Substance Abuse Fact Sheet
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Introduction top
Substance use has fluctuated nationally since the mid-70s when the government and other independent sources began collecting data on this behavior. Over the past 5-10 years, the level of substance use has remained relatively stable; however, research indicates changes in the types of drugs used. Each year, a number of national surveys are conducted to determine the prevalence of substance use in this country, the number of new users (or incidence of the behavior), and the attitudes of users and non-users.
Overview top
The National Household Survey on Drug Abuse (NHSDA) is a household survey conducted by the federal government's Substance Abuse and Mental Health Services Administration (SAMHSA). The most recent data from 1999 report:
- An estimated 14.8 million Americans currently use illicit drugs, representing 6.7 percent of the population 12 and older.
- Marijuana is the most common illicit drug, used by 75% of people reporting illicit substance use.
- Approximately 43% of the population (an estimated 6.4 million Americans) use other illicit drugs, such as cocaine, heroin, crack, hallucinogens, and other psychotherapeutic medications taken non-medically or without prescription.
Tobacco and alcohol misuse are other aspects of substance use that are tracked by national surveys.
- More than 30% of the population surveyed in the 1999 NHSDA reported current use of tobacco, with the vast majority smoking cigarettes.
- About 45 million Americans (an estimated 20.2%) reported engaging in binge drinking episodes, defined as having 5 or more drinks on one occasion during the 30 days prior to the survey.
- Over 12 million Americans (an estimated 5.6 percent) were identified as heavy drinkers, having 5 or more drinks on one occasion 5 or more times during the 30 days prior to the survey.
- Although consumption of alcohol is illegal for those under 21, 10.4 million drinkers were ages 12-20 in 1999. In this group, 6.8 million (approximately 65%) engaged in binge drinking.
Variation by Age
Rates and patterns of drug use tend to vary by age. For example, 4.1 percent of 12 year olds surveyed in the NHSDA reported current (use within the past month) illicit drug use. Among this age group, the primary illicit drugs of choice were inhalants and psychotherapeutics (2.2 percent and 1.4 percent, respectively). Only 0.6 percent of the 12 year olds used marijuana. However, by age 14, marijuana was the dominant drug, with a prevalence of 5.9 percent. Overall, the rate of current illicit drug use among 14 year olds was 9.2 percent.
Among youth 12 to 17 years of age, 10.9% had used an illicit drug within the 30 days prior to survey. Of this group, 7.7 percent had used marijuana, and 5.3 percent had used some illicit drug other than marijuana. Nearly 15% of youth in this age group report current cigarette smoking, compared to 40% of young adults aged 18-25 and 25% of adults 26 and older. More than 10 million youth under age 20, report current alcohol use, with 68% of these individuals reporting binge drinking.
New Trends
While many young people are using alcohol, tobacco, and other illicit substances, some data show a decline in each of these areas for the first time in nearly a decade. The annual PRIDE survey (National Parents' Resource Institute for Drug Education), which is the nation's largest independent survey of adolescent drug use and violence, found a 12.9% decrease in annual illicit drug use among students in grades 6-12 -- the strongest one year decline in overall drug use since 1990-1991. Alcohol use fell by 6.3 percent to the lowest levels in 12 years and cigarette smoking fell by 15.6% to the lowest levels in 8 years.1
Youth in grades 6 to 8 reported the most significant reductions, whereas the smallest changes in reported substance use were found at the 12th grade level. Among high school seniors, one in four students report using illegal drugs on a monthly basis and over 8% report daily use. Further, more than 24% of 12th graders report drinking alcohol weekly and 23% smoke cigarettes daily.2
The annual Monitoring the Future Study of 8th, 10th, and 12th graders found similar declines in youth substance use, but also noted increases in the use of MDMA (ecstasy) in each grade along with increases in the use of steroids among 10th graders.
Risk & Protective Factors
All young people are exposed to both risk and protective factors for substance abuse. Risk factors place individuals at greater than average risk for substance use, whereas protective factors buffer youth from initiating or continuing use. Typically, the greater the number of risk factors, the higher a youth's susceptibility. In contrast, the accumulation of protective factors appears to reduce risk.
