# Presentation: 660631

## Focus Area 26Substance AbuseProgress Review

**Focus Area 26****Substance Abuse****Progress Review**

**Richard J. Klein**
**National Center for Health Statistics**
**October 2, 2008**

## Substance Abuse

**Substance Abuse**

- Source: Excerpt from SAMHSA & NIH/NIDA congressional appropriations testimonies, 2004; National Survey on Drug Use and Health, SAMHSA.

**Estimated costs (2004)**
**Substance abuse costs the U.S. more than $346 billion per year**
**Illicit drug use alone costs about $161 billion**
**Usage (2007)**
**Almost 20 million (8.3%) Americans 12 years and older are current users of illicit drugs**
**Roughly 7 million Americans are abusing prescription drugs (increased 13% since 2004)**

## Highlighted Objectives

- *Percent of targeted change achieved is between -10% and 10%, and/or change not statistically significant.

**26-1 a. ****	****Alcohol-related motor vehicle crash deaths**
**26-2. ****	****Cirrhosis deaths**
**26-3. ****	****Drug-induced deaths**
**26-6. ****	****Adolescents riding with a driver who has been drinking**
**26-9 b. ****	****Average age at 1****st**** use**
**26-9 c. ****	****High school seniors abstaining from alcohol **
**26-10 b, c.****	****Illicit drug use in the past 30 days**
**26-11 a. ****	****High school seniors binge drinking in the past 2 weeks**
**26-16 a-f. ****	****Disapproval of substance abuse**
**26-18 a, b. ****	****Treatment for illicit drugs and/or alcohol abuse**
**26-20. ****	****Treatment admissions for injection drug use**
**26-21. ****	****Treatment for alcohol abuse**
**26-24. ****	****Administrative license revocation laws for DUI**
**26-25. ****	****Blood alcohol concentration laws for drivers **_**>**_** 0.08%**

**Highlighted Objectives**

- Improving

- Getting worse

- Little or no change*

- Target met

## Adolescent Alcohol Behavior

**Percent**

**2002**

**2004**

**2006**

**0**

**10**

**20**

**40**

**50**

**2000**

**30**

**2007**

**Never drank alcohol HS Seniors**

**Adolescent Alcohol Behavior**

**Obj. 26-9c **

- Note: Data are for High School seniors who have never had more than just a few sips of alcohol in their life.
- Source: Monitoring the Future, NIH, NIDA.

**1998**

**1999**

**2001**

**2003**

**2005**

## Adolescent Alcohol Behavior

**Percent**

**2002**

**2004**

**2006**

**0**

**10**

**20**

**40**

**50**

**2000**

**30**

**2007**

**1998**

**1999**

**2001**

**2003**

**2005**

**Binge drinking HS Seniors**

- Note: Binge drinking is defined as drinking five or more alcoholic beverages in a row during the past 2 weeks.
- Source: Monitoring the Future, NIH, NIDA.

**Adolescent Alcohol Behavior**

**Obj. 26-11a **

## Adolescent Alcohol Behavior

**Objs. 26-6, 9c & 11a**

- Note: Data for riding with a driver who has been drinking are for students in grades 9 – 12 during the past 30 days. Binge drinking is drinking 5+ alcoholic beverages in a row during the past 2 weeks. Data for never drinking are for High School seniors who have never had more than just a few sips of alcohol in their life.  Source: Youth Risk Behavior Surveillance System, CDC, NCCDPHP; Monitoring the Future, NIH, NIDA.

**Adolescent Alcohol Behavior**

**2002**

**2004**

**2006**

**0**

**10**

**20**

**40**

**50**

**2000**

**30**

**2007**

**1998**

**1999**

**2001**

**2003**

**2005**

**Binge drinking HS Seniors**

**Never drank alcohol HS Seniors**

**2010 Target : 30**

**Percent**

## Disapproval of Drinking Alcohol Daily,

**Disapproval of Drinking Alcohol Daily,**
** ****Adolescents**

**Obj. 26-16 a-c**

**Percent**

**2007**

**1998**

**8****th**** grade**

**12****th**** grade**

**10****th**** grade**

**2010 Target: 83**

- Note: Data are for students who report their disapproval of people who take 1-2 drinks nearly every day.
- Source:  Monitoring the Future, NIH, NIDA.

