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Substance abuse

Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods that are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, medical, and criminal justice contexts. In some cases, criminal or anti-social behavior occurs when the person is under the influence of a drug, and long-term personality changes in individuals may also occur. In addition to possible physical, social, and psychological harm, the use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.

Drugs most often associated with this term include alcohol, amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, hallucinogens, methaqualone, and opioids. The exact cause of substance abuse is not clear, but there are two predominant theories: either a genetic predisposition or a habit learned from others, which, if addiction develops, manifests itself as a chronic debilitating disease.

In 2010, about 5% of adults (230 million) used an illicit substance. Of these, 27 million have high-risk drug use—otherwise known as recurrent drug use—causing harm to their health, causing psychological problems, and or causing social problems that put them at risk of those dangers. In 2015, substance use disorders resulted in 307,400 deaths, up from 165,000 deaths in 1990. Of these, the highest numbers are from alcohol use disorders at 137,500, opioid use disorders at 122,100 deaths, amphetamine use disorders at 12,200 deaths, and cocaine use disorders at 11,100.

Public health definitions
Public health practitioners have attempted to look at substance use from a broader perspective than the individual, emphasizing the role of society, culture, and availability. Some health professionals choose to avoid the terms alcohol or drug "abuse" in favor of language considered more objective, such as "substance and alcohol type problems" or "harmful/problematic use" of drugs. The Health Officers Council of British Columbia — in their 2005 policy discussion paper, A Public Health Approach to Drug Control in Canada — has adopted a public health model of psychoactive substance use that challenges the simplistic black-and-white construction of the binary (or complementary) antonyms "use" vs. "abuse". This model explicitly recognizes a spectrum of use, ranging from beneficial use to chronic dependence.

Medical definitions
'Drug abuse' is no longer a current medical diagnosis in either of the most used diagnostic tools in the world, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM), and the World Health Organization's International Classification of Diseases (ICD).

Value judgment
Philip Jenkins suggests that there are two issues with the term "drug abuse". First, what constitutes a "drug" is debatable. For instance, GHB, a naturally occurring substance in the central nervous system is considered a drug, and is illegal in many countries, while nicotine is not officially considered a drug in most countries.

Second, the word "abuse" implies a recognized standard of use for any substance. Drinking an occasional glass of wine is considered acceptable in most Western countries, while drinking several bottles is seen as abuse. Strict temperance advocates, who may or may not be religiously motivated, would see drinking even one glass as abuse. Some groups (Mormons, as prescribed in "the Word of Wisdom") even condemn caffeine use in any quantity. Similarly, adopting the view that any (recreational) use of cannabis or substituted amphetamines constitutes drug abuse implies a decision made that the substance is harmful, even in minute quantities. In the U.S., drugs have been legally classified into five categories, schedule I, II, III, IV, or V in the Controlled Substances Act. The drugs are classified on their deemed potential for abuse. The usage of some drugs is strongly correlated. For example, the consumption of seven illicit drugs (amphetamines, cannabis, cocaine, ecstasy, legal highs, LSD, and magic mushrooms) is correlated and the Pearson correlation coefficient r>0.4 in every pair of them; consumption of cannabis is strongly correlated (r>0.5) with the usage of nicotine (tobacco), heroin is correlated with cocaine (r>0.4) and methadone (r>0.45), and is strongly correlated with crack (r>0.5)

Drug misuse
Drug misuse is a term used commonly when prescription medication with sedative, anxiolytic, analgesic, or stimulant properties is used for mood alteration or intoxication ignoring the fact that overdose of such medicines can sometimes have serious adverse effects. It sometimes involves drug diversion from the individual for whom it was prescribed.

Prescription misuse has been defined differently and rather inconsistently based on the status of drug prescription, the uses without a prescription, intentional use to achieve intoxicating effects, route of administration, co-ingestion with alcohol, and the presence or absence of dependence symptoms. Chronic use of certain substances leads to a change in the central nervous system known as a "tolerance" to the medicine such that more of the substance is needed in order to produce desired effects. With some substances, stopping or reducing use can cause withdrawal symptoms to occur, but this is highly dependent on the specific substance in question.

The rate of prescription drug use is fast overtaking illegal drug use in the United States. According to the National Institute of Drug Abuse, 7 million people were taking prescription drugs for nonmedical use in 2010. Among 12th graders, nonmedical prescription drug use is now second only to cannabis. In 2011, "Nearly 1 in 12 high school seniors reported nonmedical use of Vicodin; 1 in 20 reported such use of OxyContin." Both of these drugs contain opioids. Fentanyl is an opioid that is 100 times more potent than morphine, and 50 times more potent than heroin. A 2017 survey of 12th graders in the United States, found misuse of OxyContin of 2.7 percent, compared to 5.5 percent at its peak in 2005. Misuse of the combination hydrocodone/paracetamol was at its lowest since a peak of 10.5 percent in 2003. This decrease may be related to public health initiatives and decreased availability.

Avenues of obtaining prescription drugs for misuse are varied: sharing between family and friends, illegally buying medications at school or work, and often "doctor shopping" to find multiple physicians to prescribe the same medication, without the knowledge of other prescribers.

Increasingly, law enforcement is holding physicians responsible for prescribing controlled substances without fully establishing patient controls, such as a patient "drug contract". Concerned physicians are educating themselves on how to identify medication-seeking behavior in their patients, and are becoming familiar with "red flags" that would alert them to potential prescription drug abuse.

Signs and symptoms
Depending on the actual compound, drug abuse including alcohol may lead to health problems, social problems, morbidity, injuries, unprotected sex, violence, deaths, motor vehicle accidents, homicides, suicides, physical dependence or psychological addiction.

There is a high rate of suicide in alcoholics and other drug abusers. The reasons believed to cause the increased risk of suicide include the long-term abuse of alcohol and other drugs causing physiological distortion of brain chemistry as well as the social isolation. Another factor is the acute intoxicating effects of the drugs may make suicide more likely to occur. Suicide is also very common in adolescent alcohol abusers, with 1 in 4 suicides in adolescents being related to alcohol abuse. In the US, approximately 30% of suicides are related to alcohol abuse. Alcohol abuse is also associated with increased risks of committing criminal offences including child abuse, domestic violence, rapes, burglaries and assaults.

Drug abuse, including alcohol and prescription drugs, can induce symptomatology which resembles mental illness. This can occur both in the intoxicated state and also during withdrawal. In some cases, substance-induced psychiatric disorders can persist long after detoxification, such as prolonged psychosis or depression after amphetamine or cocaine abuse. A protracted withdrawal syndrome can also occur with symptoms persisting for months after cessation of use. Benzodiazepines are the most notable drug for inducing prolonged withdrawal effects with symptoms sometimes persisting for years after cessation of use. Both alcohol, barbiturate as well as benzodiazepine withdrawal can potentially be fatal. Abuse of hallucinogens, although extremely unlikely, may in some individuals trigger delusional and other psychotic phenomena long after cessation of use. This is mainly a risk with deliriants, and most unlikely with psychedelics and dissociatives.

Cannabis may trigger panic attacks during intoxication and with continued use, it may cause a state similar to dysthymia. Researchers have found that daily cannabis use and the use of high-potency cannabis are independently associated with a higher chance of developing schizophrenia and other psychotic disorders.

Severe anxiety and depression are often induced by sustained alcohol abuse. Even sustained moderate alcohol use may increase anxiety and depression levels in some individuals. In most cases, these drug-induced psychiatric disorders fade away with prolonged abstinence. Similarly, although substance abuse induces many changes to the brain, there is evidence that many of these alterations are reversed following periods of prolonged abstinence.

Impulsivity
Impulsivity is characterized by actions based on sudden desires, whims, or inclinations rather than careful thought. Individuals with substance abuse have higher levels of impulsivity, and individuals who use multiple drugs tend to be more impulsive. A number of studies using the Iowa gambling task as a measure for impulsive behavior found that drug using populations made more risky choices compared to healthy controls. There is a hypothesis that the loss of impulse control may be due to impaired inhibitory control resulting from drug induced changes that take place in the frontal cortex. The neurodevelopmental and hormonal changes that happen during adolescence may modulate impulse control that could possibly lead to the experimentation with drugs and may lead to addiction. Impulsivity is thought to be a facet trait in the neuroticism personality domain (overindulgence/negative urgency) which is prospectively associated with the development of substance abuse.

