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2003 National Survey on Drug Use & Health:  Results

Appendix D: Other Sources of Data

A variety of other surveys and data systems collect data on substance use and mental illness. It is useful to consider the results of these other studies when discussing the National Survey on Drug Use and Health (NSDUH) data. In doing this, it is important to understand the methodological differences between the different surveys and the impact that these differences could have on estimates of the presence of substance use and mental illness. This appendix briefly describes several of these other data systems and where possible presents comparisons between NSDUH results and results from the other surveys for 2002 and 2003 or other recent time periods. For some comparisons, NSDUH estimates were generated to be consistent with the data collection periods or groups surveyed in other studies.

In-depth comparisons of the methodologies of the three major federally sponsored national surveys of youth substance use have been done. In 1997, a comparison between the National Household Survey on Drug Abuse1 (NHSDA) and Monitoring the Future (MTF) was published (Gfroerer, Wright, & Kopstein, 1997). In 2000, a series of papers comparing different aspects of the NHSDA, MTF, and the Youth Risk Behavior Survey (YRBS) was commissioned by the U.S. Department of Health and Human Services (DHHS). Under contract with the Office of the Assistant Secretary for Planning and Evaluation, Westat, Inc., identified and funded several experts in survey methods to prepare these papers. The papers were published in the Journal of Drug Issues (Hennessy & Ginsberg, 2001). The major findings of these studies were as follows:

These findings suggest that differences in survey methodology may affect comparisons of prevalence estimates among youths from various surveys. This appendix investigates the similarities and differences among rates from NSDUH and other related surveys.

 

D.1 Other National Surveys of Illicit Drug Use

Monitoring the Future (MTF)

The Monitoring the Future (MTF) study is a national survey that tracks drug use trends and related attitudes among America's adolescents. This survey is conducted annually by the Institute for Social Research at the University of Michigan through a grant awarded by the National Institute on Drug Abuse (NIDA). The MTF and NSDUH are the Federal Government's largest and primary tools for tracking youth substance use. The MTF is composed of three substudies: (a) an annual survey of high school seniors initiated in 1975; (b) ongoing panel studies of representative samples from each graduating class that have been conducted by mail since 1976; and (c) annual surveys of 8th and 10th graders initiated in 1991. In 2002, for all three grades combined, 394 public and private schools and about 43,700 students were in the sample. In 2003, nearly 50,000 students in 392 schools were surveyed. The students complete a self-administered questionnaire during a regular class period (Johnston, O'Malley, & Bachman, 2003a; Johnston, O'Malley, Bachman, & Shulenberg, 2004a).

Comparisons between the MTF estimates and estimates based on students sampled in NSDUH have generally shown NSDUH substance use prevalence levels to be lower than MTF estimates, with relative differences being largest for 8th graders. The lower prevalences in NSDUH may be due to more underreporting in the household setting as compared with the MTF school setting. However, MTF does not survey dropouts, a group generally shown (using NSDUH) to have higher rates of illicit drug use (Gfroerer et al., 1997). In 2002 and 2003, for most comparisons of estimates of lifetime, past year, and past month prevalence of use of marijuana, cocaine, and inhalants among 8th, 10th, and 12th graders between NSDUH and MTF, NSDUH estimates were lower (see Table D.1 at the end of this appendix). In addition, both surveys showed that illicit drug use was stable or decreasing for most measures between 2002 and 2003. Exceptions were increases in past month cocaine use among 12th graders and lifetime and past year inhalant use among 8th graders included in NSDUH, and past year inhalant use among 8th graders in MTF.

Youth Risk Behavior Survey (YRBS)

The Youth Risk Behavior Survey (YRBS) is a component of the Centers for Disease Control and Prevention's (CDC's) Youth Risk Behavior Surveillance System (YRBSS), which biennially measures the prevalence of six priority health risk behavior categories: (a) behaviors that contribute to unintentional and intentional injuries; (b) tobacco use; (c) alcohol and other drug use; (d) sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases (STDs); (e) unhealthy dietary behaviors; and (f) physical inactivity. The YRBSS includes national, State, territorial, and local school-based surveys of high school students. The latest YRBS was conducted in 2003 (CDC, 2004b). The 2003 national school-based survey used a three-stage cluster sample design to produce a nationally representative sample of students in grades 9 through 12. The 2003 State and local surveys used a two-stage cluster sample design to produce representative samples of students in grades 9 through 12 in their jurisdictions. The 2003 national YRBS sample included 15,214 students in grades 9 through 12 in the 50 States and the District of Columbia. The national survey and all of the State and local surveys were conducted during the spring of 2003, with the exception of Hawaii. The Hawaii surveys were conducted in the fall of 2003. The students completed a self-administered questionnaire during a regular class period. In general, this school-based survey has found higher rates of alcohol, cigarette, marijuana, and cocaine use for youths than those found in NSDUH. The prevalence of illicit drug use is generally much higher in the YRBS than in NSDUH (e.g., past month marijuana use was 22.4 percent in the 2003 YRBS compared with 12.2 percent for youths in grades 9 through 12 in the 2003 NSDUH). This is likely due to the differences in study design (school-based vs. home-based).

