March 19, 2009

Concurrent Illicit Drug and Alcohol Use

Concurrent use of illicit drugs and alcohol is a serious public health concern because of the potential additive or interactive effects of multiple substance use,^1,2 which may lead to more severe adverse consequences than use of a single substance. Little is known about the prevalence of illicit drug use at the same time or within a few hours of alcohol use. The National Survey on Drug Use and Health (NSDUH) can help to address the need for information in this area. This issue of The NSDUH Report examines this topic using annual averages based on combined 2006 and 2007 NSDUH data.^3,4

Illicit drug use concurrent with the respondent's last alcohol use was reported by 5.6 percent of past month alcohol users aged 12 or older; this is equivalent to an estimated 7.1 million persons. The illicit drug most frequently used with alcohol was marijuana (4.8 percent), followed by cocaine and pain relievers (0.6 and 0.4 percent, respectively) (Figure 1).

Figure 1. Illicit Drug Use Concurrent with Last Alcohol Use among Past Month Alcohol Users Aged 12 or Older, by Type of Illicit Drug: 2006 and 2007

Among past month alcohol users, males were nearly twice as likely as females to report illicit drug use concurrent with last alcohol use (7.1 vs. 3.9 percent). Rates were higher among adolescent and young adult past month drinkers than their older counterparts (14.2 percent among 12 to 17 year olds, 13.5 percent among 18 to 25 year olds, 7.7 percent among 26 to 34 year olds, 4.3 percent among 35 to 49 year olds, and 1.1 percent among those aged 50 or older) (Figure 2). American Indian or Alaska Native past month drinkers had the highest rate of illicit drug use concurrent with last alcohol use, and Asian drinkers had the lowest rate (11.7 and 2.1 percent, respectively) (Figure 3).

Figure 2. Concurrent Illicit Drug and Alcohol Use among Past Month Alcohol Users Aged 12 or Older, by Age Group: 2006 and 2007

Figure 3. Concurrent Illicit Drug and Alcohol Use among Past Month Alcohol Users Aged 12 or Older, by Race/Ethnicity: 2006 and 2007

The likelihood of using illicit drugs concurrently with last alcohol use varied with the number of drinks consumed. Among past month alcohol users, those who binged on alcohol during their last occasion of use (i.e., had five or more drinks within a couple of hours) were more likely than their counterparts who did not binge (i.e., had four or fewer drinks) to have used illicit drugs concurrently with their last alcohol use (13.9 vs. 3.8 percent, respectively) (Figure 4).

Figure 4. Concurrent Illicit Drug and Alcohol Use among Past Month Alcohol Users Aged 12 or Older, by Number of Drinks on Last Occasion: 2006 and 2007

Overall, about 6 percent of past month alcohol users used an illicit drug concurrently with their last alcohol use. However, this behavior was more prevalent among certain groups—namely, males, young people aged 12 to 25, and American Indians or Alaska Natives—perhaps reflecting differentials in rates of use of illicit drugs overall. Concurrent illicit drug use also was higher among those who engaged in binge drinking than those who drank less on their last occasion of alcohol use. Some of these differentials also may reflect lower awareness of the potential adverse health consequences of simultaneous alcohol and illicit drug use. Prevention and treatment providers should continue to emphasize the risks of using alcohol and illicit drugs together, with targeted messages for those groups at greatest risk for this behavior.