Screening and assessment
The screening and assessment process of substance use behavior is important for the diagnosis and treatment of substance use disorders. Screeners is the process of identifying individuals who have or may be at risk for a substance use disorder and are usually brief to administer. Assessments are used to clarify the nature of the substance use behavior to help determine appropriate treatment. Assessments usually require specialized skills, and are longer to administer than screeners.

Given that addiction manifests in structural changes to the brain, it is possible that non-invasive magnetic resonance imaging could help diagnose addiction in the future.

Targeted assessments
There are several different screening tools that have been validated for use with adolescents such as the CRAFFT Screening Test and in adults the CAGE questionnaire. Some recommendations for screening tools for substance misuse in pregnancy include that they take less than 10 minutes, should be used routinely, include an educational component. Tools suitable for pregnant women include i.a. 4Ps, T-ACE, TWEAK, TQDH (Ten-Question Drinking History), and AUDIT.

Psychological
From the applied behavior analysis literature, behavioral psychology, and from randomized clinical trials, several evidenced based interventions have emerged: behavioral marital therapy, motivational Interviewing, community reinforcement approach, exposure therapy, contingency management They help suppress cravings and mental anxiety, improve focus on treatment and new learning behavioral skills, ease withdrawal symptoms and reduce the chances of relapse.

In children and adolescents, cognitive behavioral therapy (CBT) and family therapy currently has the most research evidence for the treatment of substance abuse problems. Well-established studies also include ecological family-based treatment and group CBT. These treatments can be administered in a variety of different formats, each of which has varying levels of research support Research has shown that what makes group CBT most effective is that it promotes the development of social skills, developmentally appropriate emotional regulatory skills and other interpersonal skills. A few integrated treatment models, which combines parts from various types of treatment, have also been seen as both well-established or probably effective. A study on maternal alcohol and other drug use has shown that integrated treatment programs have produced significant results, resulting in higher negative results on toxicology screens. Additionally, brief school-based interventions have been found to be effective in reducing adolescent alcohol and cannabis use and abuse. Motivational interviewing can also be effective in treating substance use disorder in adolescents.

Alcoholics Anonymous and Narcotics Anonymous are widely known self-help organizations in which members support each other abstain from substances. Social skills are significantly impaired in people with alcoholism due to the neurotoxic effects of alcohol on the brain, especially the prefrontal cortex area of the brain. It has been suggested that social skills training adjunctive to inpatient treatment of alcohol dependence is probably efficacious, including managing the social environment.

Medication
A number of medications have been approved for the treatment of substance abuse. These include replacement therapies such as buprenorphine and methadone as well as antagonist medications like disulfiram and naltrexone in either short acting, or the newer long acting form. Several other medications, often ones originally used in other contexts, have also been shown to be effective including bupropion and modafinil. Methadone and buprenorphine are sometimes used to treat opiate addiction. These drugs are used as substitutes for other opioids and still cause withdrawal symptoms but they facilitate the tapering off process in a controlled fashion. When a person goes from using fentanyl every day, to not using it at all, they will experience a point where they need to get used to not using the substance. This is called withdrawal.

Antipsychotic medications have not been found to be useful. Acamprostate is a glutamatergic NMDA antagonist, which helps with alcohol withdrawal symptoms because alcohol withdrawal is associated with a hyperglutamatergic system.

Heroin-assisted treatment
Three countries in Europe have active HAT programs, namely England, the Netherlands and Switzerland. Despite critical voices by conservative think-tanks with regard to these harm-reduction strategies, significant progress in the reduction of drug-related deaths has been achieved in those countries. For example, the US, devoid of such measures, has seen large increases in drug-related deaths since 2000 (mostly related to heroin use), while Switzerland has seen large decreases. In 2018, approximately 60,000 people have died of drug overdoses in America, while in the same time period, Switzerland's drug deaths were at 260. Relative to the population of these countries, the US has 10 times more drug-related deaths compared to the Swiss Confederation, which in effect illustrates the efficacy of HAT to reduce fatal outcomes in opiate/opioid addiction.

Dual diagnosis
It is common for individuals with drugs use disorder to have other psychological problems. The terms "dual diagnosis" or "co-occurring disorders", refer to having a mental health and substance use disorder at the same time. According to the British Association for Psychopharmacology (BAP), "symptoms of psychiatric disorders such as depression, anxiety and psychosis are the rule rather than the exception in patients misusing drugs and/or alcohol."

Individuals who have a comorbid psychological disorder often have a poor prognosis if either disorder is untreated. Historically most individuals with dual diagnosis either received treatment only for one of their disorders or they did not receive any treatment all. However, since the 1980s, there has been a push towards integrating mental health and addiction treatment. In this method, neither condition is considered primary and both are treated simultaneously by the same provider.

Epidemiology

The initiation of drug use including alcohol is most likely to occur during adolescence, and some experimentation with substances by older adolescents is common. For example, results from 2010 Monitoring the Future survey, a nationwide study on rates of substance use in the United States, show that 48.2% of 12th graders report having used an illicit drug at some point in their lives. In the 30 days prior to the survey, 41.2% of 12th graders had consumed alcohol and 19.2% of 12th graders had smoked tobacco cigarettes. In 2009 in the United States about 21% of high school students have taken prescription drugs without a prescription. And earlier in 2002, the World Health Organization estimated that around 140 million people were alcohol dependent and another 400 million with alcohol-related problems.

Studies have shown that the large majority of adolescents will phase out of drug use before it becomes problematic. Thus, although rates of overall use are high, the percentage of adolescents who meet criteria for substance abuse is significantly lower (close to 5%). According UN estimates, there are "more than 50 million regular users of morphine diacetate (heroin), cocaine and synthetic drugs."

More than 70,200 Americans died from drug overdoses in 2017. Among these, the sharpest increase occurred among deaths related to fentanyl and synthetic opioids (28,466 deaths). See charts below.

APA, AMA, and NCDA
In 1966, the American Medical Association's Committee on Alcoholism and Addiction defined abuse of stimulants (amphetamines, primarily) in terms of 'medical supervision': "...'use' refers to the proper place of stimulants in medical practice; 'misuse' applies to the physician's role in initiating a potentially dangerous course of therapy; and 'abuse' refers to self-administration of these drugs without medical supervision and particularly in large doses that may lead to psychological dependency, tolerance and abnormal behavior."

In 1972, the American Psychiatric Association created a definition that used legality, social acceptability, and cultural familiarity as qualifying factors: "...as a general rule, we reserve the term drug abuse to apply to the illegal, nonmedical use of a limited number of substances, most of them drugs, which have properties of altering the mental state in ways that are considered by social norms and defined by statute to be inappropriate, undesirable, harmful, threatening, or, at minimum, culture-alien."

In 1973, the National Commission on Marijuana and Drug Abuse stated: "...drug abuse may refer to any type of drug or chemical without regard to its pharmacologic actions. It is an eclectic concept having only one uniform connotation: societal disapproval. ... The Commission believes that the term drug abuse must be deleted from official pronouncements and public policy dialogue. The term has no functional utility and has become no more than an arbitrary codeword for that drug use which is presently considered wrong."

DSM
The first edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (published in 1952) grouped alcohol and other drug abuse under "sociopathic personality disturbances", which were thought to be symptoms of deeper psychological disorders or moral weakness. The third edition, published in 1980, was the first to recognize substance abuse (including drug abuse) and substance dependence as conditions separate from substance abuse alone, bringing in social and cultural factors. The definition of dependence emphasised tolerance to drugs, and withdrawal from them as key components to diagnosis, whereas abuse was defined as "problematic use with social or occupational impairment" but without withdrawal or tolerance.

In 1987, the DSM-IIIR category "psychoactive substance abuse", which includes former concepts of drug abuse is defined as "a maladaptive pattern of use indicated by...continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use (or by) recurrent use in situations in which it is physically hazardous". It is a residual category, with dependence taking precedence when applicable. It was the first definition to give equal weight to behavioural and physiological factors in diagnosis. By 1988, the DSM-IV defined substance dependence as "a syndrome involving compulsive use, with or without tolerance and withdrawal"; whereas substance abuse is "problematic use without compulsive use, significant tolerance, or withdrawal". Substance abuse can be harmful to health and may even be deadly in certain scenarios. By 1994, the fourth edition of the DSM issued by the American Psychiatric Association, the DSM-IV-TR, defined substance dependence as "when an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed", along with criteria for the diagnosis.

