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2. Illicit Drug Use

The National Survey on Drug Use and Health (NSDUH) obtains information on nine different categories of illicit drug use: marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, and the nonmedical use of prescription-type pain relievers, tranquilizers, stimulants, and sedatives. 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. This chapter presents State estimates of illicit drug use, marijuana use, perceptions of risk of marijuana use, incidence of marijuana use, use of illicit drugs other than marijuana, cocaine use, and nonmedical use of pain relievers.

2.1 Illicit Drugs

In 2008-2009, 8.4 percent of the U.S. population aged 12 or older had used an illicit drug in the past month, and this rate was higher than the rate in 2007-2008 (8.0 percent) (see Table C.1 in Appendix C). In 2008-2009, estimates of past month use of illicit drugs for persons aged 12 or older ranged from 5.3 percent in Iowa to 13.5 percent in Alaska (see Table B.1 in Appendix B). Alaska, Colorado, New Hampshire, Oregon, Rhode Island, and Vermont were in the highest fifth for 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).

Between 2007-2008 and 2008-2009, 10 States (Alaska, California, Hawaii, Illinois, Iowa, Maine, Massachusetts, New York, South Carolina, and West Virginia) showed increases in the percentage of persons aged 12 or older who used an illicit drug in the past month, and four States (District of Columbia, Kentucky, Minnesota, and Virginia) showed decreases. Illinois and Iowa were the only States that showed increases in past month illicit drug use among persons aged 12 to 17; no States showed decreases for that age group. Between these two time periods, eight States (Alaska, Iowa, Maine, Massachusetts, New York, South Carolina, Texas, and West Virginia) had increases in illicit drug use among those aged 18 and 25, and the District of Columbia and Minnesota experienced decreases in that age group. There were increases among those aged 26 years or older in six States (California, Hawaii, Iowa, Maine, Massachusetts, and South Carolina), but only Virginia's rate decreased (Table C.1).

2.2 Marijuana

In 2008-2009, past month marijuana use was reported by 6.4 percent of the population aged 12 years or older, an increase from 6.0 percent in 2007-2008 (Table C.3). All 10 States that were in the top fifth for past month illicit drug use among persons aged 12 or older also were ranked in the top fifth for past month marijuana use: Alaska, Colorado, the District of Columbia, Hawaii, Maine, Massachusetts, New Hampshire, Oregon, Rhode Island, and Vermont (Figures 2.1 and 2.9).

Seven States that were ranked in the top fifth for past month marijuana use in age groups 12 to 17, 18 to 25, and 26 or older and among persons 12 or older were Alaska, Colorado, Massachusetts, New Hampshire, Oregon, Rhode Island, and Vermont (Figures 2.9 to 2.12). Utah had the lowest rate of past month marijuana use in 2008-2009 (3.6 percent) in the 12 or older population, and Alaska had the highest rate (11.5 percent) (Table B.3). Comparing 2007-2008 with 2008-2009, 16 States showed changes in past month marijuana use among persons 12 or older: Kentucky, Minnesota, and Utah had decreases, whereas Alaska, Arizona, California, Connecticut, Hawaii, Illinois, Iowa, Maine, Massachusetts, New York, Oklahoma, South Carolina, and West Virginia had increases (Table C.3). These increases also may have contributed to an increase in the past month marijuana use rates in the Northeast (from 6.3 to 7.0 percent) and West (from 6.9 to 7.6 percent) regions among persons 12 or older.

