Substance Abuse in Young Adults between 18 to 25 years
Introduction
Substance abuse is the harmful use of psychoactive substances which may include drugs and alcohol. It is referred to as abuse because the consumer uses the substance in harmful methods or harmful quantities which can lead to addiction or any other negative effect. Drug and substance abuse is harmful to human health as it can lead to complications that are costly to manage. Substance use remains a behavioral problem among the youths in the United States. Reports show that among the 35.6 million youths in the United States, one-third of this population was reported to have been using alcohol for the past one month while a fifth of the population was reported to engage in illicit drugs. More to this, the use of alcohol has been declining over the years while the use of illicit drugs is ion the rise. In spite of the increase in drug users, the intervention and treatment remained stable. Thus, prevention and treatment of victims of substance abuse remain on the analysis, particularly the programs interventions and the relevance of advanced nursing practice in the treatment and management of drug addicts.
Substance abuse in the United States has been reported to affect most of the young adults more so those between the age of 18 and 25. Due to this, nurses are called to intervene so that they can take part in the reduction and treatment of drug abuse victims. The significance of the prevention strategy to the nursing practiced is that it will enhance their psychosocial interventions among the addicts. That is, with their involvement in the treatment and management of substance abuse addicts, they will learn new tactics including reflective practice which will increase their knowledge. For nurses to offer mental and physical health to victims of substance abuse, they have to acquire relevant training in mental health and understand youth and adult health. This calls for improved education standards for all registered nurses which be offered in all educational institutions and which will allow nurses to handle victims of drug abuse. Advanced practice nurses will be in a position to apply their knowledge skills and competency in the treatment and management of Youths in the United States.
The program is expected to increase collaboration of nurses with other medical professionals where nurses are expected to work closely in a team to promote the program intervention. It will promote management of teams and improve quality in practice where the nurses will be responsible for service development, quality governance, clinical audit as well as their participation in further research. Their involvement will call for training of the non-specialist staff so that they can play a part in prevention and control of substance use among young adults in the United States. The advanced practice nurses will reduce the issue by offering relevant interventions and treatment to the victims of drug abuse. The interventions include education such as offering public health information to the victims which will help in improving their position. Advanced practice nurses have the role to prescribe and offer all clinical services which act as their resources during their intervention.
Population
Although cases of substance abuse reported in the United States include individuals among all ages, the most affected population is young adults between 18 to 25 years. Youths are the people who are easily influenced to engage in deviant behaviors, substance abuse being one of them. Stressful circumstances, social, economic status, level of education, neglect, physical and sexual abuse, deviant peer relationships, peer pressure, and emotional abuse are among the recognized factors that have driven most of the youths to substance abuse. Youths above 21 years have a high tendency to engage in drug abuse as compared to those between 18 and 20. As a result, most of the American youths have developed mental disorders while some have joined rehabilitation centers due to addiction. Thus, they are the target of the research topic with the aim of developing solutions that will help in the prevention and treatment of substance abuse cases.
Program Specific for Youths
To curb the effect of substance and drug-use among the youths, Now Is the Time Initiative which is under SAMHSA was implemented. This program promotes and comes up with early intervention strategies that aim at reducing the impact of substance use disorders and mental disorders associated with drug abuse. The program reported that 16.3% of the youths between 18 and 25 are dependent on drug abuse and the rate have been increasing yearly. The program applies to the whole American community, and recently, it has shown its great concern towards youths being the largest population to indulge in drug abuse. Since mental and substance abuse disorders have a great impact to the health of individual youths, families, and communities, the program aims at preventing the outcome of substance abuse at an early stage as well as reducing the impact of associated disorder not only to the individual but the community at large.
Cost of Managing Substance Abuse
Drug and substance abuse among the youths remains a significant health problem in the United States. The behavioral patterns that are developed by the youths during their developmental period predict their current health status as well as the risk of developing complex conditions during their adulthood. Youths between 18 and 25 are more susceptible to participate in drug and substance use due to the underdeveloped state of their brain which impacts on their ability to make wise decisions (Brown, 2013). The youths are also at risk of developing long-term effects of drug use due to continual use of such drugs. Thus, the issue of drug abuse is not only an individual concern but has a great effect on the family, community and healthcare sector in general.
