Drug Use Estimates

(drug usage - kinds of drugs) "Psychoactive substances can be classified into five broad, not mutually exclusive categories (adapted from Brand et al26):

• Depressants:e.g.alcohol,anxiety reducing drugs,sedatives, sleeping medication and opioid painkillers.
• Stimulants: e.g. nicotine, caffeine, cocaine and amphetamines
• Psychedelics: e.g. LSD, mescaline, psilocybin,and ayahuasca
• Cannabis
• Psychiatric medications: e.g. antipsychotics, antidepressants and mood stabilizers."

(drug usage - benefits of drugs) "The Health Officers Council¹³ identified categories of beneficial attributes of substances:

• Physical: pain relief, assistance with sleep, decreased risk of cardiovascular disease, increased endurance, stimulation or diminution of appetite.
• Psychological: relaxation, relief of stress and anxiety, increase alertness, assistance in coping with daily life, mood alteration, pleasure, performance improvement, or enhancement of creativity.
• Social: facilitation of social interaction, religious, spiritual or ceremonial use.
• Economic: wealth and job creation, industrial activity, employment, agricultural development, tax revenue generation."

(drug usage - demographics) "Legal and illegal use of drugs was most strongly associated with age, sex, and income. Higher income was associated with a greater likelihood of drug use for all drug types examined, which is perhaps not surprising given that drug use requires disposable income. Relationship status was linked to illegal (but not legal) drug use: both cocaine and cannabis use were more likely among persons who had never been married or previously been married."

(drug usage - global distribution) "Globally, drug use is not distributed evenly. In general, the US had among the highest levels of use of all drugs. Much lower levels were observed in lower income countries in Africa and the Middle East, and lower levels of use were reported in the Asian locales covered."

(drug usage - rates in United States and Europe) "Although statistics on drug use in the United States are not fully reliable, the numbers available indicate that US consumption of cocaine and marijuana has been essentially stable for many years—although considerably reduced from its peak in the 1970s and 1980s. The data also show that, today, the United States consumes illegal substances at a rate some three times that of Europe—although the use of drugs in the EU continues to grow rapidly and a few countries actually consume more per capita than the United States. In both the United States and Europe, the wholesale and street prices of cannabis and cocaine have declined in the past several years, although reportedly their potency has increased and demand remains steady. Across the world, illicit drugs appear to be available at stable or declining prices. A recent EU Commission study concluded that global drug production and use remained largely unchanged during the period from 1998 through 2007."

Drug Usage - Data

(2010 - drug usage - prescription amphetamines) "Use of the amphetamine Ritalin outside of medical supervision showed a distinct increase around 1997—with annual prevalence among 12th graders going from 0.1% in 1992 to 2.8% in 1997—and then stayed level for a few years ... Results from the new [survey] question suggest an ongoing, gradual decline in Ritalin use, which continued into 2009 in all five populations. The decline continued further in 2010 among 8th and 10th graders, but use leveled in 2010 among 12th graders, college students, and young adults.

"Another amphetamine used in the treatment of the symptoms of attention deficit hyperactivity disorder (ADHD) is Adderall. ... annual prevalence rates in both 2009 and 2010 were higher than those for Ritalin in all five populations. This suggests that Adderall may have to some degree replaced the use of Ritalin and may help to account for the declines that we have been observing for the latter drug. In 2010 some increase in Adderall use occurred in three of the five populations (10th graders and college students being the exception). The absolute prevalence rates are fairly high, particularly among college students (9.0% in 2010) and young adults generally (7.0%)."

(2010 - drug usage - use among 50 year-olds) "Among 50-year-old high school graduates in 2010, we estimate that about three-quarters (75%) have tried marijuana, and that about two-thirds (66%) have tried an illicit drug other than marijuana."

(2010 - drug usage - dependence by race) "In 2010, among persons aged 12 or older, rates of substance dependence or abuse were lower among Asians (4.1 percent) and Native Hawaiians or Other Pacific Islanders (5.6 percent) than among other racial/ethnic groups. The rates for the other racial/ethnic groups were 16.0 percent for American Indians or Alaska Natives, 9.7 percent for persons reporting two or more races, 9.7 percent for Hispanics, 8.9 percent for whites, and 8.2 percent for blacks."

(2009 - drug usage - illicit drug use in the U.S. Army) "Given that illicit drug use is inconsistent with Army Values, one would not expect the presence of multiple and serial drug offenders in the Army. Data for FY 2001 – FY 2009 indicate otherwise.⁷⁶ Drug testing results reveal that of the total number of Soldiers tested, 3.5% (58,687 of 1,662,004) were positive for illicit drug use ... That includes Soldiers who tested positive one, two or three or more times. When separated into these specific categories, 36,470 (62%) were first time positives, 11,828 (20%) were multiple, and 10,389 (18%) were serial offenders.

(2009 - drug usage - Afghanistan) "Illicit drug use has increased across the country, dramatically so for opium, heroin and other opiates. In four years, the number of regular opium users in Afghanistan grew from 150,000 to approximately 230,000 ‐ a jump of 53 per cent. The numbers are even more alarming for heroin. In 2005, the estimate of regular heroin users in the country was 50,000, compared to approximately 120,000 users in 2009, a leap of 140 per cent. Overall, the annual prevalence of regular opiate use is estimated to be 2.7 per cent of the adult population1 (between 290,000 and 360,000 persons). Opium is by far the most commonly used opiate with an estimated prevalence of about 1.9 per cent of the adult population. Heroin prevalence is estimated to be about 1.0 per cent of the adult population and other opiates users2 are estimated to make up about 0.5 per cent of the adult population."

(2005-2008 - drug usage - prescription antidepressants) "Antidepressants were the third most common prescription drug taken by Americans of all ages in 2005–2008 and the most frequently used by persons aged 18–44 years. From 1988–1994 through 2005–2008, the rate of antidepressant use in the United States among all ages increased nearly 400%."

(2008 - drug usage - opium consumption) "The world consumes some 3,700 tons of illicit opium per year (1/3 raw and 2/3 processed into heroin) and seizes 1,000 tons. Illicit opiate trade flows have never been previously known: this report breaks new ground by estimating them by country (and regions)."

