Highlights

This report presents the first information from the 2007 National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of the United States aged 12 years old or older. The survey interviews approximately 67,500 persons each year. Unless otherwise noted, all comparisons in this report described using terms such as "increased," "decreased," or "more than" are statistically significant at the .05 level.

Illicit Drug Use

In 2007, an estimated 19.9 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 8.0 percent of the population aged 12 years old or older. Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used nonmedically.
The rate of current illicit drug use among persons aged 12 or older in 2007 (8.0 percent) was similar to the rate in 2006 (8.3 percent).
Marijuana was the most commonly used illicit drug (14.4 million past month users). Among persons aged 12 or older, the rate of past month marijuana use in 2007 (5.8 percent) was similar to the rate in 2006 (6.0 percent).
In 2007, there were 2.1 million current cocaine users aged 12 or older, comprising 0.8 percent of the population. These estimates were similar to the number and rate in 2006 (2.4 million or 1.0 percent).
Hallucinogens were used in the past month by 1.0 million persons (0.4 percent) aged 12 or older in 2007, including 503,000 (0.2 percent) who had used Ecstasy. These estimates were similar to the corresponding estimates for 2006.
There were 6.9 million (2.8 percent) persons aged 12 or older who used prescription-type psychotherapeutic drugs nonmedically in the past month. Of these, 5.2 million used pain relievers, the same as the number in 2006.
In 2007, there were an estimated 529,000 current users of methamphetamine aged 12 or older (0.2 percent of the population). These estimates were not significantly different from the estimates for 2006 (731,000 or 0.3 percent).
Among youths aged 12 to 17, the current illicit drug use rate remained stable from 2006 (9.8 percent) to 2007 (9.5 percent). Between 2002 and 2007, youth rates declined significantly for illicit drugs in general (from 11.6 to 9.5 percent) and for marijuana, cocaine, hallucinogens, LSD, Ecstasy, prescription-type drugs used nonmedically, pain relievers, stimulants, methamphetamine, and the use of illicit drugs other than marijuana.
The rate of current marijuana use among youths aged 12 to 17 declined from 8.2 percent in 2002 to 6.7 percent in 2007. The rate decreased for both males (from 9.1 to 7.5 percent) and females (from 7.2 to 5.8 percent).
Among young adults aged 18 to 25, there were decreases from 2006 to 2007 in the rate of current use of several drugs, including cocaine (from 2.2 to 1.7 percent), Ecstasy (from 1.0 to 0.7 percent), stimulants (from 1.4 to 1.1 percent), methamphetamine (from 0.6 to 0.4 percent), and illicit drugs other than marijuana (from 8.9 to 8.1 percent).
From 2002 to 2007, there was an increase among young adults aged 18 to 25 in the rate of current use of prescription pain relievers, from 4.1 to 4.6 percent. There were decreases in the use of hallucinogens (from 1.9 to 1.5 percent), Ecstasy (from 1.1 to 0.7 percent), and methamphetamine (from 0.6 to 0.4 percent).
Among those aged 50 to 54, the rate of past month illicit drug use increased from 3.4 percent in 2002 to 5.7 percent in 2007. Among those aged 55 to 59, current illicit drug use showed an increase from 1.9 percent in 2002 to 4.1 percent in 2007. These trends may partially reflect the aging into these age groups of the baby boom cohort, whose lifetime rates of illicit drug use are higher than those of older cohorts.
Among persons aged 12 or older who used pain relievers nonmedically in the past 12 months, 56.5 percent reported that the source of the drug the most recent time they used was from a friend or relative for free. Another 18.1 percent reported they got the drug from just one doctor. Only 4.1 percent got the pain relievers from a drug dealer or other stranger, and 0.5 percent reported buying the drug on the Internet. Among those who reported getting the pain reliever from a friend or relative for free, 81.0 percent reported in a follow-up question that the friend or relative had obtained the drugs from just one doctor.
Among unemployed adults aged 18 or older in 2007, 18.3 percent were current illicit drug users, which was higher than the 8.4 percent of those employed full time and 10.1 percent of those employed part time. However, most illicit drug users were employed. Of the 17.4 million current illicit drug users aged 18 or older in 2007, 13.1 million (75.3 percent) were employed either full or part time.
In 2007, there were 9.9 million persons aged 12 or older who reported driving under the influence of illicit drugs during the past year. This corresponds to 4.0 percent of the population aged 12 or older, similar to the rate in 2006 (4.2 percent), but lower than the rate in 2002 (4.7 percent). In 2007, the rate was highest among young adults aged 18 to 25 (12.5 percent).