National Longitudinal Study of Adolescent Health (Add Health)

The National Longitudinal Study of Adolescent Health (Add Health) was conducted to measure the effects of family, peer group, school, neighborhood, religious institution, and community influences on health risks, such as tobacco, drug, and alcohol use. Initiated in 1994 under a grant from the National Institute of Child Health and Human Development (NICHD) with cofunding from 17 other Federal agencies, Add Health is the largest, most comprehensive survey of adolescents ever undertaken. Data at the individual, family, school, and community levels were collected in two waves between 1994 and 1996. In Wave 1 (conducted in 1994–95), roughly 90,000 students from grades 7 through 12 at 144 schools around the United States answered brief questionnaires. Interviews also were conducted with about 20,000 students and their parents in the students' homes. In Wave 2, students were interviewed a second time in their homes. In 2001 and 2002, the original Add Health respondents, now aged 18 to 26, were re-interviewed in a third wave to investigate the influence that adolescence has on young adulthood.

Survey results from the first two waves indicated that nearly one fourth of teenagers had ever smoked marijuana. Nearly 7 percent of 7th and 8th graders used marijuana at least once in the past month as did 15.7 percent of 9th through 12th graders (Resnick et al., 1997). In the 2002 NSDUH, 20.6 percent of youths aged 12 to 17 had ever used marijuana, and 8.2 percent were past month users; in 2003, these percentages were 19.6 and 7.9 percent, respectively.

Partnership Attitude Tracking Study (PATS)

The Partnership Attitude Tracking Study (PATS) is an ongoing national research study that tracks drug use and drug-related attitudes among children, teenagers, and their parents. It is sponsored by the Partnership for a Drug Free America (PDFA). In the 2002 PATS, 7,084 teenagers in grades 7 through 12 completed self-administered questionnaires (PDFA, 2003). For the first time in 2002, PATS included questions on prescription drug abuse. The 2002 PATS found that 20 percent of youths in grades 7 to 12 had ever used prescription pain killers without a doctor's prescription; 19 percent of adolescents reported lifetime use of inhalants; and 40 percent reported lifetime use of marijuana. In 2003, 7,270 youths completed the survey and prevalence rates remained very similar to rates in 2002 (PDFA, 2004). The 2003 PATS found that 21 percent of youths in grades 7 to 12 had ever used prescription drugs; 18 percent had used inhalants; and 39 percent reported using marijuana in their lifetime. NSDUH reported notably lower prevalence rates than PATS. For youths aged 12 to 17, the rate of lifetime prescription pain reliever use was 11.2 percent in the 2002 and 2003 NSDUH, lifetime inhalant use was 10.5 percent in the 2002 NSDUH and 10.7 percent in the 2003 NSDUH, and lifetime marijuana use was 20.6 percent in 2002 and 19.6 percent in 2003. The major difference in these prevalence estimates is likely to be due to the different study designs. The youth portion of PATS is a school-based survey, which may elicit more reporting of sensitive behaviors than the home-based NSDUH.

National Survey of Parents and Youth (NSPY)

The National Survey of Parents and Youth (NSPY) is sponsored by the National Institute on Drug Abuse (NIDA) to evaluate the Office of National Drug Control Policy's (ONDCP's) National Youth Anti-Drug Media Campaign. The survey is specifically designed to evaluate Phase III of the campaign, covering the period between September 1999 and June 2003. Data collection provides estimates of trends in drug use between 2000 and the first half of 2003, as well as changes between 2002 and 2003.

In Phase I (Waves 1 through 3 of data collection), a sample of youths aged 9 to 18 and their parents were recruited to participate in the in-home survey. In Phase II (Waves 4 through 7 of data collection), the respondents from Phase I participated in two additional interviews at intervals of 6 to 24 months. In December 2003, ONDCP released the sixth semiannual report of findings that contained data from all three phases (Hornik et al., 2003).

