Substance Use
The major substance use problems in New Mexico are excessive alcohol consumption, resulting in the nation's highest alcohol-related death rate, and drug use, resulting a high drug overdose death rate compared to most other states. The consequences of substance use present a large burden on the state's economy and our people.
The terms "substance abuse" and "substance use disorder" generally refer to a destructive pattern of using a substance, especially alcohol or drugs. The pattern may be characterized by significant problems or distress, such as interference with a person's family, work, school, or social obligations, or putting the person in hazardous situations or in legal jeaopardy.
Why It's Important
Eight of the ten leading causes of death in New Mexico are at least partially caused by the abuse of alcohol, tobacco, or other drugs. In 2017, the ten leading causes of death in New Mexico were heart, disease, cancer, unintentional injuries, chronic lower respiratory disease, cerebrovascular disease, diabetes, chronic liver disease, Alzheimer's disease, suicide, and influenza and pneumonia. Of these, chronic liver disease, unintentional injuries, and suicide are associated with alcohol use; chronic lower respiratory disease and influenza and pneumonia are associated with tobacco use; heart disease, malignant neoplasms, and cerebrovascular disease are associated with both alcohol and tobacco use; and unintentional injuries and suicide are associated with the use of other drugs.What Is Known
Over the past 30 years, New Mexico has consistently had among the highest alcohol-related death rates in the United States and it has had the highest alcohol-related death rate since 1997. The negative consequences of excessive alcohol use in New Mexico are not limited to death, but also include domestic violence, crime, poverty, and unemployment, as well as chronic liver disease, motor vehicle crash and other injuries, mental illness, and a variety of other medical problems. In 2006, the economic cost of alcohol abuse in New Mexico was more than $2.5 billion, or $1,250 per person. Death rates from alcohol-related causes increase with age.
New Mexico has the highest drug-induced death rate in the nation, and the consequences of drug use continue to burden New Mexico communities.
Who Is at Risk
Male rates of alcohol-related death are substantially higher than female rates. American Indians have higher alcohol-related death rates than other race/ethnicities. McKinley and Rio Arriba counties have extremely high alcohol-related death rates, driven by high rates in the American Indian and Hispanic male populations, respectively. The counties with the most deaths for the five-year period 2005-2009 are Bernalillo, San Juan, Santa Fe, McKinley, and Doña Ana. New Mexico has extremely high death rates due to both alcohol-related chronic diseases and alcohol-related injuries.
Drug-induced death rates are higher for males than for females. The highest drug-induced death rate was among Hispanic males, followed by White males. Rio Arriba County had the highest drug-induced death rate in the state, followed by Eddy, Torrance, Chaves, and Bernalillo counties. Bernalillo County continued to bear the highest burden of drug-induced death in terms of total numbers of deaths. Unintentional drug overdoses account for more than 80% of drug-induced deaths. The most common drugs causing unintentional overdose death for the period covered in this report were prescription opioids (i.e., methadone, oxycodone, morphine; 49%), heroin (36%), cocaine (31%), tranquilizers/muscle relaxants (29%) and antidepressants (16%). In New Mexico and nationally, overdose death from prescription opioids has become an issue of enormous concern as these potent drugs are widely available.
How To Reduce Risk
There is a large body of evidence on effective strategies to prevent excessive alcohol use and alcohol-related harm. In the past decade, this evidence base has been the subject of numerous systematic expert reviews to assess the quality and consistency of the evidence for particular strategies; and to make recommendations based on this evidence. These expert reviews have recently been summarized by the NMDOH. The following list summarizes the evidence-based prevention strategies that are well-recommended by experts; and that could be more widely or completely implemented in New Mexico to reduce our alcohol-related problems. Evidence Based Excessive Alcohol Use Prevention Strategies.
Primary prevention attempts to stop a problem before it starts. In New Mexico, primary prevention of alcohol-related health problems has focused on regulating access to alcohol and altering the alcohol consumption behavior of high-risk populations. Regulatory efforts have included increasing the price of alcohol (shown to be effective in deterring alcohol use among adolescents), establishing a minimum legal drinking age, regulating the density of liquor outlets, and increasing penalties for buyers and servers of alcohol to minors. DWI-related law enforcement (e.g., sobriety checkpoints), when accompanied by media activity, can also be an important form of primary prevention, increasing the perceived risk of driving after drinking among the general population.
Secondary prevention efforts try to detect and treat emergent cases before they cause harm. Screening and brief interventions (SBI) for adults in primary care settings is an evidence-based intervention to address problem drinking before it causes serious harm. Implementing this intervention more broadly in New Mexico primary care settings could help reduce our serious burden of alcohol-related chronic disease and injury.
Tertiary prevention involves the treatment of individuals diagnosed with alcohol use disorders so they can recover to the highest possible level of health while minimizing the effects of the disease and preventing complications. According to the most recent estimates from the National Survey on Drug Use and Health (NSDUH,http://oas.samhsa.gov/2k7State/NewMexico.htm#Tabs), roughly 130,000 New Mexicans report past-year alcohol dependence or abuse, indicating an acute need for treatment.
However, fewer than one in ten people in need of treatment receives it.
Nationally, the most common reasons that people who need and seek treatment do not receive it are because: they have no health insurance and cannot afford the cost; they are concerned about the possible negative effect on their job; or they are not ready to stop using.
How It's Tracked
Mental Health data can be obtained from both mortality as well as morbidity data sources:- Mortality data provides on 100% alcohol- and drug-induced deaths and drug overdoses.
- The Centers for Disease Control and Prevention (CDC) funded the development of the Alcohol-Related Disease Impact (ARDI) methodology that applies attributable fractions to underlying causes of death to arrive at the estimated number of deaths that were alcohol-related.
- Adult prevalence data come from Behavioral Risk Factor Surveillance System (BRFSS), U.S. Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services.
- Youth prevalence data come from Youth Risk and Resiliency Survey (YRRS), U.S. Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services.
- Hospital Discharge Data (HDD) for inpatient and ED visits relating to substance abuse disorders.