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2005 National Survey on Drug Use & Health:  National Results

 

Results from the 2005
National Survey on Drug Use and Health:
National Findings

 

 

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Office of Applied Studies

Acknowledgments

This report was prepared by the Division of Population Surveys, Office of Applied Studies, SAMHSA, and by RTI International, a trade name of Research Triangle Institute, Research Triangle Park, North Carolina. Work by RTI was performed under Contract No. 283-2004-00022. Contributors and reviewers at RTI listed alphabetically include Jeremy Aldworth, Ellen Bishop, Walter R. Boyle, Patrick Chen, James R. Chromy, Andrew Clarke, Elizabeth Copello, David B. Cunningham, Lanting Dai, - R. Davis, Steven L. Emrich, Ralph E. Folsom, Jr., Misty Foster, Peter Frechtel, G. G. Frick, Julia Gable, Jody M. Greene, David C. Heller, Erica Hirsch, Susan Hunter, B. Kathleen Jordan, Larry A. Kroutil, Bing Liu, Mary Ellen Marsden, Katherine B. Morton, Breda Munoz, Scott Novak, Lisa E. Packer, Lanny Piper, Jeremy Porter, Tania Robbins, Jill Ruppenkamp, Kathryn Spagnola, Paul Tillman, Thomas G. Virag (Project Director), Michael Vorburger, and Jiantong Wang. Contributors at SAMHSA listed alphabetically, with chapter authorship noted, include Peggy Barker (Chapter 8), James Colliver, Joan Epstein (Chapter 7), Joseph Gfroerer (Chapters 1, 2, 5, and 9), Joe Gustin, Arthur Hughes (Project Officer), Joel Kennet (Chapters 3 and 4), Sharon Larson (Chapter 8), Pradip Muhuri, Dicy Painter, and Doug Wright (Chapter 6). At RTI, Kathleen B. Mohar was the publication coordinator; Richard S. Straw edited the report; Diane G. Eckard and Danny Occoquan prepared the graphics; Brenda K. Porter formatted the tables; Joyce Clay-Brooks formatted and word processed the report; and Pamela Couch Prevatt, - F. Gurley, Kim Cone, and Shari B. Lambert prepared its press and Web versions. Final report production was provided by Beatrice A. Rouse, Coleen Sanderson, and Jane Feldmann at SAMHSA.

Public Domain Notice

All material appearing in this report is in the public domain and may be reproduced or copied without permission from the Substance Abuse and Mental Health Services Administration. However, this publication may not be reproduced or distributed for a fee without specific, written authorization of the Office of Communications, SAMHSA, U.S. Department of Health and Human Services. Citation of the source is appreciated. Suggested citation:

Substance Abuse and Mental Health Services Administration. (2006). Results from the 2005 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-30, DHHS Publication No. SMA 06-4194). Rockville, MD.

Obtaining Copies of Publications from SAMHSA's Office of Applied Studies

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Originating Office:  SAMHSA, Office of Applied Studies
 

September 2006

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2005 National Survey on Drug Use & Health:  National Results

Table of Contents

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List of Figures
List of Tables
Web only document: Detailed Tables (HTML)     (PDF format)

Highlights

Highlights

1. Introduction
    1.1. Summary of NSDUH
    1.2. Trend Measurement
    1.3. Format of Report and Explanation of Tables
    1.4. Other NSDUH Reports and Data

2. Illicit Drug Use
    Age
    Youths Aged 12 to 17
    Young Adults Aged 18 to 25
    Adults Aged 26 or Older
    Gender
    Pregnant Women
    Race/Ethnicity
    Education
    College Students
    Employment
    Geographic Area
    Criminal Justice Populations
    Frequency of Use
    Association with Cigarette and Alcohol Use
    Driving Under the Influence of Illicit Drugs
    Source of Prescription Drugs

3. Alcohol Use
    Age
    Underage Alcohol Use
    Gender
    Pregnant Women
    Race/Ethnicity
    Education
    College Students
    Employment
    Geographic Area
    Association with Illicit Drug and Tobacco Use
    Driving Under the Influence of Alcohol

4. Tobacco Use
    Age
    Gender
    Pregnant Women
    Race/Ethnicity
    Education
    College Students
    Employment
    Geographic Area and County Type
    Association with Illicit Drug and Alcohol Use

5. Initiation of Substance Use
    Illicit Drugs
    Marijuana
    Cocaine
    Heroin
    Hallucinogens
    Inhalants
    Psychotherapeutics
    Alcohol
    Tobacco

6. Youth Prevention-Related Measures
    Perceptions of Risk
    Perceived Availability
    Perceived Parental Disapproval of Substance Use
    Feelings about Peer Substance Use
    Fighting and Delinquent Behavior
    Religious Beliefs and Participation in Activities
    Exposure to Substance Use Prevention Messages and Programs
    Parental Involvement

7. Substance Dependence, Abuse, and Treatment
    7.1 Substance Dependence or Abuse
        Age at First Use
        Age
        Gender
        Race/Ethnicity
        Education/Employment
        Criminal Justice Populations
        Geographic Area
    7.2 Past Year Treatment for a Substance Use Problem
        Location of Treatment and Substance Treated
    7.3 Need and Receipt of Specialty Treatment
        Illicit Drug or Alcohol Use Treatment and Treatment Need
        Illicit Drug Use Treatment and Treatment Need
        Alcohol Use Treatment and Treatment Need

8. Prevalence and Treatment of Mental Health Problems
    8.1 Adults Aged 18 or Older
        Prevalence of Serious Psychological Distress
        Serious Psychological Distress and Substance Use and Dependence or Abuse
        Treatment and Unmet Need for Treatment among Adults with Serious Psychological Distress
        Treatment among Adults with Co-Occurring Serious Psychological Distress and Substance Use Disorders
        Prevalence of Major Depressive Episode
        Major Depressive Episode and Substance Use and Dependence or Abuse
        Treatment for Major Depressive Episode
        Treatment for Mental Health Problems and Unmet Treatment Need among All Adults
    8.2 Youths Aged 12 to 17
        Prevalence of Major Depressive Episode
        Major Depressive Episode and Substance Use
        Treatment for Major Depressive Episode
        Mental Health Treatment among Youths

9. Discussion of Trends in Substance Use among Youths and Young Adults

Appendix

A. Description of the Survey
B. Statistical Methods and Measurement
C. Key Definitions, 2005
D. Other Sources of Data
E. References
F. Sample Size and Population Tables
G. Selected Prevalence Tables

List of Figures

2.1 Types of Drugs Used by Past Month Illicit Drug Users Aged 12 or Older: 2005

2.2 Past Month Use of Selected Illicit Drugs among Persons Aged 12 or Older: 2002-2005

2.3 Past Month Methamphetamine Use and Illicit Drug or Stimulant Dependence or Abuse in the Past Year among Persons Aged 12 or Older, by Year: 2002-2005

2.4 Past Month Illicit Drug Use among Persons Aged 12 or Older, by Age: 2005

2.5 Past Month Use of Selected Illicit Drugs among Youths Aged 12 to 17: 2002-2005

2.6 Past Month Illicit Drug Use among Persons Aged 12 or Older, by Age: 2002-2005

2.7 Past Month Use of Selected Illicit Drugs among Young Adults Aged 18 to 25: 2002-2005

2.8 Past Month Illicit Drug Use among Adults Aged 50 to 59: 2002-2005

2.9 Past Month Marijuana Use among Youths Aged 12 to 17, by Gender: 2002-2005

2.10 Past Month Marijuana Use among Youths Aged 12 to 17, by Geographic Region: 2002-2005

3.1 Current, Binge, and Heavy Alcohol Use among Persons Aged 12 or Older, by Age: 2005

3.2 Current Alcohol Use among Persons Aged 12 to 20, by Gender: 2002-2005

3.3 Current, Binge, and Heavy Alcohol Use among Persons Aged 12 or Older, by Race/Ethnicity: 2005

3.4 Heavy Alcohol Use among Adults Aged 18 to 22, by College Enrollment: 2002-2005

3.5 Driving Under the Influence of Alcohol in the Past Year among Persons Aged 12 or Older: 2002-2005

3.6 Driving Under the Influence of Alcohol in the Past Year among Persons Aged 16 or Older, by Age: 2005

4.1 Past Month Tobacco Use among Persons Aged 12 or Older: 2002-2005

4.2 Past Month Tobacco Use among Youths Aged 12 to 17: 2002-2005

4.3 Past Month Cigarette Use, by Age: 2005

4.4 Past Month Cigarette Use among Youths Aged 12 to 17, by Gender: 2002-2005

4.5 Past Month Cigarette Use among Women Aged 15 to 44, by Age and Pregnancy Status, 2004-2005 Combined

4.6 Past Month Cigarette Use among Persons in Completely Rural Counties, by Age: 2002-2005

5.1 Past Year Initiates for Specific Illicit Drugs among Persons Aged 12 or Older: 2005

5.2 Mean Age at First Use for Specific Illicit Drugs among Past Year Initiates Aged 12 to 49: 2005

5.3 Past Year Marijuana Initiates among Persons Aged 12 or Older and Mean Age at First Use of Marijuana among Past Year Marijuana Initiates Aged 12 to 49: 2002-2005

