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| | From:  TheOldGeek1 (Original Message) | Sent: 2/9/2004 1:15 AM |
| Speech Asa Hutchinson
Administrator
Drug Enforcement Administration
National Young Leaders Conference
December 7, 2001
Washington, D.C. (NOTE: THE ADMINISTRATOR OFTEN DEVIATES FROM PREPARED REMARKS) | 
Administrator Hutchinson discusses drug abuse with over 300 high school students from across the country at the National Press Club.
Administrator Hutchinson with students attending the National Young Leaders Conference.
Students listen intently as the
Administrator answers their questions.
| Thank you. When I was a Congressman, I always had a small group of you visit me on the Hill. But I'm delighted to be with your entire council this year to discuss an issue that's very important to our nation's future. As Michele indicated, I'm from Arkansas. I understand that no one else is here from Arkansas, but that you've got a large contingent from New Jersey. Well, since my daughter married someone from New Jersey, I'm very fond of New Jersey these days. I am delighted to be here. Earlier this year, I started my third term in the United States Congress. I was expecting to continue down that career path, but out of the blue, the President of the United States asked me to head the Drug Enforcement Administration. That came as a little bit of a surprise to me. People ask me why in the world did I take on that responsibility. They ask, "Isn't that an impossible job?" The first answer is, I took the job because the President asked me to. I'm old fashioned enough to believe that when the President asks you to do something important and good, you ought to do it. But secondly, I believe drug enforcement is an important aspect of our nation's future. We have to make the right decisions in our drug policy. So I left the United States Congress. And I'm the only Member of Congress the President asked to serve in his Administration. It's a pleasure to serve under the leadership of President Bush and Attorney General Ashcroft. It's also great to be team partners with people like Bob Mueller, who is head of the FBI. I'm very privileged to be at the DEA. The DEA has about 9,000 employees, half of whom are agents. We have offices in every state of the nation as well as in 56 countries. Our budget is $1.5 billion. To give you a flavor of some of the things we do at the DEA, consider a recent investigation we conducted. Brittney Chambers was a 16-year old girl from Colorado. On her 16th birthday, a friend gave her an Ecstasy pill, which killed her. The local police investigated her death. It wasn't too difficult to identify the friend who gave her the pill. But the DEA wanted to hold the people further up the chain responsible. So we worked behind the scenes. We looked at where these Ecstasy pills were coming from and we identified the source. We got court authorization for wiretaps. We linked this case back to a major international organization that was smuggling Ecstasy into the United States from the Netherlands. Finally, we indicted over 20 individuals who were responsible at the highest level for distributing Ecstasy that led to the death of Brittney Chambers. That case is a good example of where the DEA teams up with local law enforcement. We partner with them, do sophisticated intelligence gathering, work internationally, and we bring these cases to the highest level. That's what the Drug Enforcement Administration does. In another illustration of our international work, we can look at Afghanistan. The DEA has not been stationed in Afghanistan since the 1980s because of the danger. But we're in the neighboring country of Pakistan. We have offices in Peshwar, right on the border of Afghanistan, and in Islamabad. As we see the Taliban regime falling, we want to take advantage of the opportunity to impact a country that produces 70 percent of the world's heroin. | "In the last 15 years, we've reduced cocaine usage by 75 percent. That's 4 million people fewer using cocaine today than 15 years ago. That's a measure of success. Overall drug usage has declined by one-half over the last 20 years. That's a significant amount of success because those 4 million people who are not using drugs could be your family member. Those are lives saved." | Seventy percent of the world's heroin comes from one country-Afghanistan. Most of that is destined for Europe. But we should seize this opportunity in history to have an impact in Afghanistan. As part of an international effort, we could plow under the poppy fields, and thereby reduce that enormous supply. Even though most of the heroin is destined for Europe, it would still impact the United States. That effort would have an impact on the United States by driving up the price of heroin. And when you drive up the price of heroin, what does it do? It reduces the number of people who will choose heroin abuse as a lifestyle. It's expensive, so they're not able to do it. The second thing reducing this supply will do, is that the traffickers will have to begin to "cut" the drug further-they will dilute it more to get more product. And so the potency of heroin in the United States goes down. When the potency goes down and the price goes up, you have less usage and fewer deaths as a result. We're working on an international plan to go into Afghanistan to deal with the heroin supply there. Another part of my responsibilities is that I'm part of the think tank on drug policy in this Administration. I seize the opportunity to debate drug policy with those people who think we're going in the wrong direction. National Public Radio invited me to go to New Mexico recently to debate Governor Gary Johnson on drug policy. He supports the legalization of marijuana, if not other drugs. I went to the debate, which is not exactly where the political consultants would probably have advised me to go because it was in Governor Johnson's backyard at the University of New Mexico and was not the most friendly audience. But I went because I believe we win the debate when we engage in the issue. Governor Johnson argues that we're losing the war on the drugs. I do not agree. I think we should look at that from an historical perspective. In the last 15 years, we've reduced cocaine usage by 75 percent. That's 4 million people fewer using cocaine today than 15 years ago. That's a measure of success. Overall drug usage has declined by one-half over the last 20 years. That's a significant amount of success because those 4 million people who are not using drugs could be your family member. Those are lives that are saved. Clearly, we have reached a plateau, and we've reached a level of frustration because it's a little more difficult to edge the number of drug users down further. But I believe we have the opportunity to make further inroads. The second thing legalizers argue is if you legalize marijuana, then you will reduce the incarceration rate, the investment we have in law enforcement, and the enforcement efforts along the border. They say that, by legalizing marijuana, you'll profit from taxation of it, and you'll force people away from the criminal side of it. My response to that is, unless you legalize all drugs, you will not have that economic impact. If you legalize marijuana, is that going to take the Colombian cartels out of the drug business? The Colombian cartels are going to be engaged in cocaine, they're going to be engaged in methamphetamine and heroin trafficking. And so the Colombian and Mexican criminal organizations are still going to be there. You're going to still need the enforcement along the border. The law enforcement component, the treatment component, and all that we invest, will still be necessary. And then finally, the debate is about the direction you want our country to go. Governor Johnson acknowledges that he does not use marijuana, he does not use cocaine, he does not even use alcohol. Fifteen years ago, he stopped using them because he determined they were a "handicap" to him. A handicap. In other words, they were harmful to a person. And he did not want to be handicapped. I asked him the question, "If you determined these were going to be handicaps to you, why do you want to handicap America's future? Why do you want to handicap our young people in terms of educational success, productivity in industry, and the future of our nation by legalizing and increasing the usage of harmful substances?" I am happy to engage in that debate. If you thought New Mexico was not a helpful audience to me, after that, Yale Law School invited us to debate there. Yale is a great school, but it is not a conservative school. Nevertheless, I went there, and we had a full audience of students. After Governor Johnson presented his case, I asked the audience how many are in favor of legalizing marijuana. Eighty percent of them raised their hands. The 20 percent that didn't raise their hands were DEA agents. I just wanted to make sure they didn't raise their hands! Clearly, it was a tough audience, but I think we make a difference when we engage in the debate. I'm delighted for your interest in this issue and your commitment to public policy and making a difference. I believe when you look at drug policy, you're talking about the character of our nation. We need to have a nation that has a strong character, which is why I think drug policy is a very important issue. I look forward to hearing your questions. | |
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| Cocaine use in the U.S. is down from the 1985 peak of 5.7 million cocaine users (3 percent of the population), according to the National Institute on Drug Abuse (NIDA). In the 1990s the number of users remained steady at about 1.5 million. But cocaine usage trends are notoriously difficult to track. The Office of National Drug Control Policy, using data sources other than NIDA's, estimates there are currently 3.6 million chronic cocaine users in America. Schmitz notes that her impression is that there has been a slight reduction over the past few years, but "not to the extent that it satisfies us."
