Module 2 Transcript: Just the Facts

Module Overview
In this section, you will explore:
• Your role in the prevention field
• Substance abuse and mental health statistics
• Key terms associated with substance abuse prevention
• Reasons for substance use

Faces of Prevention
At the beginning of this course, you heard from several people involved in prevention. Of the stories you
heard, which one(s) relate to your experience with prevention?

(Photos of the six characters introduced in the module one video appear on screen. Learners are asked to
select those characters to which they relate.)

In addition to these examples, many different people at the community and state level help prevent substance
abuse and other related behavioral health problems in various ways.

What Does Prevention Mean?

The examples in the previous activity depicted some aspects of the substance abuse prevention field.

What do we mean when we talk about substance abuse and prevention?

Substance abuse and dependence, poor emotional health, and mental illnesses take a toll on individuals,
families, and communities. They cost money, and they cost lives.

While the prevention of substance abuse involves reducing or stopping the abuse of alcohol, drugs, and
tobacco, it is also much more than that.

It involves decreasing or preventing the consequences of substance use in communities – such as traffic
fatalities, the expense associated with abuse and dependence, and even the emotional burden that these
problems can generate.

Just as important – prevention involves building the mental and emotional health of individuals and creating
communities that support and encourage healthy development.

This is a big job, but many different people, working in a variety of settings and capacities, can get the job
done.

Looking at the Numbers

The data about substance abuse is staggering and emphasizes the need for prevention.
Please answer the following six questions. You will not receive a grade for these questions.

Question 1:
By the year [blank], mental and substance use disorders will surpass all physical diseases as a major cause of
disability worldwide.
 a. 2020
b. 2025
c. 2030
d. 2035
The correct answer is 2020.

Question 2:
An estimated 23.5 million Americans ages 12 and older needed treatment for an illicit drug or alcohol use
problem in 2019 – that is almost one out of every [blank] people.
a. 3
b. 5
c. 10
d. 15
The correct answer is 10.

Question 3:
The annual total estimated societal cost of substance abuse in the United Sates is about [blank]?
a. $11 million
b. $711 million
c. $111 million
d. $511 million
The correct answer is $511 million.

Question 4:
Approximately [blank] percent (or 2.5 million) of adults with a serious mental illness are also dependent on or
abused drugs or alcohol.
a. 5
b. 15
c. 25
d. 35
The correct answer is 25.

Question 5:
Half of all lifetime cases of mental and substance use disorders begin by age [blank], and three-fourths begin
at age 24.
a. 14
b. 16
c. 18
d. 22
The correct answer is 14.

Question 6:
[blank] percent of Americans believe addiction can be prevented.
a. 22
b. 44
c. 66
d. 99
The correct answer is 66.
Key Terminology
Did you know…Many people use substances such as alcohol, tobacco, or drugs (including over-the-counter
medications) at some point in their lives. But what is the difference between use and misuse, or abuse and
dependence? There are many different definitions for these terms.

This page lists definitions of substance use, misuse, abuse, and dependence preferred by the Substance Abuse
and Mental Health Services Administration (SAMHSA).

Substance Use
Substance use is the consumption of low and/or infrequent doses of alcohol and other drugs such that
damaging consequences may be rara or minor. Substance use might include an occasional glass of wine or
beer with dinner, or the legal use of prescription medication as directed by a doctor to relieve pain or to treat
a behavioral health disorder.

Substance Misuse
Substance misuse is the use of a substance for a purpose not consistent with legal or medical guidelines. This
term often describes the use of a prescription drug in a way that varies from the medical direction, such as
taking more than the prescribed amount of a drug or using someone else’s prescribed drug for medical or
recreational use.

Substance Abuse
Substance abuse is when alcohol or drug use adversely affects the health of the user or when the use of a
substance imposes social and personal costs. Abuse might be used to describe the behavior of a woman who
has four glasses of wine one evening and wakes up the next day with a hangover.

According to the American Psychiatric Association’s Diagnostic and Statistical manual of Mental Disorders
(DSM-5), substance abuse falls under the larger category of substance use disorder, which is measured on a
continuum from mild to severe.