Alcohol Use

Slightly more than half of Americans aged 12 or older reported being current drinkers of alcohol in the 2007 survey (51.1 percent). This translates to an estimated 126.8 million people, which was similar to the 2006 estimate of 125.3 million people (50.9 percent).
More than one fifth (23.3 percent) of persons aged 12 or older participated in binge drinking (having five or more drinks on the same occasion on at least 1 day in the 30 days prior to the survey) in 2007. This translates to about 57.8 million people, similar to the estimate in 2006.
In 2007, heavy drinking was reported by 6.9 percent of the population aged 12 or older, or 17.0 million people. This rate was the same as the rate of heavy drinking in 2006. Heavy drinking is defined as binge drinking on at least 5 days in the past 30 days.
In 2007, among young adults aged 18 to 25, the rate of binge drinking was 41.8 percent, and the rate of heavy drinking was 14.7 percent. These rates were similar to the rates in 2006.
The rate of current alcohol use among youths aged 12 to 17 was 15.9 percent in 2007. Youth binge and heavy drinking rates were 9.7 and 2.3 percent, respectively. These rates were essentially the same as the 2006 rates.
Past month and binge drinking rates among underage persons (aged 12 to 20) have remained essentially unchanged since 2002. In 2007, about 10.7 million persons aged 12 to 20 (27.9 percent of this age group) reported drinking alcohol in the past month. Approximately 7.2 million (18.6 percent) were binge drinkers, and 2.3 million (6.0 percent) were heavy drinkers.
Among persons aged 12 to 20, past month alcohol use rates in 2007 were 16.8 percent among Asians, 18.3 percent among blacks, 24.7 percent among Hispanics, 26.2 percent among those reporting two or more races, 28.3 percent among American Indians or Alaska Natives, and 32.0 percent among whites.
In 2007, 56.3 percent of current drinkers aged 12 to 20 reported that their last use of alcohol in the past month occurred in someone else's home, and 29.4 percent reported that it had occurred in their own home. About one third (30.2 percent) paid for the alcohol the last time they drank, including 8.2 percent who purchased the alcohol themselves and 21.8 percent who gave money to someone else to purchase it. Among those who did not pay for the alcohol they last drank, 37.2 percent got it from an unrelated person aged 21 or older, 20.7 percent from another person under 21 years of age, and 19.5 percent got it from a parent, guardian, or other adult family member.
In 2007, an estimated 12.7 percent of persons aged 12 or older drove under the influence of alcohol at least once in the past year. This percentage has decreased since 2002, when it was 14.2 percent. From 2006 to 2007, the rate of driving under the influence of alcohol among persons aged 18 to 25 decreased from 24.4 to 22.8 percent.

Tobacco Use

In 2007, an estimated 70.9 million Americans aged 12 or older were current (past month) users of a tobacco product. This represents 28.6 percent of the population in that age range. In addition, 60.1 million persons (24.2 percent of the population) were current cigarette smokers; 13.3 million (5.4 percent) smoked cigars; 8.1 million (3.2 percent) used smokeless tobacco; and 2.0 million (0.8 percent) smoked tobacco in pipes.
The rate of current use of any tobacco product among persons aged 12 or older decreased from 29.6 percent in 2006 to 28.6 percent in 2007, but the rates of current use of cigarettes, smokeless tobacco, cigars, and pipe tobacco did not change significantly over that period. Between 2002 and 2007, past month use of any tobacco product decreased from 30.4 to 28.6 percent, and past month cigarette use declined from 26.0 to 24.2 percent. Rates of past month use of cigars, smokeless tobacco, and pipe tobacco were similar in 2002 and 2007.
The rate of past month cigarette use among 12 to 17 year olds declined from 13.0 percent in 2002 to 9.8 percent in 2007. However, past month smokeless tobacco use was higher in 2007 (2.4 percent) than in 2002 (2.0 percent).
Among pregnant women aged 15 to 44, combined data for 2006 and 2007 indicated that the rate of past month cigarette use was 16.4 percent. The rate was higher among women in that age group who were not pregnant (28.4 percent).

Initiation of Substance Use (Incidence, or First-Time Use) within the Past 12 Months

In 2007, an estimated 2.7 million persons aged 12 or older used an illicit drug for the first time within the past 12 months. A majority of these past year illicit drug initiates reported that their first drug was marijuana (56.2 percent). Nearly one third initiated with psychotherapeutics (30.6 percent, including 19.0 percent with pain relievers, 6.5 percent with tranquilizers, 4.1 percent with stimulants, and 1.1 percent with sedatives). A sizable proportion reported inhalants (10.7 percent) as their first illicit drug, and a small proportion used hallucinogens as their first drug (2.0 percent).
The illicit drug categories with the largest number of past year initiates among persons aged 12 or older were nonmedical use of pain relievers (2.1 million) and marijuana use (2.1 million). These estimates were not significantly different from the numbers in 2006.
In 2007, there were 775,000 persons aged 12 or older who had used inhalants for the first time within the past 12 months; 66.3 percent were under age 18 when they first used. There was no significant change in the number of inhalant initiates from 2006 to 2007.
The number of past year initiates of methamphetamine among persons aged 12 or older was 157,000 in 2007. This estimate was significantly lower than the estimate in 2002 (299,000), 2003 (260,000), 2004 (318,000), and 2006 (259,000).
Ecstasy initiation remained essentially unchanged from 2006 (860,000) to 2007 (781,000), but was lower in 2007 than in 2002 (1.2 million).
Most (85.9 percent) of the 4.6 million past year alcohol initiates were younger than age 21 at the time of initiation.
The number of persons aged 12 or older who smoked cigarettes for the first time within the past 12 months was 2.2 million in 2007, which was significantly lower than the estimate in 2006 (2.4 million) but significantly higher than the estimate for 2002 (1.9 million). Most new smokers in 2007 were under age 18 when they first smoked cigarettes (59.7 percent).