Wave 5's data were collected between January and June 2002 and included 4,040 youths and 2,882 parents. Wave 6's data were collected between July and December 2002 and included 2,267 youths and 1,640 parents. An average of the estimates from Waves 5 and 6 showed that the past year rate of marijuana use among 12 to 18 year olds was 16.4 percent. The corresponding 2002 NSDUH estimate for past year marijuana use among youths aged 12 to 18 was 18.4 percent.

Wave 7's data were collected between January and June 2003 and included 3,587 youths and 2,621 parents. Despite the differences in methodology, the two surveys produced similar estimates for youths (see Table D.2). For example, the latest wave of NSPY data indicated that 16.7 percent of youths aged 12 to 18 had used marijuana in the past year, and the 2003 NSDUH yielded an estimate of 18.1 percent among this age group.

In past waves of NSPY data collection, parents also have been asked about their drug use behaviors; however, parental use was not asked in the Wave 5 or Wave 7 data collections. Lifetime use of marijuana among parents was 53.7 percent in 2001, and past month use was 3.4 percent. According to NSDUH, lifetime use of marijuana among adults aged 18 or older was 42.7 percent in 2002 and 43.1 percent in 2003; past month use was 6.0 percent in 2002 and 2003.

National Longitudinal Alcohol Epidemiologic Survey (NLAES) and National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

The National Longitudinal Alcohol Epidemiologic Survey (NLAES) was conducted in 1991 and 1992 by the U.S. Bureau of the Census for the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Face-to-face interviews were conducted with 42,862 respondents aged 18 or older in the contiguous United States. Despite the survey name, the design was cross-sectional. The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) was conducted in 2001 and 2002, also by the U.S. Bureau of the Census for NIAAA, using a computerized interview. The NESARC sample was designed to make inferences for persons aged 18 or older in the civilian, noninstitutionalized population of the United States, including Alaska, Hawaii, and the District of Columbia, and including persons living in noninstitutional group quarters. The NESARC is designed to be a longitudinal survey. The first wave was conducted in 2001 and 2002, with a final sample size of 43,093 respondents aged 18 or older. The second wave is planned for 2004 and 2005 (Grant, Kaplan, Shepard, & Moore, 2003).

Over the decade from 1992 to 2002, the prevalence of marijuana use in the past year among adults remained stable, at about 4.0 percent (Compton, Grant, Colliver, Glantz, & Stinson, 2004). The rate of past year marijuana use among adults was 10.4 percent in the 2002 NSDUH and 10.1 percent in the 2003 NSDUH.

 

D.2 Alcohol and Cigarette Use Surveys

National Health Interview Survey (NHIS)

The National Health Interview Survey (NHIS) is a continuing nationwide sample survey that collects data using personal household interviews. The survey is sponsored by the National Center for Health Statistics (NCHS) and provides national estimates of selected health measures. The data presented are from January through September of 2002 and 2003. In the NHIS, current smokers are defined as those who smoke daily, smoked on 1 or more days in the past month, or quit smoking fewer than 30 days ago (for those who smoked 100 or more cigarettes in their lifetime). The survey estimated that 22.5 percent of the population aged 18 or older were current cigarette smokers in 2002 (Ni, Schiller, Hao, Cohen, & Barnes, 2003). Among males, 25.3 percent reported current cigarette smoking compared with 19.9 percent of females aged 18 or older. For 2003, the rates were slightly lower with an estimated 21.6 percent of the population reporting current cigarette smoking (23.7 percent among males and 19.4 percent among females).

In NSDUH, current cigarette smoking is defined as any use in the past month. The NSDUH rate was 27.5 percent in 2002 for those aged 18 or older. Although the two surveys employ different methodologies, NSDUH produces similar estimates when using the NHIS definition. For example, when using a definition similar to the NHIS definition, NSDUH estimates 25.6 percent of adults aged 18 or older were current smokers in 2002 and 25.1 percent of adults were current smokers in 2003. See Table D.3 for a comparison of smoking rates between these two surveys by age and gender.

