|Illicit Drug Use|
|Initiation of Substance Use|
|Youth Prevention-Related Measures|
|Substance Dependence, Abuse, and Treatment|
|Prevelence and Treatment of Mental Health Problems|
This report presents the first information from the 2005 National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of the United States aged 12 years old or older. The survey interviews approximately 67,500 persons each year. Unless otherwise noted, all comparisons in this report described using terms such as “increased,” “decreased,” or “more than” are statistically significant at the .05 level.
In 2005, an estimated 19.7 million Americans aged 12 or older were current (past month) illicit drug users, meaning they had used an illicit drug during the month prior to the survey interview. This estimate represents 8.1 percent of the population aged 12 years old or older. Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used nonmedically.
- The rate of current illicit drug use among persons aged 12 or older in 2005 (8.1 percent) was similar to the rate in 2004 (7.9 percent), 2003 (8.2 percent), and 2002 (8.3 percent).
- Marijuana was the most commonly used illicit drug (14.6 million past month users). Among persons aged 12 or older, the rate of past month marijuana use was about the same in 2005 (6.0 percent) as in 2004 (6.1 percent), 2003 (6.2 percent), and 2002 (6.2 percent).
- In 2005, there were 2.4 million current cocaine users aged 12 or older, which is more than in 2004 when the number was 2.0 million. However, the change in the rate of current use of cocaine between 2005 and 2004 (1.0 and 0.8 percent, respectively) was not statistically significant.
- Hallucinogens were used in the past month by 1.1 million persons (0.4 percent) aged 12 or older in 2005, including 502,000 (0.2 percent) who had used Ecstasy. These estimates are similar to the corresponding estimates for 2004.
- There were 6.4 million (2.6 percent) persons aged 12 or older who used prescription-type psychotherapeutic drugs nonmedically in the past month. Of these, 4.7 million used pain relievers, 1.8 million used tranquilizers, 1.1 million used stimulants (including 512,000 using methamphetamine), and 272,000 used sedatives. Each of these estimates is similar to the corresponding estimate for 2004.
- The rates for past month and past year methamphetamine use did not change between 2004 and 2005, but the lifetime rate declined from 4.9 to 4.3 percent. From 2002 to 2005, decreases were seen in lifetime (5.3 to 4.3 percent) and past year (0.7 to 0.5 percent) use, but not past month use (0.3 percent in 2002 vs. 0.2 percent in 2005). Although the number of past month users has remained steady since 2002, the number of methamphetamine users who were dependent on or abused some illicit drug did rise significantly during this period, from 164,000 in 2002 to 257,000 in 2005.
- The rate of current illicit drug use among youths aged 12 to 17 in 2005 was similar to the rate in 2004, but significantly lower than in 2002. The rates were 11.6 percent in 2002, 11.2 percent in 2003, 10.6 percent in 2004, and 9.9 percent in 2005.
- The rate of current marijuana use among youths aged 12 to 17 declined from 7.6 percent in 2004 to 6.8 percent in 2005. The rate of current marijuana use has declined significantly from 8.2 percent in 2002.
- There were no significant changes in past month use of any illicit drugs among young adults aged 18 to 25 between 2004 and 2005, except for cocaine use, which increased from 2.1 to 2.6 percent.
- Past month nonmedical use of prescription-type drugs among young adults aged 18 to 25 increased from 5.4 percent in 2002 to 6.3 percent in 2005. This was primarily due to an increase in pain reliever use, which was 4.1 percent in 2002 and 4.7 percent in 2003, 2004, and 2005.
- Among unemployed adults aged 18 or older in 2005, 17.1 percent were current illicit drug users, which was higher than the 8.2 percent of those employed full time and 10.4 percent of those employed part time. However, most drug users were employed. Of the 17.2 million current illicit drug users aged 18 or older in 2005, 12.9 million (74.8 percent) were employed either full or part time.
- In 2005, there were 10.5 million persons aged 12 or older who reported driving under the influence of an illicit drug during the past year. This corresponds to 4.3 percent of the population aged 12 or older, similar to the rates in 2003 (4.6 percent) and 2004 (4.4 percent), but lower than the rate in 2002 (4.7 percent). In 2005, the rate was highest among young adults aged 18 to 25 (13.4 percent).
NSDUH includes questions for nonmedical users of prescription-type psychotherapeutic drugs regarding how they obtained the drugs they recently used nonmedically. In 2005, the most prevalent source from which recently used drugs were obtained among nonmedical users of prescription-type drugs was “from a friend or relative for free.”
