Highlights

This report presents the first information from the 2009 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

In 2009, an estimated 21.8 million Americans aged 12 or older were current (past month) illicit drug users, meaning they had used an illicit drug during the month prior to the survey interview. This estimate represents 8.7 percent of the population aged 12 or older. Illicit drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used nonmedically.
The rate of current illicit drug use among persons aged 12 or older in 2009 (8.7 percent) was higher than the rate in 2008 (8.0 percent).
Marijuana was the most commonly used illicit drug. In 2009, there were 16.7 million past month users. Among persons aged 12 or older, the rate of past month marijuana use and the number of users in 2009 (6.6 percent or 16.7 million) were higher than in 2008 (6.1 percent or 15.2 million) and in 2007 (5.8 percent or 14.4 million).
In 2009, there were 1.6 million current cocaine users aged 12 or older, comprising 0.7 percent of the population. These estimates were similar to the number and rate in 2008 (1.9 million or 0.7 percent) but were lower than the estimates in 2006 (2.4 million or 1.0 percent).
Hallucinogens were used in the past month by 1.3 million persons (0.5 percent) aged 12 or older in 2009, including 760,000 (0.3 percent) who had used Ecstasy. The number and percentage of Ecstasy users increased between 2008 (555,000 or 0.2 percent) and 2009.
In 2009, there were 7.0 million (2.8 percent) persons aged 12 or older who used prescription-type psychotherapeutic drugs nonmedically in the past month. These estimates were higher than in 2008 (6.2 million or 2.5 percent), but similar to estimates in 2007 (6.9 million or 2.8 percent).
The number of past month methamphetamine users decreased between 2006 and 2008, but then increased in 2009. The numbers were 731,000 (0.3 percent) in 2006, 529,000 (0.2 percent) in 2007, 314,000 (0.1 percent) in 2008, and 502,000 (0.2 percent) in 2009.
Among youths aged 12 to 17, the current illicit drug use rate increased from 2008 (9.3 percent) to 2009 (10.0 percent). Between 2002 and 2008, the rate declined from 11.6 to 9.3 percent.
The rate of current marijuana use among youths aged 12 to 17 decreased from 8.2 percent in 2002 to 6.7 percent in 2006, remained unchanged at 6.7 percent in 2007 and 2008, then increased to 7.3 percent in 2009.
Among youths aged 12 to 17, the rate of nonmedical use of prescription-type drugs declined from 4.0 percent in 2002 to 2.9 percent in 2008, then held steady at 3.1 percent in 2009.
The rate of current Ecstasy use among youths aged 12 to 17 declined from 0.5 percent in 2002 to 0.3 percent in 2004, remained at that level through 2007, then increased to 0.5 percent in 2009.
Between 2008 and 2009, the rate of current use of illicit drugs among young adults aged 18 to 25 increased from 19.6 to 21.2 percent, driven largely by an increase in marijuana use (from 16.5 to 18.1 percent).
From 2002 to 2009, there was an increase among young adults aged 18 to 25 in the rate of current nonmedical use of prescription-type drugs (from 5.5 to 6.3 percent), driven primarily by an increase in pain reliever misuse (from 4.1 to 4.8 percent). There were decreases in the use of cocaine (from 2.0 to 1.4 percent) and methamphetamine (from 0.6 to 0.2 percent).
Among those aged 50 to 59, the rate of past month illicit drug use increased from 2.7 percent in 2002 to 6.2 percent in 2009. This trend partially reflects the aging into this age group of the baby boom cohort, whose lifetime rate of illicit drug use is higher than those of older cohorts.
Among persons aged 12 or older in 2008-2009 who used pain relievers nonmedically in the past 12 months, 55.3 percent got the drug they most recently used from a friend or relative for free. Another 17.6 percent reported they got the drug from one doctor. Only 4.8 percent got pain relievers from a drug dealer or other stranger, and 0.4 percent bought them on the Internet. Among those who reported getting the pain reliever from a friend or relative for free, 80.0 percent reported in a follow-up question that the friend or relative had obtained the drugs from just one doctor.
Among unemployed adults aged 18 or older in 2009, 17.0 percent were current illicit drug users, which was higher than the 8.0 percent of those employed full time and 11.5 percent of those employed part time. However, most illicit drug users were employed. Of the 19.3 million current illicit drug users aged 18 or older in 2009, 12.9 million (66.6 percent) were employed either full or part time. The number of unemployed illicit drug users increased from 1.3 million in 2007 to 1.8 million in 2008 and 2.5 million in 2009, primarily because of an overall increase in the number of unemployed persons.
In 2009, 10.5 million persons aged 12 or older reported driving under the influence of illicit drugs during the past year. This corresponds to 4.2 percent of the population aged 12 or older, which is similar to the rate in 2008 (4.0 percent) and the rate in 2002 (4.7 percent). In 2009, the rate was highest among young adults aged 18 to 25 (12.8 percent).