5.4 Past Year Methamphetamine Initiates among Persons Aged 12 or Older and Mean Age at First Use of Methamphetamine among Past Year Methamphetamine Initiates Aged 12 to 49: 2002-2005

5.5 Past Year Cigarette Initiates among Persons Aged 12 or Older, by Age at First Use: 2002-2005

5.6 Past Year Cigarette Initiation among Youths Aged 12 to 17 Who Had Never Smoked, by Gender: 2002-2005

6.1 Past Month Binge Drinking and Marijuana Use among Youths Aged 12 to 17, by Perceptions of Risk: 2005

6.2 Perceived Great Risk of Cigarette and Alcohol Use among Youths Aged 12 to 17: 2002-2005

6.3 Lifetime, Past Year, and Past Month Cigarette Use among Youths Aged 12 to 17: 2002-2005

6.4 Perceived Great Risk of Use of Selected Illicit Drugs among Youths Aged 12 to 17: 2002-2005

6.5 Lifetime, Past Year, and Past Month Marijuana Use among Youths Aged 12 to 17: 2002-2005

6.6 Perceived Great Risk of Smoking Marijuana Once a Month among Youths Aged 12 to 17, by Gender: 2002-2005

6.7 Perceived Availability of Selected Illicit Drugs among Youths Aged 12 to 17: 2002-2005

6.8 Disapproval of Peer Substance Use among Youths Aged 12 to 17, by Age: 2005

6.9 Past Month Illicit Drug Use among Youths Aged 12 to 17, by Participation in Fighting and Delinquent Behavior in the Past Year: 2005

7.1 Substance Dependence or Abuse in the Past Year among Persons Aged 12 or Older: 2002-2005

7.2 Dependence on or Abuse of Specific Illicit Drugs in the Past Year among Persons Aged 12 or Older: 2005

7.3 Alcohol Dependence or Abuse in the Past Year among Adults Aged 21 or Older, by Age at First Use of Alcohol: 2005

7.4 Substance Dependence or Abuse in the Past Year, by Age and Gender: 2005

7.5 Locations Where Past Year Substance Use Treatment Was Received among Persons Aged 12 or Older: 2005

7.6 Need for and Receipt of Specialty Treatment in the Past Year for Illicit Drug or Alcohol Use among Persons Aged 12 or Older: 2005

7.7 Past Year Perceived Need for and Effort Made to Receive Specialty Treatment among Persons Aged 12 or Older Needing But Not Receiving Treatment for Illicit Drug or Alcohol Use: 2005

7.8 Reasons for Not Receiving Substance Use Treatment among Persons Aged 12 or Older Who Needed and Made an Effort to Get Treatment But Did Not Receive Treatment and Felt They Needed Treatment: 2004-2005 Combined

7.9 Number of Persons Aged 12 or Older Who Felt the Need for Illicit Drug Use Treatment among Those Needing But Not Receiving Specialty Treatment for an Illicit Drug Use Problem in the Past Year: 2002-2005

8.1 Rates of Serious Psychological Distress in the Past Year among Adults Aged 18 or Older, by Age: 2004-2005

8.2 Past Year Treatment among Adults Aged 18 or Older with Both Serious Psychological Distress and a Substance Use Disorder: 2005

8.3 Major Depressive Episode in the Past Year among Adults Aged 18 or Older, by Race/Ethnicity: 2004-2005

8.4 Substance Use among Adults Aged 18 or Older, by Major Depressive Episode in the Past Year: 2005

8.5 Past Year Treatment for Mental Health Problems among Adults Aged 18 or Older, by Type of Treatment: 2002-2005

8.6 Reasons for Not Receiving Treatment in the Past Year among Adults Aged 18 or Older with an Unmet Need for Treatment Who Did Not Receive Treatment: 2005

8.7 Major Depressive Episode in the Past Year among Youths Aged 12 to 17, by Race/Ethnicity: 2004-2005

8.8 Substance Use among Youths Aged 12 to 17, by Major Depressive Episode in the Past Year: 2005

8.9 Past Year Treatment for Mental Health Problems among Youths Aged 12 to 17, by Gender: 2002-2005

B.1 Required Effective Sample as a Function of the Proportion Estimated

List of Tables

9.1 Comparison of NSDUH and MTF Prevalence Estimates among Youths: 2002-2005

9.2 Comparison of NSDUH and MTF Prevalence Estimates among Young Adults: 2002-2005

B.1 Demographic and Geographic Domains Forced to Match Their Respective U.S. Census Bureau Population Estimates through the Weight Calibration Process, 2005

B.2 Summary of 2005 NSDUH Suppression Rules

B.3 Weighted Percentages and Sample Sizes for 2004 and 2005 NSDUHs, by Screening Result Code

B.4 Weighted Percentages and Sample Sizes for 2004 and 2005 NSDUHs, by Final Interview Code

B.5 Response Rates and Sample Sizes for 2004 and 2005 NSDUHs, by Demographic Characteristics

B.6 Nonmedical Use of Methamphetamine, Stimulants, and Psychotherapeutics in Lifetime, Past Year, and Past Month and Illicit Drug Use in Lifetime, Past Year, and Past Month, by Age Group: Percentages, 2005 Core Data Only and 2005 Core & Noncore Data

B.7 Results from New Consistency Questions (Added in 2006) among Respondents Who Initially Reported No Methamphetamine Use in Core and Subsequently Reported Methamphetamine Use on Noncore Questions (First Added in 2005): Percentages, Quarter 1 of 2006 Raw Data

D.1 Use of Specific Substances in Lifetime, Past Year, and Past Month among 8th, 10th, and 12th Graders in NSDUH and MTF: Percentages, 2004 and 2005

D.2 Lifetime and Past Month Substance Use among Students in Grades 9 to 12 in YRBS and NSDUH: 2003 and 2005

D.3 Past Year and Past Month Marijuana Use among Youths Aged 12 to 18 in NSPY and NSDUH, by Age Group: 2002-2005

D.4 Past Month Cigarette Use among Persons Aged 18 or Older in NHIS and NSDUH, by Gender and Age Group: Percentages, 2004 and 2005

F.1 Survey Sample Size for Respondents Aged 12 or Older, by Gender and Detailed Age Category: 2004 and 2005

F.2 Numbers (in Thousands) of Persons Aged 12 or Older, by Gender and Detailed Age Category: 2004 and 2005

F.3 Survey Sample Size for Respondents Aged 12 or Older, by Age Group and Demographic Characteristics: 2004 and 2005

F.4 Numbers (in Thousands) of Persons Aged 12 or Older, by Age Group and Demographic Characteristics: 2004 and 2005

F.5 Survey Sample Size for Respondents Aged 12 or Older, by Age Group and Geographic Characteristics: 2004 and 2005

F.6 Numbers (in Thousands) of Persons Aged 12 or Older, by Age Group and Geographic Characteristics: 2004 and 2005

G.1 Types of Illicit Drug Use in Lifetime among Persons Aged 12 or Older: Numbers in Thousands, 2002-2005

G.2 Types of Illicit Drug Use in Lifetime among Persons Aged 12 or Older: Percentages, 2002-2005

G.3 Types of Illicit Drug Use in the Past Year among Persons Aged 12 or Older: Numbers in Thousands, 2002-2005

G.4 Types of Illicit Drug Use in the Past Year among Persons Aged 12 or Older: Percentages, 2002-2005

G.5 Types of Illicit Drug Use in the Past Month among Persons Aged 12 or Older: Numbers in Thousands, 2002-2005

G.6 Types of Illicit Drug Use in the Past Month among Persons Aged 12 or Older: Percentages, 2002-2005

G.7 Types of Illicit Drug Use in the Past Month among Persons Aged 12 to 17: Percentages, 2002-2005

G.8 Types of Illicit Drug Use in the Past Month among Persons Aged 18 to 25: Percentages, 2002-2005

G.9 Types of Illicit Drug Use in the Past Month among Persons Aged 26 or Older: Percentages, 2002-2005

G.10 Illicit Drug Use in Lifetime, Past Year, and Past Month, by Detailed Age Category: Percentages, 2004 and 2005

G.11 Illicit Drug Use in Lifetime, Past Year, and Past Month among Persons Aged 12 or Older, by Demographic Characteristics: Percentages, 2004 and 2005

G.12 Illicit Drug Use in Lifetime, Past Year, and Past Month among Persons Aged 12 to 17, by Demographic Characteristics: Percentages, 2004 and 2005