Among persons aged 12 or older who used pain relievers nonmedically in the past 12 months, 59.8 percent reported that the source of the drug the most recent time they used was from a friend or relative for free. Another 16.8 percent reported they got the drug from one doctor. Only 4.3 percent got the pain relievers from a drug dealer or other stranger, and only 0.8 percent reported buying the drug on the Internet.
- Slightly more than half of Americans aged 12 or older reported being current drinkers of alcohol in the 2005 survey (51.8 percent). This translates to an estimated 126 million people, which is higher than the 2004 estimate of 121 million people (50.3 percent).
- More than one fifth (22.7 percent) of persons aged 12 or older participated in binge drinking (having five or more drinks on the same occasion on at least 1 day in the 30 days prior to the survey) in 2005. This translates to about 55 million people, comparable with the estimate in 2004.
- In 2005, heavy drinking was reported by 6.6 percent of the population aged 12 or older, or 16 million people. This rate is similar to the rate of heavy drinking in 2004 (6.9 percent). Heavy drinking is defined as binge drinking on at least 5 days in the past 30 days.
- In 2005, among young adults aged 18 to 25, the rate of binge drinking was 41.9 percent, and the rate of heavy drinking was 15.3 percent. These rates are similar to the rates in 2002, 2003, and 2004.
- The rate of current alcohol use among youths aged 12 to 17 declined from 17.6 percent in 2004 to 16.5 percent in 2005. Youth binge drinking also declined during that period, from 11.1 to 9.9 percent, but heavy drinking did not change significantly (2.7 percent in 2004 and 2.4 percent in 2005).
- Although there were declines in past month and binge alcohol use among youths aged 12 to 17 between 2004 and 2005, overall underage (persons aged 12 to 20) past month and binge drinking rates have remained essentially unchanged since 2002. In 2005, about 10.8 million persons aged 12 to 20 (28.2 percent of this age group) reported drinking alcohol in the past month. Nearly 7.2 million (18.8 percent) were binge drinkers, and 2.3 million (6.0 percent) were heavy drinkers.
- Among persons aged 12 to 20, past month alcohol use rates were 12.0 percent among Native Hawaiians or Other Pacific Islanders, 15.5 percent among Asians, 19.0 percent among blacks, 21.7 percent among American Indians or Alaska Natives, 24.0 percent among those reporting two or more races, 25.9 percent among Hispanics, and 32.3 percent among whites.
- In 2005, an estimated 13.0 percent of persons aged 12 or older drove under the influence of alcohol at least once in the past year. This percentage has dropped since 2002, when it was 14.2 percent. The 2005 estimate corresponds to 31.7 million persons.
- In 2005, an estimated 71.5 million Americans aged 12 or older were current (past month) users of a tobacco product. This represents 29.4 percent of the population in that age range. In addition, 60.5 million persons (24.9 percent of the population) were current cigarette smokers; 13.6 million (5.6 percent) smoked cigars; 7.7 million (3.2 percent) used smokeless tobacco; and 2.2 million (0.9 percent) smoked tobacco in pipes.
- The rates of current use of cigarettes, smokeless tobacco, cigars, and pipe tobacco were unchanged between 2004 and 2005 among persons aged 12 or older. However, between 2002 and 2005, past month use of a tobacco product declined from 30.4 to 29.4 percent, and past month cigarette use decreased from 26.0 to 24.9 percent.
- The rate of past month cigarette use among 12 to 17 year olds declined from 13.0 percent in 2002 to 10.8 percent in 2005. Cigar use in the past month declined to 4.2 percent of youths in 2005 from the 2004 estimate of 4.8 percent. Past month smokeless tobacco use was reported by 2.1 percent of youths in 2005, similar to estimates since 2002.
- Among pregnant women aged 15 to 44, combined data for 2004 and 2005 indicated that the rate of past month cigarette use was 16.6 percent. The rate was higher among women in that age group who were not pregnant (29.6 percent).
- The illicit drug categories with the largest number of recent initiates among persons aged 12 or older were nonmedical use of pain relievers (2.2 million) and marijuana use (2.1 million). These estimates are not significantly different from the numbers in 2004.
- In 2005, there were 877,000 persons aged 12 or older who had used inhalants for the first time within the past 12 months; 72.3 percent were under age 18 when they first used. There was no significant change in the number of inhalant initiates from 2002 to 2005.
- The number of recent new users of methamphetamine taken nonmedically among persons aged 12 or older was 192,000 in 2005. Between 2002 and 2004, the number of methamphetamine initiates remained steady at around 300,000 per year, but there was a decline from 2004 (318,000 initiates) to 2005.
- Most (88.9 percent) of the 4.3 million recent alcohol initiates were younger than 21 at the time of initiation.
