Drug Use in the USA

Nation’s Youth Turning Away from Marijuana, as Perceptions of Risk Rise; Most Adults with Substance Abuse Problems Are Employed

Secretary Tommy G. Thompson announced today that there is a five percent decline in the number of American youth between the ages of 12 and 17 who have ever used marijuana. Current use of marijuana plummeted nearly 30 percent among 12 and 13 year olds. The findings were included in the 2003 National Survey on Drug Use and Health released today at the annual Recovery Month press conference.

The findings, released by HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA), show that while overall, the change in the category “current use of any illicit drug” was not statistically significant, the use of some drugs decreased sharply. For youth, 12-17, past year use of Ecstasy and LSD dropped precipitously, by 41 percent for Ecstasy and 54 percent for LSD. Overall, 19.5 million Americans ages 12 and older, 8 percent of this population, currently use illicit drugs. The data indicate that of the 16.7 million adult users (18 and older) of illicit drugs in 2003, about 74 percent were employed either full time or part time.

SAMHSA Administrator Charles Curie said: “Employers who think alcohol and drug abuse will never be a problem in their workplace need to consider that more than three quarters of adults who have serious drug and or alcohol problems are employed. Encouraging employees to find help when they need it can result in fewer accidents and fewer workers absent on Monday morning. It may even save an employee’s life, family, or job. Creating a drug-free workplace program or enhancing an existing program can lead to a healthier, more productive work force and be an important part of solving one of our nation’s most persistent problems.”
The survey found that of the 19.4 million adults (age 18 and over) characterized with abuse of or dependence on alcohol or drugs (19.4 million) in 2003, 14.9 million (77 percent) were employed either full or part time. This amounts to over ten percent of full-time workers as well as over ten percent of part-time workers.


Marijuana continues to be the most commonly used illicit drug, with 14.6 million current users (6.2 percent of the population). The study shows that there were an estimated 2.6 million new marijuana users in 2002. About two thirds of these new users were under age 18, and about half were female.

An important positive change detected by the survey was an increase in the perception of risk in using marijuana once a month or more frequently. Both youth and young adults reported a significant increase in their awareness of the risks of smoking marijuana. Particularly striking was the 20 percent decline between 2002 and 2003 in the number of youth that were “heavy users” of marijuana (those smoking either daily or 20 or more days per month). Perceived availability of the drug also declined significantly among youth.

The results of this year’s survey demonstrate that anti-drug messages inside and outside of school, participation in religious and other activities, parental disapproval of substance use and positive attitudes about school are linked to lower rates of youth marijuana use. For example, those exposed to anti-drug messages outside of school had rates of current marijuana use that were 25 percent lower than those not reporting such exposure (7.5 percent vs. 10.0 percent). Youth who believe that their parents would “strongly disapprove” of marijuana had use rates fully 80 percent lower than those who reported that their parents would not “strongly disapprove” (5.4 percent vs. 28.7 percent).


The numbers of binge and heavy drinkers did not change between 2002 and 2003. About 54 million Americans ages 12 and older participated in binge drinking at least once in the 30 days prior to being surveyed. These people had five or more drinks on one or more occasion in the past month. There were 16.1 million heavy drinkers, who had five or more drinks on five or more occasions in the past month. The highest prevalence of binge and heavy drinking in 2003 was among young adults ages 18-25, with both binge and heavy drinking at their peak at age 21.

There were 10.9 million drinkers under legal age (ages 12-20) in the month prior to the survey interview in 2003. This is 29 percent of this age group. Of these, nearly 7.2 million (19.2 percent) were binge drinkers and 2.3 million (6.1 percent) were heavy drinkers.

Drunk driving declined from the 2002 survey, but drugged driving remained similar to that reported in the 2002 survey. An estimated 13.6 percent of persons aged 12 or older drove under the influence of alcohol at least once in the 12 months prior to their interviews (32.3 million people) in 2003, a decrease from 14.2 percent (33.5 million) in 2002. An estimated 10.9 million persons reported driving under the influence of an illicit drug during the past year. This is 4.6 percent of the population ages 12 and older.

