Drug Abuse in the United States

by Ministry of Foreign Affairs of the People's Republic of China

Introduction

The challenge arisen from the use of drugs is an international one; it is most acute in the United States. Twelve percent of global drug users come from the country, three times the proportion of the U.S. population to that of the world. Based on facts and statistics, this report examines the gravity, causes and economic and social costs of drug abuse in the United States.

I. Drug Abuse: A Social Malaise in the United States

◆ The U.S. National Center for Drug Abuse Statistics (NCDAS) lists eight categories of drugs most commonly used in the country: alcohol, cannabis, cocaine, fentanyl, opioids (mainly referring to psychotropic substances under control), prescription stimulants, methamphetamine and heroin. Forty-six percent of U.S. drug users report having experience using cannabis and prescription stimulants, 36 percent opioids and methamphetamine, 31 percent prescription stimulants, 15 percent heroin and 10 percent cocaine.

◆ In 2021, findings by NCDAS show about 19.4 percent of Americans have used illegal substances at least once. Out of the 280 million aged 12 and older, 31.9 million are drug users, with 11.7 percent on illegal substances and 19.4 percent either having consumed illicit drugs or misused prescription drugs in 2020. If alcohol and tobacco users are included, the number of people in the United States who are abusing substances totals 165 million.

◆ During the past 12 months, 48.2 million Americans over the age of 18 consumed cannabis at least once. Between 2018 and 2019, use of the substance increased by 15.9 percent. Though outlawed by the federal authorities, cannabis is legal in 15 states for recreational use. The cannabis industry in the country surged despite the onset of the COVID-19 pandemic. When many businesses closed in March 2020 amid the pandemic, cannabis pharmacies in the eight states that legalized the substance were able to maintain their "essential businesses" because sales were allowed to continue during the period of mass home quarantine. As a result, legal cannabis sales in the United States hit a record 17.5 billion U.S. dollars in 2020, a 46 percent jump from that of 2019, according to BDSA, a platform providing cannabis sales data.

◆ During the past 12 months, 10.1 million Americans have consumed opium at least once. According to the Centers for Disease Control and Prevention (CDC), opioid is the primary driver of the spike in drug-related deaths. Between April 2020 and April 2021, 75,000 Americans died from opium overuse -- more than 75 percent of the total deaths from drug overdose and a 50 percent rise year on year.

◆ Each year, 95,000 people in the United States die from alcohol abuse. During the COVID-19 pandemic, over 60 percent of Americans increased their consumption of alcohol. According to the latest data, 25.8 percent of those aged 18 and older reported binge drinking in the past month, and on any given day 261 Americans would die from excessive drinking, 80 percent of whom are adults over the age of 35.

◆ Adolescents experience the fastest rise in drug overdose deaths. In this group, the 18 to 25-year-olds are the heaviest drug users, with 39 percent of them using drugs. For the 26 to 29-year-olds, it is 34 percent. Seventy percent of drug users try illicit drugs before the age of 13, and drug users as a population group is becoming younger. The Journal of the American Medical Association (JAMA) reports that between January 2021 and June 2021, about 1,150 youngsters aged 14 to 18 died from drug overdose, a 20 percent increase from that of 2020 and more than doubling the number in 2019. In addition, 47 percent of adolescents start consuming illicit drugs upon graduation from high school.

II. Enormous Social Cost of Drug Abuse in the United States

◆ Drug overdose exacts a high death toll on the U.S. population, greatly eroding the base of labor force and weighing on life expectancy. According to a report on the American journal Science, American death toll of drug overdose has increased exponentially over the past 38 years -- up 9 percent almost every year and doubling about every eight years. A record high of 72,000 deaths was registered in 2017. The report also shows drug abuse plagues almost all states in the United States, with only a few exceptions, i.e. South Dakota, Nebraska and Iowa. In the past decade, drug abuse deaths in the country have risen significantly; the numbers more than tripled in Delaware and New Hampshire. According to the CDC, in the year following the outbreak of the pandemic (from April 2020 to April 2021), more than 100,000 people in the United States died from drug overdose, eight times that of shooting incidents, and nearly tripling the number of deaths in traffic accidents. Between 1999 and 2017, there were more than 700,000 cumulative deaths from drug overdose in the United States. Drug overdose in the country has claimed more lives than AIDS, traffic accidents and shootings, and 70 percent of the deaths are men between the age of 25 and 54.

