1. Focus Area 26: Substance Abuse Progress Review October 13, 2004

2. Substance abuse, including smoking, illegal drugs, and alcohol, costs our Nation more than $484 billion per year. Illicit drug use alone accounts for about $161 billion. Drug abuse is inextricably linked with adverse effects such as infectious diseases, crime, accidents, and teenage pregnancies. Approximately half of those suffering from a chronic alcohol or drug disorder also suffer from a chronic psychiatric disorder. The Burden of Substance Abuse Source: Excerpt from SAMHSA & NIH/NIDA congressional appropriations testimonies, 2004.

3. No alcohol/ illicit drugs in 30+ days - Adolescents No marijuana in 30+ days - Adolescents No illicit drugs in 30+ days - Adults TBD 26-10 Adolescent and adult use of illicit substances 26-9 Substance-free youth 26-1 Motor vehicle crash deaths and injuries Substance Abuse Objectives 26-7 Alcohol- and drug-related violence 26-2 Cirrhosis deaths 26-3 Drug induced deaths 26-4 Drug-related hospital ER visits 26-5 Alcohol-related hospital ER visits 26-6 Adolescents riding with a driver who has been drinking 26-8 Lost productivity 26-11 Binge drinking Alcohol-related deaths Alcohol-related injuries Drug-related deaths Drug-related injuries In past 2 weeks - HS seniors In past 2 weeks - College students In past month - Adults In past month - Adolescents Average age 1 st use - Alcohol Average age 1 st use - Marijuana HS Sr. never using - Alcohol HS Sr. never using – Illicit drugs No changeCannot assessTarget to be determinedTarget met TBD Getting worse TBD TBD TBD TBD TBD M Improving M

4. 26-19 Treatment in correctional institutions Consuming 5+ alcoholic drinks Smoking marijuana once per month Using cocaine once per month TBD Females Males 26-17 Perception of risk 26-12 Average annual alcohol consumption Substance Abuse Objectives (cont.) 26-13 Low-risk drinking among adults 26-14 Steroid use among adolescents 26-15 Inhalant use among adolescents 26-16 Disapproval – substance abuse 26-22 Hospital emergency department referrals 26-25 BAC levels for motor vehicle drivers 1-2 drinks every day - 8 th graders 1-2 drinks every day - 10 th graders 1-2 drinks every day - 12 th graders Marijuana once/twice - 8 th graders Marijuana once/twice - 10 th graders Marijuana once/twice - 12 th graders 8 th graders 10 th graders 12 th graders 26-18 Treatment gap for illicit drugs 26-20 Treatment for injection drug use 26-21 Treatment gap for problem alcohol use 26-23 Community partnerships/coalitions Administrative license revocation 26-24 Administrative license revocation laws laws TBD TBD No changeCannot assessTarget to be determinedTarget metGetting worse M Improving TBD M M

5. 26-9dYouth free of illicit drugs 26-10bAdolescent use of marijuana 26-11aBinge drinking – 12 th grade 26-14Steroid use – 8 th, 10 th, and 12 th grades 26-16cDisapproval of regular drinking 26-16fDisapproval of marijuana use Highlighted Objectives Adolescents

6. Use of Drugs & Marijuana and Disapproval of Marijuana: 12th Grade Objs. 26-9d & 26-16f Source: Monitoring the Future Study (MTF), NIH, NIDA. Percent Disapproval of trying marijuana once or twice 2010 Target: Disapproval of Marijuana 0 90 60 30

7. Use of Drugs & Marijuana and Disapproval of Marijuana: 12th Grade Objs. 26-9d & 26-16f Source: Monitoring the Future Study (MTF), NIH, NIDA. Percent Disapproval of trying marijuana once or twice 2010 Target: Disapproval of Marijuana 0 90 60 30 Ever used marijuana

8. 2010 Target: Illicit drug use Use of Drugs & Marijuana and Disapproval of Marijuana: 12th Grade Objs. 26-9d & 26-16f Source: Monitoring the Future Study (MTF), NIH, NIDA. Ever used illicit drugs Percent Disapproval of trying marijuana once or twice 2010 Target: Disapproval of Marijuana 0 90 60 30 Ever used marijuana Note: Use of illicit drugs is the converse of Obj. 26-9d which tracks never using any illicit drugs.