In 2008-2009, 10.8 percent of persons aged 12 or older reported marijuana use in the past year, an increase from 10.2 percent in 2007-2008 (Table C.2). Of the age groups 12 to 17, 18 to 25, and 26 or older, persons aged 18 to 25 accounted for the highest rate of past year marijuana use (29.1 percent). Utah had the lowest rate (7.2 percent) of past year marijuana use among persons aged 12 or older, while Alaska had the highest rate in that age group (16.3 percent). Six States (Colorado, Massachusetts, New Hampshire, Oregon, Rhode Island, and Vermont) were in the top fifth for past year marijuana use among persons 12 or older and in all three age groups (12 to 17, 18 to 25, and 26 or older) (Figures 2.5 to 2.8). Fourteen States experienced changes in past year marijuana use among persons aged 12 or older between 2007-2008 and 2008-2009: Kentucky and Rhode Island had decreases, whereas California, Colorado, Connecticut, Hawaii, Idaho, Illinois, Iowa, Maine, Massachusetts, New York, Oklahoma, and Texas had increases. Similar to past month marijuana use, there were also increases in past year marijuana use among persons 12 or older in the Northeast (from 10.6 to 11.7 percent) and West (from 11.5 to 12.5 percent) regions of the United States (Table C.2).

2.3 Perceptions of Risk of Marijuana Use

An individual's perception of the risks of substance use has been shown to be inversely related to whether he or she actually uses the substance (e.g., Bachman, Johnston, & O'Malley, 1998). Of the 10 States that ranked in the highest fifth for past month marijuana use among persons aged 12 or older in 2008-2009, 8 States (Alaska, Colorado, Maine, Massachusetts, New Hampshire, Oregon, Rhode Island, and Vermont) were included in the lowest fifth for the perceived risk of smoking marijuana once a month (Figures 2.9 and 2.13).

New Hampshire, which ranked in the top fifth for past month marijuana use, had the lowest percentage of people aged 12 years or older (25.3 percent) reporting smoking marijuana once a month as a great risk (Table B.4 and Figure 2.9). Mississippi, which was ranked in the lowest fifth for past month marijuana use, had the highest rate (47.3 percent) of perceiving such risk (Table B.4 and Figure 2.9).

Between 2007-2008 and 2008-2009, the national percentage of persons aged 12 or older perceiving a great risk of smoking marijuana once a month decreased from 37.9 to 36.1 percent (Table C.4). Additionally, this rate decreased between the same time periods from 34.2 to 32.3 percent for youths aged 12 to 17. Between these two time points, 21 States showed decreases in the perceived risk of smoking marijuana once a month among persons 12 or older: Alabama, Alaska, Arizona, California, Connecticut, Delaware, Idaho, Illinois, Indiana, Iowa, Michigan, Nebraska, New Jersey, New York, North Carolina, Ohio, Oklahoma, Rhode Island, Tennessee, Utah, and Vermont. These State-level decreases in the perceived great risk of smoking marijuana once a month also led to decreases in all four regions (Northeast, Midwest, South, and West). Between 2007-2008 and 2008-2009, 9 States showed decreases for youths aged 12 to 17: Arizona, California, Illinois, Kansas, Massachusetts, Minnesota, New Jersey, North Carolina, and Tennessee. No increases were observed in any State for that measure in any age group.

2.4 Incidence of Marijuana Use

Related to the prevalence of marijuana use is the number of persons who used marijuana for the first time ever over a specific period of time. In this report, the incidence of marijuana use is defined as the number of persons who used marijuana for the first time during a 2-year period preceding the survey interview. Unlike the NSDUH national findings report (OAS, 2010a), this report averages data over a 2-year period and calculates the annualized marijuana incidence rate (expressed as a rate per 100 person-years of exposure).8 For the combined years 2008-2009, the national marijuana incidence rate for persons aged 12 or older was 1.7 percent (Table B.5). Colorado and Vermont had the highest rate (2.5 percent), and Louisiana, Mississippi, Pennsylvania, Tennessee, Utah, and West Virginia had the lowest rate (1.3 percent) among persons 12 or older.

