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Who Are America's Drug Users?


How Many People Use Illicit Drugs?

According to the National Household Survey on Drug Abuse, in 1999 an estimated 14.8 million Americans (see the chart) were current illicit drug users, meaning they had used some illicit drug during the month prior to the survey. This represents 6.7 percent of the population 12 years and older.(1) This number is down more than 50% from the peak year of 1979 (see the chart) when 25 million people (14.1% of the population) were using illegal drugs.

In 1999, more than 4 million of the drug using population were hardcore users: 3.3 million chronic cocaine users and 977,000 chronic heroin users, according to Office of National Drug Control Policy estimates.(2) While casual use of illicit drugs, and cocaine in particular, has fallen dramatically (see the chart) since the early 1980s, the number of hard-core users of cocaine and heroin has remained virtually unchanged.(3)

Who they Are

(4) In terms of age ranges, the highest rate of illicit drug use is found among older teens: the 1999 Monitoring the Future study found that 22% of 10th graders and 26% of 12th graders reported using an illicit drug in the past month.(5) They are closely followed by young adults; the Household Survey found that 20-21% of Americans aged 18-20 reported past month use of some illicit drug.

Men have consistently had a higher rate of drug use than women. In 1999, 8.7% of men were current users of illicit drugs, compared to 4.9% of women. Among children aged 12-17, the rates for boys were only slightly higher than those for girls. (8.4% vs. 7.1%)

Of the major racial/ethnic groups, the rate of drug use is highest among the American Indian/Native American population (10.6%) and those reporting mixed race (11.2%), followed by African Americans (7.7%), Hispanics (6.8%), whites (6.6%). The lowest rates are found among the Asian population. (3.2%).

Drug use rates have historically been highly correlated with educational status, and remain so. College graduates have the lowest rates of current drug use (4.8%).

Drug use is more prevalent in metropolitan than non-metropolitan areas, and higher in the West (7.9%) than in the Northeast (7.4%), Midwest (6.7%), or South (5.6%).(6)

What They Use

According to the 1999 National Household Survey, marijuana is by far the most commonly used drug, with 11.1 million current users (see the chart). This means that three out of four illegal drug users currently use marijuana--in addition to whatever other drugs they are using. The level of marijauna use remained relatively constant throughout the 1990s.(7)

As well as measuring the levels of current drug use, the National Household Survey also counts the number of new users of each drug every year, in order to identify emerging trends in drug use. This "iniation rate" for marijuana increased dramatically in the early 1990s, and has remained stable since 1994.(8) In 1998, 2.3 million people tried marijuana for the first time.(9) The alltime high for new use of marijauna was in 1977, when 3.4 million people tried the drug.

The ONDCP believes that marijuana is the most readily available illegal drug in the United States.(10) Prices have remained relatively stable over the last decade, ranging between $400 to $1000 per pound in the Southwest border areas and between $700 and $2000 per pound in the Midwest and Northeast.(11)

According to the Household Survey, there were 1.5 million current cocaine users in 1999, representing 0.7% of the total population over 12. There were 413,000 current crack users (0.18%).(12)

The rate of cocaine use dropped dramatically between 1985, when it was as high as 3%, and 1992, when it had dropped to 0.7%. The rate did not change significantly through 1998, though there has been a slight increase since 1998.(13)

As for new users of cocaine, this number hit a 17 year low-point in 1991--down from the period of 1977-1987 when more than one million new users tried cocaine each year. The number of new users of cocaine peaked in 1983, when the number of new initiates was estimated to be 1.6 million. The number of new users each year dropped steadily from 1983, most sharply during the period of intense media attention to crack.

