Highlights

This report presents State estimates for 25 measures of substance use and mental health based on the combined 2009 and 2010 National Surveys on Drug Use and Health (NSDUHs). Sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), NSDUH is an ongoing survey of the civilian, noninstitutionalized population of the United States aged 12 years or older. Interview data from 135,811 persons were collected in 2009-2010 (see Table A.9 in Appendix A). With the exception of the four mental health measures, separate estimates are presented for each measure in four age groups: 12 to 17, 18 to 25, 26 or older, and all persons 12 or older. For past year serious mental illness, past year any mental illness, past year suicidal thoughts, and past year major depressive episode (i.e., depression), estimates are available for adults in three age groups: 18 to 25, 26 or older, and 18 or older. In addition, estimates for major depressive episode are available for youths aged 12 to 17. This report also includes estimates for persons aged 12 to 20 for two of the measures—past month alcohol use and past month binge alcohol use, representing underage use of alcohol. Although estimates for persons aged 18 or older for the substance use measures are not included in this report, they are available at http://www.samhsa.gov/data/NSDUH/2k10State/NSDUHsae2010/Index.aspx. Additionally, tables showing the total number of persons associated with each measure are available at this Web site.

For each measure, States have been ranked and categorized into quintiles, or fifths, in order to simplify the discussion.¹ Estimates presented in this report are based on a hierarchical Bayes estimation method that combines survey data with a national model. Note that these estimates are benchmarked to the national design-based estimates (for details, see Section A.6 in Appendix A). In addition to presenting State estimates for 2009-2010, Chapters 2 to 6 provide comparisons of the 2008-2009 estimates with the 2009-2010 estimates for all measures and indicate whether the differences between the two are statistically significant.² Increases or decreases are discussed only if they are statistically significant at the 0.05 level. Tables showing comparisons between 2002-2003 and 2009-2010 State estimates will be available on the SAMHSA Web site at http://www.samhsa.gov/data/NSDUH/2k10State/NSDUHsae2010/Index.aspx.

Illicit Drug Use

In 2009-2010, 8.8 percent of the U.S. population aged 12 or older used an illicit drug in the past month, which was higher than the rate in 2008-2009 (8.4 percent). Past month use of illicit drugs among persons aged 12 or older ranged from 5.3 percent in North Dakota to 14.2 percent in Alaska. Between 2008-2009 and 2009-2010, rates of past month illicit drug use among persons aged 12 or older increased in eight States (Colorado, District of Columbia, Idaho, Maryland, Michigan, Texas, Virginia, and Washington). Only Hawaii's rate decreased. (Tables B.1 and C.1)
In 2009-2010, past month marijuana use was reported by 6.8 percent of the U.S. population aged 12 years or older, an increase from 6.4 percent in 2008-2009. This rate ranged from 3.1 percent in Utah to 11.8 percent in Alaska. Utah had the lowest rate across all age groups presented. Seven States were ranked in the top fifth for past month marijuana use in age groups 12 to 17, 18 to 25, 26 or older, and 12 or older: Colorado, Maine, Massachusetts, New Hampshire, Oregon, Rhode Island, and Vermont. Between 2008-2009 and 2009-2010, past month marijuana use among persons aged 12 or older increased in 10 States: Colorado, District of Columbia, Idaho, Illinois, Massachusetts, Michigan, New Mexico, Oklahoma, Texas, and Washington. Only Tennessee's rate decreased in the 12 or older age group. (Tables B.3 and C.3; Figures 2.9 to 2.12)
In 2009-2010, the rate of perceived great risk of marijuana use once a month among persons 12 or older was 33.6 percent nationwide and ranged from 22.3 percent in Colorado to 45.2 percent in Mississippi. Between 2008-2009 and 2009-2010, the national percentage of persons aged 12 or older perceiving a great risk of smoking marijuana once a month decreased from 35.8 to 33.6 percent. Decreases in the national rates occurred in every age group, including among persons aged 12 to 17 (from 31.8 to 29.9 percent). Twenty States showed decreases in the perceived great risk of smoking marijuana once a month among persons aged 12 or older. Decreases occurred in 16 States among youths aged 12 to 17, 22 States among persons aged 18 to 25, and 15 States among persons aged 26 or older. No increases were observed in any State or age group. Among youths aged 12 to 17, 7 of the 10 States that ranked in the highest fifth for past month marijuana use also ranked in the lowest fifth for perceived great risk of smoking marijuana once a month (Colorado, District of Columbia, Massachusetts, New Hampshire, Oregon, Rhode Island, and Vermont). (Tables B.4 and C.4; Figures 2.10 and 2.14)
In 2009-2010, the national prevalence of past year cocaine use among persons aged 12 or older was 1.9 percent, which was a decline from 2.0 percent in 2008-2009. State-level rates ranged from 1.0 percent in Alabama, Iowa, and North Dakota to 3.1 percent in Colorado, the District of Columbia, and Vermont. Between 2008-2009 and 2009-2010, 10 States showed decreases in past year cocaine use among persons aged 12 or older. No increases were observed in any State or age group. (Tables B.7 and C.7)
In 2009-2010, 4.9 percent of persons aged 12 or older nationwide reported having used pain relievers nonmedically in the past year. Estimates ranged from 3.6 percent in South Dakota to 7.0 percent in Oklahoma. Between 2008-2009 and 2009-2010, past year nonmedical use of pain relievers among persons aged 12 or older increased in Missouri and Wyoming and decreased in Hawaii and Oklahoma. (Tables B.8 and C.8)

