can you please help me with the assignment. You have read Chapters 1 through 4

can you please help me with the assignment. You have read Chapters 1 through 4 and are moving into Chapter 5. In the e-book on page 3, there is a section: SUDs as Unsuspected Influences on Society. After reviewing the list, select two facts and discuss your thoughts on the impact of health care in America. Do you agree or disagree? What is a recommendation for addressing the facts? Find at least one additional reference to support your response. Your response must be a minimum of one page, not more than 3 pages. APA format is not required. Just need your name and the two facts. SUDs as Unsuspected Influences on Society It is difficult to identify every way in which SUDs influence society. Even the different ways in which we go about estimating the social cost is a matter of debate (Vella et al., 2018). Yet, we typically see the cost outlined in relation to economic costs, cost to the medical care system, loss of productivity, impact on health, and then loss of life (Koob & Volkow, 2021). It has been estimated that the direct and indirect costs of SUDs consume over 15% of the average state’s budget in the United States (National Center on Addiction and Substance Abuse at Columbia University [CASA], 2009a). Each year in the United States, individuals who misuse illicit drugs spend $100 billion to purchase those drugs (Kilmer et al., 2014b), while another $467 billion is spent annually on substance misuse and addiction (CASA, 2015). This is misleading, however, as only 2% of the money spent goes toward prevention and treatment (CASA, 2015). The cost of incarcerating those who are convicted of drug-related offenses is not considered part of the cost of the “war on drugs” but a part of the Department of Corrections budget. The cost of providing health care for the families of those convicted of drug-related offenses becomes part of the Department of Human Services budget, and so on (Cafferty, 2009). The focus continues to be penalization rather than treatment, a vicious cycle in need of interruption (Volkow, 2021). In the 21st century, the rising cost of health care in the United States and elsewhere has become hotly debated. Politicians speak at length about the rising cost of health care, but often ignore the impact of SUDs, such as the following facts: Alcohol misuse contributes to more than 200 health conditions (World Health Organization, 2018). Close to half a million individuals died because of drug use in 2019 alone (United Nations, 2021). When considering indirect and direct deaths, the number of deaths because of drug and alcohol use each year goes up to close to 12 million (Ritchie & Roser, 2019). Approximately 20-25% of patients seen by primary care physicians have SUDs (Jones et al. 2004; McLellan et al., 2017). Substance misuse and SUDs can cause or exacerbate more than 70 health conditions (CASA, 2015). Excessive alcohol use was a factor in 50% of all deaths from acute traumatic injuries (Baron et al. 2009). Approximately one million hospital emergency room visits are the result of illicit drug use (Centers for Disease Control and Prevention, 2010b). Approximately 40% of all hospital admissions can be tied either directly or indirectly to alcohol use/misuse (Baron et al., 2009; Greenfield, 2007; Greenfield & Hennessy, 2008). Hospitalized persons with SUDs are more likely to require rehospitalization within 30 days of discharge than individuals without SUDs (Walley et al., 2012). Approximately 25% of those individuals on Medicaid have SUDs. As this group ages, the cost of their medical care increases at a higher rate than for age-matched individuals without an SUD (“Substance abuse adds millions,” 2008). There were 47,055 drug overdose deaths in 2014, of which 28,047 involved a narcotic either alone or in combination with other chemicals (Rudd et al., 2015). SUDs are frequently intertwined with psychiatric problems, further contributing to the rising cost of health care as evidenced by the facts that: The SUDs are a factor in 50-75% of all psychiatric hospital admissions (Miller, 2004). Of hospital stays that are non-pregnancy/delivery related, 17% involve individuals with psychiatric disorders co-occurring with SUDs (Heslin et al., 2015). One-third of persons who commit suicide have an alcohol use disorder (Karch et al., 2010). Between 40 and 60% of individuals who committed suicide were intoxicated at the time of their deaths, and 10% had evidence of other drugs in their bodies at the time of their death (Karch et al., 2010). Traumatic brain injury (TBI) accounts for almost one-third of trauma-related deaths in the United States each year, and between 29 and 52% of those who survive the TBI have alcohol in their bodies at the time of admission to a hospital (Miller & Adams, 2006). Neurological damage that is apparently induced by long-term heroin abuse appears to continue for at least three years after the individual discontinues the abuse of the substance (Zou et al., 2015). SUDs and interpersonal violence: There is a well-documented relationship between SUDs and violent behavior that has remained relatively constant over the years. Yet, ongoing research is needed to fully understand the impact of SUDs and violence (United Nations, 2016). Data indicates that there is elevated risk of violence with substance misuse (Whiting et al., 2020). Half of all perpetrators of a violent crime were found to have been drinking before the commission of the crime (Coghlan, 2008; Parrott & Giancola, 2006). Researchers have found that adults misusing substances are 2.7 times as likely to have been physically abused as a child and 4.2 times as likely to have neglected a child than were peers who do not misuse substances (Ireland, 2001). Alcohol is involved in 40-86% of all homicides committed in the United States (Parrott & Giancola, 2006) and 40% of homicide cases in Europe (Coghlan, 2008). Illicit drug use increases a woman’s chance of being murdered by her significant other by as much as 28-fold, even if they were not misusing chemicals themselves at the time of their death (Parrott & Giancola, 2006). Forty percent of homicide victims across 17 states in the United States were found to have alcohol in their systems (Naimi et al., 2016). Additionally, abusive situations may prevent individuals from moving towards recovery from substance misuse (Pallatino et al., 2019).

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