Omar Bennett
Drug abuse and misuse of prescription drugs are generally more prevalent among men than women. In 2022, about 107,941 drug overdose deaths occurred in the US, with opioid-related deaths constituting 75.6% of drug overdose deaths. Adults aged 35-44 account for the highest share of opioid overdose deaths at 27.3%, followed by those 55 and older at 23.9%. West Virginia has the highest rate of overdose deaths at 80.9 deaths per 100,000 people. Globally, more than 100,000 people die from drug overdoses annually, with most of these deaths resulting from opioid overdoses. Opioid-related deaths have also been increasing in recent years, with the US Department of Health and Human Services declaring the opioid crisis a public emergency in 2017.
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What You'll Learn
Opioid use and overdose
Opioids are strong pain relievers derived from the Papaver somniferum poppy plant. They include natural opiates like opium, morphine, diacetylmorphine (heroin), and codeine, as well as synthetic compounds like methadone, oxycodone, and fentanyl. Opioids have analgesic and sedative effects, and their use can lead to euphoria, which is one of the main reasons they are taken for non-medical reasons.
The non-medical use, prolonged use, misuse, and use without medical supervision of opioids can lead to dependence and other health problems. Opioid dependence is a disorder characterised by a strong internal drive to use opioids, resulting in impaired control over their use. Opioids can cause breathing difficulties due to their pharmacological effects, and an opioid overdose occurs when excessive stimulation of the opioid pathway leads to decreased respiratory effort and potentially, death.
The number of opioid overdoses has increased in recent years, particularly in the United States. From 1999 to 2022, over 720,000 people died from opioid overdoses in the US, with synthetic opioid deaths increasing by 1,040% between 2013 and 2019. During the COVID-19 pandemic, a further substantial increase in opioid overdose deaths was reported, driven by the increased availability of potent synthetic opioids on the illicit drug market. In 2022, 75.6% of drug overdose deaths in the US were opioid-related, with synthetic opioids like fentanyl being a major contributor.
Worldwide, about 600,000 deaths were attributable to drug use in 2019, with close to 80% of these related to opioids and about 25% caused by opioid overdose. Effective treatments for opioid dependence exist, such as medication-assisted treatments using methadone and buprenorphine, but less than 10% of those who need treatment are receiving it. Naloxone, an opioid overdose reversal medication, can prevent death if administered in time.
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Amphetamine and cocaine overdose
Amphetamine and cocaine are stimulants that can be taken orally, intranasally, intravenously, or smoked. The stimulant effect is additive, with amphetamines providing a much longer "high" compared to cocaine. However, the prolonged use of stimulants often results in an unpleasant emotional state, very different from the initial euphoria.
Tolerance to these drugs builds up over time, and naive users are at a high risk of overdose if they take a dose similar to that of more experienced users. The risk of overdose is also higher when these drugs are combined with other substances, especially injected heroin ("snowball" or "speedball") and alcohol (which produces cocaethylene).
Between 1999 and 2022, over 720,000 people in the US died from opioid overdoses, with synthetic opioids like fentanyl and tramadol contributing significantly to recent increases in overdose deaths. In 2022, there were about 107,941 drug overdose deaths in the US. While the number of overdose deaths has been increasing, it is important to note that the majority of drug use is episodic and non-problematic, with most people who have used drugs in their lifetime not using them in the past year.
From 2003 to 2023, the rate of cocaine-related overdose deaths increased from 1.8 to 8.6 deaths per 100,000 people. In 2019, clinics dealing with primary care, pain management, or substance abuse disorders saw a significant increase in urine samples testing positive for potentially fatal drugs, including methamphetamine ("meth") and cocaine.
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Drug use disorder rates by gender
Drug abuse and misuse of prescription drugs are generally more prevalent in males than in females. For example, among Americans aged 12 years and older, 16.8% used drugs in the last month, with 3.4% misusing opioids. However, few statistics are available that explore trends among gender identities.
Women are more likely to do drugs with an intimate partner, whereas men are more likely to do drugs with other male friends. In terms of specific substances, after alcohol and tobacco, cannabis was the most frequently used drug, with 46.3% having used it. However, only 9.1% of users developed a cannabis dependence. In contrast, 16.2% had tried cocaine, and 16.7% of these users qualified as cocaine dependent. Heroin had the lowest usage rate at 1.5%, but 23.1% of users became dependent.
