Imagine the population of the United States represented
by 1,000 people. This is how they used tobacco, alcohol, and illicit drugs
in the past month, based on the most recent findings from the
National Survey on Drug Use and Health.
The National Survey on Drug Use and Health is the go-to resource for learning about how Americans use, abuse, and seek treatment for tobacco, alcohol, and illicit drugs. Once a year, the Substance Abuse and Mental Health Services Administration (SAMHSA) conducts the survey by interviewing about 70,000 people, whose responses are then extrapolated to accurately represent the U.S. population.1 In this article, we have visualized a selection of the latest figures from 2014 by applying them to a crowd of 1,000 people, who together represent everyone in the United States aged 12 or over. This way, with just a glance, we’re able to get an intuitive sense of the scale of drug use, abuse, and treatment.
The graphic above shows the breakdown of how 1,000 randomly selected Americans used alcohol, tobacco, and illicit drugs in the last 30 days. Just over a third reported not consuming any of the three substances, while roughly the same number said they used alcohol but not tobacco or an illicit drug.2 It’s fairly uncommon to find someone who has used an illicit drug in the last 30 days but not consumed any alcohol, which explains why the groups that include drug and tobacco use but not alcohol are the smallest in number. In fact, only 11 people out of the 1,000 used an illicit drug but not alcohol or tobacco. 50 people used all three substances (smoked, drank, and used at least one drug) – which equates to 5% of the U.S. population.
If we extend the time period from one month to one year, more people report having used one or more of the substances. The number of people who used an illicit drug goes from 102 out of 1,000 in the last 30 days, to 167 in the last year; alcohol from 527 to 666; and tobacco from 252 to 306.3
During the same one-year period, 81 of the 1,000 people consumed alcohol or drugs to such a degree that, according to the Diagnostic and Statistical Manual of Mental Disorders, they had substance use disorders (SUDs). The graphic below shows how these 81 people were split by the type of SUD they had.4
For an even clearer overview of the use of alcohol, tobacco, and illicit drugs in the last 30 days, we can use a Venn diagram to compare how they overlap.
Alcohol is by far the most commonly used substance of the three, both by itself and in combination with tobacco and illicit drugs. Let’s examine in more detail how our 1,000 people drank in the last month.
527 of the 1,000 people consumed alcohol in the past 30 days.
Their drinking habits are divided into the following three categories.
A total of 139.7 million people aged 12 or over were current alcohol users in 2014, which means they drank on at least one occasion in the last month.5 That equates to 527 of our 1,000 people, 53.7% of whom were men. The only drinking category of the three with a higher proportion of women than men is “consumed alcohol in moderation” – binge drinking and heavy drinking were both dominated by guys. In fact, seven out of 10 heavy drinkers (which means binge drinking on at least five days in the last 30) were male. Gender is clearly one contributing factor in how much a person drinks. What about age?
Alcohol use steadily increases after the age of 12, until it peaks at 21 and then falls – with some fluctuations – later in life.6 While all three drinking categories seem to have very low rates for 12- to 17-year-olds in the graph above, in fact 11.5% of current alcohol users in 2014 belonged to this age bracket. This was a lower percentage than in 2002 through 2012, but still meant that one in nine 12- to 17-year-olds consumed alcohol in the past 30 days in 2014. In comparison, three-fifths of 18- to 25-year-olds were current alcohol users (and more than a third of them were binge drinkers, having consumed five or more drinks on at least one day). Levels of binge drinking among people aged 12 or older didn’t change significantly from 2002 to 2014.7
In 2014, 6.2% of the population were heavy alcohol users, having consumed five or more drinks on five or more days in the past month. That’s 62 of our 1,000 people, or 16.5 million people (the combined populations of New York, Los Angeles, Chicago, and San Diego). The number of heavy drinkers remained steady between 2011 and 2014. Only 1% of 12- to 17-year-olds were heavy drinkers in 2014, whereas for 18- to 25-year-olds, the number was nearly 11 times higher (10.8%, or 3.8 million people).
It’s a good thing that alcohol use hasn’t increased in the last several years, as the economic and health costs of excessive drinking are considerable. The Centers for Disease Control (CDC) estimates that excessive drinking cost the United States $249 billion in 2010 (or $2.05 per drink), from productivity loss, health care, and crime. Binge drinking was responsible for 77% of those costs.