Youth Prevention-Related Measures

Perceived risk is measured by NSDUH as the percentage reporting that there is great risk in the substance use behavior. Among youths aged 12 to 17, there were no changes in the perceived risk of marijuana, cocaine, or heroin use between 2006 and 2007. However, between 2002 and 2007, there were increases in the perceived risk of smoking marijuana once a month (from 32.4 to 34.5 percent) and smoking marijuana once or twice a week (from 51.5 to 54.7 percent). On the other hand, the percentage of youths who perceived that trying heroin once or twice is a great risk declined from 58.5 percent in 2002 to 57.0 percent in 2007, and those who perceived that using LSD once or twice a week is a great risk declined from 76.2 to 74.2 percent.
Almost half (49.1 percent) of youths aged 12 to 17 reported in 2007 that it would be "fairly easy" or "very easy" for them to obtain marijuana if they wanted some. Around one quarter reported it would be easy to get cocaine (24.5 percent). About one in seven (14.1 percent) indicated that heroin would be "fairly" or "very" easily available, and 14.4 percent reported easy availability for LSD.
The percentage of youths aged 12 to 17 reporting that it would be easy to obtain cocaine declined from 25.9 percent in 2006 to 24.5 percent in 2007. In addition, the perceived availability decreased between 2002 and 2007 for marijuana (from 55.0 to 49.1 percent), heroin (from 15.8 to 14.1 percent), and LSD (from 19.4 to 14.4 percent).
A majority of youths aged 12 to 17 (91.0 percent) in 2007 reported that their parents would strongly disapprove of their trying marijuana or hashish once or twice. Current marijuana use was much less prevalent among youths who perceived strong parental disapproval for trying marijuana or hashish once or twice than for those who did not (4.6 vs. 28.1 percent).
In 2007, 11.3 percent of youths aged 12 to 17 reported that they had participated in substance use prevention programs outside of school within the past year. Almost four fifths (77.9 percent) reported having seen or heard drug or alcohol prevention messages from sources outside of school, lower than in 2002 when the percentage was 83.2 percent. Most (59.6 percent) youths reported in 2007 that they had talked with a parent in the past year about the dangers of drug, tobacco, or alcohol use.

Substance Dependence, Abuse, and Treatment

In 2007, an estimated 22.3 million persons (9.0 percent of the population aged 12 or older) were classified with substance dependence or abuse in the past year based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Of these, 3.2 million were classified with dependence on or abuse of both alcohol and illicit drugs, 3.7 million were dependent on or abused illicit drugs but not alcohol, and 15.5 million were dependent on or abused alcohol but not illicit drugs.
Between 2002 and 2007, there was no change in the number of persons with substance dependence or abuse (22.0 million in 2002, 22.3 million in 2007).
The specific illicit drugs that had the highest levels of past year dependence or abuse in 2007 were marijuana (3.9 million), followed by pain relievers (1.7 million) and cocaine (1.6 million).
Adults aged 21 or older who had first used alcohol before age 21 were more likely than adults who had their first drink at age 21 or older to be classified with alcohol dependence or abuse (9.6 vs. 2.2 percent).
The rate of substance dependence or abuse for males aged 12 or older in 2007 was about twice as high as the rate for females (12.5 vs. 5.7 percent). Among youths aged 12 to 17, however, the rate of substance dependence or abuse among males was the same as the rate among females (7.7 percent for both).
Treatment need is defined as having a substance use disorder or receiving treatment at a specialty facility (hospital inpatient, drug or alcohol rehabilitation, or mental health centers) within the past 12 months. In 2007, 23.2 million persons aged 12 or older needed treatment for an illicit drug or alcohol use problem (9.4 percent of persons aged 12 or older). Of these, 2.4 million (1.0 percent of persons aged 12 or older and 10.4 percent of those who needed treatment) received treatment at a specialty facility. Thus, 20.8 million persons (8.4 percent of the population aged 12 or older) needed treatment for an illicit drug or alcohol use problem but did not receive treatment at a specialty substance abuse facility in the past year.
Of the 20.8 million people in 2007 who were classified as needing substance use treatment but did not receive treatment at a specialty facility in the past year, 1.3 million persons (6.4 percent) reported that they felt they needed treatment for their illicit drug or alcohol use problem. Of these 1.3 million persons who felt they needed treatment, 380,000 (28.5 percent) reported that they made an effort to get treatment, and 955,000 (71.5 percent) reported making no effort to get treatment.

