Understanding how social change and technological development have shifted the way substance use disorders (SUD) affect individuals and families
Parents face many challenges in the present world. Changes to society and culture as a result of developments in technology, the growth of cities, the availability of information, and shifting identity roles mean that the experiences parents had as children and adolescents are often far removed from the realities of young people today. In many respects, this is normal and natural – it is the role of a child to grow away from and beyond their parents to become their own functional, capable human beings. But when it comes to the riskier and more dangerous aspects of growing up, the widening gap between the past experiences of parents and the lived realities of children and teens can make it difficult for families to provide support when young people need it most.
Such is the case with drug use. For many parents, the idea of a child experimenting with drugs and alcohol may not be immediately alarming. These parents can remember their own first experiences with drinking, smoking marijuana, or dabbling in stronger “party” drugs as young people. Many successful professionals and adults at one time knew a friend who was able to acquire these things and have fond memories of occasionally imbibing at a party or in another social environment.
However, the landscape of drug and alcohol use has since changed significantly. The type of drugs that are popular, the ways of accessing them, and the environments in which they are commonly used by young people are no longer the same. As a parent, teacher, caregiver, concerned adult, or even as a therapist, coach, or healthcare professional, it is crucial to understand how changes in the practices of drug use in the United States and elsewhere are affecting the relationship between young people and substance use disorder.
Over my next two blog posts, I will explore the complex ways in which the landscape of drug use – the types of drugs that are commonly used, the reasons behind their use by young people, and the way in which illegal drug dealers go about their trade – has changed significantly in the United States and globally and what this means for young people. There are strong connections between these changes and the prevalence of substance use disorder in children and teenagers, and understanding how one influences the other can help us provide support and treatment for those of all ages who are struggling with drug use.
Prescription Drugs: A Different Kind of Drug Market
Many people, when they think about drug use, still immediately conjure up the image of a marijuana joint or a bag of magic mushrooms. This is not surprising considering how frequently these hallucinogenic-type drugs have been portrayed in popular culture, particularly in the last two or three decades.  But while these familiar hallucinogenics remain popular and are still often used by young people (as well as by adults), they no longer represent the majority of drug use in the United States.
Research published in 2014 indicated that prescription drug abuse was the most prevalent form of drug abuse in the United States: at that time approximately 16.7 million people aged 12 and older in the US used prescription drugs, reflecting a 250% increase in prescription drug use over a 20-year period. This same study found that the highest risk period for developing a problem with prescription drug use is during adolescence: in 2012 13% of 12th graders reported prescription opioid use. Opioids are painkillers used for treating acute pain and include such drugs as Codeine, Morphine, and Fentanyl. 
These alarming statistics are concurrent with a rise in prescriptions for opiates by doctors across the United States. Opioids have been proven to be extremely successful in managing chronic conditions such as cancer,  which is one reason why prescriptions have doubled over the past ten years. According to Dr Nishat Siddiqi, many medical schools in the mid-Nineties encouraged the prescribing of opioids if basic pain management tools (such as ibuprofen, acetaminophen, or paracetamol) didn’t work. 
The issue, of course, is that these prescriptions are not always used as intended. Statistics indicate that 16.3 million people misuse their own or someone else’s opioid prescriptions.  This type of misuse could be as simple as taking more of the drug than prescribed in one day, week, or month, but it could also be even more serious. In many cases, opioids that are obtained legally go on to be sold illegally. Fentanyl in particular has become an incredibly popular street drug, with dealers obtaining prescriptions from genuine sources and then selling individual pills for profit to whomever can afford them. Given that research has shown that deaths from prescription opioid overdose now outnumber both cocaine and methamphetamine overdoses combined, this is a shift to which we, as concerned adults, must pay close attention. 
Anti-anxiety, anti-depressant, and attention deficit medications are often misused in this same way: drugs such as Adderall, Ritalin, Ativan, Xanax, and Valium, which are often prescribed for genuine reasons, find their way onto the illegal market and into the hands of young people.
In next week’s blog, I will explore how the reasons young people find for seeking out and taking illegal drugs have changed, and what that means for substance use disorder and its treatment. I will also look at how developments in digital and social technologies have enabled a different kind of drug dealing to become commonplace and how concerned adults can educate themselves on the process.
 Olley, N. (2008) Review: Drugs and popular culture: drugs, media and identity in contemporary society. The British Journal of Criminology, Volume 58, Issue 3. Pp. 415-418. https://doi.org/10.1093/bjc/azn022
 McHugh, R.K. et al. (2014) Prescription Drug Abuse: From Epidemiology to Public Policy. Journal of Substance Abuse Treatment. Jan; 48(1): 1-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250400/
 Silversides, A. (2009) Opioid Prescribing Challenges Doctors. Canadian Medical Association Journal. Oct 13, 181(8): E143-E144. doi: 10.1503/cmaj.109-3033
 Siddiqi, N. (2019) In the 1990s, doctors were told to give out opioids. Was it a good idea? The New Statesman. March 20. https://www.newstatesman.com/politics/health/2019/03/1990s-doctors-were-told-give-out-opioids-was-it-good-idea
 NCDAS. (2022) Prescription Drug Abuse Statistics: Key Findings. National Center for Drug Abuse Statistics. https://drugabusestatistics.org/prescription-drug-abuse-statistics/
 Falkowski, C. (2017) The Changing Landscape of Drug Abuse: What’s New? What Can We Do? Minnesota Medicine 100(3):30-31.