9. Obj. 26-10b SOURCE: National Survey on Drug Use & Health (NSDUH), SAMHSA. Total White Female American Indian Male Hispanic BlackAsian Percent 5 20 10 15 0 Marijuana Use, 2002 & 2003: Ages 12-17 Years 2002 Note: Adolescents reporting marijuana use in the past 30 days.

10. Obj. 26-10b SOURCE: National Survey on Drug Use & Health (NSDUH), SAMHSA. Total White Female American Indian Male Hispanic BlackAsian Percent 5 20 10 15 0 Marijuana Use, 2002 & 2003: Ages 12-17 Years 20022003 Note: Adolescents reporting marijuana use in the past 30 days.

11. Objs. 26-14a, b, and c Source: Monitoring the Future Study (MTF), NIH, NIDA. 8 th Grade Percent 2010 Target.5 2.5 3.0 2.0 1.5 1.0 0 Illicit Steroid Use in the Past Year: 8 th, 10 th, and 12 th Graders

12. Objs. 26-14a, b, and c Source: Monitoring the Future Study (MTF), NIH, NIDA. 8 th Grade Percent 10 th Grade 2010 Target.5 2.5 Illicit Steroid Use in the Past Year: 8 th, 10 th, and 12 th Graders 3.0 2.0 1.5 1.0 0

13. Objs. 26-14a, b, and c Source: Monitoring the Future Study (MTF), NIH, NIDA. 8 th Grade Percent 10 th Grade 2010 Target.5 2.5 12 th Grade 3.0 2.0 1.5 1.0 0 Illicit Steroid Use in the Past Year: 8 th, 10 th, and 12 th Graders

14. Binge Drinking and Disapproval of Regular Drinking: 12th Grade Objs. 26-11a & 26-16c Source: Monitoring the Future Study (MTF), NIH, NIDA. Disapproval of 1-2 drinks/day Percent 2010 Target: Disapproval of regular drinking 0 90 60 30

15. Binge Drinking and Disapproval of Regular Drinking: 12th Grade Objs. 26-11a & 26-16c Source: Monitoring the Future Study (MTF), NIH, NIDA. Disapproval of 1-2 drinks/day Binge Drinking Percent 2010 Target: Disapproval of regular drinking 2010 Target: Binge drinking 0 90 60 30 Note: Binge drinking is defined as having 5+ alcoholic drinks in a row during the past 2 weeks.

16. 26-1aMotor vehicle crash deaths – Alcohol related 26-10cUse of illicit drugs 26-12Average annual alcohol consumption 26-13Low-risk drinking – Females and Males 26-24Administrative license revocation (ALR) laws 26-25Blood alcohol concentration (BAC) levels for motor vehicle drivers Highlighted Objectives Adults

17. Annual Per Capita Alcohol Consumption: Ages 14 Years and Over Obj. 26-12 Gallons of Ethanol SOURCE: Alcohol Epidemiologic Data System (AEDS), NIH, NIAAA. 1997200019991998 2010 Target 1.5 2.5 2.4 2.3 2.2 2.1 2.0 1.9 1.8 1.7 1.6 2.18 2.14 2.16

18. Guidelines for low-risk drinking are as follows: In a typical week — no more than 14 drinks (men) or no more than 7 drinks (women), On any day — no more than 4 drinks (men) or no more than 3 drinks (women) Source: Helping Patients With Alcohol Problems: A Health Practitioner’s Guide (NIAAA, 2004).

19. Drinkers Exceeding Guidelines for Low-Risk Drinking, 2002: Ages 18 Years and Over Objs. 26-13a & b SOURCE: National Epidemiologic Survey on Alcohol and Related Conditions, NIAAA, NIH. MaleFemale Total White American Indian Hispanic Black Hawaiian Asian HS grad > HS College 2010 Targets Percent Note: Data are for current (in the past year) drinkers.

