Substance Use Disorder (SUD): A CALL to Action

Recent statistics from the National Institute on Drug Abuse (NIDA) report 40 million people in the U.S. have a SUD.  Of those approximately only six to twelve percent receive treatment.  Additionally, The CDC reported over 80,000 individuals died in 2024 due to a drug overdose.  While the overdose statistic is an uncomfortable and alarming number, it is over a 25% decrease from previous years.  Based on the prevalence of SUD, like me, chances are that substance use disorder has touched you in some way and for many, this condition leaves you with so many thoughts and emotions and a desire on how to better understand it and address it.

Historically, a situation in which someone was struggling with alcohol or drugs has been referred to by many titles that include misuse, abuse, addiction, and dependence, with an emphasis on viewing it as either a weakness or moral choice.  Greater understanding has shifted towards an attitude that it is a treatable chronic medical and brain disease.  With this said, SUD is a term with a broad definition and variations depending on what organization defines it.  The National Institute of Mental Health reports SUD affects the brain and behavior, causing difficulties in work, school, or in relationships.  The National Institute of Drug Abuse (NIDA) defines SUD as a medical condition characterized by the inability to control the use of substances, despite the negative consequences. The American Medical Association (AMA) and the American Society of Addiction Medicine (ASAM) classify addiction as a chronic brain disease while the Substance Abuse and Mental Health Services Administration (SAMHSA) document SUD is a chronic disease where people compulsively seek and use drugs despite harmful consequences.

While I have been in the field of substance use for four decades, despite organizations identifying SUD as a disease, it has been my belief that this condition does not receive the same level of acceptance, attention, or regard other recognized diseases such as Alzheimer’s, Multiple Sclerosis, and Parkinson’s receive.  At one point, opioid use was considered a pandemic and yet focus and efforts lacked reaching levels that made a significant impact.  

What will it take to generate a prominent change from a focus of citing statistics and ideas regarding approaches, to expanding and implementing useful, successful strategies when addressing SUD?

I believe significantly more education, more comprehensive awareness, and extensive wide-reaching training can get us there.  Easier said than done and the many of us who have had firsthand experiences with SUD know how the denials, untruths, open anger, broken promises and the shame, guilt and fear shared by both the diagnosed and those close to him/her complicate the situation.  Add to that the fact that many of us quietly further the unwritten rules of don’t talk, don’t ask, and certainly don’t feel.  These dynamics are often in the playbook of rules in a family labelled as a dysfunctional one, a label I don’t subscribe to as those in it have had to learn on their own to survive in that environment.  I call that adaptation and functioning.  Ironically, some of these barriers have existed within our first responder family as well, as many of us have been told too often to be seen not heard.

When it comes to our job performance our approach is straight forward.  We seek to be confident, skilled, and successful and use the skills and tools provided to us to be so.  We train, train and train some more to learn and to make our responses on the scene automatic and successful; just the same, we are human.   Therefore, to affect change regarding this disease we must own its presence, openly communicate, and work together.  What will shape its future lies in our attitude and appropriate recognition, education, and expansive, repeated in-depth training of it and solutions.   SUD is often referred to as a cunning, baffling, powerful disease that fosters many stigmas; we must believe and persist that we have the power to prevail over it through our collective actions.

If you or a family member are having any issues with behavioral health or a substance use disorder, please reach out for help. Responder Health (responderhealth.com) is an organization that offers resources specifically for first responders and their families. Responder Health provides confidential and full-service solutions that support first responders through stress and traumatic events, and provides them with the education, resources, and community they need to live healthy, happy lives. Our peer advocate hotline (253)243-3701 offers a confidential 24-hour crisis referral service for all public safety employees, all emergency services personnel, and their family members nationwide.