G.13 Illicit Drug Use in Lifetime, Past Year, and Past Month among Persons Aged 18 or Older, by Demographic Characteristics: Percentages, 2004 and 2005

G.14 Nonmedical Use of Methamphetamine in Lifetime, Past Year, and Past Month among Persons Aged 12 or Older and Illicit Drug and Stimulant Dependence or Abuse in the Past Year and Received Last or Current Treatment for Stimulant Use at a Specialty Facility in the Past Year among Persons Aged 12 or Older, by Past Year and Past Month Nonmedical Use of Methamphetamine: Numbers in Thousands, 2002-2005

G.15 Nonmedical Use of Methamphetamine in Lifetime, Past Year, and Past Month among Persons Aged 12 or Older and Illicit Drug and Stimulant Dependence or Abuse in the Past Year and Received Last or Current Treatment for Stimulant Use at a Specialty Facility in the Past Year among Persons Aged 12 or Older, by Past Year and Past Month Nonmedical Use of Methamphetamine: Percentages, 2002-2005

G.16 Tobacco Product and Alcohol Use in the Past Month among Persons Aged 12 or Older, by Gender: Numbers in Thousands, 2002-2005

G.17 Tobacco Product and Alcohol Use in the Past Month among Persons Aged 12 or Older, by Gender: Percentages, 2002-2005

G.18 Tobacco Product and Alcohol Use in the Past Month among Persons Aged 12 to 17, by Gender: Percentages, 2002-2005

G.19 Tobacco Product and Alcohol Use in the Past Month among Persons Aged 18 to 25, by Gender: Percentages, 2002-2005

G.20 Tobacco Product and Alcohol Use in the Past Month among Persons Aged 26 or Older, by Gender: Percentages, 2002-2005

G.21 Alcohol Use in Lifetime, Past Year, and Past Month among Persons Aged 12 to 20, by Gender: Percentages, 2002-2005

G.22 Alcohol Use, Binge Alcohol Use, and Heavy Alcohol Use in the Past Month, by Detailed Age Category: Percentages, 2004 and 2005

G.23 Alcohol Use, Binge Alcohol Use, and Heavy Alcohol Use in the Past Month among Persons Aged 12 to 20, by Demographic Characteristics: Percentages, 2004 and 2005

G.24 Cigarette Use in Lifetime, Past Year, and Past Month, by Detailed Age Category: Percentages, 2004 and 2005

G.25 Cigarette Use in Lifetime, Past Year, and Past Month among Persons Aged 12 to 17, by Demographic Characteristics: Percentages, 2004 and 2005

G.26 Cigarette Use in Lifetime, Past Year, and Past Month among Persons Aged 18 or Older, by Demographic Characteristics: Percentages, 2004 and 2005

G.27 Perceived Risk and Availability of Substances among Persons Aged 12 to 17: Percentages, 2002-2005

G.28 Past Year Initiation of Substance Use among Persons Aged 12 or Older: Numbers in Thousands, 2002-2005

G.29 Substance Dependence or Abuse for Specific Substances in the Past Year among Persons Aged 12 or Older: Numbers in Thousands, 2002-2005

G.30 Substance Dependence or Abuse for Specific Substances in the Past Year among Persons Aged 12 or Older: Percentages, 2002-2005

G.31 Substance Dependence or Abuse in the Past Year among Persons Aged 12 or Older, by Demographic Characteristics: Percentages, 2004 and 2005

G.32 Received Substance Use Treatment at Any Treatment Location or at a Specialty Facility in the Past Year among Persons Aged 12 or Older: Numbers in Thousands, 2002-2005

G.33 Received Substance Use Treatment at Any Treatment Location or at a Specialty Facility in the Past Year among Persons Aged 12 or Older: Percentages, 2002-2005

G.34 Needed and Received Treatment for a Substance Use Problem in the Past Year among Persons Aged 12 or Older: Numbers in Thousands, 2002-2005

G.35 Needed and Received Treatment for a Substance Use Problem in the Past Year among Persons Aged 12 or Older: Percentages, 2002-2005

G.36 Needed and Received Treatment for an Illicit Drug or Alcohol Problem in the Past Year among Persons Aged 12 or Older, by Demographic Characteristics: Percentages, 2004 and 2005

G.37 Perceived Need for Illicit Drug or Alcohol Treatment and Whether Made an Effort to Get Treatment in the Past Year among Persons Aged 12 or Older Classified as Needing But Not Receiving Treatment for an Illicit Drug or Alcohol Problem, by Demographic Characteristics: Numbers in Thousands, 2004 and 2005

G.38 Perceived Need for Illicit Drug or Alcohol Treatment and Whether Made an Effort to Get Treatment in the Past Year among Persons Aged 12 or Older Classified as Needing But Not Receiving Treatment for an Illicit Drug or Alcohol Problem, by Demographic Characteristics: Percentages, 2004 and 2005

G.39 Serious Psychological Distress in the Past Year among Persons Aged 18 or Older, by Age Group and Demographic Characteristics: Percentages, 2004 and 2005

G.40 Illicit Drug Dependence or Abuse in the Past Year among Persons Aged 18 or Older, by Past Year Serious Psychological Distress, Gender, and Age Group: Percentages, 2004 and 2005

G.41 Received Mental Health Treatment/Counseling in the Past Year among Persons Aged 18 or Older, by Past Year Serious Psychological Distress and Demographic Characteristics: Percentages, 2004 and 2005

G.42 Had at Least One Major Depressive Episode (MDE) in Lifetime or Past Year among Persons Aged 12 to 17, and Receipt of Treatment in the Past Year for Depression among Persons Aged 12 to 17 with an MDE in Lifetime or Past Year, by Hispanic Origin and Race: Percentages, 2004 and 2005

G.43 Had at Least One Major Depressive Episode (MDE) in Lifetime or Past Year among Persons Aged 18 or Older, and Receipt of Treatment in the Past Year for Depression among Persons Aged 18 or Older with an MDE in Lifetime or Past Year, by Demographic Characteristics: Percentages, 2004 and 2005

G.44 Substance Dependence or Abuse in the Past Year among Persons Aged 12 to 17, by Past Year Major Depressive Episode (MDE): Percentages, 2004 and 2005


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2005 National Survey on Drug Use & Health:  National Results

Highlights

This report presents the first information from the 2005 National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco in the civilian, noninstitutionalized population of the United States aged 12 years old or older. The survey interviews approximately 67,500 persons each year. Unless otherwise noted, all comparisons in this report described using terms such as "increased," "decreased," or "more than" are statistically significant at the .05 level.

Illicit Drug Use

Alcohol Use

Tobacco Use

Initiation of Substance Use (Incidence, or First-Time Use)

Youth Prevention-Related Measures

Substance Dependence, Abuse, and Treatment

Prevalence and Treatment of Mental Health Problems


Go to the Table Of Contents

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2005 National Survey on Drug Use & Health:  National Results

1. Introduction

This report presents the first information from the 2005 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 name was the National Household Survey on Drug Abuse (NHSDA). This initial report on the 2005 data presents national estimates of rates of use, numbers of users, and other measures related to illicit drugs, alcohol, and tobacco products. Measures related to mental health problems also are presented, including data on depression and on the co-occurrence of substance use and mental health problems. Estimates from NSDUH for States and areas within States will be presented in separate reports.

A major focus of this report is a comparison of substance use prevalence estimates between 2004 and 2005. Trends since 2002 also are discussed for some measures. Because of improvements to the survey in 2002, the 2002 data constitute a new baseline for tracking trends in substance use and other measures. Therefore, estimates from the 2002 through 2005 NSDUHs should not be compared with estimates from the 2001 and earlier surveys in the series to assess changes in substance use and mental health problems over time.

1.1. Summary of NSDUH

NSDUH is the primary source of statistical information on the use of illegal drugs by the U.S. population. Conducted by the Federal Government since 1971, the survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at the respondent's place of residence. The survey is sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services, and is planned and managed by SAMHSA's Office of Applied Studies (OAS). Data collection is conducted under contract with RTI International, Research Triangle Park, North Carolina.1 This section briefly describes the survey methodology; a more complete description is provided in Appendix A.

NSDUH collects information from residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories) and from civilians living on military bases. The survey excludes homeless persons who do not use shelters, military personnel on active duty, and residents of institutional group quarters, such as jails and hospitals. Appendix D describes surveys that cover populations outside the NSDUH target population.

Since 1999, the NSDUH interview has been carried out using computer-assisted interviewing (CAI). Most of the questions are administered with audio computer-assisted self-interviewing (ACASI). ACASI is designed to provide the respondent with a highly private and confidential means of responding to questions to increase the level of honest reporting of illicit drug use and other sensitive behaviors. Less sensitive items are administered by interviewers using computer-assisted personal interviewing (CAPI).