The youths who are involved in regular substance abuse are at risk of contracting drug abuse disorders. Somani & Meghani, (2016) reported that the global Hepatitis C is a common disease to those who inject drugs and according to the reported cases of Hepatitis C in the year 2011 who were approximately 7.2 million, 1.2 million of those had contracted Hepatitis B virus while 1.6 million of those had contracted HIV. This confirms that there is an increased risk of diseases to those who abuse drugs as compared to those who have never consumed drugs and alcohol in a lifetime. HIV rates are also increasing among youths due to sharing of needles used when injecting drugs. The injections also increase the risk of developing lung cancer among the youths. Apart from these conditions, substance abuse triggers mental health problems some of them including developmental lag, withdrawal, apathy and attempted suicide. Most suicidal cases reported are as a result of depression emanating from drug and substance use.
Drug and substance abuse cause deaths among the youths. Somani & Meghani (2016) affirmed that among all deaths reported in the year 2011, 200, 000 were drug-related deaths. This is a huge number more so when it is associated with the youths who hold the future of tomorrow. Other effects of drug and substance abuse included assaults, rapes, teen suicides, traffic fatalities, child abuse, murder, and theft. Some reported having dropped out of school due to poor performance and failure to cope with other students. Some youths are reported to have harmed themselves without knowing which transfer the cost of care to parents. Drug use leads to loss of productivity among the youths hence loss of employment and career.
Drug abuse imposes a cost not only on a family but in the community. Families with such victims are greatly affected emotionally especially when the victim was the soul breadwinner. Cases of domestic violence have been reported among drug users were they become aggressive due to drug addiction. The cost of drugs used to treat and manage these victims is high which involves the whole community to take part in the treatment. Also, the cost of rehabilitation is left as part of the family as well as the community which can lead to a deteriorating society. This is because the community has to offer support regarding programs and intervention to control the use of substance and alcohol which can also be expensive. Besides the cost of medicine, substance abuse can lead to multiple hospital admissions, disease, accidents, deaths and disabilities which have a great impact on families and communities involved.
Substance abuse has a great impact on the United States healthcare system. This is because out of the 5 Medicaid dollars spent in hospitals, one belongs to substance abuse patient. Also in every five covered Medicaid patients, one patient is under drug abuse. This means that the United States health care system spends more resources on the treatment and management of substance abuse victims. Also, in all patients that required hospitalization on a daily basis, more than 70 cases were attributed to drug and substance abuse (Dart, 2017). Since substance abuse may sometimes complicate care, high cost is experienced by the United States healthcare system hence effective interventions should be made regarding the issue. Some estimates reveal that $520.8 billion is spent yearly in the treatment and management of substance abuse related disorders which could have been used on another project.
Program Goals/Interventions
The primary goal of Now Is The Time initiative is to protect youths and young adults between 18 and 25 by ensuring schools are a safe place and making mental health services accessible to the youths. The initiative has several programs all aimed at improving the health of the youths on matters relating to mental health. Since it is under SAMHSA, it will be implemented by SAMHSA where all programs related to it will also be implemented. Program implementation can only be effective if several parties are involved in the implementation. SAMHSA plans to coordinate with communities, government, states and other territories in the implementation and adoption of the initiative which will prevent mental health disorders as well as treating them. The government will enforce policies and provide resources required in the program for it to be effective in the United States.
The program aims at improving access to treatment and other support services for all youths and young adults at risk of serious mental conditions, those who are already experiencing mental condition as well as the whole society. It will also increase awareness of the symptoms of mental conditions by educating youths on such and other related symptoms. It is expected to come up with appropriate services and interventions for young adults so that they can manage mental health problems with their families. To achieve this, SAMHSA will offer support to the establishment of Prevention Prepared Communities (PPC) who will work together to achieve to promote the emotional health of young adults.
Another goal of the SAMHSA is to train all health care providers and communities in a way that they can improve services and support to young adults between 18 and 25. This was a way to form a strong and a prevention-oriented team that will aid in achieving their prevention goal. Healthcare providers are involved in the treatment of drug addicts while the community is responsible for offering guidance to these young adults so that they can get rid of drug and substance abuse. This will be enhanced by collaborating with the United States Department of Education and prevention Prepared Communities (PPC) so that they can all train communities and providers in various ways to improve services offered to the addicts. With such training, effective treatment and management of drug addicts in the community will be promoted thus reducing cases of mental health disorders. This will also promote the social and emotional well-being of the affected youths.
