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2. Illicit Drug Use

The National Survey on Drug Use and Health (NSDUH) obtains information on nine different categories of illicit drug use: marijuana, cocaine, heroin, hallucinogens, inhalants, and nonmedical use of prescription-type pain relievers, tranquilizers, stimulants, and sedatives. In these categories, hashish is included with marijuana, and crack is considered a form of cocaine. Nonmedical use of prescription-type pain relievers, tranquilizers, stimulants, or sedatives is defined as use of at least one of these medications without a prescription belonging to the respondent or use that occurred simply for the experience or feeling the drug caused. Estimates of illicit drug use reflect any of the nine categories listed above. In this chapter, estimates are presented for illicit drugs, marijuana, perceptions of risk of marijuana use, incidence of marijuana use, illicit drugs other than marijuana, cocaine, and pain relievers.

2.1 Illicit Drugs

In 2007-2008, 8.0 percent of the U.S. population aged 12 or older had used an illicit drug in the past month, and the percentage was similar in 2006-2007 (8.1 percent) (see Table C.1 in Appendix C). In 2007-2008, estimates of past month use of illicit drugs ranged from a low of 4.1 percent in Iowa to a high of 13.3 percent in Rhode Island for persons aged 12 or older (see Table B.1 in Appendix B). Colorado, District of Columbia, New Hampshire, Oregon, Rhode Island, and Vermont were in the highest fifth for persons aged 12 or older and for each of the age subgroups: 12 to 17, 18 to 25, and 26 or older (Figures 2.1 to 2.4).

Five States showed significant changes from 2006-2007 to 2007-2008 (at the 5 percent level of significance) in the percentage of persons aged 12 or older who used an illicit drug in the past month: Iowa, Louisiana, and Wyoming had decreases, and Hawaii and Oregon had increases. Among persons aged 18 to 25, six States had decreases (Florida, Iowa, Maine, New Mexico, Washington, and Wyoming), while two States showed increases (Hawaii and Oregon). Arkansas was the only State among youths aged 12 to 17 to show a significant change from 2006-2007 to 2007-2008, which was a decrease in the use of illicit drugs in the past month (Table C.1).

2.2 Marijuana

Marijuana, the most commonly used illicit drug, was used by 6.0 percent of the population in 2007-2008 during the past month (Table B.3). States showing high prevalence rates for illicit drug use also had high prevalence rates for past month use of marijuana. Of the 10 States in the top fifth for past month use of an illicit drug among persons aged 12 or older, 9 States also were ranked in the top fifth for past month marijuana use: Alaska, Colorado, District of Columbia, Montana, New Hampshire, Oregon, Rhode Island, Vermont, and Washington (Figures 2.1 and 2.9).

Seven States that ranked in the top fifth for past month marijuana use in all three age groups (12 to 17, 18 to 25, and 26 or older) and among persons 12 or older were Colorado, Maine, Montana, New Hampshire, Oregon, Rhode Island, and Vermont (Figures 2.9 to 2.12). Iowa had the lowest rate of past month marijuana use in 2007-2008 (3.2 percent) in the 12 or older population, and Rhode Island had the highest rate (10.9 percent) (Table B.3). Eight States showed significant changes in the past month marijuana use among persons 12 or older: Iowa, New Mexico, Virginia, and Wyoming had decreases, whereas Delaware, Hawaii, North Carolina, and Oregon had increases (Table C.3).

Nationally in 2007-2008, 10.2 percent of persons aged 12 or older reported marijuana use in the past year (Table B.2). Young adults aged 18 to 25 reported the highest rate of past year use of marijuana (27.5 percent). Iowa had the lowest rate (6.2 percent) of past year use of marijuana among persons aged 12 or older. Rhode Island had the highest rate of past year marijuana use in that age group (15.8 percent). Six States (Colorado, Montana, New Hampshire, Oregon, Rhode Island, and Vermont) were in the top fifth for past year marijuana use among persons 12 or older and in all three age groups (12 to 17, 18 to 25, and 26 or older) (Figures 2.5 to 2.8). Eight States showed significant changes in past year use of marijuana among persons aged 12 or older between 2006-2007 and 2007-2008: Iowa, Louisiana, Massachusetts, Pennsylvania, and Wyoming had decreases, whereas Arizona, Hawaii, and North Carolina had increases. There was also a decrease in past year marijuana use among persons 12 or older in the Northeast region (from 11.1 percent in 2006-2007 to 10.6 percent in 2007-2008) (Table C.2).

