Highlights

This report presents State estimates for 25 measures of substance use and mental health based on the 2008 and 2009 National Surveys on Drug Use and Health (NSDUHs). Sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), NSDUH is an ongoing survey of the civilian, noninstitutionalized population of the United States aged 12 years or older. Interview data from 137,436 persons were collected in 2008-2009 (see Table A.9 in Appendix A). With the exception of the four mental health outcomes, separate estimates are presented for each outcome in four age groups: 12 to 17, 18 to 25, 26 or older, and all persons 12 or older. For past year serious mental illness, past year any mental illness, past year suicidal thoughts, and past year major depressive episode (i.e., depression), estimates are available for adults in three age groups: 18 to 25, 26 or older, and 18 or older. In addition, estimates for major depressive episode are available for youths aged 12 to 17. This report also includes estimates for persons aged 12 to 20 for two of the measures—past month alcohol use and past month binge alcohol use, representing underage use of alcohol. Although estimates for persons aged 18 or older for the substance use outcomes are not included in this report, they are available at http://www.samhsa.gov/data/states.htm. Additionally, tables showing the total number of persons associated with each measure are available at this Web site.

For each measure, States have been ranked and categorized into quintiles, or fifths, in order to simplify the discussion.¹ Estimates presented in this report are based on a hierarchical Bayes estimation method that combines survey data with a national model. Note that these estimates are benchmarked to the national design-based estimates (for details, see Section A.6 in Appendix A). In addition to presenting State estimates for 2008-2009, Chapters 2 to 6 provide comparisons of the 2007-2008 estimates with the 2008-2009 estimates for all outcomes and indicate whether the differences between the two are statistically significant. Increases or decreases are discussed only if they are statistically significant at the 0.05 level. Chapter 7 compares estimates between 2002-2003 and 2008-2009 for a select set of outcomes.

Illicit Drug Use

In 2008-2009, 8.4 percent of the U.S. population aged 12 or older had used an illicit drug in the past month, and this rate was higher than the rate in 2007-2008 (8.0 percent). Estimates in 2008-2009 ranged from 5.3 percent in Iowa to 13.5 percent in Alaska. (Tables B.1 and C.1)
Nationally, past month illicit drug use among persons aged 12 to 17 decreased from 11.4 percent in 2002-2003 to 9.7 percent in 2008-2009 and remained unchanged among persons aged 18 to 25, 26 or older, and 12 or older. Among persons aged 12 to 17, 17 States had decreases: Delaware, Florida, Hawaii, Kentucky, Louisiana, Michigan, Minnesota, Montana, Nebraska, North Carolina, North Dakota, Pennsylvania, South Dakota, Texas, Vermont, Virginia, and Washington. No States had increases in this age group. (Table D.1)
In 2008-2009, past month marijuana use was reported by 6.4 percent of the U.S. population aged 12 years or older, an increase from 6.0 percent in 2007-2008. Utah had the lowest rate in 2008-2009 (3.6 percent), and Alaska had the highest rate (11.5 percent). All 10 States that were in the top fifth for past month illicit drug use among persons aged 12 or older also were ranked in the top fifth for past month marijuana use. These States were Alaska, Colorado, the District of Columbia, Hawaii, Maine, Massachusetts, New Hampshire, Oregon, Rhode Island, and Vermont. Comparing 2007-2008 with 2008-2009, 3 States had decreases in past month marijuana use, and 13 States had increases. (Tables B.3 and C.3; Figures 2.1 and 2.9)
Between 2002-2003 and 2008-2009, past month marijuana use decreased nationally among persons aged 12 to 17 from 8.0 to 7.0 percent, and it increased among persons aged 26 or older from 4.0 to 4.4 percent. Among 12 to 17 year olds, 11 States had declines: Florida, Kentucky, Louisiana, Minnesota, Montana, Nebraska, North Dakota, Pennsylvania, South Dakota, Vermont, and West Virginia. There were no increases in this age group. (Table D.3)
Nationwide in 2008-2009, 10.8 percent of persons aged 12 or older reported marijuana use in the past year, which was an increase from 10.2 percent in 2007-2008. Two States (Kentucky and Rhode Island) experienced decreases in past year marijuana use among persons aged 12 or older between 2007-2008 and 2008-2009, while 12 States had increases (California, Colorado, Connecticut, Hawaii, Idaho, Illinois, Iowa, Maine, Massachusetts, New York, Oklahoma, and Texas). (Table C.2)
Between 2007-2008 and 2008-2009, the national percentage of youths aged 12 to 17 perceiving great risk in smoking marijuana once a month decreased from 34.2 to 32.3 percent. These rates declined in 9 States among youths aged 12 to 17 and in 21 States among young adults aged 18 to 25. No increases were observed in any State or age group. (Table C.4)
For the combined years 2008-2009, the national marijuana incidence rate for persons aged 12 or older was 1.7 percent. Kentucky's rate decreased between 2007-2008 and 2008-2009, while California, Connecticut, Delaware, Georgia, Idaho, Iowa, Michigan, Nevada, New Jersey, and Texas showed increases. (Tables B.5 and C.5)
For the years 2008 and 2009 combined, the national estimate of past month use of illicit drugs other than marijuana among persons aged 12 or older was 3.5 percent. Iowa had the lowest rate (2.0 percent), and Rhode Island had the highest rate (5.5 percent). (Table B.6)
In 2008-2009, the prevalence of past year cocaine use among persons aged 12 or older was 2.0 percent in the Nation, which was a decrease from 2.2 percent in 2007-2008. The District of Columbia, Louisiana, and South Carolina stand out for their ranking in the lowest fifth for ages 12 to 17 and the highest fifth for ages 26 or older. Between 2007-2008 and 2008-2009, 11 States showed decreases (Arizona, Arkansas, Georgia, Indiana, Kentucky, Maryland, Minnesota, Ohio, Oregon, Tennessee, and Virginia), while New Hampshire showed an increase in past year cocaine use among persons aged 12 or older. (Tables B.7 and C.7; Figures 2.25 and 2.27)
Twenty-two States experienced decreases in past year cocaine use among the 12 or older age group between 2002-2003 and 2008-2009. In addition, decreases were observed among 12 to 17 year olds in 34 States, among 18 to 25 year olds in 14 States, and among persons aged 26 or older in 3 States. Decreases also were observed nationally for all age groups. No increases in past year cocaine use were observed in any age group at the State level. (Table D.7)
Nationally in 2008-2009, 4.8 percent of persons aged 12 or older reported having used pain relievers nonmedically in the past year. In 2008-2009, Oklahoma had the highest percentage (8.1 percent), while Iowa and Nebraska shared the lowest rate (3.6 percent). (Table B.8)
Nationally, nonmedical use of pain relievers in the past year among persons aged 12 or older did not change between 2002-2003 and 2008-2009 (4.8 percent in 2008-2009 and in 2002-2003). However, rates among persons aged 12 or older increased in Montana, New York, Ohio, and Oklahoma and decreased in Florida and Wyoming between 2002-2003 and 2008-2009. (Table D.8)

