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National Household Survey on Drug Abuse to Include Mental
Health Data
December 01, 1998 | Alcohol Abuse [1]
By Arline Kaplan [2]
The National Household Survey on Drug Abuse (NHSDA), the primary source of statistical
information on Americans' use of alcohol, tobacco and illicit drugs, will be expanded in upcoming
years to include substantial information on mental illness and state-level data on drug abuse,
according to Nelba Chavez, Ph.D., administrator of the Substance Abuse and Mental Health Services
Administration (SAMHSA).
The National Household Survey on Drug Abuse (NHSDA), the primary source of statistical information
on Americans' use of alcohol, tobacco and illicit drugs, will be expanded in upcoming years to include
substantial information on mental illness and state-level data on drug abuse, according to Nelba
Chavez, Ph.D., administrator of the Substance Abuse and Mental Health Services Administration
(SAMHSA).
At the American Psychiatric Association's recent 50th Institute on Psychiatric Services, Chavez
explained that she initially viewed the NHSDA as "just another survey." However, her original opinion
soon changed. "The more we have done analyses," she said, "I have discovered it is an unbelievable
survey."
Conducted since 1971, the survey collects data by administering questionnaires to a representative
sample of the United States civilian, noninstitutionalized population ages 12 and older.
"This year we will be expanding the Household Survey, which means we will be interviewing more
than 70,000 [people] in the United States [up from 24,505 people interviewed in 1997]. We hope to
be able to give you information on a state-by-state basis...and our current plan is to expand the
mental health component of the survey, so by the year 2000 or 2001, we can have an ongoing
picture of the mental health of the United States."
In discussing the preliminary results released in 1998, Chavez said the 1997 NHSDA revealed "some
disturbing connections for something that we already know. One of the things we found is that
adolescents who use marijuana are more likely to engage in [destructive] behaviors, such as
destroying property, violence, attacking other kids, etc. But the other thing that is very
interesting...is marijuana use among our youth is clearly associated with anxiety and depression.
Now, we here may all agree that it is true, but outside, on [Capitol] Hill, who will believe this? I have
had people who have said to me, 'Take care of the substance abuse problems and mental illness
goes away.'"
The data in the 1997 NHSDA enhance a prior SAMHSA report, Adolescent Self-Reported Behaviors
and Their Association with Marijuana Use, which was based on NHSDA data from the 1994 through
1996. According to that report, adolescents ages 12 to 17 who use marijuana weekly are nine times
more likely than nonusers to experiment with illegal drugs or alcohol, six times more likely to run
away from home, five times more likely to steal, almost four times more likely to engage in violence
and three times more likely to have thoughts about committing suicide. In a self-report checklist,
adolescents also associated social withdrawal, physical complaints, anxiety and depression,
attention problems and thoughts of suicide with past-year marijuana use.
According to Chavez, the 1997 NHSDA also showed a "tremendous increase in the use of alcohol
among 12- and 13-year-olds." The percentage of young people in that age group reporting alcohol
use in the past month climbed from 5.1% in 1996 to 6.7% in 1997, and the percentage of 12- and
13-year-olds reporting binge-drinking (five or more drinks on the same occasion within the past
month) climbed from 1.0% in 1996 to 1.1% in 1997. However, the percentage of 12- and
13-year-olds reporting heavy use of alcohol has slightly declined. Although the survey includes only
those 12 and older, Chavez said alcohol use begins at much younger ages.
"We have found 9-year-olds who are already alcohol-dependent," she said.
Other data from current and past NHSDAs has enabled researchers to begin examining the
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prevalence of substance use among racial and ethnic groups, Chavez noted.
"We went back to 1991...and very interesting information came forth on 11 subgroups," she said.
The information was published in a recent report, Prevalence of Substance Use Among Racial/Ethnic
Subgroups in the United States, 1991-1993. It provides the first national estimates of illicit drug use,
alcohol abuse and dependence, tobacco use, and the need of illicit drug abuse treatment for
Asian/Pacific Islanders, Native Americans, Caribbean Americans, Central Americans, Cuban
Americans, Mexican Americans, Puerto Ricans, South Americans and other Hispanic Americans.
Relative to the total U.S. population age 12 and older, Native Americans, Mexican Americans, Puerto
Ricans and African Americans exhibited higher prevalences of illicit drug use, heavy cigarette use,
alcohol dependence and the need for illicit drug abuse treatment, while Asian/Pacific Islanders,
Caribbean Americans, Central Americans and Cuban Americans had lower prevalences.
For example, Native Americans (American Indians and Alaska Natives) exhibited a prevalence of
illicit drug use of 19.8%. Rates of illicit drug use among other subgroups were: 13.3% for Puerto
Ricans, 13.1% for African Americans, 12.7% for Mexican Americans, 11.8% for Caucasians, 10.7% for
South Americans, 10.6% for other Hispanic Americans, 8.2% for Cuban Americans, 7.6% for
Caribbean Americans, 6.5% for Asian/Pacific Islanders and 5.7% for Central Americans. By
comparison, prevalence of any illicit drug use for the total U.S. population was 11.9%.
A new area of investigation in the 1997 NHSDA involved assessing the impact of voter initiatives on
drug use in California and Arizona. In 1996, voters in both states passed propositions to legalize
marijuana for certain medical uses. According to Chavez, the NHSDA expanded its sample in those
states to gauge the effects.
The survey found that Californians were more likely to perceive greater risk in smoking cigarettes
than the remainder of the nation, but both Californians and Arizonans were less likely to perceive
greater risk in using marijuana than other residents of the United States. Also, the prevalence of
current use of any illicit drugs among people age 12 and older was somewhat higher in California
(8.3%) and Arizona (8.4%) as compared with the remainder of the country, excluding those two
states (6.1%).
However, a difference between California and Arizona was noted in the number of adolescents using
illicit drugs. In Arizona, 16.8% of adolescents ages 12 to 17 were current illicit drug users, compared
with 9.1% of youth in California and 11.9% of youth in the remainder of the United States.
Other highlights of the 1997 survey are:
An estimated 13.9 million Americans (6.4% of the U.S. population age 12 and older) were
current users of illicit drugs in 1997 (meaning they had used an illicit drug sometime during
the 30 days prior to the interview).
In 1997, 11.4% of youth reported using illicit drugs in the past month, an increase from 9.0%
in 1996.
An estimated 1.5 million Americans (0.7% of the population age 12 and older) were current
cocaine users and 11.1 million (5.1% of the population age 12 and older) were current
marijuana/hashish users.
Current smokers numbered 64 million Americans, with 4.5 million between the ages of 12
and 17. Adolescents who smoked were 12 times as likely to use illicit drugs and 23 times as
likely to drink heavily as nonsmoking youth.
In 1997, approximately 111 million persons age 12 and older were current alcohol users
(51% of the total population). Of these, about 31.9 million engaged in binge drinking and
about 11.2 million were heavy drinkers.
Looking at trends in new use of substances, in 1996, 2.5 million people started using
marijuana, 171,000 person starting using heroin, 675,000 starting using cocaine and 1.1
million started using hallucinogens.
(Copies of the reports and summaries of the surveys mentioned in this article may be obtained free
of charge by calling SAMHSA's National Clearinghouse for Alcohol and Drug Information at
(800)729-6686 or at (www.samhsa.gov)-Ed.
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Links:
[1] http://www.psychiatrictimes.com/alcohol-abuse
[2] http://www.psychiatrictimes.com/authors/arline-kaplan
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