and from the devastating social, medical, physical, and psychoemotional costs of substance abuse.
Regarding the incidence rate, the National Institute of Drug Abuse (1991) reports that there are an estimated 10 to 15 million Americans who have serious problems directly related to substance abuse and about 35 million people who are indirectly affected (e.g. family members, children, friends, etc.) Substance abuse is most prevalent among youths and young adults (Johnston, O'Malley & Bachman, 1991).
In terms of the consequences of substance abuse, approximately 15 to 20 percent of the nation's health care costs ($50 billion per year) are believed to be related to alcohol or drug abuse; moreover, these are blamed for a significant lowering of worker productivity at all levels of the economic system (Mathre, 1994).
Sue, Sue and Sue (1994) further report that substance abuse lowers the life expectancy by about ten to twelve years and is associated with a variety of health programs including organ damage, brain dysfunction, cardiovascular disease, and mental disorders. Further, Sue et al. report substance abusers have higher suicide rates than the average population (up to 58 percent greater for some alcoholics). Finally, alcohol and other forms of substance abuse are believed to be a factor in a large percentage of crime and domestic problems (Sue, Sue & Sue, 1994).
In her discussion of substance abuse, Mathre (1994) delineated the tragedy and scope of the problem as follows:
Substance abuse is clearly a national health problem that is linked to numerous forms of morbidity and mortality. Approximately 30% to 50% of all hospital admissions are related to the effects of substance abuse...The substance abuser is not only at risk for personal heath problems but may pose a threat to the health and safety of family members, coworkers, and other members of the community. Substance abuse and addiction affect all ages, races,...