Skip Navigation
Diverse group of young people

Related Resources

Substance Abuse

Although progress has been made in substantially lowering rates of substance abuse in the United States, the use of mind- and behavior-altering substances continues to take a major toll on the health of individuals, families, and communities nationwide. In 2005, an estimated 22 million Americans struggled with a drug or alcohol problem.

Substance abuse—involving drugs, alcohol, or both—is associated with a range of destructive social conditions, including family disruptions, financial problems, lost productivity, failure in school, domestic violence, child abuse, and crime. Moreover, both social attitudes and legal responses to the consumption of alcohol and illicit drugs make substance abuse one of the most complex public health issues. Estimates of the total overall costs of substance abuse in the United States, including lost productivity and health- and crime-related costs, exceed $600 billion annually.1


The Substance Abuse Leading Health Indicators are:


Health Impact of Substance Abuse

Substance abuse contributes to a number of negative health outcomes and public health problems, including:

  • Cardiovascular conditions
  • Pregnancy complications
  • Teenage pregnancy
  • Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)
  • Sexually transmitted diseases (STDs)
  • Domestic violence
  • Child abuse
  • Motor vehicle crashes
  • Homicide
  • Suicide

For example, data show that:

  • The use of cocaine, MDMA (ecstasy), amphetamines, and steroids have been linked to abnormal cardiovascular functioning, ranging from abnormal heart rate to heart attacks.2
  • Approximately one-fourth of AIDS cases in the United States have resulted from injection drug use.3
  • More than half of all people arrested in the United States, including for homicide, assault, and theft, test positive for illicit drugs.4
  • In 2009, an estimated 10.5 million people age 12 or older reported driving under the influence of illicit drugs in the previous year.5 In 2009, among fatally injured drivers, 18 percent tested positive for at least one drug.6
  • Prenatal drug exposure can result in premature birth, miscarriage, low birth weight, and a variety of behavioral and cognitive problems.7

Back to Top

Substance Abuse Across the Life Stages

Substance abuse remains a serious concern for Americans of all ages.

Children and Adolescents

  • On an average day in 2006, youth used the following substances for the first time: 7,970 drank alcohol; 4,348 used an illicit drug; 4,082 smoked cigarettes; and 2,517 used pain relievers nonmedically.8
  • Daily marijuana use increased among students in 8th, 10th, and 12th grades from 2009 to 2010. Among 12th graders, marijuana use was at its highest point since the early 1980s, with 6.1 percent of all high school seniors reporting marijuana use.8
  • Prescription medications, such as painkillers, and over-the-counter cough and cold medicines are some of the most abused drugs among high school seniors.8
  • 13.8% of students in 8th grade, 28.9% of students in 10th grade, and 41.2% of students in 12th grade consumed at least 1 drink in the past 30 days. Youth who used alcohol in the past month drank an average of 4.7 drinks per day on the days they drank.

Adults

  • In 2009, people age 18 to 25 had the highest rates of current drug use of any age group, at 21.2%. This is largely driven by the widespread use of marijuana among this age group (18.1%).5
  • 41.7% of young adults age 18 to 25, 36.3% of adults age 26 to 34, and 19.2% of people age 35 or older reported binge drinking in 2009.5
  • Adults dependent on alcohol report higher rates of illicit drug use and nonmedical use of prescription drugs compared with the general population.9

Determinants of Substance Abuse

Several biological, social, environmental, psychological, and genetic factors are associated with substance abuse. These factors can include gender, race and ethnicity, age, income level, educational attainment, and sexual orientation.10 Substance abuse is also strongly influenced by interpersonal, household, and community dynamics.

Family, social networks, and peer pressure are key influencers of substance abuse among adolescents. For example, research suggests that marijuana exposure through friends and siblings was a primary determinant of adolescents’ current marijuana use.11 Understanding these factors is key to reducing the number of people who abuse drugs and alcohol and improving the health and safety of all Americans.

Disparities in Substance Abuse

Some populations are more likely to abuse alcohol and illicit drugs. Data from 2008 show:

Alcohol and illicit drug use in adolescents

  • Among racial and ethnic groups, Asian adolescents age 12 to 17 had the lowest (best) rate of alcohol or illicit drug use (7.4%). In 2008, rates for adolescents in other racial and ethnic groups were:
    • American Indian or Alaska Native: 23.3%
    • White non-Hispanic: 19.8%
    • Hispanic or Latino: 18.5%
    • Black non-Hispanic : 14.5%
  • Among income groups, adolescents from families with incomes below the Federal Poverty Level (FPL) had the lowest (best) rate of alcohol or illicit drug use (15.9%). The rate was 27.4% among adolescents from families with incomes 600% of FPL and over, 73% higher than the best group rate.
  • Adolescents born outside the United States had a lower (better) rate of alcohol or illicit drug use (15.0%) than adolescents born in the United States (18.5%). The rate for adolescents born in the United States was 24% higher than that for adolescents born outside the United States.

