While illicit drug use among Americans who are 12 years old or older has remained stable, it continues to decline in one subset of that population: youths between the ages of 12 and 17.

This was one of the findings of three comprehensive federal surveys on drug abuse and its effects on American society. The surveys—the 1999 National Household Survey (NHS), the 1999 Drug Abuse Warning Network (DAWN) Report, and the Treatment Episode Data Set, 1993-98 (TEDS)—were coordinated by the Substance Abuse and Mental Health Services Administration (SAMHSA).

U. S. Department of Health and Human Services Secretary Donna E. Shalala, Ph.D., released the survey data at a press conference last month highlighting SAMHSA’s current and future efforts to make sure the decline in drug use continues.

"More of our young people," said Shalala, "are obviously getting the message that drugs are not the stuff of dreams, but of nightmares."

The current data, for the year 1999, show that, for the third year in a row, illicit drug use among 12- to 17-year-olds in the U.S. has declined, from 11.4 percent in 1997 to 9 percent in 1999.

For the first time, the federal surveys show state-by-state estimates of the use of specific drugs, including alcohol and cigarettes, by age group, giving both researchers and clinicians an accurate overview of the prevalence of drug abuse in America.

Because of significant changes to the survey protocols, substance abuse specialists now have data on many of the most significant details of the demographics and preferences of individuals with drug abuse or addiction problems.

The newly expanded data on demographics and geographic populations is expected to be a valuable tool to clinicians, helping them to better tailor their programs to their communities.

The NHS is conducted each year, providing annual estimates of levels of use of illicit drugs, tobacco, and alcohol. Prior to 1999 the study involved an average of 13,000 respondents, using paper-and-pencil questionnaires. Last year’s survey involved nearly 70,000 individuals, using interactive, multilingual, computerized questionnaires.

The NHS data confirm that the trend of declining teen drug abuse that began in 1997 continued into 1999. In particular, marijuana use, the teen "drug of choice", decreased from 9.4 percent in 1997 to 7 percent in 1999. The same was true of tobacco use among teens, decreasing from 19.9 percent in 1997 to 15.9 percent in 1999.

For the first time, the survey also gathered data on which specific brands of cigarettes were most popular among specific groups of teens. More than half of white and Hispanic youth smokers named Marlboro as their usual brand. Nearly three-quarters of African-American youth smokers reported that Newport was their first choice.

The survey found that current use of other illicit substances, cocaine, inhalants, hallucinogens, and heroin for the 12 and older population remained stable.

"The survey," said Barry McCaffrey, director of the White House Office of National Drug Control Policy, "provides extremely encouraging news that teen drug use is going down significantly."

The 1999 Drug Abuse Warning Network (DAWN) Report provides information on the impact of drug use on hospital emergency rooms across the United States. The report lists the number of emergency room visits that were directly related to the use of an illegal drug or nonmedical use of a legal drug.

The Treatment Episode Data Set (TEDS) 1993-98 provides information on the demographic and substance abuse characteristics of those individuals admitted for treatment of drug and alcohol abuse in facilities across the country. Any substance abuse treatment program receiving federal funding, for either inpatient or outpatient programs, must report data to the TEDS.

The two reports together give substance abuse professionals an overview of the toll that abuse and addiction take on American society. Interestingly, although reported adolescent illicit drug use declined, admissions for treatment of drug or alcohol abuse increased 45 percent from 1993 to 1998. The largest part of this increase was due to a 32 percent increase in admissions for marijuana abuse. More than half of the admissions for marijuana abuse were referred from the criminal justice system. Other sources included self-referrals, as well as referrals by clinics and counselors.

The massive amount of data released by SAMHSA provides a detailed look at the substance abuse problem in the U.S. Although overall the total numbers of teens abusing illicit drugs and alcohol continues to decline, the data indicate that those who are abusing are experiencing more drug-related problems.

Nelba Chavez, Ph.D., administrator of SAMHSA, said, "Our efforts do appear to be paying off in lower levels of drug use among teens, but we must do more to reduce illicit drug use among adults. The need for treatment is obvious, the data are real, and the problems encountered because of drug abuse are growing. People need to be reminded that treatment can help people get off and stay off drugs."

"Protecting our children from drugs isn’t a job for the government alone," added Secretary Shalala. "We need a bipartisan commitment to target our resources. We need parents, we need coaches, clergy, media, and everyone else involved in each child’s life to keep up the steady drumbeat of anti-drug messages echoing from every corner of society."

"The toll that drug abuse and addiction places on our society," McCaffrey told Psychiatric News, "is far greater than the individual parts represented by the new data. Young people think they are only experimenting, but as the studies show, they are really gambling with their futures."