National Survey on Drug Use and Health Depression among Adults
Issue 3 2006

Serious Psychological Distress and Substance Use among Young Adult Males

In Brief

  • An estimated 10.3 percent of males aged 18 to 25 (1.6 million persons) experienced serious psychological distress (SPD) during the past year

  • Divorced or separated males aged 18 to 25 were more likely to have experienced past year SPD than their counterparts who were married or never married (20.9 percent vs. 7.3 and 10.5 percent, respectively)

  • Males aged 18 to 25 with past year SPD were more likely than those without past year SPD to have engaged in heavy alcohol use (27.2 vs. 20.7 percent), binge alcohol use (56.7 vs. 49.9 percent), and illicit drug use (35.6 vs. 22.1 percent) in the past month
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The transition from adolescence to adulthood is a time when individuals assume new social roles and form new identities that provide the foundations for later life. It is also a time of great risk for substance use and mental health problems. Research has shown that substance use and mental health problems tend to be highest among persons in their late adolescent and young adult years, with substance use generally being higher among males and mental health problems generally being higher among females.1

The National Survey on Drug Use and Health (NSDUH) includes questions to assess serious psychological distress (SPD) and substance use. SPD is an overall indicator of nonspecific psychological distress. NSDUH measures past year SPD using the K6 distress questions.2,3 The K6 questions measure symptoms of psychological distress during the 1 month in the past 12 months when respondents were at their worst emotionally.

NSDUH asks persons aged 12 or older about their use of illicit drugs and alcohol, including binge and heavy alcohol use, in the past month. Binge alcohol use is defined as drinking 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. Heavy alcohol use is defined as drinking five or more drinks on the same occasion on each of 5 or more days in the past 30 days; all heavy alcohol users are also binge alcohol users. NSDUH defines any illicit drug as marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically.4

This report examines SPD and substance use among young adult males aged 18 to 25, a relatively understudied group with respect to mental health issues. All findings are annual averages based on combined 2002, 2003, and 2004 NSDUH data.
Figure 1. Percentages of Males Aged 18 to 25 Who Experienced Past Year SPD, by Marital Status: 2002, 2003, and 2004 Figure 2. Percentages of Males Aged 18 to 25 Who Reported Heavy Alcohol Use, Binge Alcohol Use, and Illicit Drugs in the Past Month, by Race/Ethnicity: 2002, 2003, and 2004
Figure 1. Percentages of Males Aged 18 to 25 Who Experienced Past Year SPD, by Marital Status: 2002, 2003, and 2004 Figure 2. Percentages of Males Aged 18 to 25 Who Reported Heavy Alcohol Use, Binge Alcohol Use, and Illicit Drugs in the Past Month, by Race/Ethnicity: 2002, 2003, and 2004
Serious Psychological Distress

An estimated 10.3 percent of males aged 18 to 25 (1.6 million persons) experienced SPD during the past year. Males aged 18 to 22 were more likely to have had past year SPD than males aged 23 to 25 (10.8 vs. 9.3 percent). Males aged 18 to 25 who were divorced or separated were more likely to have experienced SPD than their counterparts who were married or never married (Figure 1).5 There were no statistically significant differences in the rate of past year SPD across racial/ethnic groups.

For males aged 18 to 22, the prevalence of SPD among those who were full-time college students was 9.4 percent; the prevalence was 14.3 percent among those who were part-time students, and 11.6 percent among those not enrolled in college.6

Figure 3. Percentages of Males Aged 18 to 25 Reporting Heavy Alcohol Use, Binge Alcohol Use, and Illicit Drug Use in the Past Month, by Past Year SPD: 2002, 2003, and 2004
Figure 3. Percentages of Males Aged 18 to 25 Reporting Heavy Alcohol Use, Binge Alcohol Use, and Illicit Drug Use in the Past Month, by Past Year SPD: 2002, 2003, and 2004
Alcohol and Illicit Drug Use

