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Misuse of Prescription Drugs |
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This chapter presents estimates of the prevalence of nonmedical use of prescription psychotherapeutic drugs in each of the 50 States and the District of Columbia. Estimates of the rate of past year use of any prescription psychotherapeutic drug, pain relievers, tranquilizers, stimulants, methamphetamine, and sedatives are provided based on averages for 2002, 2003 and 2004. Over that 3-year period, the National Survey on Drug Use and Health (NSDUH) accrued a total of 203,670 interviews, including an average of approximately 10,900 respondents in each of eight large sample States (California, Florida, Illinois, Michigan, New York, Ohio, Pennsylvania, and Texas) and an average of approximately 2,700 in each of the remaining States and the District of Columbia. The estimates in this chapter were generated directly from the weighted NSDUH sample,1 which is designed to be representative of the United States as a whole and of each of the States and the District of Columbia. Further information about the sample is provided in Appendix A.
The map figures in this chapter are shaded according to the magnitude of estimated prevalence of the respective measures of prescription drug misuse. States ranking among the top 10 in the particular measure are shown in dark gray, States in the middle of the rankings are shown in white, and the 10 States with the lowest prevalence are shown in light blue.2
The tables for this chapter provide prevalence estimates for past year use of psychotherapeutic drugs in the respective categories for persons aged 12 or older, youths aged 12 to 17, young adults aged 18 to 25, and adults aged 26 or older. For each prevalence estimate, the tables also show the 95 percent confidence interval (CI), which gives a measure of the precision of the estimate. For instance, the State with the highest rate of past year misuse of any prescription psychotherapeutic drug was Kentucky, with a rate of 8.5 percent (Table 7.1). The 95 percent CI for that estimate is from 7.5 to 9.7 percent. This indicates that if multiple independent samples of the same size and design were drawn from that same population, the estimated prevalence would fall between 7.5 and 9.7 percent in 95 percent of the samples. Another interpretation is that the true prevalence has a 95 percent chance of falling within that interval.
In this chapter, State rankings are discussed in terms of the range and the national average. However, the difference between the highest (or lowest) rate and the next-to-highest (or next-to-lowest) rate is typically very small and not statistically significant. For example, Nevada ranked first in past year stimulant misuse with a rate of 2.7 percent, but the rate in second-ranking Montana, 2.4 percent, was only 0.3 percentage points different and statistically not different from the Nevada estimate. Therefore, it is important to consider the CI when comparing States. For Nevada, for example, the 95 percent CI for any past year stimulant misuse runs from 1.9 to 3.8 percent. The estimate for Montana clearly falls within that interval. The estimate for Ohio, 1.0 percent, falls outside this range, and the CI for Ohio (from 0.8 to 1.2 percent) does not overlap the CI for Nevada (1.9 to 3.8 percent). We can therefore conclude that the estimated rate of stimulant use among the population aged 12 or older is higher for Nevada than for Ohio.3
For the Nation as a whole, an annual average of 6.2 percent of persons aged 12 or older had used a prescription psychotherapeutic drug nonmedically in the 12 months leading up to the survey. Of the 10 highest-ranking States for misuse of any prescription psychotherapeutic drug, 7 States were in the West, 1 was in the Midwest, 1 was in the South, and 1 was in the Northeast (Table 7.1 and Figure 7.1). As noted above, the prevalence was highest in Kentucky (8.5 percent); followed by Nevada (8.1 percent); Colorado and Utah (7.8 percent each); New Mexico, Oregon, and Rhode Island (7.7 percent each); and Arizona, Idaho, and Indiana (7.6 percent each). The prevalence of any prescription psychotherapeutic drug misuse was lowest in South Dakota (4.0 percent), followed by New Jersey (4.1 percent), Iowa (4.4 percent), Nebraska (4.5 percent), and North Dakota and Virginia (4.8 percent each).
Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003, and 2004.
Nationwide, an average of 9.1 percent of youths aged 12 to 17 were past year nonmedical users of any prescription psychotherapeutic drug. There was no strong pattern of geographic distribution for this measure. States ranking high in prescription drug misuse among youths included Kentucky (12.7 percent), Washington (12.2 percent), Michigan and Oregon (11.5 percent each), and Oklahoma (11.4 percent). States ranking low in past year misuse of any prescription drug among youths included the District of Columbia (5.5 percent), Maryland (6.6 percent), Connecticut (6.7 percent), and New York (6.9 percent).