##  Cirrhosis Deaths, 2001-2005

- Note: Data are for ICD-10 codes K70, K73-K74.  Data are age-adjusted to the 2000 standard population. Legend represents quintiles of the rates. Rates are calculated by health service area.** **Rates are per 100,000 population.
- Source: National Vital Statistics System—Mortality, CDC, NCHS.

** ****Cirrhosis Deaths, 2001-2005**

**Obj. 26-2**

**Age-adjusted per 100,000 population**

**2010 Target: 3.2**

##  Cirrhosis and Alcohol-Induced Deaths, 2005

- Note: Cirrhosis deaths - ICD-10 codes K70, K73-K74. Alcohol-induced deaths - ICD-10 codes can be found in National Vital Statistics Reports, Vol. 56, Num.10, 4/24/2008. Rates are per 100,000 population and age-adjusted to the 2000 standard population. American Indian includes Alaska Native. Asian includes other Pacific Islander. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race. Respondents were asked to select one or more races. Data for the single race categories shown are for persons who reported only one racial group. Source: National Vital Statistics System—Mortality, CDC, NCHS.

**Cirrhosis Deaths**

**Total**

- White

- American
- Indian

- Hispanic

- Male

- Female

**Per 100,000 population**

** ****Cirrhosis and Alcohol-Induced Deaths, 2005**

- Black

- Asian

**Obj. 26-2**

**25**

**15**

**5**

**0**

**20**

**10**

## Alcohol-Related Motor Vehicle Fatalities 

**Per 100,000 population**

**Total**

**American Indian**

**Black**

**Asian**

**White**

**Hispanic**

**(2007)**

**1998**

**Alcohol-Related Motor Vehicle Fatalities **

**Obj. 26-1a**

**2006**

- Note: Data are for deaths in crashes involving a driver, motorcycle rider, or nonoccupant (i.e. pedestrian, pedalist) with a BAC of .08 g/dL or greater American Indian includes Alaska Native. Asian includes Other Pacific Islander. The categories black and white exclude persons of Hispanic origin. Persons of Hispanic origin may be any race Source: Fatality Analysis Reporting System, Department of Transportation (DOT), National Highway Traffic Safety Administration (NHTSA).

## States with Alcohol Related Laws

**01**

**02**

**05**

**  ****0**

**51**

**States with Alcohol Related Laws**

**Administrative License Revocation Laws**

**.08 Blood Alcohol Concentration Laws**

**  ****0**

**51**

**2007**

**1998**

**99**

**06**

**04**

**03**

**00**

**01**

**02**

**05**

**99**

**06**

**04**

**28**

**00**

**2007**

**1998**

**Objs. 26-24 & 25**

- Source: Department of Transportation (DOT), National Highway Traffic Safety Administration (NHTSA).

**States and DC**

**03**

**50**

**46**

**32**

**51**

**51**

**51**

**19**

**18**

**15**

**42**

**42**

**42**

**42**

**42**

**42**

**42**

**42**

**42**

**42**

## Marijuana Use,

- * New users used marijuana for the first time in the past 12 months.
- Source: National Survey on Drug Use and Health, SAMHSA.

**Marijuana Use,**
**Adolescents 12-17**

**Objs. 26- 9b & 10b**

**2002 – 15.0 years**

**2007 – 15.3 years**

**Average age at 1****st**** use among new users***

## Disapproval of Trying Marijuana,

**Disapproval of Trying Marijuana,**
** ****Adolescents**

**Obj. 26-16 d-f**

**Percent**

**2007**

**1998**

**8****th**** grade**

**12****th**** grade**

**10****th**** grade**

**2010 Target: 72**

- Note: Data are for students who disapprove of trying marijuana or hashish once or twice.
- Source:  Monitoring the Future, NIH, NIDA.

