Addiction in America

From Shatterproof

Over 20 million Americans struggle with addiction, but many don’t get the treatment they need.

It doesn’t have to be this way.

Addiction is a public health crisis.

The addiction crisis is deadlier than ever before.

Overdoses are the #1 cause of accidental death in our country. 81,230 overdose deaths occurred in the United States from June 2019 through May 2020. That’s the highest number of overdose deaths ever recorded in a single year. Synthetic opioids like fentanyl are the biggest drivers but the use of stimulants like cocaine and methamphetamines is also on the rise. From 2013 to 2018, the rate of cocaine overdose deaths tripled.

42 states

During the COVID-19 pandemic, this tragedy has gotten worse. In some communities, overdose-related emergency calls are up as much as 40% and 42 states reported increases in overdose deaths during the pandemic. 

And it’s not just overdoses taking lives: In 2018, more than 175,000 deaths in the U.S. were related to alcohol and other drugs. That makes substance use the third largest cause of death in the nation. 

Effective addiction treatment is hard to access and rarely covered by insurance.

Only 1 in 10 people who need treatment ever receive it, and even fewer receive high-quality care that’s rooted in scientific evidence. Medications are one of the most effective treatments we have for substance use disorder but many cannot get them. 60% of residential treatment facilities don’t offer addiction medication and only 1% offer all three types of medications.

One in four physicians received addiction training

Even though addiction is an illness, treatment has long existed outside of mainstream medicine. In a survey of physicians and nurse practitioners, only one in four said they’d received addiction training during medical education.

Treatment for addiction isn’t one size fits all. But health insurance coverage often limits patients’ options. In many states, Medicaid does not cover residential treatment. Only 60% of employer-sponsored health plans cover addiction medications. And extra hoop-jumping like prior authorization requirements delay and limit access to lifesaving care.

While much of the coverage of the opioid epidemic has focused on white, rural populations, the epidemic affects white, Black and Latinx people proportionally.

In fact, overdoses are rising more quickly among communities of color. The annual growth rate from 2018 to 2020 for Black individuals (16.1%) and Latinx individuals (12.6%) well surpassed the rate of white individuals during the same period (3.8%). What’s more, overdoses among Native Americans are above the national average, and the rate continues to grow. 

Stigma makes it more difficult to receive compassionate, high-quality, evidence-based care — and racism makes this worse for Black individuals.

Access to treatment dramatically favors white individuals, who are 35 times more likely to receive a prescription for buprenorphine, a medication for addiction treatment shown to increase the odds of successful, long-term recovery. 

Black people are more likely to experience negative legal outcomes for drug offenses. Approximately 14% of the US population is Black – and they use substances at similar rates as other populations – but they represent 29% of arrests for drug offenses and 33% of people incarcerated for drug offenses.

People suffering from addiction receive punishment more often than treatment.

Addiction is the only medical illness that’s criminalized, but punishment does not reduce drug use or overdoses.

137,000 people in the U.S. are in prison or jail for drug possession

Approximately 137,000 people are in state prisons or jails in the United States on any given day for drug possession, often for possessing small quantities of illegal drugs. And penalties are doled out inequitably: Racial and ethnic minorities, especially Black and Latinx Americans, are significantly more likely to be arrested and receive stronger sentences for drug-related offenses. 

More than half of those in state prisons and two-thirds of people awaiting sentencing in jail exhibit problematic substance use, or meet the criteria for addiction. What’s more, while people with substance use disorders serve jail time, they have incredibly limited access to evidence-based treatments. 

It doesn’t have to be this way.

Addiction costs our country more than $740 billion each year. And the costs keep rising. We’re hemorrhaging money on this crisis, and all that spending is not doing much to protect our loved ones. 

Myths of Addiction

The following is from Shatterproof: a national nonprofit organization dedicated to ending the addiction crisis in the United States.

Addiction Myths vs. Facts

Most of what the average American knows about addiction is rooted in discrimination and stereotypes. The shame and social disapproval associated with addiction are greater than for any other medical illness.

Stereotypes can show up anywhere: In movies and on the TV news, in our classrooms and workplaces, even in our homes. And these stereotypes aren’t just hurtful and untrue: They directly contribute to the stigma that prevents people in need from getting treatment.

Here are some common myths about addiction. Do any of these sound familiar to you?

Myth: “Addiction only happens to certain kinds of people.”

Fact: Addiction can happen to anyone, no matter their race, upbringing, personality type, or grade point average. There are genetic, social, and psychological risk factors that can put some people at greater risk—but addiction has nothing to do with a person’s character.

Myth: “Addiction is a choice! Kids should just say no.”

Fact: No one, whether they’re a teen or an adult, chooses how their brain will react to substances. The majority of American teenagers report they’ve tried alcohol, and many experiment with other drugs, too. There are effective ways to prevent drug use and addiction—but “just saying no” doesn’t really do that.

Myth: “People with addiction are all criminals.”

Fact: Most of the time, the only person directly harmed by an addiction is the person who’s addicted. Yet millions of people are in jail or prison right now just because they struggle with substance use.

Myth: “People with addiction need tough love. Helping them just enables drug use.”

Fact: Showing love and support are never bad things. Boundaries and self-care are important, but lifesaving interventions should never be denied out of an impulse to teach someone a lesson. Not only is it cruel, but it’s ineffective. Addiction is an illness.

Myth: “Addiction medications are just replacing one addiction with another.”

Fact: Medications for addiction treatment (MAT), especially for opioid use disorder, have been proven to save lives and substantially improve recovery rates. For people in treatment for substance use disorders, medications ease withdrawal symptoms to give people the space they need to recover and prevent overdoses. Medications don’t create a high or cause impairment—they allow patients to work, drive, care for their families, and live full lives.

Myth: “People with addiction are hopeless.”

Fact: People can and do recover from addiction every single day. In fact, millions of Americans are thriving in recovery right now. We just don’t hear their stories as often. Once treatment begins, someone with a substance use disorder can move on to manage their illness, just as they would any other chronic illness. With the right treatment, recovery is possible for everyone.Science of AddictionAddiction is a treatable medical illness. Here’s what research shows about how drugs affect the brain and body.Addiction in America22 million people in America struggle with addiction and it’s the third largest cause of death, but many don’t get the help they need.Educating FamiliesWe provide resources to millions of families who are looking for information, tools, and support.