Among young adults aged 18 to 25, the average rate of past year misuse of any prescription psychotherapeutic drug in 2002, 2003, and 2004 was 14.5 percent nationally. States ranking high in this measure included Rhode Island (23.4 percent); Oklahoma (19.9 percent); Kentucky, Louisiana, and West Virginia (19.5 percent each); New Hampshire (19.3 percent); and Arkansas (19.0 percent). States with lower prevalences of psychotherapeutic drug misuse among young adults included the District of Columbia (9.5 percent), South Dakota (10.0 percent), North Dakota (10.6 percent), and Iowa (10.7 percent).
Overall, an annual average of 4.4 percent of adults aged 26 or older used prescription psychotherapeutic drugs nonmedically in the year preceding the interview. Of the 10 States highest in psychotherapeutic drug misuse in this age group, 8 States were in the West. The top-ranking States were Nevada (6.7 percent), Kentucky (6.1 percent), and California, Colorado, and New Mexico (5.8 percent each). The lowest rates of prescription psychotherapeutic drug misuse among adults aged 26 or older were observed in South Dakota (2.0 percent), Nebraska (2.5 percent), New Jersey (2.6 percent), and Virginia (2.8 percent).
In the Nation as a whole, an annual average of 4.8 percent of persons aged 12 or older used pain relievers nonmedically in the 12 months leading up to the survey, based on combined data for 2002, 2003, and 2004. Of the 10 States ranking highest in this measure, 7 States were in the West. The top-ranking States were Kentucky (7.0 percent), Colorado (6.7 percent), Washington (6.2 percent), and Indiana, Nevada, Rhode Island, and Utah (6.1 percent each) (Table 7.2 and Figure 7.2). Of the 10 States ranking low on misuse of pain relievers, 5 States were in the Midwest. The lowest rate was found in the District of Columbia (2.6 percent), followed by Iowa (2.6 percent), South Dakota (2.7 percent), and Nebraska (2.8 percent).
Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003, and 2004.
Among youths aged 12 to 17, an average of 7.5 percent were past year nonmedical users of pain relievers nationwide. The highest rates were observed in Washington (10.7 percent), Kentucky (10.2 percent), Oregon (10.0 percent), and Michigan and Oklahoma (9.9 percent each). States ranking low in nonmedical use of pain relievers among youths included the District of Columbia (4.3 percent), Maryland (4.4 percent), Iowa (5.1 percent), and Kansas (5.4 percent).
Pain reliever misuse in the past year was reported by an annual average of 11.8 percent of young adults aged 18 to 25 in the Nation as a whole. The States highest in this measure among young adults included Rhode Island (18.3 percent), Kentucky (17.3 percent), West Virginia (16.2 percent), New Hampshire (15.8 percent), and Indiana (15.6 percent). Five States in the Midwest were among the 10 States with the lowest rates of pain reliever misuse among young adults. The District of Columbia had the lowest rate (5.3 percent), followed by South Dakota (6.7 percent), North Dakota (7.4 percent), and Iowa (7.8 percent).
Among adults aged 26 or older nationwide, an average of 3.1 percent were past year nonmedical users of pain relievers in 2002, 2003, and 2004. Of the 10 States with the highest prevalence, 7 States were in the West. Colorado ranked highest (5.0 percent), followed by Kentucky (4.8 percent), Nevada (4.7 percent), Georgia (4.6 percent), Arizona (4.3 percent), Washington (4.1 percent), and Oregon and Utah (4.0 percent each). Three States in the Midwest ranked lowest in pain reliever misuse among adults aged 26 or older: Nebraska (1.1 percent), South Dakota (1.2 percent), and Iowa (1.3 percent). They were followed by Mississippi and New Jersey (1.8 percent each).
Across the Nation, 2.1 percent of persons aged 12 or older were past year nonmedical users of tranquilizers, based on data averaged for 2002, 2003 and 2004. Rates of tranquilizer misuse were particularly high in the South, led by Kentucky (4.6 percent), South Carolina (3.6 percent), and Louisiana (3.5 percent) and followed by Arkansas (3.1 percent) and Florida and Tennessee (3.0 percent each) (Table 7.3 and Figure 7.3). Several of the States with low rates of tranquilizer misuse were in the Midwest, including South Dakota (0.6 percent), North Dakota (0.8 percent), Minnesota (0.8 percent), Nebraska (1.0 percent), and Iowa (1.1 percent); the rate also was low in Hawaii (1.0 percent).
Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003, and 2004.
Among youths aged 12 to 17, the average national rate of past year tranquilizer misuse was 2.2 percent. Eight States in the South ranked highest on this measure: Kentucky (4.9 percent), Arkansas and North Carolina (3.9 percent each), Tennessee (3.8 percent), Louisiana (3.6 percent), Florida and South Carolina (3.5 percent each), and West Virginia (3.3 percent). The rate of tranquilizer misuse among youths was lowest in the District of Columbia (0.1 percent), followed by Connecticut and New Mexico (0.8 percent each).