Prescription Drug Abuse

Against the backdrop of generally good news, the non-medical lifetime use of prescription pain relievers showed a five percent increase for the population 12 and older, with young adults (18-25) experiencing a 15 percent increase in lifetime, as well as current use. Over all, current use of prescription pain relievers non-medically remained stable from 2002-2003. There was a statistically significant increase in lifetime non-medical use of Vicodin, Lortab, or Lorcet from 13.1 million to 15.7 million. Percocet, Percodan, or Tylox misuse in a lifetime increased from 13.1 million to 15.7 million people. Hydrocodone lifetime non-medical use increased from 4.5 million people to 5.7 million; OxyContin lifetime misuse increased from 1.9 million people to 2.8 million; non-medical methadone use increased from 0.9 million to 1.2 million; and non-medical use of Tramadol increased from 52,000 to 186,000 from 2002 to 2003.

Estimates for persons who currently used psychotherapeutic drugs taken non-medically are similar in 2003 to estimates for 2002. There were 6.3 million persons currently using prescription medications non-medically in 2003, about 2.7 percent of the population ages 12 or older. Of these, an estimated 4.7 million used prescription pain relievers; 1.8 million used tranquilizers; 1.2 million used stimulants, including methamphetamine; and 0.3 million used sedatives.

Other Drugs of Abuse

There were an estimated 2.3 million persons who currently used cocaine in 2003, 604,000 of whom used crack. One million persons used hallucinogens, including LSD, PCP, Ecstasy and other substances, and 119,000 people were estimated to currently use heroin. These projections are all similar to estimates for these drugs in 2002. But, past month inhalant use among youth ages 16 or 17 increased from 0.6 percent in 2002 to 1.0 percent in 2003. Methamphetamine use did not change significantly between 2002 and 2003, with 600,000 past month users each year.

The survey reported 21.6 million Americans in 2003 classified with dependence on drugs, alcohol, or both (9.1 percent of the population ages 12 and older). Over 20 million persons needed but did not receive treatment for an alcohol or drug problem in 2002 and 2003, but the number receiving specialized substance abuse treatment declined from 2.3 million in 2002 to 1.9 million in 2003. Of the 20 million people in need of treatment in 2003 who did not receive it, about 1 million recognized that need. Only 273,000 tried to obtain treatment and were unable to access it. The other 764,000 made no effort to get treatment.

Serious Mental Illness and Substance Abuse

The report found a major correlation between serious mental illness and substance dependence and abuse. In 2003, an estimated 4.2 million adults suffered from serious mental illness and substance dependence or abuse in the past year. Adults who used illicit drugs were more than twice as likely to have serious mental illness, compared to adults who did not use an illicit drug. In 2003, 18.1 percent of adult past-year users of illicit drugs had serious mental illness that year, while the rate was 7.8 percent among adults who had not used an illicit drug. Among adults with substance dependence or abuse, 21.6 percent had serious mental illness, compared to 8.0 percent among those who did not have dependence or abuse.

Among adults with serious mental illness in 2003, 21.3 percent (4.2 million people) were dependent on or abused alcohol or illicit drugs. The rate among adults without serious mental illness was only 7.9 percent.


Tobacco use rates in the past month remained essentially the same from 2002 to 2003, with 70.8 million people reporting current use of a tobacco product. Of these, 60.4 million smoked cigarettes in the past month, 12.8 million smoked cigars, 7.7 million used smokeless tobacco and 1.6 million smoked tobacco in pipes. There were significant declines in past year and lifetime cigarette use among youths ages 12 to 17 between 2002 and 2003, and a decline in the rate of cigarette smoking among young females.

The 2003 survey is based on interviews with 67,784 respondents ages 12 and older who were interviewed in their homes. This includes persons residing in dormitories or homeless shelters. Not included in the survey are persons on active military duty, in prisons, or other institutionalized populations or people who are homeless but not in shelters. Lifetime use is defined as ever used a substance in one’s lifetime. Past year use is having used the substance at least once in the past 12 months. Current use is use in the past 30 days.

Source: SAMHSA Press Office . September 9, 2004 www.oas.samhsa.gov

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