Alcohol Use

Slightly more than half of Americans aged 12 or older reported being current drinkers of alcohol in the 2009 survey (51.9 percent). This translates to an estimated 130.6 million people, which is similar to the 2008 estimate of 129.0 million people (51.6 percent).
In 2009, nearly one quarter (23.7 percent) of persons aged 12 or older participated in binge drinking. This translates to about 59.6 million people. The rate in 2009 is similar to the estimate in 2008. Binge drinking is defined as having five or more drinks on the same occasion on at least 1 day in the 30 days prior to the survey.
In 2009, heavy drinking was reported by 6.8 percent of the population aged 12 or older, or 17.1 million people. This rate was similar to the rate of heavy drinking in 2008. Heavy drinking is defined as binge drinking on at least 5 days in the past 30 days.
Among young adults aged 18 to 25 in 2009, the rate of binge drinking was 41.7 percent, and the rate of heavy drinking was 13.7 percent. These rates were similar to the rates in 2008.
The rate of current alcohol use among youths aged 12 to 17 was 14.7 percent in 2009, which is similar to the 2008 rate (14.6 percent). Youth binge and heavy drinking rates in 2009 (8.8 and 2.1 percent) were also similar to rates in 2008 (8.8 and 2.0 percent).
Past month and binge drinking rates among underage persons (aged 12 to 20) declined between 2002 and 2008, but then remained unchanged between 2008 (26.4 and 17.4 percent) and 2009 (27.2 and 18.1 percent).
Among persons aged 12 to 20, past month alcohol use rates in 2009 were 16.1 percent among Asians, 20.4 percent among blacks, 22.0 percent among American Indians or Alaska Natives, 25.1 percent among Hispanics, 27.5 percent among those reporting two or more races, and 30.4 percent among whites.
In 2009, 55.9 percent of current drinkers aged 12 to 20 reported that their last use of alcohol in the past month occurred in someone else's home, and 29.2 percent reported that it had occurred in their own home. About one third (30.3 percent) paid for the alcohol the last time they drank, including 9.0 percent who purchased the alcohol themselves and 21.3 percent who gave money to someone else to purchase it. Among those who did not pay for the alcohol they last drank, 37.1 percent got it from an unrelated person aged 21 or older, 19.9 percent from another person younger than 21 years old, and 20.6 percent from a parent, guardian, or other adult family member.
In 2009, an estimated 12.0 percent of persons aged 12 or older drove under the influence of alcohol at least once in the past year. This percentage has dropped since 2002, when it was 14.2 percent. The rate of driving under the influence of alcohol was highest among persons aged 21 to 25 (24.8 percent).

Tobacco Use

In 2009, an estimated 69.7 million Americans aged 12 or older were current (past month) users of a tobacco product. This represents 27.7 percent of the population in that age range. In addition, 58.7 million persons (23.3 percent of the population) were current cigarette smokers; 13.3 million (5.3 percent) smoked cigars; 8.6 million (3.4 percent) used smokeless tobacco; and 2.1 million (0.8 percent) smoked tobacco in pipes.
Between 2002 and 2009, past month use of any tobacco product decreased from 30.4 to 27.7 percent, and past month cigarette use declined from 26.0 to 23.3 percent. Rates of past month use of cigars, smokeless tobacco, and pipe tobacco in 2009 were similar to corresponding rates in 2002.
The rate of past month tobacco use among 12 to 17 year olds remained steady from 2008 to 2009 (11.4 and 11.6 percent, respectively). The rate of past month cigarette use among 12 to 17 year olds also remained steady between 2008 and 2009 (9.1 and 8.9 percent, respectively) but declined since 2002 when the rate was 13.0 percent. However, past month smokeless tobacco use among youths increased from 2.0 percent in 2002 to 2.3 percent in 2009.

Initiation of Substance Use (Incidence, or First-Time Use) within the Past 12 Months

In 2009, an estimated 3.1 million persons aged 12 or older used an illicit drug for the first time within the past 12 months. This averages to about 8,500 initiates per day and is similar to the estimate for 2008 (2.9 million). A majority of these past year illicit drug initiates reported that their first drug was marijuana (59.1 percent). Nearly one third initiated with psychotherapeutics (28.6 percent, including 17.1 percent with pain relievers, 8.6 percent with tranquilizers, 2.0 percent with stimulants, and 1.0 percent with sedatives). A sizable proportion reported inhalants (9.8 percent) as their first illicit drug, and a small proportion used hallucinogens as their first drug (2.1 percent).
In 2009, the illicit drug categories with the largest number of past year initiates among persons aged 12 or older were marijuana use (2.4 million) and nonmedical use of pain relievers (2.2 million). These estimates were not significantly different from the numbers in 2008. However, the number of marijuana initiates increased between 2007 (2.1 million) and 2009 (2.4 million).
In 2009, the average age of marijuana initiates among persons aged 12 to 49 was 17.0 years, significantly lower than the average age of marijuana initiates in 2008 (17.8 years), but similar to that in 2002 (17.0 years).
The number of past year initiates of methamphetamine among persons aged 12 or older was 154,000 in 2009. This estimate was significantly higher than the estimate in 2008 (95,000), but lower than the estimate in 2002 (299,000).
There was a significant increase in the number of past year initiates of Ecstasy between 2008 and 2009, from 894,000 to 1.1 million. The estimate was 1.2 million in 2002, declined to 642,000 in 2003, and nearly doubled between 2005 (615,000) and 2009.
The number of past year cocaine initiates declined from 1.0 million in 2002 to 617,000 in 2009. The number of initiates of crack cocaine declined during this period from 337,000 to 94,000.
In 2009, there were 180,000 persons who used heroin for the first time within the past year, significantly more than the average annual number from 2002 to 2008. Estimates during those years ranged from 91,000 to 118,000 per year.
Most (85.5 percent) of the 4.6 million past year alcohol initiates were younger than 21 at the time of initiation.
The number of persons aged 12 or older who smoked cigarettes for the first time within the past 12 months was 2.5 million in 2009, similar to the estimate in 2008 (2.4 million), but significantly higher than the estimate for 2002 (1.9 million). Most new smokers in 2009 were younger than 18 when they first smoked cigarettes (58.8 percent or 1.5 million).
The number of persons aged 12 and older who used smokeless tobacco for the first time within the past year increased from 951,000 in 2002 to 1.5 million in 2009.

