Highlights

This report presents State estimates for 23 measures of substance use or mental health problems based on the 2004 and 2005 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 approximately 136,100 persons were collected in 2004-2005. Separate estimates have been produced for four age groups: 12 to 17, 18 to 25, 26 or older, and all persons 12 or older. For each measure, States have been ranked and categorized into quintiles, or fifths, in order to simplify the discussion. Estimates presented in this report are based on hierarchical Bayes estimation methods that combine survey data with a national model.

In addition to State estimates for 2004-2005, this report includes estimates of change between 2003-2004 and 2004-2005 for all measures except serious psychological distress (SPD) and major depressive episode (MDE). Also in this report are estimates for persons aged 12 to 20 for two of the measures—past month alcohol use and binge alcohol use. Please note that the change between 2003-2004 and 2004-2005 can be viewed as the average annual change between 2003 and 2005; therefore, the total change for that period is approximately twice the average annual change.

Illicit Drug Use

Estimates of past month use of illicit drugs ranged from a low of 5.9 percent in Iowa to a high of 12.2 percent in Alaska for all persons aged 12 or older in 2004-2005. At the national level, the use of illicit drugs among youths aged 12 to 17 declined from 10.9 percent in 2003-2004 to 10.3 percent in 2004-2005 (approximately a 1.2 percent change between 2003 and 2005). Five States showed significant decreases in past month use of illicit drugs among youths: California (from 12.1 to 10.6 percent), Michigan (from 12.3 to 10.6 percent), New Mexico (from 16.2 to 13.0 percent), North Dakota (from 10.8 to 8.5 percent), and Washington (from 11.7 to 9.6 percent). Among the 12 significant changes that occurred across all four age groups between 2003-2004 and 2004-2005, 11 were decreases. (Table s B.1 and C.1)
Nationally in 2004-2005, 10.5 percent of all persons aged 12 or older reported marijuana use in the past year. The State rankings for past year use of marijuana were fairly similar to those for past month use of marijuana among persons 12 or older. Iowa had the lowest rate of past month marijuana use (4.2 percent) in the 12 or older population, and Alaska had the highest rate (10.1 percent). There were significant decreases in both the past month and past year use of marijuana among youths aged 12 to 17 nationally. Past year marijuana use among youths declined from 14.7 percent in 2003-2004 to 13.9 percent in 2004-2005, and past month marijuana use from 7.7 to 7.2 percent over the same period. (Table s B.2, B.3, C.2, and C.3, Figures 2.5 and 2.9)
The national percentage of persons aged 12 or older perceiving a great risk of using marijuana once a month decreased significantly between 2003-2004 and 2004-2005, from 39.7 to 39.0 percent. Although there was a decline in perceived risk in the general population, there were no increases in past month use of marijuana for any State in any age group. Four States showed declines in perceived risk among the 12 or older population: Kansas (from 43.5 to 39.8 percent), Louisiana (from 45.7 to 42.4 percent), Montana (from 39.0 to 36.0 percent), and Oregon (from 33.2 to 30.1 percent). (Table C.4)
For the combined years 2004-2005, the national marijuana incidence rate for all persons aged 12 or older was 1.7 percent. Alaska had the highest rate, 2.6 percent; Alabama, Arkansas, Florida, Mississippi, and West Virginia shared the lowest rate, 1.4 percent. Rates of first use of marijuana declined significantly among youths aged 12 to 17 between 2003-2004 and 2004-2005 (from 6.3 to 5.8 percent), young adults aged 18 to 25 (from 6.6 to 6.2 percent), and in the overall population aged 12 or older (from 1.8 to 1.7 percent). (Table s B.5 and C.5)
Past month use of illicit drugs other than marijuana was relatively stable between 2003-2004 and 2004-2005 among all persons aged 12 or older; however, among youths aged 12 to 17, the rates dropped from 5.5 to 5.1 percent. North Dakota and South Dakota had the lowest rate (2.8 percent) of past month use of an illicit drug other than marijuana among persons 12 or older in 2004-2005, and Colorado had the highest rate (4.5 percent). (Table s B.6 and C.6)
The national prevalence rate for the use of cocaine in the past year among all persons aged 12 or older was 2.3 percent in 2004-2005. The District of Columbia had the highest rate of past year cocaine use (3.4 percent) among persons aged 12 or older; North Dakota had the lowest rate (1.7 percent) in that population. (Table B.7)
Although the nonmedical use of pain relievers among the general population aged 12 or older remained unchanged between 2003-2004 and 2004-2005 (at 4.8 percent), a significant decrease was observed among youths aged 12 to 17 (from 7.5 to 7.1 percent). Utah had the highest percentage (6.5 percent) of persons aged 12 or older using pain relievers for nonmedical purposes in the past year in 2004-2005; South Dakota had the lowest rate in the Nation—3.4 percent. (Table s B.8 and C.8)

