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National Survey on Drug Use and Health Illicit Drug Use among Lifetime Nondrinkers and Lifetime Alcohol Users
January 14, 2005

Illicit Drug Use among Lifetime Nondrinkers and Lifetime Alcohol Users

In Brief

  • In 2002 and 2003, 11.8 percent of persons 21 years of age or older (23.5 million persons) had never consumed alcohol in their lifetime
  • Among nondrinkers, 2.7 percent (644,000 persons) used an illicit drug in the past year; nonmedical use of pain relievers was the illicit drug used most often
  • Male and female nondrinkers reported similar past year illicit drug use (2.8 and 2.7, respectively)

Research has shown an association between illicit drug use and alcohol use in both adolescent and adult populations.1,2,3 However, little is known about the characteristics of persons who use illicit drugs but have never used alcohol. The National Survey on Drug Use and Health (NSDUH) asks respondents aged 12 or older to report their use of alcohol and illicit drugs in their lifetime as well as in the past year. NSDUH defines "any illicit drug" use as including marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically. NSDUH also asks respondents to report any symptoms of substance dependence or abuse. Dependence and abuse are defined by criteria in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which include such symptoms as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference in major obligations at work, school, or home during the past year.4 This report uses data from the 2002 and 2003 NSDUH to compare the patterns of illicit drug use among persons who have used alcohol in their lifetime (lifetime alcohol users) with the patterns of illicit drug use among persons who have never used alcohol in their lifetime (lifetime nondrinkers).


Prevalence of Alcohol and Illicit Drug Use

In 2002 and 2003, an estimated 88.2 percent of persons aged 21 or older (175.6 million) were lifetime alcohol users, whereas an estimated 11.8 percent (23.5 million) were lifetime nondrinkers. Over half of lifetime alcohol users (52.7 percent) had used one or more illicit drugs at some time in their life, compared to 8.0 percent of lifetime nondrinkers. Among persons who had used an illicit drug in their lifetime, the average age at first illicit drug use was 19 years for lifetime alcohol users, versus 23 years for lifetime nondrinkers.

Lifetime alcohol users aged 21 or older had a significantly higher rate of past year illicit drug use (13.7 percent) compared with lifetime nondrinkers (2.7 percent). In addition, lifetime alcohol users had significantly higher rates of past year use across all illicit drug categories, with the exception of inhalants (Table 1). Nonmedical use of pain relievers was the illicit drug used most often by lifetime nondrinkers, whereas lifetime alcohol users reported using marijuana most frequently.

Table 1. Estimated Numbers and Percentages of Persons Aged 21 or Older Reporting Past Year Illicit Drug Use, by Lifetime Alcohol Use and Type of Illicit Drug: 2002 and 2003 Figure 1. Percentages of Persons Aged 21 or Older Reporting Past Year Illicit Drug Use, by Lifetime Alcohol Use and Race/Ethnicity*: 2002 and 2003
Table 1.  Estimated Numbers and Percentages of Persons Aged 21 or Older Reporting Past Year Illicit Drug Use, by Lifetime Alcohol Use and Type of Illicit Drug: 2002 and 2003 Figure 1.  Percentages of Persons Aged 21 or Older Reporting Past Year Illicit Drug Use, by Lifetime Alcohol Use and Race/Ethnicity*: 2002 and 2003

Prevalence of Illicit Drug Use by Demographic Characteristics and Lifetime Alcohol Use

Among lifetime nondrinkers aged 21 or older, the prevalence of past year illicit drug use was similar for males (2.8 percent) and females (2.7 percent). Among lifetime alcohol users aged 21 or older, males had a significantly higher rate of past year illicit drug use than females (16.1 vs. 11.3 percent, respectively). Asians had the highest prevalence of past year illicit drug use among lifetime nondrinkers (4.4 percent), but this difference was not statistically significant compared with other racial/ethnic groups (Figure 1). Among lifetime alcohol users, Asians had a significantly lower rate of past year illicit drug use compared with other racial/ethnic groups.

Lifetime alcohol users aged 21 or older had significantly higher rates of past year illicit drug use across all age categories compared with lifetime nondrinkers (Figure 2). Among lifetime nondrinkers, 4.1 percent of persons aged 21 to 34 used an illicit drug in the past year compared with 26.0 percent of lifetime alcohol users aged 21 to 34.

There was no difference in reported past year illicit drug use among lifetime nondrinkers aged 21 or older by annual family income (Figure 3). Comparatively, among lifetime alcohol users, persons in lower income families were more likely to report past year illicit drug use than persons in higher income families.

Figure 2. Percentages of Persons Aged 21 or Older Reporting Past Year Illicit Drug Use, by Lifetime Alcohol Use and Age: 2002 and 2003 Figure 3. Percentage of Persons Aged 21 or Older Who Reported Past Year Illicit Drug Use, by Lifetime Alcohol Use and Family Income Level: 2002 and 2003
Figure 2.  Percentages of Persons Aged 21 or Older Reporting Past Year Illicit Drug Use, by Lifetime Alcohol Use and Age: 2002 and 2003 Figure 3. Percentage of Persons Aged 21 or Older Who Reported Past Year Illicit Drug Use, by Lifetime Alcohol Use and Family Income Level: 2002 and 2003

Dependence on or Abuse of Illicit Drugs

In 2002 and 2003, 2.5 percent of all lifetime alcohol users aged 21 or older were dependent on or abused an illicit drug in the past year compared with 0.4 percent of lifetime nondrinkers. An estimated 88,000 persons aged 21 or older were dependent on or had abused illicit drugs in the past year but had never drunk alcohol.


End Notes
  1. Wadsworth, E. J., Moss, S. C., Simpson, S. A., & Smith, A. P. (2004). Factors associated with recreational drug use. Journal of Psychopharmacology, 18, 238–248.

  2. Best, D., Rawaf, S., Rowley, J., Floyd, K., Manning, V., & Strang, J. (2000). Drinking and smoking as concurrent predictors of illicit drug use and positive drug attitudes in adolescents. Drug and Alcohol Dependence, 60, 319–321.

  3. Kandel, D. B., Yamaguchi, K. & Chen, K. (1992), Stages of progression in drug involvement from adolescence to adulthood: Further evidence for the gateway theory, Journal of Studies on Alcohol, 53 (5), 447–57.

  4. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV) (4th ed.). Washington, DC: Author.

Figure and Table Notes

Source: SAMHSA, 2002 and 2003 NSDUH.

* (Figure 1) Estimates for American Indians or Alaska Natives and Native Hawaiians or Other Pacific Islanders are not shown due to small sample sizes.

The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). Prior to 2002, this survey was called the National Household Survey on Drug Abuse (NHSDA). The 2002 and 2003 data are based on information obtained from 135,910 persons aged 12 or older, including 71,648 persons aged 21 or older. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.

The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)

Information and data for this issue are based on the following publications:

Office of Applied Studies. (2004). Results from the 2003 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 04–3964, NSDUH Series H–25). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Office of Applied Studies. (2003). Results from the 2002 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 03–3836, NSDUH Series H–22). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Also available online: http://www.oas.samhsa.gov.

Because of improvements and modifications to the 2002 NSDUH, estimates from the 2002 and 2003 surveys should not be compared with estimates from the 2001 or earlier versions of the survey to examine changes over time.

The NSDUH Report (formerly The NHSDA Report) is published periodically by the Office of Applied Studies, Substance Abuse & Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available on-line: http://www.oas.samhsa.gov. Citation of the source is appreciated. For questions about this report please e-mail: shortreports@samhsa.hhs.gov.

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