Youth Prevention-Related Measures

Perceived risk is measured by NSDUH as the percentage reporting that there is great risk in the substance use behavior. The percentage of youths aged 12 to 17 perceiving great risk in smoking marijuana once or twice a week increased from 51.5 percent in 2002 to 55.0 percent in 2005, but dropped to 49.3 percent in 2009. Between 2002 and 2008, the percentages who reported great risk in smoking one or more packs of cigarettes per day increased from 63.1 to 69.7 percent, but in 2009 the percentage dropped to 65.8 percent.
Almost half (49.9 percent) of youths aged 12 to 17 reported in 2009 that it would be "fairly easy" or "very easy" for them to obtain marijuana if they wanted some. Approximately one in five reported it would be easy to get cocaine (20.9 percent). About one in seven (13.5 percent) indicated that LSD would be "fairly" or "very" easily available, and 12.9 percent reported easy availability for heroin. Between 2002 and 2009, there were declines in the perceived availability for all four drugs.
A majority of youths aged 12 to 17 (90.5 percent) in 2009 reported that their parents would strongly disapprove of their trying marijuana or hashish once or twice. Current marijuana use was much less prevalent among youths who perceived strong parental disapproval for trying marijuana or hashish once or twice than for those who did not (4.8 vs. 31.3 percent).
In 2009, almost four fifths (77.0 percent) reported having seen or heard drug or alcohol prevention messages from sources outside of school, lower than in 2002 (83.2 percent). The percentage of school-enrolled youths reporting that they had seen or heard prevention messages at school also declined during this period, from 78.8 to 74.9 percent.

Substance Dependence, Abuse, and Treatment

In 2009, an estimated 22.5 million persons (8.9 percent of the population aged 12 or older) were classified with substance dependence or abuse in the past year based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Of these, 3.2 million were classified with dependence on or abuse of both alcohol and illicit drugs, 3.9 million were dependent on or abused illicit drugs but not alcohol, and 15.4 million were dependent on or abused alcohol but not illicit drugs.
Between 2002 and 2009, the number of persons with substance dependence or abuse was stable (22.0 million in 2002 and 22.5 million in 2009).
The specific illicit drugs that had the highest levels of past year dependence or abuse in 2009 were marijuana (4.3 million), pain relievers (1.9 million), and cocaine (1.1 million). The number of persons with marijuana dependence or abuse has not changed since 2002, but the number with pain reliever dependence or abuse has increased (from 1.5 million to 1.9 million) and the number with cocaine dependence or abuse has declined (from 1.5 million to 1.1 million).
In 2009, adults aged 21 or older who had first used alcohol at age 14 or younger were more than 6 times as likely to be classified with alcohol dependence or abuse than adults who had their first drink at age 21 or older (16.5 vs. 2.5 percent).
The rate of substance dependence or abuse for males aged 12 or older in 2009 was nearly twice as high as the rate for females (11.9 vs. 6.1 percent). Among youths aged 12 to 17, however, the rate of substance dependence or abuse among males (6.7 percent) was similar to the rate among females (7.4 percent).
Between 2002 and 2009, the percentage of youths aged 12 to 17 with substance dependence or abuse declined from 8.9 to 7.0 percent.
Treatment need is defined as having a substance use disorder or receiving treatment at a specialty facility (hospital inpatient, drug or alcohol rehabilitation, or mental health centers) within the past 12 months. In 2009, 23.5 million persons aged 12 or older needed treatment for an illicit drug or alcohol use problem (9.3 percent of persons aged 12 or older). Of these, 2.6 million (1.0 percent of persons aged 12 or older and 11.2 percent of those who needed treatment) received treatment at a specialty facility. Thus, 20.9 million persons (8.3 percent of the population aged 12 or older) needed treatment for an illicit drug or alcohol use problem but did not receive treatment at a specialty substance abuse facility in the past year.
Of the 20.9 million persons aged 12 or older in 2009 who were classified as needing substance use treatment but did not receive treatment at a specialty facility in the past year, 1.1 million persons (5.1 percent) reported that they felt they needed treatment for their illicit drug or alcohol use problem. Of these 1.1 million persons who felt they needed treatment, 371,000 (34.9 percent) reported that they made an effort to get treatment, and 693,000 (65.1 percent) reported making no effort to get treatment.

1. Introduction

This report presents a first look at results from the 2009 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. The report presents national estimates of rates of use, numbers of users, and other measures related to illicit drugs, alcohol, and tobacco products. The report focuses on trends between 2008 and 2009 and from 2002 to 2009, as well as differences across population subgroups in 2009. Estimates from NSDUH for States and areas within States will be presented in separate reports. NSDUH estimates related to mental health, which have been included in national findings reports in prior years, are not included in this 2009 report. A separate report focusing on 2009 mental health data, including co-occurring mental and substance use disorders, will be published later in 2010.

1.1. Summary of NSDUH

NSDUH is the primary source of statistical information on the use of illegal drugs, alcohol, and tobacco by the U.S. civilian, noninstitutionalized population aged 12 or older. 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 and analysis are 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.

From 1971 through 1998, the survey employed paper and pencil data collection. 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 mode for responding to questions in order 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 2009 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 about half 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) and had a sample size of about 3,600 each. For the remaining 42 States and the District of Columbia, the sample size was about 900 per State. 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, screening was completed at 143,565 addresses, and 68,700 completed interviews were obtained. The survey was conducted from January through December 2009. Weighted response rates for household screening and for interviewing were 88.8 and 75.7 percent, respectively. See Appendix B for more information on NSDUH response rates.

1.2. Limitations on Trend Measurement

Because of the shift in interviewing method in 1999, the estimates from the pre-1999 surveys are not comparable with estimates from the current CAI-based surveys. Although the design of the 2002 through 2009 NSDUHs is similar to the design of the 1999 through 2001 surveys, there are also important methodological differences that affect the comparability of the 2002 to 2009 estimates with estimates from prior surveys. The most important change was the incentive payment started in 2002 and continuing in subsequent surveys. Each NSDUH respondent completing the interview is given $30. Also, the name of the survey was changed in 2002, from the National Household Survey on Drug Abuse (NHSDA) to the current name. Improved data collection quality control procedures were introduced in the survey starting in 2001, and updated population data from the 2000 decennial census were incorporated into the sample weights starting with the 2002 estimates. 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 in more detail (see OAS, 2005).

