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2004 State Estimates of Substance Use and Mental Health
(from the 2003-2004 National Surveys on Drug Use & Health)

bulletNational data      bulletState level data       bulletMetropolitan and other subState area data

2. Illicit Drug Use

The National Survey on Drug Use and Health (NSDUH) obtains information on nine different categories of illicit drug use: marijuana, cocaine, heroin, hallucinogens, inhalants, and nonmedical use of prescription-type pain relievers, tranquilizers, stimulants, and sedatives. Estimates of "any illicit drug" use reflect any of the nine categories listed above. In 2003-2004, an estimated 8.1 percent of the population aged 12 or older had used an illicit drug in the past month, and the estimated percentage was similar in 2002-2003 (8.3 percent) (Table B.1 and C.1). Marijuana, the most commonly used illicit drug, was used by 6.1 percent of the population in 2003-2004 during the past month (Table B.3).

2.1 Any Illicit Drug

Estimates of past month use of any illicit drug ranged from a low of 5.8 percent in Mississippi to a high of 11.8 percent in Alaska for all persons aged 12 or older (Table B.1). See Section 1.2 for a discussion of the proper use of the prediction intervals [PIs]. Alaska, New Hampshire, New Mexico, Rhode Island, and Vermont were in the highest fifth for all persons aged 12 or older and for each of the age subgroups: 12 to 17, 18 to 25, and 26 or older (Figures 2.1 to 2.4).

Four States showed significant decreases from 2002-2003 to 2003-2004 (at the 5 percent level of significance) in the percentage of all persons who used an illicit drug in the past month among those aged 12 or older: the District of Columbia (from 11.6 to 9.6 percent), Florida (from 8.7 to 7.8 percent), Nevada (from 10.3 to 8.7 percent), and Washington (from 10.0 to 8.5 percent) (Table C.1). At the national level, the use of any illicit drug among youths aged 12 to 17 declined from 11.4 percent in 2002-2003 to 10.9 percent in 2003-2004. Both the Midwest and the South contributed significantly to the national decline in the percentage of youths who used any illicit drug in the past month. Six States showed significant decreases among youths: Illinois (from 10.8 to 9.1 percent), Nebraska (from 12.7 to 10.1 percent), and South Dakota (from 13.3 to 9.8 percent) from the Midwest; North Carolina (from 13.6 to 11.1 percent) and Virginia (from 11.9 to 9.5 percent) from the South; and Vermont (16.7 to 14.0 percent) from the Northeast. There were no States that showed a significant increase for any age group.

2.2 Marijuana

Because marijuana is the predominant drug used by those using an illicit drug, States that had high prevalence rates for any illicit drug use also had high prevalence rates for past month use of marijuana. Eight out of ten States in the top fifth for use of an illicit drug for persons aged 12 or older also were ranked in the top fifth for past month use of marijuana. Eight States were common to the top fifth for past month marijuana use in all three age groups: 12 to 17, 18 to 25, and 26 or older: Alaska, Maine, Massachusetts, New Hampshire, New Mexico, Oregon, Rhode Island, and Vermont (Figures 2.1, 2.9 to 2.12). Mississippi and Utah had the lowest rate of past month use of marijuana (4.2 percent) in the age 12 or older population, and Alaska had the highest rate (9.9 percent) (Table B.3).

Nationally in 2003-2004, 10.6 percent of all persons aged 12 or older reported marijuana use in the past year. Young adults, aged 18 to 25, reported the highest rate of past year use of marijuana, 28.2 percent (Table  B.2). The State rankings for past year use were very similar to those for past month use among persons 12 or older (Figures 2.5 and 2.9). Mississippi had the lowest rate (7.8 percent) of past year use of marijuana among persons aged 12 or older. Alaska had the highest rate of past year marijuana use among persons aged 12 or older (15.8 percent). Vermont had the highest rate of use in the Nation in the 18 to 25 age group–43.3 percent had used marijuana in the past year (Table  B.2).

