Illicit Drugs: Use and control

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Carl Hart - The Science of Illicit Drugs

Although past-month use of illicit drugs was lower in nonmetropolitan areas compared to metropolitan areas, the prevalence of drug use disorders among people reporting past-year illicit drug use in nonmetropolitan areas was similar to that in metropolitan areas. Studies have found that persons with substance use disorders are at higher risk for drug use-related morbidity and mortality Further, given research indicating that nonmetropolitan areas have less access to substance abuse treatment services 18 and other risk reduction strategies 19 , the similar prevalence of drug use disorders in this study underscores the importance of scaling up these critical interventions in nonmetropolitan areas.

Because of the involvement of prescription opioids in the current epidemic 20 , monitoring prescribing levels along with understanding the local illicit drug trade is important for prevention efforts. Recent studies suggest that a leveling off and decline has occurred in opioid prescribing rates since and in high-dose prescribing rates since 7. However, overall opioid prescribing remained high in and the amounts prescribed varied by level of urbanization Reducing the number of persons initially exposed to prescription opioids might reduce the illicit use of opioids, the subsequent risk of addiction, and the use of illicit drugs Interventions for drug overdoses, such as naloxone administration, rescue breathing, or calling , are most useful when someone is present to administer them.

In both metropolitan and nonmetropolitan areas, the majority of overdose deaths occurred in a home, and rescue care could fall to friends or relatives who might lack knowledge about naloxone administration and follow-up care. In private locations, such as homes, bystanders might not know to call for emergency services after giving naloxone Further, naloxone is less often administered by emergency medical technicians-basics persons trained to provide basic-level life support , who are more common in rural areas 24 than paramedics who can provide advanced life support care.

Legislation designed to improve access to naloxone by laypersons is now present in all 50 states and the District of Columbia Although prevalence rates of drug use in rural areas are lower in this report, the consequences of use appear to be higher. For example, an investigation of HIV infections linked to the injection of prescription opioids found that the majority of the counties at high risk for rapid dissemination of hepatitis C virus or HIV were in rural areas Access to substance abuse treatment services is more limited in rural areas 27 and strengthening the health care delivery system while improving the integration of primary, specialty, and substance abuse services can provide the nexus of care needed to reduce drug misuse 28 — Specific interventions to address overdose deaths in rural areas have been discussed previously 25 and might include actions such as expanding the types of emergency medical service providers that can administer naloxone to reverse a drug overdose.

In addition, the following resources can assist providers and communities in efforts to reduce misuse and overdose:. The findings in this report are subject to at least six limitations. First, NSDUH is a self-reported survey and is subject to recall bias and social desirability; however, good validity and reliability have been found for substance use measured by NSDUH Second, NSDUH excluded persons who were homeless and not living in shelters or persons residing in institutions, which could lead to underestimates in drug use and drug use disorders.

Some areas might change in their urbanization categorization over time; however, few would have changed from the larger grouping of metropolitan to nonmetropolitan In addition, the NCHS county-based classification scheme was used for the entire time period for parsimony. It was not possible to analyze this underestimation by urban level directly.

Fifth, because information on intent might be coded in the mortality file even though the case could still be under investigation, it might be difficult to determine whether a death should be certified as suicide or unintentional Drug use and subsequent overdoses continue to be a critical and complicated public health challenge. However, the rising death rate of drug overdoses in rural areas, which surpassed rates in urban areas, along with persistent limited access to substance abuse treatment services in rural areas is cause for concern. Educating opioid prescribers on the CDC Guideline for Prescribing Opioids for Chronic Pain 35 and better access to evidence-based substance abuse treatment, including medication-assisted treatment for opioid addiction, are critical steps that can be taken in communities heavily impacted by substance abuse.

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Department of Health and Human Services. For a dichotomous measure, metropolitan combines categories 1—4 and nonmetropolitan combines 5 and 6. SS :1— Use of trade names and commercial sources is for identification only and does not imply endorsement by the U. CDC is not responsible for the content of pages found at these sites.