Because of changes in the questionnaire, estimates for methamphetamine, stimulants, and psychotherapeutics in this report should not be compared with corresponding estimates in OAS reports for data years prior to 2007. Estimates for 2002 to 2006 for these drug categories in this report, as well as in the 2007 and 2008 reports, incorporate statistical adjustments to enable year-to-year comparisons to be made over the period from 2002 to 2009.

1.3. Format of Report and Explanation of Tables

This report has separate chapters that discuss the national findings on six topics: use of illicit drugs; use of alcohol; use of tobacco products; initiation of substance use; prevention-related issues; and substance dependence, abuse, and treatment. A final chapter summarizes the results and discusses key findings in relation to other research and survey results. Technical appendices presented in Volume II of this report 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 (Appendix E), and present selected tabulations of estimates (Appendices F and G). A list of contributors to the production of this report also is provided (Appendix H).

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 2009 estimates are significantly different from 2008 or earlier estimates. In addition, most percentages in this report are presented to the nearest tenth of a percent. Therefore, some estimates that are significantly different from one another may nevertheless round to the same value. In some tables and figures, estimates are presented based on data combined from two or more survey years to increase precision of the estimates; those estimates are annual averages based on multiple years of data.

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 in Appendix B). Estimates that do not meet these criteria are suppressed and do not appear in tables, figures, or text. 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 outside of 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 populations of fewer than 2,500 in urbanized areas.

1.4. Other NSDUH Reports and Data

Other reports focusing on specific topics of interest will be produced using the 2009 NSDUH data and made available on SAMHSA's Web site. In particular, data on mental health will be discussed in a separate report to be released later this year: Results from the 2009 National Survey on Drug Use and Health: Mental Health Findings. The report will address overall mental illness (i.e., any mental disorder), serious mental illness, major depressive episode, and suicide-related measures. Treatment for mental health problems and the co-occurrence of substance use disorders also will be included. A report on State-level estimates for substance use and mental health for 2008-2009 will be available in early 2011.

A comprehensive set of tables, referred to as "detailed tables," is available through the Internet at http://www.oas.samhsa.gov. The tables are organized into sections based primarily on the topic. Most tables are provided in several parts, showing population estimates (e.g., numbers of drug users), rates (e.g., percentages of population using drugs), and standard errors of all nonsuppressed estimates. A small subset of these detailed tables has been selected for inclusion in Appendices F and G of this report. The appendix tables can be mapped back to the detailed tables by using the table number in parentheses in the upper left corner of each table (e.g., Table G.1 in Appendix G is Table 7.1A 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, 2010) at http://www.datafiles.samhsa.gov. Currently, files are available from the 1979 to 2008 surveys.² The 2009 NSDUH public use file will be available by the end of 2010.

2. Illicit Drug Use

The National Survey on Drug Use and Health (NSDUH) obtains information on nine 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, psilocybin mushrooms, and "Ecstasy" (MDMA). Inhalants include a variety of substances, such as nitrous oxide, amyl nitrite, cleaning fluids, gasoline, spray paint, other aerosol sprays, and glue. Respondents are asked to report use of inhalants to get high but not to report times when they accidentally inhaled a substance.

The four categories of prescription-type drugs (pain relievers, tranquilizers, stimulants, and sedatives) cover numerous medications that currently are or have been available by prescription. They also include drugs within these groupings that originally were prescription medications but currently may be manufactured and distributed illegally, such as methamphetamine, which is included under stimulants. Respondents are asked to report only "nonmedical" use of these drugs, defined as use without a prescription of the individual's own or simply for the experience or feeling the drugs caused. Use of over-the-counter drugs and legitimate use of prescription drugs are not included. NSDUH reports combine the four prescription-type drug groups into a category referred to as "psychotherapeutics."

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.

In 2009, an estimated 21.8 million Americans aged 12 or older were current (past month) illicit drug users, meaning they had used an illicit drug during the month prior to the survey interview (Figure 2.1). This estimate represents 8.7 percent of the population aged 12 or older.

Below is a bar graph. Click here for the text describing this graph.

Figure 2.1 Past Month Illicit Drug Use among Persons Aged 12 or Older: 2009

Figure 2.1

¹ Illicit Drugs include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics used nonmedically.

The overall rate of current illicit drug use among persons aged 12 or older in 2009 (8.7 percent) was higher than the rate in 2008 (8.0 percent) and higher than the rates in 2004 (7.9 percent), 2005 (8.1 percent), and 2007 (8.0 percent) (Figure 2.2).

Below is a line graph. Click here for the text describing this graph.

Figure 2.2 Past Month Use of Selected Illicit Drugs among Persons Aged 12 or Older: 2002-2009

Figure 2.2

⁺ Difference between this estimate and the 2009 estimate is statistically significant at the .05 level.

