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2004
National Survey on Drug Use & Health: Results
Results from the 2004 National
Survey on Drug Use and Health: National Findings
REVISIONS AS OF 9/8/2005
NOTE: Several updates have been
incorporated into this report since it was published. These changes were made
in the Web documents and are listed below, indicating the relevant page and
paragraph in the published version.
In several places, the published version of this
report indicates that 2004 estimates are similar to 2002 estimates. However,
statistical testing indicates a significant difference between 2004 and 2002,
so the text in this updated Web document was revised to remove the reference
to no change from the 2002 data. This occurs on the following pages in the published
report: page 1 in bullets 3 and 6; page 12 in bullets 1 and 2; page 30
in bullet 3; and page 61 in bullet 1 under Feelings about Peer Substance Use.
In addition, the following changes were also made in the web document, with
the relevant page in the published version indicated:
On page 35: bullet 1 was changed to correct the
statement; there was only one exception (not two) to the stable trend.
On page 69: in bullet 2 the estimate for persons
who drank before age 21 was changed from 9.2 to 9.6.
On page 161: in the definition of Ecstasy
Use, the spelling of "methylenedioxymethamphetamine" was corrected.
DEPARTMENT OF HEALTH AND HUMAN
SERVICES
Substance Abuse and Mental Health Services Administration
Office of Applied Studies
Acknowledgments
This report was prepared by the Division of Population
Surveys, Office of Applied Studies, SAMHSA, and by RTI International, a trade
name of Research Triangle Institute, Research Triangle Park, North Carolina.
Work by RTI was performed under Contract No. 283-03-9028. Contributors
and reviewers at RTI listed alphabetically include Jeremy Aldworth, Katherine
R. Bowman, Walter R. Boyle, Allison Burns, Sara L. Calvin, Jessica Duncan Cance,
Patrick Chen, James R. Chromy, Andrew Clarke, Elizabeth Copello, David B. Cunningham,
Teresa R. Davis, Steven L. Emrich, Ralph E. Folsom, Jr., Misty Foster, G. G.
Frick, Eric A. Grau, David C. Heller, Erica Hirsch, Susan Hunter, B. Kathleen
Jordan, Larry A. Kroutil, Judith T. Lessler, Bing Liu, Mary Ellen Marsden, Peilan
Martin, Breda Munoz, Christine Murtha, Scott Novak, Lisa E. Packer, Michael
R. Pemberton, Lanny Piper, Jeremy Porter, Tania Robbins, Kathryn Spagnola, Thomas
G. Virag (Project Director), Michael Vorburger, Jill Webster, Matthew Westlake,
and Li-Tzy Wu. Contributors at SAMHSA listed alphabetically, with chapter authorship
noted, include Peggy Barker (Chapter 8),
James Colliver (Chapters 4 and 6),
Joan Epstein (Chapters 7 and 8),
Joseph Gfroerer (Chapters 1, 2,
5, and 9),
Joe Gustin, Arthur Hughes (Project Officer), Joel Kennet (Chapter 3),
Sharon Larson (Chapters 7 and 8),
Pradip Muhuri, Dicy Painter, and Doug Wright (Chapter 6).
At RTI, Richard S. Straw edited the report with assistance from Jason Guder
and Claudia Clark. Also at RTI, Diane G. Eckard and Danny Occoquan prepared
the graphics; Brenda K. Porter and Tracy Woodall formatted the tables; Joyce
Clay-Brooks, Debbie Bond, and Judy Cannada formatted and word processed the
report; and Pamela Couch Prevatt, Teresa F. Gurley, Kim Cone, David Belton,
and Shari B. Lambert prepared its press and Web versions. Final report production
was provided by Beatrice A. Rouse, Coleen Sanderson, and Jane Feldmann at SAMHSA.
Public Domain Notice
All material appearing in this report is in the
public domain and may be reproduced or copied without permission from the Substance
Abuse and Mental Health Services Administration. However, this publication may
not be reproduced or distributed for a fee without specific, written
authorization of the Office of Communications, SAMHSA, U.S. Department of Health
and Human Services. Citation of the source is appreciated. Suggested citation:
Substance Abuse and Mental Health Services
Administration. (2005). Results from the 2004 National Survey on Drug Use
and Health: National Findings (Office of Applied Studies, NSDUH Series
H-28, DHHS Publication No. SMA 05-4062). Rockville, MD.
2004
National Survey on Drug Use & Health: Results
Table of Contents
Note: We recommend that the PDF
format of this report be used for printing the contents of this report.
If comparing the web version to the published
hard copy, please note that several updates have been incorporated into the
web version since the report was published; click
here for the note regarding the updates.
This report presents the first information from
the 2004 National Survey on Drug Use and Health (NSDUH). This survey, formerly
called the National Household Survey on Drug Abuse (NHSDA), is a project of
the Substance Abuse and Mental Health Services Administration (SAMHSA). This
survey was initiated in 1971 and is the primary source of information on the
use of illicit drugs, alcohol, and tobacco by the civilian, noninstitutionalized
population of the United States aged 12 years old or older. The survey interviews
approximately 67,500 persons each year.
Illicit Drug Use
In 2004, 19.1 million Americans, or 7.9 percent
of the population aged 12 or older, were current illicit drug users. Current
drug use means use of an illicit drug during the month prior to the survey
interview.
The rate of illicit drug use among persons
aged 12 or older in 2004 was similar to the rates in 2002 and 2003 (8.3 and
8.2 percent). Among youths aged 12 to 17, the rate declined between 2002 and
2004 (11.6 percent in 2002, 11.2 percent in 2003, and 10.6 percent in 2004).
Marijuana was the most commonly used illicit
drug in 2004, with a rate of 6.1 percent (14.6 million current users). There
were 2.0 million current cocaine users, 467,000 of whom used crack. Hallucinogens
were used by 929,000 persons, and there were an estimated 166,000 heroin users.
All of these estimates are similar to estimates for 2003.
Between 2002 and 2004, past month marijuana
use declined for male youths aged 12 to 17 (9.1 percent in 2002, 8.6 percent
in 2003, and 8.1 percent in 2004), but it remained level for female youths
(7.2, 7.2, and 7.1 percent, respectively) during the same time span.
The number of current users of Ecstasy had
decreased between 2002 and 2003, from 676,000 to 470,000, but the number did
not change between 2003 and 2004 (450,000).