Six States showed significant decreases (at the 5 percent level of significance) in the past year use of marijuana among all persons aged 12 or older in this period: Colorado (from 15.1 to 13.3 percent), Florida (from 11.4 to 10.6 percent), Nevada (from 12.0 to 10.6 percent), New Hampshire (from 16.3 to 14.6 percent), Ohio (from 10.9 to 10.1 percent), and Washington (from 13.5 to 11.6 percent) (Table  C.2). Most of these States also showed significant declines among either the 12 to 17 age group or the 18 to 25 age group. Only one State, Tennessee, showed a significant increase among persons aged 12 or older, from 7.4 to 8.4 percent. Seven States showed significant decreases from 2002-2003 to 2003-2004 in the past month use of marijuana, while New Mexico was the only State that showed a significant increase among all persons aged 12 or older in this period (Table  C.3). Nationally, there was a significant decrease in the past month use of marijuana among all persons aged 18 to 25 between 2002-2003 and 2003-2004, while significant decreases were indicated in past year use in both the 18 to 25 age group and among youths aged 12 to 17.

2.3 Perceptions of Risk of Marijuana Use

An individual's perception of the risks of substance use has been shown to be related to whether he or she actually uses the substance (e.g., Bachman, Johnston, & O'Malley, 1998). However, at the State level, only half of the (10) States that ranked in the lowest fifth of perceived great risk of using marijuana once a month were also among the States ranked in the highest fifth for past month use of marijuana in 2003-2004 for persons aged 12 or older (Figures 2.9 and 2.13).

Slightly over one quarter (26.2 percent) of all persons aged 12 or older in the State of Washington reported that using marijuana occasionally (once a month) was a great risk (Table  B.4). However, slightly more than half (51.3 percent) of all persons aged 12 or older in Mississippi indicated that occasional use of marijuana was a great risk. Along with Utah, Mississippi also had the lowest prevalence rate (4.2 percent) of use of marijuana in the past month among persons aged 12 or older (Table  B.3).

The national percentage of persons aged 12 or older perceiving a great risk of using marijuana once a month increased significantly between 2002-2003 and 2003-2004, from 39.1 to 39.7 percent (Table  C.4). Six States contributed significantly (at the 5 percent level of significance) to this national increase in perceived risk in this population: California (from 36.6 to 39.6 percent), Hawaii (from 34.3 to 38.8 percent), Maryland (from 35.6 to 39.7 percent), Massachusetts (from 26.8 to 31.2 percent), Montana (from 33.3 to 39.0 percent), and Nevada (from 34.0 to 38.0 percent). One State, Iowa, countered the national trend with a significant decrease among persons aged 12 or older, from 44.2 to 41.4 percent. Among youths aged 12 to 17, a total of 12 States had increased perceptions of great risk.

2.4 Incidence of Marijuana Use

Related to the prevalence of marijuana use is the number of persons in a period of time who used marijuana for the first time ever. When the number of first-time users of a substance increases for a number of consecutive years, the prevalence rate for the substance tends to increase also. The average annual incidence of marijuana for this report is estimated somewhat differently than in the national report (OAS, 2005c).7 The estimate for a single year is averaged over the 2 most recent years and expressed as a percentage or rate per 100 person years of exposure. For the combined years 2003-2004, the national marijuana incidence rate for all persons aged 12 or older was 1.8 percent. Alaska had the highest rate, 2.6 percent. Florida and Tennessee shared the lowest rate, 1.4 percent (Table  B.5).

Six States ranked in the top fifth for marijuana incidence in the 12 or older age group also ranked in the top fifth for past month marijuana use (Alaska, Montana, New Hampshire, New Mexico, Rhode Island, and Vermont) (Figures 2.9 and 2.17). Because most initiation of marijuana takes place at age 25 or earlier (Gfroerer, Wu, & Penne, 2002), the rates of initiation in the 26 or older age group were much lower than those in the 12 to 17 and 18 to 25 age groups: the national rates were 0.1, 6.3, and 6.6 percent, respectively. Vermont and New Mexico had the highest rate among youths aged 12 to 17 (8.8 percent), and Vermont also had the highest rate among persons aged 18 to 25 (10.5 percent) (Table  B.5).

