Chapter: Psychiatric Mental Health Nursing : Substance Abuse

Substance Abuse

SUBSTANCE USE/ABUSE AND RELATED disorders are a national health problem.

Substance Abuse

SUBSTANCE USE/ABUSE AND RELATED disorders are a national health problem. More than 15 million Americans are dependent on alcohol, and 500,000 are between the ages of 9 and 12 years. Almost 7 million persons are binge drinkers between the ages of 12 and 20 years—under the legal age limit for drinking in most states. Five thousand deaths occur each year—motor vehicle accidents, homicide, suicide, injuries—due to alcohol in persons under age 21 (National Institute on Alcohol Abuse and Alcoholism, 2009). The actual prevalence of substance abuse is difficult to determine precisely because many people meeting the criteria for diagnosis do not seek treat-ment and surveys conducted to estimate prevalence are based on self-reported data that may be inaccurate.


Drug and alcohol abuse costs business and industry an estimated $100 billion annually. Alcoholism alone accounts for 500 million lost days of work. Up to 40% of industrial fatalities and 47% of workplace injuries are linked to alcoholism and alcohol consump-tion. Estimates of motor vehicle fatalities related to alco-hol are 50% (Substance Abuse and Mental Health Services Administration, 2007). In the United States, one person is killed every 30 minutes in an alcohol-related traffic accident.


The number of infants suffering the physiologic and emotional consequences of prenatal exposure to alcohol or drugs (e.g., fetal alcohol syndrome, “crack babies”) is increasing at alarming rates. Chemical abuse also results in increased violence, including domestic abuse, homi-cide, and child abuse and neglect. These rising statistics regarding substance abuse do not bode well for future generations.


Forty-three percent of all Americans have been exposed to alcoholism in their families. Children of alcoholics are four times more likely than the general population to develop problems with alcohol (National Institute on Alco-hol Abuse and Alcoholism, 2007a). Many adult people in treatment programs as adults report having had their first drink of alcohol as a young child, when they were younger than age 10. This first drink was often a taste of the drink of a parent or family member. With the increasing rates of use being reported among young people today, this prob-lem could spiral out of control unless great strides can be made through programs for prevention, early detection, and effective treatment.

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