Substance abuse is a common problem and affects adults across the lifespan. It refers to excessive and uncontrolled consumption of various psychoactive substances, including alcohol and illicit drugs, and can develop into a substance use disorder (SUD) and addiction that may severely impact one’s mental and physical health and the overall quality of life (Cleary & Thomas, 2016). The occurrence of SUD is influenced by multiple individual and environmental factors, including gender, socio-economic status (SES), and so forth. Considering that SUD and addiction often impact multiple areas of a person’s life simultaneously, they are usually treated through comprehensive strategies, involving interprofessional collaboration. Available interventions, risks, and factors contributing to substance abuse in adults will be discussed in the present paper.
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Epidemiology and Influences
Epidemiological data indicate that alcohol use disorders (AUDs) are more prevalent than illicit drug use disorders (IDUD). The results of the 2014 National Survey on Drug Use and Health (NSDUH) revealed that alcohol dependence or abuse was reported by 16.3% of respondents, whereas IDUD was found merely in 6.5% of survey participants (Lipari & Van Horn, 2017). Together, these adverse conditions affect over 20 million adults in the United States (Lipari & Van Horn, 2017).
Among demographic influences contributing to SUD, ethnicity, and gender seem to be the most essential. Throughout the lifetime, the prevalence of both AUDs and IDUDs is higher in males (36% and 12.3%) than in females (22.7% and 7.7%) (Grant et al. 2015). Native Americans also tend to develop SUDs more frequently than people of other ethnicities. Lifetime AUD prevalence in them equates to 43% compared to 33% in Whites, 23% in Hispanics, and 22% in Blacks (Grant et al. 2015). IDUD prevalence in Native Americans is 17.2% compared to 10.8% in Whites, 9.9% in Blacks, and 7.2% in Hispanics (Grant et al. 2015).
As for SES, it affects the incidence of AUD and IDUD differently. The lifetime prevalence of alcohol abuse is greater in higher-income people, whereas low-income individuals are at a higher risk of drug abuse (Grant et al., 2015). Additionally, the overall neighborhood environment and cultural environment may be linked to the SUD incidence. Whereas such neighborhood stressors as crime and poverty increase the risk of SUD, religiosity and wider social networks are considered to be protective factors against this adverse condition (Delker, Brown, & Hasin, 2015). The provided research findings show that to address the problem of substance abuse, a comprehensive methodology targeting a wide range of factors must be implemented.
Risks and Interventions
Epidemiological studies show that younger adults (18-29 years old) are at a higher risk of substance dependence than middle-aged and older adults. The lifetime prevalence of AUD and IDUD in them is 37% and 14.2% respectively, compared to 34.4% and 12% in middle-aged adults and 13.4% and 2% in older adults (Grant et al. 2015). The health risks to which adults are exposed as a result of substance abuse differ as well. Young and middle-aged adults face the risk of alcohol overdose and poisoning, heart problems, diabetes, damages to the reproductive system, respiratory problems, and sexually transmitted diseases (Schulte & Hser, 2014). Older adults tend to suffer such conditions as diabetes, cancers, heart attack/stroke, cirrhosis, and accidental injuries due to abuse of various substances (Schulte & Hser, 2014). Besides that, SUDs in adults is often accompanied by depression, anxiety, insomnia, phobias, and other psychological disorders, including dementia/Wernicke-Korsakoff in older adults (Schulte & Hser, 2014). However, the relationships between SUD and mental disorders are usually complex and dynamic because individuals often consume alcohol and drugs to cope with already existing traumas and problems.
Considering a great variety of their negative impacts on health, SUDs can be intervened by using many pharmacological and psychosocial methods. To treat addiction, patients can be prescribed such medications as Methadone and Naltrexone, which block receptors involved in forming addiction responses (“Treatment approaches,” 2019). Though these remedies proved to be effective, especially when treating alcohol and opioid addictions, they have multiple side effects. Compared to them, psychological interventions, including counseling and cognitive-behavioral treatment that aim to modify patients’ coping strategies and mindsets, are safer (Jhanjee, 2014). By helping individuals to adopt healthier behaviors and change adverse life conditions, psychosocial interventions allow attaining long-term, sustainable results. However, they are usually time-consuming and can be relatively expensive. Moreover, the overall treatment success in their case largely depends on patients’ levels of motivation, which may be difficult to maintain independently.
Effective services aimed to reduce the burden of SUD are normally collaborative. However, according to Vourakis (2013), interdisciplinary collaborative addiction education and practice are still underdeveloped in the United States. It means that nurses should take initiative to educate themselves regarding multiple aspects of SUD and engage in networking and partnering as part of their team or independently to address the raise prevent substance abuse. They may work with and learn from existing organizations, such as CASPAR that provides social, psychological, and medical services for people across the substance use/abuse/recovery continuum (“CASPAR,” n.d.). This organization carries out outreach functions and works to demarginalize the people with SUDs (“CASPAR,” n.d.). Following CASPAR’s example, nurses as practitioners can perform SUD screening together with psychologists or/and physicians and link those at increased risk of substance abuse to relevant support services (Puskar et al., 2016). As educators, nurses can also collaborate with multiple private and public organizations working with adults (especially those at increased risk of SUD due to their SES and ethnic background) to disseminate information about SUD and factors defining its progression. Only with the help of other multidisciplinary professionals, a nurse can address the problems related to living conditions of those with SUD and help to prevent the problem at the community level.
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