The NHIS defines excessive alcohol drinkers as those who consumed greater than or equal to five drinks in 1 day at least 12 times during the past 12 months. The NHIS rate for excessive alcohol consumption among those aged 18 or older was 9.6 percent in 2002. For the 2003 early release data, NHIS redefined excessive alcohol drinking as having consumed greater than or equal to five drinks in 1 day at least once during the past 12 months. This NHIS rate for excessive alcohol consumption among those aged 18 or older was 19.4 percent, down slightly from the rate in 2002 of 19.9 percent (NCHS, 2004). NSDUH defines heavy alcohol use as having five or more drinks on the same occasion on at least 5 different days in the past 30 days. The NSDUH rates for heavy drinking among those 18 or older were 7.2 percent in 2002 and 7.3 percent in 2003.

Monitoring the Future (MTF)

Even though MTF estimates of cigarette use among 8th and 10th graders are higher overall than NSDUH estimates, both surveys showed a slight decrease in past month smoking in all grade levels between 2002 and 2003. For example, among 10th graders, past month smoking was 17.7 percent in 2002 and 16.7 percent in 2003 according to the MTF. The NSDUH past month smoking rates for 10th graders were 17.6 in 2002 and 17.0 in 2003. See Table D.1 for a comparison of the MTF and NSDUH cigarette use estimates by grade level.

Rates of alcohol consumption are higher overall in the MTF sample compared with NSDUH. Both surveys indicate a varying pattern of alcohol consumption by grade level. Table D.1 shows how the MTF estimates of alcohol use compare with NSDUH estimates.

Youth Risk Behavior Survey (YRBS)

As seen with illicit drug use, the YRBS estimates of cigarette and alcohol consumption were higher than the NSDUH estimates. The 2001 YRBS found lifetime cigarette use was 63.9 percent and past month cigarette use was 28.5 percent among students in grades 9 to 12 (CDC, 2004b). The 2002 NSDUH lifetime cigarette rate for high school students was 45.6 percent, and the past month rate was 19.6 percent. According to YRBS data, in 2003, 58.4 percent of high school students had tried cigarettes and 21.9 percent of students had smoked cigarettes during the past 30 days. The 2003 NSDUH rates were 43.6 percent for lifetime cigarette use and 19.0 percent for past month cigarette use among students.

Past month alcohol use among 9th to 12th graders in the YRBS was 47.1 percent in the 2001 survey and 44.9 percent in 2003. In contrast, NSDUH showed a past month alcohol use rate of 27.2 percent in 2002 and 26.9 percent in 2003 among 9th to 12th graders. Lifetime alcohol use rates among students were 59.6 percent in NSDUH in both 2002 and 2003 and 74.9 percent in the YRBS in 2003. It is important to note that the two surveys were conducted in different time periods.

Partnership Attitude Tracking Study (PATS)

Data from the PATS show that the prevalence of past month cigarette for adolescents in grades 7 through 12 was 28 percent in 2002 and 26 percent in 2003 (PDFA, 2004). The NSDUH prevalence of past month cigarette smoking among youths aged 12 to 17 was 13.0 percent in 2002 and 12.2 percent in 2003. Again, the lower prevalence estimates in NSDUH are likely due to its home-based study design.

Even though the PATS estimates were higher than the NSDUH estimates, both surveys showed relatively steady rates of drinking among youths from 2002 to 2003. PATS found that 53 percent of teenagers reported past year alcohol use in 2002 and 51 percent reported past year use in 2003. This compares with NSDUH estimates of 34.6 percent of youths aged 12 to 17 reporting past year use in the 2002 and 34.3 percent in 2003. The 2002 PATS also found that 36 percent of teenagers reported past month alcohol use and 30 percent reported binge drinking in 2002. In 2003, 34 percent of youths used alcohol in the past month, while 29 percent reported binge drinking. In comparison, the 2002 NSDUH rates for past month alcohol use and binge drinking for 12 to 17 year olds were 17.6 and 10.7 percent, respectively. For the 2003 NSDUH, 17.7 percent of youths reported past month alcohol use, and 10.6 reported binge drinking.

Behavioral Risk Factor Surveillance System (BRFSS)

BRFSS is a State-based telephone survey of the civilian, noninstitutionalized adult population aged 18 or older and is sponsored by the CDC. In 2001 and 2002, BRFSS collected data from all 50 States, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and Guam. BRFSS collects information on access to health care, health status indicators, health risk behaviors (including cigarette and alcohol use), and the use of clinical preventive services by State. The median percentage of adults who reported having five or more alcoholic drinks on an occasion at least once in the past month, or binge alcohol use, was 14.8 percent in 2001 and 16.1 percent in 2002 (Ahluwalia, Mack, Murphy, Mokdad, & Bales, 2003; Balluz et al., 2004). The median percentages of adults who had five or more drinks on an occasion at least five times in the past month, or heavy drinking, were 7.0 percent in 2001 and 7.3 percent in 2002 (CDC, 2002, 2004a). In comparison, the rate of binge alcohol use for adults was 24.3 percent in the 2002 NSDUH and 24.0 percent in the 2003 NSDUH. The heavy drinking rate for adults was 7.2 percent in the 2002 NSDUH and 7.3 percent in the 2003 NSDUH.

