Two thirds of Americans responding to a Kaiser Family Foundation poll said that either they or a family member has been addicted to alcohol or drugs, experienced homelessness due to addiction, or experienced a drug overdose leading to an emergency room visit, hospitalization, or death.
Alcohol is still the substance misused most often, with more than half of adults (54%) responding to the online and telephone survey stating that someone in their family has ever been addicted to alcohol.
About a quarter said they or a family member had been addicted to any illegal drug, and another quarter said they or a family member was addicted to prescription painkillers.
Almost a fifth of adults (18%) reported that they had (a) personally been addicted to drugs or alcohol, (b) had a drug overdose requiring an ER visit or hospitalization, or (c) had experienced homelessness because of addiction.
The substance misuse affects all income levels, almost equally. For adults with a household income of less than $40,000 a year, some 25% said they had been addicted. That compares to 18% of those with an income of $40,000-to-$90,000 annually, and 16% of those who make $90,000 or more a year.
White Americans reported more addiction and overdose; the difference is driven largely by alcohol and prescription painkiller addiction, the Kaiser poll found.
Sixty percent of White adults, compared with 50% of Black and 47% of Hispanic adults, said someone in their family had been addicted to alcohol. For prescription opioids, 28% of White adults, 18% of Black adults and 20% of Hispanic adults reported addiction in their family.
Opioid addiction was especially high among White adults and rural adults, with 42% of those in rural areas reporting they or a family member was addicted to opioids, compared with 30% of suburban residents and 23% of urban residents.
Substance use disorders have a big impact on families and mental health, Kaiser reported. Among those who have an addiction or a family member with addiction, 75% said the disorder had an impact on their relationship with their family.
At least half of adults are worried that someone in their family will experience a substance use disorder, with 39% worried that someone in their family might unintentionally consume fentanyl.
Almost two thirds of adults said they were "very" or "somewhat worried" that someone in their family will experience a serious mental health crisis. Thirty-six percent said they were worried someone in their family will attempt suicide.
Concerns about homelessness were highest among Hispanic adults, with 75% saying they were worried about a family member becoming homeless, compared with 60% of Black adults, and 23% of White adults. These worries were highest among those with incomes of less than $40,000 a year.
Few Receiving Treatment
Only about 46% of adults reporting personal or family addiction said that they or their family member had received treatment. White adults (51%) were more likely to have received treatment; slightly more than a third of Black and Hispanic adults reported they or a family member had been treated.
Poll respondents cited multiple barriers to treatment, including that the person did not want or refused help; stopped on their own; denied that they had an addiction; could not afford care; or felt shame or stigma. Some reported that a family member died before they could get help.
Kaiser included some of what respondents said in their own words. "We are not raised that way," said a 22-year-old Black woman from Georgia.
"Brother quit on his own and been sober for 2 years; my dad was addicted to cocaine [and] quit on his own," said a 37-year-old Hispanic man from Texas.
Only a quarter of people said they or a family member received medication-assisted treatment for opioid use disorder.
People reported an openness to having addiction treatment centers in their community, with 91% expressing support. A large majority also supported making naloxone (Narcan) freely available in places like bars, health clinics, and fire stations.
Democrats (61%) strongly or somewhat supported the establishment of safe consumption sites, while Independents (49%) were less supportive; just 23% of Republicans were supportive.
The Kaiser survey was conducted July 11-19 among a nationally representative sample of 1327 US adults in English (1246) and in Spanish (81). The majority were part of a probability-based panel where panel members are recruited randomly. The margin of error is plus or minus 3 percentage points.
Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in publications including JAMA and Smithsonian.com. You can find her on Twitter @aliciaault.