Mental Health

Serious psychological distress (SPD) is an overall indicator of past year nonspecific psychological distress that is constructed from the K6 scale administered to adults aged 18 or older in NSDUH. In 2007, there were an estimated 24.3 million adults aged 18 or older in the United States with SPD in the past year. This represents 10.9 percent of all adults in this country, a rate similar to the SPD rate in 2006 (11.3 percent) but below the rate in 2004 (12.2 percent).
Rates of SPD in 2007 were highest for adults aged 18 to 25 (17.9 percent) and lowest for adults aged 50 or older (7.0 percent).
The prevalence of SPD among women aged 18 or older (13.4 percent) was higher than that among men in that age group (8.2 percent).
SPD in the past year was associated with past year substance dependence or abuse in 2007. Among adults aged 18 or older with SPD in 2007, 22.1 percent (5.4 million) were dependent on or abused illicit drugs or alcohol. The rate among adults without SPD was 7.6 percent (15.0 million).
Among the 24.3 million adults with SPD in 2007, 10.8 million (44.6 percent) used mental health services in the past year. Among all adults with SPD, 38.8 percent received a prescription medication, 27.3 percent received outpatient services, and 5.1 percent received inpatient services for a mental health problem in the past year.
Among the 5.4 million adults with both SPD and substance dependence or abuse (i.e., a substance use disorder) in 2007, nearly half (46.5 percent) received mental health care or substance use treatment at a specialty facility; 10.4 percent received both mental health care and specialty substance use treatment, 33.3 percent received only mental health care, and 2.8 percent received only specialty substance use treatment.
In 2007, 7.5 percent of persons aged 18 or older (16.5 million persons) had at least one major depressive episode (MDE) in the past year. Almost 1 in 20 adults (4.6 percent or 10.1 million persons) had a past year MDE with severe impairment.
Having MDE in the past year was associated with past year substance dependence or abuse. In 2007, adults aged 18 or older with past year MDE had higher rates of past year illicit drug use than those without MDE (27.4 vs. 12.8 percent). Adults with past year MDE were more likely than those without MDE to be dependent on or abuse illicit drugs (8.8 vs. 2.1 percent) and alcohol (17.0 vs. 7.0 percent).
Among adults aged 18 or older who had MDE in the past year, 64.5 percent received treatment (i.e., saw or talked to a medical doctor or other professional or used prescription medication) for depression in the same time period, which was lower than in 2006 (69.1 percent).
Among adults aged 18 or older with MDE in the past year in 2007, women were more likely than men to receive treatment for depression in the past year (68.0 vs. 57.8 percent), though the treatment rate for women was significantly lower than in 2006 (73.7 percent).
In 2007, there were 2.0 million youths (8.2 percent of the population aged 12 to 17) who had MDE during the past year. An estimated 1.4 million (5.5 percent) had MDE with severe impairment in one or more role domains (chores at home; school or work; close relationships with family; or social life).
The rate of MDE in the past year was higher for adolescent females (11.9 percent) than for adolescent males (4.6 percent). The prevalence of MDE with severe impairment was 8.2 percent for females and 3.0 percent for males.
Among 12 to 17 year olds who had past year MDE in 2007, 35.5 percent had used illicit drugs during the same period. This was higher than the rate of 17.2 percent among youths who did not have past year MDE. Similarly, the rates of past month daily cigarette use and heavy alcohol use were higher for youths with MDE (4.8 and 3.8 percent, respectively) than for youths who did not have MDE (2.3 and 2.2 percent, respectively).
In 2007, 38.9 percent of youths aged 12 to 17 with past year MDE received treatment for depression (saw or talked to a medical doctor or other professional or used prescription medication). Among youths with past year MDE, 20.5 percent saw or talked to a medical doctor or other professional only, 2.5 percent used prescription medication only, and 15.6 percent received treatment from both sources for depression in the past year.
In 2007, 3.1 million youths aged 12 to 17 (12.5 percent) received treatment or counseling for problems with behavior or emotions in the specialty mental health setting (inpatient or outpatient care). Additionally, 11.5 percent of youths received services in the education setting, and 2.8 percent received mental health services in the general medical setting in the past 12 months. Mental health services were received in both the specialty setting and either the education or general medical settings (i.e., care from multiple settings) by 5.1 percent of youths.

1. Introduction

This report presents the first information from the 2007 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. This initial report on the 2007 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 depression and on the co-occurrence of substance use and mental health problems. Estimates from NSDUH for States and areas within States will be presented in separate reports.

A major focus of this report is a comparison of substance use prevalence estimates between 2006 and 2007. Trends since 2002 also are discussed for some measures. 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 through 2007 NSDUHs should not be compared with estimates from the 2001 and earlier surveys in the series to assess changes in substance use and mental health problems over time.

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 the respondent's place of residence. The survey is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services, and is planned and managed by SAMHSA's Office of Applied Studies (OAS). Data collection and analysis are 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 and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories) and from civilians living on military bases. The survey excludes homeless persons who do not use shelters, military personnel on active duty, and residents of institutional group quarters, such as jails and hospitals. Appendix D 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).

The 2007 NSDUH employed a State-based design with an independent, multistage area probability sample within each State 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 support State estimates using small area estimation (SAE) techniques. The design oversampled youths and young adults, so that each State's sample was approximately equally distributed among three age groups: 12 to 17 years, 18 to 25 years, and 26 years or older.

Nationally, 141,487 addresses were screened for the 2007 survey, and 67,870 completed interviews were obtained. The survey was conducted from January through December 2007. Weighted response rates for household screening and for interviewing were 89.5 and 73.9 percent, respectively. See Appendix B for more information on NSDUH response rates.

1.2. Trend Measurement

Although the design of the 2002 through 2007 NSDUHs is similar to the design of the 1999 through 2001 surveys, there are important methodological differences that affect the comparability of the 2002-2007 estimates with estimates from prior surveys. The most important change was the incentive payment started in 2002 and continuing in subsequent surveys. Each NSDUH respondent completing the interview is given $30. The name of the survey was also changed in 2002, from the National Household Survey on Drug Abuse (NHSDA) to the current name. In addition, improved data collection quality control procedures were introduced in the survey starting in 2001, and updated population data from the 2000 decennial census were incorporated into NSDUH sample weighting procedures starting with the 2002 estimates. Analyses of the effects 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 the 2004 NSDUH report on national findings discusses this issue in more detail (see OAS, 2005b).