The DSM-IV-TR defines substance abuse as:

 * A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:
 * Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)
 * Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
 * Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)
 * Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)
 * the symptoms have never met the criteria for substance dependence for this class of substance

The fifth edition of the DSM (DSM-5), was released in 2013, and it revisited this terminology. The principal change was a transition from the abuse-dependence terminology. In the DSM-IV era, abuse was seen as an early form or less hazardous form of the disease characterized with the dependence criteria. However, the APA's dependence term does not mean that physiologic dependence is present but rather means that a disease state is present, one that most would likely refer to as an addicted state. Many involved recognize that the terminology has often led to confusion, both within the medical community and with the general public. The American Psychiatric Association requested input as to how the terminology of this illness should be altered as it moves forward with DSM-5 discussions. In the DSM-5, substance abuse and substance dependence have been merged into the category of substance use disorders and they no longer exist as individual concepts. While substance abuse and dependence were either present or not, substance use disorder has three levels of severity: mild, moderate and severe.

Legal approaches

 * Related articles: Drug control law, Prohibition (drugs), Arguments for and against drug prohibition, Harm reduction

Most governments have designed legislation to criminalize certain types of drug use. These drugs are often called "illegal drugs" but generally what is illegal is their unlicensed production, distribution, and possession. These drugs are also called "controlled substances". Even for simple possession, legal punishment can be quite severe (including the death penalty in some countries). Laws vary across countries, and even within them, and have fluctuated widely throughout history.

Attempts by government-sponsored drug control policy to interdict drug supply and eliminate drug abuse have been largely unsuccessful. In spite of the huge efforts by the U.S., drug supply and purity has reached an all-time high, with the vast majority of resources spent on interdiction and law enforcement instead of public health. In the United States, the number of nonviolent drug offenders in prison exceeds by 100,000 the total incarcerated population in the EU, despite the fact that the EU has 100 million more citizens.

Despite drug legislation (or perhaps because of it), large, organized criminal drug cartels operate worldwide. Advocates of decriminalization argue that drug prohibition makes drug dealing a lucrative business, leading to much of the associated criminal activity.

Some states in the U.S., as of late, have focused on facilitating safe use as opposed to eradicating it. For example, as of 2022, New Jersey has made the effort to expand needle exchange programs throughout the state, passing a bill through legislature that gives control over decisions regarding these types of programs to the state's department of health. This state level bill is not only significant for New Jersey, as it could be used as a model for other states to possibly follow as well. This bill is partly a reaction to the issues occurring at local level city governments within the state of New Jersey as of late. One example of this is in the Atlantic City Government which came under lawsuit after they halted the enactment of said programs within their city. This suit came a year before the passing of this bill, stemming from a local level decision to shut down related operations in Atlantic City made in July that same year. This lawsuit highlights the feelings of New Jersey residents, who had a great influence on this bill passing the legislature. These feelings were demonstrated in front of Atlantic City City hall, where residents exclaimed their desire for these programs. All in all, the aforementioned bill was signed effectively into law just days after it passed legislature, by New Jersey Governor Phil Murphy.

Cost
Policymakers try to understand the relative costs of drug-related interventions. An appropriate drug policy relies on the assessment of drug-related public expenditure based on a classification system where costs are properly identified.

Labelled drug-related expenditures are defined as the direct planned spending that reflects the voluntary engagement of the state in the field of illicit drugs. Direct public expenditures explicitly labeled as drug-related can be easily traced back by exhaustively reviewing official accountancy documents such as national budgets and year-end reports. Unlabelled expenditure refers to unplanned spending and is estimated through modeling techniques, based on a top-down budgetary procedure. Starting from overall aggregated expenditures, this procedure estimates the proportion causally attributable to substance abuse (Unlabelled Drug-related Expenditure = Overall Expenditure × Attributable Proportion). For example, to estimate the prison drug-related expenditures in a given country, two elements would be necessary: the overall prison expenditures in the country for a given period, and the attributable proportion of inmates due to drug-related issues. The product of the two will give a rough estimate that can be compared across different countries.

Europe
As part of the reporting exercise corresponding to 2005, the European Monitoring Centre for Drugs and Drug Addiction's network of national focal points set up in the 27 European Union (EU) the member states, Norway, and the candidates' countries to the EU, were requested to identify labeled drug-related public expenditure, at the national level.

This was reported by 10 countries categorized according to the functions of government, amounting to a total of EUR 2.17 billion. Overall, the highest proportion of this total came within the government functions of health (66%) (e.g. medical services), and public order and safety (POS) (20%) (e.g. police services, law courts, prisons). By country, the average share of GDP was 0.023% for health, and 0.013% for POS. However, these shares varied considerably across countries, ranging from 0.00033% in Slovakia, up to 0.053% of GDP in Ireland in the case of health, and from 0.003% in Portugal, to 0.02% in the UK, in the case of POS; almost a 161-fold difference between the highest and the lowest countries for health, and a six-fold difference for POS.

To respond to these findings and to make a comprehensive assessment of drug-related public expenditure across countries, this study compared health and POS spending and GDP in the 10 reporting countries. Results suggest GDP to be a major determinant of the health and POS drug-related public expenditures of a country. Labeled drug-related public expenditure showed a positive association with the GDP across the countries considered: r = 0.81 in the case of health, and r = 0.91 for POS. The percentage change in health and POS expenditures due to a one percent increase in GDP (the income elasticity of demand) was estimated to be 1.78% and 1.23% respectively.

Being highly income elastic, health and POS expenditures can be considered luxury goods; as a nation becomes wealthier it openly spends proportionately more on drug-related health and public order and safety interventions.

United Kingdom
The UK Home Office estimated that the social and economic cost of drug abuse to the UK economy in terms of crime, absenteeism and sickness is in excess of £20 billion a year. However, the UK Home Office does not estimate what portion of those crimes are unintended consequences of drug prohibition (crimes to sustain expensive drug consumption, risky production and dangerous distribution), nor what is the cost of enforcement. Those aspects are necessary for a full analysis of the economics of prohibition.

United States
These figures represent overall economic costs, which can be divided in three major components: health costs, productivity losses and non-health direct expenditures.

 * Health-related costs were projected to total $16 billion in 2002.
 * Productivity losses were estimated at $128.6 billion. In contrast to the other costs of drug abuse (which involve direct expenditures for goods and services), this value reflects a loss of potential resources: work in the labor market and in household production that was never performed, but could reasonably be expected to have been performed absent the impact of drug abuse.
 * Included are estimated productivity losses due to premature death ($24.6 billion), drug abuse-related illness ($33.4 billion), incarceration ($39.0 billion), crime careers ($27.6 billion) and productivity losses of victims of crime ($1.8 billion).

 * The non-health direct expenditures primarily concern costs associated with the criminal justice system and crime victim costs, but also include a modest level of expenses for administration of the social welfare system. The total for 2002 was estimated at $36.4 billion. The largest detailed component of these costs is for state and federal corrections at $14.2 billion, which is primarily for the operation of prisons. Another $9.8 billion was spent on state and local police protection, followed by $6.2 billion for federal supply reduction initiatives.

According to a report from the Agency for Healthcare Research and Quality (AHRQ), Medicaid was billed for a significantly higher number of hospitals stays for opioid drug overuse than Medicare or private insurance in 1993. By 2012, the differences were diminished. Over the same time, Medicare had the most rapid growth in number of hospital stays.

Canada

Substance abuse takes a financial toll on Canada's hospitals and the country as a whole. In the year 2011, around $267 million of hospital services were attributed to dealing with substance abuse problems. The majority of these hospital costs in 2011 were related to issues with alcohol. Additionally, in 2014, Canada also allocated almost $45 million towards battling prescription drug abuse, extending into the year 2019. Most of the financial decisions made on substance abuse in Canada can be attributed to the research conducted by the Canadian Centre on Substance Abuse (CCSA) which conduct both extensive and specific reports. In fact, the CCSA is heavily responsible for identifying Canada's heavy issues with substance abuse. Some examples of reports by the CCSA include a 2013 report on drug use during pregnancy and a 2015 report on adolescents' use of cannabis.

Immigrants and refugees
Immigrant and refugees have often been under great stress, physical trauma and depression and anxiety due to separation from loved ones often characterize the pre-migration and transit phases, followed by "cultural dissonance", language barriers, racism, discrimination, economic adversity, overcrowding, social isolation, and loss of status and difficulty obtaining work and fears of deportation are common. Refugees frequently experience concerns about the health and safety of loved ones left behind and uncertainty regarding the possibility of returning to their country of origin. For some, substance abuse functions as a coping mechanism to attempt to deal with these stressors.

Immigrants and refugees may bring the substance use and abuse patterns and behaviors of their country of origin, or adopt the attitudes, behaviors, and norms regarding substance use and abuse that exist within the dominant culture into which they are entering.