National Longitudinal Study of Adolescent Health (Add Health)

Results from the 1994–95 National Longitudinal Study of Adolescent Health indicated that nearly 3.2 percent of 7th and 8th graders smoked six or more cigarettes a day, as did 12.8 percent of 9th through 12th graders (Resnick et al., 1997). In addition, the Add Health study found that 7.3 percent of 7th and 8th graders used alcohol on 2 or more days in the past month, as did 23.1 percent of 9th through 12th graders.

National Survey of Parents and Youth (NSPY)

Past waves of the NSPY collected information on cigarette and alcohol use, but Wave 5 in 2002 did not. In 2001, this survey estimated that 34.9 percent of youths aged 12 to 18 had used cigarettes at some point in their lifetime and past month cigarette use was 11.7 percent. The 2002 NSDUH rates of lifetime and past month cigarette use for youths aged 12 to 18 were 38.8 and 16.7 percent, respectively. The 2003 NSDUH rates for lifetime and past month cigarette use among youths aged 12 to 18 were 36.2 and 15.8 percent, respectively. The two surveys have produced similar smoking estimates over the past few years.

In 2001, the NSPY estimated that 45.9 percent of youths aged 12 to 18 had used alcohol at some point in their lifetime, and the estimate for past month use was 36.5 percent for the same age group. The 2002 NSDUH rates for lifetime and past month alcohol use were 49.1 and 22.2 percent, respectively, and the 2003 rates were 49.0 and 22.2 percent. Both the 2002 and 2003 NSDUH estimates are based on data collected from January through June.

Harvard School of Public Health College Alcohol Study (CAS)

In 1993, the Harvard School of Public Health conducted a mail survey of students from a nationally representative sample of 140 colleges. The purpose of the study was to gather data on the drinking patterns of college students. The study was repeated in 1997, 1999, and 2001. Response rates were 70 percent in 1993, 59 percent in 1997 and 1999, and 52 percent in 2001. The 2001 survey analyzed data from 119 of the 140 universities in the 1993 sample (Wechsler et al., 2002). The 2001 survey found that the overall rate of binge drinking was 44.4 percent. The CAS defined binge drinking as the consumption of five or more drinks in a row for men and four or more drinks in a row for women. The study found that the number of students who binge drank frequently was 22.8 percent and those who did not drink at all was 19.3 percent. The 2002 NSDUH binge drinking rate among full-time undergraduates aged 18 to 22 was 44.4 percent, and the 2003 estimate was 43.5 percent. It is useful to note that NSDUH defines binge drinking as five or more drinks in a row on at least one occasion in the past month for both men and women. Despite using different definitions of binge drinking, the CAS estimate and the NSDUH estimate are the same, but it is important to note that the two studies were conducted in different time periods.

 

D.3 Other Surveys of Substance Abuse and Dependence

National Comorbidity Survey (NCS)

The National Comorbidity Survey (NCS) was sponsored by the National Institute of Mental Health (NIMH), the National Institute on Drug Abuse (NIDA), and the W. T. Grant Foundation. It was designed to measure the prevalence of the illnesses in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) (American Psychiatric Association [APA], 1987) in the general population. The NCS was a household survey consisting of more than 8,000 respondents aged 15 to 54. The interviews took place between 1990 and 1992. The NCS used a modified version of the Composite International Diagnostic Interview (the UM-CIDI) for its diagnoses. The results showed that 3.6 percent of the population abused or were dependent on some type of drug in the previous 12 months (Kessler et al., 1994). The corresponding NSDUH rates for persons aged 12 or older were 3.0 percent in 2002 and 2.9 percent in 2003. Alcohol abuse or dependence, however, showed a much higher prevalence in both the NCS and NSDUH. In the NCS, 14.1 percent of the population was abusing or dependent on alcohol in the previous year. In NSDUH, 7.7 percent in 2002 and 7.5 percent in 2003 of persons aged 12 or older were alcohol abusers or dependent on alcohol, rates well below the NCS rate. When comparing these two studies, one should keep in mind that they were conducted in two different time periods and they each used a different set of diagnostic questions. The 2002 and 2003 NSDUH estimates for abuse and dependence were based on the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (APA, 1994).

