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Healthy People 2020: Leading Health Indicators for American Indian/Alaska Native Populations

SUBSTANCE ABUSE

Although progress has been made in substantially lowering rates of substance abuse in the United States, the use of mind- and behavior-altering substances continues to take a major toll on the health of individuals, families, and communities nationwide. In 2005, an estimated 22 million Americans struggled with a drug or alcohol problem.

Substance abuse—involving drugs, alcohol, or both—is associated with a range of destructive social conditions, including family disruptions, financial problems, lost productivity, failure in school, domestic violence, child abuse, and crime. Moreover, both social attitudes and legal responses to the consumption of alcohol and illicit drugs make substance abuse one of the most complex public health issues. Estimates of the total overall costs of substance abuse in the United States, including lost productivity and health- and crime-related costs, exceed $600 billion annually.¹

Health Impact of Substance Abuse

Substance abuse contributes to a number of negative health outcomes and public health problems, including:

• Cardiovascular conditions
• Pregnancy complications
• Teenage pregnancy
• Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)
• Sexually transmitted diseases (STDs)
• Domestic violence
• Child abuse
• Motor vehicle crashes
• Homicide
• Suicide

For example, data show that:

• The use of cocaine, MDMA (ecstasy), amphetamines, and steroids have been linked to abnormal cardiovascular functioning, ranging from abnormal heart rate to heart attacks.²
• Approximately one-fourth of AIDS cases in the United States have resulted from injection drug use.³
• More than half of all people arrested in the United States, including for homicide, assault, and theft, test positive for illicit drugs.⁴
• In 2009, an estimated 10.5 million people age 12 or older reported driving under the influence of illicit drugs in the previous year.⁵ In 2009, among fatally injured drivers, 18 percent tested positive for at least one drug.⁶
• Prenatal drug exposure can result in premature birth, miscarriage, low birth weight, and a variety of behavioral and cognitive problems.⁷

AI/AN FACTS

Alcohol and illicit drug use in adolescents

• Among racial and ethnic groups, Asian adolescents age 12 to 17 had the lowest (best) rate of alcohol or illicit drug use (7.4%). In 2008, rates for adolescents in other racial and ethnic groups were:
  • American Indian or Alaska Native: 23.3%
  • White non-Hispanic: 19.8%
  • Hispanic or Latino: 18.5%
  • Black non-Hispanic : 14.5%
• Among income groups, adolescents from families with incomes below the Federal Poverty Level (FPL) had the lowest (best) rate of alcohol or illicit drug use (15.9%). The rate was 27.4% among adolescents from families with incomes 600% of FPL and over, 73% higher than the best group rate.

Binge drinking in adults

• Among racial and ethnic groups, Asian adults had the lowest (best) rate of binge drinking (13.5%) in 2008. In 2008, rates for adults in other racial and ethnic groups were:
  • Hispanic or Latino: 29.7%
  • American Indian or Alaska Native: 29.6%
  • White non-Hispanic: 27.7%
  • Black non-Hispanic: 24.9%

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References:

1. National Institute on Drug Abuse, National Institutes of Health. Understanding drug abuse and addiction.NIDA InfoFacts. Bethesda, MD; 2011. p.1. Available fromhttp://drugabuse.gov/PDF/InfoFacts/Understanding.pdf [PDF - 4.65KB]
2. National Institute on Drug Abuse, National Institutes of Health. Cardiovascular effects. Medical Consequences of Drug Abuse. Bethesda, MD: 2011. Available fromhttp://www.drugabuse.gov/consequences/cardiovascular
3. National Institute on Drug Abuse, National Institutes of Health. Drug abuse and the link to HIV/AIDS and other infectious diseases. NIDA InfoFacts. Bethesda, MD: 2011. p.2. Available fromhttp://drugabuse.gov/PDF/Infofacts/DrugAIDS.pdf [PDF - 5.33KB]
4. Office of National Drug Control Policy. 2010 Annual Report: Arrestee Drug Abuse Monitoring Program II. Washington, DC; 2011. p.xii. Available from http://www.whitehouse.gov/sites/default/files/ondcp/policy-and-research/adam2010.pdf [PDF - 2.2MB]
5. Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. Results from the 2009 National Survey on Drug Use and Health: Volume I. Summary of National Findings. Rockville, MD: 2010. Available from http://oas.samhsa.gov/nsduh/2k9nsduh/2k9resultsp.pdf
6. National Highway Traffic Safety Administration, U.S. Department of Transportation. Drug involvement of fatally injured drivers. Traffic Safety Facts. Washington, DC: 2010. p.1. Available from http://www-nrd.nhtsa.dot.gov/Pubs/811415.pdf [PDF - 184KB]
7. National Institute on Drug Abuse, National Institutes of Health. Prenatal effects. Medical Consequences of Drug Abuse. Bethesda, MD. Available from http://drugabuse.gov/consequences/prenatal