Marijuana was the most commonly used illicit drug (16.7 million past month users). In 2009, marijuana was used by 76.6 percent of current illicit drug users and was the only drug used by 58.0 percent of them. Illicit drugs other than marijuana were used by 9.2 million persons or 42.0 percent of illicit drug users aged 12 or older. Current use of other drugs but not marijuana was reported by 23.4 percent of illicit drug users, and 18.6 percent used both marijuana and other drugs.
Among persons aged 12 or older, the rate of past month marijuana use and the number of users in 2009 (6.6 percent or 16.7 million) were higher than in 2008 (6.1 percent or 15.2 million) and in 2007 (5.8 percent or 14.4 million) (Figure 2.2).
An estimated 9.2 million people aged 12 or older (3.6 percent) were current users of illicit drugs other than marijuana in 2009. The majority of these (7.0 million persons or 2.8 percent of the population) used psychotherapeutic drugs nonmedically in the past month. An estimated 5.3 million persons used pain relievers nonmedically in the past month in 2009, 2.0 million used tranquilizers, 1.3 million used stimulants, and 370,000 used sedatives.
The number and percentage of current nonmedical users of psychotherapeutic drugs in 2009 (7.0 million or 2.8 percent) were higher than in 2008 (6.2 million or 2.5 percent) (Figure 2.2). Small but statistically significant increases in the percentage using stimulants (from 0.4 percent in 2008 to 0.5 percent in 2009) and sedatives (from 0.09 to 0.15 percent) contributed to this increase, along with a small increase for pain relievers (from 1.9 to 2.1 percent) that was not statistically significant (Figure 2.3). Though higher than in 2008, the 2009 rates for any psychotherapeutic drug use were similar to those in 2007 (6.9 million or 2.8 percent).

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Figure 2.3 Past Month Nonmedical Use of Types of Psychotherapeutic Drugs among Persons Aged 12 or Older: 2002-2009

Figure 2.3

⁺ Difference between this estimate and the 2009 estimate is statistically significant at the .05 level.

The number and percentage of past month nonmedical users of stimulants increased from 904,000 (0.4 percent) in 2008 to 1.3 million (0.5 percent) in 2009, based in part on an increase in methamphetamine users, from 314,000 (0.1 percent) to 502,000 (0.2 percent).
The number of past month methamphetamine users decreased between 2006 and 2008, but then increased in 2009. The numbers were 731,000 (0.3 percent) in 2006, 529,000 (0.2 percent) in 2007, 314,000 (0.1 percent) in 2008, and 502,000 (0.2 percent) in 2009.
The estimated number and percentage of persons aged 12 or older who used cocaine in the past month in 2009 (1.6 million users or 0.7 percent) were similar to those in 2008 (1.9 million or 0.7 percent), but lower than the estimates in 2006 (2.4 million or 1.0 percent).
Hallucinogens were used in the past month by 1.3 million persons aged 12 or older (0.5 percent) in 2009, including 760,000 (0.3 percent) who had used Ecstasy. The number and percentage of Ecstasy users in 2009 were higher than in 2008 (555,000 or 0.2 percent). Longer term data show that there were 676,000 Ecstasy users in 2002; the number decreased to 450,000 in 2004, then increased to 760,000 in 2009.

Age

Rates of past month illicit drug use varied with age. Through the adolescent years from 12 to 17, the rates of current illicit drug use in 2009 increased from 3.6 percent at ages 12 or 13 to 9.0 percent at ages 14 or 15 to 16.7 percent at ages 16 or 17 (Figure 2.4). The highest rate was among persons aged 18 to 20 (22.2 percent). The rate was 20.5 percent among those aged 21 to 25, and it was 14.4 percent among those aged 26 to 29. Among persons aged 65 or older, the rate was 0.9 percent.

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Figure 2.4 Past Month Illicit Drug Use among Persons Aged 12 or Older, by Age: 2008 and 2009

Figure 2.4

⁺ Difference between this estimate and the 2009 estimate is statistically significant at the .05 level.

From 2008 to 2009, statistically significant increases in the rate of illicit drug use were observed among three of the age groups shown in Figure 2.4. Among youths aged 16 or 17, the rate increased from 15.2 to 16.7 percent; for young adults aged 21 to 25, it increased from 18.4 to 20.5 percent; and among adults aged 50 to 54, the rate increased from 4.3 to 6.9 percent.
In 2009, adults aged 26 or older were less likely to be current drug users than youths aged 12 to 17 or young adults aged 18 to 25 (6.3 vs. 10.0 and 21.2 percent, respectively). However, there were more drug users aged 26 or older (12.2 million) than users aged 12 to 17 (2.5 million) and users aged 18 to 25 (7.1 million) combined.
The rate of past month illicit drug use increased from 2008 to 2009 among youths aged 12 to 17 (from 9.3 to 10.0 percent) and young adults aged 18 to 25 (from 19.6 to 21.2 percent) (Figure 2.5).

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Figure 2.5 Past Month Illicit Drug Use among Persons Aged 12 or Older, by Age: 2002-2009

Figure 2.5

⁺ Difference between this estimate and the 2009 estimate is statistically significant at the .05 level.

Youths Aged 12 to 17

In 2009, 10.0 percent of youths aged 12 to 17 were current illicit drug users (Figure 2.6): 7.3 percent used marijuana, 3.1 percent engaged in nonmedical use of prescription-type psychotherapeutics, 1.0 percent used inhalants, 0.9 percent used hallucinogens, and 0.3 percent used cocaine.

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Figure 2.6 Past Month Use of Selected Illicit Drugs among Youths Aged 12 to 17: 2002-2009

Figure 2.6

⁺ Difference between this estimate and the 2009 estimate is statistically significant at the .05 level.

Among youths aged 12 to 17, the types of drugs used in the past month varied by age group. Among 12 or 13 year olds, 1.6 percent used prescription-type drugs nonmedically, 1.4 percent used inhalants, and 0.8 percent used marijuana. Among 14 or 15 year olds, marijuana was the most commonly used drug (6.3 percent), followed by prescription-type drugs used nonmedically (3.3 percent); inhalants and hallucinogens tied for third rank (0.8 percent). Marijuana also was the most commonly used drug among 16 or 17 year olds (14.0 percent); it was followed by prescription-type drugs used nonmedically (4.3 percent), hallucinogens (1.6 percent), inhalants (0.8 percent), and cocaine (0.6 percent).
After gradually declining from 11.6 percent in 2002 to 9.3 percent in 2008, the rate of past month illicit drug use among 12 to 17 year olds increased to 10.0 percent in 2009 (Figure 2.6). Marijuana use declined from 8.2 percent in 2002 to 6.7 percent in 2006, held steady at that rate through 2008, then increased to 7.3 percent in 2009. Nonmedical use of psychotherapeutic drugs declined from 4.0 percent in 2002 and 2003 to 2.9 percent in 2008; the rate in 2009, 3.1 percent, was not significantly different from the rate in 2008.
In 2002, 0.5 percent of youths aged 12 to 17 were current users of Ecstasy. The rate declined to 0.3 percent in 2004 and remained at that level through 2007. It increased to 0.5 percent in 2009.

