Substance Use
If this a medical emergency or suspected overdose, call 911 immediately.
Substance use affects the health and wellbeing of individuals and our community.
Substance misuse refers to the harmful use of alcohol, tobacco, marijuana and other drugs. Repeated substance use can lead to dependence, which typically includes a strong desire to take the drug despite the negative consequences.
A substance use disorder (SUD) is a mental health disorder that affects a person’s brain and behavior, leading to a person’s inability to control their use of substances. The recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home.
Read below to learn more about each substance and data available for Madison County.
Table of Contents
Alcohol
Alcohol is the most commonly used substance in the United States. The CDC describes excessive alcohol use as unhealthy drinking behaviors such as binge drinking, heavy drinking, and any alcohol use by people under 21 years or pregnant women.1
About 18.3% of adults in Madison County reported binge drinking in 2021 (compared to 14.9% of NYS adults in 2022).2,3 According to the 2023 BRiDGES Community Adult Opinion Survey, nearly one-quarter (23%) of Madison County adults reported participating in binge drinking at least once in the past 30 days.4 Binge drinking is defined as the consumption of 5 or more alcoholic drinks within a short period of time for men and the consumption of 4 or more within a short period of time for women.5 In the 2022 Madison County Teen Assessment Project (TAP) Report, approximately 70% of high school students reported never having consumed alcohol, an increase from 58% in 2018.5 Among students who had at least one drink in their lifetime, 63.2% reported not drinking in the past 30 days, compared to 80% in 2018.6
Driving under the influence of alcohol impacts a person’s ability to drive safely. The chart below shows an increase in alcohol-related motor vehicle crashes in 2023. Although it appears the rate of crashes have decreased in 2024, there are delays in receiving the data, and the graph is likely to change. More data will be uploaded as it becomes available.
Tobacco/Vaping
Nicotine is a highly addictive substance that is consumed through tobacco products. About 18.6% of adults in Madison County identify as current smokers compared to only 12.0% of New York State adults.2 Nearly 35% of Madison County adults who make less than $25,000 annually use tobacco products. This is significantly higher than New York State adults with the same income (20.4%).3 According to the 2022 Madison County Teen Assessment Project (TAP) Report, 7.6% of students have tried a cigarette, down from 11% in the previous assessment (2018).6
Vaping products or e-cigarettes emerged into the US marketplace in 2007 and have increased in popularity since, particularly among young people. Vaping products may be a delivery system for nicotine or tetrahydrocannabinol (THC). The 2022 TAP Report revealed 19.4% of high school students in Madison County have tried e-cigarettes, similar to the state average (18.7%).6 E-cigarette use among Madison County adults from 8.9% in 2018 to 10.4% in 2021. 7
Opioids
Opioids are a class of substances that reduce pain.8 These addictive drugs are man-made or naturally derived from the opium poppy plant.8 Some opioids are prescription drugs (such as OxyContin, morphine, and pharmaceutical fentanyl), and other opioids are made for the illegal drug market (such as heroin and non-prescribed fentanyl).7
Fentanyl, the most potent opioid, is 50 to 100 times stronger than morphine.9 As small as two (2) milligrams of fentanyl can be fatal.10 Illicitly manufactured fentanyl is a major contributor to the rising numbers of overdoses and deaths and is often added to other drugs and consumed unknowingly.11,12 In the 2022 TAP Report, less than 1% of students reported using heroin or other opiates at least once, down from 1.5% of the students surveyed in 2018.5
The rate of opioid-related deaths decreased in 2022 among residents in Madison County, Central New York, and New York State (excluding New York City).13
Cannabis
On March 31st, 2021, New York State legalized recreational cannabis for adults aged 21 or older with the passage of the Marijuana Regulation and Taxation Act (MRTA)*.14 Cannabis, also known as marijuana, refers to the dried leaves, flowers, stems, and seeds of the Cannabis sativa or Cannabis indica plant and contains tetrahydrocannabinol (THC), a psychoactive compound used for both recreational and medicinal purposes.15
(*This legislation imposes various restrictions, including age limits, possession caps, rules for home cultivation, DUI prohibitions, and more. Adults should thoroughly understand these regulations before engaging in recreational use.)
Medicinally, cannabis has gained FDA approval for conditions such as seizures in epilepsy (e.g., Epidiolex), nausea in cancer patients, and appetite loss in AIDS patients.15 Recreational users enjoy cannabis for its relaxing and euphoric effects.16 In Madison County, approximately 14% of adults use cannabis recreationally, with an additional 12% using it both recreationally and medicinally.17
Despite its legal status and medical benefits, misuse of cannabis can lead to health risks, including Cannabis Use Disorder.19 Inhaling cannabis products may harm the lungs, and cannabis can be contaminated, leading to accidental ingestion of unknown substances.20 Certain groups, such as individuals with specific health conditions, pregnant or breastfeeding women, and those underage, should avoid cannabis altogether.21
Anyone who is under 21 years old is prohibited from purchasing or using marijuana due to its potential to harm developing brains.22 In Madison County, underage marijuana use appears to be declining. According to the 2022 TAP, approximately 83% of high school students have abstained from marijuana, the highest rate since the survey began in 1999.6
In the past year, admissions related to marijuana use have nearly doubled in Madison County and overall increased in the Central New York region. Across the entire state, admissions have lowered. There are delays in receiving data for 2024, and the chart is likely to change. More data will be uploaded as it becomes available.
Citations
- CDC: Alcohol Use and Your Health
- New York State Behavioral Risk Factor Surveillance Survey (2021)
- New York State Behavioral Risk Factor Surveillance Survey Brief (2022)
- Joel LaLone Consulting & BRiDGES. Community Adult Alcohol Opinion Survey (2023)
- National Institute of Alcohol Abuse and Alcoholism: Alcohol's Effect on Health
- Madison County Teen Assessment Project (2022)
- Behavioral Risk Factor Surveillance System (2021)
- U.S Department of Health and Human Services: What are Opioids?
- National Institute on Drug Abuse: What is Fentanyl?
- U.S Drug Enforcement Administration: Facts about Fentanyl
- CDC: Fentanyl
- National Institute on Drug Abuse: Opioids
- New York State Department of Health, Opioid-Related Data in New York State
- Adult-Use Cannabis Legalization: What You Need to Know. New York State
- National Institute on Drug Abuse: Cannabis (Marijuana)
- CDC: About Cannabis.
- The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research.
- Joel LaLone Consulting & BRiDGES. Community Adult Survey Regarding Recent Legalization of Recreational Marijuana Use and Sales in Madison County, New York (2022).
- Understanding Your Risk for Cannabis Use Disorder
- CDC: Cannabis and Lung Health.
- Who Should Avoid Using Cannabis?
- CDC: Cannabis and Teens
Updated March 4, 2025