Alcohol Use

Nationally, about half (51.8 percent) of Americans aged 12 or older reported being current (i.e., past month) drinkers of alcohol in 2009-2010. In this time period, rates of use among persons aged 12 or older ranged from 26.4 percent in Utah to 64.1 percent in Wisconsin. Among persons aged 12 or older, 8 of the 10 States that were ranked in the bottom fifth for current use were from the South (Alabama, Arkansas, Kentucky, Louisiana, Mississippi, South Carolina, Tennessee, and West Virginia). Arizona was the only State with a decrease among persons aged 12 or older from 2008-2009 to 2009-2010 (from 51.2 to 48.1 percent). (Tables B.9 and C.9; Figure 3.1)
Nationally, almost a quarter (23.4 percent) of persons aged 12 or older participated in binge drinking in the past month in 2009-2010. Rates ranged from 13.2 percent in Utah to 29.9 percent in Wisconsin. Two States showed decreases in binge drinking between 2008-2009 and 2009-2010 among persons 12 or older: Florida (from 21.9 to 20.7 percent) and Ohio (from 25.3 to 23.6 percent). Idaho (from 20.1 to 21.9 percent) and Washington (from 21.4 to 23.9 percent) showed increases. (Tables B.10 and C.10)
In 2009-2010, 42.6 percent of persons aged 12 or older perceived a great risk of having five or more drinks of an alcoholic beverage once or twice a week (i.e., binge drinking), an increase from 41.8 percent in 2008-2009. The highest rate occurred in Utah (50.8 percent), while the lowest was in South Dakota (33.6 percent). Among persons aged 12 or older, a decrease was seen in Montana (from 39.1 to 36.6 percent), and increases were seen in Arkansas, California, Florida, New Hampshire, and Pennsylvania. Increases also were seen in the Northeast, South, and West regions. (Tables B.11 and C.11)
Past month use of alcohol among persons aged 12 to 20 (underage use of alcohol) was 26.7 percent nationally, ranging from 16.5 percent in Utah to 34.6 percent in Vermont. Four States displayed decreases in alcohol use in this age group from 2008-2009 to 2009-2010: Colorado, Louisiana, Michigan, and North Dakota. Virginia showed an increase. In 2009-2010, Utah had the lowest past month underage binge drinking rate (12.7 percent), and North Dakota had the highest rate (24.2 percent). The national rate of underage binge drinking was 17.5 percent. Decreases occurred in eight States between 2008-2009 and 2009-2010: Colorado, Florida, Michigan, New Hampshire, North Dakota, Ohio, Oregon, and South Dakota. No States showed an increase in this age group. (Tables B.12 and C.12)

Tobacco Use

Nationally among persons aged 12 or older, the rate for past month use of tobacco in 2009-2010 was 27.6 percent and ranged from 16.8 percent in Utah to 40.2 percent in West Virginia. Among the 12 or older age group, decreases in past month tobacco use from 2008-2009 to 2009-2010 were seen in Kentucky and Wisconsin. Increases were seen in Alaska and Mississippi. (Tables B.13 and C.13)
Among persons aged 12 or older in 2009-2010, the national rate of past month cigarette use was 23.2 percent. West Virginia had the highest rate (32.0 percent), while Utah had the lowest rate (15.8 percent). Nationally, decreases were observed among youths aged 12 to 17 (from 9.1 percent in 2008-2009 to 8.7 percent in 2009-2010) and among persons aged 12 or older (from 23.6 to 23.2 percent). (Tables B.14 and C.14)
Nationwide, the rates of perception of great risk of smoking one or more packs of cigarettes per day decreased from 2008-2009 to 2009-2010 among persons aged 12 or older (from 72.2 to 71.2 percent) and among youths aged 12 to 17 (from 67.5 to 65.4 percent). In 2009-2010 among persons 12 or older, the rates ranged from 62.3 percent in Kentucky to 76.4 percent in New York. At the State level, there were decreases from 2008-2009 to 2009-2010 in the perception of great risk of heavy cigarette use across three age groups (12 to 17: 17 States had decreases; 18 to 25: 10 States had decreases; and 26 or older: 5 States had decreases). (Table C.15)