Binge drinking in adults

  • Among racial and ethnic groups, Asian adults had the lowest (best) rate of binge drinking (13.5%) in 2008. In 2008, rates for adults in other racial and ethnic groups were:
    • Hispanic or Latino: 29.7%
    • American Indian or Alaska Native: 29.6%
    • White non-Hispanic: 27.7%
    • Black non-Hispanic: 24.9%
  • Among education groups, adults age 25 and over with an advanced degree had the lowest (best) rate of binge drinking (18.9%). Rates for adults age 25 and over in other education groups were:
    • 22.0% among adults with less than a high school education, 16% higher than the best group rate
    • 26.5% among adults with a high school education, 40% higher than the best group rate
    • 26.6% among adults with some college education, also 40% higher than the best group rate
    • 25.5% among adults with a college degree, 34% higher than the best group rate
  • Adults born outside the United States had a lower (better) rate of binge drinking (20.7%) than adults born in the United States (28.2%). The rate for adults born in the United States was 36% higher than that for adults born outside the United States.

Back to Top

About the Disparities Data

All disparities described are statistically significant at the 0.05 level of significance.

  • Alcohol and Illicit Drug Use in Adolescents (SA-13.1)
    • Data for this measure are available annually and come from the National Survey on Drug Use and Health (NSDUH), Substance Abuse and Mental Health Services Administration (SAMHSA).
    • Alcohol or illicit drug use by adolescents age 12 to 17 is defined as using at least one of the following substances in the past month: alcohol, marijuana or hashish, cocaine (including “crack”), inhalants, hallucinogens (including PCP and LSD), heroin, or any nonmedical use of analgesics, tranquilizers, stimulants, or sedatives.
  • Binge Drinking in Adults (SA-14.3)
    • Data for this measure are available annually and come from NSDUH, SAMHSA.
    • Binge drinking is defined as drinking 5 or more alcoholic beverages for men and 4 or more alcoholic beverages for women at the same time or within a couple of hours of each other during the past 30 days.

References

1National Institute on Drug Abuse, National Institutes of Health. Understanding drug abuse and addiction. NIDA InfoFacts. Bethesda, MD; 2011. p.1. Available from http://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction

2National Institute on Drug Abuse, National Institutes of Health. Cardiovascular effects. Medical Consequences of Drug Abuse. Bethesda, MD: 2011. Available from http://www.drugabuse.gov/consequences/cardiovascular

3National Institute on Drug Abuse, National Institutes of Health. Drug abuse and the link to HIV/AIDS and other infectious diseases. NIDA InfoFacts. Bethesda, MD: 2011. p.2. Available from http://www.drugabuse.gov/publications/drugfacts/hivaids-drug-abuse-intertwined-epidemics

4Office of National Drug Control Policy. 2010 Annual Report: Arrestee Drug Abuse Monitoring Program II. Washington, DC; 2011. p.xii. Available from http://www.whitehouse.gov/sites/default/files/ondcp/policy-and-research/adam2010.pdf [PDF - 2.2MB]

5Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. Results from the 2009 National Survey on Drug Use and Health: Volume I. Summary of National Findings. Rockville, MD: 2010. Available from http://oas.samhsa.gov/nsduh/2k9nsduh/2k9resultsp.pdf [PDF - 2MB]

6National Highway Traffic Safety Administration, U.S. Department of Transportation. Drug involvement of fatally injured drivers. Traffic Safety Facts. Washington, DC: 2010. p.1. Available from http://www-nrd.nhtsa.dot.gov/Pubs/811415.pdf [PDF - 184KB]

7National Institute on Drug Abuse, National Institutes of Health. Prenatal effects. Medical Consequences of Drug Abuse. Bethesda, MD. Available from http://drugabuse.gov/consequences/prenatal

8Johnston, LD, O’Malley, PM, Bachman, JG, et al. Monitoring the Future: National Results on Adolescent Drug Use: Overview of Key Findings, 2009. Bethesda, MD: National Institute on Drug Abuse, National Institutes of Health; 2010. Available from http://www.monitoringthefuture.org/pubs/monographs/overview2009.pdf [PDF - 1.3MB] External Web Site Policy

9Hedden SL, Martins SS, Malcolm RJ, et al. Patterns of illegal drug use among an adult alcohol dependent population: results from the national survey on drug use and health. Drug Alcohol Depend. 2010;106(2-3):119–125; and comparison data for the general population aged 18 or older from the 2007 NSDUH (Full Text). Available from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2814886/pdf/nihms141266.pdf [PDF - 1.3MB]

10Centers for Disease Control and Prevention. CDC health disparities and inequalities report: United States, 2011. MMWR. 2011;60(suppl). Available from http://www.cdc.gov/mmwr/pdf/other/su6001.pdf [PDF - 3MB]

11Galea S, Nandi A, Vlahov D. The social epidemiology of substance use. Epidemiol Rev. 2004;26(1):36–52.

Back to Top