Addiction Medicine: Closing the Gap between Science and Practice

Four out of every 10 (39.6 percent) fatal traffic
crashes involve a driver who is under the
influence of alcohol* or who tested positive for
other drugs.^99

Overdose deaths caused by controlled
prescription drugs and illicit drugs have
increased five-fold since 1990^100 and now
surpass the total number of deaths caused by
traffic accidents.^101

Individuals with addiction are at increased risk
of potentially fatal diseases including cancer,^102
heart disease^103 and sexually-transmitted
diseases.^104 More specifically, smoking
contributes to multiple types of cancer as well as
heart and respiratory disease.^105 Alcohol
contributes to some of the leading causes of
death, including heart disease, cancer and stroke,
as well as to other serious illnesses such as
cirrhosis, hepatitis and pancreatitis.^106 Injection
drug use contributes to HIV, hepatitis C and
hepatitis B.^107 CASA Columbia’s research
found that risky substance use and addiction
cause or contribute to more than 70 other
conditions requiring medical care, including
cancer, respiratory disease, cardiovascular
disease, pregnancy complications, HIV/AIDS,
cirrhosis, ulcers and trauma.^108 (See Table 3.9)

• Has a blood alcohol concentration of 0.08 or higher.

The many negative consequences of our failure

to prevent risky substance use and treat

addiction extend beyond the individual to

family, friends, community and society.^109

Risky substance use and untreated addiction

contribute to family dysfunction and financial

troubles, disrupted social relationships, unsafe

sexual practices, unplanned pregnancies, lost

work productivity, legal problems, poor

academic and career performance,

homelessness, property and violent crimes,

domestic violence, child abuse and neglect,

rapes and other sexual assaults and motor

vehicle crashes and fatalities.^110

Risky substance use and addiction adversely

affect the mental health of other family members

as well. Family members ages 19 and older are

at approximately twice the risk of having

addiction or clinical depression as those ages 19

and older in families without a member with

addiction, and they have higher health care

costs.^111

Children and adolescents are particularly

vulnerable to the health consequences of

substance use.^112 Approximately 70 percent of

child welfare cases are caused or exacerbated by

parental risky use and addiction.^113 Children

exposed to parental substance use are at

increased risk of emotional and behavioral

problems, conduct disorder, poor developmental

outcomes and risky substance use and addiction

in adolescence and adulthood.^114 Children and

adolescents with family members who have

addiction are more likely to be diagnosed with a

number of medical conditions, including asthma,

depression, headaches, attention deficit/

hyperactivity disorder, trauma and addiction,

than children in families of similar demographic

characteristics who do not have a member with

addiction.^115

Table 3.8

Deaths Attributable to Substance Use

Deaths/Year
Total Deaths Attributable to
Substance Use

578,819

Tobacco 443,000
Alcohol 98,334
Other drugs 37,485*

• Based on data from 2009.

Sources: Tobacco--Centers for Disease Control and
Prevention (2008); Alcohol--CASA Columbia
analysis of the Alcohol and public health: Alcohol-
Related Disease Impact (ARDI) (2012); Other
Drugs--Centers for Disease Control and Prevention
(2010); Kochanek, K., et al. (2011).