In 2004, 6.0 million persons were current
users of psychotherapeutic drugs taken nonmedically (2.5 percent). These include
4.4 million who used pain relievers, 1.6 million who used tranquilizers, 1.2
million who used stimulants, and 0.3 million who used sedatives. These estimates
are all similar to the corresponding estimates for 2003.
There were significant increases in the lifetime
prevalence of use from 2003 to 2004 in several categories of pain relievers
among those aged 18 to 25. Specific pain relievers with statistically significant
increases in lifetime use were Vicodin®, Lortab®,
or Lorcet® (from 15.0 to 16.5 percent); Percocet®,
Percodan®, or Tylox® (from 7.8 to 8.7 percent);
hydrocodone products (from 16.3 to 17.4 percent); OxyContin®
(from 3.6 to 4.3 percent); and oxycodone products (from 8.9 to 10.1 percent).
Among youths aged 12 to 17, rates of current
illicit drug use varied significantly by major racial/ethnic groups in 2004.
The rate was highest among American Indian or Alaska Native youths (26.0 percent).
Rates were 12.2 percent for youths reporting two or more races, 11.1 percent
for white youths, 10.2 percent for Hispanic youths, 9.3 percent for black
youths, and 6.0 percent for Asian youths.
In 2004, 19.2 percent of unemployed adults
aged 18 or older were current illicit drug users compared with 8.0 percent
of those employed full time and 10.3 percent of those employed part time.
However, of the 16.4 million illicit drug users aged 18 or older in 2004,
12.3 million (75.2 percent) were employed either full or part time.
Alcohol Use
121 million Americans aged 12 or older were
current drinkers of alcohol in 2004 (50.3 percent). 55 million (22.8 percent)
participated in binge drinking, defined as five or more drinks on at least
one occasion in the 30 days prior to the survey. 16.7 million (6.9 percent)
were heavy drinkers, defined as binge drinking on 5 or more days in the past
month. These numbers are all similar to the corresponding estimates for 2002
and 2003.
The highest prevalence of binge and heavy
drinking in 2004 was for young adults aged 18 to 25 (41.2 and 15.1 percent,
respectively). The peak rate of both measures occurred at age 21 (48.2 and
19.2 percent, respectively).
The rate of underage drinking remained the
same in 2004 as in 2002 and 2003. About 10.8 million persons aged 12 to 20
reported drinking alcohol in the month prior to the survey interview in 2004
(28.7 percent of this age group). Of these, nearly 7.4 million (19.6 percent)
were binge drinkers, and 2.4 million (6.3 percent) were heavy drinkers.
Among persons aged 12 to 20 in 2004, past
month alcohol use rates were 16.4 percent among Asians, 19.1 percent among
blacks, 24.3 percent among American Indians or Alaska Natives, 26.4 percent
among those reporting two or more races, 26.6 percent among Hispanics, and
32.6 percent among whites.
Among pregnant women aged 15 to 44, 11.2 percent
reported past month alcohol use and 4.5 percent reported past month binge
drinking, based on combined 2003 and 2004 data.
32.5 million persons aged 12 or older in 2004
(13.5 percent) drove under the influence of alcohol at least once in the 12
months prior to the interview. This was similar to the rate in 2003.
Young adults aged 18 to 22 enrolled full time
in college were more likely than their peers not enrolled full time (this
category includes part-time college students and persons not enrolled in college)
to use alcohol, binge drink, and drink heavily in 2004. Binge and heavy use
rates for college students were 43.4 and 18.6 percent, respectively, compared
with 39.4 and 13.5 percent, respectively, for other persons aged 18 to 22.
Tobacco Use
70.3 million Americans were current users
of a tobacco product in 2004. This is 29.2 percent of the population aged
12 or older. 59.9 million (24.9 percent) smoked cigarettes, 13.7 million (5.7
percent) smoked cigars, 7.2 million (3.0 percent) used smokeless tobacco,
and 1.8 million (0.8 percent) smoked tobacco in pipes.
The rate of tobacco use declined between 2002
and 2004, from 30.4 to 29.2 percent, primarily due to a decline in cigarette
use from 26.0 to 24.9 percent. The rate of cigar use remained steady, but
smokeless tobacco use dropped from 3.3 to 3.0 percent.
Young adults aged 18 to 25 continued to have
the highest rate of past month cigarette use (39.5 percent). The rate did
not change significantly between 2002 and 2004. The rate of cigarette use
among youths aged 12 to 17 declined from 13.0 percent in 2002 to 11.9 percent
in 2004.
A higher proportion of males than females
aged 12 or older smoked cigarettes in 2004 (27.7 vs. 22.3 percent). Among
youths aged 12 to 17, however, girls (12.5 percent) were more likely than
boys (11.3 percent) to smoke.
Based on 2003 and 2004 data combined, 18.0
percent of pregnant women aged 15 to 44 smoked cigarettes in the past month
compared with 30.0 percent of women in that age group who were not pregnant.
However, among those aged 15 to 17, this pattern did not hold. The rate of
cigarette smoking among pregnant women aged 15 to 17 was 26.0 percent compared
with 19.6 percent among nonpregnant women of that age (not a statistically
significant difference).
In completely rural nonmetropolitan counties,
current cigarette use among persons aged 12 or older declined from 31.8 percent
in 2002 to 22.8 percent in 2004.
Among the 93.4 million persons who had ever
smoked cigarettes daily in their lifetime, nearly half (46.2 percent) had
stopped smoking in 2004; that is, they did not smoke at all in the past 30
days. The remaining 53.8 percent were still current smokers.
Initiation of Substance Use (Incidence)
Based on a new approach to estimating incidence,
the 2004 NSDUH shows that the illicit drug category with the largest number
of new users was nonmedical use of pain relievers. 2.4 million persons used
pain relievers nonmedically for the first time within the past 12 months.
The average age at first use among these new initiates was 23.3 years.
In 2004, 2.1 million persons had used marijuana
for the first time within the past 12 months. This estimate was not significantly
different from the number in 2003 (2.0 million). The average age at first
use among the 2.1 million recent marijuana initiates was 18.0 years. Most
(63.8 percent) of the recent initiates were younger than age 18 when they
first used.
In 2004, 4.4 million persons had used alcohol
for the first time within the past 12 months. The number of alcohol initiates
increased from 3.9 million in 2002 and 4.1 million in 2003. Most (86.9 percent)
of the 4.4 million recent alcohol initiates in 2004 were younger than age
21 at the time of initiation.