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Cocaine: The First Decade OverviewIt appears that the cocaine epidemic that swept through the nation during the 1980s may now be subsiding, leaving in its wake large numbers of people with long-term dependencies. Drug use in general, and the problems associated with it, are still at very high levels by historic standards, and the street violence surrounding drug trafficking may yet grow worse over the next several years, especially in the inner city. However, available indicators of drug use show that both initiation rates and the total number of people using drugs are declining. The composition of the drug-using population has also begun to change. The data indicate that the sharpest reductions in drug use have occurred in suburban areas and among the educated middle class: It is likely that changing attitudes (e.g., increasing concern about the dangers of drug use and decreasing social approval) rather than enforcement efforts have influenced occasional users to quit using drugs. Unfortunately, over the last decade as cocaine became cheaper, more readily available, and more addictive in the smokable form of "crack," it appears that both poor and criminal segments of the population, especially in the inner cities, began to use the drug more heavily. As a result, these people now represent a larger share of the drug-using popu-lation. The data also point to an increasingly strong associa-tion between cocaine use and health problems, and cocaine use and crime. This in part may explain why, in the face of declining drug use, we may see continued or even increasing drug-related health problems and violence in the inner cities. Below we describe some of the apparent changes in the trends and composition of the cocaine-using population over the last decade. National Surveys of Drug UseThe most widely reported measures of drug use are provided by two national surveys funded by the National Institute on Drug Abuse (NIDA): the High School Senior Survey (HSSS), conducted annually by the University of Michigan; and the periodic National Household Survey on Drug Abuse (NHSDA), which reports on drug use in the general population. The weaknesses of the surveys are well known, but they are not likely to distort general trends. For example, the surveys exclude populations known to be rich in drug users: The HSSS does not include school dropouts, and the NHSDA excludes institutional populations (such as those in prison) and the homeless. The surveys also rely on the willingness of individuals to report disapproved behavior. Since approval of drug use has declined over the last decade, it is likely that the willingness to report such use has also declined. Thus, one cannot use the data to estimate the number of heavy drug users, and the trends may be less sharp than they appear in the surveys. However, the trendlines certainly point in the correct direction. Figure 1 shows the percentage of successive high school classes reporting use of marijuana, cocaine, or any illicit drug within the last 30 days.  Figure 1: Trends in drug use among high school seniors, 1975-1991
(High School Senior Survey, HSSS)
After a steep rise in the late 1970s, drug use in general (dominated by marijuana use) declined sharply. For cocaine, the pattern is somewhat more complicated. Cocaine use rose from about 2 percent in 1975 to nearly 6 percent in 1979, where it remained except for a sharp peak in 1985 (6.7 percent). From 1985 to 1991, usage declined steadily to 1.4 percent. Figure 2 shows a similar pattern in the NHSDA for 18-25 year olds, the age group with the highest drug-use rates. Marijuana use rose sharply in the late 1970s and then fell throughout the 1980s. For cocaine, use increased in the late 1970s, then leveled off and did not begin to reverse until the mid-1980s.  Figure 2: Trends in drug use among 18Ð25 year olds, 1974-1991
(National Household Survey on Drug Abuse, NHSDA)
As noted above, it appears that the driving force behind these trends has been an increasing awareness of the dangers of drug use and a growing sense of social disapproval. Certainly, decreased availability is not a factor. The proportion of HSSS respondents reporting marijuana as readily available or available has been around 85 percent every year. For cocaine, perceived availability rose from 46 percent in 1979 to 59 percent in 1989, before falling to 51 percent in 1991. Urinalysis MeasuresDrug testing of adult arrestees reveals a very different picture. Usage within this segment of the population is much higher, and although rates are no longer rising, they still remain near their peaks. In the District of Columbia, which has the longest-standing and most comprehensive drug-testing program, the percentage of arrestees testing positive for cocaine rose from 15 percent in March 1984, when testing began, to over 60 percent in 1988. As Figure 3 shows, the percentage held steady for about a year and then began to decline in 1989. Even so, two years into the decline, 50 percent of the arrestees were still testing positive for cocaine.  Figure 3: Percent of arrestees testing positive for any drug and cocaine, 1984-1991
(Washington, D.C., Pretrial Services Agency urinalysis results) It is important to note that arrest is not a rare event for young-adult urban males. For example, RAND estimated that nearly one quarter of all males born in the late 1960s and living in the District of Columbia were arrested between the ages of 18 and 21. Thus the drug-testing data point to very high usage rates in a significant portion of the young-adult urban male population. The new Drug Use Forecasting (DUF) system created by the National Institute of Justice shows that this extraordinary rate of drug involvement is not restricted to the District of Columbia. DUF currently collects urinalysis data from a sample of arrestees in 23 cities, mostly from persons arrested for nondrug felony offenses. The data show that in the first quarter of 1990, over 50 percent of male arrestees in all 20 cities tested positive for at least one illicit drug (including marijuana), and in 7 of the cities 50 percent or more of the arrestees tested positive for cocaine. Drug-positive rates in most of the cities continue to be near their peaks. However, there is some good news. It appears that the rate of drug use among young arrestees has declined. The District of Columbia data show that in September 1987, 45 percent of juvenile arrestees tested positive for drugs. By September 1991, this figure had dropped to 19 percent. Over this same time period, the rate of those testing positive for cocaine dropped from 19 to 9 percent. These low rates for juvenile arrestees suggest that drug use is declining even among those at highest risk of becoming most seriously harmed by drugs. In addition, interviews with street dealers in Washington and Newark found that, unlike their older counterparts, few of the younger sellers were using drugs. Given these findings, it seems reasonable that high research and policy priority should be placed on finding ways to discourage young people from entering the trade and on helping them exit the trade if they are already in it--before they begin using drugs and become addicts who must sell to support their own habit. DAWN Emergency Room and Coroner ReportsThe NIDA Drug Abuse Warning Network (DAWN) is an important data set that has been used to gauge patterns and trends among those most heavily involved with illicit drugs. We believe that it has been given too much weight in that role, though it is very useful for gaining other insights into changing characteristics of drug use. The DAWN system collects information from a sample of emergency rooms and county medical examiners, primarily in 21 metropolitan areas. Each emergency room (ER) and medical examiner (ME) is asked to provide information on all drug-related episodes or deaths. (ME cases do not include homicide victims whose deaths may have been related to drug market activities.) Prior to 1989, the sample was opportunistic and did not permit estimation of the absolute number of ER cases. In 1989, NIDA implemented a new sampling scheme that allowed estimation of the total numbers of ER episodes related to particular drugs or classes of drugs in individual metropolitan areas. Cocaine-related ER admissions and deaths in the opportunistic DAWN sample increased about tenfold over the decade (Figure 4). Only in late 1989 did the ER figures start to decline (Figure 5).  Figure 4: Emergency room and medical examiner mentions of cocaine in DAWN
sample facilities, 1978-1989  Figure 5: Total DAWN estimates of cocaine-related emergency room episodes, 1989-1991 Both ER and ME data show a sharp aging in the heavy-user population, suggesting that a defined cohort of users is moving through the pipeline. In 1982, about 50 percent of those dying from cocaine use were over age 30; by 1989, the figure had risen to 76 percent. Correspondingly, the percentage of those aged 18-24 dying from cocaine use had fallen from 23 to 14 percent. Recent ER data reflect a similar pattern: Between the first quarter of 1989 and the third quarter of 1990, the percentage of cocaine-related ER episodes involving men over age 30 increased from 46 to 55 percent, and the percentage of episodes involving women over age 30 increased from 35 to 42 percent. DAWN records also provide information on why the individual used drugs (e.g., psychic effects, recreation, drug-dependence) and why he or she sought admission to an emergency room (e.g., unexpected reaction, requesting detoxification). These data show that an increasing fraction of the cocaine-related ER episodes have involved dependent users seeking either treatment or relief from health problems associated with chronic drug use. Thus, the upturn in DAWN ER episodes in 1991 may be driven less by a growing number of users or heavy users of cocaine than by the aging of a fixed user-population increasingly troubled by the health consequences of its own drug use. The DAWN data also show that the decline in cocaine-related ER episodes from their peak in the third quarter of 1989 was much stronger in suburban than in metropolitan areas (Figure 6). During this period, cocaine-related ER episodes in major cities fell by 17.5 percent, as compared to 50 percent outside the cities. Thus it appears that persistent heavy drug use leading to acute incidents is becoming increasingly concentrated within the cities.  Figure 6: Cumulative cocaine-related emergency room episodes for 21 DAWN metropolitan areas, 1989-1990 DiscussionIt is important for the policy and research communities to try to determine how the drug problem is likely to change, so that policies and programs can be adjusted accordingly. It seems probable that the prevalence of drug use will continue to decline for some years. This is largely due to changing attitudes about drug use in general and the recognition of crack cocaine for what it is--a drug with a strong potential for dependency, and one that may well send the user to the emergency room or the morgue. Even the young sellers we interviewed in Newark referred derisively to their cocaine clients as "fiends." What is not declining, and perhaps may do so only slowly, is the number of people dependent on illicit drugs--and unfortunately most of the social problems associated with drugs, including crime and violence, the spread of the Human Immunodeficiency Virus (HIV), and the rising burden on publicly funded hospitals, come not from new users but from addicts. Looking at the end of the heroin epidemic in American cities in the mid-1970s may help us understand where we are in the cocaine epidemic and what lies ahead. By 1975, very few people were becoming heroin users for the first time; in that sense the epidemic was over. But the number of heroin users in inner city communities has not even now, 15 years later, shown much decline. Most of those who became addicted in the late 1960s and early 1970s at the height of the drug's popularity have not been able to shake their addiction, even though many have been in and out of treatment frequently. New initiates were sufficient to replace those addicts who died or stopped using, but initiation rates were quite low, at least until the end of the 1980s. While a number of factors may influence the rise and fall in popularity of a particular drug such as heroin or cocaine, one of the strongest determinants seems to be the effects of the drug itself. At their introduction, the focus is on the pleasurable effects of such drugs. Five or ten years later, the degradation of the users' physical and social lives has become a self-evident warning to initiates of the cost they will pay. In this sense, the cocaine epidemic, like the heroin epidemic ten years earlier, may be burning itself out. However, there will be many "hot spots," many residual effects, for years to come. One important distinction between the heroin and cocaine years must be made. Selling heroin was never an important source of economic mobility for young, poorly educated inner city males; selling cocaine has appeared to be so. And it is likely that much of the cocaine dealers' income has come from selling to middle class users. As this market declines, competition will increase among dealers, perhaps violently. In addition, since selling cocaine has been the primary source of earnings for poor adult males dependent on cocaine, these individuals may turn to other forms of crime to finance their continued consumption, relying more on muggings, burglary, and shoplifting for income, just as heroin user/dealers have done for many years. Equally troubling is the possibility that the drug markets in inner cities have led to a change in how young males view violence. Increasingly over the last decade, the most visible role models in terms of upward economic mobility have been drug dealers, whose success is related to the use of force. Violence may now be seen as a way to improve one's lot in life. Although we may be nearing the end of the widespread use of cocaine, poor urban communities are going to be the last to benefit. And given the possibilities discussed above, it seems clear that even though the indicators encouragingly point to the passing of an epidemic and a strong decline in new users, the nation's drug problems are far from over. The law enforcement community must be prepared for the possibility of even more crime and violence in the inner city. Health care systems will have to cope with an increasingly ill popu-lation of aging users. And treatment programs must find ways to expand their efforts to rehabilitate the large cohort of cocaine users who will need help for many years to come. ReferencesJohnston, Lloyd D., Jerald G. Bachman and Patrick M. O'Malley, Monitoring the Future, annual reports 1975-1991, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan. National Institute on Drug Abuse, Trends in Drug-Abuse-Related Hospital Emergency Room Episodes and Medical Examiner Cases for Selected Drugs: DAWN 1976-1985, NIDA Statistical Series H, Number 3, Rockville, Maryland, 1987. National Institute on Drug Abuse, Data from the Drug Abuse Warning Network, Annual Data 1983-1989, NIDA Statistical Series I, Numbers 3-9, Rockville, Maryland, 1984-1990. National Institute on Drug Abuse, National Household Survey on Drug Abuse, Highlights, 1990, Rockville, Maryland. National Institute of Justice, Drug Use Forecasting (DUF), quarterly report, October 1990, Washington, D.C. Office of National Drug Control Policy, National Drug Control Strategy, annual reports 1989-1990, The White House, Washington, D.C. Pretrial Services Agency, District of Columbia, "Adult Drug Testing Statistics" and "Juvenile Drug Testing Statistics," monthly reports 1984-1991, Washington, D.C. U.S. Department of Health and Human Services, HHS News, December 1991, Washington, D.C.
