Trends and Patterns of Drug Use

(See: Drugs in American Society, 5th, 6th, 7th, 8th, and 9th editions, Erich Goode, McGraw-Hill, 1999/2005/2008/2012/2014. Chapters 6/7/1, and Mosher and Akins, Drugs and Drug Policy: The Control of Consciousness Alteration, Sage Publications, 2007. Statistics are gathered from the various surveys discussed, especially: Substance Abuse and Mental Health Services Administration, Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.)

Categorizing Varieties of Use:

Legal Status:

Purpose/Goal of Use

 

Illegal Instrumental

Goal approved, means not necessarily.

Illegal Recreational

Drug use is end in itself, not means to an end: Get High

Legal Instrumental

OTC and Pharmaceuticals

Legal Recreational

ASC, Social use

World Drug Report Archive

World Drug Report: 2012 (Transnational Institute Response to the 2008 report)

2016 World Drug Report (local copy)

Legal Instrumental Use

Besides accepted medical use, instrumental use of other legal drugs: Nicotine==> Stay awake while studying.

OTC (Over-The Counter)

  • Proprietary drugs
  • $29.3 billion in sales for all, $11.6 billion psychoactive, for 2012 ($15 billion total sales in 1995)
  • Not strongly psychoactive (in USA)
  • Rarely used for high (last resort, Look Alikes)
  • Fairly Safe: Acetaminophen 20,543 non-lethal ER and 113-980 deaths (2013) vs. 27 billion doses sold (2009).

Prescription

  • Ethical/Legend (established in 1938)
  • Advertised only to doctors until 1997 when congress approved direct to consumer advertising.
    • 2009: FDA and Congress cutting back on drug advertising
    • "In a recent IMS survey on direct-to-consumer advertising, 29% of physicians said they received specific requests from patients for Claritin, making it by far the most frequently requested brand-name product," noted Paul Allen, Vice President, Product Management at IMS. "Overall, Schering spent $18.5 million in the first half of 1997 alone on TV ads. However, they were outspent by Merck, Novartis, Glaxo Wellcome, and Pfizer. Now that companies can communicate brand and indication in the same TV ad, we expect the industry's investment in this type of marketing to double."  (Pharmacy Times, 1999)

      "Advertisements on TV or in magazines have made some people aware of conditions they didn’t realize they had, or of new treatments for conditions that they were aware of. In certain cases, DTC ads have made patients aware that they are not alone in suffering from various conditions, and that help is available." (Pharmacy Times, 2001)

  • Shopping for Drugs.
  • Prescription Status set by Pharmaceutical Industry until 1951.
  • Legitimate for medical purposes
  • Prescribed by licensed Physician (300,000)
  • Sold by licensed Pharmacy (150,000 pharmacists; 60,000 pharmacies)
  • MAJOR SOURCE OF PSYCHOACTIVE DRUG USE
    1. Over $145,092,763,000 per year in sales (2000); $124,835,595,000 (1999) (Pharmacy Times) (around $95 Billion in 1997)
    2. 1,563,974,000 New Prescriptions in 2000.
    3. 2.98 billion total prescriptions in 2000, 2.8 billion in 1999, 2.5 billion in 1997, 2.4 billion in 1996, 1.5 billion in 1990 (Pharmacy Times, 1999 and Pharmacy Times, 2001)
    4. 1 in 5 are psychoactive (approximately).
    5. 2007: Spending on Psychotherapeutic Drugs Soars
    6. Sales top $300 billion in 2010 (local copy)--soar to $374 billion in 2014 and $448 Billion in 2016!
    7. Therapeutic Drug Use (CDC): 2011-2014 48.9% of the US population used at least one presription drug in the past 30 days.

Use and Distribution of Prescription Drugs

Researching, Developing, Testing, and Marketing a new drug

Valium

  • Mid 1960's==> #1: $250 million/year
  • 1975 was its best year==> 61.3 million prescriptions
  • 1980 only 33.6, yet still best seller
  • Patent expired 1980, falls to #3, then #4 in 1983
  • 1984 three companies market generic diazepam
  • 1986-- Valium is #11; 1990 #47
  • 2012, sales of generic versions of diazepam no longer in top 200 in sales but 86 by prescriptions dispensed (2014), and even Alprazolam (Xanax) appears to be slipping.