Young Adults Aged 18 to 25

Rates of current use of illicit drugs in 2009 were higher for young adults aged 18 to 25 (21.2 percent) than for youths aged 12 to 17 (10.0 percent) and adults aged 26 or older (6.3 percent). Among young adults, 18.1 percent used marijuana in the past month, 6.3 percent used prescription-type drugs nonmedically, 1.8 percent used hallucinogens, and 1.4 percent used cocaine (Figure 2.7).

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Figure 2.7 Past Month Use of Selected Illicit Drugs among Young Adults Aged 18 to 25: 2002-2009

Figure 2.7

⁺ Difference between this estimate and the 2009 estimate is statistically significant at the .05 level.

From 2008 to 2009, the rate of current illicit use among young adults aged 18 to 25 increased from 19.6 to 21.2 percent, driven largely by an increase in marijuana use (from 16.5 to 18.1 percent).
From 2002 to 2009, there were net increases in young adults' past month nonmedical use of psychotherapeutic drugs (from 5.5 to 6.3 percent) and nonmedical use of pain relievers (from 4.1 to 4.8 percent). Over the same period, there were net declines in young adults' use of cocaine (from 2.0 to 1.4 percent) and methamphetamine (from 0.6 to 0.2 percent).

Adults Aged 26 or Older

Among adults aged 26 or older, 6.3 percent were current illicit drug users in 2009. In this age group, 4.6 percent used marijuana, and 2.1 percent used prescription-type drugs nonmedically. Less than 1 percent used cocaine (0.6 percent), hallucinogens (0.2 percent), heroin (0.1 percent), and inhalants (0.1 percent). The only statistically significant changes between 2008 and 2009 in the rates of past month use among adults in this age group involved nonmedical use of stimulants (which increased from 0.2 to 0.4 percent) and methamphetamine use (which rose from 0.1 to 0.2 percent). In addition to these increases between 2008 and 2009, the rate of current marijuana use among adults aged 26 or older was higher in 2009 (4.6 percent) than in 2002 (4.0 percent).
Among adults aged 50 to 59, the rate of current illicit drug use increased from 2.7 to 6.2 percent between 2002 and 2009 (Figure 2.8). For those aged 50 to 54, the rate increased from 3.4 percent in 2002 to 6.9 percent in 2009. Among those aged 55 to 59, current illicit drug use increased from 1.9 percent in 2002 to 5.4 percent in 2009. These patterns and trends partially reflect the aging into these age groups of members of the baby boom cohort, whose rates of illicit drug use have been higher than those of older cohorts.

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Figure 2.8 Past Month Illicit Drug Use among Adults Aged 50 to 59: 2002-2009

Figure 2.8

⁺ Difference between this estimate and the 2009 estimate is statistically significant at the .05 level.

Gender

In 2009, as in prior years, the rate of current illicit drug use among persons aged 12 or older was higher for males than for females (10.8 vs. 6.6 percent, respectively). Males were more likely than females to be current users of several different drugs, including, for example, marijuana (8.6 vs. 4.8 percent), psychotherapeutics (3.1 vs. 2.4 percent, for nonmedical use), and cocaine (0.9 vs. 0.4 percent). However, males and females had similar rates of past month nonmedical use of tranquilizers (0.8 percent for both) and methamphetamine (0.2 percent for both).
In the total population aged 12 or older, the rate of current illicit drug use among males increased from 9.9 percent in 2008 to 10.8 percent in 2009, but females' rates for the 2 years did not differ significantly (6.3 and 6.6 percent, respectively). Among males, current marijuana use increased from 7.9 to 8.6 percent, and increases were seen for current nonmedical use of psychotherapeutics (from 2.6 to 3.1 percent), pain relievers (from 2.0 to 2.4 percent), stimulants (from 0.4 to 0.6 percent), and sedatives (from 0.1 to 0.2 percent). Among females, there were no statistically significant differences between the 2008 and 2009 rates for any drugs.
Among youths aged 12 to 17 in 2009, males had higher rates than females for current use of illicit drugs overall (10.6 percent for males vs. 9.4 percent for females) and use of marijuana (8.3 vs. 6.3 percent) (Figure 2.9). Females, on the other hand, had higher rates than males for nonmedical use of psychotherapeutic drugs (3.5 percent for females vs. 2.8 percent for males) and nonmedical use of pain relievers (2.9 vs. 2.4 percent).

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Figure 2.9 Past Month Marijuana Use among Youths Aged 12 to 17, by Gender: 2002-2009

Figure 2.9

⁺ Difference between this estimate and the 2009 estimate is statistically significant at the .05 level.

Past month marijuana use among males aged 12 to 17 declined from 9.1 percent in 2002 to 6.8 percent in 2006 (Figure 2.9), then increased to 8.3 percent in 2009, a rate that was not significantly different from the rate in 2002 (9.1 percent). Among female youths, little change in current marijuana use occurred from 2002 to 2004. However, rates subsequently declined, and the percentage in 2009 (6.3 percent) was lower than that in 2002 (7.2 percent).

