The new 144-page report released on Friday by The National Center on Addiction and Substance Abuse (CASA) at Columbia University also reveals that alcohol and other drugs are significant factors in all crime. In 2006, alcohol and other drugs were involved in these inmate offenses:
78 percent of violent crimes;
83 percent of property crimes; and
77 percent of public order, immigration or weapon offenses; and probation/parole violations.

Despite these high rates, the CASA report found that only 11 percent of all inmates with substance abuse and addiction disorders receive any treatment during their incarceration. The report found that if all inmates who needed treatment and aftercare received such services, the nation would break even in a year if just over 10 percent remained substance and crime free and employed. Thereafter, for each inmate who remained sober, employed and crime free the nation would reap an economic benefit of $90,953 per year.

“States complain mightily about their rising prison costs; yet they continue to hemorrhage public funds that could be saved if they provided treatment to inmates with alcohol and other drug problems and stepped up use of drug courts and prosecutorial drug treatment alternative programs,” said Susan E. Foster, CASA’s Vice President and Director of Policy Research and Analysis.

The report also noted that in 2005, federal, state and local governments spent $74 billion on incarceration, court proceedings, probation and parole for substance-involved adult and juvenile offenders and less than one percent of that amount—$632 million—on prevention and treatment for them.

Twelve years ago, CASA released Behind Bars: Substance Abuse and America’s Prison Population. CASA prepared this report to see if any progress had been made in reducing the number of substance-involved offenders behind bars and to examine and identify promising practices for cost-effective investments. To conduct this study, CASA researchers analyzed data on inmates from 11 federal sources, reviewed more than 650 articles and other publications, examined best practices in prevention and treatment for substance-involved offenders, reviewed accreditation standards and analyzed costs and benefits of treatment.

The CASA report also found that compared to non-substance involved inmates, substance-involved inmates are not only likelier to be re-incarcerated, begin their criminal careers at an early age, and have more contacts with the criminal justice system, but they are also:
Four times likelier to receive income through illegal activity;
Twice as likely to have had at least one parent who abused alcohol or other drugs when they were children;
41 percent likelier to have some family criminal history;
29 percent less likely to have completed at least high school; and
20 percent likelier to be unemployed a month before incarceration.

Click here to read CASA’s full news release on the report.

Here is a link to the website of  NACOA the National Association of Children of Alcoholics. It is filled with experience strength and hope for children with many real world programs to help them and those who comfort and support them. Check it out for information you can use in your daily life.

    Along those lines here is a link to SAMHSA’s guide for Community Action for Children of Alcoholics. It is a fact filled program of action, packed into a 41 page PDF.

   If you would like to help get the message of hope out to the children themselves here is a link to the NACOA brochure titled “It Feels so Bad” which speaks to the kids themselves letting them know it’s not their fault and that there is help available. You may print these out and distribute them to the kids yourself.

   And, if you would like to help educate your church  to be more proactive in the community regarding drug and alcohol dependency here is a link to a SAMHSA training manual titled “Core competencies for Clergy and other Pastoral ministers in addressing alcohol and drug dependence and the impact on family members“ 

  Although this next pamphlet is designed for use by the clergy, it holds much information that any of us could use.  It is titled “ Preventing and Addressing Alcohol and Drug Problems” and should be recommended reading for all parents and other caretakers of children.

“This new data has profound implications for the health and well-being of older adults who continue to abuse substances,” said SAMHSA Administrator, Pamela S. Hyde, J.D. “These findings highlight the need for prevention programs for all ages as well as to establish improved screening and appropriate referral to treatment as part of routine health care services.”  

Substance abuse at any age is associated with numerous health and social problems, but age-related physiological and social changes make older adults more vulnerable to the harmful effect of illicit drug use.

“This study highlights the fact that older Americans face a wide spectrum of healthcare concerns that must be addressed in a comprehensive way,” said Assistant Secretary for Aging, Kathy Greenlee.  “The Administration on Aging is committed to working with SAMHSA and all other public health partners in meeting these challenges.”  

The latest SAMHSA short report, Illicit Drug Use among Older Adults, shows that an estimated 4.3 million adults aged 50 or older (4.7 percent) used an illicit drug in the past year. In fact, 8.5 percent of men aged 50 to 54 had used marijuana in the past year (as opposed to only 3.9 percent of women in this age group). The SAMHSA report also shows that marijuana use was more common than nonmedical use of prescription drugs among males 50 and older, (4.2 vs. 2.3 percent), but among females the rates of marijuana use and nonmedical use of prescription drugs were similar (1.7 and 1.9 percent). 

