He said that he and his colleagues had found that lower LSD use in teens was probably the result of a drop in availability rather than an increase in perceived risk of the drug. There is concern is that the decline in perceived risk and disapproval of the drug might make this group vulnerable to LSD use if supply increases, he noted.
“This erosion in perceived risk is something that we believe happens as new cohorts of young people enter adolescence and don't know what their predecessors learned about the drug. We call it 'generational forgetting,'” Dr. Johnston said.
The NSDUH study showed that current illicit drug use was higher among young adults aged 18-25 years (20%) than it was in youths aged 12-17 (9%) and those aged over 26 (6%). However, the 2007 and 2008 rates remained steady.
Among those aged 50-59 years—the baby boomers—past-month use increased from 2.7% in 2002 to 4.6% in 2008. In the 50- to 54-year-old group, that rate went from 3.4% in 2002, to 6.0% in 2006 and 4.3% in 2008; and in the 55- to 59-year-old group, the levels were 1.9% in 2002 and 5.0% in 2008. The investigators suggest this increase might be a result of the aging boomers' higher lifetime rates of illicit drug use.
Among the continuing concerns is that of the 23.1 million people who need treatment for illicit drug use, only 2.3 million (about 10%) receive treatment. Gil Kerlikowske, director of the office of National Drug Control Policy, emphasized the importance of addressing these treatment disparities, adding that “treatment is half the cost of incarceration.”
Mr. Kerlikowske's contention that he had “ended the war with drug users” and that the new focus should be on “prevention, treatment, and recovery in a holistic way” drew praise from Dr. Bell and Dr. Johnston.
“Thank God someone with sense is in the national drug control policy area. This is a shift we have been pushing in the Institute of Medicine's 2009 report,” Dr. Bell said.
Dr. Johnston said he had long been a proponent of demand-side action in dealing with drug use. “There is good evidence from our studies that demand-side factors have reduced drug use substantially at times,” he said.
The NSDUH interviews about 67,500 individuals in the general U.S. population aged 12 years and older. Each respondent who completes the interview receives $30. Military personnel, inmates, inpatients, and homeless persons who do not live in a shelter are excluded.
Source Elsevier Global Medical News
Illicit Drug Use, Suicide, Depression Closely Related
Mental illness appears to raise the stakes when it comes to illicit drug use and cigarette use, the 2008 NSDUH data show.
For example, the incidence of past-year illicit drug and cigarette use in mentally ill persons aged 18 years and older was almost double that in those without mental illness. The rates of alcohol use, however, were closer between the groups.
Regarding suicide consideration, planning, and attempts, there were notable differences between the two groups: Past-year substance users were more than three times more likely to have considered suicide than were nonusers (11.0% vs. 3.0%, respectively), more than four times more likely to have planned a suicide (3.4% vs. 0.8%, and nearly seven times more likely to have attempted suicide (2.0% vs. 0.3%), the SAMHSA noted in a press release based on data from the survey.
The survey asked all adult respondents (those aged 18 and over) about suicidal thoughts and behavior, whereas data on mental illness were collected both in youths aged 12-17 years and in adults. Until now, suicidality data had been collected only within the major depressive episode module.
The data showed that in the general U.S. public, nearly 8.3 million adults (3.7%) seriously considered committing suicide in the previous year, 2.3 million had made a suicide plan, and 1.1 million had attempted suicide. Young adults aged 18-25 years were at greatest risk for suicidal thoughts (6.7%), compared with those aged 26-49 (3.9%) and the 50 or older age group (2.3%). The trends for planning and attempting were similar in the three age groups.
The findings showed “just how pervasive the risk of suicide is in our nation. … The magnitude of the public health crisis revealed by this study should motivate us to do everything possible to reach those at risk,” Dr. Broderick said.
Among youths, rates of substance, alcohol, and cigarette use in those with major depressive episode were more than double those of nonusers. Of those with past-year episode, 37.4% had used illicit drugs, compared with 17.2% of nonusers; 3.6% vs. 1.8%, respectively, reported daily cigarette use; and 3.4% vs. 1.8% reported heavy alcohol use.