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
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
"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
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
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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.
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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.
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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.
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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).
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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
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.oas.samhsa.gov.
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