In 2015, more than 27 million people in the U.S. used illicit drugs in a way that was harmful to their health and that caused problems in their work, family, and community at large.1 Globally, approximately 275 million people, between the ages of 15 and 64, used drugs at least once during 2016, and approximately 31 million of the people who use drugs suffer from substance use disorders.2 Yet only one in six people with a substance use disorder got treatment in 2016.2
The non-medical use of prescription opioids has become a major public health issue in the United States. In a study conducted in 2014, 10.3 million people reported abusing prescription opioids nonmedically—and that number has only grown.3 More than 130 people in the United States die every day after an opioid overdose.4 More than 47,00 American died in 2017 from opioid overdose—including prescription opioids, heroin, and illicitly manufactured fentanyl.4
It’s estimated that around the world, a little more than 35 million people abuse meth or amphetamines, 15 million abuse cocaine, and around 10 million regularly abuse opioids.5 Additionally, abuse of illicit stimulants, such as methamphetamine and “crank,” are widespread epidemics in the Southwest and Northwest regions of the U.S.5
From the effects illicit drug users have on people in their family, including children, to the burden the drugs place on local and national economies, the negative impact is challenging to quantify but impossible to avoid.
The statistics above relate directly to those who are using illicit drugs, but they neglect to demonstrate how the people behind those numbers cause a kind of ripple effect of damage on society at large. From the effects illicit drug users have on people in their family, including children, to the burden the drugs place on local and national economies, the negative impact is challenging to quantify but impossible to avoid.
The effects of illicit drug use on society can be best understood by examining the overarching impacts on violence and crime, health, and finances.
Illicit drug activity can increase crime and brutality, particularly gun violence, which poses a real danger to a peaceful society. Users often commit crimes to obtain money for drugs, and drug users, in turn, may become unstable, causing outbursts that lead to violence.6
That said, rates of drug-related violence and crime in the United States tend to fluctuate depending on the illicit substances that are most popular in a given era. For example, illicit drug-related crime peaked in the 1980s and 1990s with the rise of crack cocaine. In the 1990s, rates of violent crime decreased, and the change is attributed to the increased popularity of marijuana.7
Incarceration rates due to non-violent drug offenses are on the rise. Looking deeper into this increase, you can see that there are also racial implications. People of color comprise 60% of the imprisoned population—African Americans make up 62.6% of drug offenders in state prisons.8 In the entire U.S., the prison admission rates on drug charges for black males is 13 times higher than the admission for white males.7
Men and women who have served extensive prison sentences for nonviolent drug offenses are not only left with little or no social support once released, but they also suffer high rates of recidivism. Many convicted felons are not able to secure legitimate employment upon release. Thus, the prison system can become a revolving door without sufficient rehabilitation strategies. If policy makers wish to decrease rates of illicit drug-related violence and crime, this system may require further examination and change.
Illicit drugs lead to negative health effects, and the health risks increase with the frequency and quantity of the use.8 Unfortunately, people are often not aware of the health consequences their drug use has caused until it is too late. Due to the magnitude of these health effects, policy makers have passed some legislation that attempts to minimize the overall impact of illicit drug use on society.
Adverse health outcomes in illicit drug users can include:9
Most deaths from drug overdose are unintentional or accidental in nature, and this risk increases when drugs are combined, such as when illicit drugs like heroin are combined with additional respiratory-depressing substances like alcohol or benzodiazepines.9 Illicit opioid use is also a significant cause of fatality from overdose, accounting for more than triple the amount of deaths in 2009 than 1999.10
Illicit drugs have harmful and sometimes unpredictable effects, since their production is not regulated. Short-term effects of MDMA use include restlessness, anxiety, hyperthermia, and swelling in the brain.11 More severe health consequences of MDMA use, such as liver dysfunction, cardiovascular problems, psychosis, coma, and death, are rare and are more reflective of impure street MDMA.11
Illicit drugs have harmful and sometimes unpredictable effects, since their production is not regulated.
Stimulant drug overdoses can lead to arrhythmia, stroke, and cardiac arrest. This only touches on the short-term outcomes, but a drug like cocaine, for example, can lead to long-term defects ranging from liver, kidney, and lung damage to mental issues like psychosis.12
Illicit drug use further impacts the health of pregnant women and their developing fetuses. A higher incidence of fetal exposure to methamphetamine has been shown to lead to prenatal complications, such as “intraventricular hemorrhage, fetal growth restriction, decreased birth weight, cardiac abnormalities, cleft palate, and behavioral effects in neonates.”13
These serious outcomes related to illicit drugs have led policy makers and providers to come up with more effective treatment goals. In response to the opioid and heroin epidemic and associated public health problems, federal, state, and other vested parties are implementing a series of policies and programs focused on eliminating the inappropriate or over-prescribing of opioids. These efforts include educating health professionals and the public about substance misuse, implementing prescription drug monitoring programs, and enforcing regulatory actions to stop haphazard prescribing.3
In response to the issues associated with methamphetamine, Congress passed the Comprehensive Methamphetamine Control Act, which limits access to precursor chemicals and amps up consequences for the manufacturing and trafficking of methamphetamine.5
The public health system in the United States is made up of a network of private and public entities that coalesce on national, state, and local levels, so the responsibility for establishing conditions that allow individuals to thrive is shared among these 3 levels.14 At the federal level, the White House revealed a $1.1 billion budget proposal to Congress in early 2017 that included a request for more funding for health care services needed to combat the addiction crisis. This request represents the largest increase in direct federal funding for treating substance use disorders in decades.
To get a sense of the societal costs of illicit drug use, a recent Surgeon General report estimated the yearly economic impact on the United States at $193 billion.1 Drug-related crime costs are measured at $61 billion, while more than 60% of those arrested have illicit substances in their system when detained.15 Environmentally, methamphetamine use cost California $5.5 million to clean up in 2001.5 Add in the more than $11 billion in costs to the healthcare system for drug intervention and treatment and an estimated $120 billion hit on workplace productivity, and the impact becomes painfully evident.9
Drug-related crime costs are measured at $61 billion, while more than 60% of those arrested have illicit substances in their system when detained.15
Hospital and ER visits, inpatient stays, outpatient costs, primary care, and total medical costs all factor into the complicated financial situation exacerbated by illicit substance abuse.1 Medicaid and Medicare often insure most people who don’t otherwise have access to healthcare or treatment coverage.
Detox and rehab (outpatient and inpatient) can be costly, depending on the length of stay and what amenities are offered in the facility. Often, people who are severely addicted go through a detox facility first and then enter an inpatient or outpatient treatment program for an extended time. Most insurance companies will only pay for a portion of the treatment (usually 30 days), yet effective treatment often requires lengthier care. All of these interventions can incur separate costs.
Many people don’t realize some of the other hidden costs of illicit drug use, such as the toll it takes on work productivity. Businesses can suffer from the illicit drug problem by losing employees or from theft, which lowers productivity. It takes time and resources to train staff, especially when there is high turnover due to such issues. Communities that are overtaken by addiction, violence, and drug-related crimes suffer economically.
Reviewing this information as a whole, it becomes very evident that illicit drugs are a pervasive societal problem, warranting serious attention and effective solutions.