Addiction Medicine: Closing the Gap between Science and Practice

Whites are more likely to have addiction than
individuals of other races/ethnicities. Rates of
addiction involving nicotine are highest among
whites, while rates of addiction involving
alcohol are highest among whites and Hispanics.
Rates of addiction involving illicit drugs are
highest among blacks.^56 (Table 3.7)

Between 2002 and 2010, the rate of addiction
declined from 17.6 percent (41.4 million) to 15.9
percent (40.3 million), driven primarily by the
decline in rates of addiction involving nicotine
(10.5 percent in 2002 to 9.0 percent in 2010).^57

Special Populations ............................................................................................................

Certain populations--such as pregnant women,
the young and the elderly--are more vulnerable
to the damaging and addictive effects of
tobacco, alcohol and other drugs. Among
individuals with co-occurring disorders,
members of the military exposed to combat and
persons involved in the justice system, the
likelihood of risky use and addiction is
significantly higher than in the general
population.

Pregnant Women ..........................................................................................................

In 2010, 16.2 percent of pregnant women were
risky users of tobacco, alcohol or other drugs*
and 14.7 percent of pregnant women met clinical
criteria for addiction.† Although pregnant
women are less likely to engage in risky
substance use or have addiction than non-
pregnant women,^58 any substance use by
pregnant women is concerning because of the
risk of pregnancy complications, adverse health
consequences for the fetus and health and
behavioral consequences for children prenatally
exposed to addictive substances.^59

Adolescents and Young Adults ....................................................................................

Use of tobacco, alcohol and other drugs while
the brain is still developing increases the risk of
addiction. Because the brain continues to

• Compared to 34.2 percent of non-pregnant women.
  † Compared to 16.2 percent of non-pregnant women.

develop into the mid-20s, the use of tobacco,

alcohol, controlled prescription drugs and illicit

drugs among 12- to 25-year olds is a significant

public health concern.^60 Despite this, risky

substance use is high in this age group:

 About half (50.6 percent, 29.6 million) of

12- to 25-year olds have used a tobacco

product‡ in their lifetime;

 Two-thirds (64.9 percent, 37.9 million) of

12- to 25-year olds have used alcohol in

their lifetime;

 Four in 10 (40.6 percent, 23.7 million) 12-

to 25-year olds have used an illicit drug in

their lifetime; and

 Approximately one-fifth (21.0 percent, 12.3

million) of 12- to 25-year olds have misused

‡ Includes cigarettes, cigars, pipes and smokeless

tobacco.

Table 3.7

Prevalence of Addiction,* by Race/Ethnicity, 2010

Percent (Number in Millions)

White Black Hispanic Other

Total Addiction,*

Ages 12+

17.6

(29.9M)

13.4

(4.0M)

12.9

(4.7M)

9.9

(1.6M)

Nicotine With/

Without Other

Substance Addiction

10.9

6.9

4.2

4.9

Alcohol With/ Without

Other Substance

Addiction

7.4

5.8

7.6

5.0

Illicit Drugs With/

Without Other

Substance Addiction

1.9

3.5

2.9

1.6

Controlled Prescription

Drugs With/Without

Other Substance

Addiction**

(1.0)

(0.6)

(1.0)

(0.7)

Multiple Substances 2.9 2.9 2.4 2.0

* Based on past 30-day nicotine dependence, as defined in the

NDSS, and past-year alcohol and/or other drug abuse or dependence,

as defined in the DSM-IV.

** The rate of addiction involving controlled prescription drugs is too

low to assure statistical reliability of data by race/ethnicity.

Source: CASA Columbia analysis of The National Survey on Drug

Use and Health (NSDUH), 2010.