Pregnant Women

Among pregnant women aged 15 to 44 years, 4.5 percent used illicit drugs in the past month based on data averaged for 2008 and 2009. This rate was significantly lower than the rate among women in this age group who were not pregnant (10.6 percent). Among pregnant women, the average rate of current illicit drug use in 2008-2009 (4.5 percent) did not change significantly from 2006-2007 (5.2 percent) and was similar to the rate observed in 2003-2004 (4.6 percent). However, the rate of current illicit drug use among women aged 15 to 44 who were not pregnant increased from 9.7 percent in 2006-2007 to 10.6 percent in 2008-2009.
The rate of current illicit drug use in the combined 2008-2009 data was lower for pregnant women than for nonpregnant women among those aged 18 to 25 (7.1 vs. 16.8 percent, respectively) and among those aged 26 to 44 (2.2 vs. 7.6 percent). Among women aged 15 to 17, however, those who were pregnant and those who were not pregnant did not differ significantly in their rate of illicit drug use (15.8 and 13.0 percent).

Race/Ethnicity

Current illicit drug use among persons aged 12 or older varied by race/ethnicity in 2009, with the lowest rate occurring among Asians (3.7 percent) (Figure 2.10). Rates were 18.3 percent for American Indians or Alaska Natives, 14.3 percent for persons reporting two or more races, 9.6 percent for blacks, 8.8 percent for whites, and 7.9 percent for Hispanics.

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Figure 2.10 Past Month Illicit Drug Use among Persons Aged 12 or Older, by Race/Ethnicity: 2009

Figure 2.10

Note: Due to low precision, estimates for Native Hawaiians or Other Pacific Islanders are not shown.

From 2008 to 2009, there were increases in the rate of current illicit drug use for American Indians or Alaska Natives (from 9.5 to 18.3 percent) and Hispanics (from 6.2 to 7.9 percent) aged 12 or older.

Education

Illicit drug use in 2009 varied by educational status. Among adults aged 18 or older, the rate of current illicit drug use was lower for college graduates (6.1 percent) than for those who did not graduate from high school (10.2 percent), high school graduates (8.8 percent), and those with some college (9.8 percent). However, adults who had graduated from college were more likely to have tried illicit drugs in their lifetime when compared with adults who had not completed high school (51.8 vs. 39.7 percent). The rate of current illicit drug use increased from 8.1 percent in 2008 to 10.2 percent in 2009 among adults who had not completed high school.

College Students

Among persons aged 18 to 22 years old, the rate of current use of illicit drugs in 2009 among full-time college students (22.7 percent) was similar to the rate among other persons in that age group (22.3 percent), which includes part-time college students, students in other grades or types of institutions, and nonstudents. The rate of current use of illicit drugs overall among 18 to 22 year olds who were in college full time increased from 20.2 percent in 2008 to 22.7 percent in 2009, but there was no significant change in the rate of drug use among those not enrolled full time in college.
Among full-time college students aged 18 to 22, there were increases from 2008 to 2009 in the rate of current use of marijuana (from 17.9 to 20.2 percent) and current nonmedical use of psychotherapeutic drugs overall (from 5.2 to 6.3 percent) and OxyContin^® (from 0.2 to 0.6 percent). There were no significant changes in the rates of current use for any drugs among persons aged 18 to 22 who were not full-time college students.

Employment

Current illicit drug use differed by employment status in 2009. Among adults aged 18 or older, the rate of illicit drug use was higher for unemployed persons (17.0 percent) than for those who were employed full time (8.0 percent) or part time (11.5 percent) (Figure 2.11). Among those in the "other" employment category, which includes retired persons, disabled persons, homemakers, students, and other persons not in the labor force, the rate of current illicit drug use increased from 4.9 percent in 2008 to 6.0 percent in 2009.

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Figure 2.11 Past Month Illicit Drug Use among Persons Aged 18 or Older, by Employment Status: 2008 and 2009

Figure 2.11

⁺ Difference between this estimate and the 2009 estimate is statistically significant at the .05 level.
¹ The Other Employment category includes retired persons, disabled persons, homemakers, students, or other persons not in the labor force.

Although the rate of past month illicit drug use was higher among unemployed persons compared with those from other employment groups, most drug users in 2009 were employed. Of the estimated 19.3 million current illicit drug users aged 18 or older in 2009, 12.9 million (66.6 percent) were employed either full or part time. The number of unemployed illicit drug users increased from 1.3 million in 2007 to 1.8 million in 2008 and 2.5 million in 2009, primarily because of an overall increase in the number of unemployed persons between 2007 and 2009 (Figure 2.11). Increases also were seen in the numbers of past month illicit drug users among adults who were employed part time (from 3.1 to 3.6 million) and those in the "other" employment category (retired persons, disabled persons, homemakers, students, and other persons not in the labor force) (from 3.1 to 4.0 million). NSDUH estimates the numbers of persons who were employed full time were 122.2 million in 2008 and 114.8 million in 2009; the estimated numbers of unemployed persons were 9.0 million in 2008 and 14.7 million in 2009. The rate of current illicit drug use among unemployed adults was 19.6 in 2008 and 17.0 percent in 2009; although this difference is not statistically significant, the rate in 2009 may reflect the inclusion of persons who had been employed in 2008 but were unemployed at the time they were interviewed in 2009.