##  Drug-Induced Deaths

**Per 100,000 population**

**Total**

**American Indian**

**Black**

**Asian**

**White**

**Hispanic**

**1999**

**Obj. 26-3**

** ****Drug-Induced Deaths**

- Note: Drug induced deaths ICD-10 codes can be found in National Vital Statistics Reports, Vol. 56, Num. 10, 4/24/08. Methadone and Cocaine deaths are  ICD-10 codes T40.3 and T40.5 respectively Data are age-adjusted to the 2000 standard population. The categories black and white exclude persons of Hispanic origin. American Indian includes Alaska Natives.  Asian includes other Pacific Islander. Persons of Hispanic origin may be any race. Only one race could be recorded prior to 2003. For 2003 and later years, one or more races could be recorded. Data by single race categories are for persons for whom only one racial group was recorded. Source: National Vital Statistics System—Mortality, CDC, NCHS.

##  Drug-Induced Deaths

**2005**

**1999**

** ****Drug-Induced Deaths**

**Per 100,000 population**

**Total**

**American Indian**

**Black**

**Asian**

**White**

**Hispanic**

**Obj. 26-3**

- Note: Drug induced deaths ICD-10 codes can be found in National Vital Statistics Reports, Vol. 56, Num. 10, 4/24/08. Methadone and Cocaine deaths are  ICD-10 codes T40.3 and T40.5 respectively Data are age-adjusted to the 2000 standard population. The categories black and white exclude persons of Hispanic origin. American Indian includes Alaska Natives.  Asian includes other Pacific Islander. Persons of Hispanic origin may be any race. Only one race could be recorded prior to 2003. For 2003 and later years, one or more races could be recorded. Data by single race categories are for persons for whom only one racial group was recorded. Source: National Vital Statistics System—Mortality, CDC, NCHS.

## Drug-Induced Deaths, 2001-2005

- Note: Data are for a number of ICD-10 codes which can be found in the National Vital Statistics Reports, Vol. 56, Num. 10, April 24, 2008.  Data are age-adjusted to the 2000 standard population. Legend represents quintiles of the rates. Rates are calculated by health service area.** **Rates are per 100,000 population.
- Source: National Vital Statistics System—Mortality, CDC, NCHS.

**Drug-Induced Deaths, 2001-2005**

**Obj. 26-3**

**Age-adjusted per 100,000 population**

**2010 Target: 1.2**

## Needing and Receiving Treatment

**2010 Target: 16**

**2010 Target: 11.9**

**Needing and Receiving Treatment**

**Objs. 26-18, 20 & 21**

**1997 – 215,560**

**2006 – 237,945**

**2010 Target: 256,680**

- Note: Data are for people needing treatment for a drug and/ or alcohol problem if he or she was dependent on or abused alcohol and/or drugs or received specialty treatment in the past 12 months. Specialty treatment is treatment received at drug or alcohol rehabilitation facilities (inpatient or outpatient), hospitals (inpatient only), or mental health centers. Source: Treatment Episodes Data System, OAS, SAMHSA,; National Survey on Drug Use and Health, SAMHSA.

**Admissions for injection drug use**

## Progress Toward 2010 Targets

- *Percent of targeted change achieved is between -10% and 10%, and/or change not statistically significant.

**Progress Toward 2010 Targets**

- Target met or exceeded
- Improving
- Little or no change*
- Getting worse
- No trend data (baseline only)
- Dropped at midcourse
- Retained as developmental

- 4
- 16
- 15
- 3
- 2
- 3
- 5

## Summary

**Summary**

**Adolescent attitudes and behavior regarding substance abuse are improving.**
**BAC Laws have been enacted by all States.**
**Drug deaths are increasing, especially those caused by methadone and cocaine.**
**Although rates are improving, most people who need substance abuse treatment do not receive it.**
**Major disparities exist, especially for the American Indian/Alaska Native population.**

## Acknowledgements

**Acknowledgements**

**Elizabeth Jackson****	**
**Health Statistician**
**CDC/NCHS**
**EMW6@cdc.gov**
- Contributors:
- Nancy Brady, SAMHSA
- Deepthi Kandi,** **CDC/NCHS
- Jeffrey Pearcy, CDC/NCHS
- Carter Roeber, LTG Associate
- Asel Ryskulova, CDC/NCHS

## Progress review data and slides

- can be found on the web at:

**http://www.cdc.gov/nchs/hphome.htm**