October 11, 2002

Substance Abuse or
Dependence
T
he NHSDA asks respondents aged 12 or
older to report on their use of alcohol
and illicit drugs, as well as their
symptoms of substance abuse or dependence
during the past year. Any illicit drug refers to
marijuana/hashish, cocaine (including crack),
inhalants, hallucinogens, heroin, or prescription-
type drugs used nonmedically. The NHSDA
defines abuse and dependence using criteria in
the American Psychiatric Association’s
Diagnostic and Statistical Manual of Mental
Disorders (DSM-IV), which includes such
symptoms as physical danger, trouble with the
law due to substance use, increased tolerance,
and interference in everyday life during the past
year (Table 1).1 The NHSDA also asks
respondents about the highest level of school
they completed.

In Brief Prevalence of Substance Use,

Abuse and/or Dependence
● In 2001, almost 17 million In 2001, an estimated 28 million persons aged
Americans aged 12 or older 12 or older (13 percent) used an illicit drug during
the past year. Of these, an estimated 450,000
abused or were dependent on (0.2 percent) had used heroin, 4 million (2 percent)
either alcohol or illicit drugs had used cocaine, 8 million (4 percent) had used
prescription-type pain relievers nonmedically,
● The highest rate of abuse or and 21 million (9 percent) had used marijuana.
dependence on alcohol or illicit Almost 17 million Americans aged 12 or
drugs was among 21 year olds older (7 percent) abused or were dependent on
either alcohol or an illicit drug during the past
● Among past year heroin users, year. Of these, approximately 11 million abused
or were dependent on alcohol only, and more
50 percent abused or were than 3 million abused or were dependent only
dependent on heroin during on an illicit drug (Figure 1). Over 2 million
the past year persons abused or were dependent on both
alcohol and an illicit drug.
The NHSDA Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration
(SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA.
Additional copies of this report or other reports from the Office of Applied Studies are available on-line: http://www.DrugAbuseStatistics.samhsa.gov.
Citation of the source is appreciated.
NHSDA REPORT: SUBSTANCE ABUSE OR DEPENDENCE
Figure 1. Estimated Numbers (in Thousands) of
Persons Aged 12 or Older Reporting Past Year
Abuse or Dependence for Any Illicit Drug* or Alcohol:
2001
2,423 3,181
10,975
Types of Illicit Drugs
Among past year users of heroin, 50
percent (200,000 persons) abused or
were dependent on heroin during the
past year (Figure 2). About 25
percent of past year cocaine users
(1 million persons) abused or were
dependent on cocaine. Among past
year marijuana users, about 17
percent (almost 4 million persons)
abused or were dependent on
marijuana, and 12 percent of
prescription-type pain reliever
(nonmedical) users (1 million
persons) abused or were dependent
on this substance.
Demographic
Characteristics
Rates of abuse of or dependence on
alcohol or an illicit drug were
highest among young adults aged 18
to 25 (18 percent), followed by
youths aged 12 to 17 (8 percent) and
adults aged 26 or older (5 percent).
The highest rate of abuse of or
Figure 2. Percentages of Persons Reporting
Dependence or Abuse among Past Year Users of
Specific Drugs: 2001
100%
80%
60%
50.0
40%
20%
Any Illicit Drug Only
Alcohol Only
0%
Both Alcohol and Heroin
Any Illicit Drug
dependence on alcohol or an illicit
drug was among 21-year olds (23
percent); prevalence generally
decreased with each increasing year
of age thereafter (Figure 3).
Males aged 12 or older were
twice as likely as females to abuse or
be dependent on alcohol or any illicit
drug (10 percent versus 5 percent,
respectively). Rates of abuse or
dependence on alcohol or illicit
drugs among persons aged 12 or
older were highest among American
Indians/Alaska Natives (14 percent),
followed by Hispanics (8 percent),
whites (8 percent), blacks (6 percent),
and Asians (4 percent).
Education and Substance
Abuse or Dependence
In general, among adults aged 18 or
older, rates of abuse of or
dependence on alcohol or an illicit
drug were higher among those who
had not completed high school than
those who completed high school or
college (Figure 4). For instance, 8
October 11, 2002
24.9
16.5
11.8
Cocaine Marijuana Pain
Relievers**
percent of those who had not
completed high school abused or
were dependent on alcohol or illicit
drugs during the past year compared
with 6 percent of college graduates.
End Note
1. American Psychiatric Association. (1994).
Diagnostic and statistical manual of mental
disorders (4th ed.). Washington, DC: Author.
Table and Figure Notes
Note: Abuse or dependence is based on the
definition found in the 4th ed. of the Diagnostic
and Statistical Manual of Mental Disorders
(DSM-IV).
*Any Illicit Drug refers to marijuana/hashish,
cocaine (including crack), inhalants,
hallucinogens, heroin, or prescription-type
drugs used nonmedically.
**Prescription-type pain relievers used
nonmedically.
Source (all figures): SAMHSA 2001 NHSDA.
Source (Table 1): American Psychiatric
Association. (1994). Diagnostic and statistical
manual of mental disorders (4th ed.).
Washington, DC: Author.
October 11, 2002 NHSDA REPORT: SUBSTANCE ABUSE OR DEPENDENCE

