Millions of Americans in Denial About Their Own Drug Abuse

Results of the 2001 National Household Survey on Drug Abuse reveal that, while millions of Americans habitually smoke pot, drink alcohol, snort cocaine and swallow prescription drugs, too many drug users who meet the criteria for needing treatment do not recognize that they have a problem. The figure of those “in denial” is estimated at more than 4.6 million–a significantly higher number of individuals in need of professional help than had previously been thought.

According to the results of the survey, of the 5.0 million people who needed but did not receive treatment in 2001, an estimated 377,000 reported that they felt they needed treatment for their drug problem. This includes an estimated 101,000 who reported that they made an effort but were unable to get treatment and 276,000 who reported making no effort to get treatment.

“We have a large and growing denial gap when it comes to drug abuse and dependency in this country,” said John Walters, Director of National Drug Control Policy. “We have a responsibility–as family members, employers, physicians, educators, religious leaders, neighbors, colleagues, and friends–to reach out to help these people. We must find ways to lead them back to drug free lives. And the earlier we reach them, the greater will be our likelihood of success.”

70,000 Participated in the Nationwide Survey

70,000 people, aged 12 and older, participated in the nationwide survey and were asked questions concerning run-ins with the law, drunken driving, difficulties at school or work, as well as details of their drug use. Many users who said they’d encountered trouble in most areas still believed they were in control of their habit.

Overall, the Household Survey found that 15.9 million Americans age 12 and older used an illicit drug in the month immediately prior to the survey interview. This represents an estimated 7.1 percent of the population in 2001, compared to an estimated 6.3 percent the previous year.

The survey’s results reveal that 10.8 percent of youths age 12 to 17 were current drug users in 2001 compared with 9.7 percent in 2000. (On a positive note, youth cigarette use in 2001 was slightly below the rate for 2000, continuing a downward trend since 1999.)

Among young adults age 18 to 25, current drug use increased between 2000 and 2001 from 15.9 percent to 18.8 percent. There were no statistically significant changes in the rates of drug use among adults age 26 and older.

Substance Abuse and Mental Health Services Administration (SAMHSA) Administrator Charles G. Curie emphasized that, “Behind these numbers are real children and adults impacted by drug use. We must refuse to give up on people who have handed over their aspirations and their futures to drug use. People need to know help is available, treatment is effective and recovery is possible.” Curie added that the prevalence of drug use and abuse is partly due to a drop in the amount of people who see certain substances, such as marijuana, as harmful.


An estimated 2.4 million Americans used marijuana for the first time in 2000. Because of the way trends in the new use of substances are estimated, estimates of first- time use are always a year behind estimates of current use. The annual number of new marijuana users has varied considerably since 1965 when there were an estimated 0.6 million new users. The number of new marijuana users reached a peak in 1976 and 1977 at around 3.2 million. Between 1990 and 1996, the estimated number of new users increased from 1.4 million to 2.5 million and has remained at this level.

The measure of perceived risk in the use of marijuana among youth provides an important predictor of drug use, particularly among youths. As perceived risk of using marijuana decreases, rates of marijuana use tend to increase. Perceived great risk of smoking marijuana once or twice a week decreased from 56.4 percent in 2000 to 53.3 percent in 2001. Among youths age 12 to 17, the percentage reporting great risk in marijuana use declined from 56.0 to 53.5 percent.


The number of persons who had ever tried Ecstasy (MDMA) increased from 6.5 million in 2000 to 8.1 million in 2001. There were 786,000 current users in 2001. In 2000, an estimated 1.9 million persons used Ecstasy (MDMA) for the first time compared with 0.7 million in 1998. This change represents a tripling in incidence in just 2 years.


The number of persons reporting use of Oxycontin ® for non-medical purposes at least once in their lifetime increased from 221,000 in 1999 to 399,000 in 2000 to 957,000 in 2001. The annual number of new users of pain relievers non medically has also been increasing since the mid-1980s when there were roughly 400,000 initiates. In 2000, there were an estimated 2.0 million.


About 10.1 million persons age 12 to 20 years reported current use of alcohol in 2001. This number represents 28.5 percent of this age group for whom alcohol is an illicit substance. Of this number, nearly 6.8 million, or 19.0 percent, were binge drinkers and 2.1 million, or 6.0 percent, were heavy drinkers. In 2001, more than 1 in 10 Americans, or 25.1 million persons, reported driving under the influence of alcohol at least once in the 12 months prior to the interview. The rate of driving under the influence of alcohol increased from 10.0 to 11.1 percent between 2000 and 2001. Among young adults age 18 to 25 years, 22.8 percent, drove under the influence of alcohol.


An estimated 66.5 million Americans 12 years or older reported current use of a tobacco product in 2001. This number represents 29.5 percent of the population. Youth cigarette use in 2001 was slightly below the rate for 2000, continuing a downward trend since 1999.

Rates of youth cigarette use were 14.9 percent in 1999, 13.4 percent in 2000, and 13.0 percent in 2001. The annual number of new daily smokers age 12 to 17 decreased from 1.1 million in 1997 to 747,000 in 2000. This translates into a reduction from 3,000 to 2,000 in the number of new youth smokers per day.

Measuring the Most Serious Problems

The Household Survey includes a series of questions designed to measure more serious problems resulting from use of substances. Overall, an estimated 16.6 million persons age 12 or older were classified with dependence on or abuse of either alcohol or illicit drugs in 2001 (7.3 percent of the population). Of these, 2.4 million were classified with dependence or abuse of both alcohol and illicit drugs, 3.2 million were dependent or abused illicit drugs but not alcohol, and 11.0 million were dependent on or abused alcohol but not illicit drugs. The number of persons with substance dependence or abuse increased from 14.5 million (6.5 percent of the population) in 2000 to 16.6 million (7.3 percent) in 2001.

Between 2000 and 2001, there was a significant increase in the estimated number of persons age 12 or older needing treatment for an illicit drug problem. This number increased from 4.7 million in 2000 to 6.1 million in 2001. During the same period, there was also an increase from 0.8 million to 1.1 million in the number of persons receiving treatment for this problem at a specialty facility. However, the overall number of persons needing but not receiving treatment increased from 3.9 million to 5.0 million.

New Focus on Mental Health Needs

For the first time, the Household Survey included questions that measure serious mental disorders. Both youths and adults were asked questions about mental health treatment in the past 12 months.

The survey found a strong relationship between substance abuse and mental problems. Among adults with serious mental illness in 2001, 20.3 percent were dependent on or abused alcohol or illicit drugs; the rate among adults without serious mental illness was 6.3 percent. An estimated 3.0 million adults had both serious mental illness and substance abuse or dependence problems during the year.

In 2001, there were an estimated 14.8 million adults age 18 or older with serious mental illness. This represents 7.3 percent of all adults. Of this group with serious mental illness, 6.9 million received mental health treatment in the 12 months prior to the interview.

In 2001, an estimated 4.3 million youths age 12 to 17 received treatment or counseling for emotional or behavioral problems in the 12 months prior to the interview. This represents 18.4 percent of this population and is significantly higher than the 14.6 estimate for 2000. The reason cited most often by youths for the latest mental health treatment session was “felt depressed” (44.9 percent of youths receiving treatment), followed by “breaking rules or acting out” (22.4 percent), and “thought about or tried suicide” (16.6 percent).

Source: U.S. Dept. of Health and Human Services