Addiction medicine and the free clinic movement.

TLDR: The good news is that substantial progress has been made in countering substance abuse through education and treatment, producing declining rates of marijuana, cocaine, and amphetamine use among adult populations, however, recent high school surveys found that thisProgress has been reversed among adolescents.

Abstract: Abuse of alcohol and other drugs represents the United States' biggest national public health problem. The two most widely used surveys of drug use in the U.S. are the National Household Survey on Drug Use (NIDA 1993a) and the High School Senior Survey (NIDA 1993b). These surveys provide information on alcohol and other drug use patterns among eighth, ninth, and tenth graders in the United States and provide an idea of substance abuse trends in society in general. Based on these surveys, in 1992, 98 million Americans reported using alcohol in the last month, and 10 million were problem drinkers. Fifty-four million smoked cigarettes, 11 million used illicit drugs, and 2.6 million reported nonmedical use of prescription drugs (Brady 1995). It can easily be seen that between the 1960s and the 1990s, America has progressed from a country with drug-using subcultures to a drug-using society. Epidemiological surveys of psychiatric disorders in the United States indicated that 13% to 24% of Americans suffer from substance-abuse disorders at some time in their lives, making this the most prevalent of all medical disorders in the United States. In terms of age, those Americans between 18 and 25 were the most likely to engage in heavy alcohol and illicit drug use, a subject of great concern to every family in the United States (Brady 1995). But it is our children who are at the greatest risk of substance abuse, and tragically, this substance abuse occurs while their central nervous systems are still developing. In a very real sense, the onset of substance abuse occurs when it is the most detrimental to their psychosocial development. These epidemiological studies provide us with good news and bad news. The good news is that substantial progress has been made in countering substance abuse through education and treatment, producing declining rates of marijuana, cocaine, and amphetamine use among adult populations. However, recent high school surveys found that this progress has been reversed among adolescents. In other words, the trend is downward in adult populations, but starting to go up in eighth graders and high-school students. There appears to be a doubling in the number of young people who have experimented with hallucinogenic drugs. Tragically, there appears to be a form of \" generational forgetting \" at work here: the lessons learned from the 1960s on the dangers of drugs seem not to have been transferred to this new generation …