In terms of prescription drug misuse, 14.4 million people in 2023 misused prescription psychotherapeutic drugs. Of these, 8.6 million misused prescription pain relievers, 4.7 million misused tranquilizers or sedatives, and 3.9 million misused stimulants. Additionally, 8.9 million Americans aged 12 and older misused opioids at least once in a 12-month period, with 5.9 million qualifying as having an opioid use disorder.
Young adults aged 18 to 25 made up the majority of those who started cigar smoking in 2023, with 1.1 million people. Additionally, 39.3% of the 2 million people who started cigar smoking in the past year were under 21.
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Cannabis dependence
Cannabis contains compounds called cannabinoids, some of which are psychoactive, meaning they act on the brain to modify mood or consciousness. It is usually smoked or vaporised and inhaled, but it can also be consumed in tea, baked goods, candies, or other edible forms. Synthetic cannabinoids, which are manufactured to replicate individual chemicals found in cannabis, are often more potent and can be more dangerous.
The effects of cannabis can include enhanced senses and changes in mood, but it may also have harmful short- and long-term effects, such as paranoia and memory loss. It can be addictive, and its use may disrupt a person's life and relationships. Cannabis use disorder is a chronic condition with the potential for both recovery and relapse, and it often co-occurs with other mental health conditions. Treatment for cannabis use disorder depends on the severity of the disorder and is highly individualised, often requiring continuing care. Effective treatments are available, including detoxification, cognitive and behavioural therapies, contingency management, and participation in self-help programs or support groups.
In the United States, about 13% of adults use cannabis products, and its use is gaining popularity as more states move to legalise it for recreational or medicinal purposes. However, it is important to note that drug abuse and misuse of prescription drugs are generally more prevalent in males than females, and the effects of drugs are often portrayed negatively in the media, leading to the stigmatisation of people who use them.
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Psychedelics dependence
Psychedelics, also known as hallucinogens, are a class of psychoactive substances that profoundly alter perception, mood, and cognitive processes. They affect all the senses and can cause hallucinations. The effects of psychedelics can last several hours and vary depending on the type, dosage, and environment in which they are consumed.
Psychedelics are generally not associated with physical dependence or a high risk of addiction. Research suggests that only a small percentage of users may develop a dependence on psychedelics. For example, in a study by Anthony et al. (1994), the prevalence rate of psychedelic use was 10.6%, but only 4.9% of users qualified for a dependence diagnosis. While it is not likely to develop physical dependence on psychedelics, psychological dependence can occur in some individuals.
One psychedelic substance that has been identified to cause tolerance is lysergic acid diethylamide (LSD). Tolerance means that an individual may need to take higher doses of the drug over time to achieve the same effect. While tolerance to LSD does not indicate physical dependence, it can be dangerous as higher dosages are associated with more side effects and risks. Additionally, LSD can cause cross-tolerance to other hallucinogens, such as psilocybin. However, there is no significant literature describing withdrawal symptoms from LSD or associating its use with the development of a substance use disorder or addiction.
Despite the relatively low risk of dependence, psychedelics can be misused and may lead to mild to serious health issues when abused. Signs of misuse include spending a significant amount of time using or recovering from the drug, neglecting important commitments, using the drug in combination with other dangerous substances, and continuing to use despite negative consequences. Chronic use of psychedelics has been associated with the development of hallucinogen-induced persistent perception disorder, as well as potential emotional issues such as depression, anxiety, and issues with motivation.
Psychedelics have also been explored for their potential therapeutic benefits. Research has suggested that psychedelics like psilocybin can reduce cravings for alcohol and promote abstinence, making them potentially useful in the treatment of substance use disorders. Additionally, psychedelics have been studied for their potential in treating depression and reducing anxiety. However, it is important to note that the effects of psychedelics can be unpredictable, and feelings of stress or anxiety before use may result in an unpleasant experience, known as a "bad trip," which can potentially lead to serious emotional issues.
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Frequently asked questions
After alcohol and tobacco, cannabis is the most frequently used drug.
Heroin has the highest rate of dependency at 23.1% of users.
The United States has the highest death rate from drug overdoses.
West Virginia has the highest rate of overdose deaths, with 80.9 deaths per 100,000 people.
Opioids have the highest death rate, with a steep rise in deaths over the last decade.