The 2005 NSDUH employed a State-based design with an independent, multistage area probability sample within each State and the District of Columbia. The eight States with the largest population (which together account for 48 percent of the total U.S. population aged 12 or older) were designated as large sample States (California, Florida, Illinois, Michigan, New York, Ohio, Pennsylvania, and Texas). For these States, the design provided a sample sufficient to support direct State estimates. For the remaining 42 States and the District of Columbia, smaller, but adequate, samples support State estimates using small area estimation (SAE) techniques. The design oversampled youths and young adults, so that each State's sample was approximately equally distributed among three age groups: 12 to 17 years, 18 to 25 years, and 26 years or older.

Nationally, 134,055 addresses were screened for the 2005 survey, and 68,308 completed interviews were obtained. The survey was conducted from January through December 2005. Weighted response rates for household screening and for interviewing were 91.3 and 76.2 percent, respectively. See Appendix B for more information on NSDUH response rates.

1.2. Trend Measurement

Although the design of the 2002 through 2005 NSDUHs is similar to the design of the 1999 through 2001 surveys, there are important methodological differences that affect the comparability of the 2002-2005 estimates with estimates from prior surveys. In addition to the name change, each NSDUH respondent completing the interview is now given an incentive payment of $30. These changes, implemented in 2002 and continued subsequently, resulted in an improvement in the response rate, but also affected respondents' reporting of items that are the basis of prevalence measures produced each year. Comparability also may be affected by improved data collection quality control procedures that were introduced beginning in 2001 and by the incorporation of new population data from the 2000 decennial census into NSDUH sample weighting procedures. Analyses of the effects of these factors on NSDUH estimates have shown that 2002 and later data should not be compared with 2001 and earlier data from the survey series to assess changes over time. Appendix C of the 2004 NSDUH report on national findings discusses this issue in more detail (see OAS, 2005).

1.3. Format of Report and Explanation of Tables

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

Tables, text, and figures present prevalence measures for the population in terms of both the number of persons and the percentage of the population. Substance use tables show prevalence estimates by lifetime (i.e., ever used), past year, and past month use. Analyses focus primarily on past month use, which also is referred to as "current use." Tables and figures in which estimates are presented by year have footnotes indicating whether the 2005 estimates are significantly different from 2004 or earlier estimates.

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

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

Data are presented for racial/ethnic groups based on current guidelines for collecting and reporting race and ethnicity data (Office of Management and Budget [OMB], 1997). Because respondents were allowed to choose more than one racial group, a "two or more races" category is presented that includes persons who reported more than one category among the basic groups listed in the survey question (white, black or African American, American Indian or Alaska Native, Native Hawaiian, Other Pacific Islander, Asian, Other). Respondents choosing both Native Hawaiian and Other Pacific Islander but no other categories mentioned above are classified in the combined "Native Hawaiian or Other Pacific Islander" category instead of the "two or more race" category. It should be noted that, except for the "Hispanic or Latino" group, the racial/ethnic groups discussed in this report include only non-Hispanics. The category "Hispanic or Latino" includes Hispanics of any race.

Data also are presented for four U.S. geographic regions and nine geographic divisions within these regions. These regions and divisions, defined by the U.S. Census Bureau, consist of the following groups of States:

Northeast Region - New England Division: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont; Middle Atlantic Division: New Jersey, New York, Pennsylvania.

Midwest Region - East North Central Division: Illinois, Indiana, Michigan, Ohio, Wisconsin; West North Central Division: Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota.

South Region - South Atlantic Division: Delaware, District of Columbia, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia; East South Central Division: Alabama, Kentucky, Mississippi, Tennessee; West South Central Division: Arkansas, Louisiana, Oklahoma, Texas.

West Region - Mountain Division: Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming; Pacific Division: Alaska, California, Hawaii, Oregon, Washington.

Geographic comparisons also are made based on county type, a variable that reflects different levels of urbanicity and metropolitan area inclusion of counties, based on metropolitan area definitions issued by the OMB in June 2003 (OMB, 2003). For this purpose, counties are grouped based on the 2003 rural-urban continuum codes. These codes were originally developed by the U.S. Department of Agriculture (Butler & Beale, 1994). Each county is either inside or outside a metropolitan statistical area (MSA), as defined by the OMB.

Large metropolitan areas have a population of 1 million or more. Small metropolitan areas have a population of fewer than 1 million. Small metropolitan areas are further classified based on whether they have a population of 250,000 or more. Nonmetropolitan areas are areas outside MSAs. Counties in nonmetropolitan areas are further classified based on the number of people in the county who live in an urbanized area, as defined by the Census Bureau at the subcounty level. "Urbanized" counties have a population of 20,000 or more in urbanized areas, "less urbanized" counties have at least 2,500 but fewer than 20,000 population in urbanized areas, and "completely rural" counties have fewer than 2,500 population in urbanized areas.

1.4. Other NSDUH Reports and Data

Other reports focusing on specific topics of interest will be produced using the 2005 NSDUH data and made available on SAMHSA's website. A report on State-level estimates for 2004-2005 will be available in early 2007.

In addition to the tables in Appendices F and G, a more extensive set of tables, including standard errors, is available upon request from OAS or through the Internet at http://www.oas.samhsa.gov. Tables in Appendices F and G can be mapped back to these detailed tables by using the table number in parentheses in the upper left corner of each table (e.g., Table F.1 in Appendix F is Table 9.1N in the detailed tables). Additional methodological information on NSDUH, including the questionnaire, is available electronically at the same Web address. Brief descriptive reports and in-depth analytic reports focusing on specific issues or population groups also are produced by OAS. A complete listing of previously published reports from NSDUH and other data sources is available from OAS. Most of these reports also are available through the Internet (http://www.oas.samhsa.gov). In addition, OAS makes public use data files available to researchers through the Substance Abuse and Mental Health Data Archive (SAMHDA, 2006) at http://www.icpsr.umich.edu/SAMHDA/index.html. Currently, files are available from the 1979 to 2004 surveys. The 2005 NSDUH public use file will be available by the end of 2006.


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2005 National Survey on Drug Use & Health:  National Results

2. Illicit Drug Use

The National Survey on Drug Use and Health (NSDUH) obtains information on nine different categories of illicit drug use: use of marijuana, cocaine, heroin, hallucinogens, and inhalants; and the nonmedical use of prescription-type pain relievers, tranquilizers, stimulants, and sedatives. In these categories, hashish is included with marijuana, and crack is considered a form of cocaine. Several drugs are grouped under the hallucinogens category, including LSD, PCP, peyote, mescaline, 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 as well as drugs within these groupings that may be manufactured illegally, such as methamphetamine, which is included under stimulants. 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; therefore, over-the-counter drugs and legitimate uses of prescription drugs are not included. NSDUH reports combine the four prescription-type drug groups into a category referred to as "psychotherapeutics."

Because of concerns that methamphetamine use is underestimated in NSDUH due to its inclusion within the prescription-type drug questions, new questions regarding methamphetamine use were added to NSDUH in 2005. Preliminary analysis of these new data showed that underestimation is occurring, and additional questions may be needed to make it possible to estimate correctly the actual prevalence rate for methamphetamine use. Additional questions were included in the 2006 NSDUH. A discussion of these analyses, including preliminary data from the new 2006 questions, is provided in Section B.4.6 in Appendix B. Estimates of methamphetamine use in this chapter and in the tables in Appendix G are based on the same "core" NSDUH questions that were used in the 2004 survey and are therefore comparable with estimates from previous years.

Estimates of "illicit drug use" reported from NSDUH reflect the use of any of the nine drug categories listed above. Use of alcohol and tobacco products, while illegal for youths, is not included in these estimates, but is discussed in Chapters 3 and 4.