2.3 Perceptions of Risk of Marijuana Use

An individual's perception of the risks of substance use has been shown to be inversely related to whether he or she actually uses the substance (e.g., Bachman, Johnston, & O'Malley, 1998). At the State level, 8 of the 10 States that ranked in the lowest fifth of perceived great risk of using marijuana once a month (namely, Alaska, Colorado, District of Columbia, Maine, New Hampshire, Oregon, Vermont, and Washington) were also among the States that ranked in the highest fifth for past month use of marijuana in 2007-2008 for persons aged 12 or older (Figures 2.9 and 2.13).

About one quarter (25.8 percent) of persons aged 12 or older in New Hampshire, which ranked in the top fifth quintile for past month marijuana use, reported that using marijuana occasionally (once a month) was a great risk (Table B.4 and Figure 2.9). Mississippi, which ranked in the lowest fifth for past month marijuana use, had the highest rate (49.0 percent) of perceiving occasional use of marijuana as a great risk (Table B.4 and Figure 2.9).

The national percentage of persons aged 12 or older perceiving a great risk of using marijuana once a month decreased between 2006-2007 and 2007-2008 (from 38.9 to 37.9 percent) (Table C.4). Decreases were particularly observed among young adults aged 18 to 25 and among persons 26 or older. Nine States (Alabama, Georgia, Hawaii, Idaho, Maryland, Nebraska, New York, North Carolina, and Ohio) showed significant decreases in the perceived risk of using marijuana once a month among persons 12 or older. No significant increases were observed in any State for that measure and age group.

2.4 Incidence of Marijuana Use

Related to the prevalence of marijuana use is the number of persons in a period of time who used marijuana for the first time ever. In this report, the incidence of marijuana use is defined as the number of persons who used marijuana for the first time during a 2-year period preceding the survey. Unlike the NSDUH national findings report (OAS, 2009), this report averages data over a 2-year period and calculates the annualized marijuana incidence rate (expressed as a rate per 100 person-years of exposure).7 For the combined years 2007-2008, the national marijuana incidence rate for persons aged 12 or older was 1.7 percent (Table B.5). New Hampshire had the highest rate (2.5 percent), and Utah and West Virginia shared the lowest rate (1.2 percent) among persons 12 or older.

Eight States that were ranked in the top fifth for marijuana incidence in the 12 or older age group also ranked in the top fifth for past month marijuana use (Alaska, Colorado, District of Columbia, Montana, New Hampshire, Oregon, Rhode Island, and Vermont) (Figures 2.9 and 2.17). Most initiation of marijuana takes place at age 25 or earlier (Gfroerer, Wu, & Penne, 2002). It follows that the rates of initiation in the 26 or older age group were much lower than those in the 18 to 25 and 12 to 17 age groups. The national rates of marijuana initiation were 5.5, 6.5, and 0.1 percent for persons aged 12 to 17, 18 to 25, and 26 or older age groups, respectively (Table B.5). Colorado, Rhode Island, and Vermont had the highest rate among youths aged 12 to 17 (7.5 percent), and Utah had the lowest rate among youths aged 12 to 17 (3.8 percent) and among young adults aged 18 to 25 (3.0 percent). Four States in the Northeast region and four States in the West region were in the top fifth for marijuana incidence among 12 to 17 and 18 to 25 year olds (Massachusetts, New Hampshire, Rhode Island, and Vermont in the Northeast region and Colorado, Montana, New Mexico, and Oregon in the West region), while six States in the South region were in the lowest fifth among these two age groups (Alabama, Louisiana, Mississippi, Oklahoma, South Carolina, and Texas) (Figures 2.18 and 2.19).

Six States showed significant changes in marijuana incidence rates among persons 12 or older between 2006-2007 and 2007-2008: Iowa, Louisiana, Pennsylvania, and Wyoming showed declines, and California and North Carolina showed increases. There was also an increase in the marijuana incidence rate in the West region (from 1.7 percent in 2006-2007 to 1.8 percent in 2007-2008) among persons aged 12 or older (Table C.5).

