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22 Million Americans Suffer from Substance Dependence or Abuse

In 2002, an estimated 22 million Americans suffered from substance dependence or abuse due to drugs, alcohol, or both, according to the newest results of SAMHSA's Household Survey. There were 19.5 million Americans (8.3 percent of the population age 12 or older) who used illicit drugs currently, 54 million who participated in binge drinking in the previous 30 days, and 15.9 million who were heavy drinkers.

The report highlights that 7.7 million people (3.3 percent of the total population age 12 and older) needed treatment for a diagnosable drug problem and 18.6 million (7.9 percent of the population) needed treatment for a serious alcohol problem. Only 1.4 million received specialized substance abuse treatment for an illicit drug problem and 1.5 million received treatment for alcohol problems. More than 94 percent of people with substance use disorders who did not receive treatment did not believe they needed treatment.

There were 362,000 people who recognized they needed treatment for drug abuse. Of these, 88,000 tried but were unable to obtain treatment for drug abuse in 2002. There were 266,000 who tried, but could not obtain treatment for alcohol abuse.

"There is no other medical condition for which we would tolerate such huge numbers unable to obtain the treatment they need," said U.S. Health and Human Services Secretary Tommy G. Thompson. "We need to enact President Bush's Access to Recovery Program to provide treatment to those who seek to recover from addiction and move on to a better life.

The new 2002 Household Survey has been renamed the National Survey on Drug Use and Health. The survey creates a new baseline with many improvements.

John Walters, White House Director of National Drug Control Policy, pointed out that "a denial gap of over 94 percent is intolerable. People need to understand the addictive nature of drugs and not presume that they are 'all right' when everyone around them knows better. Families and friends need to urge their loved ones to seek treatment when they experience the toll that addiction takes on loved ones and communities."

The 2002 survey found that marijuana is the most commonly used illicit drug, used by 14.6 million Americans. About one third, 4.8 million, used it on 20 or more days in the past month. There was a decline in the number of adolescents under age 18 initiating use of marijuana between 2000 and 2001, according to the 2002 survey. There were 1.7 million youthful new users in 2001, down from 2.1 million in 2000. The percentage of youth age 12 to 17 who had ever used marijuana declined slightly from 2001 to 2002, from 21.9 percent to 20.6 percent. Most adolescents age 12 to 17 reported that the last marijuana they used was obtained without paying, usually from friends.

"Prevention is the key to stopping another generation from abusing drugs and alcohol," said SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W. "It is gratifying to see that fewer adolescents under age 18 are using marijuana. Now, we need to step up our prevention activities to drive the numbers down further."

The survey found that 30 percent of the population age 12 and older-71.5 million people-use tobacco. Most of them smoke cigarettes. But, the number of new daily smokers decreased from 2.1 million per year in 1998 to 1.4 million in 2001. Among youth under age 18, the decline was from 1.1 million per year in each year between 1997 and 2000 to 757,000 in 2001. This is a decrease from about 3,000 new youth smokers per day to 2,000 per day.

In 2002, 2 million persons currently used cocaine, 567,000 of whom used crack. Hallucinogens were used by 1.2 million people, including 676,000 who used Ecstasy. There were 166,000 current heroin users. Among adolescents age 12 to 17, inhalant use was higher than use of cocaine.

The second most popular category of drug use after marijuana is the non-medical use of prescription drugs. An estimated 6.2 million people, 2.6 percent of the population age 12 or older, were current users of prescription drugs taken non-medically. Of these, an estimated 4.4 million used narcotic pain relievers, 1.8 million used anti-anxiety medications (also known as tranquilizers), 1.2 million used stimulants, and 0.4 million used sedatives. The survey estimates that 1.9 million persons age 12 or older used OxyContin non-medically at least once in their lifetime.

Current illicit drug use is highest among young adults age 18 to 25, with more than 20 percent using drugs. Youth age 12 to 17 also are significant users, with 11.6 percent currently using illicit drugs. Among adults age 26 and older, 5.8 percent reported current drug use. There were also 9.5 million full-time workers, 8.2 percent, who used illicit drugs in 2002. Of the 16.6 million illicit drug users age 18 or older in 2002, 12.4 million were employed either full or part time.

The 2002 survey found that 11 million people, 4.7 percent of the population age 12 or older, reported driving under the influence of an illicit drug during the past year. Those age 21 reported the highest rate of driving while drugged, 18 percent, but the rate was 10 percent or greater for each age from 17 to 25. Other findings included:

Alcohol Use

Approximately 10.7 million people age 12 to 20 (28.8 percent of this age group) reported drinking alcohol in the month prior to the survey interview. Of these, 7.2 million were binge drinkers (19.3 percent) and 2.3 million were heavy drinkers (6.2 percent). There were 33.5 million Americans who drove under the influence of alcohol at least once in the 12 months prior to the interview.

Treatment

Of those 3.5 million people age 12 or older who received some kind of treatment related to the use of alcohol or illicit drugs in the 12 months prior to the survey interview, 974,000 received treatment for marijuana, 796,000 for cocaine, 360,000 for non-medical use of narcotic pain relievers, 277,000 for heroin, and 2.2 million received treatment for alcohol.

Trends in Lifetime Use

Trends in lifetime use of substances were calculated from the 2002 survey based on reports of prior use. Use of pain relievers non-medically among those age 12 to 17 increased from 9.6 percent in 2001 to 11.2 percent in 2002, continuing an increasing trend from 1989 when only 1.2 percent had ever used pain relievers non-medically in their lifetime. Among young adults age 18 to 25, the rate of ever having used pain relievers non-medically increased from 19.4 percent in 2001 to 22.1 percent in 2002. This rate was 6.8 percent in 1992.

Youth Prevention-Related Measures

From 2001 to 2002, for teens age 12 to 17, the lifetime LSD rate is down from 3.3 percent of this population to 2.7 percent, the Ecstasy rate is unchanged from 3.2 percent to 3.3 percent, cocaine use is up from 2.3 percent of this population to 2.7 percent, and inhalant use is up from 9 percent in 2001 to 10.5 percent in 2002.

In 2002, the survey found over 83 percent of youth age 12 to 17 reported having seen or heard alcohol or drug prevention messages outside of school in the past year. Youth who had seen or heard these messages indicated a slightly lower rate of past-month use of an illicit drug (11.3 percent) than teens who had not seen or heard these types of messages (13.2 percent).

Serious Mental Illness

There are 4 million adults who have both a substance use disorder and serious mental illness. In 2002, there were an estimated 17.5 million adults age 18 or older with serious mental illness. This is 8.3 percent of all adults. Adults who used illicit drugs were more than twice as likely to have serious mental illness as adults who did not use an illicit drug. Among adults who used an illicit drug in the past year, 17.1 percent had serious mental illness in that year, compared to 6.9 percent of adults who did not use an illicit drug. Among adults with serious mental illness in 2002, over 23 percent were dependent on or abused alcohol or illicit drugs. The rate among adults without serious mental illness was only 8.2 percent.

Among adults with substance dependence or abuse, 20.4 percent had serious mental illness, compared with 7 percent among adults who were not dependent on or abusing alcohol or drugs.

Findings from the 2002 National Survey on Drug Use and Health are available online at www.DrugAbuseStatistics.samhsa.gov.

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