The use of illicit drugs is down among the nation's youth, according to the results of a government survey released last month, but officials cautioned that they must remain vigilant about continuing to pursue drug-prevention efforts due to rising rates of prescription drug use among young adults.

"Prescription drug use rates are approaching initiation rates for marijuana. We have to wake up and pay attention to what is going on," declared John Walters, director of the White House Office of National Drug Control Policy, at a press conference held in Washington, D.C., in September.

Each year, the Substance Abuse and Mental Health Services Administration (SAMHSA) surveys approximately 67,500 people in their homes to estimate national drug-use rates and prevalence and the prevalence of alcohol and substance-use disorders and other mental health problems.

Researchers from RTI International, a research firm located in Research Triangle Park, N.C., collect the data, which are then extrapolated to population estimates.

Results from the 2006 National Survey on Drug Use and Health (NSDUH) revealed that an estimated 20.4 million Americans aged 12 and older were current or past month drug users, representing about 8.3 percent of Americans in that age group.

Marijuana (including hashish) was the most commonly used illicit drug, with 14.8 million current users; marijuana accounts for 72.8 percent of current illicit drug use. Government officials noted that marijuana use has dropped among young people in recent years. For instance, among 12- to 17-year-olds, current marijuana use dropped from 8.2 percent in 2002 to 6.7 percent in 2006.

There were 9.6 million people aged 12 and older who were current users of drugs other than marijuana in 2006. Most (7 million) used psychotherapeutic drugs nonmedically.

About 5.2 million people were current nonmedical users of prescription pain medication in 2006, a substantial jump from the 4.7 million estimated to have used these medications nonmedically in 2005. Among people aged 12 and older who used pain medications nonmedically in the preceding year, over half (55.7 percent) obtained the pain medications from a friend or relative for free. Another 9.3 percent reported buying the medications from a friend or family member, and 19 percent reported getting the medications from a doctor.

"Many of these painkillers that are being abused are unused medications that should be properly disposed of," noted SAMHSA Administrator Terry Cline, Ph.D., at the press conference.

Little change in cocaine use was found in the most recent survey. In 2006 there were about 2.6 million current cocaine users, the same number as in 2005.

Methamphetamine use rates have remained steady since 2002. In 2006, there were an estimated 731,000 current users of methamphetamine aged 12 or older.

The number of current heroin users increased from 136,000 in 2005 to 338,000 in 2006.

In 2006, slightly more than half of Americans aged 12 or older reported being current drinkers of alcohol, or an estimated 125 million people. About 57 million people age 12 or older participated in binge drinking, defined as five or more drinks on the same occasion on at least one day in the prior month.

About 17 million people were estimated to have engaged in heavy drinking, which means that they consumed five or more drinks on the same occasion for five or more days in the prior month.

An estimated 72.9 million Americans were current users of tobacco. Among these, the vast majority (61.6 million) were cigarette smokers.

The NSDUH also collects information on substance abuse and dependence.

In 2006, an estimated 22.6 million people aged 12 or older were classified with substance dependence or abuse in the past year. Of these, 3.2 million were classified with dependence on or abuse of both alcohol and drugs, 3.8 million were dependent on or abused drugs but not alcohol, and 15.6 million were dependent on or abused alcohol but not drugs.

Dependence on drugs or alcohol was defined as meeting three of seven dependence criteria for substances, which included questions to measure a withdrawal criterion and three out of six dependence criteria for substances that did not include withdrawal questions based on criteria in the DSM-IV.

Drugs with the highest rates of past year dependence or abuse in 2006 were marijuana, followed by cocaine and pain relievers.

Of the 7 million people aged 12 and older who were classified with dependence on or abuse of illicit drugs in 2006, 4.2 million were dependent on or abused marijuana and hashish, representing 1.7 percent of the population aged 12 and older—almost 60 percent of all those classified with drug abuse or dependence in the United States.

About 1.7 million people aged 12 and older were classified with abuse or dependence on cocaine and 1.6 million with abuse or dependence on pain relievers.

One of SAMHSA's goals, Walters said, is not only to prevent the initiation of substance use, but to "provide for more capacity for substance abuse treatment and follow through with support for those in recovery."

Screening for drug use in classrooms, the criminal justice system, and doctors' offices is an important first step, he noted.

"Together, we will change the future of the substance abuse problem in the U.S.," he said. For survey results on the use

The article 30 Million in U.S. Have Had Depression discusses survey results pertaining to psychological distress experienced by adults.

The results of the 2006 National Survey on Drug Use and Health are posted at<oas.samhsa.gov/nsduhLatest.htm>.▪