Substance Use Disorder in the United States: My Story & the Statistics
Authored by J Alexandria Hunt-Garcia, Digital Community Organizer.
According to the 2022 United States National Survey on Drug Use and Health (NSDUH), 46.8 million Americans (16.7%) aged 12 and older battled with substance use disorder (SUD) in the past year. Among these, 10.5% had an alcohol use disorder, highlighting the widespread nature of substance-related issues across the nation. While statistics provide a broad picture of the crisis, they often obscure the individual and emotional journeys. This is my story, a journey deeply intertwined with substance use and the eventual discovery of hope through harm reduction.
A Traumatic Beginning
My descent into substance use began with a life-shattering event. At age 16, I was a victim of a violent sexual assault. Traumatized and with no access to adequate mental health care, I sought solace in the only way I could find: heroin. The drug numbed the unbearable pain and provided an escape from the traumatic memories that haunted my daily life. Coming from a “normal” middle-class family I never imagined that I could become someone who relied on opiates just to get out of bed every day. I didn’t think that happened to “people like me.”
The Descent into Darkness
For many, substance use does not spiral into chaos, but for me, the unresolved trauma of my assault quickly led me down a destructive path. Heroin became my primary means of coping, leading to extremely chaotic use. This drove me into isolation, homelessness, and repeated encounters with the criminal legal system. The stigma surrounding my substance use and circumstances only exacerbated my plight, creating a vicious cycle that seemed impossible to break. When I was arrested for the first time, I quickly learned that my belief that correctional systems rehabilitate, could not have been more wrong.
Life Behind Walls
Incarceration as a woman with a substance use disorder and mental health issues is a uniquely harrowing experience. Imagine the anguish of being trapped in the hot, unyielding walls of a prison, where every day feels like an endless cycle of despair. The isolation was suffocating, with each moment spent in that sterile, dehumanizing environment deepening the wounds of trauma.
“How do you know an inmate is lying, their mouth is moving.” That was a line I heard from dozens of officers and medical staff while incarcerated. I truly felt its sting when I was nine months postpartum and forced to stop my depression medication because I was labeled as a drug-seeker, plunging me into a deeper abyss of despair while trying to cope with the separation from my child. The lack of compassionate care, coupled with the pervasive stigma from prison staff, made every day a fight for survival. Incarceration wasn't just a punishment; it was a brutal reinforcement of the belief that I was beyond redemption, a belief that chipped away at any remnants of hope I desperately clung to.
Despite all of this, I never stopped fighting for myself. I always held the core belief that I could be better. Sadly, determination was not always enough to keep me out of cycles of chaotic or risky drug use. I was 20 years old when I was released from prison for the first time. My boyfriend and I immediately drove to the closest place with a restroom, a Wendy's, and I overdosed less than 30 minutes after my release. I survived, but due to lack of oxygen, my brain has never been the same. It wouldn’t be my last time being released from prison, and it wouldn’t be my last overdose. I desperately craved normalcy, but didn’t know how to achieve it. My trauma was like a monkey on my back, and no one would give me the skills to control him.
A Ray of Hope: Harm Reduction
After a decade of struggling, my life took a pivotal turn when I encountered a local harm reduction group in Arizona. I thought they were cool at the time, but I didn’t see how they would be relevant to me. It wasn’t until a week later when I was sitting on my kitchen floor, extremely sick and unable to inject heroin due to my damaged vascular system that it finally clicked. I pounded my fists on the floor and screamed into the ether that I was done living, that I couldn’t do it anymore. I felt like a failure and didn’t see a way out. I had no money for rehab, and prison didn’t help. I chose to kill myself. I injected 3 times the amount that I normally did into my right thigh, and somehow I survived. In that moment I knew that was the sign that I needed to find a way to live, no matter what that way was. I contacted the harm reduction organization I’d met a week prior. This group introduced me to concepts that were stigmatized in my circles but offered a new way to manage my lifestyle. With their help, I connected with a doctor who prescribed Medication for Opioid Use Disorder (MOUD), specifically methadone.