The number of persons who smoked cigarettes
for the first time within the past 12 months was 2.1 million in 2004, not
significantly different from the estimates in 2002 (1.9 million) or 2003 (2.0
million). About two thirds of new smokers in 2004 were under the age of 18
when they first smoked cigarettes (67.8 percent).
Youth Prevention-Related Measures
The percentage of youths aged 12 to 17 indicating
that smoking marijuana once a month was a great risk increased from 32.4 percent
in 2002 to 34.9 percent in 2003, but did not change between 2003 and 2004
(35.0 percent). There were declines between 2003 and 2004 in the percentages
of youths perceiving a great risk in using cocaine and heroin. Perceived risk
of cigarette use increased between 2003 and 2004, but there was no change
in the perceived risk of having four or five drinks of alcohol nearly every
day or having five or more drinks once or twice a week.
The percentage of youths reporting that it
would be easy to obtain marijuana declined between 2002 and 2003, from 55.0
to 53.6 percent, and again between 2003 and 2004, to 52.2 percent. The percentage
of youths reporting that LSD would be easy to obtain also decreased between
2002 and 2004, from 19.4 to 16.9 percent, as did the perceived availability
of heroin (15.8 to 14.0 percent).
Most youths (89.8 percent) reported that their
parents would strongly disapprove of their trying marijuana or hashish once
or twice. Among these youths, only 5.1 percent had used marijuana in the past
month. However, among youths who perceived that their parents would only somewhat
disapprove or neither approve nor disapprove of their trying marijuana, 30.0
percent used marijuana.
Substance Dependence, Abuse, and Treatment
22.5 million Americans aged 12 or older in
2004 were classified with past year substance dependence or abuse (9.4 percent
of the population), about the same number as in 2002 and 2003. Of these, 3.4
million were classified with dependence on or abuse of both alcohol and illicit
drugs, 3.9 million were dependent on or abused illicit drugs but not alcohol,
and 15.2 million were dependent on or abused alcohol but not illicit drugs.
In 2004, 19.9 percent of unemployed adults
aged 18 or older were classified with dependence or abuse, while 10.5 percent
of full-time employed adults and 11.9 percent of part-time employed adults
were classified as such. However, most adults with substance dependence or
abuse were employed either full or part time. Of the 20.3 million adults classified
with dependence or abuse, 15.7 million (77.6 percent) were employed.
In 2004, 3.8 million people aged 12 or older
(1.6 percent of the population) received treatment in the past 12 months for
a drug or alcohol use problem. Of these, 2.3 million received treatment at
a specialty facility for substance use treatment, including 1.7 million at
a rehabilitation facility as an outpatient, 947,000 at a rehabilitation facility
as an inpatient, 775,000 at a hospital as an inpatient, and 982,000 at a mental
health center as an outpatient. Nonspecialty treatment locations were self-help
groups (2.1 million persons), private doctor's offices (490,000 persons),
emergency rooms (453,000 persons), and prisons or jails (310,000 persons).
(Note that the estimates of treatment by location include persons reporting
more than one location.)
Persons dependent on or abusing a substance
in the past 12 months, or who received specialty treatment for a substance
use problem within the past 12 months, are classified as needing treatment.
In 2004, the number of persons aged 12 or older needing treatment for an alcohol
or illicit drug use problem was 23.48 million (9.8 percent). Of these, 2.33
million received treatment at a specialty facility in the past year. Thus,
21.15 million people needed but did not receive treatment at a specialty facility
in 2004. The number needing but not receiving treatment did not change significantly
from 2002 to 2004.
Of the 21.1 million people who needed but
did not receive treatment in 2004, an estimated 1.2 million (5.8 percent)
reported that they felt they needed treatment for their alcohol or drug use
problem. Of the 1.2 million persons who felt they needed treatment, 441,000
(35.8 percent) reported that they made an effort but were unable to get treatment,
and 792,000 (64.2 percent) reported making no effort to get treatment.
Among people who needed but did not receive
treatment and felt they needed treatment for a substance use problem, the
most often reported reasons for not receiving treatment were not ready to
stop using (40.0 percent) and cost or insurance barriers (34.5 percent). However,
among the people who made an effort but were unable to get treatment, 42.5
percent reported cost or insurance barriers, and only 25.3 percent reported
that they were not ready to stop using. These results are based on 2003 and
2004 combined data.
The number of persons needing treatment for
an illicit drug use problem in 2004 (8.1 million) was higher than the number
needing treatment in 2003 (7.3 million); similarly, the number of persons
receiving treatment for drug use at a specialty facility was higher in 2004
(1.4 million) than in 2003 (1.1 million). These 2004 estimates were similar
to the corresponding estimates in 2002 (7.7 million needing treatment, 1.4
million receiving treatment).
6.6 million people needed but did not receive
treatment for an illicit drug use problem in 2004. Of these, 598,000 (9.0
percent) felt they needed treatment. This number increased from 362,000 in
2002 and from 426,000 in 2003. Of the 598,000 persons who felt they needed
treatment in 2004, 194,000 (32.4 percent) reported that they made an effort
but were unable to get treatment, and 404,000 (67.6 percent) reported making
no effort to get treatment.
Prevalence and Treatment of Mental Health
Problems
In 2004, there were 35.1 million (14.7 percent)
persons aged 12 or older who had at least one major depressive episode (MDE)
in their lifetime. Of these, 19.3 million persons (8.1 percent of the population)
had an MDE in the past 12 months, including 2.2 million youths aged 12 to
17 and 17.1 million adults aged 18 or older.
The past year prevalence of MDE was highest
for persons aged 18 to 25 (10.1 percent) and lowest for those aged 26 or older
(7.6 percent). The rate among youths aged 12 to 17 was 9.0 percent. Females
were more likely than males to have MDE in the past year (10.6 vs. 5.5 percent).
Persons with past year MDE were more likely
than those without MDE to have used an illicit drug in the past year (28.8
vs. 13.8 percent). Similarly, substance dependence or abuse was more prevalent
among persons with MDE than among those without MDE (22.0 vs. 8.6 percent,
respectively).
Among persons aged 12 or older with past year
MDE, 62.3 percent received treatment (i.e., saw or talked to a medical doctor
or other professional or used prescription medication) for depression within
the past 12 months.
While MDE estimates describe persons with
a specific mental disorder, the survey also produces estimates of serious
psychological distress (SPD), which describe persons with a high level of
distress due to any type of mental problem. In 2004, there were 21.4 million
adults aged 18 or older with SPD. This represents 9.9 percent of all adults,
a rate that increased since 2002 when it was 8.3 percent.
