NATIONAL HOUSEHOLD SURVEY ON DRUG ABUSE: problems measurement

1997 National Household Survey on Drug Abuse

Measurement of Problems Related to Substance Use

Respondents to the 1997 NHSDA who used drugs in the 12 months prior to the interview were instructed to answer a series of questions about problems that occurred in the same 12-month period and were associated with their drug use. Questions on problems related to use of different drugs were patterned after symptoms of dependence, according to criteria set in the American Psychiatric Association's (APA's) Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (APA, 1994).

Respondents were asked whether they had experienced any of the following seven behavioral or psychological problems in the past year that are potentially and cumulatively suggestive of drug dependence:

1. wanting to or trying or tried to cut down or stop using the drug but being unable to do so;

2. tolerance for the drug such that the same amount had less effect than before;

3. spending a great deal of time (i.e., for a period of at least a month) getting, using, or getting over the effects of using the drug;

4. use of the drug more often or in larger amounts than intended;

5. reduction of important activities, such as going to work or school, caring for children, or engaging in recreational activity due to use of the drug;
6. emotional or psychological problems caused by use of the drug; and

7. physical health problems caused by use of the drug (see footnotes to Tables 9.1 through 9.4 for precise item wordings).

The definitions of these problems, however, are different in number and kind from those used in the 1994 NHSDA and in earlier years. Consequently, data in this chapter cannot be compared directly with NHSDA data prior to 1995. Furthermore, readers should not interpret reports of these problems as being necessarily equivalent to a clinical diagnosis of drug dependence.

In addition to estimates of the prevalence of each of these specific problems, three summary measures also were constructed for marijuana, cocaine, alcohol, and cigarettes:

occurrence of any of the above seven problems in the past 12 months due to use of a given drug,
occurrence of two or more of the above problems in the past 12 months for a given drug, and
occurrence of three or more of the above problems in the past 12 months for a given drug.

These summary measures refer to the number of specific types of problems (from the list of seven) that occurred during the past year related to the use of a particular drug. These measures do not refer to the total number of times that each specific problem may have occurred.

As noted above, respondents who had not used illicit drugs, alcohol, or tobacco in the past year were instructed to skip these questions. A small proportion of the sample, however, chose to skip these questions even though they had reported earlier in the interview that they had used at least one of the substances at some time in the past year. For the analyses in this chapter, these respondents were treated as though they had no substance-associated problems in the past year. In addition, some respondents who did not report use of a given drug on that drug's answer sheet subsequently reported in a later section of the interview that they experienced problems related to their use of that drug in the past 12 months. Data from these respondents on drug-related problems also were disregarded in the absence of prior indications of past year use.21 Given these exclusions, the data here should be interpreted with some caution because some estimates of drug-related problems may be conservative. This may be particularly the case for cocaine, which had the lowest prevalence of past year use of the four drugs examined in this chapter; consequently, excluding or including respondents in estimates of cocaine-related problems could have a greater impact on estimates for cocaine than for the other three drugs.

21 This exclusion of data from respondents who reported past year drug problems in the absence of reported use in the past year was not done for the 1994 to 1996 NHSDA Main Findings. Therefore, the 1997 total population estimates may be somewhat lower than those reported in 1994 to 1996.

This page was last updated on June 03, 2008.

SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.

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