- The number of persons aged 12 or older who smoked cigarettes for the first time within the past 12 months was 2.3 million in 2005, which was significantly greater than the estimate for 2002 (1.9 million). Most new smokers in 2005 were under age 18 when they first smoked cigarettes (63.4 percent).
- Perceived risk is measured by NSDUH as the percentage reporting that there is great risk in the substance use behavior. Among youths aged 12 to 17, there were no changes in the perceived risk of marijuana, cocaine, heroin, or LSD use between 2004 and 2005. However, between 2002 and 2005, there were increases in the perceived risk of smoking marijuana once a month (from 32.4 to 34.0 percent) and smoking marijuana once or twice a week (from 51.5 to 55.0 percent). On the other hand, the percentage of youths who perceived that trying heroin once or twice is a great risk declined from 58.5 percent in 2002 to 56.5 percent in 2005, and those who perceived that using cocaine once a month is a great risk declined from 50.5 to 48.8 percent.
- The proportion of youths aged 12 to 17 who reported perceiving great risk from smoking one or more packs of cigarettes per day increased from 63.1 percent in 2002 to 68.3 percent in 2005.
- Over half (51.0 percent) of youths aged 12 to 17 reported in 2005 that it would be “fairly easy” or “very easy” for them to obtain marijuana if they wanted some. Around one quarter reported it would be easy to get cocaine (24.9 percent) or crack (25.3 percent). One in seven (14.0 percent) indicated that heroin would be “fairly” or “very” easily available, and about one in six (15.7 percent) said it would be easy for them to get LSD if they wanted some.
- The perceived availability among youths decreased between 2002 and 2005 for marijuana (from 55.0 to 51.0 percent), crack (from 26.5 to 25.3 percent), heroin (from 15.8 to 14.0 percent), and LSD (from 19.4 to 15.7 percent). However, the percentage reporting that it would be easy to obtain cocaine showed no decline over this period (25.0 percent in 2002 and 24.9 percent in 2005).
- A majority of youths (90.2 percent) reported that their parents would strongly disapprove of their trying marijuana or hashish once or twice. Current marijuana use was much less prevalent among youths who perceived strong parental disapproval for trying marijuana or hashish once or twice than for those who did not (4.6 vs. 27.0 percent).
- Almost four fifths (77.9 percent) of youths aged 12 to 17 enrolled in school reported in 2005 they had seen or heard drug or alcohol prevention messages at school in the past year, a percentage similar to the 2004 estimate of 78.2 percent. Past month use of an illicit drug was lower for youths exposed to such messages in school (9.2 percent) than for youths not reporting such exposure (13.2 percent).
- In 2005, an estimated 22.2 million persons (9.1 percent of the population aged 12 or older) were classified with substance dependence or abuse in the past year based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Of these, 3.3 million were classified with dependence on or abuse of both alcohol and illicit drugs, 3.6 million were dependent on or abused illicit drugs but not alcohol, and 15.4 million were dependent on or abused alcohol but not illicit drugs.
- Between 2002 and 2005, there was no change in the number of persons with substance dependence or abuse (22.0 million in 2002, 21.6 million in 2003, 22.5 million in 2004, and 22.2 million in 2005).
- The specific illicit drugs that had the highest levels of past year dependence or abuse in 2005 were marijuana (4.1 million), followed by cocaine (1.5 million) and pain relievers (1.5 million).
- Adults aged 21 or older who had first used alcohol before age 21 were more likely than adults who had their first drink at age 21 or older to be classified with alcohol dependence or abuse (9.6 vs. 2.1 percent).
- There were 3.9 million persons aged 12 or older (1.6 percent of the population) who received some kind of treatment for a problem related to the use of alcohol or illicit drugs in 2005. More than half (2.1 million) received treatment at a self-help group. There were 1.5 million persons who received treatment at a rehabilitation facility as an outpatient, 1.1 million at a rehabilitation facility as an inpatient, 1.0 million at a mental health center as an outpatient, 773,000 at a hospital as an inpatient, 460,000 at a private doctor’s office, 399,000 at an emergency room, and 344,000 at a prison or jail. None of these estimates changed significantly between 2004 and 2005.
- More than half (2.5 million) of the 3.9 million persons who received treatment for a substance use problem in the past year received treatment for alcohol use during their most recent treatment. There were 1.1 million persons who received treatment for marijuana use during their most recent treatment. Estimates for other drugs were 797,000 persons for cocaine, 466,000 for pain relievers, 358,000 for hallucinogens, 351,000 for stimulants, and 326,000 for heroin. (Note that respondents could indicate that they received treatment for more than one substance during their most recent treatment.)
