Substance Dependence, Abuse and Treatment

Highlights

This report provides the first information on substance dependence, abuse, and treatment obtained from the 2000 National Household Survey on Drug Abuse (NHSDA), a project of the Substance Abuse and Mental Health Services Administration (SAMHSA). Because of major changes to the NHSDA and the definition for measuring treatment need, these estimates cannot and should not be compared with estimates from previous years.

Several important changes to the NHSDA in 1999 and 2000 affected the estimates of drug use, as well as the estimates for dependence, abuse, and needing and receiving treatment. Between 1998 and 1999, there were major changes to the design and methodology of the NHSDA and the questions in the NHSDA. In addition to the changes in 1999, in 2000 there were two changes that had a major impact on the estimates of treatment need and the treatment gap (i.e., persons who needed but did not receive treatment): (a) a change in the definition of treatment need and (b) elimination of a ratio adjustment to inflate NHSDA estimates.

A respondent in the 2000 NHSDA is defined as needing treatment if he or she met the criteria for dependence or abuse or received treatment at a specialty facility during the 12 months prior to the interview. The questions that measure dependence or abuse status are based on the criteria specified in the 4^th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (American Psychiatric Association [APA], 1994). A detailed description of the DSM-IV criteria and the questions that cover them are given in Appendix C.

Only the 2000 NHSDA data are discussed in this report. A more detailed description of the changes in the survey and their impact on the estimates can be found in Appendix C.

This report provides national estimates on the extent of substance dependence, abuse, and treatment in the United States in 2000. More detailed analyses and State-level estimates will be provided in later reports. Selected findings are given on the following pages.

Dependence on and/or Abuse of Illicit Drugs and Alcohol

• In 2000, an estimated 14.5 million Americans aged 12 or older were classified with dependence on or abuse of either alcohol or illicit drugs (6.5 percent of the total population). Of these, 1.9 million were classified with dependence on or abuse of both alcohol and illicit drugs (0.9 percent of the population). An estimated 2.4 million Americans were dependent on or abused illicit drugs but not alcohol (1.1 percent of the total population). An estimated 10.2 million Americans were dependent on or abused alcohol but not illicit drugs (4.6 percent of the population).

• Among past year users of heroin in 2000, 60.1 percent (0.2 million) were classified with dependence on or abuse of heroin. Among users of cocaine, 22.5 percent (0.7 million) were classified with dependence on or abuse of cocaine. Corresponding percentages for other substances were 15.3 percent (2.8 million) for marijuana and 11.2 percent (0.7 million) for pain relievers.

• Adults in 2000 who first used drugs or alcohol at a younger age were more likely to be classified with dependence on or abuse of substances than adults who initiated use at a later age. Among those who first tried marijuana at age 14 or younger, 10.2 percent were classified with past year illicit drug dependence or abuse compared with only 2.0 percent of adults who had first used marijuana at age 18 or older. Among those who first tried alcohol at age 14 or younger, 13.4 percent were classified with dependence on or abuse of alcohol in the past year compared with only 3.1 percent of adults who had first used alcohol at age 18 or older.

Treatment for a Substance Use Problem

• An estimated 2.8 million people aged 12 or older (1.3 percent of the population) received some kind of treatment for a problem related to the use of alcohol or illicit drugs in the 12 months prior to being interviewed in 2000. This includes treatment received at a specialty facility, as well as other locations, such as self-help groups and private physicians' offices. Of these, 0.9 million received treatment for both alcohol and illicit drugs (0.4 percent of the total population). An estimated 0.4 million persons received treatment for illicit drugs but not alcohol (0.2 percent of the total population), and an estimated 1.2 million people received treatment for alcohol but not illicit drugs (0.5 percent of the total population).

• In 2000, males were more likely to receive treatment compared with females among persons aged 12 or older, as well as among youths aged 12 to 17. An estimated 1.8 percent of males aged 12 or older received treatment for an alcohol or illicit drug problem in the past year comparedwith 0.8 percent of females. Among youths aged 12 to 17, the percentage of males who received treatment for an alcohol or illicit drug problem was 1.8 percent, and the percentage of females who received treatment was 1.3 percent, even though there were comparable rates of abuse and dependence within this age group.

• In 2000, the pattern in rates of treatment at specific locations for a problem with illicit drugs was similar to the pattern in rates of treatment at specific locations for a problem with alcohol. Among the 1.3 million people who received treatment for an illicit drug problem in the past year, most people received treatment at a self-help group (0.4 million persons). Treatment at an outpatient rehabilitation facility was the next largest group of people (0.3 million persons).

Needing and Receiving Treatment for Illicit Drug or Alcohol Use

• In 2000, an estimated 4.7 million people aged 12 or older (2.1 percent of the total population) needed treatment for illicit drug abuse problems, including 4.3 million classified with illicit drug dependence or abuse and another 0.3 million who received specialty treatment but were not dependent or abusing. Of those who needed treatment, 0.8 million people (16.6 percent of the people who needed treatment) received treatment at a specialty facility. The remaining 3.9 million (1.7 percent of the total population) did not receive specialty treatment and constitute the drug abuse "treatment gap."

• Among the 2.1 million persons aged 12 or older who received alcohol treatment in the past year, a greater number received treatment at a self-help group than any other location (0.5 million people). An estimated 0.3 million people received alcohol treatment at each of the following three locations: (a) an inpatient rehabilitation facility, (b) an outpatient rehabilitation facility, and (c) an outpatient mental health center. Rates of treatment need for illicit drugs showed similar patterns by demographic subgroup to rates for illicit drug dependence or abuse.

This page was last updated on June 16, 2008.

SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.