As of 1990 sales of all generics account for one-third of the market

  • We're talking BIG BUCKS here!
  • The role of advertising in the health industry has been critiqued by a number of commentators.
  • $1000's are spent per physician, millions more on direct-to-consumer ads today: "As DTC ads become more and more common, we may see future increases in prescriptions for products for depression, allergies, arthritis, and gastrointestinal problems. (Pharmacy Times, 2001)

    Concern is that the drive for profits by pharmaceutical companies, leads to the over prescribing of psychoactive medicine as doctors are inundated with information on the "wonders" of these drugs (and demands for certain drugs by their patients).

Interestingly, from the early 1970's through the mid 1980's, prescriptions for:

  • Barbiturates dropped by 90%
  • Amphetamines dropped by 60%
  • Methaqualone (which skyrocketed from 1976-1986) fell to NO prescriptions

What's Going on Here??

"Pharmacological Revolutions"

(Oakley Ray, Erich Goode, and Keel)
  1. Vaccines: Polio, Smallpox==> Medicines as powerful and beneficial
  2. Antibiotics (1940's)==> Faith in drugs as cures
  3. Anti-psychotics==> Acceptance of drug's impact on the mind
  4. Oral Contraceptives==> Use drugs on healthy body in order to gain control
  5. Decline in the use of psychoactive drugs, overall, by a factor of 50%==> "We can get along without them." (Goode)

One notable exception to overall trend in Psycho-Pharmaceuticals during the 1980s: Prozac. (And, perhaps, the herald of a "new age")

  • Hit the market in 1987
  • Quickly takes #1 spot: 1 million prescriptions/month
  • 1988-89 prescribing up X3
  • 1989-1990 up another 60%
  • Now??? Horror Stories, but major legal struggle by Eli Lilly to defend the drug. Current status: warnings but no official action.
  • Currently (2012) no longer on top 200 list (beat by both Cymbalta and Lexapro) and SSRIs rank 23rd for number of prescriptions written, and 5th for sales.
  • And, over the last two decades: Ambien, Lunestra, Strattera, Viagra....SO:

This (#5) appears to have been a short-lived revolution. Now maybe beginning of #6- "Better Living Through Chemistry: Part 2"

"Although only one antidepressant (Zoloft) made it to the top 10 of total prescriptions, on the money side, manufacturers of such medications had nothing to be depressed about. Two of the top grossing drugs in 2000 were antidepressants—Lilly’s Prozac and Pfizer’s Zoloft. Also among the top 10 earners was the antipsychotic drug Zyprexa. And coming in at number eleven was the antianxiety agent, Paxil. The SSRI category ranked third in the top 20 categories ranked by total prescriptions dispensed, third in new prescriptions dispensed, and second in total dollar sales. Dollar sales for the SSRI/SNRI category rose 19% from 1999 to reach a huge $8.33 billion." (Pharmacy Times, 2001)

(BTW: These revolutions are significantly related to illicit use, too.)

Problem: As we enforce tighter controls on one drug, others, sometimes older and more problematic drugs, other times new "replacements" drugs, increase in use and problems increase. 1989 NY law on benzodiazepines (which were created to replace the more problematic barbiturates) and other similar "minor" depressants, led to significant increases in the use of more problematic depressants, including barbiturates. And, Prozac, created to (at least partially) replace the benzodiazepines, seems to have its own problems.

INTEREST: If a drug is psychoactive, it rarely remains purely instrumental

  • Heroin, Cocaine all original used medically, even OTC
  • Heroin: Pain==> Britain
  • Amphetamines: Inhalers
  • Marijuana: Glaucoma, AIDS, Chemotherapy
  • U.S. stopped marijuana use for medical purposes: 1985 (Marinol), supported by DEA in 1992
  • Physicians often hesitate to use even strong doses of morphine to relieve the pain of terminally ill cancer patients: "Problem of addiction"

Important: Definition of legal/illegal; instrumental/recreational SHIFTS (Relativity)

Legal Recreational Use

Tremendous marketing/advertising activity

  • Huge profits: Tobacco and Kids ("Who Profits From Tobacco Sales to Children?" 1990)
  • $1.23 billion in sales to children
  • $52 million in Federal taxes
  • Office of Smoking and Health Budget: $3.5 million
  • Children cultivated as lifelong/permanent market
  • But: Now Federal Government is debating defining nicotine as addictive and is seeking to regulate advertising, promotions, and sales.
  • 2006 Update on tobacco sales to youth

Not identical to illegal recreational, but close

Pleasure is not an either/or proposition, but a continuum

Cigarette smoking and health events, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. "Achievements in Public Health, 1900-1999: Tobacco Use -- United States, 1900-1999." 1999.

