National data      State level data       Metropolitan and other subState area data

Substance Abuse in States and Metropolitan Areas:
Model Based Estimates from the 1991-1993 National Household Surveys on Drug Abuse

Chapter 3

3. State And MSA Small Area Estimates:

3.1 Cigarette And Alcohol Use

3.2 Illicit Drug Use

3.3 Dependence On Substances

3.4 Treatment For Substance Abuse

3.5 Arrested For Any Crime In Past Year

 3. State And MSA Small Area Estimates

Small area estimates were developed for 26 States and 25 Metropolitan Statistical Areas (MSAs). In this chapter, we present estimates for the number of people affected by each of the eleven measures of substance abuse behaviors and problems, prevalence rate estimates, and 95 percent confidence bound charts for the State estimates. Appendix A presents the values for these confidence bounds. All estimates are annualized, that is, they represent rates and numbers of users for a single year based on the average over the three year, 1991-1993, period.

The two most prevalent outcome measures which were considered for this project were past month use of cigarettes and alcohol. Unlike some of the illicit drug use and dependence measures which were constructed from a respondent= s answers to several questions, these outcome measures were constructed from the NHSDA using the edited version of the corresponding single, drug recency-of-use questions.

Cigarette Use in Past Month. There were an estimated 52.4 million current smokers per year during 1991-1993, corresponding to a rate of 25.5 percent of Americans age 12 and older. Among the 26 States, rates ranged from 22.6 percent to 31.4 percent. States with the highest rates of smoking were Kentucky (31.4 percent), West Virginia (30.6 percent), Tennessee (29.5 percent), Ohio (29.2 percent), and South Carolina (29.0 percent). Minnesota (22.6 percent) and California (22.8 percent) had the lowest rates of cigarette use in the past month.

Among the 25 MSAs, rates ranged from 20.2 percent to 27.5 percent. MSAs with the highest rates of smoking were Boston (27.5 percent), Denver (27.1 percent), Detroit (26.5 percent), San Antonio (26.1 percent), and Dallas (26.1 percent). Nassau-Suffolk (20.2 percent), El Paso (20.4 percent), and Miami-Hialeah (20.9 percent) had the lowest rates of cigarette use in the past month.

Alcohol Use in Past Month. There were an estimated 102.8 million current drinkers per year during 1991-1993, corresponding to a rate of 49.9 percent of Americans age 12 and older. Among the 26 States, rates ranged from 36.4 percent to 58.7 percent. States with the highest rates of alcohol use were Minnesota (58.7 percent), New Jersey (56.4 percent), Wisconsin (55.1 percent), Washington (54.5 percent), and New York (53.4 percent). West Virginia (36.4 percent), Oklahoma (37.5 percent), Tennessee (38.2 percent) and Kentucky (38.5 percent) had the lowest rates of alcohol use in the past month.

Among the 25 MSAs, rates ranged from 41.2 percent to 65.9 percent. MSAs with the highest rates of alcohol use were Minneapolis-St. Paul (65.9 percent), Oakland (65.0 percent), Newark (62.2 percent), Boston (61.5 percent), and Nassau-Suffolk (59.6 percent). Tampa-St. Petersburg (41.2 percent), Miami-Hialeah (44.4 percent), and Baltimore (44.8 percent) had the lowest rates of alcohol use in the past month.

The three illicit drug use measures considered in this research included past month use of cocaine, any illicit drug and any illicit drug except marijuana. Like past month use of alcohol and cigarettes, past month use of cocaine was estimated from the NHSDA data using an edited version of the corresponding, single recency-of-use question. Any illicit drug use as well as the use of any illicit drug except marijuana were established using edited versions of several NHSDA recency-of-use responses, including most recent use of hallucinogens, heroin, cocaine, inhalants, marijuana and the nonmedical use of sedatives, tranquilizers, stimulants or analgesics.

Any Illicit Drug Use In Past Month. Estimates for any illicit drug use in past month are presented in the third columns of Exhibits 3.1-3.4 (located at the end of Section 3). There were an estimated 12.0 million past month illicit drug users during 1991-1993, corresponding to a rate of 5.8 percent of Americans age 12 and older. Among the 26 States, rates ranged from 4.1 percent to 8.2 percent. States with the highest rates of drug use were California (8.2 percent), New Mexico (7.8 percent), Oregon (7.1 percent), and Oklahoma (7.0 percent). Wisconsin (4.1 percent), West Virginia (4.2 percent) and Louisiana (4.4 percent) had the lowest rates of illicit drug use in the past month.

Among the 25 MSAs, rates ranged from 3.6 percent to 11.4 percent. MSAs with the highest rates of drug use were Oakland (11.4 percent, nearly twice as large as the national rate), Anaheim-Santa Ana (8.8 percent), Denver (8.3 percent), San Bernardino (7.4 percent), and San Diego (7.1 percent). El Paso (3.6 percent), Miami-Hialeah (3.8 percent), and Houston (4.0 percent) had the lowest rates of illicit drug use in the past month.

