Focus Area 26 Substance Abuse Progress Review

1
Focus Area 26Substance AbuseProgress Review
Richard J. Klein National Center for Health
Statistics October 2, 2008
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Substance Abuse

• 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)

Source Excerpt from SAMHSA NIH/NIDA
congressional appropriations testimonies, 2004
National Survey on Drug Use and Health, SAMHSA.
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Highlighted Objectives
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 1st 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
Improving
Getting worse
Little or no change
Target met
Percent of targeted change achieved is between
-10 and 10, and/or change not statistically
significant.
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Adolescent Alcohol Behavior
Percent
50
40
30
Never drank alcohol HS Seniors
20
10
0
2002
2004
2006
2000
2007
1998
1999
2001
2003
2005
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.
Obj. 26-9c
5
Adolescent Alcohol Behavior
Percent
50
40
Binge drinking HS Seniors
30
20
10
0
2002
2004
2006
2000
2007
1998
1999
2001
2003
2005
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.
Obj. 26-11a
6
Adolescent Alcohol Behavior
Percent
50
2010 Target 30
40
Binge drinking HS Seniors
30
Never drank alcohol HS Seniors
20
10
0
2002
2004
2006
2000
2007
1998
1999
2001
2003
2005
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.
Objs. 26-6, 9c 11a
7
Disapproval of Drinking Alcohol Daily,
Adolescents
2007
1998
Percent
2010 Target 83
8th grade
12th grade
10th grade
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.
Obj. 26-16 a-c
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Cirrhosis Deaths, 2001-2005
2010 Target 3.2
Age-adjusted per 100,000 population
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 SystemMortality, CDC,
NCHS.
Obj. 26-2
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Cirrhosis and Alcohol-Induced Deaths, 2005
Per 100,000 population
Cirrhosis Deaths
Total
American Indian
Hispanic
White
Black
Asian
Male
Female
25
15
5
0
20
10
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 SystemMortality, CDC, NCHS.
Obj. 26-2
10

Alcohol-Related Motor Vehicle Fatalities
1998
2006
Per 100,000 population
(2007)
Total
American Indian
Black
Asian
White
Hispanic
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).
Obj. 26-1a
11
States with Alcohol Related Laws
States and DC
51
51
51
51
51
50
46
42
42
42
42
42
42
42
42
42
42
32
28
19
18
15
0
0
01
02
05
2007
1998
99
06
04
03
00
01
02
05
99
06
04
00
2007
1998
03
Administrative License Revocation Laws
.08 Blood Alcohol Concentration Laws
Source Department of Transportation (DOT),
National Highway Traffic Safety Administration
(NHTSA).
Objs. 26-24 25
12
Marijuana Use, Adolescents 12-17
Average age at 1st use among new users
2002 15.0 years
2007 15.3 years
New users used marijuana for the first time in
the past 12 months. Source National Survey on
Drug Use and Health, SAMHSA.
Objs. 26- 9b 10b
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Disapproval of Trying Marijuana, Adolescents
2007
1998
Percent
2010 Target 72
8th grade
12th grade
10th grade
Note Data are for students who disapprove of
trying marijuana or hashish once or
twice. Source Monitoring the Future, NIH,
NIDA.
Obj. 26-16 d-f
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Drug-Induced Deaths
1999
Per 100,000 population
Total
American Indian
Black
Asian
White
Hispanic
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
SystemMortality, CDC, NCHS.
Obj. 26-3
15

Drug-Induced Deaths
2005
1999
Per 100,000 population
Total
American Indian
Black
Asian
White
Hispanic
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
SystemMortality, CDC, NCHS.
Obj. 26-3
16

Drug-Induced Deaths, 2001-2005
2010 Target 1.2
Age-adjusted per 100,000 population
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 SystemMortality, CDC, NCHS.
Obj. 26-3
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Needing and Receiving Treatment
2010 Target 24
Admissions for injection drug use
2010 Target 16
1997 215,560
2010 Target 11.9
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.
Objs. 26-18, 20 21
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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
Percent of targeted change achieved is between
-10 and 10, and/or change not statistically
significant.
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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.

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Acknowledgements
Elizabeth Jackson Health Statistician CDC/NCHS EM
W6_at_cdc.gov Contributors Nancy Brady,
SAMHSA Deepthi Kandi, CDC/NCHS Jeffrey Pearcy,
CDC/NCHS Carter Roeber, LTG Associate Asel
Ryskulova, CDC/NCHS
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Progress review data and slides can be found on
the web at
http//www.cdc.gov/nchs/hphome.htm