Drug Abuse Trends and Treatment Approaches for 2023

Substance use disorders involve a wide range of substances and patterns of abuse. However, the abuse of opioid prescription drugs and the rise in overdose deaths it is causing, largely due to the powerful synthetic opioid fentanyl, continues to be the biggest drug issue in America. Polysubstance abuse is also a concern.

Prescription painkiller alternatives are being further developed, including approaches that involve various types of therapy. The need to address underlying issues that might lead to drug use, including unresolved trauma and undiagnosed cooccurring disorders, is also coming more into focus.

In this article, we will discuss the most pertinent drug trends to be aware of in 2023.

Fentanyl Trends

Close to 1 million individuals have died from drug overdoses since 1999, according to the Centers for Disease Control and Prevention (CDC).¹ Opioids remain the main driver of drug overdose deaths today, with 82.3% involving fentanyl or a similar synthetic opioid.¹ Fentanyl is largely undetectable and is often cut into drugs such as cocaine, methamphetamine, and fake prescription pills including opioid painkillers and benzodiazepines, like Xanax.

The US Drug Enforcement Administration issued a public advisory in August about the dangers of “rainbow fentanyl,” which gets its name from its multicolored appearance.² This form of the drug raised concerns that drug dealers were intentionally targeting young people, even children.

In November, researchers at the University of Houston announced they have developed a fentanyl vaccine that blocks the drug from entering the brain, eliminating both the high and the risk of overdose.³ Human clinical trials are currently underway. As with all medication-assisted treatment (MAT), the vaccine may not be the right option for everyone, and therapy to modify thoughts and behaviors that contribute to drug abuse should be the focus of recovery treatment.

Polysubstance Abuse

Overdose deaths from methamphetamine and other psychostimulant use are also on the rise going into 2023, including and not including synthetic opioid involvement.

Many overdoses from fentanyl and meth involve polysubstance abuse, intentionally or unintentionally. Mixing drugs can make the drugs’ effects stronger and even more unpredictable, which is what makes polysubstance abuse particularly dangerous and even deadly. The CDC’s most recent numbers show that more than half of all overdose deaths involve the use of multiple substances.¹

Dual Diagnosis

With today’s growing awareness of mental health issues in general, more attention is being focused on the fact that substance abuse often cooccurs with other mental health conditions, including anxiety disorders, mood disorders, and more. This awareness is helping to improve intake screenings at addiction treatment centers and other behavioral health services facilities, which improves outcomes for people living with addiction.

Although it is true that symptoms for both disorders tend to improve when even 1 of the disorders is treated, the best long-term results come from treating both conditions at the same time.

Trauma’s Impact

Trauma and its effects are also gaining wider acceptance as contributors to the development of mental health illnesses and disorders, including substance abuse.

Since the summer of 2021, The Body Keeps the Score has been on the New York Times Best Seller List for Nonfiction for more than 214 weeks. The book was written by psychiatrist and confounder of the Trauma Research Foundation, Bessel van der Kolk, in 2014 and focuses on how trauma can influence everyday experiences long after the traumatic experience occurred.⁴

Many attribute the book’s recent success to the COVID-19 pandemic and the trauma it caused many individuals. One of the main lessons we have learned about trauma is that it is a subjective experience that can involve anything from warfare to childhood abuse to social isolation. Being able to identify signs and symptoms of trauma gives health care providers more tools for aiding patients in their recovery from drug or alcohol addiction.

Pain Management

Clinicians are helping individuals manage their pain so that they do not have to rely on prescription painkillers. Cognitive behavioral therapy, acceptance and commitment therapy, relaxation training, and even group therapy have all been shown to be effective treatment options for chronic pain.

Prevention Strategies

Education remains critical for the prevention of substance use and abuse. Young people sometimes perceive prescription drugs to be safer than other drugs. One-quarter of teenagers believe that prescription drugs can be used safely to help them study, and almost 1 in 3 parents believe that attention-deficit/hyperactivity disorder (ADHD) drugs can help with a child’s academic performance, even if the child does not have ADHD, the Substance Abuse and Mental Health Services Administration reports.⁵

Since COVID, many students and employees report feeling stressed out and overworked. Mental health days are being built into time-off policies for employees as well as for high school and college students. This gives employees and students the chance to take a break from their daily routines and focus on their mental health.

Some students are demanding that their schools review their mental health policies. At the end of November, students at Yale sued the school for alleged “systemic discrimination against students with mental health disabilities” regarding the school’s withdrawal and reinstatement policies involving students with specific health conditions.⁶

Concluding Thoughts

Several news outlets have run stories where an individual, often a parent, states that experimental drug use is not possible today because of fentanyl and other highly dangerous drugs. However, no drug use is ever safe; it always comes with the risk of addiction.

Thankfully, we have more tools for preventing addiction, supporting mental health, and helping individuals when addiction does develop. A personalized approach often works best, taking into consideration each individual’s complete health history and current thoughts and behaviors. As we gain a better understanding of underlying issues, the stigma surrounding addiction and all mental illnesses will continue to be overcome.

Ms Fischer is a writer and editor for Ohio Recovery Center, an addiction treatment provider offering substance abuse care in Van Wert, Ohio.

References

1. Drug overdose deaths remain high. Centers for Disease Control and Prevention. Updated June 2, 2022. Accessed December 12, 2022. https://www.cdc.gov/drugoverdose/deaths/index.html

2. DEA warns of brightly-colored fentanyl used to target young Americans. Drug Enforcement Administration. News release. August 30, 2022. Accessed December 12, 2022. https://www.dea.gov/press-releases/2022/08/30/dea-warns-brightly-colored-fentanyl-used-target-young-americans

3. Haile CN, Baker MD, Sanchez SA, et al. An immunconjugate vaccine alters distribution and reduces the antinociceptive, behavioral and physiological effects of fentanyl in male and female rats. Pharmaceutics. 2022;14(11):2290.

4. van der Kolk B. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Publishing; 2015.

5. Rise in prescription drug misuse and abuse impacting teens. Substance Abuse and Mental Health Services Administration. Updated April 13, 2022. Accessed December 12, 2022. https://www.samhsa.gov/homelessness-programs-resources/hpr-resources/rise-prescription-drug-misuse-abuse-impacting-teens
6. Burke M. Yale sued over 'systemic discrimination' against students with mental health disabilities. NBC News. December 1, 2022. Accessed December 12, 2022. https://www.nbcnews.com/news/us-news/yale-students-sue-ivy-league-school-systemic-discrimination-students-m-rcna59565