1.3. Change in Estimates for Psychotherapeutic Drugs and Stimulants

This report includes revised estimates of nonmedical use of prescription psychotherapeutic drugs and prescription stimulants that take into account data on methamphetamine use based on information obtained from survey items added to NSDUH in 2005, 2006, and 2007. The 2006 NSDUH national findings report incorporated revised estimates for methamphetamine use based on these new items (OAS, 2007b), and this report extends the revisions to use of stimulants and any prescription psychotherapeutics. In a methodological study, these measures were found to be noticeably higher when the data from the new methamphetamine use items were taken into account. Estimates for use of illicit drugs overall and use of illicit drugs other than marijuana, however, were affected only minimally by these methamphetamine use items and were not revised. See Section B.4.6 in Appendix B for more information on the results of this study.

The 2006 estimates for nonmedical use of stimulants and prescription psychotherapeutics in this report have been revised based on the additional questions on methamphetamine use, and statistical adjustments have been applied to the estimates from 2002 to 2005. These modifications control for the potentially confounding effects of the questionnaire changes and enable year-to-year comparisons to be made over the period from 2002 to 2007. Section B.4.6 in Appendix B provides a discussion of the revised measures and the procedures used to generate estimates based on them. Because of these changes, estimates for nonmedical use of stimulants and psychotherapeutic drugs in this report are not comparable to corresponding estimates in previous NSDUH reports. Methamphetamine use estimates in this report also are not comparable with those in NSDUH reports for survey years prior to 2006.

1.4. Format of Report and Explanation of Tables

This report has separate chapters that discuss the national findings on seven topics: use of illicit drugs; use of alcohol; use of tobacco products; initiation of substance use; prevention-related issues; substance dependence, abuse, and treatment; and mental health problems and treatment. A final chapter summarizes the results and discusses key findings in relation to other research and survey results. Technical appendices describe the survey (Appendix A), provide technical details on the statistical methods and measurement (Appendix B), offer key NSDUH definitions (Appendix C), discuss other sources of related data (Appendix D), list the references cited in the report (as well as other relevant references) (Appendix E), and present selected tabulations of estimates (Appendices F and G).

Tables, text, and figures present prevalence measures for the population in terms of both the number of persons and the percentage of the population. Substance use tables show prevalence estimates 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 in which estimates are presented by year have footnotes indicating whether the 2007 estimates are significantly different from 2006 or earlier estimates.

Statistical tests have been conducted for all statements appearing in the text of the report that compare estimates between years or subgroups of the population. Unless explicitly stated that a difference is not statistically significant, all statements that describe differences are significant at the .05 level. Statistically significant differences are described using terms such as "higher," "lower," "increased," and "decreased." Statements that use terms such as "similar," "no difference," "same," or "remained steady" to describe the relationship between estimates denote that a difference is not statistically significant. In addition, a set of estimates for survey years or population subgroups may be presented without a statement of comparison, in which case a statistically significant difference between these estimates is not implied and testing was not conducted.

All estimates presented in the report have met the criteria for statistical reliability (see Section B.2.2 of Appendix B). Estimates that do not meet these criteria are suppressed and do not appear in tables, figures, or text. Also, subgroups with suppressed estimates are not included in statistical tests of comparisons. For example, a statement that "whites had the highest prevalence" means that the rate among whites was higher than the rate among all nonsuppressed racial/ethnic subgroups, but not necessarily higher than the rate among a subgroup for which the estimate was suppressed.

Data are presented for racial/ethnic groups based on current guidelines for collecting and reporting race and ethnicity data (Office of Management and Budget [OMB], 1997). 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 basic groups listed in the survey question (white, black or African American, American Indian or Alaska Native, Native Hawaiian, Other Pacific Islander, Asian, Other). Respondents choosing both Native Hawaiian and Other Pacific Islander but no other categories mentioned above are classified in the combined "Native Hawaiian or Other Pacific Islander" category instead of the "two or more race" category. 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.

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. Census Bureau, 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 also are made based on county type, a variable that reflects different levels of urbanicity and metropolitan area inclusion of counties, based on metropolitan area definitions issued by the 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 a population of 20,000 or more 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.

1.5. Other NSDUH Reports and Data

Other reports focusing on specific topics of interest will be produced using the 2007 NSDUH data and made available on SAMHSA's website. A report on State-level estimates for 2006-2007 will be available in early 2009.

A comprehensive set of tables, referred to as "detailed tables," is available through the Internet at http://oas.samhsa.gov. The tables are organized into sections based primarily on the topic, and most tables are provided in several parts, showing population estimates (e.g., numbers of drug users), rates (e.g., percentages of population using drugs), and standard errors of all nonsuppressed estimates. A small subset of these detailed tables has been selected for inclusion in Appendices F and G of this report. The appendix tables can be mapped back to the detailed 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 8.1A 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://oas.samhsa.gov). In addition, OAS makes public use data files available to researchers through the Substance Abuse and Mental Health Data Archive (SAMHDA, 2008) at http://www.icpsr.umich.edu/SAMHDA/index.html. Currently, files are available from the 1979 to 2006 surveys.² The 2007 NSDUH public use file will be available by the end of 2008.

2. Illicit Drug Use

The National Survey on Drug Use and Health (NSDUH) obtains information on nine different categories of illicit drug use: 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, psilocybin mushrooms, and "Ecstasy" (MDMA). Inhalants include a variety of substances, such as nitrous oxide, amyl nitrite, cleaning fluids, gasoline, spray paint, other aerosol sprays, and glue. The four categories of prescription-type drugs (pain relievers, tranquilizers, stimulants, and sedatives) cover numerous medications available by prescription and drugs within these groupings that may be manufactured illegally, such as methamphetamine, which is included under stimulants. Respondents are asked to report only "nonmedical" use of these drugs, defined as use without a prescription of the individual's own or simply for the experience or feeling the drugs caused. Use of over-the-counter drugs and legitimate use 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.