Substance Dependence, Abuse, and Treatment Need

The national rate in 2009-2010 for past year dependence or abuse of illicit drugs or alcohol among persons aged 12 or older was 8.9 percent. State percentages ranged from 7.4 percent in Utah to 12.0 percent in the District of Columbia. Among persons aged 12 or older, the rate of past year dependence or abuse of illicit drugs or alcohol at the State level decreased significantly from 2008-2009 to 2009-2010 for Georgia, Minnesota, and Missouri. (Tables B.20 and C.20)
In 2009-2010, 7.3 percent of the population aged 12 or older was classified with dependence or abuse of alcohol nationwide in the past year. At the State level among persons aged 12 or older, the District of Columbia had the highest rate (9.5 percent), and Utah had the lowest rate (5.7 percent). For the 12 or older age group, between 2008-2009 and 2009-2010, decreases in the rates of past year dependence or abuse of alcohol were observed in Minnesota and Missouri. (Tables B.16 and C.16)
Nationally in 2009-2010, about 2.8 percent of persons aged 12 or older were classified with dependence or abuse of illicit drugs in the past year, a rate that remained unchanged from 2008-2009. The District of Columbia had the highest rate of past year illicit drug dependence or abuse (3.9 percent) among persons aged 12 or older, and North Dakota had the lowest rate (2.0 percent). Among persons aged 12 or older between 2008-2009 and 2009-2010, decreases were observed in Kentucky, Nevada, Rhode Island, and West Virginia, and an increase was seen in Mississippi. (Tables B.18 and C.18)
The national rate in 2009-2010 for needing but not receiving treatment for an illicit drug problem among persons aged 12 or older was 2.5 percent, which was the same as the rate in 2008-2009. In 2009-2010, this rate ranged from 1.8 percent in North Dakota to 3.0 percent in California and Rhode Island. Among persons aged 12 or older, decreases between 2008-2009 and 2009-2010 were observed in Kentucky, Nevada, Rhode Island, and West Virginia. (Tables B.21 and C.21)
The percentage of persons aged 12 or older needing but not receiving treatment for alcohol problems was 6.9 percent in 2009-2010. Among the States, the lowest rate observed was in Utah (5.4 percent), while the highest rate was in the District of Columbia (9.2 percent). Among persons aged 12 or older, declines in the rate of needing but not receiving treatment for an alcohol problem from 2008-2009 to 2009-2010 were seen in Minnesota and New Mexico. A decline also was seen in the Midwest region. (Tables B.22 and C.22)

Mental Disorders

Nationally in 2009-2010, 4.9 percent of adults aged 18 or older (an increase from 4.6 percent in 2008-2009) had serious mental illness in the past year. Arkansas had the highest rate (6.3 percent), while Maryland and New Jersey had the lowest rate (4.3 percent) among adults 18 or older. From 2008-2009 to 2009-2010, nine States had an increase, whereas no decreases were seen. (Tables B.23 and C.23)
In 2009-2010, the national rate of past year any mental illness among adults aged 18 or older was 20.0 percent. The highest rate for any mental illness among persons aged 18 or older occurred in Utah (25.4 percent), while the lowest rate occurred in Georgia (17.9 percent). Alabama, Idaho, Montana, Rhode Island, Tennessee, Utah, and West Virginia ranked in the highest fifth for both past year serious mental illness and past year any mental illness. Two States had increases in past year any mental illness rates between 2008-2009 and 2009-2010 (Alabama and Idaho). (Tables B.24 and C.24; Figures 6.1 and 6.4)
In 2009-2010, 3.8 percent of adults aged 18 or older had serious thoughts of suicide in the past year in the United States, which was similar to the rate from 2008-2009 (3.7 percent). State-level estimates ranged from 3.1 percent in Georgia and Texas to 5.0 percent in Utah. (Tables B.25 and C.25)
Nationwide in 2009-2010, 6.7 percent of adults aged 18 or older had a major depressive episode in the past year, ranging from 5.9 percent in New Mexico to 8.2 percent in Utah. Between 2008-2009 and 2009-2010, rates of depression among adults aged 18 or older increased in Iowa and Ohio. (Tables B.26 and C.26)
In 2009-2010, 8.1 percent of youths aged 12 to 17 experienced depression nationwide during the past year, which was similar to the rate in 2008-2009 (8.2 percent). In 2009-2010, rates of depression among youths ranged from 6.9 percent in the District of Columbia and Louisiana to 9.6 percent in Missouri. At the State level, there were no significant changes in the rates of depression among youths between 2008-2009 and 2009-2010. (Tables B.26 and C.26)