The National Comorbidity Survey Replication (NCS-R) was conducted between February 2001 and December 2002 with more than 9,000 respondents aged 18 or older. Data on substance abuse and dependence will be released in the summer of 2005.

National Longitudinal Alcohol Epidemiologic Survey (NLAES) and National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)

The NLAES and NESARC included an extensive set of questions designed to assess the presence of symptoms of alcohol and drug abuse and dependence in persons' lifetimes and during the prior 12 months, based on the criteria from the DSM-IV (APA, 1994). The 1991–1992 NLAES found that 7.4 percent of adults were abusing or dependent on alcohol (Grant, 1995). In the 2001–2002 NESARC, the rate of alcohol abuse among adults was 4.7 percent, and the rate of alcohol dependence was 3.8 percent. Between 1992 and 2002, the prevalence of alcohol abuse increased and the prevalence of dependence declined (Grant et al., 2004). In 2002, NSDUH found that 7.9 percent of adults were abusing or dependent on alcohol; in 2003, this rate was 7.7 percent. The NLAES and NESARC also found that the prevalence of marijuana dependence or abuse among adults increased from 1.2 percent in 1992 to 1.5 percent in 2002 (Compton et al., 2004). In comparison, the 2002 NSDUH found that 2.7 percent of adults were abusing or dependent on some illicit drug; in 2003, this rate was 2.6 percent. The 2002 and 2003 NSDUHs also estimated that 3.2 million adults each year, or about 1.5 percent of all adults, were abusing or dependent on marijuana. Although the estimates from these two surveys are relatively close, one should note that they were conducted using different methodologies

 

D.4 Other National Surveys of Mental Illness

National Comorbidity Survey

The National Comorbidity Survey (NCS) was a collaborative epidemiologic investigation designed to study the prevalence and correlates of DSM-III-R (APA, 1987) disorders and patterns and correlates of service utilization for these disorders, as described in Section D.3. The NCS was the first survey to administer a structured psychiatric interview to a nationally representative sample. The survey was carried out in the early 1990s with a household sample of over 8,000 respondents. Diagnoses were based on a modified version of the Composite International Diagnostic Interview (the UM-CIDI), which was developed at the University of Michigan for the NCS. Items on mental illness included personal and family history of psychiatric problems, mental health treatment, symptoms of psychiatric disorders, and mental health status. According to the NCS, 6.4 percent of persons aged 18 or older were classed as having serious mental illness (SMI) in the past year; 7.5 percent of persons aged 18 to 54 and 4.3 percent of persons aged 55 or older had SMI (Kessler et al., 1996).

 

D.5 Surveys of Populations Not Covered by NSDUH

National Survey of Parents and Youth (NSPY)

The NSPY, described above, is distinct in that it measures drug use and attitudes among youths as young as 9 years. The earlier NSPY results showed that youths aged 9 to 11 were strongly opposed to marijuana use. Wave 3 of the survey estimated that only 0.3 percent of youths aged 9 to 11 had used marijuana in the past year. The corresponding rates for Waves 1 and 2 were 0.8 and 0.0, respectively (ONDCP, 2004).

Washington, DC, Metropolitan Area Drug Study (DC*MADS)

The Washington, DC, Metropolitan Area Drug Study (DC*MADS) was designed (a) to estimate the prevalence, correlates, and consequences of drug abuse among all types of people residing in one metropolitan area of the country during one period of time with special focus on populations who were underrepresented or unrepresented in household surveys and (b) to develop a methodological model for similar types of research in other metropolitan areas of the country. Sponsored by NIDA and conducted from 1989 to 1995 by RTI and Westat, Inc., the project included 11 separate but coordinated studies that focused on different population subgroups (e.g., homeless people, institutionalized individuals, adult and juvenile offenders, new mothers, drug abuse treatment clients) or different aspects of the drug abuse problem (e.g., adverse consequences of drug abuse). DC*MADS provided a replicable methodological approach for developing representative estimates of the prevalence of drug abuse among all population subgroups, regardless of their residential setting, in a metropolitan area. The key population domains in DC*MADS were the homeless, the institutionalized, and the household.