This chapter includes revised estimates of the nonmedical use of prescription psychotherapeutic drugs and prescription stimulants that take into account data on methamphetamine use based on information obtained from survey items added to NSDUH in 2005, 2006, and 2007. The 2006 NSDUH national findings report incorporated revised estimates for methamphetamine use based on these additional items (Office of Applied Studies [OAS], 2007b), and this report extends the revisions to use of stimulants and any prescription psychotherapeutics. In a methodological study, these measures were found to be noticeably higher when the data from the additional methamphetamine use items were taken into account. Estimates for use of illicit drugs overall and use of illicit drugs other than marijuana, however, were affected only minimally by these methamphetamine use items and were not revised. See Section B.4.6 in Appendix B for more information on the results of this study.

The 2006 estimates for nonmedical use of stimulants and prescription psychotherapeutics in this report have been revised based on the additional questions on methamphetamine use, and statistical adjustments have been applied to the estimates from 2002 to 2005. These modifications control for the potentially confounding effects of the questionnaire changes and enable year-to-year comparisons to be made over the period from 2002 to 2007. Section B.4.6 in Appendix B provides a discussion of the revised measures and the procedures used to generate estimates based on them. Because of these changes, estimates for the nonmedical use of stimulants and psychotherapeutic drugs in this report are not comparable with corresponding estimates in previous NSDUH reports. Methamphetamine use estimates in this report also are not comparable with those in NSDUH reports for survey years prior to 2006.

In 2007, an estimated 19.9 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 (Figure 2.1). This estimate represents 8.0 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 2007 (8.0 percent) was similar to the rate in 2006 (8.3 percent) and has remained stable since 2002 (8.3 percent) (Figure 2.2).

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Figure 2.1 Past Month Illicit Drug Use among Persons Aged 12 or Older: 2007

Figure 2.1

¹ Illicit Drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used nonmedically.

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Figure 2.2 Past Month Use of Selected Illicit Drugs among Persons Aged 12 or Older: 2002-2007

Figure 2.2

⁺ Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

Marijuana was the most commonly used illicit drug (14.4 million past month users). In 2007, marijuana was used by 72.8 percent of current illicit drug users and was the only drug used by 53.3 percent of them. Illicit drugs other than marijuana were used by 9.3 million persons or 46.7 percent of illicit drug users aged 12 or older. Current use of other drugs but not marijuana was reported by 27.2 percent of illicit drug users, and 19.4 percent used both marijuana and other drugs.
Among persons aged 12 or older, the overall rate of past month marijuana use in 2007 (5.8 percent) was similar to the rate in 2006 and the rates in earlier years going back to 2002 (Figure 2.2).
An estimated 9.3 million people aged 12 or older (3.7 percent) were current users of illicit drugs other than marijuana in 2007. Most (6.9 million persons, or 2.8 percent of the population) used psychotherapeutic drugs nonmedically. In addition to the estimated 5.2 million nonmedical users of pain relievers in 2007, 1.8 million used tranquilizers, 1.1 million used stimulants, and 346,000 used sedatives. The numbers of nonmedical users of pain relievers, tranquilizers, and sedatives in 2007 were similar to the corresponding numbers in 2006, and the percentage rates also remained stable (Figure 2.3). However, the number and percentage of nonmedical stimulant users decreased from 2006 to 2007.

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Figure 2.3 Past Month Nonmedical Use of Types of Psychotherapeutic Drugs among Persons Aged 12 or Older: 2002-2007

Figure 2.3

⁺ Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

The estimated number and percentage of persons aged 12 or older who used cocaine in the past month in 2007 (2.1 million users or 0.8 percent of the population) were similar to those in 2006 (2.4 million or 1.0 percent) and 2002 (2.0 million or 0.9 percent). The number of past month crack users was also similar over this period (610,000 in 2007 vs. 702,000 in 2006 and 567,000 in 2002).
Hallucinogens were used in the past month by 1.0 million persons aged 12 or older (0.4 percent) in 2007, including 503,000 (0.2 percent) who had used Ecstasy. These estimates are similar to the corresponding estimates for 2006. However, lifetime use of Ecstasy increased from 10.2 million persons (4.3 percent) in 2002 to 12.4 million (5.0 percent) in 2007, while past year use of Ecstasy decreased from 3.2 million (1.3 percent) to 2.1 million (0.9 percent) over the same period.
The number of current heroin users decreased from 338,000 in 2006 to 153,000 in 2007, and the corresponding prevalence rate decreased from 0.14 to 0.06 percent.
In both 2006 and 2007, an estimated 5.2 million persons aged 12 or older (2.1 percent in each year) were current nonmedical users of prescription pain relievers (Figure 2.3). This number was higher than the estimated 4.4 million in 2002, but the difference between the rates in 2002 and 2007 (1.9 and 2.1 percent, respectively) was not statistically significant. However, the rate was higher in 2007 (2.1 percent) than in 2004 (1.8 percent).
In 2007, the estimated number of past month nonmedical users of stimulants aged 12 or older, 1.1 million, was lower than it had been in 2006 (1.4 million); the corresponding rates also showed a decline (from 0.6 percent in 2006 to 0.4 percent in 2007). These numbers for stimulants included 529,000 persons (0.2 percent) who were current users of methamphetamine in 2007, similar to the number and rate in 2006 (731,000 persons or 0.3 percent of the population). However, the estimated number of past year methamphetamine users declined from 1.9 million in 2006 to 1.3 million in 2007, and the corresponding rate declined from 0.8 to 0.5 percent.