It is important to note that the importance of a given risk or protective factor can vary with the type of substance, a youth's stage of development, and a youth's gender or ethnic/racial group. For example:
- Parental communication of norms has been found to be a protective factor for alcohol use, but not for marijuana use;3
- Repeating a grade in school increases a youth's risk for cigarette use in grades 7-8, but not in grades 9-12;3 and
- Aggressive behavior in early childhood is predictive of later substance abuse for boys, but not for girls..4
Also, it is important to keep in mind that factors significant for earlier stages of use and initiation (such as "trying" marijuana) may differ from those related to the transition to dependence (for example, heroin addiction or alcoholism). Social, situational, and environmental factors are likely to be more influential in initial or low-level substance use, while individuals who progress from use to abuse or addiction are influenced to a greater extent by biological, psychological, and psychiatric factors.5
Risk and protective factors exist in six different domains: the individual environment, family environment, peer association, school-related, society-related, and community environment.
Individual Risk and Protective Factors
Numerous individual factors have been identified that increase an individual's risk for substance use and abuse. Boys are typically at much greater risk for early initiation and later substance abuse than girls.6
The age at which one first drinks alcohol or tries other substances is also an important factor. Age at initiation is predictive of later problems with a substance, with earlier use placing individuals at greater risk for later abuse. About 40 percent of those who start drinking at age 14 years or under, develop alcohol dependence at some point in their lives; for those who start drinking at age 21 years or older, only 10 percent develop alcohol dependence.6
Age at onset of alcohol and marijuana use is also a strong predictor of progression to other drugs.6 In one study, researchers found that if a child smoked tobacco or drank alcohol, he/she was 65 times more likely to use marijuana than a child who never smoked or drank. Children who used marijuana were 104 times as likely to use cocaine compared with their peers who never used marijuana.4
Youth with emotional and psychological problems are at greater risk for substance use and abuse. Boys with a history of aggressive behavior early in childhood are more likely to use drugs, as are youth with persistent antisocial behavior in early adolescence, such as misbehaving in school, skipping school, and getting into fights with other children.7 A history of sensation-seeking, low harm-avoidance, and lack of impulse control also puts boys at risk.7
Finally, antisocial beliefs and values and specific positive beliefs about a substance can increase the likelihood of substance use.
Identified individual-level protective factors that promote resistance to drug use include: positive self-esteem, self-control, assertiveness, social competence, a spiritual or religious identity, and academic achievement.3 4.
Family Environment Risk and Protective Factors
If children are raised in a family with a history of addiction to alcohol or other drugs, the risk of their having substance abuse problems themselves increases..7 8 Access to alcohol and drugs in their homes also increases youth's likelihood of substance use.3
Parental family management and discipline practices can also put youth at risk, including a lack of clear expectations for behavior, failure of parents to monitor their children (knowing where they are and who they are with), and use of excessively severe or inconsistent punishment.7 A low level of parent/child attachment and nurturing can also increase a youth's risk for substance use, as can a chaotic home environment.9 Finally, abuse in the home has also been implicated as a significant risk factor for later substance abuse.4
In contrast, factors such as parent/family connectedness, warmth and attachment, parent/ adolescent shared activities, parent supervision, high parental school expectations, and parental communication of norms against a substance, can promote resistance to drug use.3 6.
Peer Association Risk and Protective Factors
Exposure and attachment to peers who use drugs or express positive views about substance use can increase a youth's risk for substance use. In contrast, peers who have conventional values and who express negative views about substance use can decrease the likelihood that a youth will use drugs.4
School-Related Risk and Protective Factors
Lack of school bonding can increase a youth's risk for substance use, while school connectedness and school achievement can serve as protective factors.3
Community Environment and Society-Related Risk and Protective Factors
A number of community environment and society-related risk and protective factors have also been identified. Risk factors can include: community disorganization, lack of community bonding, community attitudes favorable to drug use, inadequate services and opportunities for youth, and pro-drug messages in the media.10
Protective factors can include: opportunities for youth participation in community activities, high expectations of youth, and decreased accessibility of drugs and alcohol.10
The Relationship between Substance Use and Violence
While there are many young people who use drugs and do not become involved in violence, substance use and involvement in violent behavior are clearly interrelated. There is a correlation between the severity and frequency of drug use and the severity and frequency of delinquency. This pattern is observed across age, gender, and ethnic groups.
