¶ … drug use and abuse in the United States and presents differing approaches that are used (or proposed) to get a handle on the problem. There is no doubt that the drug abuse issue is not new and it is not being reduced by any significant amount. This paper presents statistics and scholarly research articles that delve into various aspects of the drug abuse issue in the United States, with particular emphasis on drugs that are abused in eastern Kentucky and generally in the Appalachian communities. History of Drug Use & Availability

The history of illegal drug use in the United States goes back to the 19th Century, according to the U.S. Drug Enforcement Agency (DEA). The DEA has a Museum in Arlington, Virginia, that illustrates the history of drug discoveries, drug use, and drug abuse through the years. The DEA reports that morphine, heroin, and cocaine were "discovered" in the 19th century, and were considered "wonder drugs" (DEA). The first "drug epidemic" occurred in the early part of the 20th century (use of cocaine and opium), but by WWII, "American drug use had become so rare it was seen as a marginal social problem" (DEA). In the 1960s, the "new generation" of drug users caused an "explosion" of drug abuse and hence, federal laws were passed; in the 1970s, cocaine "reappeared" and then crack cocaine appeared which spread addition "and violence at epidemic levels" (DEA). Hence, the DEA was launched in 1973.

In the 1980s, "…six million Americans" used cocaine on a regular basis, which created a huge market and brought drug cartels in Colombia into the picture (DEA). Today, Mexican and Colombian-based drug cartels smuggle huge amounts of cocaine into the United States. Also, black tar heroin and marijuana are being smuggled into the U.S. -- and methamphetamine is another drug that is trafficked into the country.

High School Drug Usage -- A Quick Review

The future of the United States depends to a great extent on the quality of young people emerging through educational programs throughout the country. Hence, elected officials, educators, parents, clergy, community leaders, and members of the law enforcement community have been paying close attention to drug use and abuse by young people. The statistics bear out the need for close observation of the drug use among adolescents and especially high school age young people because the drugs they experiment with prior to college are logically expected to become habits as they continue through their educational careers (and work experiences) beyond high school.

The Bureau of Justice Statistics (BJS) Drugs and Crime Facts (2008) shows that 65.5% of high school seniors reported having used alcohol within the last year; 43.1% consumed alcohol within the previous 30 days (prior to the survey); and 32.4% reported having used marijuana within the past year. The BJS found that use of marijuana by high school seniors dipped a bit in 2007; daily use of marijuana in 1996 was reported by 2.7% of those surveyed; that rose to 4.7% in 2003, and dipped to 3.5% in 2007. Daily cocaine use by high school students was very rare, but in 2007 5.4% of those surveyed admitted to using cocaine with the past year, up from 5.1% in 2006, but down from 6.6% in 2004 (BJS).

As to marijuana use, 42.6% of high school students reporting having using it (or hashish) at some point in their lives; 7.2% said they had used cocaine and 1.3% used heroin. Among high school senior the regular use of marijuana increased from 12% to 19% between 1992 and 2008; among 10th graders (sophomores) the use of marijuana rose from 8% in 1992 to 14%; and among 8th graders marijuana use rose from 4% in 1992 to 6% in 2008 (BJS).

As to college students' usage, cocaine was used daily by 2.9% of college students in 1996 and by 2007 some 5.4% of college students were snorting cocaine daily (BJS). Daily marijuana use by college students was reported to be about 35.9% in...

This chart shows a general, gradual decline in the use of cocaine by high school seniors.
In 2008, 4.4% of high school seniors had used cocaine within the past year, and just 1.9% was using cocaine at least once a month.

Interestingly, a high percentage of high school seniors agree that they "risk harming themselves" when they use drugs, albeit that percentage has declined significantly when it comes to marijuana use. According to the BJS, in 1988 seventy-seven percent of high school seniors reported that marijuana was harmful to their health but in 2008 that percentage slipped to 51.7%. As to cocaine use, 89.2% said it could harm them in 1988 and by 2008, 80.7% still held to that belief. The use of heroin was seen as harmful by 88.8% of high school seniors in 1988; in 2008 the percentage who agree heroin is harmful remained high -- 86.4% (BJS).