20. 2 12 0 8 4 6 10 Alcohol-Related Motor Vehicle Fatalities by BAC Level Source: Fatality Analysis Reporting System (FARS), Department of Transportation (DOT), National Highway Traffic Safety Administration (NHTSA). Per 100,000 population Obj. 26-1a BAC = 0.00 (no alcohol) Note: BAC is the Blood Alcohol Concentration.

21. 2 12 0 8 4 6 10 Alcohol-Related Motor Vehicle Fatalities by BAC Level Source: Fatality Analysis Reporting System (FARS), Department of Transportation (DOT), National Highway Traffic Safety Administration (NHTSA). Per 100,000 population BAC = 0.01+ Obj. 26-1a 2010 Target: BAC 0.01+ BAC = 0.00 Note: BAC is the Blood Alcohol Concentration. Alcohol-related motor vehicle fatal crashes relate to the death of either a driver or a nonmotorist that occurs within 30 days of the motor vehicle crash.

22. 2 12 0 8 4 6 10 Alcohol-Related Motor Vehicle Fatalities by BAC Level Source: Fatality Analysis Reporting System (FARS), Department of Transportation (DOT), National Highway Traffic Safety Administration (NHTSA). Per 100,000 population BAC = 0.08+ BAC = 0.01+ Obj. 26-1a 2010 Target: BAC 0.01+ BAC = 0.00 Note: BAC is the Blood Alcohol Concentration. Alcohol-related motor vehicle fatal crashes relate to the death of either a driver or a nonmotorist that occurs within 30 days of the motor vehicle crash.

23. 2 12 0 8 4 6 10 Alcohol-Related Motor Vehicle Fatalities by BAC Level Source: Fatality Analysis Reporting System (FARS), Department of Transportation (DOT), National Highway Traffic Safety Administration (NHTSA). Per 100,000 population BAC = 0.08+ BAC = 0.01+ Obj. 26-1a 2010 Target: BAC 0.01+ BAC = 0.00 Change Since 1998 BAC 0.00: -4% BAC 0.01+: -2% BAC 0.08+: -1% Change Since 1982 BAC 0.00: +15% BAC 0.01+: -47% BAC 0.08+: -48% Note: BAC is the Blood Alcohol Concentration. Alcohol-related motor vehicle fatal crashes relate to the death of either a driver or a nonmotorist that occurs within 30 days of the motor vehicle crash.

24. 0 51 With lawsWithout laws Enactment of ALR and BAC Laws by States States ALR Laws.08 BAC Per Se Laws 34 2010 Target Obj. 26-24 & 26-25 41 18 28 Source: Department of Transportation (DOT), National Highway Traffic Safety Administration (NHTSA). 0 51 200319991998 41 200020012002 51 45 16 17 20021999199820002001 2004

25. Obj. 26-10c Total White Female American Indian Male Hispanic BlackHawaiianAsian Percent SOURCE: National Survey on Drug Use & Health (NSDUH), SAMHSA. 5 20 10 15 0 2002 Illicit Drug Use in the Past 30 Days, 2002 & 2003: Ages 18 Years and Over

26. Obj. 26-10c Total White Female American Indian Male Hispanic BlackHawaiianAsian Percent SOURCE: National Survey on Drug Use & Health (NSDUH), SAMHSA. 5 20 10 15 0 20022003 Illicit Drug Use in the Past 30 Days, 2002 & 2003: Ages 18 Years and Over

27. Primary Substance Primary Substance of Abuse at Treatment Admission, 2001: Ages Under 55 Years and 55 Years and Over Percent SOURCE: Treatment Episode Data Set (TEDS), SAMHSA. 5 Ages <55 6 74 44 18 13 15 Ages 55+ 14 100 25 75 0 50 Note: Admissions reported to TEDS from substance abuse treatment facilities receiving State alcohol and/or drug agency funds (including Federal Block Grant funds).

28. Progress review data and slides can be found on the web at: http://www.cdc.gov/nchs/hphome.htm