SUBSTANCE USE AND TREATMENT

This section describes trends in illicit drug, alcohol, and cigarette use during the past month as well as current, past month, and past year substance abuse treatment prior to and after September 11. Figure 1, shown earlier, highlights the NYC and the NY CMSA areas that are discussed.

2.1 Illicit Drug Use

The NHSDA collects information on the use of a wide variety of illicit and licit drugs taken for nonmedical reasons. The survey obtains data on recency and frequency of drug use. In addition to examining the general prevalence of illicit drug use before and after September 11, this report focuses specifically on the use of marijuana and psychotherapeutic drugs because the number of users is sufficient to support analyses of changes in prevalence rates. In addition, the frequency of marijuana use is explored. Psychotherapeutics include pain relievers, tranquilizers, sedatives, and stimulants. These categories include drugs that can be obtained through prescription or illegally but are, in any case, used for nonmedical purposes. Over-the-counter drugs that might be similar, or drugs used under a physician's direction are excluded from these analyses.

For persons aged 12 or older in NYC, reports of past month use of any illicit drug, marijuana, or psychotherapeutics did not change significantly during the course of 2001, nor were there any changes in the number of days marijuana users reported using this substance. Among youths aged 12 to 17 in NYC, an increase was noted in the rate of past month nonmedical psychotherapeutic use between quarters 1 through 3 and quarter 4 in 2001 (1.1 percent vs. 1.8 percent), based on the comparison of this trend in 2001 with the observed trend during 2000.

As was the case with NYC, there were no changes in the rates of illicit drug use in the NY CMSA after the terrorist attacks among persons aged 12 or older. However, there were some shifts in rates and frequency of use when the data were analyzed by gender. Among males in 2001, the prevalence rate of past month marijuana use increased from 5.1 percent in the first three quarters of the year to 9.3 percent in the fourth quarter (Figure 2). This trend was also significantly different than the trend for males during 2000 (5.2 percent during quarters 1 through 3 vs. 4.7 percent in quarter 4). Among females, the frequency of past month marijuana use dropped from 9.4 days to 5.3 days during 2001.

Figure 2 Percentages of Males Aged 12 or Older Reporting Past Month Marijuana Use, by Time Period and Geographic Area: 2000 and 2001

NYC = New York City.
NY CMSA = New York Consolidated Metropolitan Statistical Area.
C-CMSA = Combined Consolidated Metropolitan Statistical Areas of Los Angeles, Detroit, and Chicago.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000 and 2001.

In the C-CMSA, there were no significant changes overall in the prevalence of past month use of any illicit drug, marijuana, or psychotherapeutics during 2001, nor were there any changes in the frequency of marijuana use, either with or without a seasonal adjustment. Among persons aged 18 or older, however, the rate of marijuana use increased significantly between quarters 1 through 3 (5.0 percent) and quarter 4 (6.9 percent) in 2001.

When the NY CMSA trends were compared with the C-CMSA trends, no significant differences were observed in trends in the rates of past month use of any illicit drug, marijuana, or psychotherapeutics in 2001. Disaggregating by gender showed some differences. In the NY CMSA, the decrease in the rate of past month psychotherapeutics use by females from the first three quarters of 2001 (2.4 percent) to the fourth quarter (1.0 percent) was significantly different from the increase observed in the C-CMSA during the same time period (2.1 percent to 3.5 percent). Likewise, the decrease in the frequency of past month marijuana use among females in the NY CMSA (9.4 days vs. 5.3 days) differed from the increase noted in the C-CMSA (9.7 days vs. 14.6 days) during 2001.

2.2 Alcohol Use

The NHSDA asks respondents about their use of alcohol during the past month as well as the frequency and quantity of their alcohol use. The frequency and quantity of use are measured by the mean number of days past month drinkers consumed five or more drinks on the same occasion, while the quantity of alcohol used is measured by the mean number of drinks consumed per day. The events of September 11 seem to have had limited impact on alcohol use despite press reports of unusually heavy crowds at bars in NYC.

During the course of 2001, there were no significant changes in the prevalence of past month alcohol use among persons aged 12 or older in NYC. No changes were observed in the number of drinks per day consumed or the mean number of days people had five or more drinks. Analyses by age, however, showed some differences. Among youths aged 12 to 17 in NYC who were current drinkers, the mean number of days five or more drinks were consumed declined between the first three quarters of 2001 (3.0 days) to the fourth quarter of the same year (0.7 days).

In the NY CMSA, the rates of past month alcohol use increased among persons aged 18 or older during 2001, rising from 51.4 percent in the first three quarters to 58.0 percent in the fourth (Figure 3). Among males, there was a small increase during 2001 in the mean number of binge days among past month drinkers, from 2.1 days to 2.4 days, which was significantly different than the decline seen during 2000, from 2.0 days to 1.2 days. A similar pattern was observed for males in NYC, although the difference was not statistically significant (Figure 4).