Nationwide, an average of 5.1 percent of young adults aged 18 to 25 misused tranquilizers in the 12 months preceding the survey. The top-ranking States for this measure included Kentucky (11.1 percent), West Virginia (10.3 percent), Louisiana (9.8 percent), Tennessee (9.5 percent), and Arkansas (9.4 percent). Four States in the Midwest were lowest in tranquilizer misuse among young adults: South Dakota (0.9 percent), North Dakota (1.3 percent), Iowa (2.1 percent), and Minnesota (2.4 percent).
Among adults aged 26 or older nationally, an average of 1.6 percent reported past year misuse of tranquilizers based on data from 2002 through 2004. States ranking high in this measure for this age group included Kentucky (3.5 percent), South Carolina (3.1 percent), and Massachusetts (2.5 percent). Once again, the four lowest-ranking States were in the upper Midwest: South Dakota (0.4 percent) and Minnesota, Nebraska, and North Dakota (0.5 percent each).
Combined data for 2002, 2003, and 2004 indicate that, nationwide, an annual average of 1.2 percent of persons aged 12 or older used stimulants nonmedically in the 12 months before the survey. States ranking high in stimulant misuse tended to be in the West and included Nevada (2.7 percent), Montana (2.4 percent), Wyoming (2.1 percent), and Oregon and Washington (1.9 percent each) (Table 7.4 and Figure 7.4). Also ranking high were Kentucky (2.0 percent) and Massachusetts (1.9 percent). States ranking low in stimulant misuse among persons aged 12 or older included North Carolina (0.4 percent), New Jersey (0.5 percent), and Connecticut, Florida, and New York (0.7 percent each).
Note: Includes methamphetamine.
Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003, and 2004.
Among youths aged 12 to 17, past year misuse of stimulants was reported by an average of 2.3 percent nationwide. The 10 top-ranking States for youth stimulant misuse included 8 States in the North: Montana (4.8 percent); South Dakota (4.0 percent); North Dakota (3.5 percent); Massachusetts, Minnesota, and Wisconsin (3.4 percent each); and Idaho and Michigan (3.2 percent each). Other high-ranking States included Oklahoma (3.3 percent) and Arkansas (3.2 percent). States ranking low in stimulant misuse among youths included the District of Columbia (1.2 percent), New York (1.3 percent), Utah (1.6 percent), and New Mexico (1.7 percent).
Across the Nation, an annual average of 3.6 percent of young adults aged 18 to 25 misused stimulants in the past year. Four States in New England were among the top seven States in this measure among young adults: Rhode Island (8.1 percent), Vermont (7.4 percent), Massachusetts (7.2 percent), and New Hampshire (5.7 percent). Other high-ranking States were Wyoming (7.1 percent), Arkansas (6.5 percent), and South Carolina (5.7 percent). States ranking low in stimulant misuse among young adults included North Carolina (1.4 percent), New Jersey (2.2 percent), Georgia and Illinois (2.4 percent each), and Florida and Maryland (2.5 percent each).
Among adults aged 26 or older, an annual average of 0.7 percent were past year nonmedical users of stimulants. Five of the six top-ranking States for stimulant misuse in this age group were in the West: Nevada (2.3 percent), Montana (1.5 percent), Oregon (1.4 percent), Washington (1.3 percent), and California (1.2 percent). The second-ranking State was Kentucky (1.7 percent). States ranking low in stimulant misuse among adults aged 26 or older included New Hampshire (less than 0.1 percent) and Connecticut, New Jersey, North Carolina, and Virginia (0.1 percent each).
Nationwide, an estimated 0.6 percent of persons aged 12 or older used methamphetamine in the 12 months prior to the survey, based on data averaged for 2002, 2003, and 2004. Rates of methamphetamine use were generally highest in the West, with Nevada (2.2 percent), Montana and Wyoming (1.5 percent each), and Arizona and New Mexico (1.3 percent each) (Table 7.5 and Figure 7.5). Nebraska (1.3 percent) ranked fifth. States in the Northeast comprised 8 of the 11 bottom-ranking States for this measure: Connecticut (less than 0.1 percent); Maine, New Jersey, New York, and Pennsylvania (0.1 percent each); and Massachusetts, New Hampshire, and Vermont (0.2 percent each). Other States in the bottom 11 included North Carolina (0.1 percent) and Maryland and Illinois (0.2 percent each).
Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003, and 2004.