Figure 2.1 Types of Drugs Used by Past Month Illicit Drug Users Aged 12 or Older: 2005

Figure 2.1     D

Figure 2.2 Past Month Use of Selected Illicit Drugs among Persons Aged 12 or Older: 2002-2005

Figure 2.2     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Figure 2.3 Past Month Methamphetamine Use and Illicit Drug or Stimulant Dependence or Abuse in the Past Year among Persons Aged 12 or Older, by Year: 2002-2005

Figure 2.3     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Age

Figure 2.4 Past Month Illicit Drug Use among Persons Aged 12 or Older, by Age: 2005

Figure 2.4     D

Youths Aged 12 to 17

Figure 2.5 Past Month Use of Selected Illicit Drugs among Youths Aged 12 to 17: 2002-2005

Figure 2.5     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Figure 2.6 Past Month Illicit Drug Use among Persons Aged 12 or Older, by Age: 2002-2005

Figure 2.6     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Young Adults Aged 18 to 25

Figure 2.7 Past Month Use of Selected Illicit Drugs among Young Adults Aged 18 to 25: 2002-2005

Figure 2.7     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Adults Aged 26 or Older

Figure 2.8 Past Month Illicit Drug Use among Adults Aged 50 to 59: 2002-2005

Figure 2.8     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Gender

Figure 2.9 Past Month Marijuana Use among Youths Aged 12 to 17, by Gender: 2002-2005

Figure 2.9     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Pregnant Women

Race/Ethnicity

Education

College Students

Employment

Geographic Area

Figure 2.10 Past Month Marijuana Use among Youths Aged 12 to 17, by Geographic Region: 2002-2005

Figure 2.10     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Criminal Justice Populations

Frequency of Use

Association with Cigarette and Alcohol Use

Driving Under the Influence of Illicit Drugs

Source of Prescription Drugs


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2005 National Survey on Drug Use & Health:  National Results

3. Alcohol Use

The National Survey on Drug Use and Health (NSDUH) includes questions about the recency and frequency of consumption of alcoholic beverages, such as beer, wine, whiskey, brandy, and mixed drinks. An extensive list of examples of the kinds of beverages covered is given to respondents prior to the question administration. A "drink" is defined as a can or bottle of beer, a glass of wine or a wine cooler, a shot of liquor, or a mixed drink with liquor in it. Times when the respondent only had a sip or two from a drink are not considered to be consumption. For this report, estimates for the prevalence of alcohol use are reported primarily at three levels defined for both males and females and for all ages as follows:

Current (past month) use - At least one drink in the past 30 days (includes binge and heavy use).

Binge use - Five or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days (includes heavy use).

Heavy use - Five or more drinks on the same occasion on each of 5 or more days in the past 30 days.

Age

Figure 3.1 Current, Binge, and Heavy Alcohol Use among Persons Aged 12 or Older, by Age: 2005

Figure 3.1     D

Underage Alcohol Use

Figure 3.2 Current Alcohol Use among Persons Aged 12 to 20, by Gender: 2002-2005

Figure 3.2     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Underage Alcohol Use by Race/Ethnicity, Region, and Size of Metropolitan Area

Gender

Pregnant Women

Race/Ethnicity

Figure 3.3 Current, Binge, and Heavy Alcohol Use among Persons Aged 12 or Older, by Race/Ethnicity: 2005

Figure 3.3     D

Education

College Students

Figure 3.4 Heavy Alcohol Use among Adults Aged 18 to 22, by College Enrollment: 2002-2005

Figure 3.4     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Employment

Geographic Area

Association with Illicit Drug and Tobacco Use

Driving Under the Influence of Alcohol

Figure 3.5 Driving Under the Influence of Alcohol in the Past Year among Persons Aged 12 or Older: 2002-2005

Figure 3.5     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Figure 3.6 Driving Under the Influence of Alcohol in the Past Year among Persons Aged 16 or Older, by Age: 2005

Figure 3.6     D


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2005 National Survey on Drug Use & Health:  National Results

4. Tobacco Use

The National Survey on Drug Use and Health (NSDUH) includes a series of questions about the use of tobacco products, including cigarettes, chewing tobacco, snuff, cigars, and pipe tobacco. Cigarette use is defined as smoking "part or all of a cigarette." For analytic purposes, data for chewing tobacco and snuff are combined as "smokeless tobacco."

Figure 4.1 Past Month Tobacco Use among Persons Aged 12 or Older: 2002-2005

Figure 4.1     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Age

Figure 4.2 Past Month Tobacco Use among Youths Aged 12 to 17: 2002-2005

Figure 4.2     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Figure 4.3 Past Month Cigarette Use, by Age: 2005

Figure 4.3     D

Gender

Figure 4.4 Past Month Cigarette Use among Youths Aged 12 to 17, by Gender: 2002-2005

Figure 4.4     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Pregnant Women

Figure 4.5 Past Month Cigarette Use among Women Aged 15 to 44, by Age and Pregnancy Status, 2004-2005 Combined

Figure 4.5     D

Race/Ethnicity

Education

College Students

Employment

Geographic Area and County Type

Figure 4.6 Past Month Cigarette Use among Persons in Completely Rural Counties, by Age: 2002-2005

Figure 4.6     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Association with Illicit Drug and Alcohol Use


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2005 National Survey on Drug Use & Health:  National Results

5. Initiation of Substance Use

Information on substance use initiation, also known as incidence or first-time use, is important for policymakers and researchers. Measures of initiation are often leading indicators of emerging patterns of substance use. They provide valuable information that can be used in the assessment of the effectiveness of current prevention programs and in determining where prevention efforts need to focus.

With its large sample size and oversampling of youths aged 12 to 17 and young adults aged 18 to 25, the National Survey on Drug Use and Health (NSDUH) provides a variety of estimates related to substance use initiation based on questions on age and month at first use. Using this information, along with the interview date and the respondent's date of birth, a date of first use is determined for each substance used by a respondent. Estimates of the number of initiates, rates of initiation, and average age at first use can be constructed for specific time periods. For example, estimates for calendar years as far back as 1965 have been tabulated from 2002-2004 NSDUH data to show long-term trends in initiation. However, recent methodological assessments of these long-term trend estimates of initiation have suggested that they are biased, due to suspected recall errors that seem to increase with the length of recall (Gfroerer, Hughes, Chromy, Heller, & Packer, 2004). Evidence of forward and backward telescoping, where respondents shift their reported age at first use either closer to their current age or further from the interview date, also has been found (Golub, Johnson, & Labouvie, 2000; Johnson & Schultz, 2005).

Because of concerns about the validity of trend estimates of incidence based on long recall periods, an alternative approach to estimating incidence was developed and presented for the first time in the 2004 NSDUH national findings report (Office of Applied Studies [OAS], 2005b) and is continued in this 2005 NSDUH report. The new estimates describe initiation of substance use in the 12 months prior to the interview date, and individuals who initiated use within the past 12 months are defined as recent or past year initiates. Estimates for each year are produced independently based on the data from the survey conducted that year. This approach should improve the comparability of estimates across years. Although it will not eliminate reporting biases, the approach should minimize recall bias because the estimates are based on a more recent time period than the previously produced calendar year estimates. The more recent time period also provides more timely information on incidence. Finally, an advantage of this approach is that initiation estimates can be analyzed in conjunction with past year prevalence estimates because they reflect the same time period. For example, this approach allows the estimation of initiates as a proportion of past year users. For specific substances, initiation prior to age 12 is not well covered, and initiation prior to age 11 is not included at all. This problem primarily affects estimates of initiation for cigarettes, alcohol, and inhalants because they tend to be initiated at a younger age than other substances.

As a measure of central tendency, means are heavily influenced by the presence of extreme values in the data. Thus, for the purposes of this report, mean age at initiation will refer specifically to the mean age at initiation among persons aged 12 to 49. This constraint was implemented so that the mean age estimates reported would not be influenced by those few respondents who were past year initiates at age 50 or older. This should increase the utility of these results to health researchers and analysts by providing a better picture of the substance use initiation behaviors among the civilian, noninstitutionalized population in the United States. Note that this constraint only affects estimates of mean age at initiation; other estimates in this chapter, including the number and prevalence of past year initiates, are among all persons aged 12 or older.

See Section B.4.1 in Appendix B for further discussion of the methods and bias in initiation estimates. The Substance Abuse and Mental Health Services Administration (SAMHSA) continues to study the advantages and disadvantages of alternative methods of estimating incidence.

Illicit Drugs

Figure 5.1 Past Year Initiates for Specific Illicit Drugs among Persons Aged 12 or Older: 2005

Figure 5.1     D

Figure 5.2 Mean Age at First Use for Specific Illicit Drugs among Past Year Initiates Aged 12 to 49: 2005

Figure 5.2     D

Marijuana

Figure 5.3 Past Year Marijuana Initiates among Persons Aged 12 or Older and Mean Age at First Use of Marijuana among Past Year Marijuana Initiates Aged 12 to 49: 2002-2005

Figure 5.3     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.
1 Mean age at first use estimates are among recent initiates aged 12 to 49.

Cocaine

Heroin

Hallucinogens

Inhalants

Psychotherapeutics

Figure 5.4 Past Year Methamphetamine Initiates among Persons Aged 12 or Older and Mean Age at First Use of Methamphetamine among Past Year Methamphetamine Initiates Aged 12 to 49: 2002-2005

Figure 5.4     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.
1 Mean age at first use estimates are among recent initiates aged 12 to 49.

Alcohol

Tobacco

Figure 5.5 Past Year Cigarette Initiates among Persons Aged 12 or Older, by Age at First Use: 2002-2005

Figure 5.5     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Figure 5.6 Past Year Cigarette Initiation among Youths Aged 12 to 17 Who Had Never Smoked, by Gender: 2002-2005

Figure 5.6     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.