Tobacco:

Americans 12 and up
1991
2001
 2002 2012 2016
Cigarettes     26.0% 22.1% 19.1%
Smoke tobacco (past month)
27%
29.5%
 30.4% 26.7% 23.5%
Smokeless tobacco
3.4%
3.2%
 3.3% 3.5% 3.3%
Cigars (6.9% 1998)
5.4%
5.4% 5.2% 4.6%

Past Month Tobacco Use among Persons Aged 12 or Older: 2002-2013 (Latest NSDUH)

past month tobacco use 2002-2012

 

Past Month Tobacco Use among Youths Aged 12 to 17: 2002-2013 (Latest NSDUH)

teen tobacco use 2002-2012

  • Smokers 4 times more likely to be heavy users of ETOH and illicit drugs
  • Rate of use of alcohol and nicotine (except among the young) is declining, except for Caffeine (most popular)
  • Nicotine alone is used by more people than all illicit drugs combined
  • Nicotine is used most frequently by those who use drug
  • eCigarettes

Current MTF Data (MTF: Cigarettes: Trends in 30-Day Use, Risk, Disapproval, and Availability in Grades 8, 10, and 12

Current National Survey on Drug Use & Health

Alcohol:

Historical Data:

Recent Alcohol Industry Statistics

Contemporary Trends:

Where people drink the most booze and do the most drugs. Washington Post Wonkblog, 5/23/2016.

Americans 12 and up 1991
2001
 2002 2010 2013 2016
Ever tried ETOH 85%
81.7%
 83% 82.5% 82.3% 80.2%
Used ETOH past month 52%/21% teens
48.3%/teen use stable
 51% 51.8% 52.2% 50.7%
Binge Drinkers --
20.5% (15.7% 1998)
 22.9% 23.1% 23% 24.2%
Heavy Drinkers (binge 5x/month) --
5.7% (5.9% 1998)
 6.7% 6.7% 6.3% 6.0%

Current, Binge, and Heavy Alcohol Use among Persons Aged 12 or Older, by Age: 2013 (Latest NSDUH)

alcohol use by age 2012

Correlates of legal drug use

Illegal Instrumental

  • Socially Approved Purpose
  • User's self-image==> NOT "drug" user; Don't seek "High," "technically illegal- but not criminal or deviant"
  • Viewed similar to OTC use
  • Public Opinion: Goal is OK, means--problematic, but not "as" deviant as illegal recreational

Sources

  • Diversion of legally manufactured pharmaceuticals
  • "Script" doctors
  • Illicit manufacture
  • Smuggling

Steroid use (Goldstein's "Anabolic Steroids: An Ethnographic Approach)

  • Element of and often focal point of subculture
  • Link to roles and status and expectations from dominant culture
    • Masculinity
    • Perfect Body
    • Sex appeal
    • Success
    • Winning is everything

Illegal Recreational Use

  • Big Bucks here: U.S.- consume 60% of world's output
  • Internationally, spend more on illicit drugs than any other product or service ($1/2 trillion) (accuracy?)
  • U.S. sales (DEA est.) $80 billion in 1980; $30-130 billion is the typical range
  • U.S. News and World Report-- $100 billion
  • Whatever: HUGE DEMAND
  • Statistics are difficult, no records kept of the sales
  • Drug Use in Europe: The European Monitoring Centre for Drugs and Drug Addiction
  • World Drug Report Archive

Newsbrief: UN Reports Drug Use on the Rise Worldwide
http://www.stopthedrugwar.org/chronicle/243/worldofdrugs.shtml

"The United Nations Drug Control Programme has released its annual report, showing an increase in global drug consumption. According to the report, 185 million people now use illicit drugs. 147 million of these are cannabis (marijuana) users, but the increase of global consumption is primarily due to increased use of ecstasy and amphetamines.

Worldwide, cannabis use is most popular among individuals ages 18 to 20, and other drugs are most popular among those aged 18 to 25. Almost half of all 10th graders in the United States have used drugs, the report says, though the rate has fallen somewhat since last year. No other country in the world was reported to have a rate nearly that high, despite the massive US drug war effort."

