Endnotes for Chapter 2

1 Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies, Summary of Findings from the 1998 National Household Survey on Drug Abuse (NHSDA), DHHS Publication No. SMA99-3328, (Rockville: MD: U.S. Department of Health and Human Services, 1999), p. 1. The U.S. Department of Health and Human Services' Substance Abuse and Mental Health Services Administration National Household Survey on Drug Abuse includes a series of questions based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) used to assess dependence on substances. NHSDA includes questions about health and emotional problems associated with substance abuse, attempts to cut down on use, tolerance, and other symptoms. Respondents are also asked to report whether they received treatment or counseling for a substance-abuse problem.

2 The Gallup Organization, Consultation with America: A Look at How Americans View the Country's Drug Problem, Final Report (Rockville, MD: The Gallup Organization, November 22, 1999).

3 National League of Cities, National School Boards Association, Joe DiMaggio Children's Hospital and Youth Crime Watch, Ten Critical Threats to America's Children:Warning Signs for the Next Millennium (Alexandria, VA: The National League of Cities, November 1999), p. 13.

4 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Summary of Findings from the 1998 National Household Survey on Drug Abuse (NHSDA), DHHS Publication No. (SMA)99-3328(Rockville, MD: U.S. Department of Health and Human Services, 1999), p.1.

5 Ibid., p. 15.

6 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Analysis of Substance Abuse and Treatment Need Issues, Analytic Series A-7, DHHS Publication No. SMA98-3227 (Rockville, MD: U.S. Department of Health and Human Services, 1998), p. 93.

7 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Driving After Drug or Alcohol Use: Findings from the 1996 National Household Survey on Drug Abuse, Analytic Series A-8, DHHS Publication No. SMA99-3273 (Rockville, MD: U.S. Department of Health and Human Services, 1998), p. 50.

8 Thomas A. Gray and Eric D. Wish, Substance Abuse Need for Treatment Among Arrestees (SANTA) in Maryland: Youth in the Juvenile Justice System (Rockville, MD: Maryland Alcohol and Drug Abuse Administration, 1998).

9 Brook, J.S., Balka, E.B., and Whiteman, M., The Risks for Late Adolescence of Early Adolescent Marijuana Use, American Journal of Public Health, 1549-1554, 1999, p. 89.

10 Partnership for a Drug-Free America, 1999 Partnership Attitude Tracking Study: Teens in Grades 7 through 12 (New York, NY: PDFA, Spring 1999).

11 Johnston, L.D., O'Malley, P.M., & Bachman, J.G., National survey results on drug use from the Monitoring the Future study, 1975-1998 Volume I: Secondary school students, NIH Publication No. 99-4660, (Rockville, MD: National Institute on Drug Abuse, 1999), c. 420 pp.

12 National Institute on Alcohol Abuse and Alcoholism, "Advancing Knowledge through Research" Fact Sheet, Fall, 1999.

13 Merrill, Jeffrey, Kimberly Fox, Susan Lewis and Gerald Pulver, Cigarettes, Alcohol, Marijuana: Gateways to Illicit Drug Use (New York: National Center on Addiction and Substance Abuse, Columbia University, 1994), p. 15.

14 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Results from the 1998 National Household Survey on Drug Abuse, p. 20. Binge drinking is defined as consuming five or more drinks on one occasion during the past thirty days. A heavy drinker is defined as one who consumes five or more drinks on one occasion five or more days during the past thirty days.

15 National Center on Addiction and Substance Abuse at Columbia University (CASA), No Place to Hide: Substance Abuse in Mid-Size Cities and Rural America, Commissioned by the United States Conference of Mayors and Funded by the DEA with Support from the National Institute on Drug Abuse, January 1999, p. 3.

16 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Results from the 1998 National Household Survey on Drug Abuse, p. 22.

