Why do Americans consume so many drugs?

Americans are more likely to try illegal drugs than anyone else in the world, according to global survey data from the World Health Organization.

Forty-two percent of American adults have tried marijuana, for example, while only 20 percent of the Dutch have done so—despite the Netherlands’ long-running policy of tolerating sales and possession without criminal penalties. We’re also number one in terms of the percentage of our population that has tried cocaine (16 percent), with most European countries (including Holland) having averages around one to two percent. In Colombia—a major source country for the drug—only four percent of the population has taken cocaine.

We have evolved a brain that allows us to see, hear, taste, move, think, etc., and also to repeat things that feel good. That happens because a part of our brain sends out feel-good signals when we do something we enjoy, like eating good food, playing a video game, kicking a goal in soccer, listening to our favorite music, or going upside-down on a roller coaster. The system that says to us, “Hey, that was good, do it again!” is called the “reward system.”

Turns out that alcohol and drugs affect this system really well; they are effective at going right to our brain’s “reward system” and putting it into high gear.

This very effective stimulation of the reward system is why many people can become addicted to drugs, since feeling good is what drives much of our behavior. Drugs, in a sense, trick the system that has evolved for helping us in our world and instead can turn our world upside down.

Americans consume 80% of opiate painkillers produced in the world, according to congressional testimony by the American Society of Interventional Pain Physicians. And addicts are not the only ones impacted by the crisis.

While there is no comprehensive data on the prevalence of addictions, academic studies and government reports suggest addiction epidemics in several areas, including the following (with prevalence estimates cited by Sussman, 2017, Table 6.1 and Table 7.1):

• Marijuana: 7% of 18-year-olds, 2% of 50-year-olds;
• Illicit drugs, non-marijuana: 8% of 18-year-olds, 5% of 50-year-olds
• Tobacco: 15% of US adult population
• Alcohol: 10% for older teenagers and adults
• Food addiction: 10% of US adult population (= 25% of obese population)
• Gambling: 1-3% of US adult population
• Internet: 2% of US adult population
• Exercise: 3-5% of US adult population (22-26% of college youth)
• Workaholism: 10% of US adult population
• Shopping addiction: 6% of US adult population
• Love and sex addiction: 3-6% of adult population

According to Sussman’s estimates, around half of the population suffers from one or more addictions at any one time.

There is no single comprehensive epidemiology of addictive behaviors in the United States, in part because there is no consensus on the definition and diagnosis of addiction, and in part because the data are not comprehensively collected and analyzed to understand the prevalence and co-morbidities of various kinds of addictions. It is clear that some individuals are highly vulnerable to multiple addictions, in part because of the underlying neurobiological mechanisms of addiction that are common across addictive behaviors, e.g. a weakening of executive control.

The US is in the midst of epidemics of several addictions, both of substances and behaviors. Recent data of the Institute of Health Metrics and Evaluation (IHME) show that the US has among the world’s highest rates of substance abuse.

the “legend of the dancing goats” says that coffee beans were first discovered in a field in Ethiopia by a goat herder who noticed that his goats were acting weird sometimes, running around and dancing wildly. He couldn’t figure out why and so decided to study them.

He saw them eating small red berries on a certain shrub found in the area—turns out those were coffee plants. After eating the berries with the coffee beans inside, the goats started their “dancing.” Legend also has it that the goat herder also started eating the berries and dancing with them!

Plenty of similar stories and observations have been made of other animals that seem to get “high” from naturally occurring drugs or fermented fruits:

• Cats are attracted to the valerian plant and to catnip, which seems to give them extreme pleasure.
• In parts of Africa, the marula fruit ripens, and animals—from monkeys to elephants—are attracted to the overripe and fermenting fruits that make them act “funny.”
• Birds have been seen sitting on smoking tree trunks after bush fires and seem to be intoxicated—they get dizzy and fall off of the smoldering trunk only to get up and do it over and over.

Back to our question…so why do we (or at least some of us) and our animal counterparts like these natural-occurring substances and synthetic or man-made drugs? The answer is simple…blame it on our brains!

Example: Alcohol

Researchers have shown how emotional disposition is correlated with problematic use of alcohol, wherein if the reason for alcohol consumption is positive, the user is thought to drink to enhance positive feelings with greater control of the substance than if the user’s emotional disposition prior to alcoholic consumption was negative. In these cases, the individual is drinking to cope and is shown to have less control over his/her own use. Alcohol mediates negative feelings by their suppression but also encourages the habituated continuance of positive emotion. Recovering alcoholics often report that the reason for relapse is often related to the impulse to compensate for negative feelings, resulting in a motivation to cope and therefore drink.

There is a tremendous co-occurrence of addictions, consistent with the dual-decision theory that attributes addictive behavior to the dominance of the DA-mesolimbic circuitry relative to the PFC circuitry. Individuals with addictions may choose several kinds of short-run boosts to dopamine over their long-term wellbeing. Sussman cites voluminous data on the co-occurrences of addictions, with 30% to 60% co-occurrence of cigarettes, alcohol, and other drug use disorders. 

Howard Levine runs a pharmacy on Long Island that was twice robbed by an addict desperate for painkillers. He no longer provides most prescription painkillers.

Unlike drugs like heroin or cocaine, painkiller drugs are legal. Many are now asking whether over-prescription by doctors is making the epidemic worse.

Reference:

https://en.wikipedia.org/wiki/Evolutionary_models_of_human_drug_use#cite_note-saah-9

https://psmag.com/social-justice/try-drugs-anyone-else-9-ways-addiction-different-america-85093

bbc.com/news/av/magazine-17963222

https://worldhappiness.report/ed/2019/addiction-and-unhappiness-in-america/

https://archives.drugabuse.gov/blog/post/so-why-do-people-drugs