The Dasis Report (Drug and Alcohol Information System)

Issue 4, 2006

Age of First Use among Admissions for Drugs: 1993 and 2003

In Brief

The average age of first use among admissions for drug use showed a slight decrease, from 18.8 in 1993 to 18.6 in 2003

Between 1993 and 2003, the average age of first use was unchanged among admissions younger than 18 (12.8) and decreased among all other age groups

The percentage of criminal justice referrals using drugs before age 13 increased from 14 percent in 1993 to 18 percent in 2003

The age when people first use drugs is considered an important marker in efforts to control drug abuse. According to the 2004 National Survey on Drug Use and Health, “adults who had first used substances at a younger age were more likely to be classified with dependence or abuse than adults who initiated use at a later age.”¹ This report will look at age of first use among Treatment Episode Data Set (TEDS) admissions for drugs other than alcohol.² TEDS collects data on the approximately 1.8 million annual admissions to substance abuse treatment facilities, primarily those that receive some public funding. Up to three substances may be reported in TEDS as being used at the time of admission.³ This report classifies admissions according to the earliest age at which use began for any of the drugs reported. For some admissions, it is possible that initiation of drug use may have occurred at an even earlier age if the first drug used was not among the three drugs reported at time of admission.

There are two ways of evaluating age of first use among TEDS admissions: the first is the average or mean age; and the second is to measure the percentage of admissions who started before a given age. Since studies of drug use commonly employ drug use before the age of 13 as an indicator,⁴ that age will also be used in this report when describing age of first use as a percentage of admissions.

The average age of first use among admissions for drug use showed a slight decrease, from 18.8 in 1993 to 18.6 in 2003. This trend was echoed in the increase in the proportion of admissions for drug use who started before age 13: 12 percent in 1993 compared to 14 percent in 2003.

Earliest Drug of Abuse

Among admissions whose earliest reported drug of abuse at admission was stimulants, opiates, or cocaine, the average age of first use rose between 1993 and 2003: for stimulants, from 18.5 to 19.7; for opiates, from 21.0 to 22.1; and for cocaine, from 22.5 to 22.7. However, the average age of first use decreased among admissions whose earliest reported drug of abuse was marijuana, from 15.1 in 1993 to 14.6 in 2003.

The percentage of admissions that initiated drug use before age 13 increased between 1993 and 2003 for marijuana and opiate admissions (from 20 to 23 percent for marijuana admissions and from 4 to 5 percent for opiate admissions), and declined for cocaine and stimulant admissions (from 5 to 4 percent for cocaine admissions and from 10 to 9 percent for stimulant admissions).

Sociodemographics

Among female admissions, there was a slight decline in the average age of first use, from 19.5 to 19.4 between 1993 and 2003. Male admissions had a larger drop in average age of first use, from 18.6 to 18.2. The percentage of admissions initiating drug use before age 13 increased for both females (11 percent in 1993 vs. 12 percent in 2003) and males (13 percent in 1993 vs. 15 percent in 2003). Between 1993 and 2003, the average age of first use decreased among Black (20.6 in 1993 vs. 19.7 in 2003), Hispanic (19.3 in 1993 vs. 18.7 in 2003), and Asian/Pacific Islander (18.7 in 1993 vs. 18.1 in 2003) admissions. The average age increased slightly among Native American/Alaska Native (16.6 in 1993 vs. 16.7 in 2003) admissions and was unchanged among White admissions at 18.0.

Among Black admissions, the percentage using drugs before age 13 increased from 8 percent in 1993 to 11 percent in 2003 (Figure 1). The percentage using drugs before age 13 also increased among Hispanic admissions (10 percent in 1993 vs. 13 percent in 2003) and Asian/Pacific Islander admissions (16 percent in 1993 vs. 19 percent in 2003) and American Indian/Alaska Native admissions (21 percent in 1993 vs. 23 percent in 2003). The percentage initiating drug use before age 13 was unchanged among White admissions (15 percent).

Figure 1. Percent of Admissions Initiating Drug Use Before Age 13, by Race/Ethnicity: 1993 and 2003

Source: 2003 SAMHSA Treatment Episode Data Set (TEDS).

Between 1993 and 2003, the average age of first use was unchanged among admissions younger than 18 (12.8) and decreased among all other age groups (Table 1). The largest decrease, almost 2 years, was among admissions aged 45 or older at the time of admission (26.5 in 1993 vs. 24.6 in 2003). The percentage of admissions starting drug use before age 13 increased for all age groups except 18- to 24-year-olds.