Street children
Street children in many developing countries are a high-risk group for substance misuse, in particular solvent abuse. Drawing on research in Kenya, Cottrell-Boyce argues that "drug use amongst street children is primarily functional—dulling the senses against the hardships of life on the street—but can also provide a link to the support structure of the 'street family' peer group as a potent symbol of shared experience."

Musicians
In order to maintain high-quality performance, some musicians take chemical substances. Some musicians take drugs such as alcohol to deal with the stress of performing. As a group they have a higher rate of substance abuse. The most common chemical substance which is abused by pop musicians is cocaine, because of its neurological effects. Stimulants like cocaine increase alertness and cause feelings of euphoria, and can therefore make the performer feel as though they in some ways 'own the stage'. One way in which substance abuse is harmful for a performer (musicians especially) is if the substance being abused is aspirated. The lungs are an important organ used by singers, and addiction to cigarettes may seriously harm the quality of their performance. Smoking harms the alveoli, which are responsible for absorbing oxygen.

Veterans
Substance abuse can be a factor that affects the physical and mental health of veterans. Substance abuse may also harm personal and familial relationships, leading to financial difficulty. There is evidence to suggest that substance abuse disproportionately affects the homeless veteran population. A 2015 Florida study, which compared causes of homelessness between veterans and non-veteran populations in a self-reporting questionnaire, found that 17.8% of the homeless veteran participants attributed their homelessness to alcohol and other drug-related problems compared to just 3.7% of the non-veteran homeless group.

A 2003 study found that homelessness was correlated with access to support from family/friends and services. However, this correlation was not true when comparing homeless participants who had a current substance-use disorders. The U.S. Department of Veterans Affairs provides a summary of treatment options for veterans with substance-use disorder. For treatments that do not involve medication, they offer therapeutic options that focus on finding outside support groups and "looking at how substance use problems may relate to other problems such as PTSD and depression".

Sex and gender
There are many sex differences in substance abuse. Men and women express differences in the short- and long-term effects of substance abuse. These differences can be credited to sexual dimorphisms in the brain, endocrine and metabolic systems. Social and environmental factors that tend to disproportionately affect women, such as child and elder care and the risk of exposure to violence, are also factors in the gender differences in substance abuse. Women report having greater impairment in areas such as employment, family and social functioning when abusing substances but have a similar response to treatment. Co-occurring psychiatric disorders are more common among women than men who abuse substances; women more frequently use substances to reduce the negative effects of these co-occurring disorders. Substance abuse puts both men and women at higher risk for perpetration and victimization of sexual violence. Men tend to take drugs for the first time to be part of a group and fit in more so than women. At first interaction, women may experience more pleasure from drugs than men do. Women tend to progress more rapidly from first experience to addiction than men. Physicians, psychiatrists and social workers have believed for decades that women escalate alcohol use more rapidly once they start. Once the addictive behavior is established for women they stabilize at higher doses of drugs than males do. When withdrawing from smoking women experience greater stress response. Males experience greater symptoms when withdrawing from alcohol. There are gender differences when it comes to rehabilitation and relapse rates. For alcohol, relapse rates were very similar for men and women. For women, marriage and marital stress were risk factors for alcohol relapse. For men, being married lowered the risk of relapse. This difference may be a result of gendered differences in excessive drinking. Alcoholic women are much more likely to be married to partners that drink excessively than are alcoholic men. As a result of this, men may be protected from relapse by marriage while women are at higher risk when married. However, women are less likely than men to experience relapse to substance use. When men experience a relapse to substance use, they more than likely had a positive experience prior to the relapse. On the other hand, when women relapse to substance use, they were more than likely affected by negative circumstances or interpersonal problems.

title: Substance abuse


text:
Scouting in Arizona

Scouting in Arizona has a long history, from the 1910s to the present day, serving thousands of youth in programs that suit the environment in which they live.

Early history
Boy Scouting was founded by Robert Baden-Powell in England and co-founded by the American Scout Major Frederick Russell Burnham. Boy Scouting was brought to the United States by William D. Boyce. He incorporated the Boy Scouts of America on February 8, 1910. The Boy Scouts of America was chartered by Congress on June 15, 1916. This is the same year as the first Boy Scout Council in Arizona was formed with the Prescott Council. Burnham served as the Honorary President of the Arizona Boy Scouts throughout the 1940s until his death in 1947.

The first two Boy Scout troops in Arizona Territory were organized in Prescott, in September 1910 and in Tombstone at almost the same time. In Prescott, E.P. Cole of Whipple Barracks was the first Scoutmaster. Arizona Territorial Historian Sharlot Hall was an honorary member of the Tombstone troop. Scouting came to Phoenix in the fall 1910 with Clarence R. Craig as the Scoutmaster. Other Scout troops were formed; in Bisbee in early 1911. and in St. Joseph and Snowflake about the same time.

Harold Steele, principal of the then new Tucson High School, organized the first Scout troop in Tucson on April 20, 1911.

On November 29, 1911 The Church of Jesus Christ of Latter-day Saints (LDS Church) organized the MIA Scouts along the lines recommended by the Boy Scouts of America as part of their Mutual Improvement Association youth program. In March 1912, the LDS Church published their first lessons for the MIA Scouts in the Improvement Era. On May 21, 1913, the LDS Church was invited by the Boy Scout National Council to become the first Chartered Sponsored Organization in their movement. The Boy Scouts of America program was then adopted in all LDS Church congregations as part of their youth program. Each LDS Church congregation in Arizona organized a Scout troop.

In April 1921 the eight LDS troops in the Maricopa (LDS) Stake and the Methodist troop met in at the Coffee Cup in Mesa to organize the Apache Council. This was the second council in Arizona. George A. Johnson was the first Council President. Edwin M. LeBaron was the first Field Commissioner. Their first summer camp was held on Sycamore Creek near Payson, Arizona.

On September 16, 1921, the board of the Apache Council met with Scouters from Phoenix at the Tempe National Bank to reorganized into the Roosevelt Council, to be headquartered in Phoenix. Tim Murray from Galveston Texas, was the first professional Scout Executive. The 1922 summer camp was at Pineair (now call Reavis Ranch located in the Superstition Wilderness Area about 45 mi east of Mesa). The name, Camp Geronimo, is still used by the Grand Canyon Council camp although the location has changed several times. Throughout the 1940s, Frederick Russell Burnham served as the Honorary President of the Roosevelt Council Boy Scouts.

The Roosevelt Council changed its name to the Theodore Roosevelt Council. In 1993 the Theodore Roosevelt Council (located in Phoenix) and the Grand Canyon Council (located in Flagstaff) merged with the Phoenix council assuming the current name, the Grand Canyon Council. The Nassau County Council in New York was renamed to the Theodore Roosevelt Council in 1997.

Campaign to Save the Bighorn Sheep
In 1936, Boy Scouts in Arizona mounted a statewide campaign to save the Bighorn Sheep. The Scouts first became interested in the sheep through the efforts of Major Frederick Russell Burnham. Burnham observed that fewer than 150 of these sheep still lived in the Arizona mountains. He called George F. Miller, then Scout Executive of the Phoenix Scout Council, with a plan to save the sheep. Burnham said, "I want you to save this majestic animal, not only because it is in danger of extinction, but of more importance, some day it might provide domestic sheep with a strain to save them from disaster at the hands of a yet unknown virus." Several other prominent Arizonans join the movement and a save the bighorns poster contest was started in schools throughout the state. Burnham provided prizes and appeared in store windows across Arizona. The contest-winning bighorn emblem was made up into neckerchief slides for the 10,000 Boy Scouts, and talks and dramatizations were given at school assemblies and on radio. The National Wildlife Federation, the Izaak Walton League, and the Audubon Society also joined the effort.

These efforts led to the establishment of two bighorn game ranges in Arizona: Kofa National Wildlife Refuge and Cabeza Prieta National Wildlife Refuge. On January 18, 1939, over 1500000 acre were set aside and a civilian conservation corp side camp was set up to develop high mountain waterholes for the sheep. The Desert Bighorn Sheep is now the official mascot for Arizona Boy Scouts.

Today
There are two Boy Scouts of America (BSA) local councils in Arizona, and other multi-state councils that serve portions of Arizona:

Catalina Council
Catalina Council, BSA serves the southeastern portion of Arizona, from Ajo, Arizona to the US-Mexico border in the south, and all the way east to the New Mexico border. Catalina Council is headquartered in Tucson, Arizona, has two Districts, and two camps.

