Substance misuse and abuse take many forms and have far-reaching consequences, especially as substantial contributing factors to many health problems. Current research shows abused substances -- alcohol, tobacco, and other drugs -- cause short- and long-term changes in the brain's ability to process information and respond to stimuli. As individuals move from substance use to misuse to abuse to addiction, the negative impact of the substance on the brain increases until the person has fundamentally changed his or her brain chemistry.

Impact
Substance abuse affects the entire community through decreases in workplace productivity and increases in health, judicial, and social service costs. Crime and violence are perhaps the most visible effects of substance abuse on a community. Of the people convicted for a crime in 1996, approximately 28% were under the influence of alcohol or other drugs when they committed that crime. Substance abuse is also a significant factor in domestic violence. Alcohol or drug use was reported in approximately 70% of violent crimes in 1995 where the victim and perpetrator were related.

Studies have also shown that after treatment, people who abused substances were involved in fewer moving violations, accidents, and DUI and criminal arrests. Effective treatment programs can also save an average of $11 in other social costs for every dollar spent on treatment. These effective programs are tailored to the individual and address not only their substance abuse but also their employment, educational, spiritual, social, recreational, legal, and physical needs.

Our Service Region
Approximately 20% of the population in the Foundation's service area are affected in some way by substance abuse. State funds in all three states are inadequate to provide the needed services to treat people with substance abuse problems. In addition, managed care and health insurance reforms have reduced coverage of substance abuse treatment.

Consequently, decisions about which prevention and treatment programs will be offered tend to be made based on funding issues alone. This leaves gaps in treatment and results in waiting lists that range from three weeks to six months. In order to get some treatment, clients may be placed in treatment programs that are either too intense or too weak for their needs. Instead of helping the client, inappropriate treatment can compound the problem.

Substance Use Disorders Advisory Group
The Health Foundation convened an Advisory Group of substance abuse service providers and other professionals in 1998 to assist in understanding the status of substance abuse services in our region. This Advisory Group also helped the Foundation develop two strategies to target funding toward the substance abuse services that the community needs most.