Foundations in Continuing Education

Substance Abuse and Chemical Dependency

Chapter Two - Epidemiology

Chapter 1: Background Terminology

Chapter 2: Epidemiology
Prevalence
Incidence

Chapter 3: Pathophysiology of Addiction

Chapter 4: Classification and Characteristics of Psychoactive Substances

Chapter 5: Treatment

Chapter 6: Identification of the Abusing Patient

Chapter 7: Implications for Dental Treatment

Chapter 8: Impaired Oral Health Team Members

Chapter 9: Conclusion

Appendices

Post Examination

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Prevalence 4

(U.S. Public Health Service, Substance Abuse and Mental Health Services Administration, (2006)

The prevalence of substance abuse is simply the number of individuals who are currently abusing drugs and/or alcohol. It is important for you to know the demographics of substance abuse. This knowledge helps you identify individuals in your own practice who are at risk, or who are currently abusing drugs or alcohol. The National Survey on Drug Use and Health (NSDUH) is conducted annually by the Substance Abuse and Mental Health Service Administration (SAMHSA) and was previously named the National Household Survey on Drug Abuse (NHSDA). This representative survey provides an estimate of the prevalence of illicit drug, alcohol and tobacco use in the United States (U.S.). The sample population consists of uninstitutionalized individuals age 12 or older. (Note: the term current means individuals who used the substance in the month prior to their interview.) Although this survey gives us a general description of drug and alcohol use in the U.S., it should not be used solely to judge individuals for risk of substance abuse.

According to the 2005 NSDUH, 22.7% of the population are binge drinkers, 6.6% are heavy drinkers.

  • 29.3% of the population are current smokers, 3.3% use smokeless tobacco.
  • 8.1% of the population are current illicit drug users.
  • In 2005, an estimated 19.7 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 8.1 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 2005 (8.1 percent) was similar to the rate in 2004 (7.9 percent), 2003 (8.2 percent), and 2002 (8.3 percent).
  • Tobacco is the second most commonly used substance in the United States next to alcohol. However, it is the leading preventable cause of death and disability in the U.S.
  • Marijuana was the most commonly used illicit drug (14.6 million past month users). In 2005, it was used by 74.2 percent of current illicit drug users. Among current illicit drug users, 54.5 percent used only marijuana, 19.6 percent used marijuana and another illicit drug, and the remaining 25.8 percent used only an illicit drug other than marijuana in the past month.
  • Alarmingly, the past few years showed an increase in the abuse of pain medications, namely oxycodone (brand names such as Oxycontin, Percocet, Percodan, Tylox, and hydrocodone (Lortab, Vicodin, many other brand names.). Beginning in 2002, new items were added to the, 2005 Monitoring the Future (MTF) Survey, asking specifically about the use of OxyContin and Vicodin.

Misuse of prescription medications:

  • For example, the 2006 Monitoring the Future report of 8th, 10th, and 12th graders found that 10.5 percent of 12th graders reported using Vicodin for non-medical reasons and 4.5 percent of 12th graders reported using OxyContin without a prescription.

  • Annual use of OxyContin by 12th-graders has risen from 4.0 percent in 2002 to 5.5 percent in 2005. Annual OxyContin use has remained more stable in the lower grades since 2002, with 1.8 percent of 8th-graders and 3.2 percent of 10th-graders reporting annual use in 2005. The annual prevalence rate for Vicodin was considerably higher than for OxyContin, at 9.5 percent among 12th-graders, 5.9 percent among 10th-graders, and 2.6 percent among 8th-graders in 2005. Considering the addictive potential of oxycodone and hydrocodone, these are disturbingly high rates of use. Recent news stories have highlighted the increasing number of teens and adults abusing prescription drugs, particularly painkillers.

Table 1: Epidemiology of Drug Use
(Monitoring the Future Report, 2006) 5
Age
 In 2005, Rates of current use of illicit drugs were higher for young adults aged 18 to 25 (20.1 percent) than for youths aged 12 to 17 and adults aged 26 or older, with 16.6 percent using marijuana, 6.3 percent using prescription-type drugs non-medically, 2.6 percent using cocaine, and 1.5 percent using hallucinogens
Race Current illicit drug use was associated with race/ethnicity in 2005. The rate was lowest among Asians (3.1 percent). Rates were 12.8 percent for American Indians or Alaska Natives, 12.2 percent for persons reporting two or more races, 9.7 percent for blacks, 8.7 percent for Native Hawaiians or Other Pacific Islanders, 8.1 percent for whites, and 7.6 percent for Hispanics.
Gender Males were more likely in 2005 to report current illicit drug use than females (10.2 vs. 6.1 percent, respectively). Males were about twice as likely to use marijuana as females (8.2 vs. 4.0 percent). However, the rates of non-medical use of prescription-type psychotherapeutics were similar for both males (2.8 percent) and females (2.5 percent).

Among pregnant women aged 15 to 44 years, 3.9 percent reported using illicit drugs in the past month based on combined 2004 and 2005 NSDUH data. This rate was significantly lower than the rate among women aged 15 to 44 who were not pregnant (9.9 percent). The 2002-2003 combined rate of current illicit drug use among pregnant women (4.3 percent) was not significantly different from the 2004-2005 combined rate.
Geography Among persons aged 12 or older, the rate of current illicit drug use in 2005 was 9.0 percent in the West, 8.9 percent in the Northeast, 7.5 percent in the South, and 7.5 percent in the Midwest.

The rate of current illicit drug use in metropolitan areas was higher than the rate in non-metropolitan areas in 2005. The rates were 8.4 percent in large metropolitan counties, 8.4 percent in small metropolitan counties, and 6.9 percent in non-metropolitan counties as a group. Within non-metropolitan areas, counties that were urbanized had a rate of 7.8 percent, less urbanized counties had a rate of 6.5 percent, while completely rural counties had a rate of 5.1 percent.

The rate of current illicit drug use in completely rural counties had declined between 2002 and 2003, from 6.7 to 3.1 percent, but then increased to 5.1 percent in 2005. The rate in 2005 was not significantly different from the rate in 2004 (4.6 percent).

Among youths aged 12 to 17, there was evidence of regional differences in trends of marijuana use between 2002 and 2005. Current marijuana use rates declined in the Northeast, Midwest, and South between 2002 and 2005. In the West, the rates were steady between 2002 and 2004 (8.0 percent in 2002, 8.7 percent in 2003, and 9.3 percent in 2004) and then declined to 6.8 percent in 2005.
Education Illicit drug use in 2005 was associated with educational status. Among adults aged 18 or older, the rate of current illicit drug use was lower among college graduates (5.0 percent) compared with those who did not graduate from high school (9.8 percent), high school graduates (8.6 percent), and those with some college (8.9 percent). However, adults who had graduated from college were more likely to have tried illicit drugs in their lifetime when compared with adults who had not completed high school (51.7 vs. 37.7 percent).
Employment Illicit drug use in 2005 was associated with educational status. Among adults aged 18 or older, the rate of current illicit drug use was lower among college graduates (5.0 percent) compared with those who did not graduate from high school (9.8 percent), high school graduates (8.6 percent), and those with some college (8.9 percent). However, adults who had graduated from college were more likely to have tried illicit drugs in their lifetime when compared with adults who had not completed high school (51.7 vs. 37.7 percent).

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