17 Ibid.

18 U.S. Department of Health and Human Services, Healthy People 2010: Understanding and Improving Health (Washington, D.C.: U.S. Department of Health and Human Services, Government Printing Office, 2000), p. 31.

19 The Department of Health and Human Services, The Centers for Disease Control and Prevention, "Tobacco Use Among Middle and High School Students — United States 1999," Morbidity and Mortality Weekly Report, Vol. 49. No.3, January 28, 2000, pp. 49-53.

20 Ibid.

21 National Center on Addiction and Substance Abuse at Columbia University (CASA), No Place to Hide: Substance Abuse in Mid-Size Cities and Rural America, Commissioned by the United States Conference of Mayors and Funded by the DEA with Support from the National Institute on Drug Abuse, January 1999, p. 3.

22 Jayant K., Pakhale S.S., Toxic constituents in bidi smoke, in Sanghvi LD, Notani P, eds. Tobacco and health: the Indian scene (Bombay, India: Tata Memorial Center, 1989).

23 Rickert W.S., Determination of yields of "tar," nicotine, and carbon monoxide from bidi cigarettes: final report (Ontario, Canada: Labstat International, Inc., 1999).

24 Gupta P.C., Hamner J.E. III, Murti P.R., eds. Control of tobacco-related cancers and other diseases; proceedings of an international symposium (Bombay, India: Tata Institute of Fundamental Research, Oxford University Press, 1992).

25 National Center on Addiction and Substance Abuse at Columbia University, Dangerous Liaisons: Substance Abuse and Sex (New York: National Center on Addiction and Substance Abuse at Columbia University, December 1999).

26 Ibid.

27 Rome, E.S., Rybicki, M.S., & Durant, R.H. (1998), "Pregnancy and Other Risk Behaviors Among Adolescent Girls in Ohio," Journal of Adolescent Health. 22(1), pp. 50-55.

28 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Results from the 1998 National Household Survey on Drug Abuse, p. 15.

29 Ibid., p. 25.

30 Http://www.pridesurveys.com/, March 14, 2000

31 Partnership for a Drug-Free America, 1999 Partnership Attitude Tracking Study: Teens in Grades 7 through 12, (New York, NY: PDFA, December 1999).

32 National Center on Addiction and Substance Abuse at Columbia University (CASA), No Place to Hide: Substance Abuse in Mid-Size Cities and Rural America, p. 2.

33 Drug Enforcement Administration, Drug Intelligence Brief — Drug Trafficking in the United States, September 1999, p. 9.

34 National Drug Intelligence Center, Draft National Drug Threat Assessment 2000: An Interim Report (Johnstown, PA: U.S. Department of Justice, 1999), p. 12.

35 Drug Enforcement Administration, Drug Intelligence Brief — The Cannabis Situation in the United States, December 1999, p. 4.

36 Ibid., p. 5.

37 Drug Enforcement Administration, 1998 Domestic Cannabis Eradication/Suppression Program Statistics.

38 Drug Enforcement Administration, Drug Intelligence Brief — Mexican marijuana in the United States, September 1999 (Washington, D.C: Strategic Domestic Unit, Domestic Support Section B, Office of Int'l. Enforcement Support, DEA), p.3.

39 http://www.usdoj.gov/dea/concern/marijuana_factsheet.html , March 23, 2000.

40 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Results from the 1998 National Household Survey on Drug Abuse, p. 16.