Alcohol Use

In 2004-2005, the rate of past month alcohol use in States among all persons aged 12 or older ranged from a low of 30.1 percent in Utah to a high of 65.3 percent in Wisconsin. The rate of past month alcohol use among persons aged 12 or older increased between 2003-2004 and 2004-2005 from 50.2 to 51.1 percent. At the same time, past month alcohol use among youths aged 12 to 17 decreased from 17.7 to 17.1 percent. Seven States showed significant increases in past month alcohol use among persons 12 or older between 2003-2004 and 2004-2005, contributing to the national increase: Alabama, Arizona, Kansas, Minnesota, Tennessee, Texas, and Wisconsin. (Table s B.9 and C.9)
In 2004-2005, the rate of past month binge alcohol use among persons aged 12 or older ranged from 16.3 percent in Utah to 31.5 percent in North Dakota. The national rate in 2004-2005 (22.7 percent) remained the same as the rate in 2003-2004, and the rates among youths aged 12 to 17, young adults aged 18 to 25, and persons aged 26 or older did not change either. (Table s B.10 and C.10)
In 2004-2005, 41.2 percent of all persons aged 12 or older perceived a great risk of binge drinking. People's perceptions of the risk of binge drinking were moderately and inversely related to their actual rates of binge drinking at the State level in 2004-2005. Seven of the ten States (Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota, and Wisconsin) with the highest rates of binge use of alcohol in 2004-2005 among persons 12 or older also were States with the lowest perceived risk of binge drinking for the population aged 12 or older. Between 2003-2004 and 2004-2005, there were no changes in the percentage of persons reporting a great risk in binge alcohol use, either nationally or in the four census regions in any of the age groups. (Table s B.11 and C.11, Figures 3.5 and 3.9)
With respect to underage drinking (i.e., drinking among persons aged 12 to 20), past month alcohol use ranged from a low of 21.3 percent in Utah to a high of 39.5 percent in Wisconsin. Although there was no significant change at the national level in underage alcohol use between 2003-2004 and 2004-2005, six States (Hawaii, Michigan, New Hampshire, New Mexico, North Dakota, and Washington) displayed significant decreases, and two States (Texas and Utah) had significant increases. (Table s B.12 and C.12)
The lowest State estimate for past month underage (aged 12 to 20) binge use of alcohol was 14.3 percent in Tennessee. North Dakota had the highest rate for this measure, 29.5 percent. Eight of the States that ranked in the highest fifth for past month underage use of alcohol also ranked in the highest fifth for past month underage binge use of alcohol: Iowa, Massachusetts, Montana, North Dakota, Rhode Island, South Dakota, Vermont, and Wisconsin. There was no change at the national level between 2003-2004 and 2004-2005 for underage binge use of alcohol. (Table s B.12 and C.12, Figures 3.13 and 3.14)