Alcohol Use

Nationally, about half (51.8 percent) of Americans aged 12 or older in 2008-2009 reported using alcohol in past month. The highest rates occurred in the 18 to 25 age group, with New Hampshire having the highest rate (75.1 percent). Five States (Alabama, Idaho, Iowa, Kansas, and Oklahoma) showed increases from 2007-2008 to 2008-2009 in the percentage of persons aged 12 or older who used alcohol in the past month. Virginia was the only State with a decrease in the 12 or older age group (from 53.6 to 50.8 percent). (Tables B.9 and C.9)
Nationwide, past month alcohol use among persons aged 12 or older increased between 2002-2003 (50.5 percent) and 2008-2009 (51.8 percent). In addition, alcohol use rates increased in 11 States, including 6 from the South (Alabama, Arkansas, District of Columbia, Illinois, Kansas, Mississippi, New Hampshire, North Carolina, Oregon, Pennsylvania, and Tennessee). (Table D.9)
In 2008-2009, almost a quarter (23.5 percent) of persons aged 12 or older in the United States participated in binge drinking in the past month. Estimates during this time period ranged from 14.1 percent in Utah to 29.8 percent in North Dakota. Two States showed decreases in binge drinking between 2007-2008 and 2008-2009 among persons aged 12 or older: Minnesota (from 30.1 to 26.9 percent) and North Dakota (from 32.6 to 29.8 percent). (Tables B.10 and C.10)
Past month use of alcohol among persons aged 12 to 20 in 2008-2009 (underage use of alcohol) ranged from a low of 14.2 percent in Utah to a high of 36.6 percent in Vermont. Utah had the lowest rate of underage binge alcohol use (11.5 percent), and North Dakota had the highest rate for this measure (26.4 percent). (Table B.12)
Underage (aged 12 to 20) binge alcohol use in the past month decreased nationwide from 19.2 percent in 2002-2003 to 17.7 percent in 2008-2009. Twenty-one States showed declines in underage binge alcohol use rates. (Table D.12)

Tobacco Use

Nationally among persons aged 12 or older, the rate for past month use of tobacco in 2008-2009 was 28.0 percent. Decreases in tobacco use from 2007-2008 to 2008-2009 were seen in Arizona, Colorado, Florida, Georgia, Minnesota, Ohio, and Rhode Island. (Tables B.13 and C.13)
In 2008-2009, the national estimate of past month use of cigarettes among persons aged 12 or older was 23.6 percent. Kentucky had the highest rate (32.0 percent), and Utah had the lowest rate (16.4 percent). (Table B.14)
Cigarette use in the past month decreased nationally between 2002-2003 and 2008-2009 across all age groups (12 or older, 12 to 17, 18 to 25, and 26 or older). The number of States showing decreases in cigarette use between 2002-2003 and 2008-2009 diminished with increasing age (12 to 17 year olds: 42 States; 18 to 25 year olds: 31 States; 26 or older: 6 States). (Table D.14)
Nationwide, the rates of perception of great risk of smoking one or more packs of cigarettes a day decreased from 69.3 percent in 2007-2008 to 67.7 percent in 2008-2009 among youths aged 12 to 17. At the State level, there were 54 decreases in the perception of risk of heavy cigarette use across three age groups (12 to 17: 14 States with decreases; 18 to 25: 31 States with decreases; and 26 or older: 9 States with decreases). No increases occurred in any State or age group. (Table C.15)