RAND is a nonprofit institution that seeks to improve public policy through research and analysis. RAND Issue Papers explore topics of critical interest to the policymaking community, with the intent of stimulating discussion in a policy area. They may identify trends or present tentative observations or informed judgement based on an ongoing program of research. Results of specific studies are documented in other RAND publications and in professional journal articles and books. This paper was prepared by Peter H. Reuter and RB-6000 |
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Chapter II (continued)
3. Cocaine Overall usage �?/B> Cocaine use stabilized in the United States between 1992 and 1998. Past-month cocaine use declined from 3 percent of the population (5.7 million) in 1985 to 0.7 percent (1.4 million) in 1992, and did not change significantly through 1998. An estimated 1.8 million Americans were past-month cocaine users in 1998, a statistically insignificant increase from 1997 (1.5 million) and 1996 (1.7 million). The number of frequent and occasional* users of cocaine remained statistically unchanged since 1992. In 1998, the number of frequent users of cocaine was estimated at 595,000 compared to 682,000 in 1997. The number of occasional users decreased from 2.6 million in 1997 to 2.4 million in 1998. 40 In 1998, there were an estimated 3.3 million hardcore chronic users of cocaine in the United States. Between 1992 and 1998 the estimated number of hardcore chronic cocaine users remained relatively stable, ranging between 3.3 and 3.6 million. 41 Despite the stabilization of overall use since 1992, the number of first-time users of any form of cocaine rose between 1996 and 1997 from 670,000 to 730,000. This level is still lower than during the early 1980s when the new initiate figures were between 1.1 and 1.4 million per year. 42 Current Cocaine Use (Past-Month) 
Source: SAMHSA, National Household Survey on Drug Abuse (various years) Use among youth �?/B> The 1999 MTF reported that among eighth graders, the rate of past-year use of crack cocaine declined 14 percent (from 2.1 to 1.8 percent) from 1998; this was the first such decrease in the 1990s. In 1999 the rate of past-month use of crack cocaine among tenth graders dropped 27 percent (1.1 to 0.8 percent) from 1998; twelfth graders were the only youth group that did not report a decline in past-month use. The perceived harmfulness among twelfth graders for trying crack once or twice fell 8 percent (from 52.2 to 48.2 percent) between 1999 and 1998. 43 Cocaine Inflation Rates Source: SAMHSA, 1998 National Household Survey on Drug Abuse Availability �?/B> Cocaine continues to be readily available in nearly all major metropolitan areas. 44 The August 1999 report of the Semiannual Interagency Assessment of Cocaine Movement estimated that 174 metric tons of cocaine arrived in the United States in the first six months of 1999. 45 Approximately 60 percent of the cocaine smuggled into the U.S. crosses the Southwest border. 46 Average Age of First Cocaine Use Source: SAMHSA, 1998 National Household Survey on Drug Abuse Over the past three years, domestic cocaine availability has been estimated at 347 metric tons for 1996, 281 metric tons for 1997, and 301 metric tons for 1998. These estimates were developed by an ONDCP-sponsored drug flow analysis using a composite model that integrates four independent measures of cocaine availability, from both a consumption approach and several supply approaches. 47 Since 1989, the average retail purity of cocaine remained relatively stable - between 65 and 80 percent.48 Similarly, the retail price of pure cocaine has remained relatively stable since 1994 at $170 per pure gram. 49 Law-enforcement agencies throughout the nation continue to report serious problems with cocaine, crack, and related criminal activity. Approximately 60 percent of agencies queried by NDIC reported cocaine as the greatest threat.50 Average Price For Cocaine *Based on annualized data through June 1998
Source: 1999 ONDCP-Adjusted from DEA STRIDE Data Cocaine Purity at the Retail Level *Based on annualized data through June 1998
Source: 1999 ONDCP-Adjusted from DEA STRIDE Data  Source: DEA, Federal-wide Drug Seizure System (FDSS)
* A frequent user is defined as one who uses a controlled substance on fifty-one or more days during the past year. An occasional user is defined as one who uses a controlled substance on twelve or fewer days during the past year.
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language=JavaScript></SCRIPT>  | | Drug Information | | Heroin is Surpassing Cocaine As Users' Choice By Farah Stockman
Source: Boston Globe
May 26, 2003 <WIRE_BODY>The two drugs were once considered twin threats of equal dangerousness, and Steven Richard knew them both.
First, the young car salesman from Sandwich fell for cocaine's expensive, hyperactive high. Then, years later, he was introduced to heroin pure enough to snort. Its euphoria came cheaper than beer. In 1992, heroin and cocaine each drove about 11,000 addicts into state-funded treatment centers in Massachusetts. But since then, the number of cocaine admissions has steadily fallen while the number of heroin admissions has steadily climbed. By 2001, 4,334 admitted patients in Massachusetts named cocaine as their nemesis, while heroin haunted 37,399, according to a report by the National Drug Intelligence Center. Those numbers solidify the commonwealth's position as one of a handful of states to see a dramatic rise in heroin admissions accompanied by a steep fall in cocaine admissions. ''Heroin has emerged as the greatest drug threat to Massachusetts,'' reads the report, which was released this month. The yearly report, which comes as state lawmakers wrangle over whether to cut funding to methadone clinics that treat heroin addicts, blames the growth of heroin addiction on fallen prices and increased purity that allows the drug to be sniffed or smoked instead of injected. The House would like to stop paying for the clinics, but the Senate's proposed budget continues their funding. The rise in heroin use is ominous because the drug is far more likely to create a lifelong addiction than cocaine, according to specialists and users. ''It takes a very long time to conduct heroin treatment, and a lot of providers will tell you the success rate is very low,'' said Jim Dreier, an analyst with the Drug Intelligence Center, an agency within the Department of Justice, based in Johnstown, Pa. ''With cocaine, there are higher success rates for treatment. It is not as lengthy a process. . . . The physiological dependence is not as strong.'' Heroin users make up only a small percentage of all drug treatment admissions in most Southern and Midwestern states. Clinics in California have seen a decline in the number of heroin addicts who are being displaced by amphetamine users, according to a Globe review of statistics compiled by the US Department of Health and Human Services. In New York, heroin admissions have surpassed cocaine admissions, but the gap between the two numbers is not nearly as wide as it is in Massachusetts. ''It's an East Coast phenomenon,'' said Thomas Clark, Boston's former representative to the Community Epidemiology Work Group, a federal program run by the National Institute on Drug Abuse, which tracks drug-use trends across the country. The decline in cocaine admissions has puzzled researchers, who say it could reflect everything from supply patterns to regional drug fads to repeat visits by heroin users, who, because of the difficulty of breaking their addiction, may be trumping cocaine abusers at treatment centers. ''The treatment system has a limited number of slots, so as one goes up, the other almost has to come down,'' Clark said. ''The heroin users are coming in and displacing the cocaine users.'' Using data from treatment centers may mask some of the cocaine usage, Clark said, because cocaine addicts, who have no medically treatable symptoms of withdrawal, have a harder time getting insurance companies to pay for treatment. But, if the decline in cocaine admissions raises questions, the rise of heroin is an all-too familiar tale. In the early 1990s, the same Colombian drug cartels that sell cocaine on the East Coast decided to wrestle the heroin market away from Asian producers. Their strategy: to push down the price and make heroin so pure it could be smoked or snorted, Dreier said. ''It was a marketing decision,'' he said, adding that there was a false belief that snorting the drug or smoking it -- a practice called ''chasing the dragon'' -- would not be addictive. The price of a thumbnail-size bag of heroin dropped from about $15 in the 1970s to about $5. The average purity of heroin sold to small-scale users rose from 3 percent in 1981 to nearly 30 percent in 2000, according to nationwide statistics compiled for the Office of National Drug Control Policy. The purity of some heroin on Boston's streets has been found to be as high as 70 percent. Low prices and high potency have fueled a new generation of heroin users in Massachusetts who are, by and large, younger, wealther, and more suburban than the heroin addicts of the past. ''I see people from the upper middle class. I see 18- and 19-year-old kids,'' said Dana Moulton, 52, who once abused heroin and is now a project assistant with the Massachusetts Organization for Addiction Recovery, a nonprofit education group. ''I could see the transition. . . . In the 1980s, you didn't see young people using heroin the way we do now. You had to be in the loop'' to get it. Unlike in California, where much of the heroin comes from Mexico in forms too impure to inhale, the purer heroin in Massachusetts began to attract a following from people who had never used the drug. One recovering addict at Phoenix House Springfield Center, a state-funded residential treatment facility in Springfield, recalls the disgust he felt for heroin when he was in high school. ''It was taboo. [I had] the mental image of a guy with hair down his back who never shaves and weighs 100 pounds soaking wet,'' said the man, a 37-year-old drywall finisher. ''I swore I would never put a needle in my arm.'' But, nine years ago, his cousin told him he didn't have to use a needle, so he began sniffing it. He got hooked, and could not believe how many of his co-workers and acquaintances were sniffing heroin, too. He said he started off buying it from teenagers on Blue Hill Avenue, he said, but soon began to buy it from men in suits with offices on Boylston Street. ''You get a business card, beep them, they come see you, and go have a social drink over lunch,'' he said. At $5 a bag, he said, ''I thought I had discovered gold.'' Steven Richard, now 31 and recovering at Phoenix House from his addictions, said snorting the drug also lured him into becoming a user. ''I was always against needles,'' he said. ''I never, ever thought that I would inject drugs.'' Richard's journey toward hard-core addiction began when he was a teenager who had moved from Cape Cod to Florida to be with a girlfriend. One day, he was driving down the highway in Florida, and a friend passed him a pipe full of crack. He puffed and nearly veered off the road. The hit was instant. The next three years were sleepless and wired as he broke into homes so he could afford to ''chase'' the high. Going to jail at age 20 was enough to motivate him to stay clean, and he moved back to his family's home on Cape Cod, got a job selling cars, bought a house, and began living with with his girlfriend. But seven years later, in 1997, a childhood friend asked for a ride to Boston and, somewhere near the Forest Hills T station, handed him a bag of heroin to snort. He didn't resist, and the drug became a full-time addiction he could afford on earnings from a paper route. ''There were nights where I spent almost $1,500 in one night on cocaine,'' said Richard. ''With heroin, $400 could last me close to a week.'' After a few years of sniffing, he graduated to injecting the drug, asking a friend to do it the first time because he was scared of the needle. Now, five years, $60,000 in credit card debt, and countless court arraignments later, what public health officials call ''an epidemic'' has cost Richard not only his home, but also the seven-year-long relationship that he lost when heroin became his only passion. ''She's got a baby now,'' he said wistfully of the girlfriend who married someone else. ''It's been four years now, and I still think about it.'' </WIRE_BODY> This story ran on page A1 of the Boston Globe on 5/26/2003.
