Drugs, Substance Abuse and Mental Issues in the USA 

drugs medicine opioids

In general and on average, people in the USA are supposedly the biggest drug users in the world. They are taught from practically birth that if something is wrong, there is no need to have any discomfort physically or psychologically. Just take some medicine or a bunch of medicines and your life will be alright again. Besides, you deserve happiness — so the message goes.

In fact, Americans are taught, I read, to feel that there is something wrong with them if they are not all of the time gleeful and productive. If they are going through menopause or feeling despondent because a spouse just died, why not just take some pills, powders or liquid? Then in your avoidance of the disturbing matter, your problematic reaction to it will simply melt away. Even with the endless barrage of tv commercials regarding drugs and booze, people are taught that everything can be alright if they just take “X” as a remedy for a particular affliction or just join the group and drink lots to have a good time.

Yet all of the legal drugs aren’t enough for some people to find that magical, elusive happiness-place. So they resort to illegal drug use, spray sniffing, cough syrup, alcohol and other “fixes” for their perceived sense of alienation from their jobs, their homes, their leisure activities, their families and their presumed friends.

Accordingly almost $150 billion are spend in the USA on illegal drugs each year and a comparable amount — on liquor. Yes, that is approximately the same huge amount that is spent on alcohol each year in America. Yet the loss to the economy that drug and alcohol use cause is around a $600 billion drain on the economy each year, and medical bills are supposedly the number one cause for bankruptcy in America.

As far as the statistics go: “Data are for the U.S.

“Prescription drug use

  • “Percent of persons using at least one prescription drug in the past 30 days: 48.6% (2015-2018)
  • “Percent of persons using three or more prescription drugs in the past 30 days: 24% (2015-2018)
  • “Percent of persons using five or more prescription drugs in the past 30 days: 12.8% (2015-2018)

“Source: Health, United States, 2019, table 39 pdf icon[PDF – 9.8 MB]


“Physician office visit

  • “Number of drugs ordered or provided: 2.9 billion
  • “Percent of visits involving drug therapy: 73.9%
  • “Most frequently prescribed therapeutic classes:
    • Analgesics
    • Antihyperlipidemic agents
    • Dermatological agents

“Source: National Ambulatory Medical Care Survey: 2016 National Summary Tables, tables 22, 24, 25 pdf icon[PDF – 793 KB]


“Hospital emergency department visits

  • “Number of drugs given or prescribed: 336 million
  • “Percent of visits involving drug therapy: 79.5%
  • “Most frequently prescribed therapeutic classes
    • Analgesics
    • Minerals and electrolytes
    • Antiemetic or antivertigo agents

“Source: 2018 NHAMCS Public Use File


“Health Expenditures

“Data are for the U.S.

  • “Per capita national health expenditures: $11,172 (2018)
  • “Total national health expenditures: $3.6 trillion (2018)
  • “Total national health expenditures as a percent of Gross Domestic Product: 17.7% (2018)”


– Data from Centers for Disease Control and Prevention

If that information is difficult to subsume, then let’s look at some more: According to the 2018 National Survey on Drug Use and Health, nearly one in five people in the USA aged twelve and older (19.4%) took illegal drugs in 2018. Simultaneously the second most common illegal drug use that year involved pain relievers with many people obtaining them from relatives and friends. This usage involved 3.6% of the population.

Moreover, “NSDUH also allows for estimation of opioid misuse, which is defined as the use of heroin or the misuse of prescription pain relievers. In 2018, an estimated 10.3 million people aged 12 or older misused opioids in the past year, including 9.9 million prescription pain reliever misusers and 808,000 heroin users. Approximately 506,000 people misused prescription pain relievers and used heroin in [2018].” – 2018 National Survey on Drug Use and Health

The study goes on to state that one in seven adolescents (14.4%) or 3.5 million had a major depressive episode in 2018 and amongst young adults aged 18 to twenty-five 13.8% or 4.6 million had a major depressive episode. I guess that there really is no magic happiness pill.

Further, mental illness also was prevalent for a high percentage of the US population. For example, 19.1% or 47.6 million people in the USA had a mental illness, an emotional disorder or a behavioral one in 2018 while representing an impaired state of being so severe that it impinged upon the quality of life. Similarly, it substantially interfered with or severely limited one or more major life activities. (Anyone can look at a class of students, a crowd in a grocery store, a party or any other gathering and imagine that 19.1 had serious mental problems and as I read years ago, 1/5th of the population would be sufficiently mentally ill at any given point so as to require institutionalization whether the placement actually occurred or not.)

In addition and concerning substance abuse treatment in 2018, “an estimated 21.2 million people aged 12 or older needed substance use treatment. This number translates to about 1 in 13 people who needed treatment (7.8 percent). About 1 in 26 adolescents aged 12 to 17 (3.8 percent), about 1 in 7 young adults aged 18 to 25 (15.3 percent), and 1 in 14 adults aged 26 or older (7.0 percent) needed treatment.” – 2018 National Survey on Drug Use and Health, Substance Abuse and Mental Health Services Administration,

Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health – SAMHSA

If one is interested in statistics regarding drug use and substance abuse globally, this site can provide some information:

Drug use in the U.S. – Statistics & Facts | Statista

It may contain some relevant facts.

I, in my life so far, have seen several people addicted to and hallucinating on drugs concerning which some of the drugs were prescribed medicine given in the doses that doctors ordered. I have also observed people trapped in alcohol addiction while having impaired judgement during times of alcohol use and have seen yet others prone to taking illegal drugs like cocaine and LSD.

My own grandmother was hooked for years on Valium as her medical doctor, who treated her for depression and anxiety after her husband died, simply didn’t care about her enough to prevent her addiction. So my own family chose to personally help her 24/7 during withdrawal until she was over her strong craving for Valium. (Perhaps we should have sued the MD. to teach him to respect his patients better even if he didn’t personally care about them.)

After all that I’ve read and witnessed, I have no intention to use addictive drugs unless I’m in a terminal stage of some ailment that is killing me while I’m also trying to endure extreme pain. Then, I would consider, say, Morphine, Oxycodone or some other pain relieving drug that has a high risk for addiction and dependency.

This is because even though I have been offered opioid treatment in a hospital setting when gravely ill and in severe hurt, I refuse the awful,  physical and mentally disturbing effects of an addictive habit for now. Thus, I  prefer the hurt over developing a vicious drug fixation and habit.

Accordingly, my advise to anyone contemplating use of a strong drug, heavy alcohol drinking or employment of some other potentially lethal substance — please consider your options carefully. In addition, read the fine print carefully since some of the likely side effects can be far worse than the trouble that led to the desire for the substance in the first place.

Sally Dugman writes from MA, USA.



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