In 1920, the Tucson Council (#011) was formed, changing its name to Catalina Council (#011) in 1922. The Cochise County Council (#008), founded in 1922, merged with the Catalina Council in 1963.

Districts
The council is divided into districts which serve Scouting units directly.
 * Cochise District – Santa Cruz, Cochise, and eastern portion of Pima Counties
 * Sky Islands District – Southern Pinal County and western Pima County

Camps

 * Camp Lawton Scout Camp has been leased from the National Forest Service since 1921 and has been continuously operated by the Catalina Council. It is located in the Santa Catalina mountains outside of Tucson, Arizona.
 * Double V Scout Ranch is located on South Kinney Road six miles (10 km) southwest of Tucson, near Tucson Mountain Park's Cat Mountain. The 360 acre ranch was acquired on a long-term lease from the Bureau of Land Management in 1969. It is used for both Cub Scout and Boy Scout camping and events. Improvements include a large stone ramada equipped with picnic tables, restrooms, and water misters for cooling. The ranch also has an Olympic-size swimming pool. A natural formation on the northwest side of adjacent Cat Mountain visible from the ranch is called the "Indian chief" because of its strong resemblance to an Indian's profile. Scenes from the 1970s television series Petrocelli were filmed at the ranch.

Grand Canyon Council
The Grand Canyon Council serves Scouts in Arizona and New Mexico, offering Cub Scouts and Scouts BSA to boys and girls ages 5 through 18. Additionally ages 14 through 21 can be involved with Venturing, a high adventure outdoor program or in Learning for Life, a career-based program.

In 1916, the Globe Council was founded, ending in 1919. In 1925, the Verde Council (#0715) was founded. It merged into the Yavapai-Mohave Council in 1927.

In 1921, the Phoenix Council (#010) was founded, changing its name to the Maricopa County Council (#010) in 1923. The Maricopa County council changed its name to the Roosevelt Council in 1924. In 1922, the Yavapai District was founded, changing its name to the Yavapai & Mohave Counties Council (#012) in 1924. In 1926, Yavapai and Mohave Counties changed its name to Yavapai-Mohave Council (#012). In 1922, the Grand Canyon Council was founded. It merged into Yavapai-Mohave in 1929. The combined councils changed their names to the Northern Arizona Council. In 1934, the council was disbanded and service was taken over by Direct Service.

The Three G Council (#009) was formed in 1943, changing its name to the Copper Council in 1962. In 1977, the Copper Council merged into the Theodore Roosevelt Council (#010). In 1993, the Theodore Roosevelt Council reformed into Grand Canyon Council (#010). Note that this is unrelated to Theodore Roosevelt Council (#386), previously known as Nassau County Council, located in New York. That Council took their current name in 1997.

Organization
In 2017, Grand Canyon Council underwent a realignment, reducing the number of districts to six Community Districts. Districts are:

Districts
 * Central District
 * Gila River District – Ahwatukee, Casa Grande, Chandler, Maricopa, Tempe, South Phoenix, and Yuma.
 * Lost Dutchman District
 * Ponderosa District – Prescott, Prescott Valley, Chino Valley, Verde Valley, Williams, Flagstaff, Winslow, Holbrook, Page.
 * Pinnacle Peak District
 * Sonoran Sunset District

Camps

 * Camp Raymond is located 30 mi outside of Flagstaff, Arizona, between the Kaibab National Forest and the Coconino National Forest, along the rim of Sycamore Canyon. Camp Raymond has 18 campsites and offers a variety of program areas, including Boy Scout Resident Camp during the summer, with 9 program areas and 31 merit badges. For older Scouts, Camp Raymond offers C.O.P.E, Climbing, and Mountain Biking. The camp is named after Dr. R.O. Raymond, one of the first doctors in Flagstaff, Arizona, and the founder of the Raymond Educational Foundation. Dr. Raymond, along with many other community leaders, had the idea to create a permanent summer camp in northern Arizona. The 160 acre site was purchased in April 1964 for $200 an acre. A Camp Development Committee was formed under the leadership of William Preston as soon as the purchase was finalized. They worked quickly to resolve water and sanitation concerns and opened the camp in the summer of 1964.  The next big push for development at Camp Raymond was in the 1970s, when the Ranger house and Quartermaster-Trading Post building were constructed. The Handicraft shed and handicap shower facilities were added in 1988,the pool in 1990 and a lake in 2009.  Today, Camp Raymond has 18 campsites, each with a wash stand, latrine, cooking area, picnic tables, and running water. Camp Raymond is available for Boy Scout Troops and Cub Scout Packs for Troop Camping, Family Camping and District Camporees. Camp Raymond has an Archery Range and Shooting Range, including rifle and shotgun skeet ranges.
 * Camp Geronimo – Located between Payson, Arizona and Pine, Arizona, near the Mogollon Rim. Camp Geronimo recently celebrated its 50th year at the camp's current location at the confluence of East and West Webber Creeks. It incorporates the former Spade Ranch house along with extensive camping and recreational facilities. Camp Geronimo is owned and operated by the Grand Canyon Council.

 * Camp Geronimo sits on 200 acre of forest and meadows, and is surrounded by over 5,000 acre of ponderosa pine forest at the edge of the Colorado Plateau. It primarily serves as a one-week summer camp for Scouts BSA, but also has limited accommodations for families to stay the summer in cabins.

 * The camp has 29 campsites, three chapels, a lake, craft lodge, obstacle course, swimming pool, climbing tower (Temporary), nature lodge, dining hall, rifle range, Low C.O.P.E. program, archery range, and a muzzleloading range. Every area has a department that teaches classes over the summer. Scouts enrolled in the summer program are able to take four classes at the camp, and can earn merit badges with their achievements.

 * The Spade Ranch house, located in Camp Geronimo, has been around for over 100 years. Every year during the Scout summer camp, older Scouts participate in high adventure activities. The Spade Ranch house was built by the Spade family on the basis of Webber Creek just beneath the Mogollon Rim. The Spade Ranch house is also the home to the Mogollon Monster story, which is a classic traditionally told for every group of campers that come through each week during the summer camp.

 * R-C Scout Ranch is located a half-hour east of Payson. It is the location of Cub Scout Resident Camp and many training programs. R-C Scout Ranch is available to Boy Scout Troops and Cub Scout Packs for camping, and offers cabins for winter camping.
 * The Heard Scout Pueblo is located near 20th Street and Baseline Road in Phoenix, Arizona.The Heard Scout Pueblo hosts the Grand Canyon Council Cub Scout Day Camp every summer, and offers camping opportunities for Cub Scout Packs and Boy Scout Troops.
 * Lake Pleasant Camp is an aquatics and nature based camp located at the Desert Outdoor Center at Lake Pleasant 20 mi north of central Phoenix in Peoria, Arizona. It is operated in cooperation with the Maricopa County Parks Department.

The Grand Canyon Council also has an Order of the Arrow lodge, Wipala Wiki #432.

Great Southwest Council
The Great Southwest Council of the Boy Scouts of America is headquartered in Albuquerque, New Mexico, and provides Scouting to youth in northern New Mexico, northeast Arizona, Utah south of the Colorado River, and the Durango and Mesa Verde areas of Colorado.

Las Vegas Area Council
Formerly Boulder Dam Area Council, Las Vegas Area Council serves Scouts in Nevada, California and Mohave County, Arizona.

San Diego-Imperial Council
The San Diego-Imperial Council is headquartered in San Diego, California, and serves youth members and volunteer leaders through Scout units in San Diego and Imperial counties of Southern California, as well as a portion of Arizona. Desert Pacific Council was renamed to San Diego-Imperial Council on January 3, 2005.

Other Scout associations in Arizona

 * 1st Arizona Baden-Powell Scouts Rover Troop 30 has established an Adult Scouter Group, a Rover Crew. This is an adult fraternal Scouting organization whose motto is simply "Service". As an organization, they are dedicated to support community projects and Troop 30's programs and equipment. Yet as a fraternal group of Scouters, they enjoy the activity of the "Open Air" and the fun of camping. The Crew believes that they can model the Patrol Method and Leadership Skills they expect their Boy Scout Group and Senior Scout Group to learn.

Girl Scouting in Arizona
There are two Girl Scout councils in Arizona.

In Arizona, Girl Scouts was started in Prescott in 1916 by Maxine Dunning though the first troop in Arizona was not formally recognized until 1918 in Ajo. The Barbara Anderson Girl Scout Museum in Phoenix focuses on Girl Scout history, and in particular, Arizona Girl Scout history.