Although marijuana use was more common than nonmedical use of prescription drugs for adults age 50 to 59, among those aged 65 and older, nonmedical use of prescription drugs was more common than marijuana.   

The report, which examines the prevalence of any illicit drug use, marijuana use, and nonmedical use of prescription drugs, is based on data collected during 2006 to 2008 from a nationally representative sample of 19, 921 adults aged 50 or older who participated in SAMHSA’s National Survey on Drug Use and Health The full report may be seen online at http://www.oas.samhsa.gov/2k9/168/168OlderAdults.cfm.

Past month Tobacco use by Education: 

 As observed from 2002 onward, cigarette smoking in the past month was less prevalent among adults who were college graduates compared with those with less education. Among adults aged 18 or older, current cigarette use in 2008 was reported by 34.4 percent of those who had not completed high school, 30.6 percent of high school graduates who did not attend college, 26.6 percent of persons with some college, and 14.0 percent of college graduates.

Among young adults 18 to 22 years old, full-time college students were less likely to be current cigarette smokers than their peers who were not enrolled full time in college. Cigarette use in the past month in 2008 was reported by 27.2 percent of full-time college students, less than the rate of 40.6 percent for those not enrolled full time.

In 2008, current cigarette smoking was more common among unemployed adults aged 18 or older than among adults who were working full time or part time (43.0 vs. 27.2 and 23.8 percent, respectively). Cigar smoking followed a similar pattern, with 9.8 percent of unemployed adults reporting past month use compared with 6.4 percent of full-time workers and 5.5 percent of part-time workers.

Tobacco Use by Age:

 Current use of smokeless tobacco in 2008 was higher among adults aged 18 or older who were employed full time (4.8 percent) and those who were unemployed (4.9 percent) than among adults who were employed part time (1.8 percent) and those in the “other” employment category, which includes persons not in the labor force (2.0 percent).

Use of illicit drugs and alcohol was more common among current cigarette smokers than among nonsmokers in 2008, as in prior years since 2002. Among persons aged 12 or older, 20.4 percent of past month cigarette smokers reported current use of an illicit drug compared with 4.2 percent of persons who were not current cigarette smokers. Past month alcohol use was reported by 67.4 percent of current cigarette smokers compared with 46.7 percent of those who did not use cigarettes in the past month. The association also was found with binge drinking (44.6 percent of current cigarette smokers vs. 16.5 percent of current nonsmokers) and heavy drinking (16.8 vs. 3.8 percent, respectively).

Drug Use by Employment Status:

It is interesting stuff if you take the time to think about it.

This first chart shows which drugs were first used by initiates the past year.

As you can see, Marijuana still leads the pack, followed by pain relievers then inhalants.

This next chart shows drug usage by age over ths past month,

As you can see the 16 to 29 group continues to lead the pack, accounting for over 55% of last months drug usage.

Continuing that theme this chart shows DUI by age for the last month.

Once again, the 16 to 29 age group leads the group showing over 65% of the total.

And finally, this last chart shows which substances generated the most requests for treatment in the last month.

Sometimes the pictures just speak for themselves. 

Figure 1. Percentage of Discharges from Outpatient Substance Abuse Treatment, by Reason for Discharge

Percentage of Discharges from Outpatient Substance Abuse Treatment, by Primary Substance of Abuse and Reason for Discharge

Percentage of Discharges from Outpatient Substance Abuse Treatment, by Race/Ethnicity and Reason for Discharge

Percentage of Discharges from Outpatient Substance Abuse Treatment, by Educational Level, Employment Status, and Reason for Discharge

A Day in the Life of American Adolescents: Substance Use Facts

In the United States in 2006, one third of adolescents aged 12 to 17 drank alcohol in the past year, one fifth used an illicit drug, and one sixth smoked cigarettes.  Although

the percentage of adolescents using alcohol and drugs declined between 2002 and

2006, the percentage of persons aged 12 to 17 receiving substance abuse treatment

has remained relatively stable.  In 2005, 7.7 percent of all persons admitted to

publicly funded treatment facilities were aged 12 to 17.  Office of Applied Studies

(OAS) in the Substance Abuse and Mental Health Services Administration (SAMHSA)

collects, analyzes, and disseminates critical public health data. OAS manages three

national data collections that offer insight into adolescent substance use and

treatment: the National Survey on Drug Use and Health (NSDUH), the Treatment

Episode Data Set (TEDS), and the National Survey of Substance Abuse Treatment

Services (N-SSATS). This issue of The OAS Report presents facts about

adolescent substance use, including initiation, and receipt of treatment for substance

use “on an average day. Data presented in this report from the 2006 NSDUH and

the 2005 TEDS are for adolescents aged 12 to 17; data presented from the 2005 N-

SSATS are for youth under 18.