Eight States (Alaska, Colorado, the District of Columbia, Massachusetts, New Hampshire, Oregon, Rhode Island, and Vermont) that were ranked in the top fifth for past month marijuana use in the 12 or older age group also had a similar standing for marijuana incidence (Figures 2.9 and 2.17). Most initiations of marijuana take place at age 25 or earlier (Gfroerer, Wu, & Penne, 2002). It follows that the rates of initiation in the 26 or older age group were much lower than those in the 18 to 25 and 12 to 17 age groups. The national rates of marijuana initiation were 5.7, 7.0, and 0.1 percent for persons aged 12 to 17, 18 to 25, and 26 or older, respectively. Colorado had the highest rate of persons initiating marijuana between ages 12 and 17 (8.1 percent), and Louisiana and Utah shared the lowest rate (3.9 percent). With respect to marijuana initiation between ages 18 and 25, Vermont had the highest rate (11.9 percent), while Utah had the lowest rate (3.5 percent). Seven States (Colorado, Connecticut, Delaware, Massachusetts, Oregon, Rhode Island, and Vermont) were in the top fifth for marijuana incidence for persons aged 12 to 17, 18 to 25, and 12 or older, whereas six States (Alabama, Louisiana, Mississippi, Pennsylvania, Tennessee, and Utah) were in the bottom fifth corresponding to the lowest initiation rates in those three age groups (Figures 2.17 to 2.19).

Between 2007-2008 and 2008-2009, Kentucky showed a decrease in the marijuana incidence rate among persons 12 or older, while California, Connecticut, Delaware, Georgia, Idaho, Iowa, Michigan, Nevada, New Jersey, and Texas showed increases. Between these two time points, there were also increases in this rate in the Northeast (from 1.6 to 1.7 percent) and West (from 1.8 to 2.0 percent) regions of the United States (Table C.5).

2.5 Illicit Drugs 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. For the years 2008 and 2009 combined, the national estimate of past month use of illicit drugs other than marijuana among persons aged 12 or older was 3.5 percent (Table B.6). Iowa had the lowest rate (2.0 percent), and Rhode Island had the highest rate (5.5 percent) among persons 12 or older. Five States (Hawaii, Massachusetts, New Hampshire, Oregon, and Rhode Island) that were in the top fifth for past month use of an illicit drug among those aged 12 or older also had a similar standing for past month use of an illicit drug other than marijuana (Figures 2.1 and 2.20).

Nationally, between 2007-2008 and 2008-2009, there was no change in the past month use of illicit drugs other than marijuana in any of the age groups presented (Table C.6). Eleven States showed changes among persons aged 12 or older. Of them, Colorado, Maryland, Missouri, Tennessee, Virginia, and Wisconsin had decreases, while Massachusetts, New Hampshire, South Carolina, Utah, and West Virginia had increases. An increase also was observed in the Northeast region (from 7.9 to 8.8 percent) for those aged 18 to 25.

2.6 Cocaine

In 2008-2009, the prevalence of past year cocaine use among persons aged 12 or older was 2.0 percent, which was a decrease from 2.2 percent in 2007-2008 (Table C.7). Because cocaine is one of the substances included in the "illicit drug use other than marijuana" category, it is useful to compare the rankings of States with respect to these two measures. In 2008-2009, four States (New Hampshire, Oregon, Rhode Island, and South Carolina) were ranked in the highest fifth for both past month use of an illicit drug other than marijuana (aged 12 or older) and past year use of cocaine (aged 12 or older) (Figures 2.20 and 2.24). Three States (Alaska, Colorado, and Rhode Island) were ranked in the top fifth for past year cocaine use in all three age groups (12 to 17, 18 to 25, and 26 or older) and overall for those aged 12 or older (Figures 2.24 to 2.27). With respect to past year cocaine use, the District of Columbia, Louisiana, and South Carolina stand out for their ranking in the lowest fifth for those aged 12 to 17 and the highest fifth for those aged 26 or older (Figures 2.25 and 2.27).

Between 2007-2008 and 2008-2009, 12 States showed changes in past year cocaine use among persons aged 12 or older: Arizona, Arkansas, Georgia, Indiana, Kentucky, Maryland, Minnesota, Ohio, Oregon, Tennessee, and Virginia had decreases, while New Hampshire had an increase. There were decreases in cocaine use among persons 12 or older in the Midwest (from 2.1 to 1.8 percent), South (from 2.1 to 1.8 percent), and West regions (2.5 to 2.2 percent) (Table C.7).