◆ Drug abuse engenders frequent social problems. The damage to cranial nerves caused by drug taking may aggravate anxiety and cognitive disorder, induce some mental illnesses, and cause emotion dysregulation, thus leading to problems like family discord, violent crimes, and psychological trauma in children. In addition, people caught using illegal drugs may be punished by being separated from their family and deprived of job opportunities, welfare assistance, public housing and voting rights. As a result, discrimination against drug users continues, and stigmatization will further intensify inter-generational poverty and racial discrimination. This forms a vicious cycle, which is detrimental to American society and becomes an "American disease" that cannot be fixed easily. As the protracted COVID-19 pandemic and growing inflation and unemployment exacerbate anxiety and the sense of isolation among people in American society, drug abuse has become increasingly severe, and the number of people addicted to drugs has soared.

◆ Drug control incurs tremendous social cost. Such cost is entailed in crime fighting, health care, productivity loss, drug education and the prevention and treatment of other social problems. Among them, fighting drug-related crimes and health care cost the most. Since 1971, the United States has spent one trillion U.S. dollars combating drug-related crimes, according to a study by the University of Pennsylvania. In 2017, the cost of drug control in the United States exceeded 270 billion U.S. dollars.

III. Multiple Causes of Drug Abuse in the United States

For years, the U.S. federal and state governments have vowed to vigorously tackle the drug problem, but have in fact failed to take substantive measures due to lobbying by various interest groups. Drug abuse in the United States is a reflection of deep-rooted social problems, and the result of an interplay of economic interests, lobbying, and social and cultural factors.

◆ As the U.S. economy expanded after World War II, the rapid growth in national wealth created an unprecedentedly prosperous consumer market, including an active drug trade. By the 1960s, the nationwide hippie movement and the hippie culture it generated were ubiquitous in the United States, a part of which was "drug culture." Under the influence of "drug culture," drugs such as cannabis and heroin quickly became popular among young people. The hippie movement brought drugs to the public, and its promoters claimed that cannabis was harmless and not a narcotic drug. Apart from that, they pushed for the social acceptance of cannabis abuse on the grounds of human rights and liberty, and called for its legalization. After the late 1970s, as the public witnessed the tremendous harm that drug abuse caused to society, families and individuals, there was a convergence in American people's perception of drugs and drug control. By the mid-1980s, calls for drug legalization waned, but there was no substantive improvement in the drug problem in the United States. Since the 1990s, calls for drug legalization have risen again in the country.

◆ The U.S. government has pushed for the legalization of cannabis and other drugs out of economic considerations. Legalizing cannabis allows the government to generate significant tax revenues from the legal drug market, and in return, the distribution of such revenues becomes an important driver of drug legalization. The U.S. government has justified drug legalization to cover the fact that it would do anything for economic gains.

◆ In 2014, cannabis was legalized in Colorado. Since then, the cumulative sales of cannabis have exceeded one billion U.S. dollars. However, the number of deaths from various kinds of drug abuse in the state has reached record highs. According to The New York Times, American parents said it got much easier for teens to obtain cannabis after its legalization in Colorado, potentially seriously endangering their brain development. Some experts said in interviews that they had treated a number of patients with symptoms related to drug addiction including severe vomiting due to cannabis use, including children who intentionally or accidentally consumed cannabis. The legalization of cannabis has further boosted the black market, which in turn puts great pressure on the judicial system and threatens social security. A large number of criminal organizations grow cannabis in Colorado and then smuggle it into other states where it is illegal, making the cannabis trade more active and law enforcement more difficult.

◆ Knowing the serious social problems brought by the legalization of cannabis, the U.S. government has not responded by strengthening cannabis control, but instead further promoted drug legalization. Between its people's lives and health and economic interests, the U.S. government has chosen the latter, which is an important factor in the sustained push for drug legalization in the country. According to the Manhattan Institute for Policy Research, an American think tank, one could hardly see in the National Drug Control Strategy issued by the U.S. government the important roles the government is supposed to play in fighting one of the biggest public health challenges. Instead, it has sat idle as drug and substance abuse worsens.