Geographic Area

Among persons aged 12 or older, the rate of current illicit drug use in 2009 was 10.3 percent in the West, 9.2 percent in the Northeast, 7.8 percent in the South, and 7.9 percent in the Midwest.
Although none of the four regions experienced statistically significant differences between 2008 and 2009 in the rate of current illicit drug use among persons aged 12 or older, there were some significant differences for specific drugs by region. For example, marijuana use among persons in the Northeast increased from 6.2 percent in 2008 to 7.5 percent in 2009, and nonmedical use of prescription psychotherapeutics increased from 2.4 to 2.9 percent among persons in the South.
In 2009, the rate of current illicit drug use among persons aged 12 or older was higher in metropolitan areas than in nonmetropolitan areas. The rates were 9.0 percent in large metropolitan counties, 8.8 percent in small metropolitan counties, and 7.3 percent in nonmetropolitan counties as a group (Figure 2.12). Within nonmetropolitan areas, the rate was 7.9 percent in urbanized counties, 7.3 percent in less urbanized counties, and 4.6 percent in completely rural counties. Among persons in less urbanized counties in nonmetropolitan areas, the rate of current illicit drug use increased from 5.6 percent in 2008 to 7.3 percent in 2009.

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Figure 2.12 Past Month Illicit Drug Use among Persons Aged 12 or Older, by County Type: 2009

Figure 2.12

Criminal Justice Populations

In 2009, an estimated 1.7 million adults aged 18 or older were on parole or other supervised release from prison at some time during the past year. More than one fifth of these (22.8 percent) were current illicit drug users, which was higher than the rate of 8.4 percent among adults not on parole or supervised release.
Among the 5.1 million adults on probation at some time in the past year, 27.9 percent reported current illicit drug use in 2009. This was higher than the rate of 8.1 percent among adults not on probation in 2009.

Frequency of Use

In 2009, an estimated 14.2 percent of past year marijuana users aged 12 or older used marijuana on 300 or more days within the past 12 months. This translates into 4.0 million persons using marijuana on a daily or almost daily basis over a 12-month period. An estimated 36.7 percent (6.1 million) of past month marijuana users aged 12 or older used the drug on 20 or more days in the past month.

Association with Cigarette and Alcohol Use

In 2009, the rate of current illicit drug use was approximately 9 times higher among youths aged 12 to 17 who smoked cigarettes in the past month (52.8 percent) than it was among youths who did not smoke cigarettes in the past month (5.9 percent).
Past month illicit drug use also was associated with the level of past month alcohol use. Among youths aged 12 to 17 in 2009 who were heavy drinkers (i.e., consumed five or more drinks on the same occasion on each of 5 or more days in the past 30 days), 69.9 percent also were current illicit drug users, which was higher than the rate among those who were not current alcohol users (5.2 percent).

Driving Under the Influence of Illicit Drugs

In 2009, 10.5 million persons aged 12 or older reported driving under the influence of illicit drugs during the past year. This corresponds to 4.2 percent of the population aged 12 or older, similar to the rate in 2008 (4.0 percent) and not significantly different from the rate in 2002 (4.7 percent). Across age groups, the rate of driving under the influence of illicit drugs in 2009 was highest among young adults aged 18 to 25 (12.8 percent).

Source of Prescription Drugs

Past year nonmedical users of prescription-type psychotherapeutic drugs are asked how they obtained the drugs they recently used nonmedically. Rates averaged for 2008 and 2009 show that over half of the nonmedical users of prescription-type pain relievers, tranquilizers, stimulants, and sedatives aged 12 or older got the prescription drugs they used most recently "from a friend or relative for free." In a follow-up question, the majority of these respondents indicated that their friend or relative had obtained the drugs from one doctor.
Among persons aged 12 or older in 2008-2009 who used pain relievers nonmedically in the past 12 months, 55.3 percent got the pain relievers they most recently used from a friend or relative for free. Another 9.9 percent bought them from a friend or relative, and 5.0 percent took them from a friend or relative without asking. More than one in six (17.6 percent) indicated that they got the drugs they most recently used through a prescription from one doctor. About 1 in 20 users (4.8 percent) got pain relievers from a drug dealer or other stranger, and 0.4 percent bought them on the Internet. These percentages are similar to those reported in 2006-2007.
In 80.0 percent of the instances in 2008-2009 where nonmedical users of prescription pain relievers aged 12 or older obtained the drugs from a friend or relative for free, the individuals indicated that their friend or relative had obtained the drugs from just one doctor. Only 1.9 percent reported that the friend or relative had bought the drugs from a drug dealer or other stranger.
In 2008-2009, 40.9 percent of past year methamphetamine users aged 12 or older reported that they obtained the methamphetamine they used most recently from a friend or relative for free, lower than the 49.7 percent reported in 2006-2007. About three tenths (29.2 percent) bought the methamphetamine they used most recently from a friend or relative, and 21.2 percent bought it from a drug dealer or other stranger.

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

These levels are not mutually exclusive categories of use; heavy use is included in estimates of binge and current use, and binge use is included in estimates of current use.

This chapter is divided into two main sections. Section 3.1 describes trends and patterns of alcohol use among the population aged 12 or older. Section 3.2 is concerned particularly with the use of alcohol by persons aged 12 to 20. These persons are under the legal drinking age in all 50 States and the District of Columbia.

3.1. Alcohol Use among Persons Aged 12 or Older

Slightly more than half of Americans aged 12 or older reported being current drinkers of alcohol in the 2009 survey (51.9 percent). This translates to an estimated 130.6 million people, which is similar to the 2008 estimate of 129.0 million people (51.6 percent).
Nearly one quarter (23.7 percent) of persons aged 12 or older participated in binge drinking at least once in the 30 days prior to the survey in 2009. This translates to about 59.6 million people. The rate in 2009 is similar to the rate in 2008 (23.3 percent).
In 2009, heavy drinking was reported by 6.8 percent of the population aged 12 or older, or 17.1 million people. This percentage is similar to the rate of heavy drinking in 2008 (6.9 percent).

Age

In 2009, rates of current alcohol use were 3.5 percent among persons aged 12 or 13, 13.0 percent of persons aged 14 or 15, 26.3 percent of 16 or 17 year olds, 49.7 percent of those aged 18 to 20, and 70.2 percent of 21 to 25 year olds (Figure 3.1). These estimates are similar to the rates reported in 2008.

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