(2008 - alcohol - use among blacks) "Past month alcohol use, binge alcohol use, and illicit drug use remained relatively stable among black adults between 2002 and 2008 (Figure1).^4,5

"Combined 2004 to 2008 data indicate that, in the past month, 44.3 percent of black adults used alcohol, 21.7 percent reported binge alcohol use, and 9.5 percent used an illicit drug (Figure 2).

"Rates of past month alcohol use and binge alcohol use were lower among black adults than the national averages. The rate of past month illicit drug use among black adults, however, was higher than the national average.

"Rates of past month and binge alcohol use were considerably lower among young black adults than the national average of young adults (48.6 vs. 61.1 percent and 25.3 vs. 41.6 percent, respectively) (Figure 3). Past month illicit drug use among young black adults was slightly lower than the national average (18.7 vs. 19.7 percent).

"Older black adults had a rate of past month alcohol use that was considerably lower than the national average of older adults (20.3 vs. 38.3 percent) (Figure 4). Their rates of binge alcohol use and past month illicit drug use, however, did not differ significantly from the national averages.

"Compared with the national averages, adult black females had lower rates of past month alcohol use and binge alcohol use and a slightly higher rate of past month illicit drug use (Table 1).

"Compared with the national averages, adult black males had lower rates of past month alcohol use and binge alcohol use and a slightly higher rate of past month illicit drug use (Table 2)."

(2004-2008 - drug usage - substance use among Hispanics)
"● Rates of past month alcohol use and illicit drug use were lower among Hispanic adults than the national averages for adults (46.1 vs. 55.2 percent and 6.6 vs. 7.9 percent, respectively); however, past month binge alcohol use was higher among Hispanics than the national average (26.3 vs. 24.5 percent)

"● Among Hispanic adults, substance use varied greatly by subgroup; past month illicit drug use, for example, ranged from a high of 13.1 percent among adults of Spanish origin (from Spain) to a low of 3.9 percent among those of Dominican origin

"● Hispanic adults who were born in the United States had higher rates of past month substance use than Hispanic adults who were not born in the United States, regardless of age

"● Among Hispanics who needed treatment for an alcohol or illicit drug problem, the percentage who received such treatment did not differ significantly from the national average"

(2008 - drug usage - education) "Illicit drug use in 2008 varied by educational status. Among adults aged 18 or older, the rate of current illicit drug use was lower for college graduates (5.7 percent) than for those who did not graduate from high school (8.1 percent), high school graduates (8.6 percent), and those with some college (9.4 percent). However, adults who had graduated from college were more likely to have tried illicit drugs in their lifetime when compared with adults who had not completed high school (51.8 vs. 37.7 percent). The rate of current illicit drug use declined from 9.3 percent in 2007 to 8.1 percent in 2008 among adults who had not completed high school."

(marijuana - global prevalence)
(2008) "Globally, the number of people who had used cannabis at least once in 2008 is estimated between 129 and 191 million, or 2.9% to 4.3% of the world population aged 15 to 64. ... National experts in many parts of the world perceive cannabis use to be either stabilizing or increasing, although about 15 countries reported a decrease in 2007 and 2008."

(2007) "The global number of people who used cannabis at least once in 2007 is estimated to be between 143 and 190 million persons. The highest levels of use remain in the established markets of North America and Western Europe, although there are signs from recent studies that the levels of use are declining in developed countries, particularly among young people."

(2004) "Cannabis remains by far the most commonly used drug in the world. An estimated 162 million people used cannabis in 2004, equivalent to some 4 per cent of the global population age 15-64. In relative terms, cannabis use is most prevalent in Oceania, followed by North America and Africa. While Asia has the lowest prevalence expressed as part of the population, in absolute terms it is the region that is home to some 52 million cannabis users, more than a third of the estimated total. The next largest markets, in absolute terms, are Africa and North America."

(2008 - drug usage - by race) "Current illicit drug use among persons aged 12 or older varied by race/ethnicity in 2008, with the lowest rate among Asians (3.6 percent) (Figure 2.9). Rates were 14.7 percent for persons reporting two or more races, 10.1 percent for blacks, 9.5 percent for American Indians or Alaska Natives, 8.2 percent for whites, 7.3 percent of Native Hawaiians or Other Pacific Islanders, and 6.2 percent for Hispanics."

(cocaine & crack - use by youth)
(2009) "According to the 2009 Monitoring the Future survey—a national survey of 8th-, 10th-, and 12th-graders—there were continuing declines reported in the use of powder cocaine, with past-year†† usage levels reaching their lowest point since the early 1990s. Significant declines in use were measured from 2008 to 2009 among 12th-graders across all three survey categories: lifetime use decreased from 7.2 percent to 6.0 percent; past-year use dropped from 4.4 percent to 3.4 percent; and past-month use dropped from 1.9 percent to 1.3 percent. Survey measures showed other positive findings among 12th-graders as well; their perceived risk of harm associated with powder cocaine use increased significantly during the same period.

(2008) "According to the 2008 Monitoring the Future survey—a national survey of 8th-, 10th-, and 12th-graders—cocaine use among students did not change significantly, though it remained at unacceptably high levels: 3.0 percent of 8th-graders, 4.5 percent of 10th-graders, and 7.2 percent of 12th-graders have tried cocaine; 0.8 percent of 8th-graders, 1.2 percent of 10th-graders, and 1.9 percent of 12th-graders were current (past-month) cocaine users. Crack cocaine use, which has been steadily declining since 1990, showed a significant decrease among 12th-graders in the past year.

(2007) "According to the 2007 National Survey on Drug Use and Health, 35.9 million Americans aged 12 and older reported having used cocaine, and 8.6 million reported having used crack. An estimated 2.1 million Americans were current (past-month) users of cocaine; 610,000 were current users of crack. There were an estimated 906,000 new users of cocaine in 2007—most were 18 or older when they first used cocaine. Among young adults aged 18 to 25, the past-year use rate was 6.4 percent, showing no significant difference from the previous year."

(2007 - drug usage - baby boomers) "In 2007, the rate of past year use in this age group [persons aged 50 to 59] was 9.4 percent for any illicit drug, 5.7 percent for marijuana, and 4.0 percent for nonmedical use of prescription drugs. Analyses show that the observed increases are driven primarily by the aging of the baby boom cohort, which has a much higher lifetime illicit drug use rate than earlier cohorts, representing an increasing proportion of persons aged 50 to 59. Less than 3 percent of past year users initiated drug use at ages 50 to 59. Almost 90 percent of past year users initiated drug use before age 30, and many have been continuing users over the years."