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2005 National Survey on Drug Use & Health:  National Results

6. Youth Prevention-Related Measures

The National Survey on Drug Use and Health (NSDUH) includes questions for youths aged 12 to 17 about a number of risk and protective factors that may affect the likelihood that they will engage in substance use. Risk factors are individual characteristics and environmental influences associated with an increased vulnerability to the initiation, continuation, or escalation of substance use. Protective factors include individual resilience and other circumstances that appear to reduce the likelihood of substance use. Risk and protective factors include variables that operate at different stages of development and reflect different domains of influence, including the individual, family, peer, school, community, and societal levels (Hawkins, Catalano, & Miller, 1992). Interventions to prevent substance use generally are designed to ameliorate the influence of risk factors and enhance the effectiveness of protective factors.

This chapter presents findings for youth prevention-related measures collected in the 2005 NSDUH and compares these with findings from previous years. Included are measures of perceived risk from substance use (cigarettes, alcohol, and illicit drugs), perceived availability of substances, perceived parental disapproval of substance use, feelings about peer substance use, involvement in fighting and delinquent behavior, participation in religious and other activities, exposure to substance use prevention messages and programs, and parental involvement.

In this chapter, rates of substance use are compared for persons responding differently to questions reflecting risk or protective factors, such as the perceived risk of harm from using a substance. Because the NSDUH data for an individual are collected at only one point in time, it is not possible to determine causal connections from these data. However, a number of research studies of youths have shown that reducing risk factors and increasing protective factors can reduce rates of substance use (Botvin, Botvin, & Ruchlin, 1998). Earlier chapters of this report show that marijuana use, cigarette use, and binge use of alcohol among youths decreased between 2004 and 2005, yet corresponding changes in individual risk and protective factors for the same period may or may not have occurred. There can be many reasons for this, such as the lack of or weak causal connection, a lagged relationship between the occurrence of a risk factor and the change in drug behavior, or that individual use is typically the result of multiple simultaneous risk factors rather than a single factor (Newcomb, Maddahian, & Bentler, 1986).

Perceptions of Risk

One factor that can influence whether youths will use tobacco, alcohol, or illicit drugs is the extent to which youths believe these substances might cause them harm. NSDUH respondents were asked how much they thought people risk harming themselves physically and in other ways when they use various substances. Response choices for these items were "great risk," "moderate risk," "slight risk," or "no risk."

Figure 6.1 Past Month Binge Drinking and Marijuana Use among Youths Aged 12 to 17, by Perceptions of Risk: 2005

Figure 6.1     D

Figure 6.2 Perceived Great Risk of Cigarette and Alcohol Use among Youths Aged 12 to 17: 2002-2005

Figure 6.2     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Figure 6.3 Lifetime, Past Year, and Past Month Cigarette Use among Youths Aged 12 to 17: 2002-2005

Figure 6.3     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Figure 6.4 Perceived Great Risk of Use of Selected Illicit Drugs among Youths Aged 12 to 17: 2002-2005

Figure 6.4     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Figure 6.5 Lifetime, Past Year, and Past Month Marijuana Use among Youths Aged 12 to 17: 2002-2005

Figure 6.5     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Figure 6.6 Perceived Great Risk of Smoking Marijuana Once a Month among Youths Aged 12 to 17, by Gender: 2002-2005

Figure 6.6     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Perceived Availability

Figure 6.7 Perceived Availability of Selected Illicit Drugs among Youths Aged 12 to 17: 2002-2005

Figure 6.7     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Perceived Parental Disapproval of Substance Use

Feelings about Peer Substance Use

Figure 6.8 Disapproval of Peer Substance Use among Youths Aged 12 to 17, by Age: 2005

Figure 6.8     D

Fighting and Delinquent Behavior

Figure 6.9 Past Month Illicit Drug Use among Youths Aged 12 to 17, by Participation in Fighting and Delinquent Behavior in the Past Year: 2005

Figure 6.9     D

Religious Beliefs and Participation in Activities

Exposure to Substance Use Prevention Messages and Programs

Parental Involvement


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2005 National Survey on Drug Use & Health:  National Results

7. Substance Dependence, Abuse, and Treatment

The National Survey on Drug Use and Health (NSDUH) includes a series of questions to assess the prevalence of substance use disorders (i.e., dependence on or abuse of a substance) in the past 12 months. Substances include alcohol and illicit drugs, such as marijuana, cocaine, heroin, hallucinogens, and inhalants, and the nonmedical use of prescription-type psychotherapeutic drugs. These questions are used to classify persons as dependent on or abusing specific substances based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) (American Psychiatric Association [APA], 1994).

The questions on dependence ask about health and emotional problems associated with substance use, unsuccessful attempts to cut down on use, tolerance, withdrawal, reducing other activities to use substances, spending a lot of time engaging in activities related to substance use, or using the substance in greater quantities or for a longer time than intended. The questions on abuse ask about problems at work, home, and school; problems with family or friends; physical danger; and trouble with the law due to substance use. Dependence is considered to be a more severe substance use problem than abuse because it involves the psychological and physiological effects of tolerance and withdrawal. Although individuals may meet the criteria specified for both dependence and abuse, persons meeting the criteria for both are classified as having dependence, but not abuse. Persons defined with abuse do not meet the criteria for dependence.

This chapter provides estimates of the prevalence and patterns of substance use disorders occurring in the past year from the 2005 NSDUH and compares these estimates against the results from the 2002, 2003, and 2004 surveys. It also provides estimates of the prevalence and patterns of the receipt of treatment in the past year for problems related to substance use and discusses the need for and receipt of treatment at specialty facilities for problems associated with substance use.

7.1. Substance Dependence or Abuse

Figure 7.1 Substance Dependence or Abuse in the Past Year among Persons Aged 12 or Older: 2002-2005

Figure 7.1     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Figure 7.2 Dependence on or Abuse of Specific Illicit Drugs in the Past Year among Persons Aged 12 or Older: 2005

Figure 7.2     D

Age at First Use

Figure 7.3 Alcohol Dependence or Abuse in the Past Year among Adults Aged 21 or Older, by Age at First Use of Alcohol: 2005

Figure 7.3     D

Age

Gender

Figure 7.4 Substance Dependence or Abuse in the Past Year, by Age and Gender: 2005

Figure 7.4     D

Race/Ethnicity

Education/Employment

Criminal Justice Populations

Geographic Area

7.2. Past Year Treatment for a Substance Use Problem

Estimates described in this section refer to treatment received to reduce or stop illicit drug or alcohol use, or for medical problems associated with the use of illicit drugs or alcohol. This includes treatment received in the past year at any location, such as a hospital (inpatient), rehabilitation facility (outpatient or inpatient), mental health center, emergency room, private doctor's office, prison or jail, or a self-help group, such as Alcoholics Anonymous or Narcotics Anonymous. Persons could report receiving treatment at more than one location. Note that the definition of treatment in this section is different from the definition of specialty treatment described in Section 7.3. Specialty treatment only includes treatment at a hospital (inpatient), a rehabilitation facility (inpatient or outpatient), or a mental health center.

Individuals who reported receiving substance use treatment but were missing information on whether the treatment was specifically for alcohol use or illicit drug use were not counted in estimates of illicit drug use treatment or in estimates of alcohol use treatment; however, they were counted in estimates for "drug or alcohol use" treatment.

Location of Treatment and Substance Treated

Figure 7.5 Locations Where Past Year Substance Use Treatment Was Received among Persons Aged 12 or Older: 2005

Figure 7.5     D

7.3. Need and Receipt of Specialty Treatment

This section discusses the need for and receipt of treatment for a substance use problem at a "specialty" treatment facility. Specialty treatment is defined as treatment received at any of the following types of facilities: hospitals (inpatient only), drug or alcohol rehabilitation facilities (inpatient or outpatient), or mental health centers. It does not include treatment at an emergency room, private doctor's office, self-help group, prison or jail, or hospital as an outpatient. An individual is defined as needing treatment for an alcohol or drug use problem if he or she met the DSM-IV (APA, 1994) diagnostic criteria for dependence on or abuse of alcohol or illicit drugs in the past 12 months or if he or she received specialty treatment for alcohol use or illicit drug use in the past 12 months.

In this section (7.3), an individual needing treatment for an illicit drug use problem is defined as receiving treatment for his or her drug use problem only if he or she reported receiving specialty treatment for drug use in the past year. Thus, an individual who needed treatment for illicit drug use but only received specialty treatment for alcohol use in the past year or who received treatment for illicit drug use only at a facility not classified as a specialty facility was not counted as receiving treatment for drug use. Similarly, an individual who needed treatment for an alcohol use problem was only counted as receiving alcohol use treatment if the treatment was received for alcohol use at a specialty treatment facility. Individuals who reported receiving specialty substance use treatment but were missing information on whether the treatment was specifically for alcohol use or drug use were not counted in estimates of specialty drug use treatment or in estimates of specialty alcohol use treatment; however, they were counted in estimates for "drug or alcohol use" treatment.

