Understanding the Demand for Illegal Drugs (2010) / Chapter Skim
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3 Measuring the Demand for Drugs
3 Measuring the Demand for Drugs
Pages 37-64
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From page 37... ...
This chapter describes the datasets that are available on drug use and its consequences in the United States. It assesses the strengths and weaknesses of each dataset and how it con tributes to understanding of the demand for illegal drugs.
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From page 38... ...
These datasets include information regarding substance use, psychiatric disorders (including substance abuse and dependence) , welfare receipt, and substance abuse treatment receipt during the 12 months prior to the survey interview.
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. NHSDA and NSDUH are known to underrepresent frequent users of cocaine and heroin and to underrepresent the overall volume consumed of both substances (National Institute on Drug Abuse, 1997; Office of National Drug Control Policy, 2001)
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Accounting for the weighted and stratified nature of NHSDA, this number corresponds to an estimated 150,528 weekly heroin users3 in the United States. But this number represents approximately 16 percent of the estimated number of weekly heroin users as determined by a study done for the Office of National Drug Control Policy (ONDCP)
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NHSDA provides an inconsistent and incomplete mea sure of drug and alcohol dependence across survey years -- a problem addressed in one-time surveys such as the 2002 National Epidemiologic Survey of Alcohol and Related Conditions and now the NSDUH, but not addressed in a consistently implemented annual survey. Despite these limitations, NHSDA and NSDUH provide nationally representative individual data widely used for policy analysis, though the lack of state identifiers in public-use files has been a major hindrance to such analysis.
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Perhaps most importantly, MTF is administered in the classroom and provides respondents with greater anonymity than does the household survey. Thus it is not surpris ing that analyses comparing the reported rates for youth find higher rates in MTF than for a closely matched age group from NHSDA and NSDUH (Gfroerer, 1992)
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replicated NCS methodologies. These surveys provide high-quality, nationally representative data to explore a wide range of DSM-IV defined psychiatric disorders, including lifetime and current substance use disorders.
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Proxy indicators include drug-related emergency department admissions and overdoses, alcohol-related traffic fatalities, admissions into substance abuse treat ment, and toxicology screening of arrestees in major metropolitan areas. Each of these proxies captures some dimension of the social harms associated with substance use and fails to capture others.
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Several datasets provide specific information regarding the population of people who receive substance abuse treatment services. These datasets provide detailed clinical information, as well as administrative data concerning payment sources, entry characteristics of treatment cli ents, and characteristics of the treatment experience itself.
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The Treatment Episode Data Set-Discharges (TEDS-D) is an administrative data system that provides annual client-level data on discharges from alcohol or drug treatment in the same public or private substance abuse treatment facilities that comprise the TEDS sample frame.
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From page 47... ...
ADAM includes detailed, representative data regarding the severity of charges leading to arrest and booking; individuals' contact with health care and substance abuse treatment systems; lifetime, 12-month, 30-day, and 72-hour experiences of substance use; and circumstances of drug purchases and sales. ADAM also includes voluntary urine test results.
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ADAM was terminated in 2003, but ONDCP (Office of National Drug Control Policy, 2009) restarted it in 10 sites in 2007 and plans to continue it as an annual survey.
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. One exception is the government estimates that have been published on three occasions (Office of National Drug Control Policy, 1995, 1997, 2001)
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Estimates for 2000 are projections. SOURCE: Office of National Drug Control Policy (2001)
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We discuss data at the city level because there are such large differences in absolute prices, though there is considerable consistency in trends. One of the most surprising observations about major drug markets over the last 30 years has been failure of increasingly stringent supplyside enforcement (as measured by the number of people imprisoned for offenses related to drug sales)
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. The most recent data, extending a price and purity series through 2007, were recently published by ONDCP (Office of National Drug Control Policy, 2008)
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NOTES: AMT = amount; g = gram. g3-5.eps Fi SOURCE: Office of National Drug Control Policy (2008)
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During the 1990s, the number of "chronic users" of cocaine and heroin showed steady decline according to the most recent estimate published by the ONDCP (Office of National Drug Control Policy, 2001) .7 Yet the number of emergency department admissions and the number of deaths related to these drugs markedly rose.
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The age of drug users, the duration and intensity of their drug use, and other factors play important roles. Similar insights apply to the sup ply side of illegal drug markets.
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These authors report that clients under the age of 25 were four times as likely to report that they had recently robbed someone with a weapon as were clients over the age of 30. Although by some measures older clients achieved better treatment outcomes, substance abuse treatment was most cost-beneficial when provided to the most criminally active population of male clients under 25, precisely because these younger drug addicts inflict such high costs on society through their criminal offending.
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FIgURE 3-7 Changes in the age distribution of clients admitted for smoked co caine disorders, 1992 and 2006. Fig3-7.eps SOURCE: Treatment Episode Data Set (Substance Abuse and Mental Health Ser vices Administration, 2007)
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From page 58... ...
These changes do not reflect the consequence of an epidemic of new use among the older population; rather, they represent the aging of those who were caught in the earlier epidemics. Similar, although somewhat weaker evidence of aging can be found in DAWN emergency department data: see Figure 3-8.
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CONCLUSION Economic models help to illuminate drug markets, but they leave many unsettled questions. Nationally representative survey data provide a useful resource to examine the determinants of occasional drug use, particularly among youth and young adults.
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born Asian Americans: Results from the National Latino and Asian American study. American Journal of Public Health, (1)
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. An overview of the National Household Survey on Drug Abuse and re lated methodological research.
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. Should the DEA's STRIDE data be used for economic analyses of markets for illegal drugs?
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Washington, DC: Executive Office of the President. Office of National Drug Control Policy.
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From page 64... ...
. Older Adult Admissions to Substance Abuse Treatment: Findings from the Treatment Episode Data Set.
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