Substance Misuse Prevention

Substances can have a very strong effect on how the brain works and, in turn, can impact many other parts of the body. 

Substance use is closely linked with mental health. When people turn to substances to handle chronic stressors like unemployment, violence, lack of housing, or Adverse Childhood Experiences (ACEs), their mental health can get worse as their substance use disorder develops. 

Long-term substance use impairs the brain and can make it harder for a person to enjoy day-to-day activities without substances. A larger amount of the substance is needed to feel pleasure as their tolerance increases, which increases the risk of other health issues, including overdose.   

Substance use is a risk factor for:

• Bloodborne infectious disease from injection drug use 
• Certain cancers 
• Heart disease 
• Accidents and injuries 
• Hypertension and stroke 
• Liver disease 
• Fatal and nonfatal overdose 
• Anxiety disorders 
• Depression 
• Suicide 

Substance-related problems are expensive to Tennesseans. Smoking alone is associated with billions of dollars in productivity losses in Tennessee. Incarceration is expensive, yet in Tennessee substance-related offenses accounted for 18% of all incarcerated individuals across the state’s prison system as of fiscal year 2019-2020, according to the UT Institute for Public Service. 

It’s important for communities to provide trauma-informed, non-stigmatizing treatments for substance misuse so those who need help can easily find it.  When community partners work together on the social drivers that lead to substance misuse, everyone benefits. 

Any person can develop a substance use disorder (SUD), but certain groups may be more likely to develop SUDs and can face barriers when it comes to finding treatment.  

Racial and Ethnic Minorities  

Rates of past year illegal substance use, substance use disorder, and alcohol use disorder were highest for American Indian or Alaska Native (AI/AN) individuals and for people reporting two or more races than for all other racial/ethnic groups, and AI/AN youth are more likely than other American youth to use substances earlier.  For those who need SUD treatment, a SAMHSA report found, White individuals receive it 23.5% of the time compared to 18.6% for Black individuals and 17.6% for Hispanic individuals.  Overdose death rates for Black individuals increased from 24.7 per 100,000 in 2019 to 36.8 in 2020, 16.3% higher than for White individuals, according to a recent study by UCLA researchers. 

Veterans  

The most common substances used by veterans include alcohol and tobacco, and some veterans may turn to substance use to handle the mental health challenges that come with military service. Female veterans with SUDs, who face higher rates of sexual and domestic violence, may feel uncomfortable asking for treatment in male-dominated spaces and are more likely to have childcare duties that keep them from accessing treatment.    

Older Adults  

As chronic health conditions get worse with age, many adults are prescribed more medications as they grow older, which increases their risk of substance use disorders or accidental misuse. According to the National Institute on Drug Abuse, the proportion of U.S. adults aged 55 and older using heroin doubled between 2013 and 2015. 65% of people over 65 report “high risk” drinking, and over 10% currently binge drink.  Treatment is complicated for this age group, as providers mistake SUD symptoms for common chronic disease symptoms typical in older adults. In relationship with substance use, older adults are at particular risk of suicide and depression.   

To decrease substance misuse and its impacts in Tennessee, prevention is key. We need to create communities that support people from the start, improving conditions and creating community connectedness. 

We also have to meet people where they’re at to reduce the risks of existing substance use disorders. Infection, overdose, and death are real and immediate risks for people who use substances. Harm reduction is an evidence-based approach that focuses on keeping people who use substances alive and as safe as possible while retaining their autonomy and dignity. 

Activities and Programs: Evidence-informed, actionable, short-term steps that collaborative groups can take to address priority areas.

Policy and Systems Change: Systems change refers to how organizations or programs — such as school systems or health systems — are connected and work together to improve conditions to make change that lasts. This section contains evidence-informed, actionable, long-term steps that collaborative groups can take to address priority areas.

Lawrence County Teen Maze:  

The Lawrence County Health Department, in collaboration with the Lawrence County Health Council, Coordinated School Health, and the Lawrence County Substance Abuse Coalition, hosted a Teen Maze on December 7, 2022. Around 400 7th grade students from all over the county were able to participate in the event. The purpose of the activity was to provide a safe environment in which students could realize the serious consequences of certain behavior choices. Students began the maze by drawing random scenarios dealing with alcohol, drugs, sex, and tobacco that dictated their next move. Depending on the scenarios and consequences, students worked their way through the maze visiting stations such as the ER, Court, Funeral, Workforce, College, Healthy Relationships, Rehab, and Jail. Health Department staff and community professionals all ran the event stations. The final stop of the maze was an exit interview that gave students the opportunity to talk with a school-based therapist about their experience.  

Contact Amber Chunn at Amber.Chunn@tn.gov