(2007 - gateway - age of first use) According to the 2007 National Survey on Drug Use and Health:
"The average age at first nonmedical use of any psychotherapeutics among recent initiates aged 12 to 49 was 21.8 years. More specifically, it was 21.2 years for pain relievers, 21.9 years for stimulants, 24.5 years for tranquilizers, and 24.2 years for sedatives.

"In 2007, there were 106,000 persons aged 12 or older who had used heroin for the first time within the past 12 months. The average age at first use among recent initiates aged 12 to 49 was 21.8 years in 2007.

"Most (66.5 percent) of the 0.9 million recent cocaine initiates were 18 or older when they first used. The average age at first use among recent initiates aged 12 to 49 was 20.2 years, which was similar to the average age in 2006 (20.3 years).

"In 2007, the average age at first marijuana use among recent initiates aged 12 to 49 was 17.6 years, which was similar to the average in 2006 (17.4 years) (Figure 5.4). Among recent initiates aged 12 or older who initiated use prior to the age of 21, the mean age at first use was 16.2 years in 2007, which was not significantly different from the estimate (16.1 years) in 2006."

"In 2007, among recent initiates aged 12 to 49, the average age of first cigarette use was 16.9 years, similar to the average in 2006 (17.1 years)."

"In 2007, the average age at first alcohol use among recent initiates aged 12 to 49 was 16.8 years, similar to the corresponding 2006 estimate (16.6 years). The mean age at first use among recent initiates aged 12 or older who initiated use prior to the age of 21 was 15.8 years, which was the same as the 2006 estimate."

(2007 - gateway - association of drug use with alcohol and tobacco use) "In 2007, the rate of current illicit drug use was almost 9 times higher among youths aged 12 to 17 who smoked cigarettes in the past month (47.3 percent) than it was among youths who did not smoke cigarettes in the past month (5.4 percent).

"Past month illicit drug use also was associated with the level of past month alcohol use. Among youths aged 12 to 17 in 2007 who were heavy drinkers (i.e., consumed five or more drinks on the same occasion on each of 5 or more days in the past 30 days), 60.1 percent also were current illicit drug users, which was higher than the rate among nondrinkers (5.0 percent)."

(2006 - drug usage - global tobacco use) "Tobacco, a particularly addictive substance, is a case in point. About 28 per cent of the world's adult population is estimated to use tobacco, which exceeds, by far, the number of people using illicit drugs (4 per cent for cannabis and 1 per cent for ATS, cocaine and opiates combined)."

(2004 - diversion of pharmaceutical drugs - nonmedical use of psychotherapeutics) "In 2004, an estimated 2.8 million persons used psychotherapeutics nonmedically for the first time within the past year. The numbers of new users of psychotherapeutics in 2004 were 2.4 million for pain relievers, 1.2 million for tranquilizers, 793,000 for stimulants, and 240,000 for sedatives. These estimates are similar to the corresponding estimates for 2002 and 2003.

"The average age of first nonmedical use of psychotherapeutics among recent initiates was 24.7 years. For specific drug classes, the average ages were 23.3 years for pain relievers, 25.2 years for tranquilizers, 24.1 years for stimulants, and 29.3 years for sedatives.

"In 2004, the number of new nonmedical users of OxyContin® was 615,000, with an average age at first use of 24.5 years. Comparable data on past year OxyContin® initiation are not available for prior years, but calendar year estimates of OxyContin® initiation show a steady increase in the number of initiates from 1995, the year this drug was first available, through 2003 (Figure 5.5)."

(2004 - diversion of pharmaceutical drugs - nonmedical use of psychotherapeutic drugs) "In 2004, 6.0 million persons were current users of psychotherapeutic drugs taken nonmedically (2.5 percent). These include 4.4 million who used pain relievers, 1.6 million who used tranquilizers, 1.2 million who used stimulants, and 0.3 million who used sedatives. These estimates are all similar to the corresponding estimates for 2003.

"There were significant increases in the lifetime prevalence of use from 2003 to 2004 in several categories of pain relievers among those aged 18 to 25. Specific pain relievers with statistically significant increases in lifetime use were Vicodin®, Lortab®, or Lorcet® (from 15.0 to 16.5 percent); Percocet®, Percodan®, or Tylox® (from 7.8 to 8.7 percent); hydrocodone products (from 16.3 to 17.4 percent); OxyContin® (from 3.6 to 4.3 percent); and oxycodone products (from 8.9 to 10.1 percent)."

(2004 - drug usage - global problem users) "Of these 5 per cent of the population (age 15-64), who use illicit drugs at least once a year (annual prevalence), only about half of them (2.7 per cent of the population age 15-64) use drugs regularly, that is, at least once per month. The number of what are commonly understood to be drug addicts or problem drug users is some 25 million persons worldwide, equivalent to 0.6 per cent of the population age 15-64. This estimate does not seem to have changed much in recent years at the global level as increases in some countries were offset by declines in others."

(2004 - drug usage - global use by substance) "The total number of drug users in the world is now estimated at some 200 million people, equivalent to about 5 per cent of the global population age 15-64. Cannabis remains by far the most widely used drug (some 162 million people), followed by amphetamine-type stimulants (some 35 million people), which include amphetamines (used by 25 million people) and ecstasy (almost 10 million people). The number of opiate abusers is estimated at some 16 million people, of which 11 million are heroin abusers. Some 13 million people are cocaine users."

(2003-2004 - drug usage - global trends) "The paucity of the data on which the annual prevalence estimates are based does not allow for the identification of clear global trends in the short term. As an imperfect complement, UNODC [United Nations Office of Drugs and Crime] relies on the perception of the trends in their countries by national experts. A global analysis of these perceptions suggest that the strongest increase over the last decade was for cannabis use and ATS [amphetamine-type stimulants], and at lower levels for opiates and cocaine. After some stabilization in 2003, ATS drug use was perceived as having increased again, reflecting the prevailing view in East and South-East Asia that methamphetamine use has started rising again.

"Opiate abuse trends flattened in recent years. However, by 2004, opiate abuse perceptions again went upwards, as many countries around Afghanistan experienced a renewed supply-push following Afghanistan's good opium harvests of 2003 and 2004. In other parts of the world, including North America and Western Europe, abuse levels remained constant for opiates. After years of increases, cocaine use is perceived as declining slightly, notably in the Americas. In Europe, by contrast, cocaine use continues to expand."