First Substance Use

According to the 2006 NSDUH, 10.6 percent of adolescents aged 12 to 17 drank

alcohol for the first time in the past year, and 5.8 percent used an illicit drug for the first

time. The 2006 NSDUH also indicates that on an average day during the past year,

 adolescents aged 12 to 17 used the following substances for the first time (Figure 1):

• 7,970 drank alcohol for the first time;
• 4,348 used an illicit drug for the first time;
• 4,082 smoked cigarettes for the first time;
• 3,577 used marijuana for the first time;
• 2,517 used pain relievers nonmedically for the first time;
• 1,603 used inhalants for the first time;
• 1,281 used hallucinogens for the first time;
• 909 used cocaine for the first time;
• 860 used stimulants nonmedically for the first time;
• 236 used methamphetamine for the first time; and
• 86 used heroin for the first time.

Number of Adolescents Aged 12 to 17 Who Used Cigarettes, Alcohol, or Illicit Drugs for the First Time on an Average Day: 2006 NSDUH
Substance	Number of Adolescents
Alcohol	7,970
Any Illicit Drug	4,348
Cigarettes	4,082
Marijuana	3,577
Pain Relievers*	2,517
Inhalants	1,603
Hallucinogens	1,281
Cocaine	909
Stimulants*	860

Source: SAMHSA, 2006 NSDUH.

Cigarette, Alcohol, and Illicit Drug Use

According to the 2006 NSDUH, more than 8 million adolescents aged 12 to 17 drank alcohol in the past year, nearly 5 million used an illicit drug, and more than 4 million smoked cigarettes. In addition, on an average day during the past year, adolescents aged 12 to 17 used the following substances (Figure 2):

• 1,245,240 smoked cigarettes;
• 630,539 drank alcohol;
• 586,454 used marijuana;
• 49,263 used inhalants;
• 26,645 used hallucinogens;
• 13,125 used cocaine; and
• 3,753 used heroin.

Number of Adolescents Aged 12 to 17 Who Used Cigarettes, Alcohol, or Illicit Drugs on an Average Day: 2006 NSDUH
Substance	Number of Adolescents
Cigarettes	1,245,240
Alcohol	630,539
Marijuana	586,454
Inhalants	49,263
Hallucinogens	26,645
Cocaine	13,125
Heroin	3,753

Source: SAMHSA, 2006 NSDUH.

The 2006 NSDUH also indicates that:

• adolescents who used alcohol in the past month drank an average of 4.7 drinks per day on the days they drank; and
• adolescents who smoked cigarettes in the past month smoked an average of 4.6 cigarettes per day on the days they smoked.

Substance Abuse Treatment

TEDS reported that in 2005 there were 142,646 admissions for adolescents aged 12 to 17 to substance abuse treatment programs (TEDS data come primarily from facilities that receive some public funding). TEDS also indicates that on an average day in 2005, adolescent admissions to treatment presented with the following substances as the primary substance of abuse¹¹ (Figure 3):

• 255 with marijuana;
• 72 with alcohol;
• 24 with stimulants;
• 10 with cocaine;
• 7 with opiates; and
• 7 with other drugs.

Number of Adolescents Aged 12 to 17 Admitted to Publicly Funded Substance Abuse Treatment Facilities on an Average Day, by Primary Substance of Abuse: 2005 TEDS
Substance	Number of Adolescents
Marijuana	255
Alcohol	72
Stimulants	24
Cocaine	10
Opiates	7
Other Drugs	7

Source: SAMHSA, 2005 TEDS.

The 2005 TEDS also indicates that on an average day in 2005, the number of adolescent admissions to substance abuse treatment were referred by the following sources¹² (Figure 4):

• 189 by the criminal justice system;
• 66 by self-referral or referral from other individuals;
• 43 by schools;
• 37 by community organizations;
• 22 by alcohol or drug treatment providers; and
• 18 by other health care providers.