© Copyright 2003 Globe Newspaper Company. | | http://www.dpna.org/resources/trends/choice.htm |
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| | | Drug Trends | | 2003 ANNUAL REPORT ON DRUGS IN THE EU ACCEDING AND
CANDIDATE COUNTRIES Drug problems growing but enlargement offers unique chance for concerted responses (22.10.2003 LISBON/EMBARGO 10H00 CET) The arrival of 10 new EU Member States in 2004 may well fan the flames of an already complex EU drugs problem, but enlargement will also offer countries the chance to play a full part in developing concerted and coordinated responses through increased cooperation. So says the Lisbon-based drugs agency, the EMCDDA, in its Annual report 2003: the state of the drugs problem in the acceding and candidate countries to the European Union, launched today in Strasbourg. Presenting the report, Agency chief Georges Estievenart said: �?B>EU enlargement throws up an array of public concerns that cannot be ignored. Among these are increased drug trafficking, escalating drug use in the new Member States and the spread of infectious diseases. But enlargement also offers countries a unique opportunity to benefit from closer collaboration. This report hits a positive note on how progress can be achieved by new and old Member States�?working together to respond to this shared problem through sound analysis and better-informed action.�?/SPAN> On the eve of EU enlargement, the report offers a comprehensive historical overview of drugs in the countries under review since the early 1990s. It also carries three selected issues on drug and alcohol use among young people (see news release on young people), drug-related infectious diseases and national drug strategies. Infectious diseases �?priority for public health responses Potential for serious future HIV problems Today’s report warns that some east European countries are ‘threatened by the most rapidly developing HIV epidemic in the world�? In particular it cites recent and sudden increases in HIV infection among injecting drug users (IDUs) in two of the Baltic States �?B> Estonia and Latvia �?where infection has spread at an ‘alarming rate�? with prevalence rates at up to 13% and 12% respectively in national samples of IDUs. Figures from 2001 show a 41% local prevalence rate among IDUs in the Estonian capital Tallinn. And data from the same year point to a 282% rise in newly diagnosed HIV infections among IDUs in Estonia and a 67% rise in Latvia. These rises might be due to the increased availability of heroin in the region in the late 1990s, combined with low risk-awareness among users and high-risk injecting behaviour. In most other Central and East European Countries (CEECs) �?B> Bulgaria, Czech Republic, Hungary, Romania, Slovakia and Slovenia �?B> the figures are below 1%, lower than in the EU, where prevalence ranges from around 1% in Finland to 34% in Spain. In the third Baltic State, Lithuania, HIV prevalence remains below 5%. There are currently no explosive rises in HIV reported among IDUs in Central Europe. Nevertheless, the EMCDDA says that a number of indicators suggest that the potential for serious future problems remains considerable. Increasing HIV prevalence among IDUs poses a potential threat for a spread of the virus to the wider population. This, adds the agency, along with continuing high-risk behaviour, makes strengthening public-health measures a ‘must�? if HIV epidemics among IDUs and the general population are to be averted. Hepatitis B and C �?high rates in most countries For all CEECs where estimates are available, data show that prevalence of the hepatitis C virus (HCV) among IDUs is generally much higher than that of HIV. In Bulgaria, Estonia, Latvia and Lithuania, estimates among IDUs are 60% and more, broadly corresponding to the picture in the EU, where most figures range from 40�?0%. In other countries �?Czech Republic, Hungary, Slovakia and Slovenia �?average figures are lower but still high, generally around 20�?0%. Evidence from local studies shows HCV rates in this group to be rising. Overall, HCV rates among IDUs in the CEECs are similar to those of the EU and are likely to result in considerable long-term public health costs. Yet, at present, responses and treatment options remain under-developed in the region and need to evolve if they are to have a positive impact on long-term health problems. Data availability on the prevalence of the hepatitis B virus (HBV) is generally poor. This disease can also be very serious, especially among IDUs. But, unlike HCV, it can be prevented by vaccination. Vaccination is available to IDUs in all CEECs but coverage is still far from ideal. Harm reduction �?insufficient coverage Reducing drug-related harm, especially infectious diseases and overdose deaths, is one of the six objectives of the EU action plan on drugs (2000�?004) and a clear priority in most EU countries. Associated public health measures include: providing access to clean injecting equipment; distributing condoms; testing and counselling for infectious diseases; risk-awareness education for drug users; low-threshold drop-in centres; HBV vaccination and HIV/AIDS treatment. Although all 10 CEECs have now implemented preventive and harm-reduction measures, provision and coverage are too limited in most of them, in view of the prevalence of problem drug use, risk behaviour and the scale of potential consequences. Some measures �?especially syringe and needle-exchange programmes and methadone substitution �?remain controversial in many parts of central and eastern Europe. Only the Czech Republic reaches a substantial proportion of IDUs (estimated at over 50%) through a national network of syringe-exchange programmes and low-threshold projects. In Slovenia, a reasonable level of coverage is achieved in some cities. Methadone substitution treatment, which can help reduce health damage, including drug-related deaths and infectious diseases, is available in all countries, but coverage is extremely limited except in Slovenia. However, from 1997�?001 the numbers of clients on methadone increased in some countries. The current low levels of HIV infection rates among drug users in most countries should be no cause for complacency. Some studies have shown that high-risk behaviour is widespread. A 2001 study in one region of Estonia reported that 45% of IDUs shared needles. A survey in Budapest the same year reported that 33% shared needles and syringes and 41% other paraphernalia. Strong public-health measures to encourage behavioural change among IDUs and to prevent high-risk injecting and sexual behaviour are still scarce in the region. Such measures, if implemented, might save health and social costs for the individual and the community. Drug strategies in the future Member States Governments�?intentions to face the drugs problem are examined in the final chapter of today’s report, which offers an overview of the main instruments of drug policy �?laws, strategies and coordination arrangements. This focuses mainly on the 10 CEECs, but also examines legislative aspects in Cyprus, Malta and Turkey. Drug laws lean towards criminalisation The report reveals that most of the 13 acceding and candidate countries have made major changes to their drug laws over the last decade. Seven �?Bulgaria, Czech Republic, Estonia, Hungary, Lithuania, Romania and Slovakia �?have replaced or revised their penal codes redefining what constitutes a drug offence or penalty. Meanwhile, the Czech Republic and Hungary have gone a step further by carrying out impact analyses of their legal changes and acting on the results. Where legal attitudes to drugs are concerned, some countries have tended to criminalise the possession of drugs for personal use and/or drug use per se since 1990. This contrasts with more recent drug law modifications in some EU countries, which have addressed this question quite differently. Nine countries �?Bulgaria, Cyprus, Hungary, Lithuania, Malta, Poland, Romania, Slovakia and Turkey �?currently treat possession of a small amount of drugs for personal use as a criminal offence, while three �?Czech Republic, Estonia and Latvia �?consider this to be an administrative offence. Three countries consider drug use per se to be a criminal offence �?Cyprus, Malta and Turkey �?although in Malta the offence applies exclusively to the use of prepared opium. Sentences for trafficking are similar to those in the EU. Strategies now widespread but more evaluation and support needed The report observes that national drug strategies are now in place, or about to be adopted, in the 10 CEECs (information unavailable for Malta, Cyprus and Turkey). This trend, echoing that in the EU, shows that these countries are increasingly committing to the planning and implementation of drug-related activities as part of a more comprehensive approach to global drug policy. In many cases, the strategies appear to draw on target-oriented management criteria, but this approach is reportedly often weakened by the lack of political will and resources allocated to drugs. Of the 10 CEECs, only Lithuania provided costs of the strategy’s planned activities. In other countries, lack of financing was frequently cited as the reason for poor implementation of policy plans. The report refers to the need for political and financial support and the scientific evaluation of results, if the effectiveness of strategies is to be improved. Most CEEC drug strategies aim to address legal and illegal drugs; reduce drug-related infectious diseases and