Use of Any Illicit Drug Other Than Marijuana In Past Month. Estimates for any illicit drug use other than marijuana in the past month showed that 1991-1993, there were an estimated 5.0 million people who used an illicit drug, other than marijuana, in the past month. This corresponds to a rate of 2.4 percent of Americans age 12 and older. Among the 26 States, rates ranged from 1.4 percent to 4.2 percent. States with the highest rates of drug use were Oklahoma (4.2 percent), California (3.9 percent), and New Mexico (3.5 percent). Minnesota (1.4 percent) and West Virginia (1.4 percent) had the lowest rates of illicit drug use other than marijuana in the past month.

Among the 25 MSAs, rates ranged from 1.4 percent to 5.1 percent. MSAs with the highest rates of drug use (other than marijuana) were Oakland (5.1 percent, again nearly twice as large as the national rate), Anaheim-Santa Ana (4.9 percent), San Bernardino (4.6 percent), Phoenix (4.0 percent), and San Diego (3.6 percent). Detroit (1.4 percent), Minneapolis-St. Paul (1.5 percent), and Baltimore (1.8 percent) had the lowest rates of illicit drug use other than marijuana in the past month.

Use of Cocaine In Past Month. Estimates for the use of cocaine in the past month are presented in the last column of the section on illicit substance use in Exhibits 3.1- 3.4. There were an estimated 1.6 million past month cocaine users during 1991-1993, corresponding to a rate of 0.8 percent of Americans age 12 and older. Among the 26 States, rates ranged from 0.3 percent to 1.5 percent. States with high rates were Virginia (1.3 percent), New Jersey (1.0), California (1.0 percent), and Tennessee (1.0 percent). Minnesota (0.3 percent), Oregon (0.4 percent) and Kentucky (0.4 percent) had the lowest rates of cocaine use in the past month.

Among the 25 MSAs, rates ranged from 0.4 percent to 1.5 percent. MSAs with the highest rates of cocaine use were Oakland (1.5 percent), Newark (1.4 percent), Anaheim-Santa Ana (1.2 percent), New York (1.1 percent), and Dallas (1.1 percent). Minneapolis-St. Paul (0.4 percent) and Nassau-Suffolk (0.4 percent) had the lowest rates of cocaine use in the past month.

Two past year dependence measures were considered for this research: dependent on illicit drugs and dependent on alcohol only (and not dependent on illicit drugs) in the past year. These dependence measures were determined based on an algorithm developed for the NHSDA that approximates the DSM-III-R definition of dependence using the limited set of items included in the NHSDA that address the DSM-III-R criteria. (See Appendix A)

Dependent On Illicit Drugs In Past Year. Estimates for dependence on illicit drugs in the past year are presented in column six of Exhibits 3.1- 3.4. There were an estimated 2.5 million people per year dependent on illicit drugs during 1991-1993, corresponding to a rate of 1.2 percent of Americans age 12 and older. Among the 26 States, rates ranged from 0.8 percent to 2.0 percent. States with the highest rates of dependence on illicit drugs were Oregon (2.0 percent), Washington (2.0 percent) and California (1.9). West Virginia (0.8 percent), Pennsylvania (0.9 percent), Illinois (0.9 percent), Kentucky (0.9 percent), Tennessee (0.9 percent), and Florida (0.9 percent) had the lowest rates of dependence on illicit drugs in the past year.

Among the 25 MSAs, rates ranged from 0.7 percent to 3.0 percent. MSAs with the highest rates of dependence on illicit drugs were Oakland (3.0 percent), Anaheim-Santa Ana (2.2 percent), Houston (2.1 percent), and San Bernardino (2.1 percent). Miami-Hialeah (0.7 percent) and El Paso (0.8 percent) had the lowest rates of dependence on illicit drugs in the past year.

Dependent On Alcohol, Without Illicit Drugs, In Past Year. There were an estimated 6.4 million people per year dependent on alcohol only during 1991-1993, corresponding to a rate of 3.1 percent of Americans age 12 and older. Among the 26 States, rates ranged from 2.0 percent to 4.9 percent. States with the highest rates of dependence on alcohol were California (4.9 percent), Oklahoma (4.0 percent), and Louisiana (3.9 percent). New York (2.0 percent), Kentucky (2.1 percent), Tennessee (2.1 percent), and West Virginia (2.1 percent) had the lowest rates of dependence on alcohol, without illicit drugs, in the past year.

Among the 25 MSAs, rates ranged from 1.1 percent to 7.1 percent. MSAs with the highest rates of dependence on alcohol were Los Angeles (7.1 percent), Anaheim-Santa Ana (6.0 percent), Denver (4.6 percent), Atlanta (4.5 percent), and Boston (4.4 percent). Nassau-Suffolk (1.1 percent) and New York (1.8 percent) had the lowest rates of dependence on alcohol, without illicit drugs, in the past year.

