Highlights from the Federal Government’s Study

Substance Dependence or Abuse

• An estimated 22.0 million Americans in 2002 were classified with substance dependence or abuse (9.4 percent of the total population aged 12 or older). Of these,
• 3.2 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
• 14.9 million were dependent on or abused alcohol but not illicit drugs.
• Among persons aged 12 or older in 2002, the rate of substance dependence or abuse was highest among American Indians/Alaska Natives (14.1 percent). The next highest rate was among persons reporting two or more races (13.0 percent). Asians had the lowest rate of dependence or abuse (4.2 percent). The rate was similar among blacks and whites (9.5 and 9.3 percent, respectively). Among Hispanics, the rate was 10.4 percent.
• In 2002, an estimated 19.7 percent of unemployed adults aged 18 or older were classified with dependence or abuse, while 10.6 percent of full-time employed adults and 10.5 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 19.8 million adults classified with dependence or abuse, 15.3 million (77.1 percent) were employed.

Alcohol Use

• An estimated 120 million Americans aged 12 or older reported being current drinkers of alcohol in the 2002 survey
•  (51.0 percent). About 54 million (22.9 percent) participated in binge drinking at least once in the 30 days prior to the survey
• 15.9 million (6.7 percent) were heavy drinkers.
• Prevalence of current alcohol use increased with increasing age in 2002, from 2.0 percent at age 12 to 6.5 percent at age 13, 13.4 percent at age 14, 19.9 percent at age 15, 29.0 percent at age 16, and 36.2 percent at age 17. The rate reached a peak of 70.9 percent for persons 21 years old.
• About 10.7 million persons aged 12 to 20 reported drinking alcohol in the month prior to the survey interview in 2002 (28.8 percent of this age group). Of these, nearly 7.2 million (19.3 percent) were binge drinkers and 2.3 million (6.2 percent) were heavy drinkers.
• About 1 in 7 Americans aged 12 or older in 2002 (14.2 percent, or 33.5 million persons) drove under the influence of alcohol at least once in the 12 months prior to the interview.

Illicit Drug Use

• In 2002, an estimated 19.5 million Americans, or 8.3 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.
• Marijuana is the most commonly used illicit drug, with a rate of 6.2 percent. Of the 14.6 million past month marijuana users in 2002, about one third, or 4.8 million persons, used it on 20 or more days in the past month.
• In 2002, an estimated 2.0 million persons (0.9 percent) were current cocaine users, 567,000 of whom used crack. Hallucinogens were used by 1.2 million persons, including 676,000 users of Ecstasy. There were an estimated 166,000 current heroin users.
• An estimated 6.2 million persons, or 2.6 percent of the population aged 12 or older, were current users of psychotherapeutic drugs taken nonmedically. An estimated 4.4 million used pain relievers, 1.8 million used tranquilizers, 1.2 million used stimulants, and 0.4 million used sedatives.
• In 2002, approximately 1.9 million persons aged 12 or older had used OxyContin nonmedically at least once in their lifetime.
• Among youths aged 12 to 17, 11.6 percent were current illicit drug users. The rate of use was highest among young adults (18 to 25 years) at 20.2 percent. Among adults aged 26 or older, 5.8 percent reported current illicit drug use.
• Among pregnant women aged 15 to 44 years, 3.3 percent reported using illicit drugs in the month prior to their interview. This rate was significantly lower than the rate among women aged 15 to 44 who were not pregnant (10.3 percent).
• The rates of current illicit drug use were highest among American Indians/Alaska Natives (10.1 percent) and persons reporting two or more races (11.4 percent). Rates were 9.7 percent for blacks, 8.5 percent for whites, and 7.2 percent for Hispanics. Asians had the lowest rate at 3.5 percent.
• Among youths aged 12 to 17, the rate of current illicit drug use among American Indians/Alaska Natives (20.9 percent) was significantly higher than the rate among all youths (11.6 percent), and the rate among Asian youths (4.8 percent) was significantly lower compared with the overall rate for all youths.
• An estimated 17.4 percent of unemployed adults aged 18 or older were current illicit drug users in 2002 compared with 8.2 percent of those employed full time and 10.5 percent of those employed part time. However, most drug users were employed. Of the 16.6 million illicit drug users aged 18 or older in 2002, 12.4 million (74.6 percent) were employed either full or part time.
• In 2002, an estimated 11.0 million persons reported driving under the influence of an illicit drug during the past year. This corresponds to 4.7 percent of the population aged 12 or older. The rate was 10 percent or greater for each age from 17 to 25, with 21 year olds reporting the highest rate of any age (18.0 percent). Among adults aged 26 or older, the rate was 3.0 percent.

Tobacco Use

• An estimated 71.5 million Americans (30.4 percent of the population aged 12 or older) reported current use (past month use) of a tobacco product in 2002. About 61.1 million (26.0 percent) smoked cigarettes, 12.8 million (5.4 percent) smoked cigars, 7.8 million (3.3 percent) used smokeless tobacco, and 1.8 million (0.8 percent) smoked tobacco in pipes.
• A higher proportion of males than females aged 12 or older smoked cigarettes in 2002 (28.7 vs. 23.4 percent). However, among youths aged 12 to 17, girls were slightly more likely than boys to smoke (13.6 vs. 12.3 percent).
• In 2002, 17.3 percent of pregnant women aged 15 to 44 smoked cigarettes in the past month compared with 31.1 percent of nonpregnant women of the same age group.

