Two-thirds of adults in the United States say that either they or a family member have been addicted to alcohol or drugs; experienced homelessness due to addiction; or experienced a drug overdose leading to an ED visit, hospitalization, or death, according to a recent Kaiser Family Foundation Tracking Poll.
Nearly 110,000 people died from drug overdoses in the United States in 2022-a record high, according to the Centers for Disease Control and Prevention-and two-thirds of those deaths involved a synthetic opioid, such as fentanyl. Multidrug use also appears to be increasing, with some people intentionally using multiple substances and others unknowingly ingesting substances (such as methamphetamine or cocaine) that have been contaminated with another drug-often, fentanyl.
However, alcohol remains the most commonly used substance and a leading cause of preventable death, with alcohol-related deaths increasing 25% between 2019 and 2020. More than half of adults (54%) say that someone in their family has been addicted to alcohol, compared to about a quarter of adults who say their family has experienced illegal or prescription drug addiction.
Despite the negative effects of substance misuse on the health and well-being of individuals, families, and communities, fewer than half of people affected by addiction-and just one-third of affected Black and Hispanic adults-receive treatment. Approximately 75% of those treated for opioid addiction did not receive medication-assisted treatment, which includes medications such as buprenorphine or methadone with standard counseling and behavioral therapy, even though it is considered the optimum treatment for opioid use disorder.
Alcohol use disorder is even less likely to be diagnosed or appropriately treated. According to a nationwide study published in Alcohol: Clinical and Experimental Research in 2021, more than 80% of people who met the criteria for alcohol use disorder saw a health care provider within the previous year, but only about one in 10 were advised to cut back on their drinking and only 6% received treatment. Persistent stigma, shame, denial, and the belief that abstinence is the only available treatment option keep many individuals from seeking help and may hinder health care providers' efforts to help. Acamprosate, disulfiram, and naltrexone are prescription medications approved to treat alcohol use disorder by the Food and Drug Administration.
With regard to opioid use disorder, NPs and other advanced practice nurses who hold a Drug Enforcement Administration registration with Schedule II to V authority can now prescribe buprenorphine, and it's also possible to initiate buprenorphine treatment via telehealth. Nurses can also teach patients and families how to obtain and use naloxone, a nasal spray that can reverse opioid overdose and is available over the counter.-Jennifer Fink, BSN, RN