progressed to a psychiatric diagnosis of abuse or dependence. The National Comorbidity Survey (NCS) used a psychiatric diagnostic perspective to obtain population-based estimated rates of diagnoses of abuse and dependence.6 NCS was sponsored primarily by the National Institute of Mental Health (NIMH), with supplemental support from NIDA and the W.T. Grant Foundation. NCS, conducted from 1990 to 1992, was a collaborative epidemiological investigation of the prevalence, causes, and consequences of psychiatric morbidity and comorbidity in the United States.

Results from this survey of more than 8,000 Americans age 15-54 show that a significant 7.5 percent had developed dependence on illicit drugs or inhalants; 4.2 percent were dependent on cannabis and 2.7 percent were dependent on cocaine (Anthony et al., 1994). One in four (24.1 percent) members of the study population had been or were dependent on tobacco; one in seven (14.1 percent) had a diagnosis of dependence on alcohol. Men were more likely than women to be diagnosed as dependent on illicit drugs. One in eleven men (9.2 percent) reached a (lifetime7) diagnosis of dependence on illicit drugs, compared with 5.9 percent of women.

Surveys of Specific Populations

Washington, D.C., Metropolitan Area Drug Study

The 1991 Washington, D.C., Metropolitan Area Drug Study (DC*MADS), funded by NIDA, examined the nature and extent of drug use among all types of persons residing in a single metropolitan area, with a special focus on groups that are underrepresented or unrepresented in NHSDA (NIDA, 1994b). These special samples included homeless people, transients, and institutionalized individuals. The objectives of DC*MADS were to estimate the prevalence, correlates, and consequences of drug use among the diverse populations residing in the metropolitan area and to develop a research model for similar data collection in other major metropolitan areas (NIDA, 1994b).

Additionally, DC*MADS data on homeless and institutionalized populations were analyzed to determine the impact of those results on estimates of the number of injection drug users derived from studies such


There have been other important and significant efforts to determine the epidemiology of drug abuse and dependence; the most notable is the Epidemiology Catchment Area studies (Eaton and Kessler, 1985), but these were not nationally representative.


The term "lifetime" is used to indicate a disorder occurring at any time during the life span to date and does not indicate a chronic, lifelong condition.

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