Substance Use

Substance use disorders occur when regular use of alcohol and/or drugs impacts daily functioning, including health problems, disability, and inability to meet main responsibilities at home, work, or school.¹

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Leading causes of death are at least partially caused by the abuse of alcohol, tobacco, or other drugs. Chronic liver disease, unintentional injuries, and suicide are associated with alcohol use; chronic lower respiratory disease and influenza and pneumonia are associated with tobacco use; heart disease, malignant neoplasms, and cerebrovascular disease are associated with both alcohol and tobacco use; and unintentional injuries and suicide are associated with the use of other drugs.

In Utah, alcohol is the most commonly abused substance. Over 16,000 individuals receive publicly funded treatment for substance use. More Utahns die from unintended prescription drug overdoses than motor vehicle accidents.²

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According to the Utah Division of Substance Abuse and Mental Health (DSAMH) over 16,000 individuals were served in substance use disorder treatment in 2014. More men than women received services. The age group with the highest rate of admissions was ages 25-34 years. When looking at per capita rates of people per 1,000 population, American Indian/Alaskan Native individuals had the highest rate of substance use disorder treatment, with Black/African American individuals having the second highest rate per capita. Most people admitted for substance abuse disorder treatment lived on their own and were unemployed. Almost 75% had a high school education level or less than high school level. Over 50% had never been married.³

Deaths attributable to prescription opioid overdoses have more than tripled since 1999.⁴ The rate of opioid overdose deaths has been rising for Americans regardless of age or race. Utah is particularly affected by prescription opioids. Utah unintentional deaths attributable to prescription pain medication increased over 500% during 1999-2007.⁵ Most Utahns who die a drug-related death suffer from chronic pain and take prescribed pain medications.⁶

This epidemic of opioid poisonings is strongly related to widespread and rising prescription opioid misuse and abuse. An estimated 12 million Americans over age 12 misused prescription opioids during the year 2010.⁴ In a 2008 Behavioral Risk Factor Surveillance Survey, 24.5% of Utahns reported using some type of prescribed opioid during the previous year.⁷ Prescription opioid therapy, chronic non-cancer pain, high dose prescription opioids, and multiple prescriptions/pharmacies have been implicated as risk factors for overdose death.^4,5

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According to the Utah Division of Substance Abuse and Mental Health (DSAMH) over 16,000 individuals were served in substance use disorder treatment in 2014. More men than women received services. The age group with the highest rate of admissions was ages 25-34 years. When looking at per capita rates of people per 1,000 population, American Indian/Alaskan Native individuals had the highest rate of substance use disorder treatment, with Black/African American individuals having the second highest rate per capita. Most people admitted for substance abuse disorder treatment lived on their own and were unemployed. Almost 75% had a high school education level or less than high school level. Over 50% had never been married.⁸

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There is a large body of evidence on effective strategies to prevent excessive alcohol use and alcohol-related harm. In the past decade, this evidence base has been the subject of numerous systematic expert reviews to assess the quality and consistency of the evidence for particular strategies; and to make recommendations based on this evidence. These expert reviews have recently been summarized by the NMDOH. The following list summarizes the evidence-based prevention strategies; and to make recommendations based on this evidence. In Utah, DSAMH supports the Communities that Care prevention coalition to provide prevention services.⁹

The DSAMH provides the following services:

• Statewide, 13 local substance abuse authorities offer services to individuals and their families
• Services include education, prevention, early intervention, treatment and recovery support
• Multiple prevention programs are available to individuals of all ages, families, schools, and communities
• 50 drug courts are operated statewide, offering nonviolent, drug abusing offenders with intensive, court-supervised drug treatment as an alternative to jail or prison

For more information on services please access the DSAMH website, http://dsamh.utah.gov/substance-use-disorders/.

Nationally, the most common reasons that people who need and seek treatment do not receive it are: they have no health insurance and cannot afford the cost; they are not ready to stop using; they did not know where to go for treatment; they had health coverage but did not cover treatment or did not cover cost; or they had no transportation or it was inconvenient.¹⁰

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Mental Health data can be obtained from both mortality as well as morbidity data sources:

• Mortality data provides on 100% alcohol- and drug-induced deaths and drug overdoses.
• The Centers for Disease Control and Prevention (CDC) funded the development of the Alcohol-Related Disease Impact (ARDI) methodology that applies attributable fractions to underlying causes of death to arrive at the estimated number of deaths that were alcohol-related.¹¹
• Adult prevalence data come from Behavioral Risk Factor Surveillance System (BRFSS), U.S. Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services.
• Youth prevalence data come from Youth Risk and Resiliency Survey (YRRS), U.S. Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services.
• Hospital Discharge Data (HDD) for inpatient and ED visits relating to substance abuse disorders.

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• Alcohol Consumption - Binge Drinking
• Alcohol Consumption - Heavy Drinking
• Drug Overdose and Poisoning Incidents
• Substance Abuse (Alcohol or Marijuana) - Adolescents

Binge Drinking (5+ drinks for men, 4+ drinks for women) - Adults (BRFSS)

• Binge Drinking - Crude Rates
• Binge Drinking - Age-adjusted Rates
• Frequency of Binge Drinking - Mean
• Intensity of Binge Drinking - Mean

Heavy Drinking - Adults (BRFSS)

• Heavy Drinking - Crude Rates
• Heavy Drinking - Age-adjusted Rates

Current Alcohol Use - Adults (BRFSS)

• Current Alcohol Use - Crude Rates
• Current Alcohol Use - Age-adjusted Rates

Drinking and Driving - Adults (BRFSS)

• Drinking and Driving - Crude Rates
• Drinking and Driving - Age-adjusted Rates

Alcohol Use and Pregnancy (PRAMS)

• Drank 3 Months Before Pregnancy
• Drank Last 3 Months of Pregnancy

Alcohol and Other Drug Use Among Youth

• Current Alcohol Use (YRBS)
• Alcohol Use in the Past 30 Days (PNA)
• Episodic Heavy Drinking (YRBS)
• Binge Drinking (PNA)
• Offered, Sold, or Given an Illegal Drug on School Property (YRBS)
• Rode With a Driver Who Had Been Drinking Alcohol (YRBS)
• Drove After Drinking Alcohol (YRBS)
• Marijuana Use (PNA)
• Prescription Drugs (PNA)

Emergency Department Encounters for Primary Care Sensitive Conditions: Alcohol Related and/or Drug Related

• Emergency Department Encounters for Primary Care Sensitive Conditions Selections

Adverse Childhood Experiences (ACEs) - Adults (BRFSS)

• Substance Abuse in Household - Crude Rates
• Substance Abuse in Household - Age-adjusted Rates

• Opioid Data MME daily dose by age

• Use Only As Directed
• Parents Empowered
• Utah Division of Substance Abuse and Mental Health