deaths; and improve implementation and delivery of actions. All cover actions in the areas of both demand and supply reduction and most have links to the EU action plan on drugs (2000�?004). Drug policy coordination in the CEECs appears quite a new concept. In some countries, national coordination systems are very new and not yet fully operational. In others, structures, although in place for some time, have not been fully implemented due to lack of resources. Reliable information must underpin policy The report stresses that reliable and relevant information is essential for ‘underpinning the new drug strategies and policies that are under development in all acceding and candidate countries�? It also underlines the need for countries to invest in ‘surveillance and reporting systems�?necessary for a sound understanding of the drug phenomenon or tracking its evolution over time. On this note, Chairman of the EMCDDA Management Board Marcel Reimen says: ‘In the EU, national focal points and regional and local centres play a vital role in collecting and making sense of data needed for sound policy-making. It follows that, in the acceding and candidate countries, proper investment in such focal points is a prerequisite for rising to the drug challenge.' Finally in a region undergoing such rapid change, says the EMCDDA, early detection of new trends and emerging problems will be of vital importance, as will reacting quickly when new problems are identified. The importance of this message is particularly relevant to HIV and the potential for future epidemics in the countries under review. | | |
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| Results from the 2002 National Survey on Drug Use and Health (NSDUH) | Highlights This report presents, for the first time, information from the 2002 National Survey on Drug Use and Health (NSDUH). This survey, formerly called the National Household Survey on Drug Abuse (NHSDA), is a project of the Substance Abuse and Mental Health Services Administration (SAMHSA). This survey was initiated in 1971 and is the primary source of information on the use of illicit drugs, alcohol, and tobacco by the civilian, noninstitutionalized population of the United States aged 12 years old or older. The survey interviews approximately 67,500 persons each year. Because of improvements to the survey in 2002, estimates from the 2002 NSDUH should not be compared with estimates from the 2001 and earlier NHSDAs to assess change over time in substance use. Therefore, the 2002 data constitute a new baseline for tracking trends in substance use and other measures. However, it is possible to develop trend estimates based on respondents' reports of past substance use in the 2002 NSDUH. The estimates are presented in terms of lifetime and first-time substance use. Illicit Drug Use - In 2002, an estimated 19.5 million Americans, or 8.3 percent of the population aged 12 or older, were current illicit drug users. Current drug use means use of an illicit drug during the month prior to the survey interview.
- Marijuana is the most commonly used illicit drug, with a rate of 6.2 percent. Of the 14.6 million past month marijuana users in 2002, about one third, or 4.8 million persons, used it on 20 or more days in the past month.
- In 2002, an estimated 2.0 million persons (0.9 percent) were current cocaine users, 567,000 of whom used crack. Hallucinogens were used by 1.2 million persons, including 676,000 users of Ecstasy. There were an estimated 166,000 current heroin users.
- An estimated 6.2 million persons, or 2.6 percent of the population aged 12 or older, were current users of psychotherapeutic drugs taken nonmedically. An estimated 4.4 million used pain relievers, 1.8 million used tranquilizers, 1.2 million used stimulants, and 0.4 million used sedatives.
- In 2002, approximately 1.9 million persons aged 12 or older had used OxyContin nonmedically at least once in their lifetime.
- Among youths aged 12 to 17, 11.6 percent were current illicit drug users. The rate of use was highest among young adults (18 to 25 years) at 20.2 percent. Among adults aged 26 or older, 5.8 percent reported current illicit drug use.
- Among pregnant women aged 15 to 44 years, 3.3 percent reported using illicit drugs in the month prior to their interview. This rate was significantly lower than the rate among women aged 15 to 44 who were not pregnant (10.3 percent).
- The rates of current illicit drug use were highest among American Indians/Alaska Natives (10.1 percent) and persons reporting two or more races (11.4 percent). Rates were 9.7 percent for blacks, 8.5 percent for whites, and 7.2 percent for Hispanics. Asians had the lowest rate at 3.5 percent.
- Among youths aged 12 to 17, the rate of current illicit drug use among American Indians/Alaska Natives (20.9 percent) was significantly higher than the rate among all youths (11.6 percent), and the rate among Asian youths (4.8 percent) was significantly lower compared with the overall rate for all youths.
- An estimated 17.4 percent of unemployed adults aged 18 or older were current illicit drug users in 2002 compared with 8.2 percent of those employed full time and 10.5 percent of those employed part time. However, most drug users were employed. Of the 16.6 million illicit drug users aged 18 or older in 2002, 12.4 million (74.6 percent) were employed either full or part time.
- In 2002, an estimated 11.0 million persons reported driving under the influence of an illicit drug during the past year. This corresponds to 4.7 percent of the population aged 12 or older. The rate was 10 percent or greater for each age from 17 to 25, with 21 year olds reporting the highest rate of any age (18.0 percent). Among adults aged 26 or older, the rate was 3.0 percent.
Alcohol Use - An estimated 120 million Americans aged 12 or older reported being current drinkers of alcohol in the 2002 survey (51.0 percent). About 54 million (22.9 percent) participated in binge drinking at least once in the 30 days prior to the survey, and 15.9 million (6.7 percent) were heavy drinkers.
- The prevalence of current alcohol use increased with increasing age in 2002, from 2.0 percent at age 12 to 6.5 percent at age 13, 13.4 percent at age 14, 19.9 percent at age 15, 29.0 percent at age 16, and 36.2 percent at age 17. The rate reached a peak of 70.9 percent for persons 21 years old.
- About 10.7 million persons aged 12 to 20 reported drinking alcohol in the month prior to the survey interview in 2002 (28.8 percent of this age group). Of these, nearly 7.2 million (19.3 percent) were binge drinkers and 2.3 million (6.2 percent) were heavy drinkers.
- About 1 in 7 Americans aged 12 or older in 2002 (14.2 percent, or 33.5 million persons) drove under the influence of alcohol at least once in the 12 months prior to the interview.
Tobacco Use - An estimated 71.5 million Americans (30.4 percent of the population aged 12 or older) reported current use (past month use) of a tobacco product in 2002. About 61.1 million (26.0 percent) smoked cigarettes, 12.8 million (5.4 percent) smoked cigars, 7.8 million (3.3 percent) used smokeless tobacco, and 1.8 million (0.8 percent) smoked tobacco in pipes.
- A higher proportion of males than females aged 12 or older smoked cigarettes in 2002 (28.7 vs. 23.4 percent). However, among youths aged 12 to 17, girls were slightly more likely than boys to smoke (13.6 vs. 12.3 percent).
- In 2002, 17.3 percent of pregnant women aged 15 to 44 smoked cigarettes in the past month compared with 31.1 percent of nonpregnant women of the same age group.
Trends in Lifetime Substance Use - The percentage of youths aged 12 to 17 who had ever used marijuana declined slightly from 2001 to 2002 (21.9 to 20.6 percent). Among young adults aged 18 to 25, the rate increased slightly from 53.0 percent in 2001 to 53.8 percent in 2002.
- The percentage of youths aged 12 to 17 who had ever used cocaine increased slightly from 2001 to 2002 (2.3 to 2.7 percent). Among young adults aged 18 to 25, the rate increased slightly from 14.9 percent in 2001 to 15.4 percent in 2002.
- Lifetime nonmedical pain reliever prevalence among youths aged 12 to 17 increased from 2001 (9.6 percent) to 2002 (11.2 percent), continuing an increasing trend from 1989 (1.2 percent). Among young adults aged 18 to 25, the rate increased from 19.4 percent in 2001 to 22.1 percent in 2002. The young adult rate had been 6.8 percent in 1992.
- The rate of lifetime cigarette use among youths aged 12 to 17 declined from 37.3 percent in 2001 to 33.3 percent in 2002.
- The rate of lifetime daily cigarette use among youths aged 12 to 17 declined from 10.6 percent in 2001 to 8.2 percent in 2002. There also was a small decline in lifetime prevalence among young adults (37.7 to 37.1 percent) from 2001 to 2002.
Trends in Initiation of Substance Use (Incidence) - There were an estimated 2.6 million new marijuana users in 2001. This number is similar to the numbers of new users each year since 1995, but above the number in 1990 (1.6 million).
- Pain reliever incidence increased from 1990, when there were 628,000 initiates, to 2000, when there were 2.7 million. In 2001, the number was 2.4 million, not significantly different from 2000.
- The number of new daily cigarette smokers decreased from 2.1 million in 1998 to 1.4 million in 2001. Among youths under 18, the number of new daily smokers decreased from 1.1 million per year between 1997 and 2000 to 757,000 in 2001. This corresponds to a decrease from about 3,000 to about 2,000 new youth smokers per day.
