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Denial keeps millions of Americans from seeking treatment for potentially life-threatening drug and alcohol problems, according to findings from the 2002 National Survey on Drug Use and Health.

About 22 million Americans last year—9.4 percent of the total population aged 12 or older, which is about 234 million people—were either dependent on or abused drugs, alcohol, or both, according to the results of the 2002 National Survey on Drug Use and Health (NSDUH), a survey commissioned by the Substance Abuse and Mental Health Services Administration (SAMHSA).

The vast majority of that group, almost 15 million people, abused or were dependent on alcohol alone.

The survey also found that 19.5 million people, or about 8 percent of the population over age 12, reported current use of illicit drugs. Marijuana (including hashish) was the most commonly used drug of abuse in 2002—14.6 million Americans used it during the previous year. The next most popular form of drug use was the nonmedical use of prescription drugs (6.2 million people). Of these, an estimated 4.4 million people used narcotic pain relievers, 1.8 used antianxiety medications, 1.2 million used stimulants, and 250,000 used sedatives. Other illicit drugs reported include cocaine, hallucinogens, and heroin (see chart).

Most Fail to Get Treatment

SAMHSA officials estimated that 7.7 million people needed treatment for a drug problem yet found that only 1.4 million received treatment for drug abuse or dependence at a treatment facility during the year prior to the survey.

Of the 6.3 million who needed treatment for drug-related problems but did not receive it, only about 362,000 reported they felt they even needed such treatment, the survey showed. This number included 88,000 people who said they tried but were unable to get treatment.

"We need to take the courageous step of helping people find successful recovery in greater numbers," said White House Director of National Drug Control Policy John Walters at a press conference to announce the findings in Washington, D.C., in September. "We know we can save lives."

Walters pointed out that the denial surrounding drug and alcohol abuse "is one of the most difficult, frustrating, and dangerous aspects of this problem."

Surveyors gathered information on topics such as drug, alcohol, and tobacco use on 70,000 people aged 12 and over in their homes between January and December 2002.

From its inception in 1971 to 2002, the survey was known as the National Household Survey on Drug Abuse. Concerns about undercounting and other problems with survey methodology prompted SAMHSA officials to establish quality-control measures for data collection on drug and alcohol use and abuse for the new version of the survey. In addition, declining response rates to the household survey over the years led to a $30 incentive payment to respondents, beginning with the NSDUH.

As a result of these changes, precise data comparisons cannot be made between findings from the new NSDUH survey and those from past years except on age of first drug and alcohol use and lifetime prevalence of drug and alcohol use.

Fewer Taking Up Smoking

Findings revealed that 30 percent of the population aged 12 and older, or 71.5 million people, used tobacco—mostly cigarettes. However, the number of new daily smokers dropped from 21.5 million a year in 1998 to 1.4 million in 2001.

Among youth under 18, the number of new smokers dropped from 1.1 million per year between 1997 and 2000 to 757,000 in 2001.

The survey found widespread alcohol abuse among survey participants. When extrapolated to the population at large, the survey indicated that more than 20 percent of the population, an estimated 54 million persons aged 12 and older, reported binge drinking, which is defined as having five or more drinks on the same occasion at least once in the preceding month.

"Underage drinking remains a stubborn, destructive problem," said SAMHSA Administrator Charles Curie. "About 10.7 million people aged 12 to 20 reported drinking alcohol in the month prior to the survey."

Almost 7 percent of the population, about 15.9 million people, reported heavy use of alcohol, defined as having five or more drinks on the same occasion on at least five different days in the preceding month.

In addition, about 1 in 7 Americans aged 12 or older (14.2 percent, or 33.5 million people) admitted driving "under the influence" of alcohol at least once in the year prior to the survey.

"Alcoholism has permeated my family for generations," said Lynn Cooper, who appeared at the press conference to present a human side to the statistics. Although she is now in her 13th year of recovery, Cooper said for years she was a "functional alcoholic." After having her first drink in early adulthood, Cooper said, "I didn’t stop until it almost killed me. Literally."

Cooper waged a long war against the bottle. "I tried hundreds of times. One morning, I realized I couldn’t do it on my own," she recalled.

She entered a 90-day treatment program and joined a support group. Her recovery, she said, led to the recovery of her daughter and son-in-law from drug and alcohol abuse.

Her grandchildren "were born into a family of recovery," she said. "Addiction treatment is effective, and recovery happens."

Findings from the 2002 National Survey on Drug Use and Health are posted on the Web at http://www.samhsa.gov/oas/nhsda.htm#NHSDAinfo.

Related articles in Psychiatric News:

Cost, Confidentiality Keep Many From MH Treatment
Eve Bender
Psychiatric News 2003 38: 13. [Full Text]

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