One legal substance is even more costly than alcohol, however, at least in terms of human lives lost – tobacco. One in five deaths each year is caused by cigarette smoking, and a large number of our 1,000 imaginary, but representative, Americans lit up at least once in the past month during 2014.
261 of the 1,000 people used tobacco in the past 30 days, with
208 smoking cigarettes. Here’s how much they smoked.
In 2014, one in five Americans aged 12 or over smoked at least one cigarette in the past month.8 From our 1,000, that’s 208 – 122 of whom smoked every day. In fact, of people who smoked every day, almost one in four smoked more than a pack per day. It therefore stands to reason that more than 16 million Americans are living with a disease caused by smoking, and almost half a million die each year from the heart disease, cancer, diabetes, and other health conditions smoking causes. Using numbers from the CDC, we can estimate that the 208 people shown above, on average, will die 10 years earlier than 208 randomly selected nonsmokers from our original group of 1,000.9
There is some encouraging news about smoking, though. Between 2002 and 2008, one in four people aged 12 or older were current cigarette smokers. In 2013 and 2014, it had dropped to one in five. That’s still 55.2 million people, but as the chart above shows, in 2014, cigarette use was lower than in 2004 for every age group except 30–34 year olds, 50–54 year olds, and people aged 60 or over.
102 of the 1,000 people used one or more illicit drugs in the past 30 days. Here’s which drugs they used, with some individuals belonging to more than one drug category.
In 2014, 27 million people aged 12 or older were current illicit drug users.10 That’s a big number and difficult to visualize. It’s easier when we think of it as one in 10 people, or 102 men and women from our original group of 1,000. In the graphic above, the 102 people are divided by which drugs they used and, within each drug, their sex. Some people used more than one drug and therefore appear in more than one category. The vast majority of illicit drug users (86 out of 102) used marijuana, and 63.2% of the people who used marijuana in the past month were male. The second-most populated category is the non-medical use of psychotherapeutics, which includes pain relievers such as OxyContin and stimulants such as methamphetamine. Nearly one in four people who used an illicit drug belonged to this category, with an almost 50/50 split between men and women. Other drug categories are more biased in favor of men. Roughly four out of six cocaine, heroin, and hallucinogen users were male, as were seven out of 10 users of inhalants.
The percentage of people who were current users of marijuana was higher in 2014 than in any year from 2002 to 2013, and it’s thought that persons aged 26 or older could be responsible for this increase. In 2013, 5.6% of the people in this age group used marijuana in the past month. A year later, in 2014, it was one percentage point higher. That may not sound like a lot, but it equates to about 2.1 million people.
In 2014, 6.5 million Americans used a drug belonging to the psychotherapeutics category (2.5% of the population), about two-thirds of whom used pain relievers non-medically. The rate of use for this category is about the same as it was in 2013 but slightly lower than estimates for 2006, 2007, 2009, and 2010 (they ranged from 2.7 to 2.9%). The use of cocaine, hallucinogens, and inhalants also changed very little in 2014 compared with previous years. The same cannot be said for heroin, though, which – despite being highly addictive and illegal – had a higher rate of use in 2014 than 2002 to 2013. Once more, it’s over-26-year-olds, as opposed to younger people, who are thought to be the possible cause of the increase.11
The chart above shows that the use of marijuana and cocaine is highest within the 20-year-old age bracket, whereas hallucinogens and psychotherapeutics peak two years later, at 22. Only inhalants, which includes glues, paints, and sprays, has a significantly different peak age, at 14 to 15 years old. At this young age, children appear to get high using whatever legal but dangerous substances they can get their hands on.
We’ve already seen that, of 1,000 people representing the U.S. population, 82 had substance use disorders in 2014. But how many received treatment?
If we imagine that the 4.1 million people who received treatment for alcohol or illicit drug abuse in 2014 are represented by 1,000 people, this is how their most recent treatments were divided.
According to the National Institute on Drug Abuse, 400 to 600 of the 1,000 people above relapsed after their addiction treatment.
This rate is similar to what’s seen in other groups of people who have chronic conditions that require daily care, such as diabetes, hypertension, and asthma.