SPD was highly correlated with substance dependence
or abuse. Among adults with SPD in 2004, 21.3 percent (4.6 million) were dependent
on or abused alcohol or illicit drugs, while the rate among adults without
SPD was 7.9 percent.
Among the 21.4 million adults with SPD in
2004, 10.3 million, or 48.1 percent, received treatment for a mental health
problem in the past year.
Among the 4.6 million adults with SPD and
a substance use disorder in 2004, 47.5 percent (about 2.2 million) received
treatment for mental health problems, and 11.0 percent (503,000) received
specialty substance use treatment. Only 6.0 percent (274,000) received both
types of treatment.
In 2004, 27.5 million adults (12.8 percent)
received treatment for mental health problems in the past year. This estimate
is similar to the estimates in 2002 and 2003.
The most prevalent type of treatment for mental
health problems among adults in 2004 was prescription medication (10.5 percent
of the population), followed by outpatient treatment (7.1 percent). 1.9 million
adults (0.9 percent) received inpatient care for mental health problems at
some time within the past 12 months.
In 2004, 5.7 million youths aged 12 to 17
(22.5 percent) received treatment or counseling for emotional or behavior
problems in the year prior to the interview. This is higher than the estimates
for 2002 (19.3 percent) and 2003 (20.6 percent).
1. Introduction
This report presents the first information from
the 2004 National Survey on Drug Use and Health (NSDUH), an annual survey of
the civilian, noninstitutionalized population of the United States aged 12 years
old or older. Prior to 2002, the survey was called the National Household Survey
on Drug Abuse (NHSDA). This initial report on the 2004 data presents national
estimates of rates of use, numbers of users, and other measures related to illicit
drugs, alcohol, and tobacco products. Measures related to mental health problems
also are presented, including data on the co-occurrence of substance use and
mental health problems, and new data on depression among youths and adults.
State-level and SubState-level estimates from NSDUH will be presented in separate
reports.
A major focus of this report is changes in substance
use between 2003 and 2004. Trends since 2002 also are discussed in a few instances.
Because of improvements to the survey in 2002, the 2002 data constitute a new
baseline for tracking trends in substance use and other measures. Therefore,
estimates from the 2002, 2003, and 2004 NSDUHs should not be compared with estimates
from the 2001 and earlier NSDUHs to assess changes in substance use and mental
health problems over time. A discussion of long-term trends is included in the
final chapter of this report.
1.1. Summary of NSDUH
NSDUH is the primary source of statistical information
on the use of illegal drugs by the U.S. population. Conducted by the Federal
Government since 1971, the survey collects data by administering questionnaires
to a representative sample of the population through face-to-face interviews
at their places of residence. The survey is sponsored by the Substance Abuse
and Mental Health Services Administration (SAMHSA) of the U.S. Department of
Health and Human Services and is planned and managed by SAMHSA's Office of Applied
Studies (OAS). Data collection is conducted under contract with RTI International,
Research Triangle Park, North Carolina.1
This section briefly describes the survey methodology; a more complete description
is provided in Appendix A.
NSDUH collects information from residents of
households, noninstitutional group quarters (e.g., shelters, rooming houses,
dormitories), and civilians living on military bases. The survey does not include
homeless persons who do not use shelters, military personnel on active duty,
and residents of institutional group quarters, such as jails and hospitals.
Appendix E describes surveys that
cover populations outside the NSDUH target population.
Since 1999, the NSDUH interview has been carried
out using computer-assisted interviewing (CAI). Most of the questions are administered
with audio computer-assisted self-interviewing (ACASI). ACASI is designed to
provide the respondent with a highly private and confidential means of responding
to questions to increase the level of honest reporting of illicit drug use and
other sensitive behaviors. Less sensitive items are administered by interviewers
using computer-assisted personal interviewing (CAPI).
Consistent with the 2002 and 2003 surveys, the
2004 NSDUH employed a 50-State sample design with an independent, multistage
area probability sample for each of the 50 States and the District of Columbia.
The eight States with the largest population (which together account for 48
percent of the total U.S. population aged 12 or older) were designated as large
sample States (California, Florida, Illinois, Michigan, New York, Ohio, Pennsylvania,
and Texas). For these States, the design provided a sample sufficient to support
direct State estimates. For the remaining 42 States and the District of Columbia,
smaller, but adequate, samples were selected to support State estimates using
small area estimation (SAE) techniques. The design also oversampled youths and
young adults, so that each State's sample was approximately equally distributed
among three major age groups: 12 to 17 years, 18 to 25 years, and 26 years or
older.
Nationally, 130,130 addresses were screened for
the 2004 survey, and 67,760 completed interviews were obtained. The survey was
conducted from January through December 2004. Weighted response rates for household
screening and for interviewing were 90.9 and 77.0 percent, respectively. See
Appendix B for more information
on NSDUH response rates.
1.2. Trend Measurement
Although the design of the 2002, 2003, and 2004
NSDUHs is similar to the design of the 1999 through 2001 surveys, there are
important methodological differences that have an impact on the comparability
of the 2002-2004 estimates with estimates from prior surveys. In addition
to the name change, each NSDUH respondent is now given an incentive payment
of $30. These changes, both implemented in 2002 and continued in 2003 and 2004,
resulted in a substantial improvement in the survey response rate. The changes
also affected respondents' reporting of many critical items that are the basis
of prevalence measures reported by the survey each year. Comparability also
could be affected by improved data collection quality control procedures that
were introduced beginning in 2001 and by incorporation of new population data
from the 2000 decennial census into NSDUH sample weighting procedures. Analyses
of the effects of each of these factors on NSDUH estimates have shown that 2002
and later data should not be compared with 2001 and earlier data from the survey
series to assess changes over time. Appendix C of
this report discusses this issue in more detail.
Limited trend assessment can be done using information
on prior substance use collected in the 2002-2004 NSDUHs. Specifically,
questions on age at first use of substances, in conjunction with respondents'
ages and interview dates, provide data that can be used to estimate the rates
of first-time use (incidence) for years prior to 2002. Trends for 1965 to 2003
in these incidence measures for youths and young adults are discussed in Chapter 5.
However, these estimates are interpreted cautiously because they may be subject
to significant bias due to long recall periods (Gfroerer, Hughes, Chromy, Heller,
& Packer, 2004). Improved measures of recent patterns and trends in substance
use initiation are included in Chapter 5
of this report. Long-term trends in some key measures of substance use, such
as marijuana and cocaine, are assessed in Chapter 9
using data from prior NSDUHs by separately examining trends within periods during
which the survey data are comparable. These periods are 1971-1998, 1999-2001,
and 2002-2004.