Tobacco Use

Nationally among persons aged 12 or older, the rate for past month use of tobacco in 2004-2005 was 29.3 percent. The State with the highest prevalence rate for tobacco use among persons aged 12 or older was West Virginia (40.9 percent). California had the lowest rate in the Nation for tobacco use among all persons aged 12 or older (21.2 percent). Although the percentage of persons aged 12 or older using tobacco in the past month was stationary between 2003-2004 and 2004-2005, the prevalence rate among youths aged 12 to 17 declined slightly from 14.4 to 13.8 percent during the same period. (Table s B.13 and C.13)
The national rate for past month use of cigarettes among persons aged 12 or older remained almost the same between 2003-2004 (25.2 percent) and 2004-2005 (24.9 percent); however, the 12 to 17 age group and the 18 to 25 age group both had significant declines in the rates of past month use of cigarettes, from 12.0 to 11.3 percent, and from 39.9 to 39.3 percent, respectively. West Virginia had the highest rate of past month cigarette use in the Nation in 2004-2005 (32.4 percent), and California had the lowest rate (18.3 percent) among all persons aged 12 or older. (Table s B.14 and C.14)
States with high prevalence rates for cigarette use tended to have low rates of perceived risk of heavy cigarette use (i.e., smoking one or more packs a day). Five of the States (Kentucky, Missouri, Oklahoma, South Carolina, and West Virginia) that ranked in the lowest fifth for perceptions of great risk of smoking one or more packs of cigarettes a day also were ranked in the highest fifth for past month cigarette use among persons aged 12 or older in 2004-2005. The rates of perception of great risk of smoking one or more packs of cigarettes a day increased from 72.8 percent in 2003-2004 to 74.4 percent in 2004-2005 among persons 12 or older. At the State level, across the three age groups (12 to 17, 18 to 25, and 26 or older) and the combined age group of those 12 or older, there were 46 significant increases in the perceived risk of heavy smoking—and no decreases. (Table C.15, Figures 4.5 and 4.9)

Substance Dependence, Abuse, and Treatment Need

Rates of past year dependence on or abuse of alcohol remained unchanged between 2003-2004 and 2004-2005 at 7.6 and 7.7 percent for all persons aged 12 or older. In 2004-2005, Wisconsin had the highest rate (10.1 percent) among persons aged 12 or older, while Georgia had the lowest rate (6.0 percent). (Table s B.16 and C.16)
In 2004-2005, 3.4 percent of persons aged 12 or older were estimated to be dependent on alcohol in the past year, representing about 44 percent of those who were dependent on or had abused alcohol in the past year. No State had any increases or decreases in past year alcohol dependence rates between 2003-2004 and 2004-2005 either among the 12 or older population or in any of the age subgroups. (Table s B.17 and C.17)
Nationally in 2004-2005, about 2.9 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 (3.8 percent) among persons aged 12 or older, and Iowa had the lowest rate (2.3 percent). In the Midwest, the rates of past year illicit drug dependence or abuse decreased among youths aged 12 to 17 from 5.4 percent in 2003-2004 to 4.8 percent in 2004-2005. (Table s B.18 and C.18)
The percentage of persons in 2004-2005 estimated to be dependent on illicit drugs in the past year was 2.0 percent (about two thirds of those who were estimated to be dependent on or had abused illicit drugs in the past year). Nationally, there was a significant increase in the percentage of persons dependent on illicit drugs among the 18 to 25 age group from 5.4 percent in 2003-2004 to 5.7 percent in 2004-2005. (Table s B.19 and C.19)
State percentages for past year dependence on or abuse of alcohol or illicit drugs among persons aged 12 or older ranged from a low of 7.7 percent in Georgia to a high of 11.6 percent in the District of Columbia. Among all persons aged 12 or older, the rate of past year dependence on or abuse of alcohol or illicit drugs remained constant at 9.2 to 9.3 percent, respectively, in 2003-2004 and 2004-2005. The only significant national change occurred among youths aged 12 to 17, where there was a decrease from 8.9 to 8.4 percent. (Table s B.20 and C.20)
The national rate in 2004-2005 for needing but not receiving treatment for an illicit drug problem among persons aged 12 or older was 2.7 percent, which was unchanged from 2003-2004. In 2004-2005, Alaska had the highest percentage of persons aged 12 or older needing but not receiving treatment for an illicit drug use problem (3.5 percent), while North Dakota had the lowest rate (2.0 percent). (Table s B.21 and C.21)
The percentage of persons aged 12 or older needing but not receiving treatment for an alcohol problem (7.4 percent) in 2004-2005 was almost 3 times larger than the corresponding percentage for persons needing but not receiving treatment for an illicit drug problem (2.7 percent). (Table s B.21 and B.22)