Girl Scouts–Arizona Cactus-Pine Council
Girl Scouts-Arizona Cactus-Pine Council serves over 25,000 girls in northern Arizona as well as in the Utah and New Mexico sections of the Navajo Nation and in a small part of California.

Camps

 * Camp Maripai is 80 acre at 6000 ft near Prescott, Arizona. It was established in 1942.
 * Parsons Leadership Center is 20 acre at the base of South Mountain near Phoenix, Arizona
 * Camp Stephens is 5 acre at 6100 ft 10 mi east of Kingman, Arizona
 * Shadow Rim Ranch is 40 acre at 5600 ft in Tonto National Forest near Payson, Arizona
 * Willow Springs Program Center is 190 acre at 6000 ft in Prescott National Forest

Girl Scouts of Southern Arizona
Girl Scouts of Southern Arizona council serves more than 14,000 girls in Pima, Cochise, Greenlee, Yuma, and Santa Cruz counties and southern parts of Graham, Maricopa, and Pinal counties. It was previously known as Sahuaro Girl Scout Council.

Camps

 * Whispering Pines Program Center is 16 acre on Mount Lemmon in Coronado National Forest
 * The Hacienda Program Center in Tucson
 * Camp Tucker is a leave no trace camp ground near Rimrock.

Scouting museums in Arizona

 * Otis H. Chidester Museum, Tucson, Arizona, http://azscoutmuseum.com
 * Arizona Scouting Museum, http://www.arizonascoutingmuseum.org
 * Barbara Anderson Girl Scout Museum, Phoenix, Arizona

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Scouting in Arizona


text:
Scouting in California

Scouting in California has a long history, from the 1910s to the present day, serving thousands of youth in programs related to their environments.

Early history (1910–1950)
In the early days of ″Scouting″ there were several different ″Scouting″ type organizations. Some of the organizations known to have members in California were:
 * American Boy Scout (also known as the United States Boy Scout organization)
 * Boy Scouts of America (BSA)
 * California Boy Scouts
 * Peace Scouts of California

The Boy Scouts of United States (a wing of the National Highway Protective Association), Young Men's Christian Association and the Salvation Army may have also had ″Scouting″ type programs in California.

In 1914, parents and Chinese-American boys organized their own Boy Scout troop in San Francisco, the first troop for Chinese Americans and possibly the first troop in San Francisco. It was recognized as Troop 3 once San Francisco became a council. The troop continues today.

Recent history (1950–1990)
The 1953 National Scout Jamboree was held at Irvine Ranch, California. Jamboree Road in Newport Beach, California was named to commemorate the site of the 1953 event.

The 1973 National Order of the Arrow Conference was held at the University of California, Santa Barbara.

Boy Scouting in California today
There are twenty-four Boy Scouts of America local councils in California.

California Inland Empire Council
The California Inland Empire Council (CIEC) was formed in 1973 through the merger of the Arrowhead Area (#048) and Riverside Area Councils (#045). In 1974 Grayback Council (#024) also merged into the new council. In 2006, the council acquired the San Bernardino County portions of Old Baldy Council (#043). The council territory includes all of Riverside and San Bernardino Counties.

Crater Lake Council
Crater Lake Council serves Scouts in Oregon and California.

Golden Empire Council
The Golden Empire Council (#047), first chartered in 1920, serves Scouts in a large section of Northern California, primarily the Sacramento Valley and the northern Sierra Nevada mountains. The council headquarters are located in Sacramento. The council covers 16 counties in Northern California: Amador, Butte, Colusa, El Dorado, Glenn, Nevada, Placer, Sacramento, Solano, Shasta, Sierra, Sutter, Tehama, Trinity, Yolo, and Yuba counties.

Golden Gate Area Council
The SFBAC (#028) was formed by a merger of the San Francisco Area Council and Oakland Area Council in February 1964. Located in the San Francisco Bay Area, serving the cities of Colma, Daly City (northern section), San Francisco, Emeryville, Oakland, San Leandro, Hayward, Fremont, Union City, Newark, Pleasanton, Dublin, and Livermore, as well as unincorporated communities such as Castro Valley, San Lorenzo, and Sunol. In June 1916, the Oakland-Piedmont Council (#021) was chartered, changing its name in 1921 to the Oakland Area Council after Piedmont elected to organize their own council. In January 1917, the San Francisco Council (#051) was chartered, changing its name in 1924 to the San Francisco Area Council.

Greater Los Angeles Area Council
The Greater Los Angeles Area Council (GLAAC) is the council made from the merger of the Los Angeles Area Council and the San Gabriel Valley Council. The vote to merge was held on March 21, 2015. The new name Council, Greater Los Angeles Area Council, was announced on June 11, 2015. The new Council will continue with Scouting Service centers in Los Angeles and Pasadena. GLAAC has three Scout shops in Los Angeles, San Pedro and Pasadena. GLAAC operates eight BSA Camps in the greater Los Angeles area. Due to the large size of the two original councils, the merger is a process that will be completed over a time span.

Greater Yosemite Council
The Greater Yosemite Council (#059) is a local council of the Boy Scouts of America based in Modesto, California. It was founded in 1920 as the Modesto Council. In 1921 Modesto changed its name to the Stanislaus County Council, and in 1922 to the Yosemite Area Council. In 1998, the council changed its name to the Greater Yosemite Council. In 1997, the Forty Niner Council (#052) merged with the Yosemite Area Council.

The Forty Niner Council was founded in 1918 as the Stockton Council. In 1922 Stockton changed its name to San Joaquin, and in 1929 to San Joaquin-Calaveras Council. In 1957, San Joaquin-Calaveras Council changed its name to Forty Niner Council.

Organization
The council reorganized eight districts into three in 2011. The 49er District. Calaveras District, and the Big Valley District were combined into the Gold Country District. The Chief Tenaya District and the Golden Heritage District, and Waukeen District formed the Sierra Valley District. The El Capitan District and the Wawona District became the Rio Del Oro District.

Camps

 * Camp John Mensinger
 * Camp McConnell

Former camps

 * Camp Micke, near Lodi (operated by Stockton Council)
 * Camp Cowell, near Santa Cruz (operated by San Joaquin-Calaveras Council)
 * Camp Dorrington, near Arnold (operated by San Joaquin-Calaveras Council)
 * Camp Baxter, near Arnold (operated by San Joaquin-Calaveras Council)
 * Camp Paradise, previous name of Camp 49 (operated by 49er Council)
 * Camp 49er, near Avery CA. (operated by 49er Council)
 * Camp Bob MacBride, east side of Pinecrest Lake (operated by Yosemite Area Council)
 * Camp Minkalo, in Amador County (operated by 49er Council)
 * Camp Hi-Sierra, near Silver Lake in Amador County (operated by 49er Council)

Order of the Arrow

 * Toloma Lodge #64

Las Vegas Area Council
Formerly Boulder Dam Area Council, Las Vegas Area Council serves Scouts in Nevada, California and Arizona.

Long Beach Area Council
The Long Beach Area Council (LBAC), headquartered in Long Beach and founded in 1919, is one of five Boy Scouts of America councils in Los Angeles County, California.

Los Padres Council
The Los Padres Council was founded in 1917 as the Santa Barbara Council. The Santa Barbara Council changed its name in 1929 to the Mission Council and stayed that way until 1994. In 1994, the Santa Lucia Area Council merged with the Mission Council to form the Los Padres Council. The Santa Lucia Area Council (#056) was founded in 1933, as the San Luis Obispo County Council. The Central Coast Counties council (#025), founded in 1922 merged into Santa Barbara in 1924.

Marin Council
One of the six councils that serves the San Francisco Bay area, the Marin Council was formed in 1910. In 1918 it absorbed the Mill Valley and Sausalito Councils. The Marin County's Scouting community was born just six months after the national Boy Scouts of America organization in 1910.

Camps

 * Camp Marin-Sierra (Chubb Lake) located in Emigrant Gap, CA. The camp features 320-acres of forested terrain with significant facilities, including Ibach And Murray lodges, a rifle, shotgun and archery range, full commercial kitchen, rock climbing wall, camp fire bowl and waterfront facilities. Marin Sierra hosts resident camp for Scouts BSA troops and Venture crews. The facility is also used year-round by various Scout units and is staffed by a full-time ranger.
 * Camp Tamarancho located in Fairfax, CA. 412 acre camp available for year-round use, the camp has developed facilities including a full commercial kitchen, archery and rifle ranges, a chapel and both developed and primitive campsites. Tamarancho hosts BSA units from around Northern California as well as Marin Council programs such as Cub Scout day camp. The camp is staffed by a full time ranger. Surrounding the camp is one of the Bay Area’s largest network of maintained single-track mountain bike trails.

