Substance Use and Dependence Following Initiation of Alcohol or Illicit Drug Use | SAMHSA, Office of Applied Studies
This report examines the development of dependence upon a substance in the 2 years following substance use initiation.
Among year-before-last beginners (“initiates”) of specific substance use, just over two-thirds of crack cocaine, inhalant, and heroin initiates did not use the drug in the past year.
After all the hysteria about addiction lately, these numbers show startlingly low rates of continued use of illicit drugs 2 years after starting them. This is completely different from what we’ve heard from the media, which make it sound like anyone taking any illicit substance will immediately become a life-long addict.
Alcohol and marijuana were the only substances for which the majority of year-before-last initiates used the substance in the past year.
- 13.4 percent of year-before-last heroin initiates were dependent on heroin in the past year, and
- 9.2 percent of year-before-last crack initiates were dependent on any type of cocaine in the past year.
Among year-before-last initiates of alcohol use,
- 25.7 percent had not used alcohol during the past year;
- 71.1 percent had used alcohol in the past year but were not dependent on it; and
- 3.2 percent were both using and dependent on alcohol during the past year.
Among year-before-last initiates of marijuana,
- 42.4 percent had not used marijuana during the past year;
- 51.8 percent had used marijuana in the past year but were not dependent on it; and
- 5.8 percent were both using and dependent on marijuana in the past year.
The NSDUH defines substance dependence according to the criteria specified by the fourth edition of the diagnostic and Statistical Manual of Mental Disorders.
It includes such symptoms as withdrawal, tolerance, unsuccessful attempts to cut down on use, and continued use despite health and emotional problems caused by the substance.
Notice that this official definition of “dependence”/addiction requires more symptoms than just the withdrawal and tolerance that comes from any use of opioids:
- unsuccessful attempts to cut down on use, and
- continued use despite health and emotional problems caused by the substance.
Another instance of media obfuscation: the tables are displayed in terms of what DID NOT happen, just to be able to display more dramatic numbers. Since this is so unusual, most people will assume these are the percentages of what DID happen.
This table shows that most people continue to use alcohol once started; only 25.7% were NOT using it after 2 years. Surprisingly it also shows that most people did NOT continue using heroin, along with crack and inhalants.