1.3. Format of Report and Explanation of Tables
The results from the 2004 NSDUH are given in
this report, which has separate chapters that discuss the national findings
on seven topics: use of illicit drugs; use of alcohol; use of tobacco products;
trends in initiation of substance use; prevention-related issues; substance
dependence, abuse, and treatment; and mental health. A final chapter summarizes
the results and discusses key findings in relation to other research and survey
results, including trends prior to 2002. Technical appendices describe the survey
(Appendix A), provide technical
details on the statistical methods and measurement (Appendix B),
discuss issues related to the methods changes in 2002 (Appendix C),
offer key NSDUH definitions (Appendix D),
discuss other sources of related data (Appendix E),
list the references cited in the report (as well as other relevant references)
(Appendix F), and present selected
tabulations of estimates (Appendices G
and H).
Tables, text, and figures present prevalence
measures for the population in terms of both the number of substance users and
the rate of use for illicit drugs, alcohol, and tobacco products. Tables show
estimates of drug use prevalence by lifetime (i.e., ever used), past year, and
past month use. Analyses focus primarily on past month use, which also is referred
to as "current use." Tables and figures have footnotes indicating
whether the 2003 and 2004 estimates were significantly different; in addition,
figures have footnotes indicating whether the 2002 and 2004 estimates were significantly
different.
Data are presented for racial/ethnic groups in
several categorizations, based on current standards for collecting and reporting
race and ethnicity data (Office of Management and Budget [OMB], 1997) and on
the level of detail permitted by the sample. Because respondents were allowed
to choose more than one racial group, a "two or more races" category
is presented that includes persons who reported more than one category among
the seven basic groups listed in the survey question (white, black/African American,
American Indian or Alaska Native, Native Hawaiian, Other Pacific Islander, Asian,
Other). It should be noted that, except for the "Hispanic or Latino"
group, the racial/ethnic groups discussed in this report include only non-Hispanics.
The category "Hispanic or Latino" includes Hispanics of any race.
Also, more detailed categories describing specific subgroups were obtained from
survey respondents if they reported either Asian race or Hispanic ethnicity.
Data on Native Hawaiians and Other Pacific Islanders are combined in this report.
Data also are presented for four U.S. geographic
regions and nine geographic divisions within these regions. These regions and
divisions, defined by the U.S. Bureau of the Census, consist of the following
groups of States:
Northeast Region
- New England Division: Connecticut, Maine, Massachusetts, New Hampshire,
Rhode Island, Vermont; Middle Atlantic Division: New Jersey, New York,
Pennsylvania.
Midwest Region - East North Central Division: Illinois,
Indiana, Michigan, Ohio, Wisconsin; West North Central Division: Iowa,
Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota.
South Region - South Atlantic Division: Delaware,
District of Columbia, Florida, Georgia, Maryland, North Carolina, South Carolina,
Virginia, West Virginia; East South Central Division: Alabama, Kentucky,
Mississippi, Tennessee; West South Central Division: Arkansas, Louisiana,
Oklahoma, Texas.
West Region - Mountain Division: Arizona, Colorado,
Idaho, Montana, Nevada, New Mexico, Utah, Wyoming; Pacific Division:
Alaska, California, Hawaii, Oregon, Washington.
Geographic comparisons for 2003 and 2004 also
are made based on county type, which reflects different levels of urbanicity
and metropolitan area inclusion of counties, based on metropolitan area definitions
issued by OMB in June 2003 (OMB, 2003). For this purpose, counties are grouped
based on the 2003 rural-urban continuum codes. These codes were originally developed
by the U.S. Department of Agriculture (Butler & Beale, 1994). Each county
is either inside or outside a metropolitan statistical area (MSA), as defined
by the OMB.
Large metropolitan areas have a population of
1 million or more. Small metropolitan areas have a population of fewer than
1 million. Small metropolitan areas are further classified based on whether
they have a population of 250,000 or more. Nonmetropolitan areas are areas outside
MSAs. Counties in nonmetropolitan areas are further classified based on the
number of people in the county who live in an urbanized area, as defined by
the Census Bureau at the subcounty level. "Urbanized" counties have
20,000 or more population in urbanized areas, "less urbanized" counties
have at least 2,500 but fewer than 20,000 population in urbanized areas, and
"completely rural" counties have fewer than 2,500 population in urbanized
areas.
1.4. Other NSDUH Reports and Data
This report provides a comprehensive summary
of the 2004 NSDUH, including results, technical appendices, and selected data
tables. A companion report, Overview of Findings from the 2004 National
Survey on Drug Use and Health, is a shorter, more concise report that highlights
the most important findings of the survey and includes only a brief discussion
of the methods. A report on State-level estimates for 2004 will be available
in early 2006.
In addition to the tables included in Appendices G
and H of this report, a more extensive
set of tables, including standard errors, is available upon request from OAS
or through the Internet at http://www.oas.samhsa.gov.
Tables included in Appendices G
and H can be mapped back to the more
extensive set of tables by using the table number in parentheses in the upper
left corner of each table (e.g., Table G.1
in Appendix G is Table 8.1N in
the detailed tables). Additional methodological information on NSDUH, including
the questionnaire, is available electronically at the same Web address. Brief
descriptive reports and in-depth analytic reports focusing on specific issues
or population groups also are produced by OAS. A complete listing of previously
published reports from NSDUH and other data sources is available from OAS. Most
of these reports also are available through the Internet (http://www.oas.samhsa.gov).
In addition, OAS makes public use data files available to researchers through
the Substance Abuse and Mental Health Data Archive (SAMHDA, 2005) at http://www.icpsr.umich.edu/SAMHDA/index.html.
Currently, files are available from the 1979 to 2003 surveys. The 2004 NSDUH
public use file will be available by the end of 2005.
2. Illicit Drug Use
The National Survey on Drug Use and Health (NSDUH)
obtains information on nine different categories of illicit drug use: any use
of marijuana, cocaine, heroin, hallucinogens, and inhalants; and the nonmedical
use of prescription-type pain relievers, tranquilizers, stimulants, and sedatives.
In these categories, hashish is included with marijuana, and crack is considered
a form of cocaine. Several drugs are grouped under the hallucinogens category,
including LSD, PCP, peyote, mescaline, mushrooms, and "Ecstasy" (MDMA).
