Older vs Younger Users

Older Adult Drug use Increases while
Youth Drug Use Continues Downward Slide

The Substance Abuse and Mental Health Services Administration recently announced that current illicit drug use among youth ages 12-17 continues to decline.   The rate has been moving downward from 11.6 percent using drugs in the past month in 2002 to 11.2 percent in 2003, 10.6 percent in 2004 and 9.9 percent in 2005.  This initial report from the 2005 National Survey on Drug Use and Health (NSDUH), released at the annual observance of National Alcohol and Drug Addiction Recovery Month Observance, focuses on significant trends in substance abuse and mental health problems since 2002.

Similarly, the rate of current marijuana use among youth ages 12 to 17 declined significantly from 8.2 percent in 2002 to 6.8 percent in 2005, and the average age of first use of marijuana increased from under age 17 in 2003 to 17.4 years in 2005.  Furthermore, drinking among teens declined, with 16.5 percent of youth ages 12-17 reporting current alcohol use and 9.9 percent reporting binge drinking.  This compares with 17.6 percent of this age group reporting drinking in 2004 and 11.1 percent reporting binge drinking in the past month in 2004.  These declines in alcohol use by youth, ages 12-17, follow years of relatively unchanged rates.

For young adults, ages 18-25, the picture is mixed.  While there were no significant changes in overall past month use of any illicit drugs in this age group between 2002 and 2005, cocaine use increased from 2.0 in 2002 to 2.6 percent in 2005.  Past-month nonmedical use of prescription drugs among young adults increased from 5.4 percent in 2002 to 6.3 percent in 2005, due largely to an increase in the nonmedical use of narcotic pain relievers.  The rate was 4.1 percent in 2002 and 4.7 percent in 2003, 2004 and 2005.

The baby boomer generation presents a different story.  Among adults aged 50 to 59, the rate of current illicit drug use increased from 2.7 percent to 4.4 percent between 2002 and 2005, reflecting the aging into this age group - the baby boom cohort.
There was no significant change in the number of current heroin users in 2005 (136,000), nor in the rate of heroin use (0.1 percent), compared with estimates from 2004, 2003, and 2002.

Substance Dependence or Abuse

In 2005, an estimated 22.2 million persons (9.1 percent of the population ages 12 and older) were classified with substance dependence or abuse in the past year, based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV).  Of these, 3.3 million were dependent on or abused both alcohol and illicit drugs; 3.6 million were dependent on or abused illicit drugs but not alcohol; and 15.4 million were dependent on or abused alcohol, but not illicit drugs.  These numbers are basically unchanged since 2002.

There were 2.3 million people who received treatment at a specialty facility in 2005.  There were 1.2 million persons who reported that they felt they needed treatment for an illicit drug or alcohol use problem, but of these 865,000 reported making no effort to get treatment.  There were 296,000who reported they had made an effort to get treatment.  These numbers were not statistically different from the numbers in the 2004 survey.

Adults ages 21 or older who had first used alcohol before age 21 were almost 5 times more likely than adults who had their first drink at age 21 or older to be classified with alcohol dependence or abuse (9.6 percent compared to 2.1 percent).

Co-occurring Substance Use and Serious Psychological Distress

Serious psychological distress, as measured by the survey administered to adults ages 18 and older, was associated with past year substance dependence or abuse in 2005.  Among the 24.6 million adults with serious psychological distress in 2005, 21.3 percent (5.2 million) were dependent on or abused illicit drugs or alcohol.  The rate of substance dependence or abuse among adults without serious psychological distress was 7.7 percent (14.9 million people).

Among the 5.2 million adults with both serious psychological distress and substance dependence or abuse in 2005, 47 percent received mental health treatment or substance use treatment at a specialty facility: 8.5 percent received both treatment for mental health and substance use disorder, 34.3 percent received only treatment for mental health problems, and 4.1 percent received only specialty substance use treatment.


There were 30.8 million adults who had at least one major depressive episode in their lifetime, and 15.8 million adults (7.3 percent of persons ages 18 and older) who reported a major depressive episode in the past year.  This is a statistically significant decline from 17.1 million adults (8 percent) reporting past year major depressive episodes in 2004.

Having a major depressive episode in the past year was associated with past year substance dependence or abuse.  Among adults in 2005, 19.9 percent were dependent on or abused alcohol or illicit drugs, while among persons without a major depressive episode only 8.4 percent were dependent on or abused alcohol or illicit drugs.

In 2005 there were 3.4 million youths ages 12 to 17 (13.7 percent of that population) who had at least one major depressive episode in their lifetimes and 2.2 million youths (8.8 percent) who had a major depressive episode during the past year.  The occurrence of a major depressive episode in the past year among youths ages 12 to 17 was associated with a higher prevalence of illicit drug or alcohol dependence or abuse (19.8 percent).  This compares to 6.9 percent for youths who did not report past-year major depressive episodes.

The National Survey on Drug Use and Health is an annual survey of approximately 67,500 people.  The survey collects information from residents of households, residents of non-institutionalized group quarters and civilians living on military bases.

Recovery Month is observed in September to recognize the accomplishments of people in recovery, the contributions of treatment providers, and advances in substance abuse treatment.

(Source: Substance Abuse and Mental Health Services Administration: The National Survey on Drug Use and Health)


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