Approximately 10.3 percent of U.S. adults appear to have problems with drug use or abuse during their lives, including 2.6 percent who become drug dependent at some point, according to a report in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
Drug abuse refers to the intense desire to take drugs at the exclusion of other activities, and dependence occurs when the body becomes physically dependent on an illicit substance. Both are widespread and associated with substantial costs to society and individuals, according to background information in the article. "Although extensive data on drug use in the U.S. population have been available on an ongoing basis for adults and adolescents, epidemiologic data on the prevalence, correlates, disability, treatment and comorbidity of drug use disorders among adults are seldom collected," the authors write. "In fact, it has been more than 16 years since such detailed information on drug use disorders in the United States has been published."
Wilson M. Compton, M.D., M.P.E., of the National Institute on Drug Abuse, Bethesda, Md., and colleagues at the National Institute on Alcohol Abuse and Alcoholism used data from in-person interviews conducted in 2001 and 2002 with 43,093 adults representative of the entire U.S. population to determine the prevalence of abuse or dependence on nicotine, alcohol or one of 10 classes of other drugs: sedatives, tranquilizers, opiates [other than heroin], stimulants, hallucinogens, cannabis, cocaine, inhalants/solvents, heroin and other drugs. Participants were also assessed for other psychiatric disorders, including mood (such as depression), anxiety (such as panic disorder) and personality disorders (including obsessive-compulsive disorder). For those with drug use disorders, level of disability—how much the disorder affected their daily life—were ranked on a scale of zero to 100, with lower scores indicating more disability.
Over the previous 12 months, 1.4 percent of the participants reported that they had abused drugs and 0.6 percent reported that they were dependent on drugs, while 7.7 percent reported that they developed drug abuse and 2.6 percent drug dependence over their lifetime. Rates of abuse and dependence tended to be higher among men, Native Americans, those age 18 to 44, lower socioeconomic groups, those living in the West and those who were not married.
"With few exceptions, 12-month and lifetime drug abuse and dependence were positively and significantly related to alcohol use disorders, nicotine dependence and mood, anxiety and personality disorders," the authors write. "Associations of drug use disorders with other substance use disorders and anti-social personality disorder were diminished but remained strong when we controlled for psychiatric disorders." This indicates that common factors underlie both drug abuse and other psychiatric conditions. Drug abuse and dependence were also associated with mental, social and emotional disability.
Individuals who abused drugs began at an average age of 19.9, whereas those with drug dependence developed the condition at an average age of 21.7. About 8.1 percent of those who abused drugs and 37.9 percent of those who were dependent received treatment during their lives. "The adolescent onset of drug abuse and dependence revealed critical windows of opportunity for prevention efforts," the authors write.
"The results of this study indicate that immediate action must be taken to educate physicians, the public and policy makers about drug use disorders and their treatment and to develop programs to destigmatize the disorders, thereby reducing the personal suffering and adverse societal impact of drug use disorders in the United States," they conclude.
(Arch Gen psychiatry . 2007;64:566-576)
Editor's Note: This study was supported in part by the Intramural Program of the National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism. The National Epidemiological Survey on Alcohol and Related Conditions is funded by the National Institute on Alcohol Abuse and Alcoholism, with supplemental support from the National Institute on Drug Abuse.