Youth Prevention-Related Measures - Among youths indicating that "smoking marijuana once a month" was a "great risk," only 1.9 percent indicated that they had used marijuana in the past month. However, among youths who indicated "moderate, slight, or no risk," the prevalence rate was almost 6 times larger (11.3 percent).
- The percentages of youths reporting that it was fairly or very easy to obtain specific drugs were 55.0 percent for marijuana, 25.0 percent for cocaine, 19.4 percent for LSD, and 15.8 percent for heroin.
- Most youths (89.1 percent) reported that their parents would strongly disapprove of their trying marijuana once or twice. Among these youths, only 5.5 percent had used marijuana in the past month. However, among youths who perceived that their parents would only somewhat disapprove or neither approve nor disapprove of their trying marijuana, 30.2 percent reported past month use of marijuana.
Substance Dependence or Abuse - An estimated 22.0 million Americans in 2002 were classified with substance dependence or abuse (9.4 percent of the total population aged 12 or older). Of these, 3.2 million were classified with dependence on or abuse of both alcohol and illicit drugs, 3.9 million were dependent on or abused illicit drugs but not alcohol, and 14.9 million were dependent on or abused alcohol but not illicit drugs.
- Among persons aged 12 or older in 2002, the rate of substance dependence or abuse was highest among American Indians/Alaska Natives (14.1 percent). The next highest rate was among persons reporting two or more races (13.0 percent). Asians had the lowest rate of dependence or abuse (4.2 percent). The rate was similar among blacks and whites (9.5 and 9.3 percent, respectively). Among Hispanics, the rate was 10.4 percent.
- In 2002, an estimated 19.7 percent of unemployed adults aged 18 or older were classified with dependence or abuse, while 10.6 percent of full-time employed adults and 10.5 percent of part-time employed adults were classified as such. However, most adults with substance dependence or abuse were employed either full or part time. Of the 19.8 million adults classified with dependence or abuse, 15.3 million (77.1 percent) were employed.
Treatment and Treatment Need for Substance Problems - An estimated 3.5 million people aged 12 or older (1.5 percent of the population) received some kind of treatment for a problem related to the use of alcohol or illicit drugs in the 12 months prior to being interviewed in 2002. Of these, 2.2 million received treatment for alcohol during their most recent treatment. An estimated 974,000 persons received treatment for marijuana, 796,000 persons for cocaine, 360,000 for pain relievers, and 277,000 for heroin. Most people receiving treatment received it at a "specialty" substance abuse facility (2.3 million).
- In 2002, the estimated number of persons aged 12 or older needing treatment for an illicit drug problem was 7.7 million (3.3 percent of the total population). Of these persons, 1.4 million (18.2 percent) received treatment for drug abuse at a specialty substance abuse facility in the past 12 months. Of the 6.3 million people who needed drug treatment but did not receive treatment at a specialty facility in 2002, an estimated 362,000 (5.7 percent) reported that they felt they needed treatment for their drug problem. This included an estimated 88,000 (24.4 percent) who reported that they made an effort but were unable to get treatment and 274,000 (75.6 percent) who reported making no effort to get treatment.
- In 2002, the estimated number of persons aged 12 or older needing treatment for an alcohol problem was 18.6 million (7.9 percent of the total population). Of these, 8.3 percent (1.5 million) received alcohol treatment at a specialty substance abuse facility in the past 12 months. Of the 17.1 million people who needed but did not receive alcohol treatment, an estimated 761,000 (4.5 percent) reported that they felt they needed treatment for their alcohol problem. Of the 761,000 persons, 266,000 (35 percent) reported that they made an effort but were unable to get treatment, and 495,000 (65 percent) reported making no effort to get treatment.
- Among the 1.4 million persons who received specialty treatment for an illicit drug problem in the past year, 33.9 percent reported "own savings or earnings" as a source of payment for their most recent specialty treatment. An estimated 30.0 percent reported private health insurance, 26.1 percent reported Medicaid, and 23.3 percent reported public assistance other than Medicaid as a source of payment.
- Among the 1.5 million persons who received specialty treatment for an alcohol problem in the past year, 46.3 percent reported "own savings or earnings" as a source of payment for their most recent specialty treatment. An estimated 31.7 percent reported using private health insurance, 21.5 percent reported public assistance other than Medicaid, and 21.4 percent reported Medicaid.
Serious Mental Illness among Adults - In 2002, there were an estimated 17.5 million adults aged 18 or older with serious mental illness (SMI). This represents 8.3 percent of all adults. Rates of SMI were highest for persons aged 18 to 25 (13.2 percent) and lowest for persons aged 50 or older (4.9 percent). The percentage of females with SMI was higher than the percentage of males (10.5 vs. 6.0 percent).
- Adults who used illicit drugs were more than twice as likely to have SMI as adults who did not use an illicit drug. In 2002, among adults who used an illicit drug in the past year, 17.1 percent had SMI in that year, while the rate was 6.9 percent among adults who did not use an illicit drug.
- SMI was highly correlated with substance dependence or abuse. Among adults with SMI in 2002, 23.2 percent (4.0 million) were dependent on or abused alcohol or illicit drugs, while the rate among adults without SMI was only 8.2 percent.
- Among adults with substance dependence or abuse, 20.4 percent had SMI. The rate of SMI was 7.0 percent among adults who were not dependent on or abusing a substance.
Treatment for Mental Health Problems - In 2002, an estimated 27.3 million adults (13.0 percent) received mental health treatment in the 12 months prior to the interview.
- Among the 17.5 million adults with SMI in 2002, 8.4 million (47.9 percent) received treatment for a mental health problem in the 12 months prior to the interview.
- Among adults with SMI, 30.5 percent perceived an unmet need for mental health treatment in the 12 months prior to their interview. The most often reported reasons for not getting needed treatment were "could not afford the cost" (44.3 percent) and "did not know where to go for services" (20.5 percent).
- In 2002, an estimated 4.8 million youths aged 12 to 17 received treatment or counseling for emotional or behavior problems in the year prior to the interview. This represents 19.3 percent of this population.
- The reason cited most often by youths for their latest treatment session was "felt depressed" (49.5 percent of youths receiving treatment), followed by "breaking rules or acting out" (26.7 percent), "thought about killing self or tried to kill self" (19.5 percent), and "felt very afraid or tense" (19.5 percent).
- The rate of mental health treatment among youths who used illicit drugs in the past year (26.7 percent) was higher than the rate among youths who did not use illicit drugs (17.2 percent).
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| Results from the 2002 National Survey on Drug Use and Health (NSDUH) | 1. Introduction This report presents the first information from the 2002 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. Prior to 2002, the survey was called the National Household Survey on Drug Abuse (NHSDA). This initial report on the 2002 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 included. State-level estimates from NSDUH, based on a complex small area estimation (SAE) method, will be presented in other reports to be released separately. Because of improvements to the survey in 2002, estimates from the 2002 NSDUH should not be compared with estimates from the 2001 and earlier NHSDAs to assess change over time in substance use. Therefore, the 2002 data will constitute a new baseline for tracking trends in substance use and other measures.
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 their place of residence. The survey is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) and is planned and managed by SAMHSA's Office of Applied Studies (OAS). Data collection is conducted by 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, noninstitutional group quarters (e.g., shelters, rooming houses, dormitories), and civilians living on military bases. Persons excluded from the survey include homeless persons who do not use shelters, military personnel on active duty, and residents of institutional group quarters, such as jails and hospitals. Appendix E describes surveys that cover populations outside the NSDUH sampling frame. Since 1999, the NSDUH interview has been carried out using computer-assisted interviewing (CAI). The survey uses a combination of computer-assisted personal interviewing (CAPI) conducted by the interviewer and audio computer-assisted self-interviewing (ACASI). Use of ACASI is designed to provide the respondent with a highly private and confidential means of responding to questions and to increase the level of honest reporting of illicit drug use and other sensitive behaviors. Consistent with the 1999 through 2001 surveys, the 2002 NSDUH employed a 50–State sample design with an independent, multistage area probability sample for each of the 50 States 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 were selected to support State estimates using small area estimation (SAE) techniques. The design also oversampled youths and young adults, so that each State's sample was approximately equally distributed among three major age groups: 12 to 17 years, 18 to 25 years, and 26 years or older. Nationally, 136,349 addresses were screened for the 2002 survey, and 68,126 completed interviews were obtained. The survey was conducted from January through December 2002. Weighted response rates for household screening and for interviewing were 90.7 and 78.9 percent, respectively. See Appendix B for more information on NSDUH response rates.