A major finding of DC*MADS was that, when data are aggregated for populations from each of the three domains, the overall prevalence estimates for use of drugs differ only marginally from those that would be obtained from the household population alone (i.e., from NSDUH), largely because the other populations are very small compared with the household population. However, a somewhat different picture emerged when the numbers of drug users were examined. Adding in the nonhousehold populations resulted in an increase of approximately 14,000 illicit drugs users compared with the corresponding estimates for the household population. About 25 percent of past year crack users, 20 percent of past year heroin users, and one third of past year needle users were found in the nonhousehold population (Bray & Marsden, 1999).

Department of Defense (DoD) Survey of Health Related Behaviors Among Military Personnel

The 2002 DoD Survey of Health Related Behaviors Among Military Personnel is the 8th in a series of studies conducted since 1980. The sample consisted of 12,756 active-duty Armed Forces personnel worldwide who anonymously completed self-administered questionnaires that assessed substance use and other health behaviors. For the total DoD, during 30 days prior to the survey, heavy alcohol use declined from 20.8 percent in 1980 to 15.4 percent in 1998 and increased significantly to 18.1 percent in 2002; past month cigarette smoking decreased from 51.0 percent in 1980 to 29.9 percent in 1998 and increased significantly to 33.8 percent in 2002; and past month use of any illicit drugs declined from 27.6 percent in 1980 to 2.7 percent in 1998, and also showed a nonsignificant change in 2002 to 3.4 percent (Bray et al., 1999, 2003). In 2002, military personnel had significantly higher rates of heavy alcohol use than their civilian counterparts (16.9 vs. 11.2 percent) when demographic differences between the military and civilian populations were taken into account (civilian data were drawn from the 2001 NHSDA and adjusted to reflect demographic characteristics of the military). Differences in military and civilian heavy alcohol use rates were largest for men aged 18 to 25. Among this age group, the military rate was nearly twice as high as the adjusted civilian rate (32.2 vs. 17.8 percent). Military personnel showed similar rates of cigarette use (31.6 vs. 31.1 percent) compared with civilians. Rates of illicit drug use in the military were significantly lower than those observed for the comparable civilian population when demographic differences between the military and civilian populations were taken into account (3.3 vs. 12.1 percent).

Survey of Inmates in State and Federal Correctional Facilities

The 1997 Survey of Inmates in State and Federal Correctional Facilities sampled inmates from a universe of 1,409 State prisons and 127 Federal Prisons for the Bureau of Justice Statistics (BJS). Systematic random sampling was used to select the inmates for the computer-assisted personal interviews. The final numbers interviewed were 14,285 State prisoners and 4,041 Federal prisoners. Among other items, these surveys collected information on the use of drugs in the month before the offense for convicted inmates. Women in State prisons (62.4 percent) were more likely than men (56.1 percent) to have used drugs in the month before the offense (BJS, 1999, 2000). Women also were more likely to have committed their offense while under the influence of drugs (40.4 vs. 32.1 percent of male prisoners). Among Federal prisoners, men (45.4 percent) were more likely than women (36.7 percent) to have used drugs in the past month. Male and female Federal prisoners were equally likely to report the influence of drugs during their offense (22.7 percent of male and 19.3 percent of female prisoners). The survey results indicate substantially higher rates of drug use among State and Federal prisoners as compared with the household population.

 