41 Office of National Drug Control Policy, Draft — What America's Users Spend on Illegal Drugs, 1988-1998 prepared for Office of National Drug Control Policy (Washington, DC: Office of National Drug Control Policy, 1999), p. 11. National prevalence surveys, such as the NHSDA and the MTF, while useful for characterizing the size and drug use patterns among the general population, do not provide reliable estimates of cocaine use among the chronic hardcore drug using population. This is the case because (1) hardcore drug use is a relatively uncommon behavior, therefore, probability-based population surveys are unlikely to sample sufficient numbers of users to provide stable estimates, (2) hardcore chronic users are less likely to be found in households and schools in order to be surveyed, and (3) even when found in these sampling locations, they are less likely to agree to be interviewed than other categories of respondents. An alternative approach to probability-based population surveys to determine the size and characteristics of the hardcore chronic drug using population is mathematical modeling. For the past 10 years, ONDCP has been funding a study to produce modeled estimates of the dollar value of drugs consumed in the Unites States. A necessary by-product of this estimate is an estimate of the number of hardcore chronic users of cocaine and heroin. This methodology has been applied consistently to data from 1988 through 1998, thus allowing analysis of trends.

42 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Results from the 1998 National Household Survey on Drug Abuse, p. 27.

43 Johnston, L.D., O'Malley, P.M., & Bachman, J.G., National survey results on drug use from the Monitoring the Future study, 1975-1998 Volume I: Secondary school students.

44 Drug Enforcement Administration, Drug Intelligence Brief — Drug Trafficking in the United States, September 1999, p. 2.

45 Office of National Drug Control Policy, Semiannual Interagency Assessment of Cocaine Movement (Washington, D.C.: Office of National Drug Control Policy, August 1999), p. v.

46 Ibid., p. 2.

47 Office of National Drug Control Policy, Draft — What America's Users Spend on Illegal Drugs, 1988-1998 (Washington, DC: Office of National Drug Control Policy, 1999), 20. The PME analysis is based on a composite model which integrates four independent measures of cocaine availability 1) potential cocaine production developed by the Central Intelligence Agency's Crime and Narcotics Center, 2) the foreign movement analysis derived from the Interagency Assessment Cocaine Movement, 3) an estimate of cocaine crossing the U.S. border, and 4) the cocaine consumption estimate.

48 Office of National Drug Control Policy, The Price of Illegal Drug: 1981 through the second quarter of 1998, February 1999.

49 Ibid.

50 National Drug Intelligence Center, Draft National Drug Threat Assessment 2000: An Interim Report (Johnstown, PA: U.S. Department of Justice, 1999), p. 1.

51 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Results from the 1998 National Household Survey on Drug Abuse, p. 18.

52 Ibid.

53 Ibid., p. 26.

54 Office of National Drug Control Policy, Draft — What America's Users Spend on Illegal Drugs, 1988-1998, pp. 9-11. As with cocaine, estimates for the size of the hardcore heroin using population are derived from mathematical models rather than probability-based population survey estimates. See endnote 36.

55 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Results from the 1998 National Household Survey on Drug Abuse, p. 26. This decrease is not statistically significant and should be viewed with caution because of the small number of respondents on which these estimates were based.

56 Drug Enforcement Administration, Drug Intelligence Brief — Drug Trafficking in the United States, September 1999, p. 6.

57 Office of National Drug Control Policy, High Intensity Drug Trafficking Area Program (Washington, D.C.: Office of National Drug Control Policy, 1999), p. 15.

58 Ibid., p. 120.

59 Office of National Drug Control Policy, Draft - What America's Users Spend on Illegal Drugs, 1988-1998 p. 20.

60 U.S. Department of Justice, Drug Enforcement Administration, El Paso Intelligence Center, Methamphetamine Trafficking Trends (El Paso, TX: EPIC, 1999), pp. 3-4.

61 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Results from the 1998 National Household Survey on Drug Abuse, p. 104.

62 Office of National Drug Control Policy, Draft - What America's Users Spend on Illegal Drugs, 1988-1998, p. 21.

63 Johnston, L.D., O'Malley, P.M., & Bachman, J.G. (1999). National survey results on drug use from the Monitoring the Future study, 1975-1998 Volume I: Secondary school students.

64 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Results from the 1998 National Household Survey on Drug Abuse, p. 104.

65 National Center on Addiction and Substance Abuse at Columbia University (CASA), No Place to Hide: Substance Abuse in Mid-Size Cities and Rural America, p. 3.