Trends in Lifetime Substance Use

• The percentage of youths aged 12 to 17 who had ever used marijuana declined slightly from 2001 to 2002 (21.9 to 20.6 percent).
• Among young adults aged 18 to 25, the rate increased slightly from 53.0 percent in 2001 to 53.8 percent in 2002.
• The percentage of youths aged 12 to 17 who had ever used cocaine increased slightly from 2001 to 2002 (2.3 to 2.7 percent). Among young adults aged 18 to 25, the rate increased slightly from 14.9 percent in 2001 to 15.4 percent in 2002.
• Lifetime nonmedical pain reliever prevalence among youths aged 12 to 17 increased from 2001 (9.6 percent) to 2002 (11.2 percent), continuing an increasing trend from 1989 (1.2 percent). Among young adults aged 18 to 25, the rate increased from 19.4 percent in 2001 to 22.1 percent in 2002. The young adult rate had been 6.8 percent in 1992.
• The rate of lifetime cigarette use among youths aged 12 to 17 declined from 37.3 percent in 2001 to 33.3 percent in 2002.
• The rate of lifetime daily cigarette use among youths aged 12 to 17 declined from 10.6 percent in 2001 to 8.2 percent in 2002. There also was a small decline in lifetime prevalence among young adults (37.7 to 37.1 percent) from 2001 to 2002.

Trends in Initiation of Substance Use (Incidence)

• There were an estimated 2.6 million new marijuana users in 2001. This number is similar to the numbers of new users each year since 1995, but above the number in 1990 (1.6 million).
• Pain reliever incidence increased from 1990, when there were 628,000 initiates, to 2000, when there were 2.7 million. In 2001, the number was 2.4 million, not significantly different from 2000.
• The number of new daily cigarette smokers decreased from 2.1 million in 1998 to 1.4 million in 2001. Among youths under 18, the number of new daily smokers decreased from 1.1 million per year between 1997 and 2000 to 757,000 in 2001. This corresponds to a decrease from about 3,000 to about 2,000 new youth smokers per day.

Youth Prevention-Related Measures

• Among youths indicating that "smoking marijuana once a month" was a "great risk," only 1.9 percent indicated that they had used marijuana in the past month. However, among youths who indicated "moderate, slight, or no risk," the prevalence rate was almost 6 times larger (11.3 percent).
• The percentages of youths reporting that it was fairly or very easy to obtain specific drugs were 55.0 percent for marijuana, 25.0 percent for cocaine, 19.4 percent for LSD, and 15.8 percent for heroin.
• Most youths (89.1 percent) reported that their parents would strongly disapprove of their trying marijuana once or twice. Among these youths, only 5.5 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, 30.2 percent reported past month use of marijuana.

Treatment and Treatment Need for Substance Problems

• An estimated 3.5 million people aged 12 or older (1.5 percent of the population) received some kind of treatment for a problem related to the use of alcohol or illicit drugs in the 12 months prior to being interviewed in 2002.
• Of these, 2.2 million received treatment for alcohol during their most recent treatment. An estimated 974,000 persons received treatment for marijuana, 796,000 persons for cocaine, 360,000 for pain relievers, and 277,000 for heroin. Most people receiving treatment received it at a "specialty" substance abuse facility (2.3 million).
• In 2002, the estimated number of persons aged 12 or older needing treatment for an illicit drug problem was 7.7 million (3.3 percent of the total population).
• Of these persons, 1.4 million (18.2 percent) received treatment for drug abuse at a specialty substance abuse facility in the past 12 months.
• Of the 6.3 million people who needed drug treatment but did not receive treatment at a specialty facility in 2002, an estimated 362,000 (5.7 percent) reported that they felt they needed treatment for their drug problem. This included an estimated 88,000 (24.4 percent) who reported that they made an effort but were unable to get treatment and 274,000 (75.6 percent) who reported making no effort to get treatment.
• In 2002, the estimated number of persons aged 12 or older needing treatment for an alcohol problem was 18.6 million (7.9 percent of the total population).
• Of these, 8.3 percent (1.5 million) received alcohol treatment at a specialty substance abuse facility in the past 12 months.
• Of the 17.1 million people who needed but did not receive alcohol treatment, an estimated 761,000 (4.5 percent) reported that they felt they needed treatment for their alcohol problem. Of the 761,000 persons, 266,000 (35 percent) reported that they made an effort but were unable to get treatment, and 495,000 (65 percent) reported making no effort to get treatment.
• Among the 1.4 million persons who received specialty treatment for an illicit drug problem in the past year, 33.9 percent reported "own savings or earnings" as a source of payment for their most recent specialty treatment. An estimated 30.0 percent reported private health insurance, 26.1 percent reported Medicaid, and 23.3 percent reported public assistance other than Medicaid as a source of payment.
• Among the 1.5 million persons who received specialty treatment for an alcohol problem in the past year, 46.3 percent reported "own savings or earnings" as a source of payment for their most recent specialty treatment.
• An estimated 31.7 percent reported using private health insurance,
• 21.5 percent reported public assistance other than Medicaid, and
• 21.4 percent reported Medicaid.

This report presents, for the first time, information from the 2002 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.

Because of improvements to the survey in 2002, estimates from the 2002 NSDUH should not be compared with estimates from the 2001 and earlier NHSDAs to assess change over time in substance use. Therefore, the 2002 data constitute a new baseline for tracking trends in substance use and other measures. However, it is possible to develop trend estimates based on respondents' reports of past substance use in the 2002 NSDUH. The estimates are presented in terms of lifetime and first-time substance use.