Table D.1 Use of Specific Substances in Lifetime, Past Year, and Past Month among 8th, 10th, and 12th Graders in NSDUH and MTF: Percentages, 2002 and 2003
Drug/Current Grade Level SURVEY/TIME PERIOD
NSDUH (January-June) MTF
Lifetime Past Year Past Month Lifetime Past Year Past Month
2002 2003 2002 2003 2002 2003 2002 2003 2002 2003 2002 2003
Marijuana
     8th grade 12.0a 8.9 9.0 7.3 4.5 3.0 19.2 17.5 14.6b 12.8 8.3 7.5
     10th grade 30.4 29.3 25.1 23.5 12.5 12.0 38.7 36.4 30.3 28.2 17.8 17.0
     12th grade 43.4 42.4 30.8 30.4 18.2 18.2 47.8 46.1 36.2 34.9 21.5 21.2
Cocaine
     8th grade 0.6 0.8 0.5 0.6 0.1 0.2 3.6 3.6 2.3 2.2 1.1 0.9
     10th grade 4.1 4.1 3.1 2.8 1.0 0.9 6.1 5.1 4.0 3.3 1.6 1.3
     12th grade 6.0 8.1 4.5 5.0 0.5b 1.7 7.8 7.7 5.0 4.8 2.3 2.1
Inhalants
     8th grade 10.9a 14.2 4.8a 7.6 1.3 1.6 15.2 15.8 7.7a 8.7 3.8 4.1
     10th grade 13.4 12.5 4.8 4.9 2.0 1.3 13.5 12.7 5.8 5.4 2.4 2.2
     12th grade 11.0 13.2 4.1 3.3 0.8 0.7 11.7 11.2 4.5 3.9 1.5 1.5
Cigarettes
     8th grade 24.6a 20.8 14.4b 10.8 7.9b 4.5 31.4b 28.4 -- -- 10.7 10.2
     10th grade 43.3 43.2 26.3 27.1 17.6 17.0 47.4b 43.0 -- -- 17.7 16.7
     12th grade 61.3a 56.0 39.0 35.7 28.2 27.7 57.2b 53.7 -- -- 26.7a 24.4
Alcohol
     8th grade 32.9 29.8 25.0a 21.5 10.9 9.7 47.0 45.6 38.7 37.2 19.6 19.7
     10th grade 60.0 61.4 49.4 50.9 25.2 27.3 66.9 66.0 60.0 59.3 35.4 35.4
     12th grade 75.3 75.8 64.1 64.6 38.7 39.4 78.4 76.6 71.5 70.1 48.6 47.5
*Low precision; no estimate reported.
-- Not available.
a Difference between 2002 estimate and 2003 estimate is statistically significant at the 0.05 level.
b Difference between 2002 estimate and 2003 estimate is statistically significant at the 0.01 level.
MTF = Monitoring the Future.
Sources:
     SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002 and 2003.
     The Monitoring the Future Study, University of Michigan, 2002 and 2003.

 

Table D.2 Past Year and Past Month Marijuana Use among Youths Aged 12 to 18 in NSPY and NSDUH, by Age Group: 2002 and 2003
Use Measure Age Group Percent Reporting Use
NSPY NSDUH
20021 (Full Year) 2003 (January-June) 2002 (Full Year) 2003 (January-June)
Past Year 12 to 13 3.3 4.0 3.1 2.3
14 to 16 17.0 18.3 19.1 19.5
12 to 18 16.4 16.7 18.4 18.1
Past Month 12 to 13 1.1 1.8 1.4 0.9
14 to 16 8.3 8.2 9.4 9.7
12 to 18 8.9 7.9 9.8 9.9
-- Not available.
1 NSPY estimates for 2002 are averages of data from Wave 5 (collected between January and June 2002) and Wave 6 (collected between July and December 2002).
NSPY = National Survey of Parents and Youth.
Sources:
     SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003.
     National Institute on Drug Abuse, National Survey of Parents and Youth, 2002, January–June 2003.

 

Table D.3 Past Month Cigarette Use among Persons Aged 18 or Older in NHIS and NSDUH, by Gender and Age Group: Percentages, 2002 and 2003
Gender/Age NHIS (January – September) NSDUH (January – September)
2002 2003 2002 2003
Total 22.5 21.6 25.6 25.1
     18 to 44 26.6 25.3 31.4 31.1
     45 to 64 22.4 21.6 23.6 22.5
     65 or Older 9.1 9.4 9.8 10.6
Male 25.3 23.7 28.8 28.0
     18 to 44 29.9 28.1 34.2 34.2
     45 to 64 24.2 23.3 26.9 24.9
     65 or Older 10.2 10.5 12.3 10.9
Female 19.9 19.4 22.7 22.4
     18 to 44 23.4 22.5 28.7 28.2
     45 to 64 20.7 20.1 20.5 20.2
     65 or Older 8.3 8.5 7.9 10.3
Note: For the NHIS, past month cigarette use is defined as currently smoking daily or smoking 1 or more days in the past month or quitting smoking fewer than 30 days ago (for those who smoked 100+ cigarettes in the lifetime). The analysis excluded those with unknown use status (about 1 percent each year). For NSDUH, past month cigarette use is defined as having smoked in the past month. For comparison purposes, the NSDUH definition was adjusted to include those who had smoked in the past month and smoked at least 100 cigarettes in their lifetime.
NHIS = National Health Interview Survey.
Sources:
     SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003.
     National Center for Health Statistics, National Health Interview Survey, 2002, 2003.

 


End Notes

1 Beginning with the 2002 survey year, the survey name was changed from the National Household Survey on Drug Abuse (NHSDA) to the National Survey on Drug Use and Health (NSDUH).

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