Substance abuse if when one (or more) of the following occur within a 12-month period:

1. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home
(such as repeated absences or poor work performance related to substance use; substance-related
absences, suspensions, or expulsions from school; or neglect of children or household).
2. Recurrent substance use in situations in which it is physically hazardous( such as driving an automobile
or operating a machine when impaired by substance use).
3. Recurrent substance-related legal problems (such as arrests for substance related disorderly conduct).
4. Continued substance use despite having persistent or recurrent social or interpersonal problems
caused or exacerbated by the effects of the substance (for example, arguments with spouse about
consequences of intoxication and physical fights).

Substance Dependence
Substance dependence, also referred to as addiction, is a compulsive craving for a substance. It is a chronic
and progressive disease, and withdrawal is usually characterized by physiological symptoms. People who are
addicted cannot function normally without the substance because their body depends on it, either physically
or psychologically.
Substance dependence is when three (or more) of the following occur any time in the same 12-month period:
1. Tolerance, as defined by either of the following
 a. A need for markedly increased amounts of the substance to achieve intoxication or the desired
effect or
b. Markedly diminished effect with continued use of the same amount of the substance.
2. Withdrawal, as manifested by either of the following:
a. The characteristic withdrawal syndrome for the substance or
b. The same (or closely related) substance is taken to relieve or avoid symptoms.
3. The substance is often taken in larger amounts over a longer period than intended.
4. There is a persistent desire of unsuccessful efforts to cut down or control substance use.
5. A great deal of time is spent in activities necessary to obtain the substance, use the substance, or
recover from its effects.
6. Important social, occupational, or recreational activities are given up or reduced because of substance
use.

The substance use is continued despite knowledge of having a persistent physical or psychological problem
that is likely to have been cause or exacerbated by the substance (for example, current cocaine use despite
recognition of cocaine-induced depression or continued drinking despite recognition that an ulcer was made
worse by alcohol consumption).

Knowledge Check
Now that you have viewed the definitions for substance use, misuse, abuse, and dependence, take a moment
to read the following questions and choose the term that best describes the person’s behavior.

Question 1:
A 42-year-old woman uses codeine that was prescribed to her friend.
a. Substance use
b. Substance misuse
c. Substance abuse
d. Substance dependence
The correct answer is substance misuse.

Question 2:
A 28-year-old takes a prescription antidepressant for treatment of depression. He take this medication once a
day, as directed by his doctor.
a. Substance use
b. Substance misuse
c. Substance abuse
d. Substance dependence
The correct answer is substance use.

Question 3:
A 52-year-old man drinks a fifth of scotch each night. He decided to stop drinking and experienced severe
shaking and nausea on the first day without a drink.
a. Substance use
b. Substance misuse
c. Substance abuse
d. Substance dependence
The correct answer is substance dependence.
Question 4:
A college student gets into a major car accident after a night of using marijuana with his friends.
a. Substance use
b. Substance misuse
c. Substance abuse
d. Substance dependence
The correct answer is substance abuse.

Reasons for Substance Abuse

Why do people use alcohol, tobacco, or drugs?

Common reasons for substance use are to feel good, to feel better, to do better, or because others are doing
it.

• Some people use them to feel good because the initial effects of drugs are often pleasurable.
• Other people turn to alcohol, tobacco, or drugs as a way to ease distressing feelings, anxiety
experienced in social situations, or stress from the daily pressures of life.
• Improving performance, either in sports or at school or work, is another reason people use drugs.
• Curiosity or peer pressure prompts some individuals to use alcohol, tobacco, or drugs; this is
particularly true with adolescents.

There is also a genetic component that makes some individuals more vulnerable to substance use disorders.

How is a person’s emotional health related to substance abuse?

People with a mental disorder are more at risk for developing substance abuse and dependence. Since
common reasons for substance use are to feel good, feel better, do better, or because others are doing it, it’s
evident that a person’s mental and emotional well-being is connected to substance use. When people feel
good about themselves, when they are able to manage stress, and if they bounce back from adverse
situations, then they will have less need to use alcohol, tobacco, or drugs.

So, when addressing problems with alcohol, tobacco, and drugs, it’s also important to promote mental and
emotional health.

Summary
In this module we covered:

• Your role in the prevention field

• Substance abuse and mental health statistics
• Key terms associated with substance abuse prevention
• Reasons for substance use

Please continue onto module three.