1.2. Trend Measurement Although the design of the 2002 NSDUH is similar to the design of the 1999 through 2001 surveys, there are important methodological differences in the 2002 survey that affect the 2002 estimates. Besides the name change, each NSDUH respondent is now given an incentive payment of $30. These changes, both implemented in 2002, resulted in a substantial improvement in the survey response rate. The changes also affected respondents' reporting of many critical items that are the basis of prevalence measures reported by the survey each year. Further, the 2002 data could have been affected by improved data collection quality control procedures that were introduced in the survey beginning in 2001. In addition, new population data from the 2000 decennial census recently became available for use in NSDUH sample weighting procedures, resulting in another discontinuity between the 2001 and 2002 estimates. Analyses of the effects of each of these factors on NSDUH estimates (see Appendix C) have shown that 2002 data should not be compared with 2001 and earlier NHSDA data to assess changes over time. Therefore, this report presents data only from the 2002 NSDUH. Using only the 2002 data, however, limited trend assessment can be done using information collected in NSDUH on prior substance use. Specifically, questions on age at first use of substances, in conjunction with respondents' ages and interview dates, provide data that can be used to estimate the rates of first-time use (incidence), as well as the rates of lifetime prevalence (the percentage of the population that has ever used each substance) for years prior to 2002. Trends in these measures for youths and young adults are discussed in Chapters 5 and 6. Additional discussion of trends, including a comparison with the Monitoring the Future (MTF) study, is included in the final discussion in Chapter 10. The methodological changes made to NSDUH in 2002 improved the quality of the data provided by the survey. As is typically the case in ongoing surveys, adjustments in survey procedures must be made periodically in order to maintain data quality in the context of the changing environment in which surveys are conducted (e.g., a general decline in the U.S. population's willingness to participate in surveys). OAS will continue to explore and test improvements to the survey design, but no additional changes to the survey that could impact trend measurement will be implemented in the foreseeable future. Thus, subsequent reports of NSDUH data will provide detailed analyses of trends in current substance use and other measures, with the 2002 estimates from this report providing the new baseline for measuring change.
1.3. Format of Report and Explanation of Tables The results from the 2002 NSDUH are given in this report, which has separate chapters that discuss the national findings on eight topics: use of illicit drugs; use of alcohol; use of tobacco products; trends in lifetime use of substances; trends in initiation of substance use; prevention-related issues; substance dependence, abuse, and treatment; and mental health. A final chapter summarizes the results and discusses key findings in relation to other research and survey results. Technical appendices describe the survey, provide technical details on the survey methodology, discuss the effects of survey protocol changes on trend measurement, offer key NSDUH definitions, discuss other sources of data, list the references cited in the report (as well as other relevant references), and present selected tabulations of estimates. Tables and text present prevalence measures for the population in terms of both the number of substance users and the rate of use for illicit drugs, alcohol, and tobacco products. Tables show estimates of drug use prevalence 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." Data are presented for racial/ethnic groups in several categorizations, based on the level of detail permitted by the sample. 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 seven basic groups listed in the survey question (white, black/African American, American Indian or Alaska Native, Native Hawaiian, other Pacific Islander, Asian, other). It should be noted that, except for the "Hispanic or Latino" group, the race/ethnicity groups discussed in this report include only non-Hispanics. The category "Hispanic or Latino" includes Hispanics of any race. Also, more detailed categories describing specific subgroups were obtained from survey respondents if they reported either Asian race or Hispanic ethnicity. 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. Bureau of the Census, 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, which reflects different levels of urbanicity and metropolitan area inclusion of counties. For this purpose, counties are grouped based on "Rural-Urban Continuum Codes" 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 Office of Management and Budget (OMB). For New England, the New England County Metropolitan Areas (NECMA) are used for defining codes. Large metropolitan areas have a population of 1 million or more. Small metropolitan areas have a population of fewer than 1 million. Nonmetropolitan areas are areas outside MSAs. Small metropolitan areas are further classified as having either fewer than or greater than 250,000 population. Counties in nonmetropolitan areas are 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 20,000 or more population 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.
1.4. Other NSDUH Reports This report provides a comprehensive summary of the 2002 NSDUH, including results, technical appendices, and selected data tables. A companion report, Overview of Findings from the 2002 National Survey on Drug Use and Health, is a shorter, more concise report that highlights the most important findings of the survey and includes only a brief discussion of the methods. A report on State-level estimates for 2002 will be available in early 2004. In addition to the tables included in Appendices G and H of this report, a more extensive set of tables, including standard errors, is available upon request from OAS or through the Internet at http://www.DrugAbuseStatistics.SAMHSA.gov. 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://www.DrugAbuseStatistics.SAMHSA.gov). In addition, OAS makes public use data files available to researchers through the Substance Abuse and Mental Health Data Archive (SAMHDA, 2003). Currently, files are available from the 1979 to 2001 NHSDAs at http://www.icpsr.umich.edu/SAMHDA. The NSDUH 2002 public use file will be available by the end of 2003.
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| Results from the 2002 National Survey on Drug Use and Health (NSDUH) | 2. Illicit Drug Use The National Survey on Drug Use and Health (NSDUH) obtains information on nine different categories of illicit drug use: marijuana, cocaine, heroin, hallucinogens, inhalants, and 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, mushrooms, and "Ecstasy" (MDMA). Inhalants include a variety of substances, such as amyl nitrite, cleaning fluids, gasoline, paint, and glue. The four categories of prescription-type drugs (pain relievers, tranquilizers, stimulants, and sedatives) cover numerous drugs available through prescriptions and sometimes illegally "on the street." Methamphetamine is included under stimulants. Over-the-counter drugs and legitimate uses of prescription drugs are not included. Respondents are asked to report only uses of drugs that were not prescribed for them or drugs they took only for the experience or feeling they caused. NSDUH reports combine the four prescription-type drug groups into a category referred to as "any psychotherapeutics." Estimates of "any illicit drug use" reported from NSDUH reflect use of any of the nine substance categories listed above. Use of alcohol and tobacco products, while illegal for youths, are not included in these estimates, but are discussed in Chapters 3 and 4. Findings from the 2002 NSDUH on illicit drug use are summarized below. - In 2002, an estimated 19.5 million Americans aged 12 or older were current illicit drug users, meaning they had used an illicit drug during the month prior to the survey interview. This estimate represents 8.3 percent of the population aged 12 years old or older.
- Marijuana is the most commonly used illicit drug. In 2002, it was used by 75 percent of current illicit drug users. Approximately 55 percent of current illicit drug users used only marijuana, 20 percent used marijuana and another illicit drug, and the remaining 25 percent used an illicit drug but not marijuana in the past month. About 45 percent of current illicit drug users in 2002 (8.8 million Americans) used illicit drugs other than marijuana and hashish, with or without using marijuana as well (Figure 2.1).
- In 2002, an estimated 2.0 million persons (0.9 percent) were current cocaine users, 567,000 of whom used crack during the same time period (0.2 percent). Hallucinogens were used by 1.2 million persons (0.5 percent), including 676,000 users of Ecstasy (0.3 percent) (Figure 2.2). There were an estimated 166,000 current heroin users (0.1 percent).
- Of the 8.8 million current users of illicit drugs other than marijuana, 6.2 million were current users of psychotherapeutic drugs. This represents 2.6 percent of the population aged 12 or older. Of those who reported current use of any psychotherapeutics, 4.4 million used pain relievers, 1.8 million used tranquilizers, 1.2 million used stimulants, and 0.4 million used sedatives.
Figure 2.1 Types of Drugs Used by Past Month Illicit Drug Users Aged 12 or Older: 2002  D
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- In 2002, approximately 1.9 million persons aged 12 or older had used OxyContin nonmedically at least once in their lifetime. OxyContin is a controlled-release tablet form of the narcotic oxycodone that can have severe health consequences if the tablet is crushed and then ingested.
Age - Rates of drug use showed substantial variation by age. For example, 4.2 percent of youths aged 12 or 13 reported current illicit drug use in 2002 (Figure 2.3). As in other years, illicit drug use in 2002 tended to increase with age among young persons. It peaked among 18 to 20 year olds (22.5 percent) and declined steadily after that point with increasing age.
- The types of drugs used also varied by age group. Among youths aged 12 to 17, 11.6 percent were current illicit drug users: 8.2 percent used marijuana, 4.0 percent used prescription-type drugs, 1.2 percent used inhalants, 1.0 percent used hallucinogens, and 0.6 percent used cocaine (Figure 2.4). Rates of use were highest for the young adult age group (18 to 25 years) at 20.2 percent, with 17.3 percent using marijuana, 5.4 percent using prescription-type drugs nonmedically, 2.0 percent using cocaine, and 1.9 percent using hallucinogens (Figure 2.5). Among adults aged 26 or older, 5.8 percent reported current illicit drug use: 4.0 percent used marijuana and 2.0 percent used prescription-type drugs. Less than 1 percent used cocaine (0.7 percent), hallucinogens (0.2 percent), and inhalants (0.1 percent) (Figure 2.6).
- Among youths, the types of drugs used also differed by age. Among 12 or 13 year olds, 1.7 percent used prescription-type drugs nonmedically, 1.4 percent used marijuana, and 1.4 percent used inhalants. Among 14 or 15 year olds, marijuana was the dominant drug used (7.6 percent), followed by prescription-type drugs used nonmedically (4.0 percent) and inhalants (1.6 percent). Marijuana also was the most commonly used drug among 16 or 17 year olds (15.7 percent), followed by prescription-type drugs used nonmedically (6.2 percent), hallucinogens (1.9 percent), and cocaine (1.3 percent). Only 0.6 percent of youths aged 16 or 17 used inhalants.
- Although most drug use rates in 2002 were higher among youths and young adults compared with older adults, the age distribution of users varied considerably by type of drug. Almost half (47 percent) of current illicit drug users were aged 12 to 25. However, in 2002, 71 percent of hallucinogen users, as well as 71 percent of inhalant users, were 12 to 25 year olds. Conversely, only 38 percent of cocaine users and 43 percent of nonmedical psychotherapeutics users were in that age grouping.
Gender - As in prior years, men were more likely in 2002 to report current illicit drug use than women (10.3 vs. 6.4 percent). However, rates of nonmedical psychotherapeutic use were similar for males (2.7 percent) and females (2.6 percent), which was consistent with previous findings for these drugs.
