By Deni Carise, Ph.D., Chief Science Officer, Recovery Centers of America; Adjunct Asst. Professor, University of Pennsylvania, Perelman School of Medicine
As a substance use disorder treatment professional, I’ve often heard parents of young and young adult children utter the phrase “It’s not a big deal – I experimented too and turned out just fine” when describing their attitude towards drug “experimentation.” I’m not sure there ever was merit to that thinking, but I can tell you how dangerous – even deadly – the idea is that any use is “harmless experimentation” in today’s world.
As young people return to school this fall, mental health issues are top of mind for many school officials and parents. We’ve all certainly struggled with the pandemic, but this generation of youth have experienced a year like no other, most with very limited in-person social contact and inadequate education. Now they are being thrust back into “normalcy” with anxiety, fear, frustration, and more. One thing we have learned about substance use is its propensity to be viewed as a coping mechanism. But beware: there is no such thing as harmless experimenting anymore, for adults and youth alike.
The most often cited “harmless” drug is marijuana – it’s just a plant after all, right? But is it? The weed many parents (and grandparents) may have smoked in the 1960s through the 1980s contained less than 2 percent THC (tetrahydrocannabinol), the psychoactive component that alters the brain and gets you high. Nowadays, the THC concentration can range from 17-28 percent and – even more alarming – we have products such as oil, shatter, dab, and edibles that have THC concentration upwards of 95 percent. This is certainly no longer “just a plant” and we now know so much more about its impact on the developing brain. Increasing THC concentrations from 2 to 95 percent cannot possibly be viewed as harmless, and even with legalization (which trivializes the issue for many youths), many buyers still don’t even know how to gauge what levels they should buy or, sometimes, what amount of THC they are ingesting.
We are also in the midst of an opioid crisis in this country that has taken hundreds of thousands of lives since 1999 when Purdue Pharmaceuticals convinced enough people that OxyContin was non-addictive. Even after learning of its serious risk, and other prescription drugs like it, the death toll climbs, hitting record numbers this past year. In 2019, before the pandemic started, an estimated 10.1 million people aged 12 or older were misusing opioids. That number has increased during the pandemic. This suggests that we are not doing a great job educating people about the dangers of opioids and their potential addictiveness from that first dose. Opioid “experimenting” has played out for the world to see, sadly with disastrous results.
We also have methamphetamine and cocaine making unwelcome comebacks, but these aren’t the same drugs from the past either. One analysis of more than 1 million drug testing results from routine health care settings found that positive hits for meth were up nearly 487 percent from 2013 to 2019, and positive hits for cocaine were up nearly 21 percent. A UN report shows Colombian coca production more than tripled between 2012 and 2016 while over the same period, prices fell 23 percent, and purity increased nearly 20 percent. More accessibility, lower prices, and higher purity helped contribute to an 81 percent increase in the number of first-time cocaine users in the United States since 2013.
In 2019, there were 1,800 “new initiates” (people who try a drug for the first time) of cocaine use every day in the U.S. That’s 657,000 new people using cocaine in 2019 (the most recent year for which data is available). Likewise, 510 people tried methamphetamine for the first time every day resulting in over 186,000 new methamphetamine users in 2019.
Illicitly manufactured fentanyl, the powerful synthetic opioid that is similar in structure and effect to morphine but 50 to 100 times more potent, is the deadliest drug on the streets. This problem is heightened by the common practice for drug dealers to lace other drugs, including cocaine, methamphetamine, and heroin, with fentanyl, often without the user’s awareness. For people who use cocaine and methamphetamine, even very small amounts of fentanyl can be deadly.
In a 10-state study, almost 57 percent of the people who died from an overdose tested positive for fentanyl as well as cocaine, meth, or heroin. Synthetic opioids, including fentanyl, are now the most common drugs involved in drug overdose deaths in the United States, accounting for much of this nation’s 30 percent drug overdose death spike in the past year. There can be no safe experimenting with fentanyl; a person can die from the very first use. And because fentanyl is often laced into cocaine and methamphetamine, experimentation with those drugs can be deadly as well.
Drug experimentation may have existed for generations, but ours was just thrown yet another curveball. We have the perfect storm or “triple threat” of increasing use of stimulants (meth and cocaine), opioids, and a worldwide, life-altering pandemic. The CDC has stated that the COVID-19 pandemic brought new risks to Americans impacted by substance use disorder, as well as a series of new challenges related to treatment and recovery. Overdose deaths escalated drastically last year due to increased drug use as a result of the loss of connection during quarantines, perceived limited access to treatment, life impacts like job loss and financial hardships, and persisting feelings of hopelessness and depression.
In March 2020, U.S. alcohol sales rose 54 percent while online alcohol sales were up 262 percent. In June 2020, 13 percent of Americans reported starting or increasing substance use as a way of coping with stress or emotions related to COVID-19, with 40 percent reporting significant mental health or substance use problems. By July 2020, drug overdose deaths had increased 17 percent compared to the previous year. By the end of 2020, they had increased 30 percent. Clearly, the pandemic has taken (and continues to take) its toll and as a result, mental health and substance use treatment facilities are seeing spikes in its aftermath. There is an appreciation that people are getting the help they need, but there is also a recognition that this problem has significantly intensified, as the data shows:
More people are struggling.
They are more often turning to drugs to cope.
These drugs are increasingly potent and often tainted.
We therefore cannot accept that experimentation is harmless. As we continue to face pandemic turmoil and uncertainty, we must seek better ways to cope with this unrest, to ensure that we come out of this triple threat alive and well.