Epidemiology of Drug Use

Brian J. Piper, Ph.D.

Epidemiology

• Study of diseases in population• Descriptive, not inferential (+ who, - why)

– Nitrites “poppers”– LSD

http://bmj.bmjjournals.com/epidem/epid.1.html

Goals

• Monitoring the Future (MtF): self-report survey of 8th - 12th grades

• National Household Survey of Drug Use and Health (NHSDUH): interviews of age 12+

• Drug Abuse Warning Network (DAWN): ER reports

• United Nations World Drug Report

http://www.monitoringthefuture.org/http://www.oas.samhsa.gov/public.cfm

Monitoring the Future

• National survey, conducted annually by NIDA of secondary school (8th, 10th, or 12th), college students, and adults (<45 yrs)

• Missing data (drop-outs = 15%, not attending) = under-estimation

• Concern about labels (inadvertent marketing)• Self-report

– Knowledge (e.g. steroids, diet pills, club drugs)– Memory (e.g. How many drinks?)– Taboo

http://www.monitoringthefuture.org/

Demographics

• Compares use by:– Year (1975 – present)– Sex– Ethnicity– Parental education– Region– College plans

?

Year & Grade

Illicit = Scheduled drugs including marijuana, heroin, cocaine, methamphetamine, LSDNot Illicit: EtOH, cigarettes, inhalants, Ritalin for medical purposes

When does use start?

What about ethnicity?

• Ranking:– African-American– Hispanic– White

Subjective Effects

AlcoholAmphetaminesCocaineHeroinLSDMarijuanaOther HallucinogensOther Narcotics

Subjective Effects

Young Adults: 19-30

How do college student differ from others in Alcohol and Nicotine Use?

How do college student differ from others in Alcohol and Nicotine Use?

D.A.R.E.

• Founded in 1983 by Daryl Gates• Police officers give lectures to middle school• Found in 80% of U.S. school districts, 54

nations• Cohen’s d = (MeanD.A.R.E. – MeanControl )/ SDpop

d = 0.30 small, 0.50 medium, 0.70 large

http://www.dare.com/home/default.asp

Does D.A.R.E work?

Ennett S.T. (1994). American Journal of Public Health, 84, 1394-1401.

National Household Surveyon Drug Use & Health

• Face to Face 4 hour Interview (N=4,500)

• Nationally representative

• Excludes prisoners, transients

• Statistical Significance: *p < .05

• But clinical (real world) significance?

https://nsduhweb.rti.org/

Treatment Options

Treatment Options

Drug Abuse Warning Network

• Nationwide reports of ER/ED visits

• 242 hospitals nationwide

• Drug is “implicated”– Overdose– Suicide– Accident

2009

http://www.samhsa.gov/data/2k11/DAWN/2k9DAWNED/HTML/DAWN2k9ED.htm

http://www.samhsa.gov/data/2k11/DAWN/2k9DAWNED/HTML/DAWN2k9ED.htm

EthnicityAlcohol Illicit

White 59.6% 50.1%

Black 19.2% 26.9%

Hispanic 12.4% 13.1%

Other/Unknown 8.8% 9.9%

http://www.samhsa.gov/data/2k11/DAWN/2k9DAWNED/HTML/DAWN2k9ED.htm

EthnicityAlcohol Illicit National (2010 Census)

White 59.6% 50.1% 63.7%

Black 19.2% 26.9% 12.6%

Hispanic 12.4% 13.1% 16.3%

Other/Unknown 8.8% 9.9% 7.4%

http://www.samhsa.gov/data/2k11/DAWN/2k9DAWNED/HTML/DAWN2k9ED.htm

UNWDR

• United Nations World Drug Report

• Pooled data from various countries with various methods

• Provides information about drug use, treatment, and drug seizures

Annual Use

Injection Drug Use

Summary

• Data Sources:– Monitoring the Future (Survey)

– National Household Survey on Drug Use & Health (Interview)

– Drug Abuse Warning Network (ED)

– Patterns: • Year• Age• Ethnicity• Other: College Plans

Thought question

• Design an empirically based drug education program for high-school students.– What drugs would you target?– What ages?– Would ethnicity or other factors be involved in

your design making process?

http://learn.genetics.utah.edu/content/addiction/drugs/mouse.html