In the month prior to the interview, an estimated 21.4 percent of males aged 18 to 25 met the criteria for heavy alcohol use, 50.6 percent engaged in binge alcohol use, and 23.5 percent had used an illicit drug. Males aged 23 to 25 were more likely to have engaged in binge drinking in the past month than males aged 18 to 22 (53.6 vs. 49.0 percent), while males aged 18 to 22 were more likely to have used an illicit drug than those aged 23 to 25 (25.1 vs. 20.5 percent). American Indians/Alaska Natives had the highest rate of past month illicit drug use, whereas whites had the highest rates of heavy alcohol use and binge alcohol use (Figure 2). Males aged 18 to 25 who were married had lower rates of past month heavy alcohol use, binge alcohol use, and illicit drug use (12.4, 42.2, and 12.4 percent, respectively) than their peers who were divorced or separated (17.4, 53.0, and 20.6 percent) and those who had never married (22.6, 51.5, and 24.9 percent).

Among males aged 18 to 22, full-time college students were less likely to have used an illicit drug in the past month than those who were not attending college (23.6 vs. 26.7 percent); however, full-time college students were more likely to have engaged in heavy alcohol use in the past month than those attending college part-time or those who were not attending college (25.9 percent vs. 17.3 and 20.9 percent, respectively).

Co-Occurrence of SPD and Substance Use

Males aged 18 to 25 with past year SPD had higher rates of heavy alcohol use, binge alcohol use, and illicit drug use in the past month than those without past year SPD (Figure 3).

End Notes
  1. Office of Applied Studies. (2005). Results from the 2004 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 05-4062, NSDUH Series H-28). Rockville, MD: Substance Abuse and Mental Health Services Administration.

  2. Kessler, R.C., Barker, P.R., Colpe, L.J., Epstein, J.F., Gfroerer, J.C., Hiripi, E., Howes, M.J., Norman, S.L., Manderscheid, R.W., Walters, E.E., & Zaslavsky, A.M. (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry, 60, 184-189.

  3. The 2004 NSDUH sampling strategy employed a split-sample design in which approximately half of the adult respondents were administered the K6 questions embedded in the full mental health module, as administered in prior years of the survey. The other half of the adult respondents were administered only the K6 questions without other mental health symptom questions. To ensure comparability across all 3 years of data, estimates for SPD in this report are based only on respondents who were administered the K6 scale within the full module. NSDUH reports from 2002 and 2003 referred to SPD as serious mental illness (SMI). For a discussion of the methodology used to generate SPD estimates and the change in terminology, see Section B.4.4 of Appendix B in the document listed in end note 1.

  4. NSDUH measures the nonmedical use of prescription-type pain relievers, sedatives, stimulants, or tranquilizers. Nonmedical use is defined as the use of prescription-type drugs not prescribed for the respondent by a physician or used only for the experience or feeling they caused. Nonmedical use of any prescription-type pain reliever, sedative, stimulant, or tranquilizer does not include over-the-counter drugs.

  5. Estimates for widowed males aged 18 to 25 are not reported due to small sample size.

  6. For this analysis, respondents were classified as college students if they reported that they were in their first through fourth year at a college or university and that they were either full- or part-time students. Respondents were classified as nonstudents if their current enrollment status was known and they were not classified as a full- or part-time college student. Respondents who were on break were considered enrolled if they intended to return to college or university when the break ended. Respondents whose current college enrollment status was unknown were excluded from the analysis.
Figure Note

Source: SAMHSA, 2002, 2003, and 2004 NSDUHs.
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). Prior to 2002, this survey was called the National Household Survey on Drug Abuse (NHSDA). For this report, the 2002, 2003, and 2004 data are based on information obtained from 26,921 males aged 18 to 25. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.

The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)

Information on NSDUH used in compiling data for this issue is available in the following publications:

Office of Applied Studies. (2005). Results from the 2004 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 05-4062, NSDUH Series H-28). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Office of Applied Studies. (2004). Results from the 2003 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 04-3964, NSDUH Series H-25). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Office of Applied Studies. (2003). Results from the 2002 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 03-3836, NSDUH Series H-22). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Also available online: http://www.oas.samhsa.gov

Because of improvements and modifications to the 2002 NSDUH, estimates from the 2002, 2003, and 2004 surveys should not be compared with estimates from the 2001 or earlier versions of the survey to examine changes over time.

The NSDUH Report (formerly The NHSDA 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

This page was last updated on December 30, 2008.