(2003 - adolescents - age of first use) "Most teens who use alcohol, cigarettes and marijuana do so before they are 14. Among teens who have tried alcohol, tobacco or marijuana, the average age of first use is a little more than 12 for alcohol, 12-1/2 for cigarettes, and 13 years 11 months for marijuana."

(2003 - drug usage - military veterans) "In 2003, there were an estimated 25 million veterans comprising roughly 11.5 percent of the 217 million non-institutionalized civilians aged 17 or older in the United States."

"An estimated 3.5 percent of veterans used marijuana in the past month compared with 3.0 percent of their nonveteran counterparts in 2003"

"Heavy use of alcohol was more prevalent among veterans than comparable nonveterans, with an estimated 7.5 percent of veterans drinking heavily in the past month compared with 6.5 percent of their nonveteran counterparts."

"Using criteria from the DSM-IV, an estimated 2.6 percent of veterans were dependent on alcohol in the past year (Figure 2). A much smaller proportion of veterans (0.9 percent) was dependent on illicit drugs in the past year."

"An estimated 0.8 percent of veterans received specialty treatment4 for a substance use disorder (alcohol or illicit drugs) in the past year compared with 0.5 percent of their nonveteran counterparts (Figure 3). An estimated 2.8 percent of veterans were dependent on illicit drugs or alcohol but did not receive treatment in the past year.5 A similar proportion of comparable
nonveterans went untreated."

(2003 - drug usage - global treatment demand by substance) "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%)."

(2002 + 2003 - alcohol - estimated 'lifetime' substance use) "In 2002 and 2003, an estimated 88.2 percent of persons aged 21 or older (175.6 million) were lifetime alcohol users, whereas an estimated 11.8 percent (23.5 million) were lifetime nondrinkers. Over half of lifetime alcohol users (52.7 percent) had used one or more illicit drugs at some time in their life, compared to 8.0 percent of lifetime nondrinkers. Among persons who had used an illicit drug in their lifetime, the average age at first illicit drug use was 19 years for lifetime alcohol users, versus 23 years for lifetime nondrinkers."

(2002 + 2003 - alcohol - other substance use by 'lifetime' users) "Lifetime alcohol users aged 21 or older had a significantly higher rate of past year illicit drug use (13.7 percent) compared with lifetime nondrinkers (2.7 percent). In addition, lifetime alcohol users had significantly higher rates of past year use across all illicit drug categories, with the exception of inhalants (Table 1). Nonmedical use of pain relievers was the illicit drug used most often by lifetime nondrinkers, whereas lifetime alcohol users reported using marijuana most frequently."

(2002 - drug usage - heavy alcohol use among military personnel) "The significant increase from 1998 to 2002 in heavy alcohol use suggests that this is an area that may need greater emphasis by the Military. Indeed, the rate of heavy alcohol use had not changed significantly since 1988 and indicates that more than one out of six military personnel in 2002 was likely to be a heavy drinker. The finding of no significant change in illicit drug use between 1998 and 2002 and the relatively low rates of use for both surveys suggest that the Military's effort to curtail illicit drug use may have reached its lower limit. The trend line resembles an asymptotic curve that shows steep declines initially with successively smaller declines until it eventually flattens out. The 1992 through 2002 data suggest that the flattening point may have been reached and that it may not be realistic to expect drug use among military personnel to go much lower."

(2002 - drug usage - illicit drug use among military personnel) "The prevalence of any reported illicit drug use during the past 30 days declined sharply from 27.6% in 1980 to 3.4% in 2002. The decreases were statistically significant between each of the surveys from 1980 to 1992 and have remained relative stable around 3% for the decade from 1992 to 2002. Rates of illicit drug use during the past 12 months showed a parallel pattern to the 30-day use except at a higher level, as would be expected. Use declined from 36.7% in 1980 to 6.9% in 2002. Rates have been relatively constant since 1992 at around 6% to 7%."

(2002 - drug usage - tobacco use among military personnel) "The increase in the rates of cigarette smoking between 1998 and 2002 is of concern and unexpected given the strong emphasis from health planners and practitioners in the Military on smoking reduction and the wave of national attention directed toward the problems of smoking. The rate of cigarette smoking in 2002 remained the highest of the three substances, over one and three-fourths as high as heavy alcohol use and about 10 times as high as illicit drug use."

(2002 - drug usage - heavy alcohol use among military personnel) "... any illicit drug use and cigarette use both declined significantly between 1980 and 2002, although the rate of decline varied for each of the substances and between each of the eight surveys. In contrast, the rates of heavy alcohol use did not show a significant decline between 1980 (20.8%) and 2002 (18.1%), although the 1998 survey showed a significant decline from the 1980 rate of use (i.e., from 20.8% to 15.4%). When we examine the trend in heavy drinking over the eight surveys, we see that heavy alcohol use increased from 1980 to 1982, was relatively stable between 1982 and 1985, decreased significantly between 1985 and 1988, remained relatively stable with some up and down fluctuations between 1988 and 1998, and then showed a significant increase from 1998 to 2002. Overall, the heavy drinking rate for 2002 was very similar to the rate when the survey series began in 1980."

(2002 - diversion of pharmaceutical drugs - pain reliever use by young people) "Lifetime nonmedical pain reliever prevalence among youths aged 12 to 17 increased from 2001 (9.6 percent) to 2002 (11.2 percent), continuing an increasing trend from 1989 (1.2 percent). Among young adults aged 18 to 25, the rate increased from 19.4 percent in 2001 to 22.1 percent in 2002. The young adult rate had been 6.8 percent in 1992.

(marijuana - synthetic cannabinoids) ‘Spice’ and other ‘herbal’ products are often referred to as ‘legal highs’ or ‘herbal highs’, in reference to their legal status and purported natural herbal make-up (McLachlan, 2009; Lindigkeit et al., 2009; Zimmermann et al., 2009). However, albeit not controlled, it appears that most of the ingredients listed on the packaging are actually not present in the ‘Spice’ products and it is seems likely that the psychoactive effects reported are most probably due to added synthetic cannabinoids, which are not shown on the label. There is no evidence that JWH, CP and/or HU [three chemically distinct groups of synthetic cannabinoids] compounds are present in all ‘Spice’ products or even batches of the same product. Different amounts or combinations of these substances seem to have been used in different ‘Spice’ products to produce cannabis-like effects. It is possible that substances from these or other chemical groups with a cannabinoid agonist or other pharmacological activity could be added to any herbal mixture (¹⁷) (Griffiths et al., 2009).

