According to the 2020 National Survey on Drug Use and Health, nearly 59 percent of the United States population, age 12 and older, were current users (within the past 30 days of completing the survey) of tobacco, alcohol, or an illicit drug. For years, the primary substance of choice in the U.S. has been and continues to be alcohol. Tobacco is the second most commonly used substance, followed by illicit drugs, with the most commonly used illicit drug being marijuana.
Of those in the study who reported alcohol use, 22 percent reported binge alcohol use in the past month. Young adults, ages 18–25, had the highest binge alcohol use, followed by adults ages 26 or older. Many of these individuals were also heavy drinkers within the month of the survey. For marijuana use, young adults, again, had the greatest use rates, followed by adults aged 26 or older.
The survey also asked questions about risk perception because, historically, if one perceives there are high risks involved in using substances, they are less likely to use them. The majority of respondents perceived a great risk of harm related to tobacco use and risk from consuming four to five alcoholic beverages nearly daily. Perceived risks related to cocaine and heroin use were also high; however, less than 28 percent of people perceived great risk from smoking marijuana once or twice a week.
Other factors assessed in the survey were major depressive episodes, suicide risk, any mental illness, and severe mental illness. Findings show that Illicit drug, tobacco, and binge alcohol use occurs at a much greater rate for people with severe mental illness. For example, 47.8 percent of adults with severe mental illness and 39.8 percent of adults with any mental illness used illicit drugs, compared to 17 percent of adults with no mental illness who used drugs.
The year of this study, 2020, provided an additional stressor: COVID-19. Of those surveyed, one in five adults perceived the COVID-19 pandemic to negatively impact their mental health “quite a bit or a lot.” This perception could and likely did contribute to substance use rates during and since that year.
All of these details matter because they can predict the manner in which some people respond to life experiences and challenges and at what ages and times in their life they may be at greater risk and, subsequently, need greater support. As justice system and behavioral health professionals, this knowledge informs and enhances our ability to facilitate improved outcomes for those with substance use disorder.
With the proper intervention and support, individuals who are aware there is a problem with their substance use will be able to recognize that addressing the problem is better than continuing to use it. For justice system and behavioral health professionals, an evidence-based practice that is proven to inspire, instead of dictate, change is Motivational Interviewing. Motivational Interviewing involves a collaborative, person-centered approach that, through interactive conversations, identifies the change needed, helps determine readiness for change, and allows the individual the autonomy and motivation needed to follow through with the change.
Change is not easy for any of us and can be even more difficult for people experiencing mental illness and/or substance use disorder. Regular affirmation/recognition of a person’s ability to make positive change, especially when setbacks or relapses happen, is important because it builds and maintains rapport, increases self-confidence, and empowers them to actively identify solutions. Examples of affirmations include:
By using motivational interviewing, both justice system and behavioral health professionals are better able to help frame their clients' change in a way that focuses on the advantages of healthy behaviors and actions, as opposed to the disadvantages of staying the same. Most importantly, motivational interviewing can and does result in measurable, positive change.
For assistance with motivational interviewing, encouraging prosocial behavior, and preventing non-compliant behavior, contact a Carey Group consultant who can connect you with effective, research-based policies, practices, and behavioral intervention tools.
Decades of experience demonstrate that aligning justice systems and behavioral health organizations around evidence-based policies and practices offers the greatest promise of success. Carey Group offers services and products for staff in these fields, from evidence-based consulting to interactive workbooks and guides.
Carey Group’s evidence-based training and consulting services address the needs of the justice system and behavioral health professionals. Training is an essential tool for keeping staff, supervisors, leadership, and stakeholders updated with emerging knowledge and expectations for improved outcomes. Carey Group offers in-person, online, and self-directed courses on evidence-based practices, motivational interviewing, core professional competencies, case planning and management, continuous quality improvement, coaching, and the use of behavior-change tools and supervisor resources.