In addition to questions about symptoms of substance use problems that are used to classify respondents' need for treatment based on DSM-IV criteria, NSDUH includes questions asking respondents about their perceived need for treatment (i.e., whether they felt they needed treatment or counseling for illicit drug use or alcohol use). In this report, estimates for felt need for treatment are only discussed for persons who were classified as needing treatment (based on DSM-IV criteria) but did not receive treatment at a specialty facility. Similarly, estimates for whether a person made an effort to get treatment are only discussed for persons who felt the need for treatment.

Illicit Drug or Alcohol Use Treatment and Treatment Need

Figure 7.6 Need for and Receipt of Specialty Treatment in the Past Year for Illicit Drug or Alcohol Use among Persons Aged 12 or Older: 2005

Figure 7.6     D

Figure 7.7 Past Year Perceived Need for and Effort Made to Receive Specialty Treatment among Persons Aged 12 or Older Needing But Not Receiving Treatment for Illicit Drug or Alcohol Use: 2005

Figure 7.7     D

Note: Due to rounding, these percentages do not add to 100 percent.

Figure 7.8 Reasons for Not Receiving Substance Use Treatment among Persons Aged 12 or Older Who Needed and Made an Effort to Get Treatment But Did Not Receive Treatment and Felt They Needed Treatment: 2004-2005 Combined

Figure 7.8     D

Illicit Drug Use Treatment and Treatment Need

Figure 7.9 Number of Persons Aged 12 or Older Who Felt the Need for Illicit Drug Use Treatment among Those Needing But Not Receiving Specialty Treatment for an Illicit Drug Use Problem in the Past Year: 2002-2005

Figure 7.9     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Alcohol Use Treatment and Treatment Need


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2005 National Survey on Drug Use & Health:  National Results

8. Prevalence and Treatment of Mental Health Problems

This chapter presents findings on mental health problems in the United States, including the prevalence and treatment of serious psychological distress (SPD) and major depressive episode (MDE) and the association of these problems with substance use and substance dependence or abuse (substance use disorder).

SPD is an overall indicator of past year nonspecific psychological distress that is constructed from the K6 scale administered to adults aged 18 or older in the National Survey on Drug Use and Health (NSDUH). The K6 scale consists of six questions that gather information on how frequently a respondent experienced symptoms of psychological distress during the 1 month in the past year when he or she was at his or her worst emotionally. Responses to these six questions are combined to produce a score ranging from 0 to 24, where a score of 13 or greater is considered SPD. This cutoff is based on research suggesting that scores above this threshold indicate a high probability of having serious mental illness. The questions used to measure SPD and the scoring algorithm are included in Section B.4.4 of Appendix B.

The data related to SPD in this report are not comparable with data in previous reports due to changes in the survey administration of this instrument. In the 2001-2003 NSDUHs, the K6 was embedded in a module that had survey questions addressing a variety of mental health-related symptoms. The 2004 NSDUH employed a split-sample design in which approximately half of the adult respondents (sample A) were administered the K6 questions as it was administered in prior years of the survey. The other half of the adult respondents (sample B) were administered only the K6 questions without other mental health symptom questions in the module. Analyses comparing sample A and sample B data found significant differences in the reporting of the K6 items. In 2005, the full sample of adults were surveyed using the K6 as a stand-alone instrument (i.e., as in sample B in 2004). The 2004 NSDUH report showed trends in SPD from 2002 to 2004 using the A sample for 2004 estimates. In this report, 2005 SPD data are compared only with the 2004 sample B data, for which the questions were administered similarly.

In 2005, adults also were administered a module of questions to measure lifetime and past year prevalence of MDE, the severity of MDE as measured by role impairment, and treatment received specifically for depression. A similar set of questions on MDE also was administered to the full sample of youths aged 12 to 17. Some questions in the adolescent depression module were slightly modified to make them more appropriate for youths. For example, "lost interest" in the adult module was changed to "lost interest and became bored." Adult and youth depression estimates are presented separately in this chapter because of differences in the modules.

MDE is defined as a period of at least 2 weeks when a person experienced a depressed mood or loss of interest or pleasure in daily activities and had symptoms that met the criteria for major depressive disorder as described in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (American Psychiatric Association [APA], 1994). It should be noted that no exclusions were made for MDE caused by medical illness, bereavement, or substance use disorders.

Although there is substantial overlap in the populations classified with SPD and MDE, there are important distinctions between the definitions of the two. Meeting the criteria for SPD indicates that the respondent exhibited a high level of distress due to any type of mental problem, which may include general symptoms related to phobia, anxiety, or depression. However, meeting the criteria for MDE indicates that the respondent had the specific physical and emotional symptom profile indicative of major depression. The questions used to measure MDE and role impairment and the scoring algorithm for these responses are included in Section B.4.5 of Appendix B.

This chapter also presents data on the receipt of treatment for any type of mental health problem among adults and adolescents. This may be different from the treatment received specifically for MDE, and it is possible for a respondent to have indicated receipt of treatment for depression without having indicated that he or she received treatment for any mental health problems. Different questions and definitions of treatment and counseling are used for adults and youths. Treatment for adults is defined as the receipt of treatment or counseling for any problem with emotions, "nerves," or mental health in the past year in any inpatient or outpatient setting or the use of prescription medication for a mental or emotional condition. Treatment for youths is defined as receiving treatment or counseling for problems with behaviors or emotions from specific mental health or other health professionals in school, home, or from other outpatient or inpatient settings within the past year. Both the youth and the adult questions specifically exclude treatment for problems with substance use, which is asked about elsewhere in the interview. Estimates of unmet need for treatment are reported separately for all adults and for adults with SPD. Unmet need is defined using a question in the 2005 NSDUH that asks whether the respondent perceived a need for mental health treatment or counseling at any time in the 12 months prior to the interview but did not receive it.

It is important to note that because the survey covers only the U.S. civilian, noninstitutionalized population, persons who were residing in long-term psychiatric or other institutions at the time of interview were excluded from the NSDUH sample.

8.1 Adults Aged 18 or Older

Prevalence of Serious Psychological Distress

Figure 8.1 Rates of Serious Psychological Distress in the Past Year among Adults Aged 18 or Older, by Age: 2004-2005

Figure 8.1     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Serious Psychological Distress and Substance Use and Dependence or Abuse

Treatment and Unmet Need for Treatment among Adults with Serious Psychological Distress

Treatment among Adults with Co-Occurring Serious Psychological Distress and Substance Use Disorders

Figure 8.2 Past Year Treatment among Adults Aged 18 or Older with Both Serious Psychological Distress and a Substance Use Disorder: 2005

Figure 8.2     D

Note: Due to rounding, these percentages do not add to 100 percent.

Prevalence of Major Depressive Episode

Figure 8.3 Major Depressive Episode in the Past Year among Adults Aged 18 or Older, by Race/Ethnicity: 2004-2005

Figure 8.3     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.
Note: Due to low precision, estimates for Native Hawaiians or Other Pacific Islanders are not shown.

Major Depressive Episode and Substance Use and Dependence or Abuse

Figure 8.4 Substance Use among Adults Aged 18 or Older, by Major Depressive Episode in the Past Year: 2005

Figure 8.4     D

Treatment for Major Depressive Episode

Treatment for Mental Health Problems and Unmet Treatment Need among All Adults

Figure 8.5 Past Year Treatment for Mental Health Problems among Adults Aged 18 or Older, by Type of Treatment: 2002-2005

Figure 8.5     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.

Figure 8.6 Reasons for Not Receiving Treatment in the Past Year among Adults Aged 18 or Older with an Unmet Need for Treatment Who Did Not Receive Treatment: 2005

Figure 8.6     D

8.2 Youths Aged 12 to 17

Prevalence of Major Depressive Episode

Figure 8.7 Major Depressive Episode in the Past Year among Youths Aged 12 to 17, by Race/Ethnicity: 2004-2005

Figure 8.7     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.
Note: Due to low precision, estimates for Native Hawaiians or Other Pacific Islanders are not shown.

Major Depressive Episode and Substance Use

Figure 8.8 Substance Use among Youths Aged 12 to 17, by Major Depressive Episode in the Past Year: 2005

Figure 8.8     D

Treatment for Major Depressive Episode

Mental Health Treatment among Youths

Figure 8.9 Past Year Treatment for Mental Health Problems among Youths Aged 12 to 17, by Gender: 2002-2005

Figure 8.9     D

+ Difference between estimate and the 2005 estimate is statistically significant at the .05 level.


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2005 National Survey on Drug Use & Health:  National Results

9. Discussion of Trends in Substance Use among Youths and Young Adults

This report presents findings from the 2005 National Survey on Drug Use and Health (NSDUH). Conducted since 1971 and previously named the National Household Survey on Drug Abuse (NHSDA), the survey underwent several methodological improvements in 2002 that have affected prevalence estimates. As a result, the 2002 through 2005 estimates are not comparable with estimates from 2001 and earlier surveys. Therefore, the primary focus of the report is on comparisons of measures of substance use and mental health problems across subgroups of the U.S. population in 2005 and changes between 2004 and 2005, as well as between 2002 and 2005. This chapter provides an additional discussion of the findings concerning a topic of great interest—trends in substance use among youths and young adults.