2005 World Drug Report (from the executive summary):

"Some 200 million people, or 5% of the world’s population age 15-64, have used drugs at least once in the last 12 months. This is 15 million people higher than last year’s estimate but remains significantly lower than the number of persons using licit psychoactive substances (about 30% of the general adult population use tobacco and about half use alcohol). The number of cannabis users worldwide is now close to 160 million people or 4% of the population age 15-64. Estimates of the number of ATS users - 26 million people using amphetamines and 8 million using ecstasy - are slightly lower than those of last year ’s World Drug Report (WDR), reflecting declines of methamphetamine use in South-East Asia (notably Thailand) and of ecstasy use in North America (notably in the USA). The number of opiate users is estimated to have risen slightly to around 16 million people (11 million of which abuse heroin), mainly reflecting increasing levels of opiate abuse in Asia. No significant changes were observed in most other parts of the world. The number of cocaine users – close to 14 million people – rose slightly.

Unsurprisingly, the main problem drugs at the global level continue to be the opiates (notably heroin) followed by cocaine. For most of Europe and Asia, opiates continued to be the main problem drug, accounting for 62% of all treatment demand in 2003. In South-America, drug related treatment demand continued to be mainly linked to the abuse of cocaine (59% of all treatment demand). In Africa, the bulk of all treatment demand – as in the past – is linked to cannabis (64%)."

Major Domestic surveys:

NIDA supported Institute for Social Research, "Monitoring the Future survey of High School Students and Young Adults (since 1975)

SAMHSA supported "National Survey on Drug Use & Health " (NSDUH) (Formerly called the National Household Survey) (since early 1970's) 

DAWN Report (since mid 1970's) (see below)(lost funding in 2011)

ADAM: Arrestee Drug Abuse Monitoring Program. ADAM II since 2007 (Reports). 2014 Funding for ADAM II cut.

Pulse Check: January 2004 (local copy) St. Louis 2004 (local copy) January 2002 Report (local copy) seems to have lost funding. 2004 was last year available)

Complete listing of federal data sources

Other sources

MTF (ISR) Focus:

  • Use: Lifetime, Annual, 30 day, Daily (20/30)
  • Attitudes
  • Follow-up: Young Adults
  • Good on trends: How extensive, Use increasing or decreasing

SAMSHA  National Survey on Drug Use & Health

  • Pre 1990: 12-17, 18-25, over 26 years of age
  • Now 26-34, and over 35 years of age
  • No figures of daily use
  • No military, prisons, or homeless

General Findings

(NSDUH 2013)
  • ETOH and Nicotine extensively used-- Legal, Available, long cultural history
  • About 48.6% (over 100 million people) have tried illicit drugs. 2016: 48.5%
  • 15.9% used past year (12.6% 2001 NHS). 2016: 18%.
  • 9.4% past month (7.1% 2001) 2016: 10.6
  • ~3-4% are "frequent users (51 or more days over past year)
  • Over two-thirds of illicit use is Marijuana (used by 80.6% of past month illicit users, 62.9% only use marijuana): 43.7% lifetime use, 12.6% past year, 7.5% past month. (slight upward trend)

Current NHDUH

Cocaine, Hallucinogens, and non-medical use of pain relievers "tie" for the #2 spot in lifetime use.

  • Hallucinogens: 15.1%, Cocaine: 14.3%, and pain relievers: 13.5% lifetime (cocaine up compared to 2007, pain relievers down over 1% from 2012)

Cocaine

  1. 1.6% past year (2% occassional 1997 NHS)
  2. .6% past month (.9% 1998 NHS) this is also the same as for frequent use,
  3. .1% are past month crack users (.7% 1997, .2% in 2012)
  • Hallucinogen use is "high" too--1.7% past year, and .5% past month
  • 5.8% have used other psychotherapeutic drugs illicitly in the past year. 2.5% in past month (OxyContin use is declining sharply)
  • Methamphetamie: 4.7% lifetime, .5% past year, .2% past month
  • Figures on heroin too small for accuracy
  • Past Month Use 2002-2012 for various illicit drugs.
  • Latest NSDUH

Past Month Use of Selected Illicit Drugs among Persons Aged 12 or Older: 2002-2013 (Latest NSDUH)

 

Past Month Illicit Drug Use among Persons Aged 12 or Older, by Age: 2012-2013 (Latest NSDUH)

Past Month Illicit Drug Use among Persons Aged 12 or Older, by Age: 2002-2013 (Latest NSDUH)

Past Month Illicit Drug Use among Adults Aged 50 to 64: 2002-2013 (Latest NSDUH)

Past Month Nonmedical Use of Types of Psychotherapeutic Drugs among Persons Aged 12 or Older: 2002-2013 (Latest NSDUH)

Past Month and Past Year Heroin Use among Persons Aged 12 or Older: 2002-2013 (Latest NSDUH)

High School Seniors (3/4 of users of illicit drugs)

Current MTF Data (MTF 2009 Overview)

Marijuana (8th-12th) #1:

Stimulant (amphetamines) (8th-12th) #2:

Cocaine (all forms) (8th-12th) #3 (also synthetic marijuana):

Vicodin (8th-12th) #4 (down from #2 in 2009)

Tranquilizers, Cough Syrup, and Oxycotin--#5-#7

Relative to other Illicit drugs, Marijuana Use is in a class by itself!

