Combined 2006 to 2008 data indicate that an annual average of 425,000 persons aged 12 or older (0.17 percent) used a needle to inject heroin, cocaine, methamphetamine, or other stimulants during the past year
One eighth (13.0 percent) of past year injection drug users had used a needle that they knew or suspected someone else had used before them the last time they used a needle to inject drugs
Less than one third (29.0 percent) of past year injection drug users cleaned the needle with bleach prior to their last injection
More than one half (52.8 percent) of past year injection drug users purchased the last needle they used from a pharmacy, and 12.4 percent obtained the needle through a needle exchange program
Injection drug use is a high-risk behavior that can be further exacerbated by reusing or sharing needles and/or failing to clean the needle with bleach after each use. These actions can increase the user's risk for blood-borne infections, such as the human immunodeficiency virus (HIV), hepatitis C, hepatitis B, and herpes simplex virus 2. In 2006, 16 percent of new HIV cases involved intravenous drug use as a mode of transmission, and 27.6 percent of persons living with HIV/AIDS in 2007 could have contracted the disease through intravenous drug use.1 Monitoring the prevalence of injection drug use and the associated risk behaviors is vital for making decisions about designing and implementing programs to address these behaviors.
National Survey on Drug Use and Health (NSDUH) asks respondents aged 12 or older whether or not they have ever used a needle to inject heroin, cocaine, methamphetamine, other stimulants, other drugs that were not prescribed for them, or drugs that they took only for the feeling or experience they caused. Respondents who report needle use also are asked how recently they did so. In addition, for their last episode of needle use, they are asked if they had reused a needle that they used before; if they used a needle that they knew or suspected someone else had used before; if someone else used the needle after them, whether or not they used bleach to clean the needle before they used it; and how they got the needle. All findings presented in the report are annual averages based on combined data from 2006 to 2008.
Prevalence of Needle Use
An annual average of 425,000 persons aged 12 or older (0.17 percent) used a needle to inject heroin, cocaine, methamphetamine, or other stimulants during the past year.2 An estimated 241,000 persons injected heroin during the past year; 166,000 injected cocaine; 165,000 injected methamphetamines; and 95,000 injected other stimulants.
The rate of past year injection drug use was higher among persons aged 18 to 25 and those aged 26 to 34 (0.28 and 0.26 percent, respectively) than among those aged 12 to 17 and those aged 50 or older (0.09 and 0.11 percent, respectively) (Figure 1). Additionally, those aged 18 to 25 were more likely to have injected drugs than those aged 35 to 49 (0.28 vs. 0.19 percent). Males were twice as likely as females to have injected drugs (0.24 vs. 0.11 percent). Past year injection drug use varied among racial/ethnic groups, with Asians and Native Hawaiians or Other Pacific Islanders having lower rates than other groups (Figure 2).
Figure 1. Past Year Injection Drug Use among Persons Aged 12 or Older, by Age Group and Gender: 2006 to 2008
Figure 1 Table. Past Year Injection Drug Use among Persons Aged 12 or Older, by Age Group and Gender: 2006 to 2008
Age Group and Gender
Percent
12 to 17
0.09%
18 to 25
0.28%
26 to 34
0.26%
35 to 49
0.19%
50 or Older
0.11%
Male
0.24%
Female
0.11%
Source: 2006 to 2008 SAMHSA National Surveys on Drug Use and Health (NSDUHs).
Figure 2. Past Year Injection Drug Use among Persons Aged 12 or Older, by Race/Ethnicity: 2006 to 2008
Figure 2 Table. Past Year Injection Drug Use among Persons Aged 12 or Older, by Race/Ethnicity: 2006 to 2008
Race/Ethnicity
Percent
Two or More Races
0.35%
American Indian or Alaska Native
0.24%
White
0.18%
Hispanic or Latino
0.18%
Black or African American
0.14%
Native Hawaiian or Other Pacific Islander
0.02%
Asian
0.02%
Source: 2006 to 2008 SAMHSA National Surveys on Drug Use and Health (NSDUHs).
Drug Injection Risk Behaviors
The last time they injected drugs, more than one half (51.0 percent) of past year injection drug users indicated that they reused a needle that they had used before, approximately 1 in 8 (13.0 percent) indicated that they used a needle that they knew or suspected someone else had used before them, and 1 in 6 (17.7 percent) indicated that they used a needle that someone used after them (Figure 3). Less than one third (29.0 percent) of past year injection drug users cleaned the needle with bleach the last time they used a needle to inject drugs.
Figure 3. Injection Risk Behaviors at Last Use of a Needle to Inject Drugs among Past Year Injection Drug Users Aged 12 or Older: 2006 to 2008
Figure 3 Table. Injection Risk Behaviors at Last Use of a Needle to Inject Drugs among Past Year Injection Drug Users Aged 12 or Older: 2006 to 2008
Needle Use
Percent
Reused a Needle They Had Used Before
51.0%
Someone Else Used the Needle After Them
17.7%
Used a Needle That They Knew or Suspected Someone Else Had Used Before Them
13.0%
Source: 2006 to 2008 SAMHSA National Surveys on Drug Use and Health (NSDUHs).
Needle Sources
More than one half (52.8 percent) of past year injection drug users reported that the last time they injected drugs, the needle had been purchased from a pharmacy, and 12.4 percent had obtained the needle through a needle exchange program (Table 1).3
Table 1. How the Needle Was Obtained the Last Time a Needle Was Used to Inject Drugs among Past Year Injection Drug Users Aged 12 or Older: 2006 to 2008
* Percentages do not total to 100 percent because of rounding.
Source: 2006 to 2008 SAMHSA National Surveys on Drug Use and Health (NSDUHs).
Discussion
HIV prevention and education programs targeted at out-of-treatment injection drug users have been in effect for nearly two decades. The findings from NSDUH, however, suggest that the need for such programs still remains. By identifying varying rates of injection drug use among demographic groups, they also help to delineate specific subpopulations for whom modifying current programs or developing new ones may prove to be most effective.
End Notes1 Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention. (2009). Cases of HIV infection and AIDS in the United States and Dependent Areas, 2007: HIV/AIDS Surveillance Report, 2007 (Vol. 19). Atlanta, GA: U.S. Department of Health and Human Services. [Available at http://www.cdc.gov/hiv/topics/surveillance/resources/reports/] 2 NSDUH estimates of drug use prevalence are designed to describe the civilian, noninstitutionalized household population aged 12 or older. Although this population includes about 98 percent of the U.S. population aged 12 or older, some population subgroups are excluded that may have different drug-using patterns. For instance, persons living in institutional group quarters, such as prisons and residential drug treatment centers, as well as homeless persons not in shelters, are not included in NSDUH and have been shown in other surveys to have higher rates of illicit drug use. 3 A needle exchange program is a facility at which injection drug users can trade in used needles for clean needles.
Suggested CitationSubstance Abuse and Mental Health Services Administration, Office of Applied Studies. (October 29, 2009). The NSDUH Report: Injection Drug Use and Related Risk Behaviors. Rockville, MD.
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The 2006 to 2008 data used in this report are based on information obtained from 204,408 persons aged 12 or older. 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 the most recent NSDUH is available in the following publication:
Office of Applied Studies. (2009). Results from the 2008 National Survey on Drug Use and Health: National findings DHHS Publication No. SMA 09-4434, NSDUH Series H-36). Rockville, MD: Substance Abuse and Mental Health Services Administration. Also available online: http://oas.samhsa.gov.
The NSDUH 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 online: http://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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