Meanwhile the percentage of high school seniors who report that buying marijuana is no big problem is very high -- 83.9% responded to a 2008 survey saying cannabis purchases can be easily made. Nearly forty-eight percent said obtaining amphetamines was very easy and 42.4% of those high school seniors surveyed in 2008 reported that cocaine was not hard to find in their community. Even the psychedelic drug LSD, widely used as a popular recreational drug in the 1960s, is not hard to obtain, according to 28.5% of those seniors surveyed.

Drug Usage in Kentucky

"…There were 7,932 intake/baseline records of clients entering state-funded substance abuse treatment in the [Appalachian area of the] Commonwealth of Kentucky during the 12-month period from July 1, 2006, through June 30, 2007… [and] women accounted for 35.1% (2,786) of the total intake… [which is due in part to the fact that] more women in rural Appalachia reported the presence of chronic pain…" than in other regions (Shannon, et al., 2009).

The Transformation Drugs & Alcohol Treatment Center in Kentucky (using data from the Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration along with the Kentucky Office of Drug Control Policy) reports that Kentucky has "…one of the highest rates of drug abuse in the country" (Transformations, 2011). Data presented by Transformations shows that in 2007 some 722 people died from drug abuse (compared with 853 Kentuckians who died in highway accidents and 612 who died resulting from firearms). Meth lab seizures show that the growth of that addictive drug is significant: from 2007 to 2009, the seizures of meth labs by law enforcement increased by 138%. Also, Kentucky was ranked number four in the nation in terms of the production of "domestic marijuana" in 2009.

Risks for Drug Users in Rural Appalachian Kentucky

A peer-reviewed article in the journal AIDS Care (Havens, et al., 2011) points out that injection drug use in rural Appalachian Kentucky is on the rise, which is a great concern to healthcare officials because it puts the users at risk for HIV. The study presented in the article was designed to examine injection drug use (IDU) among "a cohort of felony probationers" from rural Appalachia (Kentucky) by surveying 800 rural felony probationers. In the sample, 66.5% of those surveyed were male and 95.1% were Caucasian; the average age was 32.3 years and no cases of HIV were found in the survey. Of the 800 probationers, 22.4% reported "lifetime IDU," and 34.5% reported that they shared "receptive" syringes (RSS) and 97.1% reported "distributive syringe sharing (DSS)" (Havens, 638) (receptive sharing means sharing syringes with others; distributive means getting fresh sterile syringes from pharmacies, etc.);

Sharing needles is "risky" when injecting anything (cocaine, heroin, and oxycodone), Havens explains, because the risk for HIV and "other blood-borne infections" is very high (638). Of the 179 individuals (from the 800 probationary individuals being studied) injecting drugs, "…almost half (49.7%) reported risky injection practices. In fact, injecting cocaine is "significantly associated with risky injection practices" (which are linked to HIV and HCV). The conclusion of this article offers evidence that "prescription opioid injection in rural Appalachia is an emerging problem" which could lead to an epidemic, Havens reports. What is warranted given the data presented in the article is "…education around risky injection and drug use practices" (Havens, 643).

First use of drugs in rural Appalachia -- Eastern Kentucky

Meanwhile The American Journal of Drug and Alcohol Abuse published an article titled "Examining gender differences in substance use and age of first use among rural Appalachian drug users in Kentucky" (Shannon, et al., 2011). In the article the differences in gender and age of "first use" within the rural Appalachian community is explored, which provides a snapshot into the way in which individuals become involved (and addicted) to drugs in eastern Kentucky.

The research in this article used a community-based study in Appalachia (of 400 people) to explore whether or not previously reported differences in age of users and gender (elsewhere) holds when the study is done in Appalachia. The participants averaged 32 years of age and 59% were…