Research on the Nature and Extent of Drug Use in the United States
Prevalence of Drug Use
Data from the three major surveys paint a mixed picture of the Nation's drug use problem. There is a continued high rate of drug use among all age groups, but there are also indications that drug use is leveling off, particularly among younger age groups (e.g., eighth graders), and that the use of certain drugs among younger age groups may finally be decreasing. There also appears to be a resurgence of antidrug attitudes among all grades, although there remain mixed perceptions about marijuana use.
The 1997 NHSDA found that an estimated 13.9 million Americans 12 years and older had used an illicit drug in the month prior to interview. This finding represents no significant change from 1996. Among youth 12 to 17 years old, however, past-month illicit drug use increased from 9.0 percent in 1996 to 11.4 percent in 1997, primarily due to an increase among those 12 to 13 years old. In the history of this survey, the highest rate of the past-month illicit drug use among persons 12 to 17 years old was 16.3 percent, and the lowest was 5.3 percent in 1992. From 1996 to 1997, drugs that increased in use among this age group were marijuana (from 7.1 percent to 9.4 percent) and tranquilizers (from 0.2 percent to 0.5 percent). Among persons 18 to 25 years old, cocaine use decreased from 2.0 percent in 1996 to 1.2 percent in 1997; heroin use decreased from 0.4 percent to 0.1 percent; and misuse of analgesics declined from 2.0 percent to 1.3 percent. Past-month cocaine use also declined among persons 25 to 34 years old.
Results from the 1997 MTF Study paint a similar picture. Lifetime use of marijuana, cocaine, and opiates other than heroin increased from 1996 to 1997 among high school seniors, and lifetime marijuana use increased among 10th graders. However, more recent use-within the past year and past month-remained stable with few exceptions. Results for eighth graders provided a glimmer of hope, with no increases and even decreases in a few categories. Attitudes toward substance use were mostly stable between 1996 and 1997. Perceived risk of harm was mostly stable for students in all three grades. Encouraging results were found for eighth graders, with disapproval increasing for selected marijuana, cocaine, and cigarette use indicators.
The CEWG reports that indicators of marijuana use continued to escalate across the country and that so-called "club drugs" have appeared in increasing numbers on the drug scene in several cities. Indicators of cocaine use have remained level or have even declined, whereas heroin use is stable in some cities but is rising in others, particularly in the northeastern region of the country.
In the Western United States, methamphetamine use appears to be rising, and its use has spread beyond its traditional user base-white, male, blue-collar workers-into diverse groups in all regions of the country. Methamphetamine use is increasing among men who have sex with men and who use other drugs, making this population more vulnerable to contracting and spreading sexually transmitted diseases, particularly AIDS. There has also been a notable increase in methamphetamine use among homeless and runaway youth and among male and female commercial sex workers who also trade sex for drugs. People in occupations that demand long hours, mental alertness, and physical endurance have also been increasing their use of this drug.
Many more people try drugs than go on to become regular users. Although NHSDA survey results show that nearly 36 percent of all Americans older than age 11 have tried any illicit drug during their lifetime, only 11 percent have used any illicit drug during the past year, and only 6 percent have used any illicit drug during the past month. This same finding holds true for specific illicit drugs. In their lifetime, 33 percent of Americans age 12 or older have smoked marijuana at least once, but only 5.1 percent used marijuana during the past month. Although the overall numbers are higher, the same trend holds true for cigarette use, with nearly 71 percent of Americans reporting that they had smoked a cigarette at some time in their life, but only 30 percent reported having smoked a cigarette during the past month. These findings show the importance of identifying both the factors that place people at risk for drug use and the protective factors that keep many people from becoming regular users. (The results of such studies are discussed in the next chapter.)
Rates of illicit drug use vary by ethnicity and gender.  Most current illicit drug users are white non-Hispanics, a group that accounts for 74 percent of all users. However, the rate of current illicit drug use for blacks (7.5 percent of the black population) remains somewhat higher than for whites (6.4 percent of the white non-Hispanic population) and Hispanics (5.9 percent of the Hispanic population). However, among youth the rates of use are about the same for the three ethnic groups. As has been true for some time now, in 1997 men continued to have a higher rate of current illicit drug use than women (8.5 percent of men versus 4.5 percent of women). However, among 12- to 17-year-old drug users, there was little difference in the rate of drug use between adolescent males and females (9.2 percent for males versus 8.9 percent for females).
Rates of illicit drug use in 1997 also show substantial variation by age and educational status. Among youths ages 12 to 13, 3.8 percent were current illicit drug users. The highest rates were found among young people ages 16 to 17 (19.2 percent) and ages 18 to 20 (17.3 percent). Rates of use were lower in each successive age group, with only about 1 percent of people age 50 and older reporting current illicit use. Among young adults ages 18 to 34, those who had not completed high school had the highest rate of current use (14.1 percent), whereas college graduates had the lowest rate of use (5.9 percent). This is despite the fact that young adults at different educational levels are equally as likely to have tried illicit drugs in their lifetime.
Illicit drug use also varies by geographic location. In 1997 the current illicit drug use rate was 8.1 percent in the West, 7.3 percent in the North Central, 5.8 percent in the South, and 4.7 percent in the Northeast. Rates were higher in metropolitan areas than in nonmetropolitan areas.
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