September 25, 2013 at 12:40 pm EDT | by Staff reports
National Recovery Month — are we recovering?
Josh Riley, Whitman-Walker Health, gay news, Washington Blade

Josh Riley is a Behavioral Health Manager at Whitman-Walker Health. He also serves on the DC Crystal Meth Working Group, a program of the DC Center.

By Josh Riley

September is National Recovery Month. Sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), National Recovery Month turns the spotlight on the topic of mental health and substance use in the U.S. to highlight that living well with and even overcoming these challenges is possible.

Though often associated with the 12-step self-help community, recovery is a much broader concept. SAMHSA’s definition of recovery is “a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”  This somewhat vague definition highlights the complexity of addressing and treating substance use and mental health disorders. It raises the question: are we recovering?

SAMHSA recently released the first reports from the 2012 National Survey on Drug Use and Health (NSDUH). This annual survey of people 12 years old and older attempts to quantify the extent of alcohol and drug use and mental health disorders in the U.S. Approximately 70,000 individuals are surveyed and estimates are derived.

Nationally, illicit drug use continues to increase, and has for the past 10 years (from 7.9 percent of the U.S. population in 2002 to 9.2 percent in 2012). Fifty-two percent uses alcohol, and binge and heavy drinking are still common. Since 2002, the rate of opiate abuse in the U.S. has doubled. While methamphetamine use decreased since 2011, among those aged 26 or older, use increased. More people met criteria for substance abuse or dependence than in 2011; only a small fraction (10 percent of those who needed it) received treatment.

Although local data are harder to come by, state-level data are available for the 2009-2010 survey year. Consistently, D.C. ranks near the top for illicit drug use, marijuana and alcohol use.  D.C. ranked highest for past year use of cocaine, and third highest for binge drinking. Rates of abuse and dependence in D.C. are higher than anywhere else in the country, with 12 percent of the population estimated to meet these criteria. Rates for mental health issues are similar to other states, with 20 percent meeting criteria for a mental health disorder.

Data about LGBT folks are even harder to come by. Studies that exist demonstrate that, compared to the general population, LGBT people are more likely to use alcohol and drugs, have higher rates of substance abuse and are more likely to continue heavy drinking into later life. We also face higher rates of depression, anxiety and suicide, often stemming from stigma and homophobia. There is wide variability in these studies, most of which focus exclusively on gay men, but they are telling.

Local LGBT data is even more scant. The 2008 MSM study carried out by the Department of Health found that, of the 500 men surveyed, just over half reported non-injection illicit drug use in the past year. Of these, 77 percent reported use of marijuana, 46 percent poppers, 39 percent powder cocaine, 20 percent ecstasy, 15 percent crystal meth, and five percent crack. Treatment data from WWH indicates that about 50 percent of clients seeking drug treatment in the last year indicated methamphetamine as their drug of choice, followed by alcohol (23 percent), crack (17 percent), cocaine (seven percent), and opiates (three percent). The trend of high rates of admission for methamphetamine treatment has been consistent at WWH for the past 10 years.

The data are telling and the lived experience of many of us confirms what the numbers tell us: We continue to face many substance use and mental health challenges. This isn’t to suggest that everyone who uses has a problem or needs treatment, or that all of us suffer from a mental health disorder, but if recovery is, “a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential,” the query still remains: are we recovering?

  • If you assess DC by state-level data, then of course it will appear to be extreme. As for local LGBT data, surveys widely known for selection bias may not give an accurate picture of what is actually going on.

  • Great points, Dave. Selection bias is always an issue, especially given that we tend to collect data in the places where we congregate; that certainly can skew substance abuse data. As to the DC/state comparison, I agree that it would be instructive, and possibly more accurate, to compare DC to other similar municipalities, like larger cities.

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