The most striking data about cocaine use is the stable level of hardcore chronic users (see the chart). This number has hovered between 3.3 and 3.5 million since 1989, while the number of casual users decreased by more than 50% in the same time period.(14)

According to the ONDCP, cocaine continues to be readily available in nearly all major metropolitan areas. The average retail price has remained stable since 1994, at $170 per pure gram.(15) Purity levels have also remained steady throughout the 1990s, ranging from 65 to 80%. (16)

Heroin use in the United States appears to be declining slightly after an upward trend between 1992 and 1997.(17) According to the National Household survey, in 1997 there were 325,000 current heroin users; currently there are 200,000. (18) Solid statistics on heroin use, are difficult to come by, however, both because of the relatively small number of users, and because the Household Survey data relies on self-reporting of a particularly stigmatized drug taking behavior.(19) Other research has come up with substantially higher numbers. For example, an earlier ONDCP study estimated the number of hardcore users of heroin to be as high as 980,000 in 1998.(20)

Regardless of the actual number, there are fewer heroin users than cocaine or marijuana users. However, the ONDCP calls heroin "a resurgent menace" because use of this addictive drug has been steadily increasing over the past decade, particularly among casual users.(21) With the advent of "heroin chic," more people tried heroin for the first time in 1996 than in any year going back to 1970. However, new use rates have stabilized since then. A large proportion of the recent heroin initiates are young and are smoking, sniffing, or snorting heroin, rather than injecting it.(22)

The ONDCP found that heroin on the street in 1999 was of "unprecedented retail purity," indicating that it was readily accessible.(23) High levels of purity indicate that a drug is easily accessible, because when a drug is hard to find, it is often cut with other substances. High levels of heroin purity also increase the risk of overdose.

According to the DEA, methamphetamine had appealed to a relatively small number of users until the mid-1990's, when it emerged as a major drug of choice(24) The 1998 National Household Survey estimated that 4.7 million Americans tried methamphetamine in their lifetime. This figure shows a marked increase from the 1994 estimate of 3.8 million.(25) It is used most commonly in the western states, though it seems to be spreading eastward. In 1998, meth labs were, for the first time, found in New Jersey, Delaware, and Massachusetts.(26)

What they spend

In 1999, Americans spent (see the chart) $63.2 billion on illicit drugs: $37 billion on cocaine, $12 billion on heroin, $10.2 billion on marijuana, and $4 billion on other drugs(27) The vast majority of that spending comes from hard-core addicts. Hardcore addicts make up less than quarter of the drug users in this country, but consume over two-thirds of the illegal drugs.(28)

Between 1988 and 1999, expenditures on cocaine and heroin fell.(29) While a decrease in the number of casual users of cocaine played some role in this trend, it is largely due to a fall in the street price of each drug. According to DEA statistics, heroin and cocaine prices are at record lows, and the purity at almost all-time highs.

How Do We Get These Numbers?

Statistics on drug use are notoriously hard to pin down. There are very significant methodological problems with collecting data on illegal, stigmatized and relatively uncommon activities, The National Household Survey has been conducted by the Federal Government since 1979, and is the most widely cited survey of overall illegal drug use in America. It measures drug use in all civilian household residents over the age of 12, which includes more than 98% of the U.S. population. It includes residents of shelters, rooming houses, dormitories, and civilians living on military bases. However, it excludes some important subpopulations who may have very different drug use patterns than the rest of the population. It excludes active military personnel who have been shown to have significantly lower drug use. People living in institutional group quarters, such as jails, prisons and residential drug treatment centers, are not covered in the NHSDA and have been shown in other surveys to have higher rates of illicit drug use. Also excluded are homeless people not living in a shelter on the survey date--another population shown to have higher than average rates of illicit drug use.

The Office of National Drug Control Policy (ONDCP) issues a yearly report which monitors drug use trends and lays out the prospective drug strategy. Much of the data in the annual report is based on the National Household Survey, but ONDCP also relies on other sources, particularly for data on more chronic drug users. For example, the Arrestee Drug Abuse Monitoring (ADAM) program collects data from arrestees in more than 30 U.S. cities. As might be expected, drug use prevalence is much higher among this population.(30) The ONDCP relies on this data combined with the National Household Survey, to estimate the number of hardcore versus occasional drug use, for example.

Another important national survey is the "Monitoring the Future" study of the University of Michigan, which reports annually on drug use among 8th, 10th and 12th graders. This is the most authoritative data available on teen drug use, but suffers from the obvious methodological flaw of depending on teenagers self-reporting illegal behavior.

