Nor Is It A Bright Line

April 1, 2022 By Aaron Young

By Gene Gilchrist, Ph.D., Chief Executive Officer
Stay Clean

Recently we wrote that the popular view of addiction in America is misinformed.  The impression that addiction to alcohol and drugs is a problem for the homeless portrays only a fraction of alcohol and drug use, abuse and addiction.  What does substance use, abuse and addiction look like?  There isn’t a bright line; it isn’t that simple.

The Substance Abuse and Mental Health Services Administration reports that there are 30.5 million Americans suffering substance use disorder (SUD).  The Department of Housing and Urban Development (HUD) reports that there were 580,466 homeless and that 64% of the homeless abuse alcohol or drugs.  Given these numbers, 371,498 people, 1.2%, are those depicted in the popular image.

The Centers for Disease Control estimates that 33% of adults in America do not use alcohol.  The CDC reports that 80.6% of Americans do not use “street drugs” or abuse prescription drugs. This leaves 221 million Americans who use alcohol and 64 million who use drugs.  Among these are those who drink to excess, abuse drugs, and have problems stemming from those behaviors on a regular basis.

The CDC defines binge drinking as the consumption of 5 or more drinks in a two hour period for men and 4 or more for women.  The CDC reports that 1 in 6 American adults binge drinks on average 4 times per month equaling approximately 43 million Americans.  Heavy drinking is defined as 15 drinks per week for men and 8 for women. 5.1% of Americans heavy drink once per month totaling 13.4 million Americans.

The issue of narcotics is more complex.  Except for the evolving issue with marijuana, and the use of prescription drugs “as prescribed,” these drugs are used illegally.  There is also the relatively unresearched issue of a “safe” drug use.  Noting these issues, the CDC estimate that Americans used drugs in these proportions:

  • Marijuana 15.9%
  • Heroin 3.0%
  • Methamphetamines .7%
  • Cocaine 2.0%

Americans also abuse prescription drugs in these proportions according to the CDC:

  • Opioids 3.7%
  • Tranquilizers 2.1%
  • Benzodiazepines 2.0%
  • Stimulants 1.9%
  • Sedatives .4%

19.4% of Americans use schedule 1 narcotics and abuse schedule 2 narcotics totaling 64.2 million. They are all candidates for substance use disorder since they are using illegal drugs or abusing prescription drugs. The evolution of marijuana clouds this discussion.

For our purpose there are between 110 and 115 million American adults who binge drink, heavy drink and/or use schedule I narcotics and abuse schedule 2 narcotics. Our point — there are among them those who regularly abuse alcohol and drugs. Since the NIH estimates that there are 30.5 million people with a substance use disorder, a small fraction of these, 1.2%, fit the common, perception. Harmful behaviors occur across these 110-115 million Americans. Their behavior costs America through:


    Suicides totaled 44,834 in 2020 in the U.S. ranking 10th among the causes of death.  The CDC estimates that 60% of these deaths are attributable to alcohol or drug abuse.
    Driving Under the Influence
    The CDC reports 111,000,000 self-reported incidents of driving while impaired.  Car crashes in the U.S. where drugs other than alcohol are involved totaled 16%. Marijuana is the largest contributor at 13%.  Individuals under the influence of marijuana are 25% more likely to be involved in car crashes.


We are not talking about those who make a mistake with alcohol or drugs on occasion. We intend to say that the stereotype of an addict or alcoholic as homeless is misinformed and there is far more harm being done regularly by Americans using and abusing alcohol and drugs. Binge drinking, heavy drinking, driving under the influence, domestic abuse, self-harm, and business costs are all serious problems caused in great part by alcohol and drug abuse.

It is time to abandon the notion that problem drinking, and drug use occurs only among homeless persons. It is time to abandon a model that relegates treatment only to those who have “hit bottom.” We need to recognize the effects of “casual” alcohol and drug use and arrest those behaviors earlier in the cycle of abuse and addiction.



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Stay Clean is a groundbreaking approach to create additional opportunities for addicts, alcoholics and their loved ones to find an answer.ABOUT STAY CLEAN

Stay Clean is a groundbreaking approach to create additional opportunities for addicts, alcoholics and their loved ones to find an answer. Created by recovering addicts and alcoholics, and people with experience in codependent relationships, Stay Clean is a cloud based, easily accessible, 24 hour community of recovering people and their loved ones helping each other and offering a comprehensive array of recovery services online. Members will access online Recovery Meetings, directions to find on site 12 step meetings in their area, and interact with each other in forums to find answers to their questions. There are proprietary treatment options similar to distance education and face-to-face counseling via telehealth. Counselors and peer coaches will always be highly qualified, highly credentialed, very experienced.

Finally, and perhaps most importantly, members will find easily accessible resources to work through life skills such as relationship building, parenting, career and employment, legal issues and financial management to name a few – they will find help with those kinds of issues that suffered the most during their years of active addiction.

For more information, please visit the Stay Clean web site at



Gene Gilchrist, Ph.D. is the Chief Executive Officer of Stay Clean a cloud-based clinical treatment and recovery community headquartered in Louisville, Kentucky.



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