Drug Abuse
Drug Abuse: It Affects Us All
Drug and alcohol abuse is not somebody else's problem. Every one of us probably knows someone who abuses alcohol or drugs. The problem affects us all — in our families, with our friends, at our workplaces and in our communities.
People in every walk of life and at every economic level abuse drugs and alcohol. The United States has been called the most drug-abusing industrial nation in the world, but illegal drugs are a growing problem in other industrialized countries as well. More than 10 tons of cocaine were seized by the police in Europe in 1991. People in Asia, Africa and Latin America are becoming adversely affected by the illegal drug supply with increased addiction, violence and crime.
In the United States, 26 million people used an illegal drug at least once in 1991, totaling 13 percent of the population over 12 years of age. More than 23 million people have tried cocaine. More than 1 million used crack. There are 10 million individuals using marijuana at least monthly, 2 million cocaine users and more than 10 million alcoholics. Nonmedical use of barbiturates and tranquilizers is a problem for 2 percent of the U.S. population.
Drug abuse is a major problem for young adults between the ages of 18 and 25 in the United States, with 15 percent of this age group using illegal drugs at least monthly. Of adolescents aged 12 to 17, one out of 14 uses illegal drugs at least monthly, 4 percent regularly use marijuana and 1.5 percent have tried cocaine within the past year.
Half of all traffic deaths are linked to alcohol and drug abuse. Two out of three murders, half of all fire fatalities, and eight of 10 suicides involve drugs and alcohol. More than 70 percent of individuals arrested in the 20 largest U.S. cities had been using illegal drugs.
Cost to Individuals and Families
Drug abuse impairs alertness and achievement by distorting sensory perception, interfering with memory, and causing a loss of self-control. Many abused drugs can cause long-lasting physical and psychological problems.
Marijuana smoke, which contains more cancer-causing agents than tobacco smoke, damages the lungs and pulmonary system. When smoked by pregnant women, marijuana also can create genetic problems leading to birth defects.
The liver damage, neurological problems and other dangers of alcohol abuse are well-known.
Cocaine not only affects the emotions, but also disrupts the brain's control of heartbeat and breathing and causes high blood pressure. Single or multiple uses have resulted in fatal seizures.
PCP (phencyclidine) can produce convulsions, coma and severe psychological disorders. Using PCP also can lead to heart and lung failure or ruptured blood vessels in the brain, any of which may be fatal.
Drugs can destroy an individual's ability to think and act responsibly and to perform well at school, at work or at home. When taking drugs becomes more important to the individual than dealing with reality, the continued drug abuse can destroy family relationships, friendships, outside interests, values and goals.
Many substances cause physical and psychological dependence. Regular drug abusers find they need to take larger doses to get the same effect. PCP, heroin and other drugs can alter the body's chemistry. When the user stops taking the drug, the body rebels with unpleasant and often painful symptoms of withdrawal.
There is no such thing as safe and responsible use of an illegal drug, or harmless misuse of alcohol or prescription medications. Abusing drugs can lead to lifelong consequences, such as loss of memory, high blood pressure, mental illness, heart failure, stroke, lung damage and coma. Drug abuse often can lead to death of the user.
Costs to Industry
The costs of drug and alcohol abuse on the job are staggering. Chemical abuse can lead to lost career opportunities, morale problems and job injuries. Federal experts estimate that in excess of 10 percent of all U.S. workers have used illegal drugs on the job. Three to five percent do so on a regular basis. And alcohol remains an even bigger problem in the workplace.
Chemical abuse leads to increased absenteeism and tardiness; inefficiency and lowered productivity; increased illnesses, accidents and injuries; higher medical claims; strained relations between workers; theft of company and employees' property to support drug habits; possible legal difficulties for employers; and domestic and financial problems for drug-abusing individuals. The problem also has been linked to security risks in some industries.
Drug and alcohol abuse costs U.S. business as much as $140 billion a year in lost productivity, accidents, healthcare costs and absenteeism. People abusing drugs and alcohol on the job have three to four times the number of accidents as those who don't.
Testing for Drugs of Abuse
Substance abuse is a diagnosable and treatable illness, but helping affected individuals can be both complicated and delicate. Not all drug-dependent individuals will seek help on their own. In fact, many drug and alcohol abusers do not realize they have a problem with chemical dependency and cannot stop their self-destructive behavior.
In the interest of health and safety, many organizations have begun screening for drugs. Drug testing is used in emergency rooms for overdose situations. Other arenas include drivers arrested for possible intoxication, military personnel, probationers and individuals enrolled in drug rehabilitation programs. International professional and amateur athletic organizations and tournaments screen competitors for drugs of abuse.
Most institutions want to promote a safe, healthy and productive work environment for their employees. Drug use can affect that environment, so many companies have drug testing programs to screen job applicants and to protect employees. Companies with such programs report dramatic reductions in employee accidents, fewer sick days, and healthier employees. Successful plans tend to emphasize prevention of drug abuse, rather than punishment, as a means of promoting better health for individual employees. Companies benefit from increased productivity, safety and lower liability costs.
Seventy percent of the Fortune 500 companies screened job applicants for drugs in 1991, up from 10 percent in 1983.
Types of Tests and How They Work
Saliva and breath tests, used in checking for alcoholic intoxication, are not commonly accepted as screens for drugs of abuse. The remaining options include urine screening and blood testing. Urine testing is preferable for large-scale use. Because the collection of a urine specimen does not require the puncturing of skin, licensed medical personnel are not required to administer the test and there is no danger of infection.