Just as with these other chronic, yet manageable conditions, those with substance abuse disorders may experience relapse after a period of treatment. If and when it occurs, a drug or alcohol relapse should never be equated with treatment failure; instead, it should signal the need for continued work, renewed focus and further relapse prevention education. Many treatment programs are ready to help you redouble your recovery efforts—call 1-888-823-3169 to find out about such treatment options.
Easily the most common substance for which people seek treatment is alcohol. Of the 1,000 people who received treatment at a specialty facility in 2014, 580 indicated that their last treatment session was for alcohol.12 Nearly 63% of them were male. The most male-dominated drug category was inhalants: 91% of the 189,000 people who were treated for inhalant abuse in 2014 were men. In fact, men dominated every drug category – the closest to 50/50 were sedatives and pain relievers (each 54% in favor of men), which belong to non-medical psychotherapeutics.
Approximately 100,000 more people received treatment for alcohol or drug abuse in 2014 than in 2013 (4.1 million versus 4 million). The substances that saw the biggest increases were cocaine (34% higher, from 584,000 to 781,000) and marijuana (22% increase, from 845,000 to 1.03 million). Three substances had decreases: alcohol (-4.2%), sedatives (-7.8%), and stimulants (also -7.8%).
There have also been differences in where people have received their treatment and how they’ve paid for it.
While outpatient rehab facilities have been the most common place people have received treatment for drug problems during the last five years, hospitals (inpatient) have seen the largest increase in attendance (10.2 percentage points from 2010 to 2014). Self-help groups are the only treatment location that had lower numbers in 2014 than 2010, with a marginal 2.6 percentage-point drop.
In 2010, the source of payment most used for treatment was the patient’s own savings or earnings (41.5%), but five years later, in 2014, private health insurance had taken the No. 1 spot, and personal savings had moved down to second place.13,14 It’s worth bearing in mind that some patients indicated multiple locations and sources of payment for their most recent treatments, which is why the percentages in the tables above don’t sum to 100. The source of payment with the biggest change in 2014 versus 2010 is Other Public Assistance (public funding that wasn’t Medicaid), which dropped 10.7 percentage points (332,000 to 294,000, a difference of 38,000 people).
We know that 4.1 million people received treatment for an alcohol or drug problem in 2014. But right at the beginning of this article we also saw that 22.7 million used alcohol or an illicit drug in the past month, with 8.1% of the population having a problem that was serious enough to be classed as a substance use disorder. Therefore, there must surely have been a large number of people who needed treatment but didn’t receive it.
In 2014, 7.88 million people needed treatment for an illicit drug problem, but only 1.6 million received it (20.3%).15 That’s slightly more than in 2013, when 19.5% of people who needed treatment got it, and higher still than in 2011 (18.8%) and 2010 (19.1%). The biggest differences in the category of people who needed treatment but did not receive it (2013 vs. 2014) were for 14-year-olds (106,000 dropped to 68,000) and 24-year-olds (274,000 to 188,000). It’s clear that there is a substantial gap between the total number of people who need treatment and the fraction of the population who actually receive it. And, with the use of marijuana increasing year-on-year and ranking second in the list of substances for which people receive treatment, it’s an issue that will certainly require ongoing careful attention.
Our hope is that with an ever-growing awareness of the scope of our nation’s substance abuse issues, coupled with the impetus for an expansion of the number of quality treatment outlets, these numbers will continue to improve. One persistent obstacle to receiving treatment is perhaps obvious – but a significant barrier for many nonetheless – and that is, reluctance to seek help. Don’t let perceived stigma or any other reason dissuade you from finding treatment help. Treatment can help place you back on a path towards a healthy and fulfilling life, and we can help you with the search.
Part of our mission at RecoveryBrands.com is to provide comprehensive online addiction treatment information, allowing those in need to make informed decision about their care. We operate the Rehabs.com, Recovery.org and DrugAbuse.com treatment network. There, our state and city treatment directories enable you to perform detailed searches to find substance abuse rehabilitation programs tailored towards your needs. Visit us at the aforementioned sites, or phone
1-888-341-7785 — you’ll be placed in touch with a treatment support team member who can provide more information about your substance abuse rehabilitation options.
- Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health
- Results from the 2014 National Survey on Drug Use and Health: Detailed Tables
- http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf (Page 19)
- http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf (Page 11)
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