2.7 Pain Relievers (Nonmedical Use)

Nonmedical use of prescription-type pain relievers is defined as use of these drugs without a prescription or use that occurred simply for the experience or feeling the drug caused. Over-the-counter (OTC) use and legitimate use of prescription-type pain relievers are not included. In 2008-2009, 4.8 percent of persons aged 12 or older reported having used pain relievers nonmedically in the past year, which was similar to the rate in 2007-2008 (4.9 percent) (Table C.8). There were no changes in the corresponding national rate for persons aged 12 to 17, 18 to 25 and 26 or older.

In 2008-2009, Oklahoma had the highest percentage (8.1 percent) of persons aged 12 or older using pain relievers for nonmedical purposes in the past year, and Iowa and Nebraska had the lowest rate (3.6 percent) (Table B.8). Kentucky, Nevada, Oklahoma, Oregon, and Washington were ranked in the top fifth of States for this measure in each of the three age groups (12 to 17, 18 to 25, and 26 or older) and for the total population aged 12 or older. The District of Columbia, Iowa, Maryland, and Nebraska were ranked in the lowest fifth in each of these age groups (Figures 2.28 to 2.31).

Between 2007-2008 and 2008-2009, past year nonmedical use of pain relievers among persons in all age groups (12 to 17, 18 to 25, 26 or older, and 12 or older) increased in three States: Mississippi (12 to 17), New York (18 to 25), and West Virginia (12 or older). The rate decreased in four States: California (18 to 25) and Arkansas, Tennessee, and Wisconsin (18 to 25, 26 or older, and 12 or older). The Northeast region showed an increase in past month nonmedical use of prescription pain relievers among persons aged 18 to 25, and the Western region showed a decrease in the same age group (Table C.8).

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Figure 2.1 Illicit Drug Use in Past Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 2.1

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 2.2 Illicit Drug Use in Past Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 2.2

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 2.3 Illicit Drug Use in Past Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 2.3

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 2.4 Illicit Drug Use in Past Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 2.4

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.5

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.6

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.7

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.8

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.9

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.10

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.11

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.12

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.13

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.14

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.15

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.16

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 2.17 First Use of Marijuana among Persons Aged 12 or Older, by State: Average Annual Rates Based on 2008 and 2009 NSDUHs

Figure 2.17

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 2.18 First Use of Marijuana among Youths Aged 12 to 17, by State: Average Annual Rates Based on 2008 and 2009 NSDUHs

Figure 2.18

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 2.19 First Use of Marijuana among Persons Aged 18 to 25, by State: Average Annual Rates Based on 2008 and 2009 NSDUHs

Figure 2.19

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 2.20 Illicit Drug Use Other Than Marijuana in Past Month among Persons Aged 12 or Older, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 2.20

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 2.21 Illicit Drug Use Other Than Marijuana in Past Month among Youths Aged 12 to 17, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 2.21

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 2.22 Illicit Drug Use Other Than Marijuana in Past Month among Persons Aged 18 to 25, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 2.22

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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Figure 2.23 Illicit Drug Use Other Than Marijuana in Past Month among Persons Aged 26 or Older, by State: Percentages, Annual Averages Based on 2008 and 2009 NSDUHs

Figure 2.23

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.24

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.25

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.26

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.27

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.28

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.29

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.30

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.

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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 2008 and 2009 NSDUHs

Figure 2.31

Source: SAMHSA, Center for Behavioral Health Statistics and Quality, NSDUH, 2008 and 2009.


End Notes

8 Average annual marijuana initiation rate = The average annual rate  is defined as 100 times quantity q divided by 2. Quantity q is defined as X sub 1 divided by the sum of 0.5 times X sub 1 plus X sub 2., where X sub 1 is the number of marijuana initiates in the past 24 months and X sub 2 is the number of persons who never used marijuana. 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 in Appendix B includes these estimates. For details on how average annual incidence was calculated, see Section A.8 in Appendix A.

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