Age

In 2007, rates of past month illicit drug use varied with age. Through the adolescent years from 12 to 17, the rates of current illicit drug use increased from 3.3 percent at ages 12 or 13 to 8.9 percent at ages 14 or 15 to 16.0 percent at ages 16 or 17 (Figure 2.4). The highest rate was among persons aged 18 to 20 (21.6 percent). The rate was 18.5 percent among those aged 21 to 25, 12.8 percent among those aged 26 to 29, and 0.7 percent among those aged 65 or older.

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Figure 2.4 Past Month Illicit Drug Use among Persons Aged 12 or Older, by Age: 2007

Figure 2.4

Although adults aged 26 or older were less likely to be current drug users in 2007 than youths aged 12 to 17 or young adults aged 18 to 25 (5.8 vs. 9.5 and 19.7 percent, respectively), there were more drug users aged 26 or older (11.0 million) than in the 12-to-17-year age group (2.4 million) and 18-to-25-year age group (6.5 million) combined.
Current illicit drug use remained stable from 2006 to 2007 among youths aged 12 to 17, young adults aged 18 to 25, and adults aged 26 or older. From 2002 to 2007, however, the rate of current illicit drug use among 12 to 17 year olds decreased from 11.6 to 9.5 percent (Figure 2.5).

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Figure 2.5 Past Month Use of Selected Illicit Drugs among Youths Aged 12 to 17: 2002-2007

Figure 2.5

⁺ Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

Youths Aged 12 to 17

In 2007, 9.5 percent of youths aged 12 to 17 were current illicit drug users: 6.7 percent used marijuana, 3.3 percent engaged in nonmedical use of prescription-type psychotherapeutics, 1.2 percent used inhalants, 0.7 percent used hallucinogens, and 0.4 percent used cocaine.
Among youths aged 12 to 17, the types of drugs used in the past month varied by age group. Among 12 or 13 year olds, 1.4 percent used prescription-type drugs nonmedically, 1.1 percent used inhalants, and 0.9 percent used marijuana. Among 14 or 15 year olds, marijuana was the most commonly used drug (5.7 percent), followed by prescription-type drugs used nonmedically (3.4 percent), and then inhalants (1.4 percent). Marijuana also was the most commonly used drug among 16 or 17 year olds (13.1 percent), followed by prescription-type drugs used nonmedically (4.9 percent), and then hallucinogens (1.2 percent), inhalants (1.0 percent), and cocaine (0.9 percent).
Rates of current use remained stable from 2006 to 2007 among youths aged 12 to 17 for all drugs except use of heroin, which decreased from 0.06 to 0.01 percent, and nonmedical use of tranquilizers, which increased from 0.5 to 0.7 percent.
From 2002 to 2007, rates of current use among youths aged 12 to 17 declined significantly for illicit drugs overall and for several specific drugs, including marijuana, cocaine, hallucinogens, LSD, Ecstasy, prescription-type drugs used nonmedically, pain relievers, stimulants, methamphetamine, and the use of illicit drugs other than marijuana (Figure 2.5). For illicit drug use overall, the rates were 11.6 percent in 2002, 11.2 percent in 2003, 10.6 percent in 2004, 9.9 percent in 2005, 9.8 percent in 2006, and 9.5 percent in 2007.
The rate of current marijuana use among youths aged 12 to 17 decreased from 8.2 percent in 2002 to 6.7 percent in 2007. Significant declines were also evident between 2002 and 2007 for past year marijuana use (from 15.8 to 12.5 percent) and lifetime marijuana use (from 20.6 to 16.2 percent).
Current use of illicit drugs other than marijuana among 12 to 17 year olds declined from 5.7 percent in 2002 to 4.7 percent in 2007. Over the same period, past month nonmedical use of psychotherapeutic drugs decreased from 4.0 to 3.3 percent, nonmedical use of pain relievers declined from 3.2 to 2.7 percent, nonmedical use of stimulants decreased from 0.8 to 0.5 percent, and methamphetamine use declined from 0.3 to 0.1 percent. Youths' current use of hallucinogens declined from 1.0 percent in 2002 to 0.7 percent in 2007, reflecting decreases in current use of Ecstasy (from 0.5 to 0.3 percent) and LSD (from 0.2 to 0.1 percent).

Young Adults Aged 18 to 25

Rates of current use of illicit drugs in 2007 were higher for young adults aged 18 to 25 (19.7 percent) than for youths aged 12 to 17 (9.5 percent) and adults aged 26 or older (5.8 percent). Among young adults, 16.4 percent used marijuana, 6.0 percent used prescription-type drugs nonmedically, 1.7 percent used cocaine, and 1.5 percent used hallucinogens (Figure 2.6).