Number of Substance Abuse Treatment Admissions among Adolescents Aged 12 to 17 on an Average Day, by Principal Source of Referral: 2005 TEDS
Source of Referral	Number of Admissions
Criminal Justice System	189
Self or Other Individuals	66
Schools	43
Community Organizations	37
Treatment Providers	22
Other Health Care Providers	18

Source: SAMHSA, 2005 TEDS.

In addition, N-SSATS, which collects information on substance abuse treatment at both publicly and privately funded facilities, reports how many active clients¹³ under the age of 18 received the following types of substance abuse treatment on an average day in 2005 (Figure 5):

• 76,240 were clients in outpatient treatment;
• 10,313 were clients in non-hospital residential treatment; and
• 1,058 were clients in hospital inpatient treatment.

Number of Adolescents Under Age 18 Who Were Clients in Publicly or Privately Funded Substance Abuse Treatment Facilities on an Average Day, by Service Type: 2005 N-SSATS
Service Type	Number of Adolescents
Outpatient	76,240
Non-hospital Residential	10,313
Hospital Inpatient	1,058

Source: SAMHSA, 2005 N-SSATS.

Initiation of Substance Use (Incidence, or First-Time Use) within the Past 12 Months

   In 2008, an estimated 2.9 million persons aged 12 or older used an illicit drug for the first time within the past 12 months. This averages to almost 8,000 initiates per day and is similar to the estimate for 2007. A majority of these past year illicit drug initiates reported that their first drug was marijuana (56.6 percent). Nearly one third initiated with psychotherapeutics (29.6 percent, including 22.5 percent with pain relievers, 3.2 percent with tranquilizers, 3.0 percent with stimulants, and 0.8 percent with sedatives). A sizable proportion reported inhalants (9.7 percent) as their first illicit drug, and a small proportion used hallucinogens as their first drug (3.2 percent).In 2008, the illicit drug categories with the largest number of past year initiates among persons aged 12 or older were marijuana use (2.2 million) and nonmedical use of pain relievers (2.2 million). These estimates were not significantly different from the numbers in 2007.In 2008, there were 729,000 persons aged 12 or older who had used inhalants for the first time within the past 12 months; 70.4 percent were under age 18 when they first used. There was no significant change in the number of inhalant initiates from 2007 to 2008, but the number in 2008 was significantly lower than the estimate in 2005 (877,000).The number of past year initiates of methamphetamine among persons aged 12 or older was 95,000 in 2008. This estimate was significantly lower than the estimate in 2007 (157,000) and was less than one third of the number estimated in 2004 (318,000).Following substantial drops in initiation between 2002 and 2003, estimates of initiation of Ecstasy and LSD among persons aged 12 or older have increased significantly. Between 2003 and 2008, the number of Ecstasy initiates increased from 642,000 to 894,000, and the number of LSD initiates increased from 200,000 to 394,000.Most (84.6 percent) of the 4.5 million past year alcohol initiates were younger than age 21 at the time of initiation.The number of persons aged 12 or older who smoked cigarettes for the first time within the past 12 months was 2.4 million in 2008, similar to the estimate in 2007 (2.2 million) but significantly higher than the estimate for 2002 (1.9 million). Most new smokers in 2008 were under age 18 when they first smoked cigarettes (58.8 percent); however, the number of persons initiating smoking at age 18 or older increased from about 600,000 in 2002 to 1 million in 2008.