Order of the Arrow

 * Talako Lodge #533

Nevada Area Council
Nevada Area Council serves approximately 14,000 youth through chartered organizations and BSA units in northern Nevada and northeastern California. The parts of California served by the NAC are Alpine County, Lassen County, Plumas County, the northern portion of Mono County, and the eastern portions of El Dorado County, Placer County, and Sierra County.

Orange County Council
Founded in 1920 as the Orange County Council, the council was formed by the merger of the North Orange Council (#037) and the Orange Empire Council (#039) in 1972. The North Orange Council was founded in 1944 as the Northern Orange County and changed its name to North Orange in 1965.

Orange County Council is one of the 20 largest councils by traditional membership in the nation. In 2008 it had over 40,000 youth members.

Pacific Skyline Council
One of the six councils that serves the San Francisco Bay area, the Pacific Skyline Council was founded in 1940 as the Stanford Area Council (#031). In 1994, the Stanford Area Council merged with the San Mateo County Council (#020) to form the current council.

Piedmont Council
The Piedmont Council (California) of BSA serves chartered organizations and BSA units located in the city of Piedmont, located in the East Bay hills and surrounded by the city of Oakland. The council was first chartered in 1921, and by some measurements is the smallest in the BSA, but has a high level of activity and serves a high percentage of the available youth living in Piedmont. Piedmont Council is one of the six councils that serves the San Francisco Bay Area.

Redwood Empire Council
Redwood Empire Council is the local council of the Boy Scouts of America that serves youth in Mendocino and Sonoma counties in California.

The Petaluma Council (#041) was founded in 1919, later named the Petaluma Area Council. This council renamed itself the Sonoma-Mendocino Area Council when the Scouting districts of northern Sonoma County and Mendocino County were separated from Silverado Area Council in 1942. In 1992, the Sonoma-Mendocino Council merged with the Redwood Area Council (#044), to form the Redwood Empire Council. The Redwood Area Council was founded in 1923.

San Diego-Imperial Council
The San Diego-Imperial Council is headquartered in San Diego, California, and serves youth members and volunteer leaders through Scout units in San Diego and Imperial counties of Southern California, as well as a portion of Arizona. Founded in 1916 as the Coronado Council, and the San Diego Council, in 1917 the two council merged to make the San Diego County Council (#049). Founded in 1922, the Imperial County Council (#029) changed its name to Imperial-Yuma Area Council in 1929, and changed the name again in 1959 to Desert Trails Council. In 1993 Desert Trails and San Diego County merged to become Desert Pacific Council. Desert Pacific Council was renamed to San Diego-Imperial Council on January 3, 2005.

Silicon Valley Monterey Bay Council
Silicon Valley Monterey Bay Council (#055), the result of a council merger between the Santa Clara County Council and the Monterey Bay Area Council, is a Boy Scouts of America council headquartered in San Jose, California. As of 2022, the council serves over 9,200 youth in Boy Scout troops, Cub Scout packs, Venturing crews, and Explorer posts.

Sequoia Council

 * (not to be confused with the Sequoyah Council located in Tennessee and Virginia)

The Sequoia Council serves Fresno, Madera, Kings and Tulare Counties in California. Founded in 1919 as the Fresno Council, it changed its name to Sequoia Council in 1925. In 1992, the Mount Whitney Area Council (#054) merged into Sequoia.

Southern Sierra Council
The Southern Sierra Council serves Kern, Inyo, and Mono counties in California. Founded in 1919 as the Bakersfield Council, it changed its name to the Kern County Council in 1921, and then to the Southern Sierra Council in 1965.

Ventura County Council
Ventura County Council of the Boy Scouts of America was officially chartered as Council 57 on June 23, 1921, after a series of meetings that followed a proposal put forward at a County Chamber of Commerce meeting on March 28, 1921 in the Masonic Hall. Mr. C. H. Whipple, then of Moorpark and later Oxnard, became the president; and Col. J.L. Howland became commissioner. Harvey R. Cheesman, an assistant Scout executive in the Los Angeles Council, became the first Scout Executive, assuming his duties on July 11.

Verdugo Hills Council
Verdugo Hills Council (VHC) is one of five Boy Scouts of America councils in Los Angeles County, California. Headquartered in Glendale. It was founded in 1920 as the Glendale Council, changing its name in 1922 to the Verdugo Hills Council (#058).

Western Los Angeles County Council
The Western Los Angeles County Council (WLACC) (#051) is one of five Boy Scouts of America councils in Los Angeles County, California. Headquartered in Van Nuys, the council services over 30,000 youth spanning six districts including the San Fernando Valley, Santa Clarita Valley, Antelope Valley, Malibu, and much of West Los Angeles.

The Western Los Angeles County Council was formed in 1972 with the merger of the Crescent Bay Council (#026) and the San Fernando Valley Council (#050) to form the Great Western Council. The Great Western Council was renamed Western Los Angeles County Council in 1985.

Girl Scouting in California
Girl Scouting officially started in California by 1917 when Lou Henry Hoover help form a troop in Palo Alto. In 1922 the first service unit in the western United States, Service Unit 1, was set up in Palo Alto by Lou Henry Hoover, then president of the Girl Scouts of the US, and is now part of the Girl Scouts of Northern California council.

There are 13 Girl Scout councils serving California of which 8 have headquarters there.

Girl Scouts Arizona Cactus-Pine Council
In California, serves a small portion of far eastern San Bernardino County in the south-east of the state.

Headquarters: Phoenix, Arizona Website: http://www.girlscoutsaz.org

Girl Scouts of California's Central Coast
This council was formed by the merger of Monterey and Tres Condados councils on October 1, 2007. It serves approximately 10,000 girls in Ventura, Santa Barbara, San Luis Obispo, San Benito, Monterey and Santa Cruz counties.

Camps:
 * Arnaz Program Center was dedicated in 1982 and is located on 36 acres near Ojai Valley
 * Alisal Program Center features an after school program and is located in the Salinas, California area

Girl Scouts of Central California South
Girl Scouts of Central California South was formerly Girl Scouts Golden Valley Council before expansion and renaming in October 2008. It serves about 11,000 girls in Fresno, Kern, Kings, Madera and Tulare Counties.

Girl Scouts of Greater Los Angeles
The new council, "Girl Scouts of Greater Los Angeles", is a merger on December 1, 2008 of Angeles Girl Scout Council, Girl Scout Council of Greater Long Beach, Joshua Tree Council (southeastern portion), Mt. Wilson Vista Council, Spanish Trails Council, and San Fernando Valley Girl Scout Council. It serves nearly 45,000 girls and has over 22,000 volunteers.

Camps

 * Camp Mariposa in Altadana
 * Montrose Program Center in Montrose
 * San Gabriel Program Center in San Gabriel, CA
 * El Potrero de la Cienega is 390 acre in Cleveland National Forest
 * Twin Valleys is 25 acre near Wrightwood
 * La Casita Program Center near Claremont
 * Johnstone Program Center
 * Covina Program Center
 * Chino Program Center
 * Camp Lakota is nearly 60 acre in Los Padres National Forest
 * Camp Osito Rancho is 160 acre in Big Bear Lake in the San Bernardino Mountain Range

Girl Scouts Heart of Central California
Girl Scouts Heart of Central California (GSHCC) serves nearly 27,000 girls and 10,000 volunteers in 18 counties (Alpine, Amador, Calaveras, Colusa, El Dorado, Glenn, Mariposa, Merced, Nevada, Placer, Sacramento, San Joaquin, Solano, Stanislaus, Sutter, Tuolumne, Yolo, and Yuba). GSHCC was formed on June 1, 2007, by the merger of the old Muir Trail and Tierra del Oro councils. The main headquarters is in Sacramento with an additional office in Modesto. Both offices feature large meeting spaces for troops and community members, as well as interactive STEM centers that host weekly activities. Given the natural surrounding environment in the Northern Central Valley, this council has a large and historical presence in outdoor activities such as camping, stewardship, and backpacking.

Residential camps:
 * Camp Menzies has 175 acre near Arnold in the Sierra Nevada mountains. The land was donated to the Girl Scouts in the 1940s by Charles Menzies, a Stockton businessman, who purchased the land in 1907 from a Miwok tribe.
 * The camp features a wide variety of class summer camp activities, such as archery, horseback riding, overnight expeditions, swimming, canoeing, arts & crafts, and outdoor skill building. The camp is rustic, hilly, and features open-air mesh wall cabins for the campers.
 * Camp Golden Timbers is a volunteer-run, week-long summer camp located in Pinecrest, Tuolumne County, California.
 * Camp Fleming is located on 440 acre outside of Placerville, California and is used for events such as volunteer run 'camporees', trainings (such as First Aid or backpacking skills), an annual Fall Festival, and various leadership opportunities for Girl Scouts and volunteers. It is ADA accessible.