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Figure 2.6 Past Month Use of Selected Illicit Drugs among Young Adults Aged 18 to 25: 2002-2007

Figure 2.6

⁺ Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

From 2006 to 2007, current use of several illicit drugs declined among young adults aged 18 to 25. Use of cocaine decreased from 2.2 to 1.7 percent, Ecstasy use declined from 1.0 to 0.7 percent, stimulant use went from 1.4 to 1.1 percent, methamphetamine use declined from 0.6 to 0.4 percent, and use of illicit drugs other than marijuana decreased from 8.9 to 8.1 percent.
From 2002 to 2007, the rate of current use of prescription pain relievers among young adults aged 18 to 25 increased from 4.1 to 4.6 percent. Past month use of hallucinogens overall decreased from 1.9 to 1.5 percent, and use of Ecstasy decreased from 1.1 to 0.7 percent; however, use of LSD increased from 0.1 to 0.2 percent. A decline also was seen in current use of methamphetamine (0.6 percent in 2002 vs. 0.4 percent in 2007).

Adults Aged 26 or Older

Among adults aged 26 or older, 5.8 percent reported current illicit drug use in 2007. In this age group, 3.9 percent used marijuana and 2.2 percent used prescription-type drugs nonmedically. Less than 1 percent used cocaine (0.7 percent), hallucinogens (0.2 percent), heroin (0.1 percent), and inhalants (0.1 percent). The only significant change between 2006 and 2007 in the rates of past month use among adults in this age group involved heroin, which decreased from 0.14 to 0.05 percent. Lifetime use of marijuana among adults aged 26 or older increased from 40.6 percent in 2006 to 42.0 percent in 2007, while past year nonmedical use of stimulants declined from 1.0 to 0.8 percent and past year use of methamphetamine decreased from 0.6 to 0.4 percent.
Among adults aged 50 to 59, the rate of current illicit drug use showed an irregular increasing trend between 2002 and 2007 (Figure 2.7). For those aged 50 to 54, the rate increased from 3.4 in 2002 to 6.0 percent in 2006, then ended at 5.7 percent in 2007, not significantly different from the rate in 2006. Among those aged 55 to 59, current illicit drug use also showed an irregular trend with an overall increase from 1.9 percent in 2002 to 4.1 percent in 2007. These patterns and trends may partially reflect the aging into these age groups of the baby boom cohort, whose lifetime rates of illicit drug use are higher than those of older cohorts.

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Figure 2.7 Past Month Illicit Drug Use among Adults Aged 50 to 59: 2002-2007

Figure 2.7

⁺ Difference between this estimate and the 2007 estimate is statistically significant at the .05 level.

Gender

In 2007, as in prior years, the rate of current illicit drug use among persons aged 12 or older was higher for males than for females (10.4 vs. 5.8 percent, respectively). Males were about twice as likely as females to be past month marijuana users (8.0 vs. 3.8 percent). However, males and females had similar rates of past month use of tranquilizers (0.8 and 0.7 percent for males and females, respectively), stimulants (0.4 percent for males and 0.5 percent for females), methamphetamine (0.2 percent for both males and females), sedatives (0.2 percent for males and 0.1 percent for females), and OxyContin^® (0.2 percent for males and 0.1 percent for females).
From 2006 to 2007, the rate of current heroin use decreased from 0.06 to 0.02 percent among females aged 12 or older, and the rate of current nonmedical use of stimulants declined from 0.6 to 0.4 percent among males in that age group.
Among youths aged 12 to 17 in 2007, males and females had similar rates of current use of illicit drugs (10.0 percent for males and 9.1 percent for females), cocaine (0.4 and 0.5 percent, respectively), crack (0.03 and 0.09 percent), hallucinogens (0.8 and 0.6 percent), and inhalants (1.2 and 1.1 percent). Rates also were similar for nonmedical use of prescription psychotherapeutic drugs (3.0 and 3.5 percent for males and females, respectively) and

Results from the 2007
National Survey on Drug Use and Health:
National Findings

Acknowledgments

Public Domain Notice

Electronic Access to Publication

Originating Office

Table of Contents

Citation:

Substance Abuse and Mental Health Services Administration, Office of Applied Studies (2008). Results from the 2007 National Survey on Drug Use and Health: National Findings (NSDUH Series H-34, DHHS Publication No. SMA 08-4343). Rockville, MD.

Appendix

List of Figures

List of Tables

Highlights

Illicit Drug Use

Alcohol Use

Tobacco Use

Initiation of Substance Use (Incidence, or First-Time Use) within the Past 12 Months

Youth Prevention-Related Measures

Substance Dependence, Abuse, and Treatment

Mental Health

1. Introduction

1.1. Summary of NSDUH

1.2. Trend Measurement

1.3. Change in Estimates for Psychotherapeutic Drugs and Stimulants

1.4. Format of Report and Explanation of Tables

1.5. Other NSDUH Reports and Data

2. Illicit Drug Use

Figure 2.1 Past Month Illicit Drug Use among Persons Aged 12 or Older: 2007

Figure 2.2 Past Month Use of Selected Illicit Drugs among Persons Aged 12 or Older: 2002-2007

Figure 2.3 Past Month Nonmedical Use of Types of Psychotherapeutic Drugs among Persons Aged 12 or Older: 2002-2007

Age

Figure 2.4 Past Month Illicit Drug Use among Persons Aged 12 or Older, by Age: 2007

Figure 2.5 Past Month Use of Selected Illicit Drugs among Youths Aged 12 to 17: 2002-2007

Youths Aged 12 to 17

Young Adults Aged 18 to 25

Figure 2.6 Past Month Use of Selected Illicit Drugs among Young Adults Aged 18 to 25: 2002-2007

Adults Aged 26 or Older

Figure 2.7 Past Month Illicit Drug Use among Adults Aged 50 to 59: 2002-2007

Gender