2.5 Illicit Drugs Other Than Marijuana

Illicit drugs other than marijuana include cocaine, heroin, hallucinogens, inhalants, and the nonmedical use of prescription-type pain relievers, tranquilizers, stimulants, and sedatives. The national estimate of past month use of illicit drugs other than marijuana among persons aged 12 or older was 3.6 percent for 2007-2008 combined (Table B.6). Iowa had the lowest rate (1.8 percent) of past month use of an illicit drug other than marijuana among persons 12 or older, and Rhode Island had the highest rate (5.9 percent). Four States that were in the top fifth for past month use of an illicit drug among those aged 12 or older also were ranked in the top fifth for past month use of an illicit drug other than marijuana: Colorado, District of Columbia, Oregon, and Rhode Island (Figures 2.1 and 2.20).

Nationally, the rate of past month use of illicit drugs other than marijuana decreased between 2006-2007 and 2007-2008 among persons aged 18 to 25 (from 8.5 to 8.0 percent), among youths aged 12 to 17 (from 4.8 to 4.5 percent), and among persons 12 or older (from 3.8 to 3.6 percent) (Table C.6). Ten States showed significant changes among persons aged 12 or older: Arizona, Iowa, Louisiana, Mississippi, Tennessee, Texas, Washington, and Wyoming had decreases, and Hawaii and Oregon had increases. Decreases also were observed in the Midwest and South regions for that age group.

2.6 Cocaine

The 2007-2008 national prevalence rate for the use of cocaine in the past year among persons aged 12 or older was 2.2 percent, which was a decrease from 2.4 percent in 2006-2007 (Table C.7). Because cocaine is one of the substances included in the "illicit drug use other than marijuana" category, it is useful to compare the rankings of States with respect to these two measures. In 2007-2008, five States (Arizona, Colorado, District of Columbia, Oregon, and Rhode Island) ranked in the highest fifth for both past month use of an illicit drug other than marijuana (aged 12 or older) and past year use of cocaine (aged 12 or older) (Figures 2.20 and 2.24). Alaska, Arizona, Colorado, Oregon, and Rhode Island ranked in the top fifth for past year cocaine use among all three age groups (12 to 17, 18 to 25, and 26 or older) and among persons 12 or older (Figures 2.24 to 2.27). Although the District of Columbia had the highest rate of past year cocaine use among persons aged 26 or older (4.3 percent) and among persons 12 or older (4.2 percent), it had the lowest rate among youths aged 12 to 17 (0.6 percent). Iowa had the lowest cocaine use rate among persons 26 or older (0.7 percent) and among persons 12 or older (1.2 percent) (Table B.7).

Fifteen States showed significant changes in past year cocaine use among persons aged 12 or older between 2006-2007 and 2007-2008: Alabama, Florida, Georgia, Iowa, Kansas, Massachusetts, Nebraska, New Mexico, Ohio, Oklahoma, South Dakota, Utah, and Wyoming had decreases, while Oregon and Wisconsin had had increases. There were decreases in cocaine use among persons 12 or older in the Midwest (from 2.2 to 2.1 percent) and South (from 2.4 to 2.1 percent) regions (Table C.7).

2.7 Pain Relievers (Nonmedical Use)

Nonmedical use of prescription-type pain relievers is defined as use of these drugs without a prescription or use that occurred simply for the experience or feeling the drug caused. Over-the-counter (OTC) use and legitimate use of prescription-type pain relievers are not included. In 2007-2008, 4.9 percent of persons aged 12 or older reported having used pain relievers nonmedically in the past year, which was lower than the rate in 2006-2007 (5.1 percent) (Table C.8). Nationally among youths aged 12 to 17, there was also a decline in nonmedical use of prescription pain relievers (from 6.9 to 6.6 percent).

