Perhaps no one in Minnesota knows about trends in substance abuse and addiction like Carol Falkowski (B.A. ’75, at left). For 30-plus years she has dedicated her career to understanding and combating addiction: She was at the internationally renowned Hazelden Foundation in Chisago City, Minnesota, (now the Hazelden Betty Ford Foundation) for 10 years; the Alcohol and Drug Abuse Division of the Minnesota Department of Human Services for 25 years; and now with the consulting firm Drug Abuse Dialogues, which she founded in 2012 to train health professionals, law enforcement, judges, educators, and parents on trends in drug abuse. 

The addiction landscape has shifted a lot during Falkowski’s career. Some of the trends are hopeful, such as the fact that cigarette smoking among adolescents has declined dramatically since the mid-1990s. But others worry her.

For instance, while fewer adolescents are smoking cigarettes, more are smoking marijuana. Public perceptions of the drug are changing, due in part to legalization efforts in several states. While she believes that medical marijuana shows real promise in some contexts, recreational marijuana use has unique and sometimes lasting ramifications for adolescents. For starters, she says, they’re more likely to develop an addiction.

“The longer you can delay the onset, the less likely the development of addiction, and the less likely you are of having negative consequences while you’re impaired,” she says.

Like her peers, she’s particularly discouraged by the heroin and opioid epidemic. Falkowski points to the federal Centers for Disease Control’s finding that in 2015, for the first time ever, heroin deaths outnumbered gun deaths.

“It’s an enormous phenomenon, and it’s fed both by prescription opioids and street drugs,” Falkowski says. “Seizures of heroin at our southern border have never been higher, and many people who become addicted through prescription pain medication switch to heroin because it’s never been more affordable.

“With the opioid epidemic, because of the role of prescription medication, we also have to look at the practice of medicine,” Falkowski continues. “And we’re making progress in terms of looking at prescribing guidelines, but there’s still enough opioids prescribed in this country to have all adults take a daily regimen of them for a month. This is in spite of efforts to develop treatment alternatives for chronic pain.” Synthetic drugs, from methamphetamine to cathinones like bath salts, are also deadly “game changers,” Falkowski observes. “There’s the accessibility of online drugs. And the influx of synthetic drugs from China, including synthetic drugs pressed into pills. It’s really a changing entity.”