Alcohol is the drug most frequently associated with violence. To a far greater extent than all other drugs combined, alcohol is associated with domestic violence, assault, homicide, and suicide. Alcohol is a key factor in up to 68 percent of manslaughters, 62 percent of assaults, 54 percent of murders/attempted murders, 48 percent of robberies, and 44 percent of burglaries.11
Crack cocaine is also a significant contributor to violent behavior. While overall crack use is down in this country, violence associated with this drug has had a detrimental impact on many inner-city neighborhoods. Crack users commit crimes for money to buy the highly addictive drug and crack can induce violent behavior in some users. Studies have also found that much of the drug-related violence involves disagreement over individual drug transactions or competition for territory among dealers.11
Streets, homes, and schools are all affected by alcohol- and other drug-related violence. Research demonstrates that substance use is related to: early childhood injuries, abuse, or neglect; domestic violence; youth violence; poor socialization experiences; lack of economic or educational opportunities; and community disorganization.
Substance Abuse Prevention, Intervention, And Treatment
There are three primary approaches to address the problem of substance use and abuse in this country: criminal justice, therapeutic, and public health.
- The criminal justice approach assumes that punishing illegal drug users and suppliers will decrease overall use and any violence that is related to the use, purchase, or sale of drugs. This approach sends a clear message that illegal drugs are not acceptable or tolerated, it removes offenders from the public through incarceration, and it may deter potential offenders.
- The therapeutic approach focuses on treating substance abuse as an illness and uses strategies such as therapy, detoxification, and other supportive family and community arrangements that can decrease dependency on drugs.
- The public health approach emphasizes the need to understand and address the various individual, family, community, and environmental conditions that contribute to the behavior
Although the objectives, prevention strategies, and outcomes from the various model programs are diverse, there are several unifying elements that each program has in common.
- In its own setting and its own manner, each program promotes supportive and caring relationships between youth and members of their families, their communities, and their peer groups.
- Each of the effective programs offers multifaceted interventions targeting the specific needs of its audiences.
- Each of the programs has been successful in postponing the onset of alcohol, tobacco, and illicit drug use; reducing the frequency of alcohol, tobacco, and drug use; or reducing risk factors or enhancing protective factors within the life domains that affect the development of substance use.
Federal Publications top
U.S. DEPARTMENT OF EDUCATION
- Office of Safe & Drug Free Schools
www.ed.gov/about/offices/list/osdfs/index.html
The following publications are available online through the Safe & Drug Free Schools publications library:- Action Guide: Creating Safe & Drug-Free Schools
- Keeping Schools Open as Community Learning Centers: Extending Learning in a Safe, Drug Free Environment Before and After School
- Early Warning, Timely Response: A Guide to Safe Schools
U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
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Substance Abuse and Mental Health Services Administration
www.samhsa.gov
This federal agency is charged with improving the quality and availability of prevention, treatment, and rehabilitative services in order to reduce illness, death, disability, and cost to society resulting from substance abuse and mental illnesses. -
Office of Applied Studies
http://oas.samhsa.gov/
This Office provides the latest national data on (1) alcohol, tobacco, marijuana and other drug abuse, (2) drug-related emergency department episodes and medical examiner cases, and (3) the nation's substance abuse treatment system. -
National Clearinghouse for Alcohol and Drug Information
www.health.org
This Clearinghouse provides publications via the Web site; by regular mail at P.O. Box 2345 Rockville MD 20847-2345; or by toll free telephone at 800-729-6686. Some publications that are available are:- National Household Survey on Drug Abuse: Main Findings, 1998.
- National Survey Results on Drug Use from the Monitoring the Future Study, 1975-1998, Volume I: Secondary School Students
- National Survey Results on Drug Use from the Monitoring the Future Study, 1975-1998, Volume II: College Students and Young Adults
- Alcohol, Violence and Aggression. Alcohol Alert #38
- Making the Link: Violence and Crime and Alcohol and Other Drugs
- Greenblatt, J.C., "Adolescent Self-Reported Behaviors and Their Association with Marijuana Use." Analyses of Substance Abuse and Treatment Needs Issues.
- Prevention Pipeline (newsletter)
- Centers for Disease Control and Prevention
www.cdc.gov
Until this decade, little was known about the prevalence of behaviors practiced by young people that put their health at risk. The Youth Risk Behavior Surveillance System (YRBSS) now provides such information. Developed by the CDC in collaboration with federal, state, and private-sector partners, this voluntary system includes a national survey and surveys conducted by state and local education agencies. The YRBSS provides vital information on risk behaviors among young people to more effectively target and improve health programs.