(1) NHSDA 1999 http://www.samhsa.gov/oas/NHSDA/1999/Chapter2.htm
(2) "Hardcore" use means more than weekly. The total number may be slightly lower, due to overlap between the two groups: some hardcore cocaine users may also be hardcore heroin users.
(3) National Drug Control Strategy, 2000 Annual Report. Table 3, Appendix:Drug Related Data
(4) Unless otherwise noted, statistics in this section are from the 1999 National Household Survey on Drug Abuse. http://www.samhsa.gov/oas/NHSDA/1999/Chapter2.htm
(5) http://www.monitoringthefuture.org/data/99data.html#1999data-drugs
(6) NHSDA 1999 http://www.samhsa.gov/oas/NHSDA/1999/Chapter2.htm
(7) National Drug Control Strategy, 2000 Annual Report. p.12
(8) National Drug Control Strategy, 2000 Annual Report. p.12
(9) NHSDA 1999 http://www.samhsa.gov/oas/NHSDA/1999/Chapter2.htm
(10) National Drug Control Strategy, 2000 Annual Report. p.12
(11) National Drug Control Strategy, 2000 Annual Report. p.13
(12) NHSDA 1999 http://www.samhsa.gov/oas/NHSDA/1999/Chapter2.htm
(13) National Drug Control Strategy, 2000 Annual Report. p.14
(14) National Drug Control Strategy, 2000 Annual Report. Table 3, Appendix:Drug Related Data
ONDCP's figures for hardcore use combine the data from the Household Survey with numbers from arrestees. The higher rates of drug use among arrestees combined with the differences in methodologies, explains, at least in part, the discrepancy between the number of past month users counted in the Household Survey (1.5 million in 1999) and the number of weekly hardcore users (3.3 million in 1999).
(15) National Drug Control Strategy, 2000 Annual Report. p.15
(16) National Drug Control Strategy, 2000 Annual Report. p.15
(17) National Drug Control Strategy, 2000 Annual Report. p.16
(18) NHSDA 1999 http://www.samhsa.gov/oas/NHSDA/1999/Chapter2.htm; National Drug Control Strategy, 2000 Annual Report. p.16
(19) National Drug Control Strategy, 2000 Annual Report. p.16
(20) National Drug Control Strategy, 2000 Annual Report. p.16
(21) National Drug Control Strategy, 2000 Annual Report. Table 3, Appendix:Drug Related Data
(22) NHSDA 1999 http://www.samhsa.gov/oas/NHSDA/1999/Chapter2.htm
(23) National Drug Control Strategy, 2000 Annual Report. p.17
(24) http://www.usdoj.gov/dea/briefingbook/page34-48.htm
(26) http://www.usdoj.gov/dea/concern/meth.htm
(27) Office of National Drug Control Policy, 1999. What America's Users Spend on Illegal Drugs, 1988-1999; Cited in National Drug Control Strategy, 2000 Annual Report. p. 114 Amounts are in constant 1998 dollars. These figures are calculated using a "consumption approach". The researchers use a mathematical model in which they estimate the number of harcore drug users in this country, analyze DUF (Drug Use Forecasting) interviews with hardcore users who are asked about how much they spend on drugs, multiply the number of users by their typical expenditure, then convert the resulting estimates to 1998 dollars.
(28) Susan Everingham, C. Rydell and J. Caulkins, "Cocaine Consumption in the U.S.: Estimating Past Trends and Future Scenarios," Socio-Economic Planning Sciences, Vol. 29(4), December 1995. (AS CITED BY: Office of National Drug Control Policy, "What America's Users Spend on Illegal Drugs, 1988-1995" (Washington D.C.: U.S. Government Printing Office, 1997).) The authors report that heavy users of cocaine consume 70% of all cocaine reported in the NHSDA. Hardcore heroin users account for an even larger percentage of heroin sales.
(29) National Drug Control Strategy, 2000 Annual Report. p.114
(30) 1999 Annual Report on Drug Use Among Adult and Juvenile Arrestees, National Institute of Justice, June 2000

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