannabis use is strongly associated with mental health issues. These include depression, anxiety, and suicidality, as well as “psychotic exacerbations.”

“While not a direct correlation, the frequency of these comorbidities is undeniable,” he said. “Additionally, especially in the under 25 age group, frequent cannabis usage is associated with lower I.Q. that has been shown to be irreversible.”

Vortsman pointed out that inhalation is still the most common way to use cannabis and can lead to similar complications as cigarettes, including:

  • Worsening asthma
  • Chronic obstructive pulmonary disease
  • Mouth or throat cancer

“This correlation is frequently overlooked in general cannabis users,” he said.

Women reported more severe problems except for alcohol

Compared with men, assessed women reported more severe problems for all domains except alcohol.

Adults ages from 25 to 34 years reported more severe problems with drugs, while those from 55 to 64 reported greater problems with alcohol.

Nearly 70 percent of unemployed adults experienced greater drug problems, and retired, or disabled adults had more severe psychiatric and medical problems.

“Substance use disorder and mental health conditions are often co-occurring diseases; approximately half of those with a severe mental health condition experience substance use,” Dr. Weinstein said.

The opioid epidemic

According to CDC provisional data, overdose death, including from opioids, have surpassed 100,000 in 2022 so far. However, the CDC report only looked at 2019 data and didn’t consider changes that have occurred since the COVID-19 pandemic began.

“The opioid crisis, fueled by years of improper prescription pain medication, has led many to seeking cheaper and more available, i.e., without prescription, substitute drugs like heroin, which in turn has resulted in significant increase in overdose deaths,” said Gelbart.

According to Weinstein, the proliferation of fentanyl has steadily worsened the overdose crisis year after year.

“More and more substances are being adulterated with fentanyl as evidenced by the most recent figures: in 2021, there were more than 10,000 more opioid overdose deaths than the year prior, and fentanyl’s presence in other substances such as cocaine and methamphetamine are increasing as well,” he said.

Efforts to address the opioid epidemic have created a ‘pain crisis’

Vortsman said while opioid prescriptions have been reduced by over 50 percent, “we have not been able to increase pain services by 50 percent, which has led to a true pain crisis.”

“Our patients are stuck with limited choices, and this can lead to regrettable decisions with illicit substances,” he explained.

According to Vortsman, society needs to pivot the focus from criminalizing drug usage associated with addiction to providing improved access to effective harm reduction techniques and improved addiction services.

The bottom line

The CDC reported that 2019 trends in substance use treatment, show alcohol and cannabis were the top two drugs people sought treatment for.

Experts say there is a mental health crisis in the U.S., and ‘self-medicating’ is a common coping mechanism.

They also say efforts to address the opioid crisis have created a “pain crisis,” making patients with limited choices turn to illicit drug use for relief.

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