"The emergence of new, smokable herbal products laced with synthetic cannabinoids can also be seen as a significant new development in the field of so-called ‘designer drugs’. With the appearance, for the first time, of new synthetic cannabinoids, it can be anticipated that the concept of ‘designer drugs’ being almost exclusively linked to the large series of compounds with phenethylamine and tryptamine nucleus will change significantly (¹⁸). There are more than 100 known compounds with cannabinoid receptor activity and it can be assumed that further such substances from different chemical groups will appear (with direct or indirect stimulation of CB1 receptors)."

Drug Usage - Research

(drug usage - research - limited effects of punitive drug policies) "The use of drugs seems to be a feature of more affluent countries. The US, which has been driving much of the world’s drug research and drug policy agenda, stands out with higher levels of use of alcohol, cocaine, and cannabis, despite punitive illegal drug policies, as well as (in many US states), a higher minimum legal alcohol drinking age than many comparable developed countries. The Netherlands, with a less criminally punitive approach to cannabis use than the US, has experienced lower levels of use, particularly among younger adults. Clearly, by itself, a punitive policy towards possession and use accounts for limited variation in nation level rates of illegal drug use."

(drug usage - research - myths and stereotypes) "Because the impacts of problem drug users are largely hidden, and also because their number is actually relatively small (approximately 330,000; Hay et al., 2008),²² people’s understanding of problem drug use tends to come from remote sources – the media (including the internet, television, films, magazines and books) and anecdote – rather than from direct experience. This provides fertile ground for the growth of myths and stereotypes: for example, the prevalent belief in instant addiction and the myth of the drug dealer offering free drugs at the school gates."

(drug usage - research - substance use and employment) "There were little or differences in the probability of employment by lifetime alcohol and drug use patterns. Men who had an alcohol disorder at some point in their life were equally likely as men who had never drunk alcohol to be currently employed (.91) and only slightly less likely than moderate alcohol users (.91 vs. .92, p=.09). Similarly, men who had a drug disorder at some point in their life were somewhat less likely (.90 vs. 92, p=.07) to be currently employed, but there was no statistically difference between moderate drug users and non-users. Differences among men by their current (last 12 months) alcohol and, especially, drug use patterns were greater. Current moderate alcohol drinkers were actually more likely than those who had not drunk alcohol in the last year to be employed (.93 vs. 91), while those with a current alcohol problem were less likely to be employed than either moderate or nondrinkers (.89). In contrast to moderate alcohol users, current moderate drug users were less likely to be employed than nonusers (.88 vs. .92). Men with a current drug problem were substantially less likely to be employed (.82) than either moderate or non drug users."

(drug usage - research - use unrelated to enforcement) "Opponents of drug policy reform commonly argue that drug use would increase if health-based models were emphasized over drug law enforcement,¹⁴ but we are unaware of any research to support this position. In fact, a recent World Health Organization study demonstrated that international rates of drug use were unrelated to how vigorously drug laws were enforced, concluding that 'countries with stringent user-level illegal drug policies did not have lower levels of use than countries with liberal ones.'¹⁵"

(drug usage - research - misuse preceded by prescription drugs) "... patterns of prescription drug misuse among high-risk young adults in LA and NY appear to conform to and be shaped by differences in local markets for illicit drugs in each city. Our findings indicate that current misuse of prescription drugs in both cities encompasses a broad range of practices, such as sniffing, injecting, polydrug use, and drug substitution, and involves frequent misuse of illicit substances. Initiation into prescription drug misuse was often preceded by being prescribed one or more types of prescription drugs, which was then followed by initiating illicit drugs with similar psychotropic effects."

(drug usage - research - substance use and employment) "In conclusion, this study found that chronic drug use was significantly related to employment status for men and women. On the other hand, male chronic drug users were less likely to participate in the labor force, but no significant relationship existed between chronic drug use and labor force participation for females. Perhaps the most important finding of this study, however, was the lack of any significant relationships between nonchronic drug use, employment, and labor force participation. An implication of this finding is that employers and policy makers should focus on problematic drug users in the same way that they focus on problematic alcohol users."

(drug usage - research - decriminalization) "The information we have presented adds to the current literature on the impacts of decriminalization. It disconfirms the hypothesis that decriminalization necessarily leads to increases in the most harmful forms of drug use. While small increases in drug use were reported by Portuguese adults, the regional context of this trend suggests that they were not produced solely by the 2001 decriminalization. We would argue that they are less important than the major reductions seen in opiate-related deaths and infections, as well as reductions in young people’s drug use. The Portuguese evidence suggests that combining the removal of criminal penalties with the use of alternative therapeutic responses to dependent drug users offers several advantages. It can reduce the burden of drug law enforcement on the criminal justice system, while also reducing problematic drug use."

(drug usage - research - cannabis, alcohol and tobacco cross-substitution) "... our results suggest that participation in the use of both licit and illicit drugs is price sensitive. Participation is sensitive to own prices and the price of the other drugs. In particular, we conclude that cannabis and cigarettes are complements, and there is some evidence to suggest that cannabis and alcohol are substitutes, although decriminalization of cannabis corresponds with higher alcohol use. Alcohol and cigarettes are found to be complements."

(drug usage - research - designer drug mephedrone) "The abuse of 4-methyl-methcathinone, a “designer drug” also known as “mephedrone” or “4-MMC”, has been reported in a growing number of countries and regions. Mephedrone is a derivative of methcathinone, which itself is chemically related to cathinone, one of the psychoactive ingredients found in khat (Catha edulis). Its chemical structure is also related to amphetamines. The effects of the substance are reported to be similar to other stimulant drugs, such as cocaine, amphetamine and MDMA (“ecstasy”), although there is little existing research into its pharmacology and toxicity."

(drug usage - research - low income areas) "Although residents of disadvantaged neighborhoods, neighborhoods with high concentrations of minorities, and neighborhoods with high population densities reported much higher levels of visible drug sales, they reported only slightly higher levels of drug use, along with somewhat higher levels of drug dependency. This finding indicates that conflating drug sales with use, so that poor and minority areas are assumed to be the focus of the problem of drug use, is plainly wrong. The finding is based on the data collected across 41 sites, including city and suburban (but not rural) areas in all regions."