- In 2005, the number of persons aged 12 or older needing treatment for an illicit drug or alcohol use problem was 23.2 million (9.5 percent of the population aged 12 or older). Of these, 2.3 million (0.9 percent of persons aged 12 or older and 10.0 percent of those who needed treatment) received treatment at a specialty facility. Thus, there were 20.9 million persons (8.6 percent of the population aged 12 or older) who needed treatment for an illicit drug or alcohol use problem but did not receive treatment at a specialty substance abuse facility in the past year.
- Of the 20.9 million people in 2005 who were classified as needing substance use treatment but did not receive treatment at a specialty facility in the past year, 1.2 million persons (5.6 percent) reported that they felt they needed treatment for their illicit drug or alcohol use problem. Of these 1.2 million persons who felt they needed treatment, 296,000 (25.5 percent) reported that they made an effort to get treatment, and 865,000 (74.5 percent) reported making no effort to get treatment.
- The number of people who felt they needed treatment and made an effort to get it among those who needed but did not receive treatment was not statistically different in 2005 (296,000) from the number reported in 2004 (441,000).
Serious psychological distress (SPD) is an overall indicator of past year nonspecific psychological distress that is constructed from the K6 scale administered to adults aged 18 or older in NSDUH. The data related to SPD in this report are not comparable with data in previous reports due to changes in the survey administration of this instrument.
- In 2005, there were an estimated 24.6 million adults aged 18 or older in the United States with SPD in the past year. This represents 11.3 percent of all adults in this country, a significantly lower rate than in 2004 (12.2 percent).
- Rates of SPD in 2005 were highest for adults aged 18 to 25 (18.6 percent) and lowest for adults aged 50 or older (7.1 percent).
- The prevalence of SPD among women aged 18 or older (14.0 percent) was higher than that among men in that age group (8.4 percent).
- SPD in the past year was associated with past year substance dependence or abuse in 2005. Among adults with SPD in 2005, 21.3 percent (5.2 million) were dependent on or abused illicit drugs or alcohol. The rate among adults without SPD was 7.7 percent (14.9 million).
- Among the 24.6 million adults with SPD in 2005, 11.1 million (45.3 percent) received treatment for a mental health problem in the past year. This was a higher proportion than in 2004 (41.6 percent). Among adults with SPD, 39.4 percent received a prescription medication, 28.5 percent received outpatient treatment, and 4.6 percent received inpatient treatment for a mental health problem in the past year.
- Among the 5.2 million adults with both SPD and substance dependence or abuse (i.e., a substance use disorder) in 2005, about half (47.0 percent) received mental health treatment or substance use treatment at a specialty facility: 8.5 percent received both treatment for mental health problems and specialty substance use treatment, 34.3 percent received only treatment for mental health problems, and 4.1 percent received only specialty substance use treatment.
- In 2005, there were 30.8 million adults (14.2 percent of persons aged 18 or older) who had at least one major depressive episode (MDE) in their lifetime, and 15.8 million adults (7.3 percent of persons aged 18 or older) had at least one MDE in the past year. In 2004, there were 17.1 million adults (8.0 percent) who had MDE during the past year. This represents a statistically significant decline in the rate of past year MDE between 2004 and 2005.
- Having MDE in the past year was associated with past year substance dependence or abuse in 2005. Among adults who had MDE in 2005, 19.9 percent were dependent on or abused alcohol or illicit drugs, while among persons without MDE only 8.4 percent were dependent on or abused alcohol or illicit drugs. Persons with MDE were more likely than those without MDE to be dependent on or abuse illicit drugs (8.3 vs. 2.1 percent) and alcohol (14.8 vs. 7.4 percent).
- Among adults aged 18 or older who had MDE in the past year, 65.6 percent received treatment (i.e., saw or talked to a medical doctor or other professional or used prescription medication) for depression in the same time period.
- Among adults aged 18 or older with MDE in the past year in 2005, women were more likely than men to receive treatment for depression in the past year (70.9 vs. 55.6 percent).
- In 2005, there were 3.4 million youths aged 12 to 17 years (13.7 percent of the population aged 12 to 17 years old) who had at least one MDE in their lifetime and 2.2 million youths (8.8 percent) who had MDE during the past year.
- The rate of MDE in the past year was higher for adolescent females (13.3 percent) than for adolescent males (4.5 percent).
- The occurrence of MDE in the past year among youths aged 12 to 17 was associated with a higher prevalence of illicit drug or alcohol dependence or abuse (19.8 percent). Among youths who did not report past year MDE, 6.9 percent had illicit drug or alcohol dependence or abuse during the same period.
- In 2005, 37.8 percent of youths aged 12 to 17 with past year MDE received treatment for depression (saw or talked to a medical doctor or other professional or used prescription medication.