And, Alcohol, of course:

And, Tobacco (past month):

Continued Use (Latest NSDUH)

  • Some try, then stop
  • Some use infrequently

  • Others: Loyalty

    • Highest in user loyalty: Alcohol and Cigarettes
      1. 63% of those who have ever used ETOH, used in past 30 days
      2. 40% of those who have ever used Nicotine, used in past 30 days
    • Crack was at about 25% of ever used, used past 30 days(1990), in 2012 it's at 6%-- but this ratio has fallen in recent years.  Today Cocaine: 4% "loyalty rate," and Stimulants: 9%
    • 17% of population who have ever used and 50% of HS Seniors who have tried Marijuana, still using--Marijuana ranks highest in contnuance of all illicit drugs.

  • Drugs most likely to be given up:
  1. LSD/Hallucinogens (2.7% loyalty rate)
  2. Cocaine (4% loyalty rate)
  3. Methamphetamine (4% loyalty rate)
  4. Heroin (5% loyalty rate)

Higher rate of "user loyalty" for high school students has to do with their age and the recency of initial use: We tend to see that as a population ages, many "mature out" of their drug use.

Overall Trends (MTF)

  • No surveys pre- 1970
  • "Retrospective estimates" indicate Marijuana, Cocaine and Hallucinogens were the most popular drugs.
  • 1960 estimate: 6% had ever used marijuana (18-25 year olds)
  • Use rose gradually throughout the 1960's
  • 1967: 15% had tried marijuana
  • 1967-1972: Dramatic increase, by 1972 (1st household survey) 48% had tried marijuana
  • Same pattern holds for other drugs (at correspondingly lower levels)
  • "Summer of Love"-- 1967/68 largely a localized phenomenon
  • Peak of use: 1979-1982(some disagreement here based on sampling differences of surveys and specific drug in question.
  • 1980-early 1990's: Steady and dramatic decline for just about all drugs (some exceptions and irregularities)
  • Even Alcohol and Nicotine use was down (contrary to belief that their use would increase as illicit use declined)
  • At worse use of Alcohol has been stable, but with decline in many age groups
  • Illicit use: Way down until 1990/91 (except for stability of "lifetime use")
  • Exception: Interesting Stability of LSD Use, also increases
  • 1998-2002: RISE IN REPORTED USE, growth in regular, frequent use of cocaine (peaks in 1999), perceived rise in binge drinking among young adults (40-45% of college population)
  • 1997-1998:  Stabilizing? Downward trend beginning?  Or, Lull before the storm?
  • 1998-2001: Modest increases in many drug categories
  • 2001-2002: Slight decreases in most use--especially alchol and tobacco. Even ecstasy use is down slightly from peak in 2001 (9.2% seniors/lifetime). Also, modest increases in stimulant use (cocaine and methamphetamine). Also, slight increases in heroin use--yet these findings could be insignificant year-to-year variations.
  • 2002-2006: Stabilization and or significant decrease in use--especially cigarettes.
  • 2008: Tobacco use stabilizing
  • 2010: Illicit use up, concern over prescription pain relievers, tobacco use dropping.
  • 2012: Tobacco use down, especially among the young. 2011-2012 declines in illicit use, especially among the young (Latest NSDUH)(Latest MTF)
  • 2014-2016: Slight downward trend continues (except for marijuana), more significant for alcohol and tobacco.

Correlates of illegal drug use

Attitudes toward Drug Use

Four General Areas of Concern

  1. Considered Harmful
  2. Disapproval of Use
  3. Availability
  4. Support for Criminalization (not specifically measured in recent years)
  5. See Current MTF

Between 1979 and 1990 the rate of disapproval on all three of these items DOUBLED for Marijuana and Cocaine, and increased or remained stable for other drugs. Since 1992, disapproval rankings dropped then rose slightly for cannabis, leveled off 2005-2008 and have dropped since 2009 through to 2016. Disapproval of cocaine use has been rather stable throughout the past decade.