In 2007-2008, Oklahoma had the highest percentage (6.9 percent) of persons aged 12 or older using pain relievers for nonmedical purposes in the past year, and Iowa and Nebraska had the lowest rate in the Nation—3.3 percent (Table B.8). Arkansas, Kentucky, Nevada, Oklahoma, Oregon, Tennessee, and Wisconsin ranked in the top fifth of States for this measure in each of the three age groups (12 to 17, 18 to 25, and 26 or older) and for the total population aged 12 or older. Illinois, Nebraska, New Jersey, and South Dakota ranked in the lowest fifth in each of these age groups (Figures 2.28 to 2.31).

Among all age groups (12 to 17, 18 to 25, and 26 or older) and overall (12 or older), there were 16 significant changes (distributed over 11 States) between 2006-2007 and 2007-2008 in the nonmedical use of prescription pain relievers in the past year. Among youths aged 12 to 17, Alabama and Louisiana had declines between 2006-2007 and 2007-2008. Among young adults aged 18 to 25, Connecticut, Florida, Illinois, and Iowa had declines between 2006-2007 and 2007-2008, while Oregon's rate increased. Among persons aged 26 or older, Hawaii and Oregon had increases between 2006-2007 and 2007-2008. Among persons aged 12 or older, Arkansas, Florida, Iowa, Massachusetts, and Wyoming had declines between 2006-2007 and 2007-2008, and Hawaii and Oregon showed increases. The South region showed declines in nonmedical use of prescription pain relievers among youths aged 12 to 17 (from 7.3 to 6.7 percent) and among persons 12 or older (from 5.2 to 4.9 percent) (Table C.8).

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Figure 2.1 Illicit Drug Use in Past Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.1

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.2 Illicit Drug Use in Past Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.2

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.3 Illicit Drug Use in Past Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.3

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.4 Illicit Drug Use in Past Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.4

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.5 Marijuana Use in Past Year among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.5

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.6 Marijuana Use in Past Year among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.6

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.7 Marijuana Use in Past Year among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.7

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.8 Marijuana Use in Past Year among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.8

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.9 Marijuana Use in Past Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.9

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.10 Marijuana Use in Past Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.10

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.11 Marijuana Use in Past Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.11

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.12 Marijuana Use in Past Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.12

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.13 Perceptions of Great Risk of Smoking Marijuana Once a Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.13

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.14 Perceptions of Great Risk of Smoking Marijuana Once a Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.14

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.15 Perceptions of Great Risk of Smoking Marijuana Once a Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.15

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.16 Perceptions of Great Risk of Smoking Marijuana Once a Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.16

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.17 First Use of Marijuana among Persons Aged 12 or Older, by State: Average Annual Rates Based on 2007 and 2008 NSDUHs

Figure 2.17

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.18 First Use of Marijuana among Youths Aged 12 to 17, by State: Average Annual Rates Based on 2007 and 2008 NSDUHs

Figure 2.18

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.19 First Use of Marijuana among Persons Aged 18 to 25, by State: Average Annual Rates Based on 2007 and 2008 NSDUHs

Figure 2.19

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.20 Illicit Drug Use Other Than Marijuana in Past Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.20

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.21 Illicit Drug Use Other Than Marijuana in Past Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.21

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.22 Illicit Drug Use Other Than Marijuana in Past Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.22

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.23 Illicit Drug Use Other Than Marijuana in Past Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.23

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.24 Cocaine Use in Past Year among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.24

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.25 Cocaine Use in Past Year among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.25

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.26 Cocaine Use in Past Year among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.26

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.27 Cocaine Use in Past Year among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.27

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.28 Nonmedical Use of Pain Relievers in Past Year among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.28

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.29 Nonmedical Use of Pain Relievers in Past Year among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.29

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.30 Nonmedical Use of Pain Relievers in Past Year among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.30

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.

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Figure 2.31 Nonmedical Use of Pain Relievers in Past Year among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2007 and 2008 NSDUHs

Figure 2.31

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2007 and 2008.


End Notes

7 Average annual marijuana initiation rate = 100*{[X1 ÷ (0.5 * X1 + X2)] ÷ 2}, where X1 is the number of marijuana initiates in the past 24 months and X2 is the number of persons who never used marijuana. Note that because the average annual incidence of marijuana was so low for the 26 or older age group and had such an abbreviated range, no map has been included for it; however, Table B.5 includes these estimates. For details on how average annual incidence was calculated, see Section A.7 in Appendix A.

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