66 National Drug Intelligence Center, Draft National Drug Threat Assessment 2000: An Interim Report (Johnstown, PA: U.S. Department of Justice, 1999), p. 5.

67 National Institute of Justice, Interim Report of the Methamphetamine Interagency Task Force (Washington, D.C.: U.S. Department of Justice, 1999), p. 9.

68 National Drug Intelligence Center, Draft National Drug Threat Assessment 2000: An Interim Report (Johnstown, PA: U.S. Department of Justice, 1999), p. 6.

69 Drug Enforcement Administration, (1995-1999) — unpublished data. See chart chart 45 on page 147.

70 Office of National Drug Control Policy, High Intensity Drug Trafficking Area Program (Washington, D.C.: Office of National Drug Control Policy, 1999), p. 64.

71 Drug Enforcement Administration, Drug Intelligence Brief — Drug Trafficking in the United States, September 1999, p. 8.

72 Office of National Drug Control Policy, Draft - What America's Users Spend on Illegal Drugs, 1988-1998, p. 24. Because a portion of the methamphetamine consumed in the United States is produces domestically by numerous small clandestine laboratories, often for selective chose customers, a meaningful assessment of domestic consumption is very difficult to develop. Additionally, this data represents the first attempt at estimating methamphetamine consumption; some uncertainty may exist.

73 Office of National Drug Control Policy, The Price of Illegal Drug: 1981 through the second quarter of 1998, February 1999.

74 Drug Enforcement Administration, Drugs of Concern: MDMA (Ecstasy), www.usdoj.gov/dea/concern/mdma.html, January 13, 2000.

75 See Hatzidimitriou, G., McCann, U.D., and Ricaurte, G.A. "Altered Serotonin Innervation Patterns in the Forebrain of Monkeys Treated with (±)3,4-Methylenedioxymethamphetamine Seven Years Previously: Factors Influencing Abnormal Recovery," The Journal of Neuroscience, June 15, 1999, 19(12):5096-5107 and McCann, U.D., Eligulashivili, V., Ricuarte, G.A., "Cognitive Performance in (+/-) 3,4 Methylenedioxymethamphetamine Users: A Controlled Study," Psychopharmacology, April 1999, 143(4):417-25.

76 Ibid.

77 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Emergency Department Data from the Drug Abuse Warning Network Annual 1997, DHHS Publication No. SMA99-3310 (Rockville, MD: U.S. Department of Health and Human Services, 1998), p. 36.

78 Drug Enforcement Administration, Drugs of Concern: MDMA (Ecstasy), www.usdoj.gov/dea/concern/mdma/mdma_factsheet.html, January 13, 2000.

79 Johnston, L.D., O'Malley, P.M., & Bachman, J.G. (1999). National survey results on drug use from the Monitoring the Future study, 1975-1998 Volume I: Secondary school students

80 Drug Enforcement Administration, Drug Intelligence Brief: MDMA — June 1999, p. 2.

81 Ibid., p. 2.

82 United States Customs Service, Office of Public Affairs, Ecstasy Seizures and Smuggling Methods Fact Sheet, January 5, 2000.

83 National Drug Intelligence Center, MDMA Trafficking — unclassified briefing for the Office of National Drug Control Policy, Washington, D.C., December 15, 1999.

84 Drug Enforcement Administration, Drug Intelligence Brief — Drug Trafficking in the United States, September 1999, p. 13.

85 Drug Enforcement Administration, Drug Intelligence Brief: MDMA — June 1999, p. 1.

86 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Year-End 1998 Emergency Department Data from the Drug Abuse Warning Network, DHHS Publication No. SMA00-3376 (Rockville, MD: U.S. Department of Health and Human Services, 1998), p. 107.

87 http://www.pridesurveys.com/, March 14, 2000.