(drug usage - research - low income areas) "Although serious drug use is slightly more prevalent in poor minority neighborhoods than elsewhere, the major problem for disadvantaged neighborhoods is drug distribution. These communities are victims not only of their own drug abuse but also of a criminal drug market that serves the entire society. The market establishes itself in disadvantaged communities in part because of the low social capital in these neighborhoods. The drug economy further erodes that social capital."

Drug Usage - Monitoring the Future

(drug usage - Monitoring the Future - 2010 - long term trends) "In the late 20th century, young Americans reached extraordinarily high levels of illicit drug use by U.S. as well as international standards. ... In 1975, when MTF [Monitoring the Future] began, the majority of young people (55%) had used an illicit drug by the time they left high school. This figure rose to two thirds (66%) in 1981 before a long and gradual decline to 41% in 1992—the low point. After 1992 the proportion rose considerably, reaching a recent high point of 55% in 1999; it then declined gradually to 47% in 2007 through 2009, rising to 48% in 2010. ... Among 8th graders, a gradual and continuing falloff occurred after 1996. Peak rates since 1991 were reached in 1997 in the two upper grades and declined little for several years. Between 2001 and 2007 all three grades showed declines, but annual use rates in all three grades have risen in the past one to three years."

(drug usage - Monitoring the Future - 2010 - marijuana prevalence) "Marijuana use, which had been rising among teens for the past two years, continued to rise in 2010 in all prevalence periods for all three grades. This stands in stark contrast to the long, gradual decline that had been occurring over the preceding decade. Of relevance, perceived risk for marijuana has been falling in recent years. Of particular relevance, daily marijuana use increased significantly in all three grades in 2010; and stands at 1.2%, 3.3%, and 6.1% in grades 8, 10, and 12. In other words, nearly one in sixteen high school seniors today is a current daily, or near-daily, marijuana user."

(drug usage - Monitoring the Future - 2010 - alcohol prevalence) "Alcohol use, including binge drinking, continued its longer term decline among teens, reaching historically low levels in 2010. Use has been in a long-term pattern of decline since about 1980, with the interruption of a few years in the early 1990s in which alcohol use increased along with the use of cigarettes and almost all illicit drugs. ... This statistic [binge drinking] fell to 28% by 1992, prior to the rebound in the 1990s, but has now fallen further reaching 23% in 2010—a marked improvement."

(drug usage - Monitoring the Future - 2010 - tobacco prevalence) "About four in every ten (42%) American young people have tried cigarettes by 12th grade, and about one in five (19%) 12th graders is a current smoker. (These proportions would be higher if high school dropouts were included.) Even as early as 8th grade, one in five (20%) has tried cigarettes, and 1 in 14 (7%) has already become a current smoker."

(drug usage - Monitoring the Future - 2009 - psychotherapeutic drugs) "The psychotherapeutic drugs now make up a larger part of the overall U.S. drug problem than was true 10–15 years ago, in part because use has increased for many such drugs over that period, and in part because use of a number of street drugs has declined substantially since the mid-1990s. It seems likely that young people are less concerned about the dangers of using these drugs outside of medical regimen, likely because they are widely used for legitimate purposes. (Indeed, the low levels of perceived risk for sedatives and amphetamines observed among 12th graders illustrate this point.) Also, prescription psychotherapeutic drugs are now being advertised directly to the consumer, which implies both that they are in widespread use and that they can be used with low risk."

(drug usage - Monitoring the Future - 1997-2008 - effect of decriminalization) "A study of the effects of decriminalization by several states during the late 1970s found no evidence of any impact on the use of marijuana among young people, nor on attitudes and beliefs concerning its use.⁸⁵ However, it should be noted that decriminalization falls well short of the full legalization posited in the questions here. Moreover, the situation today is very different than it was in the late 1970s, with much more peer disapproval and more rigorous enforcement of drug laws. More recent studies suggest that there may be an impact of decriminalization, such that 'youths living in decriminalized states are significantly more likely to report currently using marijuana.'"

(drug usage - Monitoring the Future - 2008 - availability of drugs) "Ever since the study began in 1975, between 83% and 90% of seniors each year have said that they could get marijuana fairly easily or very easily if they wanted some. It has been considerably less accessible to younger adolescents. Still, in 2008 nearly two fifths of 8th graders (39%) and two thirds of 10th graders (67%) reported it as being accessible. This compares to 84% for seniors."

(drug usage - Monitoring the Future - 2008 - prevalence) "Annual marijuana prevalence peaked among 12th graders in 1979 at 51%, following a rise that began during the 1960s. Then use declined fairly steadily for 13 years, bottoming at 22% in 1992—a decline of more than half. The 1990s, however, saw a resurgence of use. After a considerable increase (one that actually began among 8th graders a year earlier than among 10th and 12th graders), annual prevalence rates peaked in 1996 at 8th grade and in 1997 at 10th and 12th grades. After 1996 there was a continuing gradual decline among 8th graders through 2007, with a pause in 2005. Considering the small increase in 2008, use now is down from the 1996 peak level by about two fifths. In the upper grades, only a very modest decline occurred between 1997 and 2002, followed by a continuing gradual decline. In 10th grade, the decline continued through 2008; while for 12th graders, it halted in 2007 and then use rose slightly in 2008."

(drug usage - Monitoring the Future - 1997-2008 - effects of legalization) "Most 12th graders felt that they would be little affected personally by the legalization of either the sale or the use of marijuana. About three fifths (61%) of the respondents said that they would not use the drug even if it were legal to buy and use, while others indicated they would use it about as often as they do now (15%) or less often (1.4%). Only 5.5% said they would use it more often than they do at present, while another 8.9% thought they would try it. (Nine percent said they did not know how their behavior would be affected if marijuana were legalized.) Still, this amounts to 14.4%, or about one in seven who state that they would try marijuana, or their use would increase, if marijuana were legalized."

