Substance Use Disorders

Substance Use Disorders


Use and abuse of alcohol and narcotic substances have occurred throughout history. Advances in chemistry during the 19th and 20th centuries led to the formulation of more potent preparations as active ingredients were identified and then used to search for other agents. At one time, cocaine and opiates were widely prescribed and readily available, often being included in various elixirs and tonics. By 1914, an awareness of the potential for abuse led to federal regulation so that opiates and cocaine could only be prescribed by physicians. Similarly, the advent of Prohibition meant that alcohol was no longer freely available; as a result (until the repeal of Prohibition in 1933), there was an extensive black market in alcohol, as there now is in other substances (see Musto, 1999, for an historical review). With the creation of the U.S. Federal Bureau of Narcotics (now the Drug Enforcement Administration) in 1930, the federal government took a more active role in regulating substances with potential for abuse. Throughout the second half of the 20th century and to the present time, there have been major societal shifts in the acceptance and use of various substances—including marijuana, alcohol, and tobacco.

Pharmacologic advances have improved our understanding of brain processes and the mechanisms that may underlie substance abuse. Until recently, most of the research on substance abuse and substance dependence has come from work with adults. There has been less research on children and adolescents. Unsurprisingly, adolescents who abuse drugs or alcohol have high risk for developing dependence in adulthood (Hopfer et al., 2018).


There have been major changes in adolescent drug use over the past decade in the United States. As noted in Table 22.1, there have been some fluctuations in patterns of substance abuse, although the most consistently used substances in adolescents have included alcohol, tobacco, and marijuana. About one-third of high school seniors report use of some illegal substance (apart from marijuana) at some point in their lives. Variations in patterns of substance abuse are noteworthy but not always well understood. There has been a noteworthy decrease in smoking in adolescents during the past two decades. Despite substantial long-term declines in alcohol use, there has been some increase in the prevalence of binge drinking over the past 2 years (2019-2020). By the end of high school, nearly two out of three students (61.5%) have consumed alcohol, and a quarter of students (26%) had done so by the eighth grade (Johnston et al., 2021).

Age-related data from publicly funded substance abuse treatment programs are also presented in Table 22.2. For younger adolescents, marijuana is most frequently cited as the primary substance of abuse, but for the oldest adolescents and young adults, marijuana combined with alcohol continues to be a major problem along with a variety of other substances.

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Jun 19, 2022 | Posted by in PSYCHOLOGY | Comments Off on Substance Use Disorders
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