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Survey Finds Millions of Americans in Denial About Drug Abuse

Findings released recently from SAMHSA's 2001 National Household Survey on Drug Abuse indicated that the number of Americans who could benefit from drug treatment was significantly larger than previously understood. More than 4.6 million Americans who meet the criteria for needing treatment for illicit drug use do not recognize that they have a problem. The annual survey was released as part of the kickoff for the 13th annual National Drug and Alcohol Addiction Recovery Month observance. (See Survey Findings Launch Recovery Month.)

"We have a large and growing denial gap when it comes to drug abuse and dependency in this country," said John Walters, Director of National Drug Control Policy. "We have a responsibility—as family members, employers, physicians, educators, religious leaders, neighbors, colleagues, and friends—to reach out to help these people. We must find ways to lead them back to drug-free lives. And the earlier we reach them, the greater will be our likelihood of success."

Drug Use by Age

Overall, the Household Survey found that 15.9 million Americans age 12 and older used an illicit drug in the month immediately prior to the survey interview. This represents an estimated 7.1 percent of the population in 2001, compared to an estimated 6.3 percent the previous year.

The report highlights that 10.8 percent of youth age 12 to 17 were current drug users in 2001 compared with 9.7 percent in 2000. Youth cigarette use in 2001 was slightly below the rate for 2000, continuing a downward trend since 1999.

Among young adults age 18 to 25, current drug use increased between 2000 and 2001 from 15.9 percent to 18.8 percent. There were no statistically significant changes in the rates of drug use among adults age 26 and older.

Marijuana

An estimated 2.4 million Americans used marijuana for the first time in 2000. Because of the way trends in the new use of substances are calculated, estimates of first-time use are always 1 year behind estimates of current use. The annual number of new marijuana users has varied considerably since 1965 when there were an estimated 0.6 million new users. The number of new marijuana users reached a peak in 1976 and 1977 at around 3.2 million. Between 1990 and 1996, the estimated number of new users increased from 1.4 million to 2.5 million and has remained at this level.

The measure of perceived risk in the use of marijuana provides an important predictor of drug use, particularly among youth. As perceived risk of using marijuana decreases, rates of marijuana use tend to increase. The perception of great risk from smoking marijuana once or twice a week decreased from 56.4 percent in 2000 to 53.3 percent in 2001. Among youth age 12 to 17, the percentage reporting great risk in marijuana use declined from 56 to 53.5 percent.

"As the new school year begins, it's yet another opportunity for parents to talk to their children about the dangers of drugs, alcohol, and smoking. And it's important that parents, educators, and students work together to keep drugs out of their schools and prevent young people from engaging in drug use," said U.S. Health and Human Services Secretary Tommy G. Thompson. "When young people do not perceive the risk, use increases. This is harmful to youth, harmful to families, and harmful to communities. Nothing less than our children's futures—and their lives—are at stake."

Ecstasy and Oxycontin

The number of people who had ever tried Ecstasy (MDMA) increased from 6.5 million in 2000 to 8.1 million in 2001. There were 786,000 current users in 2001. In 2000, an estimated 1.9 million people used Ecstasy (MDMA) for the first time compared with 0.7 million in 1998. This change represents a tripling in incidence in just 2 years.

The number of people reporting use of Oxycontin for non-medical purposes at least once in their lifetime increased from 221,000 in 1999 to 399,000 in 2000 to 957,000 in 2001. The annual number of people using pain relievers for non-medical purposes for the first time has also been increasing since the mid-1980s, when there were roughly 400,000 initiates. In 2000, there were an estimated 2 million.

Alcohol

Approximately 10.1 million people age 12 to 20 reported current use of alcohol in 2001. This number represents 28.5 percent of this age group for whom alcohol is an illicit substance. Of this number, nearly 6.8 million (19 percent) were binge drinkers and 2.1 million (6 percent) were heavy drinkers. In 2001, more than 1 in 10 Americans—25.1 million people—reported driving under the influence of alcohol at least once in the 12 months prior to the interview. The rate of driving under the influence of alcohol increased from 10 to 11.1 percent between 2000 and 2001. Among young adults age 18 to 25, 22.8 percent drove under the influence of alcohol.