(drug usage - Monitoring the Future - 1997-2008 - availability of drugs) "In general, the more widely used drugs are reported to be available by higher proportions of the age group, as would be expected (see Tables 9-6, 9-7, and 9-8). Also, older age groups generally perceive drugs to be more available. For example, in 2008, 39% of 8th graders said marijuana would be fairly easy or very easy to get, versus 67% of 10th graders and 84% of 12th graders. In fact, for the other drugs included in the study, the proportion of students saying they are available to them is generally about twice as high among 12th graders compared to 8th graders, and three times as high for ecstasy. Both associations are consistent with the notion that availability is largely attained through friendship circles."

(drug usage - Monitoring the Future - 1997-2008 - effects of legalization) "As shown in Table 8-8, about equal proportions of 12th graders in 2008 believed that marijuana use should be (a) entirely legal (29%); (b) a minor violation like a parking ticket, but not a crime (30%); or (c) a crime (28%). (The remaining 13% said they 'don’t know.')

"Asked whether they thought it should be legal to sell marijuana if it were legal to use it, just over half (56%) said 'yes.' However, four fifths of those answering 'yes' (46% of all respondents) would permit the sale only to adults. Only a small minority (10%) favored the sale to anyone, regardless of age, while 31% said that sale should not be legal even if use were made legal, and 13% said they 'don’t know.'"

(drug usage - Monitoring the Future - 1975-2000 - substance availability) "Overall, it is important to note that supply reduction -- that is, reducing the availability of drugs -- does not appear to have played as major a role as many had assumed in three of the most important downturns in illicit drug use that have occurred to date, namely, those for marijuana, cocaine, and ecstasy (see Figures 8-4, 8-5, and 8-6). In the case of cocaine, perceived availability actually rose during much of the period of the downturn in use. (These data are corroborated by data from the Drug Enforcement Administration on trends in the price and purity of cocaine on the streets.) In the case of marijuana, perceived availability has remained very high for 12th graders over the past 31 years, while use dropped substantially from 1979 through 1992. Perceived availability for ecstasy did increase in association with its increasing use in the 1990s, but the decline phase for use appears to have been driven much more by changing beliefs about the dangers of ecstasy than by any sharp downturn in availability. Similarly, amphetamine use declined appreciably from 1981 to 1992, with only a modest corresponding change in perceived availability. Finally, until 1995, heroin use had not risen among 12th graders even though availability had increased substantially."

(drug usage - Monitoring the Future - 1975-2000 - drug use by U.S. youth vs. other countries) "The MTF study found that in 1999 41% of tenth grade students in the United States had used marijuana or cannabis at least once in their lifetimes. All the participating European countries had a considerably lower rate of lifetime use, averaging 17%. This proportion varied among European countries from 1% in Romania to a high of 35% in France, the United Kingdom, and the Czech Republic. The US also had one of the lowest proportions of students seeing marijuana use as carrying a risk of harm to the user, and one of the lowest proportions saying that they personally disapprove of marijuana use (pp. 345 and 348).... The US also had the highest rates of use of most of the other illicit drugs studied, as well as marijuana, with the important exception of heroin. These included amphetamines, hallucinogens, cocaine, crack, and ecstasy."

Drug Usage - Tables

(2000-2010 - Monitoring the Future - prevalence of current substance use among 8th, 10th & 12th graders combined)

^{Notes:
• All values represent the percentage who used the respective substance within the last 30-days. Generally, these are construed to be "current" users.
• All percentages are representative of grades 8, 10, and 12 combined.
• Percentages are not additive to the total for illicit drugs.
• Marijuana includes hashish.
• "Tranquilizers" include Valium and Xanax. In other studies like the National Survey on Drug Use and Health (NSDUH), tranquilizers are placed with other substances in "Pychotherapeutics."
• Over-the-counter substances are not included.
• Questionnaire changes made prior to the 2002 Monitoring the Future (MTF) survey impact trend measurement prior to that year. To match the trendable years of NSDUH reports and the Goals of the National Drug Control Strategies, this tabulation of MTF data begins with 2002. The annual data for MTF reports can date back to 1991 and earlier.}

(2000-2010 - Monitoring the Future - prevalence of lifetime substance use among 8th, 10th & 12th graders combined)

^{Notes:
• All values are "Percentage who ever used."
• All percentages are representative of grades 8, 10, and 12 combined.
• Percentages are not additive to the total for illicit drugs.
• Marijuana includes hashish.
• "Tranquilizers" include Valium and Xanax. In other studies like the National Survey on Drug Use and Health (NSDUH), tranquilizers are placed with other substances in "Pychotherapeutics."
• Over-the-counter substances are not included.
• Questionnaire changes made prior to the 2002 Monitoring the Future (MTF) survey impact trend measurement prior to that year. To match the trendable years of NSDUH reports and the Goals of the National Drug Control Strategies, this tabulation of MTF data begins with 2002. The annual data for MTF reports can date back to 1991 and earlier.}

(2002-2010 - NSDUH - estimated lifetime use by substance in 000) The following table shows the estimated "lifetime"^† drug use by U.S. residents from the baseline year of 2002, as established in the National Drug Control Strategy: 2003. The source for these data is the National Survey on Drug Use and Health (NSDUH).

Through 2010 – nine years from the baseline year of 2002 -- "lifetime" illicit drug use had increased by +10.4% to an estimated 119.5 million users or 47.1% (almost half) of the defined population. "Lifetime" users of marijuana, the most widely used illicit drug, grew to 106 million or 41.9% of the defined population. During these nine years, the use of drugs other than marijuana expanded by +8.4%. At respective rates of +56.7% and +17.4%, "Ecstasy" and "Pain Relievers" experienced the fastest growth among all illicit drugs. "Psychtherapeutics" and "Cocaine" also grew, both at rates of +7.7% and +9.7% from 2002 through 2010, although with 2010 lifetime user numbers of 52 million and 35 million, "Psychotherapeutics" and its subset "Pain Relievers" are much more pervasive. Both of these represent the non-prescription use of these otherwise legal drugs.