Substance Dependence, Abuse, and Treatment Need

In 2008-2009, 7.4 percent of the population aged 12 or older was classified with dependence on or abuse of alcohol nationwide in the past year. The District of Columbia had the highest rate of past year alcohol dependence or abuse among persons aged 26 or older (8.1 percent) and the lowest rate among persons aged 12 to 17 (3.0 percent). For the 12 or older age group, New York had an increase (from 7.1 to 7.9 percent) from 2007-2008 to 2008-2009, while decreases were observed in Illinois (from 8.2 to 7.6 percent) and Washington (from 8.0 to 7.1 percent). (Tables B.16 and C.16)
Nationally in 2008-2009, about 2.8 percent of persons aged 12 or older were dependent on or had abused illicit drugs in the past year. The District of Columbia had the highest rate of past year illicit drug dependence or abuse (4.4 percent) among persons aged 12 or older, and Iowa had the lowest rate (1.9 percent). Among persons aged 12 or older, from 2007-2008 to 2008-2009 decreases were observed in Georgia, Minnesota, and Tennessee, but an increase was seen in Pennsylvania. (Tables B.18 and C.18)
In 2008-2009, the national rate for past year dependence on or abuse of alcohol or illicit drugs among persons aged 12 or older was 8.9 percent. Of the 10 States that ranked in the highest fifth for past year alcohol dependence or abuse, 8 States also ranked in the top fifth for past year dependence on or abuse of illicit drugs or alcohol among persons aged 12 or older: Colorado, Connecticut, District of Columbia, Minnesota, Montana, New Mexico, Oregon, and South Dakota. (Table B.20; Figures 5.1 and 5.17)
Among persons aged 12 or older, rates of dependence on or abuse of alcohol or illicit drugs in the past year between 2002-2003 and 2008-2009 remained unchanged nationally and for each State except for Arizona, Illinois, and North Dakota, which showed declines. (Table D.20)
The national rate in 2008-2009 for needing but not receiving treatment for an illicit drug problem among persons aged 12 or older was 2.5 percent. Decreases between 2007-2008 and 2008-2009 were observed in Colorado (from 3.3 to 2.8 percent) and Georgia (from 2.8 to 2.4 percent). (Tables B.21 and C.21)
The percentage of persons aged 12 or older needing but not receiving treatment for an alcohol problem was 7.0 percent in 2008-2009. Although the District of Columbia ranked in the top fifth for needing but not receiving treatment for an alcohol problem among persons aged 26 or older (7.3 percent), it ranked in the lowest quintile group among 12 to 17 year olds (3.3 percent). (Table B.22)

Mental Illness, Suicidal Thoughts, and Depression

Nationally in 2008-2009, 4.6 percent of adults aged 18 or older had serious mental illness in the past year. Rhode Island had the highest rate (7.2 percent), while Hawaii and South Dakota shared the lowest rate (3.5 percent). (Table B.23)
In 2008-2009, the national rate of past year any mental illness among adults aged 18 or older was 19.7 percent. The highest rate occurred in Rhode Island (24.2 percent), while the lowest rate was in Maryland (16.7 percent). Across age groups, the highest rate of past year any mental illness was among 18 to 25 year olds (30.5 percent nationally). (Table B.24)
In 2008-2009, 3.7 percent of adults aged 18 or older in the United States had serious thoughts of suicide in the past year. State-level estimates ranged from 2.8 percent in Georgia to 5.4 percent in Utah. The District of Columbia was the only State with a rate in the lowest fifth among 18 to 25 year olds and in the highest fifth among persons aged 26 or older. (Table B.25; Figures 6.8 and 6.9)
Nationwide in 2008-2009, 6.5 percent of adults aged 18 or older had a major depressive episode (i.e., depression) in the past year. This rate was unchanged from 2007-2008 (6.6 percent). Estimates at the State level ranged from 5.2 percent in Pennsylvania to 9.5 percent in Rhode Island. In addition, 8.2 percent of youths aged 12 to 17 experienced depression nationwide during the past year, a rate that also remained unchanged from the rate in 2007-2008. These rates ranged from 6.8 percent in the District of Columbia and Pennsylvania to 10.3 percent in Oregon. At the State level, there were no changes in rates of youth depression between 2007-2008 and 2008-2009. (Tables B.26 and C.23)