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II. Progress Toward Achieving Performance Targets
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Drug Use

Twelve Impact Targets are used to assess the Strategy's progress in reducing the drug problem in the following areas: drug use, drug availability, and consequences. We will now review progress against the key indicators for these three areas using the relevant performance measures.

Reduce Drug Use Nationwide

The PME System established a 2007 target of a 50 percent reduction in the rate of overall drug use, as measured by the Household Survey. The 1996 baseline for this measure is 6.1 percent, which means the 2007 target rate is 3 percent. According to the 1997 Household Survey, overall drug use in the United States was statistically unchanged between 1996 and 1997. The overall drug problem neither worsened nor improved between 1996 and 1997. There were 14 million current users of any illicit drug in the overall household population in 1997, or 6.4 percent of the population. 3

While the performance target is focused on overall drug use, it is useful to understand the trends in the principal drugs that comprise this particular measure. Marijuana continues to be the most frequently used illicit drug, and its use dominates the trend in overall drug use. In 1997, an estimated 11.1 million individuals reported using marijuana on a past-month basis -- or 5.1 percent of the household population. This rate was statistically unchanged from 1996, when there were an estimated 10.1 million current marijuana users, or 4.7 percent of the population. 4

Heroin use remained unchanged in 1997 as compared to 1996. For both years, 0.2 percent of the household population reported past-month heroin use. This equates to 325,000 past-month users of heroin in the household population in 1997. This is an increase of 378 percent since 1993, when the number was 68,000 -- the lowest number of heroin users recorded by the Household Survey. 5

The data for cocaine generally suggest that cocaine use is dropping. The number of past-month users of cocaine decreased slightly from 1.7 million in 1996 to 1.5 million in 1997. However, this decrease was not statistically significant. 6

Use of Illegal Drugs, Alcohol, and Tobacco by Youth

While overall drug use in the United States generally remained level during 1997 as compared to 1996, this was not the case for youth drug use. Here we are facing a serious challenge. The PME System established two targets related to reducing youth drug use. One target focuses on delaying the onset of drug use. Here the performance target is to increase the average age of first-time drug use by 36 months by 2007 from the 1996 baseline level (by 12 months by 2002). The other target focuses on prevalence. It requires that the rate of youth drug use be reduced by 50 percent by 2007 (by 20 percent by 2002). Both targets use data from the Household Survey to measure progress against these targets. 7

There continues to be a serious problem with drug use among youth. The 1997 Household Survey reports that the problem worsened between 1996 and 1997: the use of illicit drugs among youth (ages 12 - 17) increased from 9.0 percent in 1996 to 11.4 percent in 1997. 8

Most of this increase was driven by marijuana use among youth. The rate of current marijuana use among 12 - 17 year olds increased from 7.1 percent in 1996 to 9.4 percent in 1997, an increase of nearly one-third. This increase in marijuana use was driven particularly by use among 12 - 13 year olds -- the rate for this age group doubled between 1996 and 1997, from 1.2 percent to 2.5 percent, and 14 - 15 year olds -- the rate for this age group increased 37 percent, from 6.7 to 9.2 percent. Both increases were statistically significant. 9

Cocaine use among youth appears to be unchanged overall. While not statistically significant, the Household Survey shows that 1.0 percent of America's 12 - 17 year olds had used cocaine during the past month in 1997 as compared to 0.6 percent in 1996. However, white youth as a subgroup of this population showed a statistically significant increase in past-month cocaine use from 0.5 percent in 1996 to 1.1 percent in 1997. 10

Heroin use among youth remained constant during 1997 as compared to 1996. The rate of past-month heroin use among 12 - 17 year olds was 0.2 percent for both years. 11

Tobacco use among youth was statistically unchanged from 1996 to 1997 for both cigarettes and smokeless tobacco. The rate of cigarette use among youth (12 - 17 years old) was 19.9 percent in 1997 compared to 18.3 percent for 1996. The rate of smokeless tobacco use was 2.0 percent in 1997 compared to 1.9 percent for 1996. 12

Alcohol use among youth also was statistically unchanged from 1996 to 1997. The Household Survey reported that 20.5 percent of America's 12 - 17 year olds had at least one drink during the past month as compared to 18.8 percent in 1996. 13

Initial Age of Drug Use Among Youth

The 1997 Household Survey reports information on the average age of first-time use of marijuana, cocaine, and heroin for 1996. Data on drug use initiation rates are from the year preceding the survey (1996) and earlier. Thus, only data for the baseline year are available. The 1998 Household Survey will provide initiation rates for 1997 and prevalence rates for 1998: the first year of this annual performance target.

The mean age of first time use of marijuana in 1996 was 16.4 years. The average ages of first use of heroin and cocaine in 1996 were 18.1 and 18.7 years of age, respectively. 14

The above results form the baseline against which to judge the efficacy of the Strategy's demand reduction efforts, particularly those efforts that focus on affecting youth attitudes about the dangers of drug use. It is expected that the National Youth Anti-Drug Media Campaign, the expansion of community-based prevention efforts, and other prevention efforts that focus on our schools and homes will stem the spread of drug initiation among youth.