Table 1. Average Age of Initiating Drug Use and Percent of Admissions Initiating Drug Use Before Age 13, by Age at Admission: 1993 and 2003

		Age at Admission
Characteristic	Year of Admission	<18	18-24	25-34	35-44	45+
Average Age of First Use	1993	12.8	15.2	18.3	21.5	26.5
	2003	12.8	15.0	17.7	20.8	24.6
Percent Initiating Drug Use Before Age 13	1993	35	18	11	6	5
	2003	37	17	12	10	6

Source: 2003 SAMHSA Treatment Episode Data Set (TEDS).

Prior Treatment

Between 1993 and 2003, the percentage of admissions initiating drug use before age 13 increased, regardless of the number of prior treatment episodes (Table 2). The average age of first use decreased for groups with fewer than four prior treatment episodes and was unchanged for those with four prior treatment episodes or five or more prior treatment episodes.

Table 2. Average Age of Initiating Drug Use and Percent of Admissions Initiating Drug Use Before Age 13, by Number of Prior Treatment Episodes: 1993 and 2003

		Number of Prior Treatment Episodes
Characteristic	Year of Admission	0	1	2	3	4	5
Average Age of First Use	1993	18.4	19.0	19.1	19.2	19.2	19.3
	2003	17.8	18.3	18.8	19.1	19.2	19.3
Percent Initiating Drug Use Before Age 13	1993	13	12	12	11	11	10
	2003	15	15	14	13	13	12

Source: 2003 SAMHSA Treatment Episode Data Set (TEDS).

Type of Referral

The proportion of admissions initiating drug use before age 13 decreased among school referrals (30 vs. 29 percent) and was unchanged among other community referrals (15 percent) and alcohol and drug abuse care provider referrals (11 percent) from 1993 to 2003 (Figure 2). Among all other types of referral, the percentage initiating drug use before age 13 increased between 1993 and 2003, although only among criminal justice referrals was the increase greater than 1 percentage point. The percentage of criminal justice referrals using drugs before age 13 increased from 14 percent in 1993 to 18 percent in 2003. Criminal justice admissions were the only referral source with a decrease in the average age of first use, from 17.6 in 1993 to 16.8 in 2003.

Figure 2. Percent of Admissions Initiating Drug Use Before Age 13, by Referral Source: 1993 and 2003

Source: 2003 SAMHSA Treatment Episode Data Set (TEDS).

End Notes

¹ Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (2005). Results from the 2004 National Survey on Drug Use and Health: National findings (NSDUH Series H-28, DHHS Publication No. SMA 05-4062). Rockville, MD.
² Age of first use is defined differently for alcohol than for drugs. For alcohol, age of first use signifies age of first intoxication. For drugs, age of first use identifies the age at which the respective drug was first used.
³ The substances reported at the time of admission may not include the first drug ever used.
⁴ Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (2005). Treatment Episode Data Set (TEDS): 1993-2003. National admissions to substance abuse treatment services (DASIS Series S-29, DHHS Publication No. SMA 05-4118). Rockville, MD.

The Drug and Alcohol Services Information System (DASIS) is an integrated data system maintained by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). One component of DASIS is the Treatment Episode Data Set (TEDS). TEDS is a compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment. The information comes primarily from facilities that receive some public funding. Information on treatment admissions is routinely collected by State administrative systems and then submitted to SAMHSA in a standard format. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once. State admission data are reported to TEDS by the Single State Agencies (SSAs) for substance abuse treatment. There are significant differences among State data collection systems. Sources of State variation include completeness of reporting, facilities reporting TEDS data, clients included, and treatment resources available. See the annual TEDS reports for details. Approximately 1.8 million records are included in TEDS each year.

The DASIS Report is prepared by the Office of Applied Studies, SAMHSA; Synectics for Management Decisions, Inc., Arlington, Virginia; and by RTI International in Research Triangle Park, North Carolina (RTI International is a trade name of Research Triangle Institute).

Information and data for this issue are based on data reported to TEDS through April 11, 2005.
Access the latest TEDS reports at:
http://www.oas.samhsa.gov/dasis.htm

Access the latest TEDS public use files at:
http://www.oas.samhsa.gov/SAMHDA.htm

Other substance abuse reports are available at:
http://www.oas.samhsa.gov

The DASIS Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available on-line: http://www.oas.samhsa.gov. Citation of the source is appreciated. For questions about this report please e-mail: shortreports@samhsa.hhs.gov

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