Girl Scouts of Northern California
A new council formed by the merger of Konocti, San Francisco Bay Area, Santa Clara County, Sierra Cascade, and Napa-Solano councils on October 1, 2007. It serves over 50,000 girls in 19 counties (Alameda, Butte, Contra Costa, Del Norte, Glenn, Humboldt, Lake, Marin, Mendocino, Napa, Santa Clara, San Francisco, San Mateo, Shasta, Siskiyou, Solano, Sonoma, Tehama, and Trinity).

Known for it annual "Golden Gate Bridging" where Junior Girl Scouts bridging to Cadette Girl Scouts walk across the Golden Gate Bridge. This event was started in 1981 with one troop, but now has several thousand scouts involved each year, many of them from outside of the council. The council has also joined with NASA Ames to have several Girl Scout robotics teams nicknamed Space Cookies; including the 80 or so strong troop/team that competes in the FIRST competition and another troop with multiple teams that participates in the VEX competitions.

Camps

 * Camp Bothin is in a canyon in Marin county north of San Francisco. See below for more information.
 * Camp Butano Creek is 145 acre located in old growth redwoods in San Mateo County next to Butano State Park
 * The Cove is a wilderness camp near Napa, California
 * Camp Deer Lake is a high adventure camp located at 6800 ft in Tahoe National Forest (Closed)
 * Camp Sugar Pine is located in Calaveras County, California in the Sierra Nevada foothills
 * Twin Canyon is 35 acre in the East Bay hills near to Briones Regional Park
 * Camp Two Sentinels, located at 8000 ft on Lake Kirkwood in Eldorado National Forest Two Sentinels Girl Scout Camp - Home
 * Skylark Ranch 280 acre on the Pacific coast north of Santa Cruz and near to Año Nuevo State Reserve.
 * Hidden Falls has 90 acre in the redwood forests of the Santa Cruz Mountains.

Camp Bothin
Camp Bothin officially known as the Bothin Youth Center, is a Girl Scout summer camp. Since 1948 it has been located in Marin County, California. The site is managed by Girl Scouts of Northern California and supported mostly through private foundation grants and individual donations.

Convalescent home
In 1905 Camp Bothin was established as "Hill Farm", a convalescent home for women and children, near Fairfax, California, on property then owned by Henry E. Bothin. Before antibiotics, medicine had few treatments other than rest and good food for many illnesses, especially tuberculosis (TB). The patients were initially housed in an old farmhouse. Normally, Hill Farm was home to 30 patients, but during the summer the mild climate allowed as many as 60, who were housed in tents and slept on cots. During this time, Miss Elizabeth H. Ashe was director.

In 1910, the officers formed the corporation named Bothin Convalescent Home for Women and Children. Mr. Bothin deeded 152 acres of land to this corporation. The old farm house was torn down and a rustic building, now known as Manor House, was erected that could accommodate 40 patients. It had deep sleeping porches (fresh air was considered important for TB patients) and an outdoor dining room.

That same year the Arequipa Sanatorium, directed by Dr. Philip King Brown, was opened to serve women in the first stages of TB. At the time, the only known treatment was rest and good nutrition, in the hopes that the lungs could recover and heal. The name Arequipa, taken from a city in Peru, was said to be a Native American word signifying 'place of rest.' Following the 1906 San Francisco earthquake, dust- and ash-filled air had contributed to a tuberculosis epidemic in San Francisco.

With the help of local artists and members of the area's philanthropic community, Dr. Brown introduced therapeutic handcrafts to the women, to combat idleness and avoid the stigma of charity. The hospital hired potter Frederick Hurten Rhead to teach patients and develop a pottery studio. Work from the Arequipa pottery is now highly prized among collectors. In 1913 Rhead was dismissed for not being sufficiently businesslike, as he led his students to experiment with glazes and techniques, and tried to get the best materials for them. His successor at the pottery was directed to reduce production costs.

In 1917, the Bothin Helping Fund was incorporated. This organization, now known as the Bothin Foundation, was responsible for raising the $30,000 needed to build Stone House. It was here that professional and business women could come to rest and recuperate after illness.

As treatment methods for TB changed, the need for the Bothin Convalescent Hospital was reduced. The Bothin property was abandoned from 1922 to 1940.

Girl Scout camp
In 1948, Miss Ashe offered a small building now known as Little House to the San Francisco Girl Scouts for troop camping. A few years later she made Manor House available for Girl Scout use, and by 1955 the entire Bothin property was offered to the Council for its use. The Girl Scouts developed the property as a camp, and added a swimming pool. They changed the name to the Henry E. Bothin Youth Center.

In the 1950s, Arequipa was closed as a hospital. In 1959 the property was leased to the Girl Scouts. By 1963 both sides of the property began to operate as the Henry E. Bothin Youth Center.

Timeline

 * 1905:Hill Farm convalescent home for children opened by Henry E. Bothin
 * 1910:
 * Bothin Convalescent Home Board founded and 152 acre is deeded.
 * Manor House built.
 * Arequipa built.
 * 1917: Bothin Helping Fund was incorporated to distribute funds under the terms of H. Bothin.
 * 1919: Stone House completed.
 * 1922–1940: Bothin was abandoned.
 * 1948:Use of Little House and Bothin property was offered to Girl Scouts.
 * 1948–1953: During this time, 181 troops, representing 2221 Girl Scouts and 556 leaders, made use of Bothin.
 * 1954: Severely crippled and mentally retarded Girl Scouts attend camp sessions.
 * 1955:
 * Use of Bothin offered to Girl Scout for at least 10 years.
 * Name changed to Henry E. Bothin Youth Center.
 * 1959: Use of Arequipa offered to Marin Girl Scout Council.
 * 1963: Entire property becomes Henry E. Bothin Youth Center.

Girl Scouts of Orange County
The council serves nearly 18,000 girls and 12,000 adult volunteers representing every zip code in Orange County. Council offices are located in Irvine, CA.

Properties
The Argyros Girl Scout Leadership Center (GSLC) located in Newport Beach is Orange County’s hub for Girl Scout STEM (Science, Technology, Engineering, and Math) programs. Visits to the GSLC provide Orange County Girl Scouts from all cultures and backgrounds extraordinary opportunities to practice leadership the Girl Scout way as they explore exciting 21st Century careers and learn how they can take action to make the world a better place.

In addition to The Argyros Girl Scout Leadership Center, Camp Scherman, and Council Office, Girl Scouts of Orange County operates 4 program centers, located in Anaheim, Laguna Beach, Yorba Linda, and Seal Beach.

Beginning in the fall of 2020 Girl Scouts of Orange County began operating two new Girl Scout Activity Centers located in the Brea Mall and the Shops at Mission Viejo.

Camps

 * Camp Joe Scherman

Girl Scouts San Diego
The council serves about 35,000 members in San Diego and Imperial counties.

Camps are Camps Winacka and Whispering Oaks both in the Cuyamaca Mountains near Julian. Winacka has 625 acre with two small lakes. Whispering Oaks has 58 acre.

Girl Scouts of San Gorgonio Council
This council serves more than 10,000 girls in Riverside and San Bernardino counties. Council camps are Camp Azalea Trails with 12 acre high in the San Jacinto Mountains near Idyllwild and Camp WiWoCa in Yucaipa.

Girl Scouts of Southern Nevada
In California it serves girls in southern Inyo country.

Girl Scouts of The Sierra Nevada
This council serves 4,500 girls and 2,000 volunteers in northern Nevada and northeast California Camps:
 * Camp Wasiu II was founded in 1988 and is located on 45 acres near Sierra City, California

International Scouting units in California
Cambodian Scouting in exile existed at least into the early 1990s in Los Angeles, alongside fellow Vietnamese Scouting in exile and Laotian Scouting in exile groups. Colonel Oleg Pantyukhov, Chief Scout of Russia, moved to the United States, where large troops of Russian Scouts were established in cities such as San Francisco, Burlingame, California, Los Angeles, etc. Also, Külföldi Magyar Cserkészszövetség Hungarian Scouting maintains four troops in Los Angeles and two in San Francisco. There is also a branch of Polish Scouting for girls in the San Francisco Bay Area.

title: Scouting in California