U.S. DEPARTMENT OF JUSTICE
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National Criminal Justice Reference Service
www.ncjrs.org
The Drugs and Crime page of the National Criminal Justice Reference Center provides an extensive listing of resources related to substance abuse and criminal activity. -
Office of Juvenile Justice and Delinquency Prevention
http://ojjdp.ncjrs.org
The Juvenile Justice Clearinghouse provides publications on juvenile justice and prevention issues. For OJJDP reports on substance abuse, visit http://ojjdp.ncjrs.org/pubs/substance.html. -
Substance Abuse Funding News
www.cdpublications.com/pubs/substanceabusefunding.php
This Web site provides public and private grant announcements of alcohol, tobacco, and drug abuse programs. Teenagers, the homeless, and other special populations are highlighted. Plus, Substance Abuse Funding News offers advice on grant seeking and proposal writing, along with tips from funding officials on what they look for in grant applications.
OFFICE OF NATIONAL DRUG CONTROL POLICY
www.whitehousedrugpolicy.gov
This Web site provides a listing of substance abuse related articles.
Federal Resources top
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
- Centers for Disease Control and Prevention
- National Center for Chronic Disease Prevention and Health Promotion
- National Institutes of Health
- National Institute of Alcohol Abuse and Alcoholism
- National Institute on Drug Abuse
- Substance Abuse and Mental Health Administration
- Center for Substance Abuse Prevention
- Center for Substance Abuse Treatment
- Your Time, Their Future
OFFICE OF NATIONAL DRUG CONTROL POLICY
U.S. DEPARTMENT OF EDUCATION
http://www.ed.gov
The agency's mission is to ensure equal access to education and to promote educational
excellence for all Americans. The Department sponsors programs that work with
schools to decrease violence within their halls, as well as with other programs
that prepare students for productive lives outside of and beyond schools. Additionally,
the Department encourages school-community partnerships to address violence-related
issues.
- Safe & Drug Free Schools Program
http://www.ed.gov/about/offices/list/osdfs/index.html/
This Program is the federal government's primary vehicle for reducing drug, alcohol and tobacco use, and violence, through education and prevention activities in the nation's schools.
U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
http://www.dhhs.gov
This is the principal federal agency for protecting the health of all Americans
and providing essential human services, especially for those who are least able
to help themselves. Identifying violence as a public health problem, the Department
supports community efforts to organize coalitions to combat youth violence and
gang activity. In addition, DHHS fulfills a critical role in supporting research
of the causes and solutions to violence by and against youth.
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Centers for Disease Control and Prevention
http://www.cdc.gov
This agency provides a system of health surveillance to monitor and prevent outbreaks of diseases. With the assistance of states and other partners, the CDC guards against international disease transmission, maintains national health statistics and provides for immunization services and supports research into disease and injury prevention. -
National Center for Chronic Disease Prevention and Health Promotion
The Division of Adolescent and School Health
http://www.cdc.gov/nccdphp/dash
This Division supports local, state, and national agencies and organizations that have the capacity to improve child and adolescent health. Some of the activities of the Division include: monitoring youth risk behaviors (YRBSS) and school health policies and programs (SHPPS); synthesizing risk behavior data and school health and adolescent health research; enabling project partners in state and local education agencies and in national organizations to implement adolescent and school health programs; evaluating school health programs; and collaborating with other federal agencies and organizations to coordinate adolescent and school health programs and research. -
National Institutes of Health
http://www.nih.gov
The National Institutes of Health is one of the world's foremost medical research centers, and the federal focal point for medical research in the U.S. -
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
http://www.niaaa.nih.gov
This Institute supports and conducts biomedical and behavioral research on the causes, consequences, treatment, and prevention of alcoholism and alcohol-related problems. -
National Institute on Drug Abuse (NIDA)
http://www.nida.nih.gov
This Institute works to ensure that science, not ideology or anecdote, forms the foundation for all of the nation's drug abuse reduction efforts. -
Substance Abuse and Mental Health Administration
http://www.samhsa.gov
This agency supports the identification and development of model programs to address the needs of the nation's high-risk youth with a special focus on substance use disorders, behavior disorders, and mental illness and how these issues affect youth violence. -
Center for Substance Abuse Prevention
http://www.samhsa.gov/centers/csap/csap.html
This Center provides national leadership in the federal effort to prevent alcohol, tobacco, and illicit drug problems. -
Center for Substance Abuse Treatment
http://www.samhsa.gov/centers/csat/csat.html
This Center was created with the congressional mandate to expand the availability of effective treatment and recovery services for alcohol and drug problems. -
Your Time, Their Future
http://www.health.org/yourtime
This program recruits caring adults to help children and young adolescents avoid becoming involved in substance abuse. The campaign, administered by SAMSHA, emphasizes the need for adults to become actively involved in providing children with activities that will keep them away from alcohol, tobacco, and other drugs.