Urine screening tests are designed to detect drugs that have been consumed by the user and whose metabolites (chemicals) are still present in the body. For this reason, a specimen may yield a positive result days or even weeks after an individual has used a drug (see chart). The length of time a drug remains detectable in urine depends on the characteristics of the specific drug, the amount taken and frequency of use, as well as the individual's age, weight, health and body chemistry.
A positive urine screening test result reveals only the presence of a drug in a urine specimen, not how or when the drug was taken. Drugs detected in urine are reported as having been scientifically identified as present in the individual's body system. A positive drug test result does not indicate whether an individual is impaired by drugs but indicates confirmed presence of the drug.
Signs of possible drug use include excessive absenteeism or tardiness, unusual irritability, sharply limited attention span, sleeping on the job, deterioration of work quality, unpredictable and unsafe behavior and mood swings. However, some of these behavior characteristics can be caused by other factors as well.
Use of Test Results
Positive test results can have severe, long-term consequences for the individual: reduced work responsibility, job loss, legal action, a criminal record, social stigmatization and a damaged reputation. For this reason, drug testing programs must use the highest-quality equipment with very specific and sensitive methods to ensure the most accurate results possible. This will eliminate the possibility of false positives or prescription drugs showing up as drugs of abuse.
Competent drug testing laboratories and responsible organizations using them are aware of the psychological, social, economic and legal implications of reporting or mismanaging incorrect results. Therefore, test results are routinely kept confidential. Detailed, accurate records of sample handling — from collection through analysis — help to protect legal rights of both the laboratory and the individual being tested.
Laboratories as a rule perform a confirmatory test before reporting a positive result. Without this, the result would be considered unconfirmed. The recommended procedure for confirmatory testing employs a highly sensitive and specific testing method based on a different chemical principle than that normally used in the initial screening.
Companies testing current employees have various options when drug test results are positive, including recommendations for drug treatment programs or disciplinary action. At least 8,000 American employers, including more than half of the Fortune 500 companies, have established in-house employee assistance programs, including counseling and drug treatment for workers seeking help. Most companies prefer to help current employees rehabilitate themselves, instead of discharging them and hiring and training new workers for the same jobs. The majority offer assistance to those who come forward voluntarily for treatment. Studies show a 35 percent to 79 percent recovery rate for employees enrolled in drug and alcohol treatment programs.
Working Toward a Solution
Drug-abusing individuals can be helped if they can be provided with intervention, education, counseling, a treatment program and other assistance. Such programs represent an important step toward preventing and alleviating the problems drug and alcohol abuse can create.
| Drugs of Abuse | ||||
|---|---|---|---|---|
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| Substance | Form | How Used | Possible Dangers | Detection Period in Urine* |
| Alcohol | Liquid | Taken orally | Liver disease, respiratory failure, depression, anxiety, coma, psychological/ physical dependence | 24 hours or less |
| Amphetamines | Capsules or tablets | Taken orally, injected, or inhaled | High blood pressure, loss of appetite, stroke, fever, heart failure, psychoses | 2-4 days or more |
| Barbiturates | Capsules or tablets | Taken orally | Respiratory failure, depression, anxiety, convulsions, insomnia, coma, psychoses, psychological/ physical dependence, death | 1-21 days or more |
| Benzodiazepines (tranquilizers) |
Capsules or tablets | Taken orally | Respiratory failure, depression, anxiety, convulsions, insomnia, coma, psychological/ physical dependence, death | 3 days or more |
| Cannabinoids (marijuana and hashish) |
Dried herbs with seeds and stems | Inhaled by smoking or eaten in cookies | Damage to short-term memory and lungs, psychoses, psychological dependence, birth defects | 5-36 days or more |
| Cocaine (coke and crack) |
Liquid or powder | Inhaled, injected, or smoked | Damage to nasal passages, weight loss, high blood pressure, heart attacks, convulsions, strokes, psychological/ physical dependence, loss of appetite, death | 2-4 days or more |
| Lysergic Acid Diethylamide (LSD) |
Capsules, gelatin, liquid, or tablets | Taken orally or in eye drops | High blood pressure, loss of appetite, sleeplessness, tremors, anxiety, flashbacks, psychological disorders | 2 days or more |
| Opiates (heroin and morphine) |
Crystals, liquid, powder, or tablets | Taken orally, injected, inhaled, or smoked | Nausea, vomiting, loss of appetite, respiratory failure, convulsions, coma, psychological/ physical addiction, death | 2-5 days or more |
| Phencyclidine (PCP) |
Crystals, liquid, powder, or tablets | Taken orally, injected, or smoked | Dulled coordination and senses, depression, anxiety, memory dysfunction, violent behavior, convulsions, high blood pressure, heart failure, stroke, coma, death | 3-8 days or more |
| Synthetic Narcotics (China White and Fentanyl) |
Crystals, liquid, or powder | Taken orally, injected, or inhaled | Nausea, vomiting, respiratory failure, convulsions, coma, infections from needles, psychological/ physical dependence, death | 2-5 days or more |
*Figures are estimates only. The amount taken, frequency of use and an individual's age, weight, health and body chemistry all affect the period of time a drug remains evident in a urine specimen.