NSDUH shows declines from 2002 to 2005 among youths aged 12 to 17 for past month rates of use (i.e., current use) of alcohol, cigarettes, marijuana, hallucinogens (such as Ecstasy and LSD), and the nonmedical use of prescription-type psychotherapeutic drugs. The past month use of cocaine and inhalants, however, showed no change among youths during that time period. Among young adults aged 18 to 25, the rates of current use of alcohol and marijuana were similar in 2002 and 2005. Cigarette use and Ecstasy use declined among young adults, but cocaine use and nonmedical use of prescription drugs increased.

An important step in the analysis and interpretation of NSDUH or any other survey data is to compare the results with those from other data sources. This can be difficult sometimes because the other surveys typically have different purposes, definitions, and designs. Research has established that surveys of substance use and other sensitive topics often produce inconsistent results because of different methods used. Thus, it is important to understand that conflicting results often reflect differing methodologies, not incorrect results. Despite this limitation, comparisons can be very useful. Consistency across surveys can provide confirmation or support for conclusions about trends and patterns of use, and inconsistent results can point to areas for further study. Further discussion of this issue is included in Appendix D, along with descriptions of methods and results from other sources of substance use and mental health data.

Unfortunately, few additional data sources are available at this time to compare with NSDUH results. One established source is Monitoring the Future (MTF), a study sponsored by the National Institute on Drug Abuse (NIDA). MTF surveys students in the 8th, 10th, and 12th grades in classrooms during the spring of each year, and it also collects data by mail from a subsample of adults who had participated earlier in the study as 12th graders (Johnston, O'Malley, Bachman, & Schulenberg, 2006a). Historically, NSDUH rates of substance use among youths have been lower than those of MTF, but the two sources usually have shown similar trends. NSDUH and MTF rates of substance use generally have been similar among young adults, and the two sources also have shown similar trends.

A comparison of NSDUH and MTF estimates for 2002 to 2005 is shown in Tables 9.1 and 9.2 for several substances that are defined similarly in the two surveys. MTF data on 8th and 10th graders combined give the closest match on age to NSDUH youth estimates, while MTF follow-up data on persons aged 19 to 24 provide the closest match on age to NSDUH young adult estimates. The NSDUH results are consistent with MTF trends. Both surveys show decreases between 2002 and 2005 in the percentages of youths using marijuana, Ecstasy, LSD, alcohol, and cigarettes in the lifetime, past year, and past month, with the exception of LSD in the past month for MTF and cigarettes in the past year for MTF for which an estimate is not available. Both surveys show no difference in the rates of past month cocaine and inhalant use among youths between 2002 and 2005. Data on young adults also show generally consistent trends in the two surveys for use of specific illicit drugs, as well as alcohol and cigarettes.

Table 9.1 Comparison of NSDUH and MTF Prevalence Estimates among Youths: 2002-2005
Substance/Time Period NSDUH
Ages 12-17
MTF
8th and 10th Grades
2002 2003 2004 2005 2002 2003 2004 2005
Marijuana                
     Lifetime 20.6 19.6 19.0 17.4   29.0 27.0   25.7   25.3  
     Past Year 15.8 15.0 14.5 13.3   22.5 20.5   19.7   19.4  
     Past Month   8.2   7.9   7.6   6.8   13.1 12.3 11.2   10.9  
Cocaine                
     Lifetime   2.7   2.6     2.4     2.3     4.9     4.4     4.4     4.5  
     Past Year   2.1   1.8     1.6     1.7     3.2     2.8     2.9     2.9  
     Past Month   0.6     0.6     0.5     0.6     1.4     1.1     1.3     1.3  
Ecstasy                
     Lifetime   3.3   2.4   2.1   1.6     5.5   4.3   3.6     3.4  
     Past Year   2.2   1.3   1.2     1.0     3.9   2.6     2.1     2.2  
     Past Month   0.5   0.4     0.3     0.3     1.6   0.9     0.8     0.8  
LSD                
     Lifetime   2.7   1.6   1.2     1.1     3.8   2.8   2.3     2.2  
     Past Year   1.3   0.6     0.6     0.6     2.1   1.5     1.4     1.4  
     Past Month   0.2   0.2     0.2     0.1     0.7     0.6     0.6     0.6  
Inhalants                
     Lifetime 10.5   10.7   11.0   10.5   14.4   14.3   14.9   15.1  
     Past Year   4.4     4.5     4.6     4.5     6.8   7.1     7.8     7.8  
     Past Month   1.2     1.3     1.2     1.2     3.1     3.2     3.5     3.2  
Alcohol                
     Lifetime 43.4 42.9 42.0 40.6   57.0 55.8 54.1 52.1  
     Past Year 34.6 34.3   33.9   33.3   49.4 48.3 47.5 45.3  
     Past Month 17.6 17.7 17.6 16.5   27.5 27.6 26.9 25.2  
Cigarettes                
     Lifetime 33.3 31.0 29.2 26.7   39.4 35.7 34.3 32.4  
     Past Year 20.3 19.0 18.4 17.3   --   --   --   --  
     Past Month 13.0 12.2 11.9 10.8   14.2 13.5 12.6   12.1  
-- Not available.
Note: MTF data for 8th and 10th graders are simple averages of estimates for those two grades. Data for 8th and 10th graders are reported in Johnston, O'Malley, Bachman, and Schulenberg (2006a). Design effects used for variance estimation are reported in Johnston, O'Malley, Bachman, and Schulenberg (2005c).
a Difference between estimate and 2005 estimate is statistically significant at the .05 level.
Sources: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003, 2004, and 2005. University of Michigan, The Monitoring the Future Study, 2002, 2003, 2004, and 2005.

Table 9.2 Comparison of NSDUH and MTF Prevalence Estimates among Young Adults: 2002-2005
Substance/Time Period NSDUH
Ages 18-25
MTF
Ages 19-24
2002 2003 2004 2005 2002 2003 2004 2005
Marijuana                
     Lifetime 53.8   53.9 52.8   52.4   56.1   56.4   55.6   54.4  
     Past Year 29.8 28.5   27.8   28.0   34.2 33.0   31.6   31.4  
     Past Month 17.3   17.0   16.1   16.6   19.8 19.9   18.2   17.0  
Cocaine                
     Lifetime 15.4   15.0   15.2   15.1   12.9   14.5   14.3 12.6  
     Past Year   6.7     6.6     6.6     6.9     6.5     7.3     7.8     6.9  
     Past Month   2.0   2.2     2.1a   2.6     2.5     2.6     2.4     2.1  
Ecstasy                
     Lifetime 15.1 14.8 13.8   13.7   16.0 16.6   14.9 12.4  
     Past Year   5.8   3.7   3.1     3.1     8.0   5.3     3.3     3.4  
     Past Month   1.1   0.7     0.7     0.8     1.6   1.0     0.8     0.6  
LSD                
     Lifetime 15.9 14.0 12.1 10.5   13.9 13.8   10.4   7.9  
     Past Year   1.8   1.1     1.0     1.0     2.4   1.5     1.2     1.1  
     Past Month   0.1     0.2     0.3     0.2     0.4     0.2     0.2     0.2  
Inhalants                
     Lifetime 15.7 14.9 14.0   13.3   11.7 11.4   10.6     9.3  
     Past Year   2.2     2.1     2.1     2.1     2.2     1.5     2.3     1.6  
     Past Month   0.5     0.4     0.4     0.5     0.8   0.3     0.4     0.3  
Alcohol                
     Lifetime 86.7 87.1 86.2   85.7   88.4   87.6   87.2   87.1  
     Past Year 77.9   78.1   78.0   77.9   83.9   82.3   83.1   82.8  
     Past Month 60.5   61.4   60.5   60.9   67.7   66.3   67.3   66.8  
Cigarettes                
     Lifetime 71.2 70.2 68.7 67.3   --   --   --   --  
     Past Year 49.0 47.6   47.5   47.2   41.8   40.8   41.4   40.2  
     Past Month 40.8 40.2   39.5   39.0   31.4 29.5   30.2  28.7  
-- Not available.
Note: MTF data for persons aged 19 to 24 are simple averages of modal age groups 19-20, 21-22, and 23-24 as reported in Johnston, O'Malley, and Bachman (2003c) and Johnston, O'Malley, Bachman, and Schulenberg (2004a, 2005a,2006b).
Note: Significance testing was not performed between 2003 and 2005 MTF data.
a Difference between estimate and 2005 estimate is statistically significant at the .05 level.
Sources: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003, 2004, and 2005.
University of Michigan, The Monitoring the Future Study, 2002, 2003, 2004, and 2005.

1 RTI International is a trade name of Research Triangle Institute.

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