Long-term Patterns through 2012

Generally, Throughout the period 1979-1990:

  • Opposition towards "Hard" drugs remained strong
  • Opposition towards legal drugs remained weak, with a growing awareness of their risks.
  • Opposition to Marijuana grew dramatically

As of 1990 most High School Seniors disapproved of illicit drug use, view it as harmful and feel the use of such substances should be criminalized.

BUT, most still felt that experimentation is OK and relatively safe

1991-1996: Strong reversal taking place

Generational Forgetting (1991-1996)?

  • No experience
  • No subculture to inform
  • Problems of use vague: not only are the use of drugs such as marijuana increasing; but LSD, Inhalants, and heroin use are remaining stable, perhaps even increasing (sampling problems)

1996 Analysis: Link to Control/Social Bonding Theory

This Millenium--Ups and downs--overall consistency in use, concerns about marijuana and alcohol use--low (for 2016 only 50% of 12th graders view using marijuana occasionally as problematic--compares to 1980). See Current MTF.

DAWN Reports (2011 DAWN)

  • Drug Abuse Warning Network
  • Charting medical problems associated with drugs
  • Emergency room episodes (ER) (drug-related reactions, including OD's) (As reported by PATIENT)
  • Medical Examiner Reports (ME) (If drugs are thought by examiner to have been a factor in the patients death)
  • Alcohol only included when in combination with other, illegal drugs for adults 21 years of age and older.
  • Pre 1990, survey of 27 metro areas, now complex nation wide sample
  • Influences and distortions:
  1. changing purity: # of users constant, but OD's increase
  2. variations in availability: dosage and frequency of use
  3. drug mixing and adulterants (is all that matters known to or reported by patient?)
  4. Route of administration
  5. no reporting of Chronic complications, only Acute
  6. one person, multiple admissions
  7. problem of drugs as an indirect cause of death- not included
  8. Some drugs show up, esp. In suicides, not because the are dangerous or unsafe, but because they are available
  9. Aging user population: older, chronic users, tend to die more, have more problems (the Graying of the Flower Children)
  10. Illegality and unstandardized doses: more problems

Laboratory Analysis of DAWN Reports:

  1. Only 20% of cases were the drugs reported actually ingested
  2. 10% significant differences
  3. 70% incomplete listing
  4. Lots of multiple drug use

Abuse potential==> Number of problems/number of total users. Dawn is risky, but drugs that show up frequently and consistently==> probably a problem.

SO:

Rates of ED visits per 100,000 population involving illicit drugs, 2011


  1. Cocaine is a big problem: 40% ER; 40% ME
    1. 1995 27% of all admissions were related to cocaine (little change in 1996 report)
  2. Alcohol, although only reported with other drugs: 24.6% ER; 33% ME.
  3. Heroin/narcotics: continuing to increase. 20.6% ER; 60% ME. This is significant since less than 1% of population has ever used vs. 10% for cocaine.
  4. For heroin increase in mid 1990s, and by 2004-2014 continual yearly increases, spiking 2010-2014. (see: 2016 National Heroin Threat Assessment Summary)

Explanations:

  • Perhaps drug marketing wars-- purity levels of heroin going up.
  • Perhaps aging cocaine population: frequent, heavy users experiencing more problems.
  • Trend of increased use

General Trends and Patterns (based primarily on MTF)

  1. Cigarettes: Use has been down, but trend flattened in early 90's and rose through the latter 1990s, now declines from peak in 1999.
  2. General use of Alcohol fluctuated throughout the 1990s, and daily use and "Binge" drinking (5 or more drinks in a row within the past two weeks) increased (40% of college age youth). However, this trend appears to have plateaued, too. Steady decline (2001-2016) for high school students.
  3. LSD use has been relatively stable. Recent (1995) surveys showing significant increases at younger age levels. Annual and lifetime prevalence was up, but past month declines 2002-2007 and relatively stable through 2016. Surge in MDMA use seems to have peaked around 2000 and shows overall decline through 2016.
  4. Heroin use, although difficult to chart, is apparently on the upswing (increasing purity and availability). Also, frequent, regular use of cocaine appears to stabilized- perhaps increasing at younger age levels
  5. Marijuana use increased rather dramatically among the younger age levels (49% HS Seniors report lifetime use, 37% past year, 22.4% past month, 5.8% daily), stablizing in 2002-2007, but trending upward 2008-2016.

Alcohol

URL: http://www.umsl.edu/~keelr/180/trends.html
Owner: Robert O. Keel rok@umsl.edu
References and Credits for this Page of Notes
Last Updated: Thursday, March 1, 2018 11:43 AM