2000 SAE Report, Volume 1 - 5. Dependence on or Abuse of Alcohol or Illicit Drugs

In 2000, a National Household Survey on Drug Abuse (NHSDA) respondent was defined as needing treatment if he or she met the criteria for dependence or abuse or received treatment at a specialty facility in the past year. The questions to measure dependence or abuse status are based on the criteria specified in the 4^th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (APA, 1994). Because of the changes between 1999 and 2000 in the questions and definitions employed for determining treatment need, it is not appropriate to compare the estimates in this report with estimates from previous years.

An estimated 14.5 million Americans aged 12 or older in 2000 were classified with dependence on or abuse of either alcohol or illicit drugs (Epstein, 2002). Most of these persons (10.2 million) were dependent on or abused alcohol only. Another 1.9 million were dependent on or abused both alcohol and illicit drugs, while 2.4 million were dependent on or abused illicit drugs but not alcohol.

5.1 Alcohol Dependence or Abuse

Nationally, 5.4 percent of the population aged 12 or older were classified with dependence on or abuse of alcohol in the past year (Epstein, 2002). Persons aged 18 to 25 had the highest rates of alcohol dependence or abuse—12.8 percent.

State estimates for persons aged 12 or older ranged from 4.5 percent in North Carolina to 7.5 percent in South Dakota (Figure 5.1; Table A.26). States in the highest fifth tended to be mostly Northern or Western (South Dakota, North Dakota, Massachusetts, Alaska, Montana, and Nebraska). States in the lowest fifth were mostly from the South (South Carolina, North Carolina, West Virginia, Virginia, and Arkansas) or from the Northeast (New York, Maine, and New Jersey).

In the 12 to 17 age group, the estimated percentage of those indicating abuse or dependence ranged from 3.7 percent in Virginia to 10.2 percent in Montana (Figure 5.2; Table A.26). Among persons aged 18 to 25, the lowest percentage was found in New Jersey (10.1 percent), and the highest State percentage was in North Dakota (21.2 percent) (Figure 5.3; Table A.26). Many States in the highest fifth for the 12 to 17 and 18 to 25 age groups were also in the highest group for all persons age 12 or older: six States in the 12 to 17 age group and eight in the 18 to 25 age group.

The percentage of persons estimated to be dependent on alcohol in the past year was only about 43 percent of those who were estimated to be dependent on or abused alcohol in the past year. State estimates for persons aged 12 or older fell into a more narrow range from 2.0 percent in Utah to 3.1 percent in Mississippi (Figure 5.5; Table A.28). A number of the States in the top fifth for dependence or abuse were no longer in the top fifth for just dependence: North Dakota, Massachusetts, Montana, Nebraska, Colorado, and Rhode Island. Those States now fell into the middle fifth or lower. A number of new States that were not in the top fifth for alcohol dependence or abuse were in the top fifth for alcohol dependence: Mississippi, Louisiana, District of Columbia, Arizona, Idaho, and California. The highest dependence rates for alcohol occurred in the 18 to 25 age group, with South Dakota having the highest rate—6.8 percent (Figure 5.7; Table A.28).

5.2 Illicit Drug Dependence or Abuse

Nationally, about 1.9 percent of persons aged 12 or older were dependent on or had abused illicit drugs in the past year, close to one third of the percentage of those who were dependent on or abused alcohol (Epstein, 2002).

States with estimated rates in the highest fifth were mostly Western States, including Arizona (2.9 percent), Alaska (2.6 percent), Colorado (2.4 percent), California (2.4 percent), Oregon (2.4 percent), Utah (2.4 percent), and Washington (2.3 percent) (Figure 5.9; Table A.30). Only three of the States in the highest fifth for past year illicit drug dependence or abuse were also in the top fifth for past year alcohol dependence or abuse: Alaska, Colorado, and Massachusetts (Figures 5.1 and 5.9; Table s A.26 and A.30).

Rates were slightly higher in the 12 to 17 and 18 to 25 age groups. Among States in the top fifth for dependence on or abuse of illicit drugs in the past year among youths aged 12 to 17, the rates ranged from 5.3 to 7.0 percent (Figure 5.10; Table A.30). Among States in the top fifth for dependence on or abuse of illicit drugs among those aged 18 to 25, the rates ranged from 6.2 to 7.2 percent (Figure 5.11; Table A.30). Five of the States in the top fifth for youths aged 12 to 17 were also in the top group for all persons 12 or older, and three of the States in the top fifth for those aged 18 to 25 were also included in the top fifth among persons aged 12 or older. (Figures 5.9 to 5.11; Table A.30).

The percentage of persons estimated to be dependent on illicit drugs in the past year was about 64 percent of those who were estimated to be dependent on or abused illicit drugs in the past year. State estimates for persons aged 12 or older ranged from 1.0 percent in Iowa to 1.8 percent in Massachusetts (Figure 5.13; Table A.32). The highest rates of illicit drug dependence were among persons aged 18 to 25, with the highest rate in Vermont—5.2 percent (Figure 5.15; Table A.32). For persons aged 12 or older, the States in the top fifth for both dependence on illicit drugs and dependence on or abuse of illicit drugs were Massachusetts, Arizona, California, Colorado, Delaware, the District of Columbia, and Washington (Figures 5.9 and 5.13; Table s A.30 and A.32).

There was some degree of relationship between high rates of past year illicit drug dependence or abuse and high rates of past year cocaine use at the State level. Six States were ranked among the highest for both measures: Arizona, Alaska, the District of Columbia, Massachusetts, Colorado, and Delaware (Figures 2.20 and 5.9; Table s A.12 and A.30).

5.3 Alcohol or Illicit Drug Dependence or Abuse

The national rate for past year dependence on or abuse of alcohol or illicit drugs among persons aged 12 or older was about 6.5 percent, slightly higher than the rate for just alcohol dependence or abuse (5.4 percent) and more than 3 times larger than the rate for illicit drug dependence or abuse (1.9 percent) (Epstein, 2002).

When examining dependence on or abuse of alcohol or illicit drugs at the State level, the States with high rates for alcohol tended to dominate the top fifth for alcohol and illicit drugs combined because of the higher rates of dependence on and abuse of alcohol relative to illicit drugs (Figures 5.1, 5.9, and 5.17; Table s A.26, A.30, and A.34).

For those aged 12 or older, the State percentages ranged from a low of 5.1 percent in North Carolina to a high of 8.3 percent in North Dakota for past year dependence on or abuse of alcohol or illicit drugs (Figure 5.17; Table A.34). Eight of ten States in the top fifth for dependence on or abuse of alcohol or illicit drugs also were in the top fifth for dependence on or abuse of alcohol alone.

The prevalence rate among persons aged 18 to 25 was almost 3 times as high as that for all persons aged 12 or older (Figures 5.17 and 5.19; Table A.34). North Dakota's rate of 23.8 percent was the highest among States for this age group. Many of the States in the top fifth both for ages 18 to 25 and for ages 12 to 17 were the same as those in the top fifth for all persons aged 12 or older (Figures 5.17 to 5.19; Table A.34).

Figure 5.1 Percentages Reporting Past Year Alcohol Dependence or Abuse among Persons Aged 12 or Older, by State: 2000

Figure 5.1 D