Reduce Drug Use in the Workplace

Drug use adversely affects productivity in the workplace, which ultimately translates to increased costs and lower profits for business and industry. Most drug users are employed, which makes the workplace important to our national effort to reduce drug use and its consequences. The PME System includes a performance target to reduce drug use prevalence in the workplace. This target focuses on reducing prevalence by 50 percent by 2007 compared to the 1996 baseline year (by 25 percent by 2002).

Among current illicit drug users age 18 and older, 73 percent were employed in 1997. This translates to 6.7 million full-time workers and 1.6 million part-time workers who are using drugs. 15 The rate of current drug use among those employed full-time was 6.2 percent in 1996 and 6.5 percent in 1997. Among those employed part-time, the rate of drug use was 8.6 percent in 1996 and 7.7 percent in 1997. These differences in rates between 1996 and 1997 are not statistically significant. 16

Reduce the Number of Chronic Users

Chronic drug users consume the vast majority of illicit drugs. Unless the number of chronic drug users is reduced, progress in reducing the overall demand for drugs will be hindered. The PME System includes a performance target to reduce the number of chronic drug users by 50 percent by 2007 (by 25 percent by 2002). At this point, no official, survey-based government estimate of the size of this drug-using population exists. One study conducted for ONDCP estimates the number of chronic users at 3.6 million for cocaine and 810,000 for heroin in 1995. 17 This same study also suggests that the size of this population has slowly declined since the early 1990s, presumably reflecting the growth in treatment capacity and its effectiveness. 18 ONDCP is now conducting Phase II of its pilot study designed to provide an accurate estimate of the size of this population. 19

As the estimate of chronic users is refined and national estimates are developed, we will have more valid and accurate estimates of chronic drug users against which to compare the targets. As long as comparable estimates for the base year (1996) are developed along with the new measures, the targets can be tracked accurately.


    3 The difference between the 6.4 percent rate of current drug use reported for 1997 and the 6.1 percent rate for 1996 is not statistically significant. (Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Preliminary Results from the 1997 National Household Survey on Drug Abuse, Rockville, MD: U.S. Department of Health and Human Services.)

    4 The difference between the 5.1 percent rate of current marijuana use reported for 1997 and the 4.7 percent rate for 1996 is not statistically significant. (Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Preliminary Results from the 1997 National Household Survey on Drug Abuse, Rockville, MD: U.S. Department of Health and Human Services.)

    5 Ibid.

    6 Ibid.

    7 The Household Survey reports data for youth drug use for respondents aged 12 - 17. Alternatively, the Monitoring the Future Study released each year by the University of Michigan could be used, but it measures prevalence for only three grades: 8th, 10th, and 12th grades. The Household Survey was chosen because of the planned expansion of its sample size, thereby making its estimates more valid and reliable, and because of its broader coverage of the youth cohort.

    8 The increase from the 9.0 percent rate of current drug use reported for 1996 and the 11.4 percent rate for 1997 is statistically significant at the .01 level. (Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Preliminary Results from the 1997 National Household Survey on Drug Abuse, Rockville, MD: U.S. Department of Health and Human Services.)

    9 The increase for 12 - 13 year olds from the 1.2 percent rate of current marijuana use reported in 1996 and the 2.5 percent rate for 1997 is statistically significant at the .01 level. The increase for 14 - 15 year olds from the 6.7 percent rate reported for 1996 and the 9.2 percent rate for 1997 is statistically significant at the .05 level. Rates for those aged 16 - 17 were statistically unchanged. (Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Preliminary Results from the 1997 National Household Survey on Drug Abuse, Rockville, MD: U.S. Department of Health and Human Services.

    10 Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Preliminary Results from the 1997 National Household Survey on Drug Abuse, Rockville, MD: U.S. Department of Health and Human Services.

    11 Ibid.

    12 The changes in cigarette and smokeless tobacco use from 1996 to 1997 are not statistically significant. (Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Preliminary Results from the 1997 National Household Survey on Drug Abuse, Rockville, MD: U.S. Department of Health and Human Services.)

    13 Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Preliminary Results from the 1997 National Household Survey on Drug Abuse, Rockville, MD: U.S. Department of Health and Human Services.

    14 Ibid.

    15 Ibid.

    16 Ibid.

    17 Office of National Drug Control Policy. What America's Drug Users Spend on Illicit Drugs, 1988 - 1995. Fall 1997, Washington, DC: Government Printing Office.

    18 Another attempt to measure chronic drug use, developed by SAMHSA using a combination of the Household Survey drug use data with treatment and arrest data, estimates that there were more than 3.6 million persons in 1994 who experienced drug problems of a severity that made them prime candidates for treatment. While this measure of chronic drug use is not equivalent to "hard core" drug use, it can be considered a conservative estimate that is subject to revision as better methods of measuring chronic drug use are developed and implemented.

    19 The Senate and House Treasury, Postal Service, and General Government Subcommittees provided $5 million to conduct Phase II of its pilot study on estimating the number of chronic addicts in the United States. The findings from Phase I of the study, which were released in Spring 1998, proved the efficacy of a new methodology to estimate the size of this population that traditional survey techniques tend to miss. Office of National Drug Control Policy. A Plan for Estimating the Number of "Hardcore" Drug Users in the United States: Preliminary Findings, Fall 1997, Washington, DC: Executive Office of the President, Office of National Drug Control Policy, Office of Programs, Budget, Research, and Evaluation.

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1999 National Drug Control Strategy Office of National Drug Control Policy