The prescription of methadone was a turning point for me. Despite the heavy stigma surrounding methadone, it provided me with the stability I desperately needed. For the first time in years, I felt a semblance of normalcy returning to my life, although the isolation and secrecy surrounding the medication were always a challenge. As I stabilized on methadone, I began to see a future beyond chaotic substance use. With the support of the people I’d connected with at the harm reduction group and my doctor, I gradually rebuilt my life, overcoming the stigma associated with my treatment.
Advocacy and Tragedy
I ended up going to prison one more time after stopping heroin, an old shoplifting charge that came back from the dead. It was during those two and a half years in prison, separated from my newborn due to a charge committed long before he was conceived, and becoming empowered by my experience with methadone that I became a passionate advocate for harm reduction and legal reform. I dedicated myself to fighting the stigma that surrounds substance use and treatment, sharing my story to help others find the support they need. My advocacy work was fueled by the belief that harm reduction could save lives and that prison couldn’t help the issues caused by drug prohibition.
However, in 2023, I faced a devastating loss that tested my resolve. My best friend, Samantha White, who worked in abstinence-only rehabs, succumbed to the pressures of stigma. Despite being loved and respected in her community, Samantha felt isolated and overwhelmed by the expectations placed upon her. In a moment of despair, she turned to fentanyl, a substance far more potent than the heroin she had once used. The result was a fatal overdose. She died alone on a bathroom floor. We had spent many years together, both incarcerated and in the free world. We had our entire lives planned, down to how we would eventually sit in rocking chairs on our porch in old age and yell at the youngsters walking by. There is nothing more challenging than navigating the grief of losing a loved one that you planned on spending the rest of your life with to a completely preventable drug overdose. To this day I struggle with the “what ifs.” What if the prison had treated her for her substance issues rather than using her for cheap labor? What if the treatment space she was working in accepted alternative treatment options and didn’t stigmatize relapse? I can’t help but think she’d still be here, fighting the good fight with me. Instead, she’ll forever sit in a bag on my shelf, a stark and harsh reminder of the consequences caused by the drug war and prohibition.
A Life-Changing Moment
Samantha's death was a life-altering event for me. Having already lost many friends to the overdose epidemic, this loss was different. Overcome with rage and grief, I initially sought retribution, wanting someone to blame for my friend's tragic end. However, as I processed my emotions, I found strength in the memory of what Samantha would have wanted. Samantha would have wanted me to continue my journey, to fight against the stigma and isolation that claimed so many lives.
In honor of Samantha and countless others lost to substance use and the stigma surrounding it, I redoubled my efforts in advocacy. I focused on educating the public about harm reduction and the importance of providing compassionate, non-judgmental support to those struggling with problematic substance use. On the other end of the spectrum, I also fight for personal autonomy for individuals who seek to use drugs recreationally. Drugs are as dangerous as we make them, and prohibition is directly responsible for the flood of newer, stronger, more dangerous substances.
The Urgency of Policy Change
Substance use disorder affects millions in the United States, but behind each statistic is a personal story of struggle, resilience, and hope. My journey from trauma and addiction to stability and advocacy highlights the importance of harm reduction and the need to combat stigma. My story is a powerful reminder that with the right support and treatment, recovery is possible, and lives can be saved. We must push for policies prioritizing life-saving measures such as access to safe use sites, treatment on demand, increased access to MOUD providers, oversight of clinics and providers, availability of testing strips, comprehensive community education, and so much more. These changes are not just necessary; they are urgent. We must act now to save lives, support recovery, and build a society where every individual struggling with addiction is met with compassion and effective help.
There is no time like now to get involved in the movement for humane drug policy, saving lives, and fewer people in cages.
Join our community Tuesday, July 9th for a webinar on the history of drug policy and what YOU can do to shape a safer, saner, healthier America.
DID YOU KNOW? Currently, in the United States, more than 650,000 people are released from prison each year, and many face significant barriers to reintegration due to systemic inequities and discriminatory policies. The SNAP felony drug ban is one such policy.
In 1996, the Personal Work and Responsibility Act was passed under the guise of welfare reform, at the last minute a provision was added that meant that anyone with a felony drug conviction could be banned from the food assistance program - FOR LIFE - no other felony charge triggered this ban. Although each state was allowed to modify or opt out of the ban, doing so required legislative action, leaving us with a patchwork of laws around the country. The RESTORE Act will undo this discriminatory law and bring hope to returning citizens everywhere.