Figure 2.3 Past Month Illicit Drug Use, by Age: 2002  D
Figure 2.4 Past Month Use of Selected Illicit Drugs among Youths Aged 12 to 17: 2002  D
Figure 2.5 Past Month Use of Selected Illicit Drugs among Young Adults Aged 18 to 25: 2002  D
Figure 2.6 Past Month Use of Selected Illicit Drugs among Adults Aged 26 or Older: 2002  D
- Among youths aged 12 to 17, the rate of current illicit drug use was higher for boys (12.3 percent) than for girls (10.9 percent) (Figure 2.7). Although boys aged 12 to 17 had a higher rate of marijuana use than girls (9.1 vs. 7.2 percent), girls were more likely to use psychotherapeutics nonmedically than boys (4.3 vs. 3.6 percent).
Figure 2.7 Past Month Illicit Drug Use among Youths Aged 12 to 17, by Gender: 2002  D
Pregnant Women - Among pregnant women aged 15 to 44 years, 3.3 percent reported using illicit drugs in the month prior to their interview. This rate was significantly lower than the rate among women aged 15 to 44 who were not pregnant (10.3 percent).
Race/Ethnicity - Rates of current illicit drug use varied significantly among the major racial/ethnic groups in 2002. The rate was highest among American Indians/Alaska Natives (10.1 percent) and persons reporting two or more races (11.4 percent). Rates were 8.5 percent for whites, 7.2 percent for Hispanics, and 9.7 percent for blacks (Figure 2.8). Asians had the lowest rate at 3.5 percent.
- There were variations in rates of past month illicit drug use among Hispanic subgroups. Rates were 10.0 percent for Puerto Ricans, 7.3 percent for Mexicans, 6.5 percent for Cubans, and 5.0 percent for Central or South Americans.
Figure 2.8 Past Month Illicit Drug Use among Persons Aged 12 or Older, by Race/Ethnicity: 2002  D
- Among youths aged 12 to 17, the rate of current illicit drug use among American Indians/Alaska Natives (20.9 percent) was significantly higher than the rate among all youths (11.6 percent), and the rate among Asian youths (4.8 percent) was significantly lower compared with the overall rate for all youths (Figure 2.9).
Education - As in other years, illicit drug use rates were correlated with educational status in 2002. Among adults aged 18 or older, the rate of current illicit drug use was lower among college graduates (5.8 percent) compared with those who did not graduate from high school (9.1 percent), high school graduates (8.0 percent), or those with some college (9.1 percent). This is despite the fact that adults who had completed 4 years of college were more likely to have tried illicit drugs in their lifetime when compared with adults who had not completed high school (50.5 vs. 37.1 percent).
Figure 2.9 Past Month Illicit Drug Use among Youths Aged 12 to 17, by Race/Ethnicity: 2002  D
College Students - In the college-aged population (i.e., those aged 18 to 22 years old), the rate of current illicit drug use was nearly the same among full-time undergraduate college students (20.7 percent) as for other persons aged 18 to 22 years, including part-time students, students in other grades, and nonstudents (22.4 percent).
Employment - Current employment status was highly correlated with rates of illicit drug use in 2002. An estimated 17.4 percent of unemployed adults aged 18 or older were current illicit drug users compared with 8.2 percent of those employed full time and 10.5 percent of those employed part time.
- Although the rate of drug use was higher among unemployed persons compared with those from other employment groups, most drug users were employed. Of the 16.6 million illicit drug users aged 18 or older in 2002, 12.4 million (74.6 percent) were employed either full or part time.
Geographic Area - Among persons aged 12 or older, the rate of current illicit drug use in 2002 was 9.7 percent in the West, 8.2 percent in the Northeast, 8.1 percent in the Midwest, and 7.6 percent in the South.
- The rate of illicit drug use in metropolitan areas was higher than the rate in nonmetropolitan areas. Rates were 8.6 percent in large metropolitan counties, 8.9 percent in small metropolitan counties, and 6.6 percent in nonmetropolitan counties as a group (Figure 2.10). Within nonmetropolitan areas, counties that were urbanized had a rate of 8.0 percent, while completely rural counties had a rate of 5.4 percent. This is not a statistically significant difference, but this finding is consistent with the pattern reported in previous surveys.
Figure 2.10 Past Month Illicit Drug Use among Persons Aged 12 or Older, by County Type: 2002  D
Criminal Justice Populations - In 2002, among the estimated 1.8 million adults aged 18 or older on parole or other supervised release from prison during the past year, 29.1 percent were current illicit drug users compared with 7.7 percent among adults not on parole or supervised release.
- Among the estimated 4.8 million adults on probation at some time in the past year, 28.7 percent reported current illicit drug use in 2002. This compares with a rate of 7.4 percent among adults not on probation in 2002.
Frequency of Use - In 2002, 12.2 percent of past year marijuana users used marijuana on 300 or more days in the past 12 months. This translates into 3.1 million persons using marijuana on a daily or almost daily basis over a 12–month period. Among past month users, about one third (32.6 percent, or 4.8 million persons) used marijuana on 20 or more days in the past month.
Association with Cigarette and Alcohol Use - In 2002, the rate of current illicit drug use was approximately 8 times higher among youths who smoked cigarettes (48.1 percent) than it was among youths who did not smoke cigarettes (6.2 percent) (Figure 2.11).
Figure 2.11 Past Month Illicit Drug Use among Youths Aged 12 to 17, by Cigarette and Alcohol Use: 2002  D
- Illicit drug use also was associated with the level of alcohol use. Among youths who were heavy drinkers, 67.0 percent also were current illicit drug users, whereas among nondrinkers, the rate was only 5.6 percent.
Driving Under the Influence of Illicit Drugs - In 2002, an estimated 11.0 million persons reported driving under the influence of an illicit drug during the past year. This corresponds to 4.7 percent of the population aged 12 or older. The rate was 10 percent or greater for each age from 17 to 25, with 21 year olds reporting the highest rate of any age (18.0 percent). Among adults aged 26 or older, the rate was 3.0 percent.
How Marijuana Is Obtained - NSDUH includes questions asking marijuana users how, from whom, and where they obtained the marijuana they used most recently. In 2002, most users (56.7 percent) got the drug for free or shared someone else's marijuana. Almost 40 percent of marijuana users bought it.
- Most marijuana users obtained the drug from a friend; 79.0 percent who bought their marijuana and 81.8 percent who obtained the drug for free had obtained it from a friend.
- More than half (55.9 percent) of users who bought their marijuana purchased it inside a home, apartment, or dorm. This also was the most common location for obtaining marijuana for free (67.2 percent). The percentages of youth users who obtained marijuana inside a home, apartment, or dorm were 34.7 percent for buyers and 48.0 percent for those who obtained it free.
- Almost 9 percent of youths who bought their marijuana obtained it inside a school building, and 4.8 percent bought it outside on school property.
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 Seventy percent of the world's heroin comes from one country-Afghanistan. Most of that is destined for Europe. But we should seize this opportunity in history to have an impact in Afghanistan. As part of an international effort, we could plow under the poppy fields, and thereby reduce that enormous supply. Even though most of the heroin is destined for Europe, it would still impact the United States.
That effort would have an impact on the United States by driving up the price of heroin. And when you drive up the price of heroin, what does it do? It reduces the number of people who will choose heroin abuse as a lifestyle. It's expensive, so they're not able to do it. Geek might be interesting to find drug / crime related statistics...they sure help to see things in perspective. Hope you don't mind if I copy all this, many thanks. |
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Seventy percent of the world's heroin comes from one country-Afghanistan. Most of that is destined for Europe. But we should seize this opportunity in history to have an impact in Afghanistan. As part of an international effort, we could plow under the poppy fields, and thereby reduce that enormous supply. The DEA hasn't deliver on this. It seems the War on Terror had conflicting priorities with the War on Drugs.   | language=JavaScript type=text/javascript>
</SCRIPT> Friday, November 28, 2003 Posted: 1:34 PM EST (1834 GMT) | | WASHINGTON (Reuters) -- Poppy cultivation in Afghanistan doubled between 2002 and 2003 to a level 36 times higher than in the last year of rule by the Taliban, according to White House figures released Friday. |
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Most of that is destined for Europe. Hmm, I noticed that too. WASHINGTON (Reuters) -- Poppy cultivation in Afghanistan doubled between 2002 and 2003 to a level 36 times higher than in the last year of rule by the Taliban, according to White House figures released Friday. Makes one wonder, doesn't it . |
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| | | From: Le_ToG | Sent: 8/16/2005 12:14 AM |
2001: In another illustration of our international work, we can look at Afghanistan. The DEA has not been stationed in Afghanistan since the 1980s because of the danger. But we're in the neighboring country of Pakistan. We have offices in Peshwar, right on the border of Afghanistan, and in Islamabad. As we see the Taliban regime falling, we want to take advantage of the opportunity to impact a country that produces 70 percent of the world's heroin. Seventy percent of the world's heroin comes from one country-Afghanistan. Most of that is destined for Europe. But we should seize this opportunity in history to have an impact in Afghanistan. As part of an international effort, we could plow under the poppy fields, and thereby reduce that enormous supply. Even though most of the heroin is destined for Europe, it would still impact the United States. That effort would have an impact on the United States by driving up the price of heroin. And when you drive up the price of heroin, what does it do? It reduces the number of people who will choose heroin abuse as a lifestyle. It's expensive, so they're not able to do it. The second thing reducing this supply will do, is that the traffickers will have to begin to "cut" the drug further-they will dilute it more to get more product. And so the potency of heroin in the United States goes down. When the potency goes down and the price goes up, you have less usage and fewer deaths as a result. We're working on an international plan to go into Afghanistan to deal with the heroin supply there. 2005 |
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