The program also plans to prevent substance abuse and improve the overall health of the communities, territories, and tribes in the United States through collaboration. To ensure this is effective, the program will make use of SAMHSA Block Grant in conjunction with other prevention programs initiated by the federal government in the prevention of substance abuse among the youths between 18 and 25 as well as promoting their overall health. It will involve the communities and territories to promote healthy behavior among the youths in the community since these behaviors are adopted from the same community. Parents and other family members are informed to take their roles in the prevention and promoting healthy behavior among the youths between 18 and 25 years.
Evidence-based Literature to Support the Intervention
The need to protect children and communities from developing mental disorders associated with substance abuse led to the implementation of NITT initiative. Also, the increased health expenditure due to increased cases of substance abuse disorders necessitated a program that could control and prevent youths from engaging in substance and drug abuse. Many workplaces are also looking for initiatives that can protect employees from mental disorders. Gaskell (2018) reported that at least 41% of employees have reported cases of mental health illness. This is quite a large number, and any untreated mental health costs an employer more than €33 billion yearly due to reduced productivity and cases of absenteeism. This poses a threat to many employers because in most cases, 40 percent of employees will try their best to cover up the mental issue from their employer (Gaskell, 2018). Now is the Time initiative has been employed in many workplaces where employers are responsible for devising a mental plan for their employees so that they can be aware of their mental illness.
A study by Straessle (2017 confirmed the effectiveness of SAMHSA in the prevention of substance abuse. This is where all prevention efforts were oriented towards risk factors of substance abuse and protective factors that youth should embrace to avoid temptations of indulging in drug and substance abuse. Also, the number of state-funded coalitions that prevent and promote the well-being of youths and communities were reported to have increased from 34 to 43 by the year 2016. This is an indication that different countries in the United States have adopted the program as the prevention measure of substance abuse. Research by Straessle (2017) stressed that even though the program is effective in some cases, it should be incorporated with other programs such as ACE to meet the goal of the initiative.
Another research by Das (2016) revealed the use of various substance abuse interventions in schools, and although different approaches have been included in his work, it is clear that long-term follow-up for the impact of these programs is not available. The study involved youths between the age of 11 and 19 and the study was qualitative. This necessitates SAMHSA NITT initiative which not only prevents substance abuse but ensures that the programs implemented meet the initial goal of the initiative. His findings uncovered the need to have programs that will focus on evaluation effectiveness of the interventions made to the young youths so that improvements can be suggested regarding the cases. With SAMHSA NITT, evaluation of the programs is assured together with suggestions of services that should be initiated for managing young adults addicted to substance abuse.
Assessment of Resources
SAMHSA have used various resources in preventing substance abuse and mental disorders among all youths between 18 and 25 years. To enhance the prevention of substance abuse, it released two publications that promote the improvement of patients health after the mental disorder. The program has several websites where information on drug and substance avoidance can be accessed and explains medication-assisted treatments that should be adopted by victims of opioid and alcohol abuse. In addition to this, the program has devised Opioid Overdose Prevention Toolkit that can be used by providers and local government in developing policies against drug and substance abuse. Another resource is Medication for Treatment of Alcohol Use Disorder (MTAUD) that guide patients on medication-assisted treatment and also nurses during their practice.
Barriers to Change
During program implementation, barriers likely to exist include lack of enough resources to facilitate the program or resistance to change. Different programs have been used in the prevention of drug and substance abuse, but the use of this new initiative can be challenging. Barriers associated with this program implementation include lack of supportive teams and lack of cooperation from other agencies and communities involved. A failed senior leadership can lead to the failed program since every program has a leader who guides others on the way forward.
In the United States, barriers were reported in the implementation of the program more so in the rural areas. This was due to inadequate resources to facilitate the program, and in some regions, communities were unwilling to take part in the program implementation. Also in the United States, there are fewer facilities. Thus, not all patients are served in those facilities. Lack of specialty substance abuse treatment programs restrict the minorities in the rural areas. Hence, a large population in the rural areas of the United States is underserved.
Summary
Substance abuse in the United States has been reported to affect most of the young adults more so those between the age of 18 and 25. The impact of drug abuse is not only at an individual level, but it affects families, communities and healthcare systems. Due to this, the United States have developed programs that act as an intervention for the increasing problem of drug and substance abuse. SAMHSA has been proposed as it reduces the use of drug and substance, promotes treatment and well-being of individuals as well as creating better and healthy communities. The program will also promote the nursing practice career as they are involved in the treatment and management of drug abuse addicts. Although it is expected to meet several goals, the implementation might be a challenge due to financial constraints.