In the C-CMSA in 2001, past month alcohol use among youths declined from 16.2 percent in the first three quarters of the year to 12.3 percent in the fourth quarter. No other changes in alcohol use were observed in the C-CMSA during 2001.

Figure 3 Percentages of Persons Aged 18 or Older Reporting Past Month Alcohol Use, by Time Period and Geographic Area: 2000 and 2001

When the NY CMSA was compared with the C-CMSA, no significant differences were observed in trends in the mean number of drinks per day or the number of days people had five or more drinks among all persons aged 12 or older in 2001. Among persons aged 12 or older, the increase in past month alcohol use, observed between the first three quarters of 2001 and the fourth quarter in the NY CMSA (48.0 percent vs. 53.7 percent) was significantly different than the decline in the C-CMSA (50.1 percent vs. 47.8 percent) during this time period. Similar findings were observed among males aged 12 or older and persons aged 18 or older.

Figure 4 Mean Number of Days Consumed Five or More Drinks Among Males Aged 12 or Older Who Were Drinkers in the Past Month, by Time Period and Geographic Region: 2000 and 2001

2.3 Cigarette Use

The NHSDA contains a number of questions about the use of cigarettes and other tobacco products. This section describes cigarette use during the month prior to the interview and the intensity of use as measured by the mean number of days users reported they smoked during that period. Assuming cigarette smokers might use cigarettes to attempt to reduce tension, differences in cigarette use could be one response to the events of September 11. However, the results of these analyses show few significant differences, and findings are somewhat conflicting.

In NYC and the NY CMSA, the rates of past month cigarette use remained stable throughout the course of 2001 among persons aged 12 or older, as did the mean number of days past month smokers reported using cigarettes. However, among females in NYC, there was asignificant difference in the trend during 2001 and the trend during 2000. From the first three quarters of 2000 to the fourth quarter of 2000, there was an increase from 16.5 percent to 31.0 percent in prevalence rate. In 2001, the rate for females in NYC declined from 22.0 percent in the first three quarters to 15.3 percent in the fourth. Similarly, among females in the NY CMSA, there was a significant difference in the trends during 2001 and 2000. There was an increase from 17.8 percent to 27.7 percent from the first three quarters of 2000 to the fourth quarter of 2000. In 2001, the rate for females declined slightly, from 21.4 percent in the first three quarters to 19.8 percent in the fourth (Figure 5).

For the C-CMSA, past month cigarette use was significantly lower among youths aged 12 to 17 in the fourth quarter of 2001 (6.9 percent) compared with the first three quarters of the same year (10.8 percent). During 2001, the mean number of days females aged 12 and older in the C-CMSA smoked during the past month increased from 22.6 days in the first three quarters to 25.3 days in the fourth quarter.

There were no significant differences observed in trends in the rates of past month cigarette smoking or the mean number of days smokers reported using cigarettes when the NY CMSA trends were compared to the C-CMSA trends.

2.4 Substance Abuse Treatment Utilization

The NHSDA asks respondents aged 12 or older about their substance abuse treatment utilization. Estimates described in this chapter refer to treatment received to reduce or stop drug or alcohol use, or for medical problems associated with the use of drugs or alcohol. For the purposes of this chapter, "treatment" is defined as any treatment received at any location, such as a hospital, rehabilitation facility (outpatient or inpatient), mental health center, emergency room, private doctor's office, self-help group, or prison/jail. Measures include utilization during the past month or past year. If individuals received substance abuse treatment during the past year, they were asked whether they were currently in treatment. This section describes reported substance abuse treatment utilization before and after September 11.

In NYC and the NY CMSA, there were no changes in reporting of past month, past year, or current substance abuse treatment utilization among persons aged 12 or older following September 11, 2001.

For youths aged 12 to 17 from the C-CMSA, past year substance abuse treatment was lower in the fourth quarter (0.4 percent) than in the first three quarters (2.1 percent) of 2001. Youths also showed significant decreases in current, past month and past year substance abuse treatment from the first three quarters to the fourth quarter of 2001 compared with the same time periods in 2000, during which treatment utilization increased.

Figure 5 Percentages of Females Aged 12 or Older Reporting Past Month Cigarette Use, by Time Period and Geographic Area: 2000 and 2001

Comparisons of trends during 2001 for the NY CMSA with trends in the C-CMSA showed one significant difference. Past year substance abuse treatment among youths aged 12 to 17 in the NY CMSA showed an increase from the first three quarters to the fourth quarter (1.0 percent vs. 1.5 percent) of 2001, while past year substance abuse treatment among youths in the C-CMSA decreased from the first three quarters to the fourth quarter (2.1 percent vs. 0.4 percent) in 2001.

SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.

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2. Substance Use and Treatment