◆ Interest groups in America keep fanning the flame of the drug problem. In order to maintain their profits, large pharmaceutical enterprises in the United States throw a large amount of money into sponsoring experts and associations to peddle the narrative that "opioids are harmless." What they want is to push for drug legalization and prod pharmacies into promoting drug sales and doctors into indiscriminate prescription of drugs. As a result, some patients have unknowingly developed drug addiction that they could not get rid of. After analyzing disclosed data from the U.S. Senate, the OpenSecrets website found that the marijuana and cannabis industry, which involved more than 20 businesses, spent as much as 4.28 million U.S. dollars on lobbying in 2021 alone. In addition, Amazon paid 14.5 million U.S. dollars between April and December in 2021 for funding lobbying activities, including for the Marijuana Opportunity, Reinvestment and Expungement Act of 2021 (MORE Act) which supported the legalization of cannabis. For the same purpose, the American Civil Liberties Union spent 920,000 U.S. dollars on lobbying between July and December in 2021. British American Tobacco and the Altria Group spent nearly 2.1 million and 6.6 million U.S. dollars respectively in 2021 on lobbying for the MORE Act. The House of Representatives actively considered bills that promote the legalization of marijuana and cannabis. "We don't need to convince people to believe in cannabis. We need to convince them to buy legally," said Cory Rothschild, vice president of a U.S. company in the cannabis industry.

◆ The drug culture influences America's drug policies. The U.S. drug culture has been shaped by the country's development history and directly affected the adjustment and evolution of America's drug policies. Due to pressure from both work and life, many people in the United States choose to take drugs for relief or leisure. Against this backdrop, in order to prevent people from using medical treatment as a pretext for drug abuse, U.S. federal law stipulates that one must present prescription by a doctor when purchasing certain drugs. However, this policy has big loopholes in terms of supervision, and drug abuse is prevalent in the United States. Pharmacies could still sell psychotropic drugs at will. As hospital reimbursement is directly linked to patient satisfaction, many doctors are forced to prescribe psychotropic drugs.

◆ The COVID-19 pandemic has made long-existing social problems even worse in the United States, and the pressure caused by such problems as gun violence, racism, social injustice and huge wealth gap is increasingly felt by young people. The various difficulties faced by young Americans are a reflection of America's persistent social illness. On the one hand, the widening gap between the rich and poor in the United States gives young Americans more doubts about the "American Dream" as they could hardly see room for upward mobility. On the other hand, young people no longer feel proud of America due to intensifying social inequality, racial conflicts and other problems. A Gallup poll showed that Americans' pride in the United States hit a record low in 2020. Only 36 percent of the respondents aged 18 to 24 said they were proud to be American, while 35 percent did not express pride in being American. In December 2021, the Kennedy School of Government at Harvard University published the findings of its survey, which showed that 52 percent of the respondents believed American democracy was "in trouble" or "failing"; only 7 percent of young Americans viewed the United States as a "healthy democracy"; 51 percent of the young respondents had "felt down, depressed and hopeless" at least a few times in the past two weeks; 25 percent of the respondents had thoughts of self-harm; and 25 percent of them believed the cause of their mental health problems was economic concerns. As young people's confidence in the United States drops dramatically and the pressure they face keeps growing, more and more of them turn to drugs to relieve their stress.

◆ The drug problem is a manifestation of America's failure in social governance. According to Howard Koh, former Assistant Secretary for Health for the U.S. Department of Health and Human Services, drug and substance abuse in the United States is one of the most devastating public health disasters. Apart from causing heavy burdens on the public health system, it could make millions of people lose their homes or jobs, become truant or face family breakdown. The COVID-19 pandemic masked this crisis, but in the meantime also amplified it. The crisis showcases the U.S. government's failed regulation across multiple systems, and it is imperative to make prompt, unified and comprehensive response.

Conclusion

The drug problem of America is a long-standing and deep-rooted disease that is yet to be cured. The U.S. government has not done enough to raise public awareness of the harm of narcotic drugs; the measures it took to reduce drug demand are ineffective; and its drug control actions produce poor results. The United States should face its own problem squarely, take actions to deal with the domestic issue of prevalent drug abuse, and protect the American people's right to life and health, instead of shying away from the problem.

The fight against drugs requires, first and foremost, one's own efforts. At the same time, it also needs cooperation among all countries. The United States should stop making unwarranted accusations against China and undermining China-U.S. counter-narcotics cooperation. Even less should it mislead the public and shift its responsibility for ineffective response to drug abuse at home onto others.