Tobacco

An estimated 66.5 million Americans age 12 or older reported current use of a tobacco product in 2001. This number represents 29.5 percent of the population.

Youth cigarette use in 2001 was slightly below the rate for 2000, continuing a downward trend since 1999. Rates of youth cigarette use were 14.9 percent in 1999, 13.4 percent in 2000, and 13 percent in 2001.

The annual number of new daily smokers age 12 to 17 decreased from 1.1 million in 1997 to 747,000 in 2000. This translates into a reduction from 3,000 to 2,000 in the number of new youth smokers per day.

Dependence and Abuse

The Household Survey includes a series of questions designed to measure more serious problems resulting from the use of substances. Overall, an estimated 16.6 million people age 12 and older were classified with dependence on or abuse of either alcohol or illicit drugs in 2001 (7.3 percent of the population). Of these, 2.4 million were classified with dependence or abuse of both alcohol and illicit drugs, 3.2 million were drug dependent or abused illicit drugs but not alcohol, and 11 million were dependent on or abused alcohol but not illicit drugs. The number of people with substance dependence or abuse increased from 14.5 million (6.5 percent of the population) in 2000 to 16.6 million (7.3 percent) in 2001.

Treatment and Need

Between 2000 and 2001, there was a significant increase in the estimated number of people age 12 and older needing treatment for an illicit drug problem. This number increased from 4.7 million in 2000 to 6.1 million in 2001. During the same period, there was also an increase from 0.8 million to 1.1 million in the number of people receiving treatment for this problem at a specialty facility. However, the overall number of people needing but not receiving treatment increased from 3.9 million to 5 million.

Of the 5 million people who needed but did not receive treatment in 2001, an estimated 377,000 reported that they felt they needed treatment for their drug problem. This includes an estimated 101,000 individuals who reported that they made an effort but were unable to get treatment and 276,000 who reported making no effort to get treatment.

Mental Illness

For the first time, the 2001 Household Survey included questions for adults that measure serious mental illness. Both youth and adults were also asked questions about mental health treatment in the past 12 months.

The survey found a strong relationship between substance abuse and mental problems. Among adults with serious mental illness in 2001, 20.3 percent were dependent on or abused alcohol or illicit drugs; the rate among adults without serious mental illness was 6.3 percent. An estimated 3 million adults had both serious mental illness and substance abuse or dependence problems during the year.

In 2001, there were an estimated 14.8 million adults age 18 and older with serious mental illness. This represents 7.3 percent of all adults. Of this group with serious mental illness, 6.9 million received mental health treatment in the 12 months prior to the interview.

In 2001, an estimated 4.3 million youth age 12 to 17 received treatment or counseling for emotional or behavioral problems in the 12 months prior to the interview. This represents 18.4 percent of this population and is significantly higher than the 14.6 percent estimate for 2000. The reason cited most often by youth for the latest mental health treatment session was "felt depressed" (44.9 percent of youth receiving treatment), followed by "breaking rules or acting out" (22.4 percent), and "thought about or tried suicide" (16.6 percent).

SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W., noted that "Behind these numbers are real children and adults affected by drug use. Drug use continues to be a serious public health crisis that affects every aspect of our society. We must refuse to give up on people who have handed over their aspirations and their futures to drug use. People need to know help is available, treatment is effective, and recovery is possible."

The Household Survey, conducted by SAMHSA's Office of Applied Studies, interviews approximately 70,000 people age 12 and older in every state over a 12-month period. It is important to note that because of the year-to-year variations in Household Survey data, conclusions about trends are best made by looking at estimates from 3 or more years. This initial report presents only national estimates. State estimates will be presented in future reports.

To obtain a copy of Results from the 2001 National Household Survey on Drug Abuse, contact SAMHSA's National Clearinghouse for Alcohol and Drug Information at P.O. Box 2345, Rockville, MD 20847-2345. Telephone: 1 (800) 729-6686 (English and Spanish) or 1 (800) 487-4889 (TDD). The complete report can also be downloaded from SAMHSA's Web site at oas.samhsa.gov/nhsda.htm.

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