U.S. DEPARTMENT OF JUSTICE
http://www.usdoj.gov
This Department is the leading federal law enforcement agency. Programs cover
issues such as domestic violence, teen courts, weapons, gangs, delinquency
and community policing. For a comprehensive listing of DOJ publications and
programs related to youth violence, visit www.usdoj.gov/youthviolence.htm.
-
Office of Justice Programs
http://www.ojp.usdoj.gov
This Program provides federal leadership in developing the nation's capacity to prevent and control crime, improve the criminal and juvenile justice systems, increase knowledge about crime and related issues, and assist crime victims. Through the programs developed and funded by its bureaus and offices, OJP works to form partnerships among federal, state, and local government officials to control drug abuse and trafficking; reduce and prevent crime; rehabilitate neighborhoods; improve the administration of justice in America; meet the needs of crime victims; and address problems such as gang violence, prison crowding, juvenile crime, and white-collar crime. -
Weed and Seed
http://www.ojp.usdoj.gov/ccdo/ws/welcome.html
Weed and Seed is a strategy to control violent crime, drug trafficking, and drug-related crime in targeted areas and to provide a safe environment for residents to live, work, and raise their families.
U.S. DEPARTMENT OF TREASURY
http://www.treas.gov
The mission of the Treasury Department is to promote prosperous and stable American
and world economies; manage the government's finances; safeguard the U.S. financial
systems, protect the nation's leaders, and secure a safe and drug-free America.
- Bureau of Alcohol, Tobacco & Firearms
http://www.atf.treas.gov/
A law enforcement organization with unique responsibilities dedicated to reducing violent crime, collecting revenue, and protecting the public. ATF enforces federal laws and regulations relating to alcohol, tobacco, firearms, explosives and arson by working directly and in cooperation with others.
OFFICE OF NATIONAL DRUG CONTROL POLICY
http://www.whitehousedrugpolicy.gov
This Office establishes policies, priorities, and objectives for the nation's
drug control program, the goals of which are to reduce illicit drug use, manufacturing,
and trafficking; drug-related crime and violence; and drug-related health consequences.
- The National Youth Anti-Drug Media Campaign
http://www.theantidrug.com
The Campaign seeks to educate youth to reject illegal drugs. It targets youth ages 9-18-especially the vulnerable middle-school adolescents-their parents, and other adults who influence the choices young people make.
- "Major Progress in Reducing Teen Drug Use, Cigarette and Alcohol Use, Gun Carrying, According to 13th Pride Survey." Press Release, September 5, 2000.
- Ibid.
- Resnick, M.D., Bearman, P.S., Blum, R.W., et al. (1997). Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health, Journal of the American Medical Association. 278(10):823-32.
- Belcher, H. and Shinitzky, H.E. (1998). Substance abuse in children: Prediction, protection, and prevention. Archives of Pediatric and Adolescent Medicine. 152(10), 952-960.
- Office of Technology Assessment. (1994). Technologies for Understanding and Preventing Substance Abuse and Addiction.
- Kosterman, R., Hawkins, J.D., Guo, J., Catalano, R.F., Abbott, R. D. (2000). The Dynamics of Alcohol and Marijuana Initiation: Patterns and Predictors of First Use in Adolescence. American Journal of Public Health. 90(3), pp 360-366.
- Hawkins, J. D., Catalano, R. F., Miller, J.R. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin; 112(1): 64-105.
- Department of Health and Human Services. (2000). Healthy People 2010: Understanding and Improving Health.
- Sloboda, Z. and David, S.L. (1997). Preventing Drug Use Among Children and Adolescents. National Institute on Drug Abuse, NIH, publication NO. 97-4212.
- Center for Substance Abuse Prevention. (1999). Here's Proof Prevention Works: Understanding Substance Abuse Prevention: Toward the 21st Century.
- National Clearinghouse for Alcohol and Drug Information. (1995). Making the Link: Violence, Alcohol & Other Drugs. www.health.org:80/govpubs/ml002/index.htm