Substance Abuse: How Much Is Enough?

Sociocultural determinants of substance abuse

Drug and substance abuse is caused by many factors that include environmental, age, race and ethnicity, gender, sexual orientation, income level and socioeconomic class (Howinson, 2005). Socioeconomic determinants that determine substance abuse include peer pressure, family influence, social networks, and societal attitudes towards substance use.

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Research has shown that social networks and peer pressure are key determinants of substance abuse among teenagers. Many young people are exposed to drugs and illegal substances from their interactions with peers and family members who use drugs (Page, 2012). In many cultures, substance abuse is determined by prevailing attitudes towards the use of certain substances.

For instance, in certain cultures, marijuana is widely accepted as a substance that helps individuals to relax and meditate (Howinson, 2005). Addiction to substance abuse is widespread in America. It has been identified as a challenge among young people, athletes, and adults. The main causes of the substance abuse and addiction include poor housing, high rates of unemployment, lack of proper health care, and inadequate education opportunities.

Direct and indirect costs of substance abuse

Substance abuse is a major public health issue in the United States that has far-reaching financial costs. Direct costs of substance abuse include health care expenditures and lost earnings due to absenteeism from work (Meara & Frank, 2005). On the other hand, indirect costs of substance abuse include expenses related to accidents and crime as well as treatment of diseases caused by substance abuse.

These diseases include heart disease, HIV/AIDS, and cancer (Meara & Frank, 2005). Other problems that cause indirect costs include stress, violence, and child abuse. Psychological costs of substance abuse emanate from treatment of disorders such as depression, anxiety, antisocial personality disorder, stress, and paranoia (Page, 2012).

Physical effects of substance abuse include intoxication, liver damage, lung damage, and kidney damage. These effects are mitigated using treatments that are very expensive. Long-term substance abuse creates tolerance to drugs, which results in increased use. This exposes victims to risks of overdose that could cause death.

Link of addiction to crimes and accidents

Criminal activities that result from substance abuse include domestic violence, robbery, assault, rape, and prostitution (Page, 2012). Drug addiction causes mental illnesses and poor perception of social support (Page, 2012). These effects motivate addicts to commit crime in order to finance their addictions.

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Others commit crimes such as rape and assault due to personality disorders and interactions with other addicts. Research estimates that between 40 and 80 percent of prostitutes use drugs (Howinson, 2005). Prostitutes are major victims of rape and assault. Many accidents are caused by drivers who lose consciousness due to intoxication from drug use (Page, 2012). On the other hand, driving under the influence has been cited as a major cause of accidents.

Implications with suicide, homicides, and interpersonal relationships

Drug addiction has been associated with suicide and homicide. Many addicts commit suicide after they develop depressive disorders that make them feel hopeless and helpless (Page, 2012). According to research, substance addiction is the second major cause of suicide in the United States.

Individuals with substance use disorders are at higher risks of committing suicide than individuals who do not use drugs. Many victims decide to commit suicide after failing in their attempts to eradicate substance abuse habits (Page, 2012). Suicide is also fueled by risk factors associated to addiction such as financial and social challenges. Substance abuse makes individuals prone to high-risk behaviors that affect their relationships with other people and increase their likelihood of harming other people (Page, 2012).

Dynamics of addiction

It is important to differentiate between individuals who can control their substance use habits and those who can. Drug users usually find reasons to rationalize their habits especially when they fail to eradicate their addictions. Substance addiction results from continued use of illegal substances with disregard to their negative effects on health and financial wellbeing.

Addiction is characterized by four key stages that include compulsion, continued use regardless of negative effects, craving, and denial (Miller, 2011). It affects the social, psychological, and biological wellbeing of individuals. Examples of defense mechanisms used by addicts include denial, rationalization, avoidance, intellectualization, regression, acting out, dissociation, projection, and reaction formation (Miller, 2011).

Defense mechanisms

Common defense mechanisms applied by addicts include denial, regression, dissociation, rationalization, and intellectualization (Miller, 2011). Denial refers to the act of ignoring the existence of a problem that has dire consequences. Many addicts act in ways that enable them to avoid dealing with reality and painful consequences of their addiction. Regression refers to embracement of past behaviors that were overcome during earlier stages of development.

Dissociation refers to loss of touch with time, people, and self (Miller, 2011). Many addicts experience disconnect in their relationships with themselves and other people. Rationalization refers to the act of justifying one’s behavior or unwillingness to eradicate destructive habits. Addicts usually justify their substance abuse habits in order to avoid denigration from other people.

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Finally, intellectualization refers to overreliance on thinking as a way of handling impulses or instincts that are likely to cause destructive behaviors (Miller, 2011). It disregards the importance of feelings and emotions in making decisions. For instance addicts focus on reasons why they cannot overcome their addictions instead of focusing on how they can use emotions of pain and regret to initiate change.


Howinson, J. H. (2005). Substance Abuse: A Comprehensive Textbook. New York: Lippincott Williams & Wilkins.

Meara, E., & Frank, R. G. (2005). Spending on Substance Abuse Treatment: How Much is Enough? Addiction, 100 (9), 1240-1248.

Miller, G. (2011). Learning the Language of Addiction Counseling. New York: John Wiley & Sons.

Page, K. (2012). A parent’s Guide to Substance Abuse and Addiction. New York.

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