^{Notes:
• The US Population numbers only count all Americans age 14 years and older.
• All drug use numbers only count those 12 years of age and older.
• The "Population %" represents the percentage of the sampled population, that does not equate to the US Census numbers listed above.
• † "Lifetime" drug use for NSDUH data means that someone has "ever used" the respective drug or tried it just once in their lifetime. "Monthly" drug use means use of the respective drug at least once per month. "Monthly" use is also is referred to as "current" use by the NSDUH.
• Use numbers are not additive. Because of poly-drug use, subordinate counts do not add to equal "Illicit drugs - all."
• Marijuana includes hashish.
• "Psychotherapeutics" include the nonmedical use of any prescription-type pain relievers, tranquilizers, stimulants, or sedatives. Over-the-counter substances are not included.
• Methodology changes made beginning with the 2002 NSDUH survey impact trend measurement. As stated, "Although the design of the 2002 and 2003 NSDUHs is similar to the design of the 1999 through 2001 surveys, there are important methodological differences that impact comparability of 2002 and 2003 estimates with estimates from prior surveys."}

(2000-2010 - NSDUH - estimated monthly "current" use by substance in 000) The following table shows the estimated number of U.S. residents who consumed the respective drug on a monthly basis from the baseline year of 2002 as established in the National Drug Control Strategy: 2003.¹ It should be noted that changes in methodology affect the comparability of data prior to 2002.

Through 2010 – nine years from the 2002 baseline – monthly users of all illicit drugs had increased to 22.6 million at rate of +15.9% since 2002. Monthly marijuana users in 2010 equaled 17.3 million, reflecting an increase of +19.1% over 2002. The two drug categories experiencing the fastest monthly user population growth between 2002 and 2010 were “Heroin” at +44% and "Pain Relievers" at +16.5%. The monthly use of alcohol also increased in 2010, up +9.6% over 2002 to 131 million current users and representing 11 million additional monthly users since 2002. Tobacco use decreased from 2002 to 2010 by -2.7% to 69.6 million current users.

^{Notes:
• † "Lifetime" drug use for NSDUH data means that someone has "ever used" the respective drug or tried it just once in their lifetime. "Monthly" drug use means use of the respective drug at least once per month. "Monthly" use is also is referred to as "current" use by the NSDUH.
• All drug use numbers only count those 12 years of age and older.
• Use numbers are not additive. Because of poly-drug use, subordinate counts do not add to equal "Illicit drugs - all."
• Marijuana includes hashish.
• "Psychotherapeutics" include the nonmedical use of any prescription-type pain relievers, tranquilizers, stimulants, or sedatives. Over-the-counter substances are not included.
• “Heavy” alcohol use is defined as drinking five or more drinks on the same occasion on each of 5 or more days in the past 30 days.
• Methodology changes made beginning with the 2002 NSDUH survey impact trend measurement. As stated, "Although the design of the 2002 and 2003 NSDUHs is similar to the design of the 1999 through 2001 surveys, there are important methodological differences that impact comparability of 2002 and 2003 estimates with estimates from prior surveys."}

(2000-2010 - NSDUH - estimated change in use by substance) The following table shows the percentage change values in "lifetime"^† and "monthly"^† illicit drug, alcohol and tobacco use for the nine years 2002-2010 and five years 2002-2006. The latter time frame matches against the goals set forth in the 2003 National Drug Control Strategy as crafted by the Office of National Drug Control Policy in February of 2003. The baseline year for measurement of the goals was the 2002 National Survey of Drug Use and Health (NSDUH).

If the stated goals were a 10% reduction in two years, five years or nine years from 2002, it can safely be said that the plan fell short of its goals, for usage of the aforementioned substances grew in almost all categories during all of the time frames covered in this table with a few notable exceptions.

In the nine years since 2002, the drugs showing the largest "lifetime" growth in use were Ecstasy (+56.7%), pain relievers (+17.4%) and heroin (+12.5%). Regarding"monthly" usage, heroin (+44%) and pain relievers (+16.5%) grew the most quickly, along with marijuana (+19.5%). Ecstasy appears to be a drug that more people are trying, but few (+1.3% monthly) use on a regular basis.

For the ONDCP goal evaluation period of 2002-2006, now five years ago, "lifetime" heroin use (+3.2%) matched only one quarter of its nine-year growth rate (+12.5%), but a surge in its "monthly" use was foretold by a spike (+103.6%) in its percentage change during the evaluation period. Similar to the nine year time frame, the use of pain relievers also jumped during the evaluation period (+13% "lifetime" and +19.3% "monthly"). It should be noted that during the evaluation period, the average number of heroin users (185,000) equaled only 4% of those who illicitly used pain relievers, often opiates as well (4.7 million users on average).

During either the last nine years or the ONDCP goal evaluation period, only two classes of illicit drugs experienced declines in usage: methamphetamine and crack cocaine. Compared to other substances, the two do have fairly small user bases, 353,000 for meth and 239,000 for crack with respect to use on a "monthly" basis. Both "lifetime"(-15.3%) and "monthly" (-48.3%) use of methamphetamine dropped during the last nine years. While the "lifetime" (+9.0%) use of crack cocaine has grown since 2002, "monthly" (-33.3%) consumption plummeted by one-third.

If history teaches lessons, the 2015 goals for the "National Drug Control Strategy: 2011" may fare little better than the those promulgated almost ten years ago. This "new" strategy calls for reduction in drug use of -10% for adults aged 18-25 and -15% for "chronic drug users" (often defined as monthly or current use) by 2015.

^{Notes:
• † "Lifetime" drug use for NSDUH data means that someone has "ever used" the respective drug or tried it just once in their lifetime. "Monthly" drug use means use of the respective drug at least once per month. "Monthly" use is also is referred to as "current" use by the NSDUH.
• "%chg" is the percentage change in users for the respective time period or drug in 2009 over that value for 2002.
• All drug use percentages are based on user counts of those 12 years of age and older.
• Use numbers are not additive. Because of poly-drug use, subordinate counts do not add to equal "Illicit drugs - all."
• Marijuana includes hashish.
• "Psychotherapeutics" include the nonmedical use of any prescription-type pain relievers, tranquilizers, stimulants, or sedatives. Over-the-counter substances are not included.
• “Heavy” alcohol use is defined as drinking five or more drinks on the same occasion on each of 5 or more days in the past 30 days.
• NSDUH reports did not begin reporting Ecstasy user data until 2001, making 2002 the first year for which a percent change over the prior year could be computed.}

(1997, 2001, & 2005 - drug usage in The Netherlands) Prevalence of drug use in the Dutch population 15-64 years of age:

(1999 - drug use in The Netherlands) Below are results from a survey of drug use in The Netherlands published in 1999. Note the difference in drug use prevalence compared to the United States. For more information check out The Netherlands section of Drug War Facts.

*^{Crack cocaine is not tracked separately.}