Three measures of treatment were considered for this research. Similar to the dependence measures above, two of the measures included receiving treatment for illicit drugs in the past year and receiving treatment for alcohol without illicit drugs, in the past year. Both of these outcome measures were constructed from edited versions of single questions from the NHSDA questionnaire. The third treatment, outcome measure considered was needing treatment for drug abuse in the past year. This needing-treatment outcome measure was constructed from edited responses to several NHSDA questions.

Had Treatment For Illicit Drugs In Past Year. There were an estimated 1.4 million people per year who had treatment for illicit drugs during 1991-1993, corresponding to a rate of 0.7 percent of Americans age 12 and older. Among the 26 States, rates ranged from 0.5 percent to 1.0 percent. The highest rates of treatment for illicit drugs were in California (1.0 percent), Oregon (0.9 percent) and Oklahoma (0.9 percent). West Virginia (0.5 percent), Indiana (0.5 percent), South Carolina (0.5 percent), and Illinois (0.5 percent) had the lowest rates of treatment for illicit drugs in the past year.

Among the 25 MSAs, rates ranged from 0.5 percent to 1.4 percent. MSAs with the highest rates of treatment for illicit drugs were Oakland (1.4 percent), San Bernardino (1.1 percent), Anaheim-Santa Ana (1.0 percent), and Boston (1.0 percent). Chicago (0.5 percent) and San Antonio (0.5 percent) had the lowest rates of treatment for illicit drugs in the past year.

Had Treatment For Alcohol, Without Illicit Drugs, In Past Year. There were an estimated 1.4 million people per year who had treatment for alcohol during 1991-1993, corresponding to a rate of 0.7 percent of Americans age 12 and older. Among the 26 States, rates ranged from 0.4 percent to 1.5 percent. The highest rates of treatment for alcohol were in Oklahoma (1.5 percent), New Mexico (0.9 percent) and Kansas (0.9 percent). New York (0.4 percent), Georgia (0.5 percent), and Kentucky (0.5 percent), North Carolina (0.5 percent), Washington (0.5 percent), and Tennessee (0.5 percent) had the lowest rates of treatment for alcohol, without illicit drugs, in the past year.

Among the 25 MSAs, rates ranged from 0.3 percent to 2.2 percent. MSAs with the highest rates of treatment for alcohol were Boston (2.2 percent), Oakland (2.1 percent), and San Bernardino (1.2 percent). New York (0.3 percent), Atlanta (0.4 percent), Tampa-St. Petersburg (0.4 percent), and San Antonio (0.4 percent) had the lowest rates of treatment for alcohol, without illicit drugs, in the past year.

Needed Treatment For Illicit Drugs In Past Year. There were an estimated 5.9 million people per year who needed treatment for illicit drugs during 1991-1993, corresponding to a rate of 2.9 percent of Americans age 12 and older. Among the 26 States, rates ranged from 2.0 percent to 4.2 percent. The highest rates of needing treatment for illicit drugs were in California (4.2 percent), Georgia (3.8 percent), and Oklahoma (3.8 percent). Indiana (2.0 percent), New Jersey (2.0 percent), Tennessee (2.1 percent), and South Carolina (2.1 percent) had the lowest rates of needed treatment for illicit drugs in the past year.

Among the 25 MSAs, rates ranged from 1.9 percent to 5.2 percent. MSAs with the highest rates of needed treatment for illicit drugs were Oakland (5.2 percent), Atlanta (4.8 percent), and Anaheim-Santa Ana (4.4 percent). Nassau-Suffolk (1.9 percent), Newark (1.9 percent), and Tampa-St. Petersburg (2.1 percent) had the lowest rates of needed treatment for illicit drugs in the past year.

Estimates for those people arrested for any crime in the past year are presented in the last column of Exhibits 3.1 - 3.4. This outcome measure refers to people who have been arrested and booked for breaking a law in the past 12 months, as was derived from an edited response to a single question in the NHSDA questionnaire. There were an estimated 3.7 million people arrested during 1991-1993, corresponding to a rate of 1.8 percent of Americans age 12 and older. Among the 26 States, rates ranged from 1.3 percent to 2.6 percent. States with the highest rates of arrests were New Mexico (2.6 percent), Georgia (2.5 percent), and Kansas (2.4 percent). Pennsylvania (1.3 percent), West Virginia (1.3 percent), New York (1.3 percent) and New Jersey (1.3 percent) had the lowest rates of arrests for any crime in the past year.

Among the 25 MSAs, rates ranged from 0.8 percent to 2.4 percent. MSAs with the highest rates of arrests were San Bernardino (2.4 percent), Denver (2.3 percent), San Diego (2.2 percent), and St. Louis (2.1 percent). New York (0.8 percent) and Nassau-Suffolk (1.1 percent) had the lowest rates of arrests for any crime in the past year.