Chapter I.
Changing Patterns of Drug Use in America
C. Chronic Drug Use Remains a Serious Public Health and Law Enforcement Problem
Researchers estimate the number of chronic cocaine users at 3.6 million and heroin users at 810,000. Yet, estimates of the number of chronic users that is, those who use drugs heavily are imprecise because many individuals who are deeply involved in drugs are difficult to locate for interviews.
For example, the Household Survey does not survey transients who do not reside in shelters, nor those incarcerated in prisons or jails. Learning more about the demographics of chronic users is vital. Chronic users maintain the illegal drug market, commit a great deal of crime, and contribute to the spread of hepatitis, tuberculosis, HIV/AIDS and other sexually transmitted diseases. Without a reasonable estimate of the number of chronic users, initiatives responsive to the scale of the problem are difficult to develop.
An Office of National Drug Control Policy (ONDCP)-funded large-scale feasibility study, conducted in Cook County, Illinois, underscored the difficulty of estimating the number of chronic users and the tendency of survey instruments to undercount. The Cook County survey interviewed self-professed chronic users where they are most likely to be found in large numbers: jails, drug-treatment programs, and homeless shelters. Researchers sought to learn about the characteristics of heavy drug-users and the frequency with which they made contact with institutions. The survey estimated that 333,000 chronic drug users were in Cook County. The results of this study of drug abuse in one county cannot be extrapolated nationwide. The next step will be applying this approach to an entire region and then, assuming the results are accurate, to the whole country.