Rates of first use of marijuana declined significantly among youths between 2002-2003 and 2003-2004 (from 6.6 to 6.3 percent), and eight States had significant decreases (at the 5 percent level of significance) for youths over the same period (Table  C.5). Those States were Delaware, Florida, Nevada, New Hampshire, North Carolina, Texas, Vermont, and Virginia. Two of those States also showed significant decreases among the combined 12 or older population: Florida declined from 1.6 to 1.4 percent, and Nevada declined from 2.0 to 1.7 percent.

2.5 Any Illicit Drug Other Than Marijuana

Illicit drugs other than marijuana include cocaine, heroin, hallucinogens, inhalants, and the nonmedical use of prescription-type pain relievers, tranquilizers, stimulants, and sedatives. The national estimate of past month use of any illicit drug other than marijuana among persons aged 12 or older was 3.6 percent for 2003-2004 combined (Table  B.6). Hawaii had the lowest rate (2.8 percent) of past month use of an illicit drug other than marijuana among persons 12 or older, and Colorado had the highest rate (4.7 percent). Four States that were in the top fifth for past month use of an illicit drug among those aged 12 or older also were ranked in the top fifth for past month use of an illicit drug other than marijuana: Alaska, Colorado, New Mexico, and Rhode Island (Figures 2.1 and 2.20). New Mexico was the only State that ranked in the top fifth in all three age groups (12 to 17, 18 to 25, and 26 or older) and for all persons aged 12 or older (Figures 2.20 to 2.23).

Past month use of any illicit drug other than marijuana was relatively stable between 2002-2003 and 2003-2004. Although rates of use appear on average to be slightly lower in 2003-2004 than in 2002-2003, none of those declines was statistically significant (at the 5 percent level of significance). Among all States and age groups, West Virginia had the only statistically significant change over the above period: an increase from 8.1 percent in 2002-2003 to 10.2 percent in 2003-2004 among young adults aged 18 to 25 (Table  C.6).

2.6 Cocaine

The national prevalence rate for the use of cocaine in the past year among all persons aged 12 or older was 2.4 percent (Table  B.7). Because cocaine is one of the substances included in the "any illicit drug other than marijuana" category, it is useful to compare the rankings of States with respect to these two substance use measures. In 2003-2004, only four of the States (Arizona, Colorado, New Mexico, and Rhode Island) ranked in the highest fifth for past month use of an illicit drug other than marijuana (aged 12 or older) also had past year rates of cocaine use (aged 12 or older) that were in the highest fifth (Figures 2.20 and 2.24). Rhode Island had the highest rate of past year cocaine use (3.5 percent) among persons aged 12 or older; Hawaii had the lowest rate (1.7 percent) in that population (Table  B.7). Arizona was the only State that ranked in the top fifth for all three age groups (12 to 17, 18 to 25, and 26 or older) (Figures 2.24 to 2.27).

At the national level, youths aged 12 to 17 reported a decrease (significant at 5 percent level of significance) between 2002-2003 and 2003-2004, from 1.9 to 1.7 percent (Table  C.7). Ohio was the only State with a decrease among the general population aged 12 or older, from 2.5 to 2.1 percent in that period. Two other States, Michigan and North Carolina, had a significant decrease in past year cocaine use among youths aged 12 to 17 and/or young adults aged 18 to 25.

