Demographics of Alcohol Use Disorder in the United States

"Consistent with previous research, rates of AUD [Alcohol Use Disorder] were greater among men than women.1,2,5,14 Age was inversely related to 12-month AUD, a finding also observed in earlier epidemiologic studies.1-5,14 Whether this result is owing to cohort effects, differential mortality, or recall bias merits further investigation. The 12-month rate of 7.1% for severe AUD among 18- to 29-year-old respondents is especially striking.

Estimated Prevalence of Drug Use Disorder in the United States

"In 2012–2013, the NESARC-III [National Epidemiologic Survey on Alcohol and Related Conditions–III], a large national survey of US adults, assessed 12-month and lifetime disorders, including DUDs, diagnosed according to the new DSM-5. The NESARC-III used rigorous survey and field methods and incorporated measures of functioning and detailed assessments of treatment use. The NESARC-III results indicate that the prevalence rates of 12-month and lifetime DSM-5 DUD were 3.9% and 9.9%, respectively, representing approximately 9,131,250 and 23,310,135 US adults, respectively.

Drug Dependence Treatment and Sustained Recovery Management

"Drug dependence treatment—within an acute care, symptoms-focused paradigm—has fallen short of properly addressing the complex, multifactorial nature of drug dependence that often follows the course of a relapsing and remitting chronic disease. There is disillusionment with the 'admit, treat, and discharge', revolving door cycles of high dropout rates, post-treatment relapse, and readmission rates.

Opioids and Pain Management

"Opioid analgesics are useful in managing acute and chronic pain. They are sometimes underused in patients with severe acute pain or with pain and a terminal disorder such as cancer, resulting in needless pain and suffering. Reasons for undertreatment include
"• Underestimation of the effective dose
"• Overestimation of the risk of adverse effects

How Federal Surveys Estimate the Prevalence Of Substance Use Disorders

"Illicit drug use disorder is defined as meeting DSM-IV criteria for either dependence or abuse for one or more of the following illicit drugs: marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, or prescription psychotherapeutic drugs that were misused (i.e., pain relievers, tranquilizers, stimulants, and sedatives). There are seven possible dependence criteria for specific illicit drugs:
"1. spent a lot of time engaging in activities related to use of the drug,
"2. used the drug in greater quantities or for a longer time than intended,

Marijuana is not a gateway drug

"Our results indicate a moderate relation between early teen marijuana use and young adult abuse of other illicit substances; however, this association fades from statistical significance with adjustments for stress and life-course variables. Likewise, our findings show that any causal influence of teen marijuana use on other illicit substance use is contingent upon employment status and is short-term, subsiding entirely by the age of 21. In light of these findings, we urge U.S.