Inhalants include a variety of substances, such as amyl nitrite, cleaning fluids,
gasoline, paint, and glue. The four categories of prescription-type drugs (pain
relievers, tranquilizers, stimulants, and sedatives) cover numerous drugs available
through prescriptions as well as drugs within these groupings that may be manufactured
illegally, such as methamphetamine, which is included under stimulants. Respondents
are asked to report only uses of drugs that were not prescribed for them or
drugs they took only for the experience or feeling they caused; therefore, over-the-counter
drugs and legitimate uses of prescription drugs are not included. NSDUH reports
combine the four prescription-type drug groups into a category referred to as
"psychotherapeutics."
Estimates of "illicit drug use" reported
from NSDUH reflect the use of any of the nine drug categories listed above.
Use of alcohol and tobacco products, while illegal for youths, is not included
in these estimates, but is discussed in Chapters 3
and 4.
NSDUH now collects more extensive data on respondents'
history of drug use, including age at first use, age at last use, and use during
the year prior to the past 12 months (i.e., during the period from 12 to 23
months ago). These data are useful in tracking trends over time in that they
allow year-to-year changes in new use (incidence), continuing use, and discontinuation
of use (quitting) to be measured separately in order to assess their impact
on past year use rates. Results for marijuana use based on these new data are
included in this chapter. Additional analysis of incidence for all substances
is presented in Chapter 5.
In 2004, an estimated 19.1 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 7.9 percent of the population aged 12 years old or older.
The overall rate of current illicit drug use
among persons aged 12 or older in 2004 (7.9 percent) was similar to the rate
in 2003 (8.2 percent) and in 2002 (8.3 percent).
Marijuana was the most commonly used illicit
drug (14.6 million past month users). In 2004, it was used by 76.4 percent
of current illicit drug users. An estimated 56.8 percent of current illicit
drug users used only marijuana, 19.7 percent used marijuana and another illicit
drug, and the remaining 23.6 percent used only an illicit drug other than
marijuana in the past month (Figure 2.1).
Figure 2.1 Types of Drugs Used by Past Month
Illicit Drug Users Aged 12 or Older: 2004
Among persons aged 12 or older, the overall
rate of past month marijuana use was about the same in 2004 (6.1 percent)
as it was in 2003 (6.2 percent) and 2002 (6.2 percent).
In 2004, an estimated 2.0 million persons
(0.8 percent) were current cocaine users (Figure 2.2);
of these, 467,000 used crack during the same time period (0.2 percent). Hallucinogens
were used by 929,000 persons (0.4 percent). There were an estimated 166,000
current heroin users (0.1 percent). All of these estimates are similar to
estimates for 2003.
Figure 2.2 Past Month Use of Selected Illicit
Drugs among Persons Aged 12 or Older: 2002-2004
An estimated 8.2 million people (3.4 percent
of the population) were current users of illicit drugs other than marijuana
in 2004. Most (6.0 million, 2.5 percent of the population) used psychotherapeutic
drugs nonmedically (Figure 2.2).
An estimated 4.4 million used pain relievers, 1.6 million used tranquilizers,
1.2 million used stimulants (including 583,000 using methamphetamine), and
0.3 million used sedatives. These estimates are all similar to the corresponding
estimates for 2003.
The number of current users of Ecstasy remained
the same in 2004 (450,000) as it had been in 2003 (470,000), after it had
decreased significantly between 2002 (676,000) and 2003. There were no significant
changes in the past month use of other hallucinogens between 2003 and 2004.
Although an estimated 23.4 million persons had tried LSD in their lifetime,
only 141,000 were current users in 2004.
There was no significant change in past month,
past year, or lifetime nonmedical use of pain relievers among persons aged
12 or older between 2003 and 2004. The rate of past month use was 2.0 percent
in 2003 and 1.8 percent in 2004.
Age
Rates of drug use showed substantial variation
by age. For example, 3.8 percent of youths aged 12 or 13 reported current
illicit drug use in 2004 (Figure 2.3).
As in prior years, illicit drug use in 2004 tended to increase with age among
young persons, peaking among 18 to 20 year olds (21.7 percent) and generally
declining after that point with increasing age.
Figure 2.3 Past Month Illicit Drug Use among
Persons Aged 12 or Older, by Age: 2004
Among youths, the types of drugs used differed
by age in 2004, as was the case in prior years. Among 12 or 13 year olds,
1.7 percent used prescription-type drugs nonmedically, 1.2 percent used inhalants,
and 1.1 percent used marijuana. Among 14 or 15 year olds, marijuana was the
dominant drug used (7.3 percent), followed by prescription-type drugs used
nonmedically (4.1 percent) and inhalants (1.6 percent). Marijuana also was
the most commonly used drug among 16 or 17 year olds (14.5 percent), followed
by prescription-type drugs used nonmedically (5.1 percent), hallucinogens
(1.7 percent), and cocaine (1.1 percent). Only 0.9 percent of youths aged
16 or 17 used inhalants.
Among all youths aged 12 to 17 in 2004, 10.6
percent were current illicit drug users: 7.6 percent used marijuana, 3.6 percent
used prescription-type drugs nonmedically, 1.2 percent used inhalants, 0.8
percent used hallucinogens, and 0.5 percent used cocaine.
The rate of current illicit drug use among
youths aged 12 to 17 gradually declined between 2002 and 2004. The rate was
11.6 percent in 2002, 11.2 percent in 2003, and 10.6 percent in 2004 (Figure 2.4).
This represents a statistically significant change between 2002 and 2004,
but not between 2002 and 2003 or between 2003 and 2004.
Figure 2.4 Past Month Use of Selected Illicit
Drugs among Youths Aged 12 to 17: 2002-2004
The rate of current marijuana use among youths
was 8.2 percent in 2002, 7.9 percent in 2003, and 7.6 percent in 2004, indicating
a steady but not statistically significant decline. However, declines in past
year and lifetime use of marijuana among youths from 2002 to 2004 were statistically
significant.
Young Adults Aged 18 to 25
Rates of current use of illicit drugs were
highest for the young adult age group (18 to 25 years) at 19.4 percent, with
16.1 percent using marijuana, 6.1 percent using prescription-type drugs nonmedically,
2.1 percent using cocaine, and 1.5 percent using hallucinogens.
There were no changes in past month use of
any drugs among young adults between 2003 and 2004. However, declines between
2002 and 2004 occurred for marijuana (17.3 percent in 2002, 17.0 percent in
2003, and 16.1 percent in 2004) and hallucinogens (1.9, 1.7, and 1.5 percent,
respectively).
