FIGURE 2.2 Past month illicit drug use, by past month alcohol use, age 12 and older, 1995. SOURCE: SAMHSA (1996a).

5 or more days in the past 30 days (SAMHSA, 1996a). Excessive alcohol consumption is responsible for more than 100,000 deaths per year in the United States (Doyle, 1996). Accidents—the fifth leading cause of death for all ages—accounted for 34.1 percent of all deaths, most due to drunk driving (Doyle, 1996; NCHS, 1996).

According to the National Household Survey on Drug Abuse, alcohol use may act as a gateway to using illicit drugs due to their strong association with each other. In 1995, 25 percent of the 11 million heavy drinkers were also current illicit drug users compared to only 1.9 percent of nondrinkers who reported having used illicit drugs in the past month (SAMHSA, 1996a) (see Figure 2.2).

In regard to age, ethnicity, gender, geography, and education, the rates of alcohol use in 1995 varied as follows (SAMHSA, 1996a):

• Age—Of the 111 million Americans who currently use alcohol, 10 million were under the age of 21; 4.4 million were binge drinkers, including 1.7 million heavy users. Young adults ages 18–25 were the most likely to binge or drink heavily.

• Ethnicity—Caucasians continue to have the highest rates of alcohol use at 56 percent, while rates for African Americans and Hispanics were 45 percent and 41 percent respectively. Binge use of alcohol was highest among Hispanics at 17.2 percent followed closely by Caucasians at 16.6 percent; African Americans had the lowest binge rate at 11.2 percent. Heavy use showed no statistically significant differences by ethnicity. Among adult Native Americans, studies show significant variations in prevalence of drinking from one tribal group to