Drug addiction, also referred to as substance use disorder, is a disease that influences an individual’s brain and behavior, leading to the lack of capacity to control the use of legal and illegal drugs. It is notable that individuals diagnosed with substance use disorders (SUD) encounter discrimination and bias from society, including healthcare and social service providers. In addition to having to deal with addiction, SUD individuals get discriminated against due to misinformation about addiction, which is further exacerbated by systemic racism. Consequently, the individuals who are addicted to substances, which may range from alcohol to more severe drugs such as opioids, encounter health disparities because they cannot get healthcare to address their physical and mental health needs. The purpose of this health promotion process paper is discuss the social determinants of drug addiction, the epidemiology of the issue, as well as cultural and health literacy considerations, which is necessary for making recommendations for health improvement.
Substance use disorder is not immediate and develops with time, beginning with the experimental use of the drug in social situations, with the use becoming more frequent, leading to addiction. The risk and severity of dependence are linked to the variety of the drug being taken. For example, opioid painkillers lead to a higher risk of addiction, which tends to develop more quickly (CDC, 2021). SUD manifests in different symptoms depending on personal characteristics; however, the main way it shows is the feeling that one has to use the drug regularly and a severe urge for the drug that blocks any other thoughts. Individuals with addiction are treated with bias because they make bad decisions in order to fulfill their addiction and continue using drugs despite them causing issues in their lives. Besides, individuals with SUD often engage in risky activities and do socially unacceptable things. Thus, it is common for drug addicts to face health disparities because healthcare and social service providers often do not take them seriously.
The three social determinants of health (SDOH) that are relevant to the discussion of SUD include employment, income, and race. Employment is an SDOH because the ability of an individual to get and hold a job is something that contributes to the higher likelihood of substance abuse, with unemployed adults reporting the highest rates of illicit drug use (Bazan et al., 2022). Statistically, among adults aged 26 and older, the illegal drug use rates are 47% higher compared to those working full-time (Bazan et al., 2022). As employment is closely linked to income, it should be noted that poverty is a social determinant of health predicting the risks of drug use. Notably, just as “drug use and misuse were the highest for those who were unemployed, similarly, it is the highest for those who suffer from poverty” (Bazan et al., 2022, p. 23). Finally, race is an SDOH that significantly influences the adverse health outcomes among individuals struggling with drug addiction. Racism within society and the healthcare industry has been shown to increase the likelihood of depression, anxiety, and psychological stress among targeted populations (Rastetter, 2021). Drug abuse may be one of the consequences of poor mental health.
As to statewide epidemiology of illicit drug use, the rate of drug abuse and drug-associated deaths in Florida is higher compared to the national average, with around 3,000 of deaths occurring yearly due to drug use (Stockton, 2022). Notably, the rate of deaths related to drug use in the state is higher than the rate of deaths due to car accidents or drug violence (Stockton, 2022). 8% of citizens of Florida have reported using illicit drugs at some point in time, which amounts to around 1.5 million people (Stockton, 2022). The pandemic has only exacerbated the drug addiction problem in the state; for example, Pasco County Sheriff’s Office reported 1,491 overdoses in 2020, which was a 71% rise from 2019 (Stockton, 2022). The determinants of increased drug use and addiction in the state were concerned with job loss, isolation, homelessness, and other stress factors linked to the pandemic.
When considering the epidemiology of illicit drug use on the national level, based on the National Survey of Drug Use and Health, 57.2 million Americans aged older than 12 years old engaged in illicit drug use in 2019, with the most commonly used drug being marijuana (Ignaszewski, 2021). Prescription pain relievers represented the second most common type of illicit drug use in 2019, misused by 9.7 million people, with 5.7 million Americans estimated to use heroin at some point in their lives, while 1.6 million people met the criteria for opioid use disorder (Ignaszewski, 2021). Notably, most prescription opioids to which Americans get addicted were obtained from friends and relatives, with addiction starting with the use of prescription drugs.
Cultural considerations in addressing the issue of drug use disorder among vulnerable populations are essential. Sociocultural beliefs have the potential to shape the attitude and behavior regarding the use and abuse of substances, while culture plays a defining role in developing individuals’ expectations regarding drug use practices (Sanders, 2021). Moreover, adverse situations occur when individuals experience a lack of cultural protection and get exposed to new norms and values. An example of this has been seen in Hispanics moving to the United States who experience issues in acculturation, which has led to the increase in their use of alcohol and illegal drugs (Guerrero, 2022). The gang culture is also considered a determinant of illicit drug use and its selling. Gang members are more likely to start using drugs at earlier ages and use a greater variety of drugs at greater frequencies (Sanders, 2021). The assessment of an individual’s cultural background is imperative for identifying links between their substance use and cultural influences.
Substance use and health care literacy are interconnected because the knowledge about the harmful effects of drug use could prevent individuals from engaging in it. According to Degan et al. (2019), low to moderate levels of health literacy were the most common for individuals undergoing substance abuse treatment. Moreover, the lack of health literacy is associated with a lower quality of life and mental health. This means that during interventions aimed at addressing substance use disorders, service providers will have to address the low health literacy of the target patients.
To conclude, substance use is a complex and multi-dimensional problem, and the populations exposed to it experience significant health disparities. Notably, individuals engaging in substance use are more likely to be of lower income, unemployed, and from underserved and minority populations who tend to have lower levels of health literacy. Care providers serving such populations should be aware of the socioeconomic and sociocultural contributors to substance use to address the problem comprehensively.
References
Bazan C., Barnes, B., Santens, R., & Verone, E. (2022). Drug use and misuse: A community health perspective. Creative Commons.
CDC. (2021). Drug overdose: Understanding the epidemic. Web.
Degan, T. J., Kelly, P. J., Robinson, L. D., & Deane, F. P. (2019). Health literacy in substance use disorder treatment: A latent profile analysis. Journal of Substance Abuse Treatment, 96, 46-52. Web.
Guerrero, E. (2022). Effective elimination of structural racism. IntechOpen.
Ignaszewski, M. J. (2021). The epidemiology of drug abuse. The Journal of Clinical Pharmacology, 61(S2), S10-S17. Web.
Rastetter, M. (2021). How racism is a structural and social determinant of health. Web.
Sanders, B. (2021). Gangs, drug use, and drug selling in the United States. Criminology and Criminal Justice. Web.
Stockton, E. (2022). Substance abuse statistics in Florida. Web.