2.7 Pain Relievers (Nonmedical Use)

In 2003-2004, 4.8 percent of all persons aged 12 or older reported having used pain relievers nonmedically in the past year, a percentage that was unchanged from 2002-2003 (Table  C.8). Kentucky had the highest percentage (6.3 percent) of persons aged 12 or older using pain relievers for nonmedical purposes in the past year (Table  B.8). The District of Columbia had the lowest rate in the Nation—3.1 percent. Kentucky and Washington ranked in the top fifth of States for this measure in each of the three age groups and for the total population aged 12 or older (Figures 2.28 to 2.31).

A significant increase (at the 5 percent level of significance) between 2002-2003 and 2003-2004 occurred in the Northeast region among persons aged 18 to 25 (from 11.2 to 12.1 percent) (Table  C.8). Only one State, Hawaii, showed a significant decrease for the total population aged 12 or older from 2002-2003 to 2003-2004 (from 3.9 to 3.1 percent). Three States had significant increases in the 18 to 25 age group: California, from 9.8 to 11.2 percent; Montana, from 10.2 to 12.5 percent; and New York, from 9.8 to 11.2 percent. Two States had significant increases in the 12 to 17 age group: Arkansas, from 8.0 to 10.7 percent; and Maine, from 7.2 to 8.8 percent.

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Figure 2.1 Any Illicit Drug Use in Past Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.1

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.2 Any Illicit Drug Use in Past Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.2

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.3 Any Illicit Drug Use in Past Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.3

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.4 Any Illicit Drug Use in Past Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.4

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.5 Marijuana Use in Past Year among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.5

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.6 Marijuana Use in Past Year among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.6

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.7 Marijuana Use in Past Year among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.7

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.8 Marijuana Use in Past Year among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.8

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.9 Marijuana Use in Past Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.9

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.10 Marijuana Use in Past Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.10

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.11 Marijuana Use in Past Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.11

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.12 Marijuana Use in Past Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.12

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.13 Perceptions of Great Risk of Smoking Marijuana Once a Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.13

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.14 Perceptions of Great Risk of Smoking Marijuana Once a Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.14

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.15 Perceptions of Great Risk of Smoking Marijuana Once a Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.15

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.16 Perceptions of Great Risk of Smoking Marijuana Once a Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.16

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.17 First Use of Marijuana among Persons Aged 12 or Older, by State: Average Annual Rates Based on 2003 and 2004 NSDUHs

Figure 2.17

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.18 First Use of Marijuana among Youths Aged 12 to 17, by State: Average Annual Rates Based on 2003 and 2004 NSDUHs

Figure 2.18

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.19 First Use of Marijuana among Persons Aged 18 to 25, by State: Average Annual Rates Based on 2003 and 2004 NSDUHs

Figure 2.19

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.20 Any Illicit Drug Use Other Than Marijuana in Past Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.20

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

Below is a map, click here for the text describing this map.

Figure 2.21 Any Illicit Drug Use Other Than Marijuana in Past Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.21

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.22 Any Illicit Drug Use Other Than Marijuana in Past Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.22

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.23 Any Illicit Drug Use Other Than Marijuana in Past Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.23

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.24 Cocaine Use in Past Year among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.24

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.25 Cocaine Use in Past Year among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.25

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.26 Cocaine Use in Past Year among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.26

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.27 Cocaine Use in Past Year among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.27

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.28 Nonmedical Use of Pain Relievers in Past Year among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.28

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.29 Nonmedical Use of Pain Relievers in Past Year among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.29

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.30 Nonmedical Use of Pain Relievers in Past Year among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.30

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.

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Figure 2.31 Nonmedical Use of Pain Relievers in Past Year among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2003 and 2004 NSDUHs

Figure 2.31

Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2003 and 2004.


End Note

7Average annual incidence rate = {(Number of marijuana initiates in past 24 months) / [(Number of marijuana initiates in past 24 months * 0.5) + Number of persons who never used marijuana]} / 2.

Please note that because the average annual incidence of marijuana was so low for the 26 or older age group and had such an abbreviated range, no map has been included for it; however, Table  B.5 includes these estimates. For details on how average annual incidence was calculated, refer to Appendix A (Section A.5).

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