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    5. Introduction During —, annual age-adjusted death rates for the five leading causes of death in the United States heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke were higher in rural nonmetropolitan areas than in urban metropolitan areas 1. Data Analysis On the basis of NSDUH data, overall prevalence of past-month illicit drug use was estimated for four 3-year periods —, —, —, and — , by CBSA designation, sex, age group, race, and annual household income.

      Results National Survey of Drug Use and Health From — to —, the prevalence of past-month use of illicit drugs was highest in large metropolitan areas Table 1. National Vital Statistics System In , nearly six times as many drug overdose deaths were reported in metropolitan areas than in nonmetropolitan areas metropolitan: 45,; nonmetropolitan: 7, in the United States Table 2. Discussion This report presents an overview of illicit drug use, illicit drug use disorders, and drug overdose deaths for metropolitan and nonmetropolitan areas in the United States.

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      Limitations The findings in this report are subject to at least six limitations. Conclusion Drug use and subsequent overdoses continue to be a critical and complicated public health challenge. Leading causes of death in nonmetropolitan and metropolitan areas—United States, — The update of the rural-urban chartbook. Fatal injury reports, national, regional and state, — Prescription opioid poisoning across urban and rural areas: identifying vulnerable groups and geographic areas. Addiction ;— Recent changes in drug poisoning mortality in the United States by urban-rural status and by drug type.

      Pharmacoepidemiol Drug Saf ;— Geospatial analysis of drug poisoning deaths involving heroin in the USA, — J Urban Health ;— Annual surveillance report of drug-related risks and outcomes—United States, Urban vs. Int J Drug Policy ;— An estimated Rates of illicit drug use is highest among those aged 18 to Cocaine is a powerfully addictive stimulant made from the leaves of the South American coca plant, and normally comes in a powder form.

      Street names for cocaine include blow, bump, coke, and snow. Cocaine is most commonly snorted or injected, and can also be smoked or administered to the skin.

      Crack Cocaine Crack is the more pure and potent form of cocaine, which typically comes in solid blocks or crystals. Crack cocaine is typically smoked, allowing it to reach the brain more quickly and result in a short-lived — yet intense — high. It is also increasingly commonly injected. Ecstasy Used by many high-schoolers and young adults, ecstasy is considered a party drug or rave drug.

      Its psychoactive effects include enhanced sensory perception and can cause lowered inhibition. Ecstasy is most commonly taken orally in pill form or dissolved in water, but can also be snorted or injected. While an addiction to this type of drug is less common than other drugs, use and abuse of these substances can cause severe negative side effects.

      Heroin Heroin is an extremely addictive substance that is synthetically derived from the opium poppy plant. Inhalants Inhalants include household items such as spray paints, markers and cleaning supplies which are inhaled through the mouth or nose in order to achieve a high. Inhaling certain types of these substances can lead to heart failure, resulting in death. Ketamine This substance is medically used as an anesthetic in veterinary practice.

      When abused, ketamine can cause hallucinations, sedation and confusion. Marijuana Marijuana is one of the most commonly abused illicit substances. The main psychoactive ingredient, THC, causes temporary euphoria followed by drowsiness, slowed reaction time and increased appetite. Meth Meth is an extremely dangerous stimulant that can cause users to become instantly addicted.

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      The short-term effects of meth include alertness and euphoria. However, long-term use of meth can lead to problems such as violent behavior, severe dental problems, psychosis, and severe paranoia. Synthetic Marijuana Synthetic marijuana refers to the growing number of manufactured substances that contain a chemical similar to THC.

      Ready to break free from an illicit drug addiction? Begin the road to recovery by calling our treatment specialists today. Speak with an expert Many illicit drugs pose serious health risks, even when taken in small doses. Some drugs can cause an addiction after a single use. People who become addicted to certain illicit substances are at a high risk of overdose, which can be fatal. Many overdoses occur when a person relapses after trying to quit and returns to using the same dose.

      They think that they need the same dose as before, when in fact their body is no longer used to that amount. This isn't going to go away.

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