Among youths aged 12 to 17, an average of 0.7 percent nationwide had used methamphetamine in the past year. Top-ranking States for methamphetamine use among youths included six States in the West and two in the Midwest: South Dakota (2.4 percent); Montana (2.3 percent); North Dakota (1.7 percent); Nevada, Washington, and Wyoming (1.6 percent each); and Colorado and Idaho (1.4 percent each). Other States in the top 10 were Arkansas and Kansas (1.4 percent each). States ranking low in methamphetamine use among youths included Connecticut and the District of Columbia (0.1 percent each), New York (0.2 percent), and Maryland and Pennsylvania (0.3 percent each).
For the Nation as a whole, an average of 1.6 percent of young adults aged 18 to 25 used methamphetamine in the past year. Of the top 11 States, 6 were in the West: Wyoming (5.3 percent), Nevada (4.3 percent), Colorado and Montana (3.4 percent each), New Mexico (3.1 percent), and Washington (3.0 percent). Other States in the top tier for methamphetamine use among young adults were Arkansas (4.6 percent), Minnesota (3.9 percent), Oklahoma (3.6 percent), and North Dakota and South Dakota (3.0 percent each). States ranking low in this measure included Connecticut and New York (0.3 percent each) and North Carolina and Vermont (0.4 percent each).
In the adult population aged 26 or older, the overall rate of past year methamphetamine use was 0.4 percent. Six of the nine highest-ranking States were in the West: Nevada (2.0 percent), Arizona and New Mexico (1.1 percent each), Montana (1.0 percent), and California and Hawaii (0.9 percent each). Other States in the top tier included Nebraska (1.0 percent) and Iowa and Kentucky (0.9 percent each). Estimates of methamphetamine use among persons aged 26 or older in six States were very low and did not meet precision standards for inclusion in the report. Among States with estimates that met precision criteria, the rates were lowest in New Hampshire and Pennsylvania (less than 0.1 percent each).
Nationwide, an estimated 0.4 percent of persons aged 12 or older misused sedatives in the past year. Three of the nine highest-ranking States for sedative misuse were in New England: Massachusetts (1.0 percent), Rhode Island (0.7 percent), and Connecticut (0.6 percent) (Table 7.6 and Figure 7.6). Others in the top tier were the District of Columbia, Idaho, and Washington (0.7 percent each) and Iowa, Kentucky, and Missouri (0.6 percent each). States with low rates of sedative misuse in the overall population aged 12 or older included Delaware, Hawaii, Nebraska, North Dakota, South Dakota, and Wisconsin (0.1 percent each).
Source: SAMHSA, Office of Applied Studies, National Survey on Drug Use and Health, 2002, 2003, and 2004.
Among youths aged 12 to 17, an estimated 0.5 percent were past year nonmedical users of sedatives in the Nation as a whole. The top-ranking States for this measure were Arkansas and Tennessee (1.0 percent each) and Alaska, Kentucky, Massachusetts, Oklahoma, and Vermont (0.9 percent each). The States with the lowest rate of sedative misuse among youths were Indiana and South Carolina (0.1 percent each) and Hawaii, Montana, Rhode Island, and Washington (0.2 percent each).
Across the total United States, 0.5 percent of young adults aged 18 to 25 used sedatives nonmedically in the 12 months prior to the survey. Three of the nine top-ranking States for this measure were in the West: Wyoming (1.2 percent) and Montana and Nevada (0.9 percent each). Other top-ranking States for past year sedative misuse among young adults were Arkansas (1.8 percent), Rhode Island (1.1 percent), New Hampshire and West Virginia (1.0 percent each), and Connecticut (0.9 percent). The States ranking lowest in sedative misuse among persons in this age group were Hawaii (less than 0.1 percent), Iowa (0.1 percent), and Georgia, Illinois, Massachusetts, and Minnesota (0.2 percent each).
Among adults aged 26 or older, past year nonmedical sedative use was estimated to involve 0.3 percent of the population nationwide. The States with the highest rates were Massachusetts (1.1 percent), Washington (0.8 percent), and the District of Columbia, Idaho, Iowa, and Rhode Island (0.7 percent each). For five States, the estimated rates of past year sedative misuse in the adult population aged 26 or older were extremely low and did not meet precision criteria for publication.
Highlights related to State-level misuse of prescription psychotherapeutic drugs in the past year include the following:
1 This direct estimation methodology is different from the model-based estimation used in some other NSDUH reports (e.g., Wright & Sathe, 2006).
2 In some instances, more than 10 or fewer than 10 States were selected as top and bottom ranking because of ties in estimated prevalence rates when rounded to the one decimal digit.
3 Nonoverlap of CIs is a conservative test of differences; some estimates with overlapping CIs are significantly different.
This page was last updated on June 03, 2008. |
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