Past year use of Ecstasy among young adults
declined from 5.8 percent in 2002 to 3.7 percent in 2003 and to 3.1 percent
in 2004.
Current nonmedical use of prescription-type
drugs showed no signs of decreasing among young adults, remaining at 6.1 percent
in 2004, compared with 6.0 percent in 2003 and 5.4 percent in 2002. There
were increases in lifetime prevalence of use from 2002 to 2004 of several
categories of pain relievers among those aged 18 to 25: Vicodin®,
Lortab®, or Lorcet®; Percocet®,
Percodan®, or Tylox®; hydrocodone products;
OxyContin®; and oxycodone products (Figure 2.5).
Figure 2.5 Lifetime Nonmedical Use of Selected
Pain Relievers among Young Adults Aged 18 to 25: 2002-2004
Among adults aged 26 or older, 5.5 percent
reported current illicit drug use in 2004: 4.1 percent used marijuana, and
1.7 percent used prescription-type drugs. In this age group, less than 1 percent
used cocaine (0.7 percent), hallucinogens (0.1 percent), and inhalants (0.1
percent). Rates of lifetime, past year, and past month illicit drug use for
adults aged 26 or older were unchanged between 2003 and 2004.
Gender
As in 2002 and 2003, males were more likely
in 2004 to report current illicit drug use than females (9.9 vs. 6.1 percent,
respectively). Males were almost twice as likely to use marijuana as females
(8.0 vs. 4.3 percent). However, rates of nonmedical use of any prescription-type
psychotherapeutic were similar for males (2.6 percent) and females (2.4 percent).
Among youths aged 12 to 17, the rate of current
illicit drug use was similar for boys and girls (10.6 percent for both). While
boys aged 12 to 17 had a higher rate of marijuana use than girls (8.1 vs.
7.1 percent) (Figure 2.6), the
rate for nonmedical use of prescription-type psychotherapeutics was higher
for girls (4.1 vs. 3.2 percent).
Figure 2.6 Past Month Marijuana Use among
Youths Aged 12 to 17, by Gender: 2002-2004
Between 2002 and 2004, past month marijuana
use declined for male youths (9.1 percent in 2002, 8.6 percent in 2003, and
8.1 percent in 2004), but it remained level for female youths (7.2, 7.2, and
7.1 percent) during the same time span.
Pregnant Women
Among pregnant women aged 15 to 44 years,
an estimated 4.6 percent reported using illicit drugs in the past month based
on combined 2003 and 2004 NSDUH data. This rate was significantly lower than
the rate among women aged 15 to 44 who were not pregnant (10.2 percent). The
combined 2002-2003 rate of illicit drug use among pregnant women (4.3
percent) was not significantly different from the 2003-2004 combined
rate.
Race/Ethnicity
Rates of current illicit drug use varied significantly
among the major racial/ethnic groups in 2004. The rate was highest among persons
reporting two or more races (13.3 percent) and American Indians or Alaska
Natives (12.3 percent). Rates were 8.1 percent for whites, 7.2 percent for
Hispanics, and 8.7 percent for blacks. Asians had the lowest rate at 3.1 percent.
Among youths aged 12 to 17, the rate of current
illicit drug use was highest among American Indians or Alaska Natives, more
than twice the overall rate among youths (26.0 vs. 10.6 percent). Rates for
other groups were 12.2 percent among those reporting two or more races, 11.1
percent among whites, 10.2 percent among Hispanics, 9.3 percent among blacks,
and 6.0 percent among Asians.
There were no statistically significant changes
between 2003 and 2004 in the rates of current illicit drug use for any racial/ethnic
subgroup. This was the case both for all persons aged 12 or older and for
youths aged 12 to 17.
The overall decline in current marijuana use
among male youths from 2002 to 2004 was consistent across major racial/ethnic
groups. Among white male youths, rates were 9.7, 9.5, and 8.5 percent in 2002,
2003, and 2004, respectively. Rates were 8.7, 6.8, and 7.6 percent for black
male youths and 8.6, 7.2, and 7.3 percent among Hispanic male youths in those
3 years.
Education
Illicit drug use rates in 2004 were correlated
with educational status. Among adults aged 18 or older, the rate of current
illicit drug use was lower among college graduates (5.6 percent) compared
with those who did not graduate from high school (8.6 percent), high school
graduates (7.8 percent), and those with some college (8.7 percent). However,
adults who had completed 4 years of college were more likely to have tried
illicit drugs in their lifetime when compared with adults who had not completed
high school (51.8 vs. 37.2 percent).
College Students
In the college-aged population (persons aged
18 to 22 years old), the rate of current illicit drug use was slightly lower
among full-time undergraduate college students (20.2 percent) than among other
persons aged 18 to 22 years, including part-time students, students in other
grades, and nonstudents (22.3 percent). The rate of current illicit drug use
among college students and other 18 to 22 year olds did not change between
2002 and 2003 or between 2003 and 2004.
Employment
Current employment status was correlated with
rates of illicit drug use in 2004. An estimated 19.2 percent of unemployed
adults aged 18 or older were current illicit drug users compared with 8.0
percent of those employed full time and 10.3 percent of those employed part
time. These rates are all similar to the corresponding rates in 2003.
Although the rate of drug use was higher among
unemployed persons compared with those from other employment groups, most
drug users were employed. Of the 16.4 million illicit drug users aged 18 or
older in 2004, 12.3 million (75.2 percent) were employed either full or part
time.
Geographic Area
Among persons aged 12 or older, the rate of
current illicit drug use in 2004 was 8.9 percent in the West, 8.4 percent
in the Northeast, 7.5 percent in the Midwest, and 7.3 percent in the South.
Similar patterns were evident in 2003 and 2002.
The rate of illicit drug use in metropolitan
areas was higher than the rate in nonmetropolitan areas in 2004. Rates were
8.1 percent in large metropolitan counties, 8.5 percent in small metropolitan
counties, and 6.3 percent in nonmetropolitan counties as a group (Figure 2.7).
Within nonmetropolitan areas, counties that were urbanized had a rate of 7.6
percent, less urbanized counties had a rate of 5.6 percent, while completely
rural counties had a rate of 4.6 percent.
Figure 2.7 Past Month Illicit Drug Use among
Persons Aged 12 or Older, by County Type: 2002-2004
The rate of current illicit drug use in completely
rural counties had declined between 2002 and 2003, from 6.7 to 3.1 percent,
but was 4.6 percent in 2004. The rate in 2004 was not significantly different
from the rate in 2003 or 2002.