      Youth Prevention-Related Measures

   Perceived risk is measured by NSDUH as the percentage reporting that there is great risk in the substance use behavior. The percentage of youths aged 12 to 17 perceiving great risk in smoking marijuana once or twice a week increased from 51.5 percent in 2002 to 55.0 percent in 2005, but dropped to 53.1 percent in 2008. A decline from 2005 to 2008 also was observed for using LSD once or twice a week (76.2 percent in 2002, 76.1 percent in 2005, and 73.9 percent in 2008). Between 2002 and 2008, the percentages who reported great risk in using alcohol and cigarettes increased. In 2002, 63.1 percent of youths reported great risk in smoking one or more packs of cigarettes per day, and in 2008 the percentage increased to 69.7 percent. In 2002, 38.2 percent reported great risk in binge drinking once or twice a week, and in 2008 the percentage increased to 40.5 percent.Almost half (49.2 percent) of youths aged 12 to 17 reported in 2008 that it would be “fairly easy” or “very easy” for them to obtain marijuana if they wanted some. Around one quarter reported it would be easy to get cocaine (22.1 percent). About one in seven (13.8 percent) indicated that LSD would be “fairly” or “very” easily available, and 13.0 percent reported easy availability for heroin. Between 2002 and 2008, there were declines in the perceived availability for all four drugs.A majority of youths aged 12 to 17 (90.8 percent) in 2008 reported that their parents would strongly disapprove of their trying marijuana or hashish once or twice. Current marijuana use was much less prevalent among youths who perceived strong parental disapproval for trying marijuana or hashish once or twice than for those who did not (4.3 vs. 29.8 percent).In 2008, 11.1 percent of youths aged 12 to 17 reported that they had participated in substance use prevention programs outside of school within the past year. This was lower than the percentage reported in 2002 (12.7 percent). Almost four fifths (78.0 percent) reported having seen or heard drug or alcohol prevention messages from sources outside of school, lower than in 2002 when the percentage was 83.2 percent. The percentage of school-enrolled youths reporting that they had seen or heard prevention messages at school also declined during this period, from 78.8 to 75.9 percent.      

As promised, here are SAMHSA’s findings on alcohol use in America. Pretty interesting stuff really. I hope you find it as enlightening as I did.

Alcohol Use

• Slightly more than half of Americans aged 12 or older reported being current drinkers of alcohol in the 2008 survey (51.6 percent). This translates to an estimated 129.0 million people, which was similar to the 2007 estimate of 126.8 million people (51.1 percent).
• In 2008, more than one fifth (23.3 percent) of persons aged 12 or older participated in binge drinking. This translates to about 58.1 million people, similar to the estimate in 2007. Binge drinking is defined as having five or more drinks on the same occasion on at least 1 day in the 30 days prior to the survey.
• In 2008, heavy drinking was reported by 6.9 percent of the population aged 12 or older, or 17.3 million people. This rate was the same as the rate of heavy drinking in 2007. Heavy drinking is defined as binge drinking on at least 5 days in the past 30 days.
• Among young adults aged 18 to 25 in 2008, the rate of binge drinking was 41.0 percent, and the rate of heavy drinking was 14.5 percent. These rates were similar to the rates in 2007.
• The rate of current alcohol use among youths aged 12 to 17 was 14.6 percent in 2008, which is lower than the 2007 rate (15.9 percent). Youth binge and heavy drinking rates in 2008 were 8.8 percent (lower than the 9.7 percent rate in 2007) and 2.0 percent, respectively.
• Past month and binge drinking rates among underage persons (aged 12 to 20) declined between 2002 and 2008. The rate of past month underage drinking declined from 28.8 to 26.4 percent, and the rate of past month binge drinking declined from 19.3 to 17.4 percent.
• Past month alcohol use rates declined between 2002 and 2008 for those aged 12 or 13 (4.3 to 3.4 percent), 14 or 15 (16.6 to 13.1 percent), 16 or 17 (32.6 to 26.2 percent), and 18 to 20 (51.0 to 48.7 percent).
• Among persons aged 12 to 20, past month alcohol use rates in 2008 were 17.2 percent among Asians, 19.0 percent among blacks, 22.9 percent among those reporting two or more races, 23.1 percent among Hispanics, 26.4 percent among American Indians or Alaska Natives, and 30.1 percent among whites.
• In 2008, 56.2 percent of current drinkers aged 12 to 20 reported that their last use of alcohol in the past month occurred in someone else’s home, and 29.6 percent reported that it had occurred in their own home. About one third (30.8 percent) paid for the alcohol the last time they drank, including 8.3 percent who purchased the alcohol themselves and 22.3 percent who gave money to someone else to purchase it. Among those who did not pay for the alcohol they last drank, 37.4 percent got it from an unrelated person aged 21 or older, 21.1 percent from another person under 21 years of age, and 21.0 percent from a parent, guardian, or other adult family member.
• In 2008, an estimated 12.4 percent of persons aged 12 or older drove under the influence of alcohol at least once in the past year. This percentage has dropped since 2002, when it was 14.2 percent. The rate of driving under the influence of alcohol was highest among persons aged 21 to 25 (26.1 percent).

We will provide additional findings from the National Survey on Drug Use and Health in future posts as time and money permit. Please stay tuned.