88 National Institute on Drug Abuse, National Institutes of Health, Anabolic Steroids: A Threat to Mind and Body, NIDA Research Reports (DHHS Publication No. (ADM)91-1810) (Washington, DC: U.S. Department of Health and Human Services, NIH, NIDA, 1991).

89 Johnston, L.D., O'Malley, P.M., & Bachman, J.G. (1999). National survey results on drug use from the Monitoring the Future study, 1975-1998 Volume I: Secondary school students.

90 National Institute on Drug Abuse, Community Epidemiology Work Group, Epidemiological Trends in Drug Abuse, Volume I (Washington, D.C.: U.S. Department of Health and Human Services, Public Health Service, National Institutes of Health, 1999), p. 77.

91 Drug Enforcement Administration, The Diversion of Drugs and Chemicals (Washington, D.C.: U.S. Department of Justice, Drug Enforcement Administration, Office of Diversion Control, 1999), p. 6.

92 Drug Enforcement Administration, The Diversion of Drugs and Chemicals, p. 7.

93 United States Customs Service, Office of Public Affairs, unpublished seizure statistics.

94 Drug Enforcement Administration, Office of Diversion Control Statistics, January 13, 2000.

95 See http://www.drugquest.com/ (January 20, 2000) and http://www.feral.org/vitality/in_1main.htm (January 20, 2000).

96 Drug Enforcement Administration, The Diversion of Drugs and Chemicals, p. 4.

97 Ibid., p. 11.

98 Federal Bureau of Investigation, Uniform Crime Reports 1998, (Washington, D.C.: U.S. Department of Justice, 1999), pp. 209-210.

99 National Institute of Justice, ADAM: 1998 Annual Report on Adult and Juvenile Arrestees, (Washington, D.C.: U.S. Department of Justice, 1999), p. 3.

100 Ibid., p. 1.

101 Ibid., p. 3.

102 Ibid., p. 2.

103 Ibid., p. 3.

104 Ibid., pp. 2-3.

105 National Drug Intelligence Center, Draft National Drug Threat Assessment 2000: An Interim Report (Johnstown, PA: U.S. Department of Justice, 1999), p. 6.

106 U.S. Department of Justice, Bureau of Justice Statistics, Corrections Statistics, Summary Findings, (www.ojp.usdoj.gov/bjs/correct.htm), January 4, 2000.

107 Allen Beck and Christopher Mumola, Prisoners in 1998, NCJ:175687 (Washington, D.C.: Bureau of Justice Statistics, August 1999) p. 1.

108 Ibid., p. 11.

109 Christopher Mumola, Substance Abuse and Treatment, State and Federal Prisoners, 1997 (Washington, DC: Bureau of Justice Statistics, 1998), p. 1.

110 Darrell Gilliard and Allen Beck, Prisoners in 1997, NCJ:170014 (Washington, D.C.: Bureau of Justice Statistics, August 1998) p. 1.

111 Bureau of Justice Statistics, Lifetime Likelihood of Going to State or Federal Prison (Washington, DC: U.S. Department of Justice, 1997).

112 Kathleen Maguire and Ann L. Pastore, eds., Sourcebook of Criminal Justice Statistics 1997 (Washington, D.C.: U.S. Department of Justice), p. 11.

113 U.S. Department of Health and Human Services, Blending Perspectives and Building Common Ground: A Report to Congress on Substance Abuse and Child Protection (Washington, DC: U.S. Government Printing Office, 1999).

114 National Center on Addiction and Substance Abuse at Columbia University (CASA), No Safe Haven: Children of Substance-Abusing Parents, 4-5.

115 National Center on Addiction and Substance Abuse at Columbia University, Dangerous Liaisons: Substance Abuse and Sex.

116 National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, The Economic Costs of Alcohol and Drug Abuse in the United States (Rockville, MD: U.S. Department of Health and Human Services, 1998), http://www.nida.nih.gov/EconomicCosts/Chapter1.html#1.10, January 11, 2000.