Among youths aged 12 to 17, there was evidence
of regional differences in trends of marijuana use between 2002 and 2004.
Rates of current marijuana use were lower in 2004 than in 2002 in the Northeast,
Midwest, and South (although the decrease was not statistically significant
in the Northeast and Midwest) (Figure 2.8).
However, in the West, rates were 8.0 percent in 2002, 8.7 percent in 2003,
and 9.3 percent in 2004.
Figure 2.8 Past Month Marijuana Use among
Youths Aged 12 to 17, by Geographic Region: 2002-2004
In 2004, among the estimated 1.5 million adults
aged 18 or older on parole or other supervised release from prison during
the past year, 25.3 percent were current illicit drug users compared with
7.5 percent among adults not on parole or supervised release.
Among the estimated 4.7 million adults on
probation at some time in the past year, 26.2 percent reported current illicit
drug use in 2004. This compares with a rate of 7.2 percent among adults not
on probation in 2004.
Frequency of Use
In 2004, 12.7 percent of past year marijuana
users used marijuana on 300 or more days in the past 12 months. This translates
into 3.2 million persons using marijuana on a daily or almost daily basis
over a 12-month period, similar to the estimates in 2002 and 2003.
The number of youths aged 12 to 17 using marijuana
daily or almost daily in the past year declined from 358,000 in 2002 to 282,000
in 2003, but the estimate for 2004 was 342,000, which was not significantly
different from the estimates for 2002 or 2003. Similarly, the number of youths
using marijuana on 20 or more days in the past month declined from 603,000
in 2002 to 482,000 in 2003, but was 536,000 in 2004.
The number of past month daily or almost daily
cocaine users increased from 133,000 in 2003 to 263,000 in 2004. Most of these
daily users were aged 26 or older (96,000 in 2003, 203,000 in 2004).
Association with Cigarette and Alcohol Use
In 2004, the rate of current illicit drug
use was approximately 8 times higher among youths aged 12 to 17 who smoked
cigarettes (47.5 percent) than it was among youths who did not smoke cigarettes
(5.6 percent).
Illicit drug use also was associated with
the level of alcohol use. Among youths aged 12 to 17 who were heavy drinkers
(i.e., drank five or more drinks on the same occasion on at least 5 different
days in the past 30 days), 65.6 percent also were current illicit drug users,
whereas among nondrinkers, the rate was only 5.0 percent.
Among youths who were both smokers and heavy
drinkers, 70.1 percent used illicit drugs compared with only 3.5 percent among
youths who did not drink or smoke.
Driving Under the Influence of Illicit Drugs
In 2004, an estimated 10.6 million persons
reported driving under the influence of an illicit drug during the past year.
This corresponds to 4.4 percent of the population aged 12 or older, which
was similar to the rates in 2002 (4.7 percent) and 2003 (4.6 percent). In
2004, the rate was highest (13.3 percent) among young adults aged 18 to 25,
a decrease from 14.7 percent in 2002.
How Marijuana Is Obtained
NSDUH includes questions asking marijuana
users how, from whom, and from where they obtained the marijuana they used
most recently. In 2004, most users (55.1 percent) got the drug for free or
shared someone else's marijuana. About 40 percent of marijuana users bought
it.
Most marijuana users obtained the drug from
a friend; 76.0 percent of those who bought their marijuana and 81.1 percent
of those who obtained the drug for free had acquired it from a friend.
More than half (52.7 percent) of users who
bought their marijuana purchased it inside a home, apartment, or dorm. This
also was the most common location for obtaining marijuana for free (65.1 percent).
Among youths aged 12 to 17, 60.4 percent got
the drug for free and 33.1 percent bought it. Among youths who bought their
marijuana, 33.6 percent bought it inside a home, apartment, or dorm. Among
youths who obtained their marijuana for free, 47.4 percent obtained it inside
a home, apartment, or dorm.
Among youths aged 12 to 17 who bought their
marijuana, 10.5 percent obtained it inside a school building, and 4.0 percent
bought it outside on school property.
Prior Marijuana Use History
Among the 25.5 million past year users of
marijuana in 2004, an estimated 2.1 million (8.4 percent) were first-time
users during the past year and 19.2 million (75.5 percent) were "continuing"
users (i.e., they had used during the prior year, which is the period from
12 to 23 months ago, and had continued to use in the past year). Additionally,
4.1 million (16.1 percent) "resumed" use in the past 12 months (i.e.,
they had used marijuana prior to 24 months ago, did not use during the prior
year, but did use in the past 12 months). These percentages are similar to
the percentages among past year marijuana users in 2003 (7.8 percent first-time
users, 77.0 percent "continuing" users, and 15.1 percent "resumed"
users).
Among the 3.7 million past year marijuana
users aged 12 to 17 in 2004, an estimated 1.3 million (34.2 percent) were
first-time users, 2.1 million (57.0 percent) were "continuing" users,
and 0.3 million (8.7 percent) had "resumed" their marijuana use
in the past 12 months. These percentages are similar to the percentages among
past year marijuana users in 2003.
A measure of "discontinuation" of
marijuana use is obtained as the percentage of those who did not use marijuana
in the past 12 months among those who did use in the prior year. Based on
this calculation, marijuana discontinuation rates in 2004 were 27.2 percent
among persons aged 12 or older, and 19.9 percent among youths aged 12 to 17.
These rates are essentially the same as the rates in 2003.
3. Alcohol Use
The National Survey on Drug Use and Health (NSDUH)
includes questions about the recency and frequency of consumption of alcoholic
beverages, such as beer, wine, whiskey, brandy, and mixed drinks. Prior to the
administration of the alcohol use questions, an extensive list of examples of
the kinds of beverages included is given to respondents. A "drink"
is defined as a can or bottle of beer, a glass of wine or a wine cooler, a shot
of liquor, or a mixed drink with liquor in it. Times when the respondent only
had a sip or two from a drink are not considered as consumption. For this report,
estimates for the prevalence of alcohol use are reported primarily at the following
three levels for males and females and all ages:
Current (past month) use -
At least one drink in the past 30 days (includes binge and heavy use).
Binge use - Five or more drinks on the same occasion (i.e., at the same
time or within a couple of hours of each other) at least once in the past 30
days (includes heavy use).
Heavy use - Five or more drinks on the same occasion on at least 5 different
days in the past 30 days.
About half (50.3 percent) of Americans aged
12 or older reported being