Figure 3. Percentages of Persons Aged 12 or Older Figure 4. Percentages of Adults Aged 18 or Older
Reporting Past Year Abuse or Dependence for Reporting Past Year Abuse or Dependence for
Alcohol or Any Illicit Drug,* by Detailed Age Alcohol or Any Illicit Drug,* by Highest Year of
Categories: 2001 Education Completed: 2001

0% 5% 10% 15% 20% 25%

0.9 9% 8.2
12 8.0
13 2.4 8% 7.2
14 5.7 7%
6.1
15 10.5
6%
16 12.3
5%
17 15.2
18 17.4 4%

19 20.2 3%
20 20.2 2%
21 22.8
Age Category

1%
22 20.3
0%
23 17.1 Less than High School Some College
24 15.2 High School Graduate College Graduate
25 13.0
26-29 10.5
30-34 8.6
35-39 8.4
40-44 6.9 Table 1. DSM-IV Diagnosis of Substance Abuse or
45-49 5.2 Dependence.
50-54 3.2
55-59 3.2 A person is defined with abuse of a substance if he or
she is not dependent on that substance and reports one
60-64 2.2
or more of the following symptoms in the past year.
65 or Older 1.6
1. Recurrent use resulting in failure to fulfill major
obligations at work, school, or home
2. Recurrent use in situations in which it is physically
hazardous (e.g., driving an automobile)
The National Household Survey on Drug Abuse (NHSDA) is an annual 3. Recurrent substance-related legal problems
survey sponsored by the Substance Abuse and Mental Health Services 4. Continued use despite having persistent or recurrent
Administration (SAMHSA). The 2001 data are based on information social or interpersonal problems
obtained from 69,000 persons aged 12 or older. The survey collects data
by administering questionnaires to a representative sample of the A person is defined as being dependent on a substance
population through face-to-face interviews at their place of residence. if he or she reports three or more of the following
The NHSDA Report is prepared by the Office of Applied Studies (OAS), symptoms in the past year.
SAMHSA, and by RTI in Research Triangle Park, North Carolina. 1. Tolerance—discovering less effect with same amount
Information and data for this issue are based on the following publications
(needing more to become intoxicated)
and statistics:
2. Withdrawal (characteristic withdrawal associated with
Office of Applied Studies. (2002). Results from the 2001 National type of drug)
Household Survey on Drug Abuse. Volume I. Summary of national findings 3. Using more or for longer periods than intended
(NHSDA Series H-17, DHHS Publication No. SMA 02-3758). Rockville, MD:
4. Desire to or unsuccessful efforts to cut down or control
Substance Abuse and Mental Health Services Administration.
substance use
Epstein, J.F. (2002). Substance dependence, abuse, and treatment: 5. Considerable time spent in obtaining or using the
Findings from the 2000 National Household Survey on Drug Abuse (NHSDA substance or recovering from its effects
Series: A-16, DHHS Publication No. SMA 02-3642). Rockville, MD:
6. Important social, work, or recreational activities given up
Substance Abuse and Mental Health Services Administration, Office of
or reduced because of use
Applied Studies.
7. Continued use despite knowledge of problems caused
Also available on-line at http://www.DrugAbuseStatistics.samhsa.gov. by or aggravated by use
Additional tables available upon request.

U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES

Substance Abuse & Mental Health Services Administration
Office of Applied Studies
www.samhsa.gov