117 Ibid., http://www.nida.nih.gov/EconomicCosts/Chapter1.html#1.2, January 23, 2000.

118 Hoyert, D.L., Kochanek, K.D., Murphy, S.L. "Deaths: Final Data for 1997." National Vital Statistics Report, Vol. 47, No. 19, (Hyattsville, MD: National Center for Health Statistics, 1999).

119 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Drug Abuse Warning Network Annual Medical Examiner Data 1998, p. 50.

120 Leshner, A, "Science-Based Views of Drug Addiction and its Treatment," Journal of the American Medical Association, October 13, 1999, http://jama.ama-assn.org/issues/v282n14/full/jct90020.html, January 27, 2000.

121 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Drug Abuse Warning Network Annual Medical Examiner Data 1998, p. 50.

122 Ibid., p. 2.

123 Ibid., p. 12.

124 Alan Leshner, "Addiction is a Brain Disease — And It Matters," National Institute of Justice Journal, October 1998, p. 3.

125 Centers for Disease Control and Prevention, HIV/AIDS Surveillance Report, 1999 (11)1:Table 28.

126 Centers for Disease Control and Prevention, Summary of Notifiable Diseases, U.S., 1997, Morbidity and Mortality Weekly Report 1998; 46(54).

127 The United States Conference of Mayors, A Status on Hunger and Homelessness in America's Cities 1999: A 26-City Survey, Washington, D.C., December 1999.

128 Culhane, Dennis P., Edmund F. Dejowski, Julie Ibanez, Elizabeth Needham and Irene Macchia, "Public Shelter Admission Rates in Philadelphia and New York City: The Implications of turnover for Sheltered Population Counts," in Understanding Homelessness: New Policy and Research Perspectives, edited by Dennis P. Culhane and Steven P. Hornburg, Fannie Mae Foundation, Washington, D.C., 1997.

129 Rog, Deborah and C. Scott Holupka, "Reconnecting Homeless Individuals and Families to the Community," Practical Lessons: The 1998 National Symposium on Homelessness Research, (Washington, D.C.: U.S. Department of Housing and Urban Development and U.S. Department of Health and Human Services, August 1999).

130 Interagency Council on the Homeless, Homelessness: Programs and the People They Serve, Technical Report, prepared by The Urban Institute, December 1999, pp. 8-18.

131 Ibid.

132 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Summary of Findings from the 1998 National Household Survey on Drug Abuse, NHSDA Series H-10, DHHS Pub. No. (SMA) 99-3328 (Washington, D.C.: U.S. Department of Health and Human Services, August 1999), p. 82.

133 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Worker Drug Use and Workplace Policies and Programs, Results from the 1994 and 1997 NHSDA, Analytic Series A-11, DHHS Publication No. (SMA) 99-3352 (Washington, D.C.: U.S. Department of Health and Human Services, September 1999), p. 10. http://www.oas.samhsa.gov/NHSDA/A-11/TOC.htm, January 22, 2000.

134 Substance Abuse and Mental Health Administration, Office of Applied Studies, Summary of Findings from the 1998 National Household Survey on Drug Abuse.

135 Ibid., p. 82.

136 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Worker Drug Use and Workplace Policies and Programs: Results from the 1994 and 1997 NHSDA, p. 26.

137 National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, The Economic Costs of Alcohol and Drug Abuse in the United States (Rockville, MD: U.S. Department of Health and Human Services, 1998), http://www.nida.nih.gov/EconomicCosts/Chapter1.html#1.10, January 11, 2000.

138 Substance Abuse and Mental Health Services Administration, Office of Applied Studies, An Analysis of Worker Drug Use and Workplace Policies and Programs: Results from the 1994 and 1997 NHSDA, p. 27.

139 Performance Measures of Effectiveness 2000: Implementation and Findings, published simultaneously with this document and on the ONDCP Web site at http://www.whitehousedrugpolicy.gov.