In Brief

Drug, alcohol and tobacco abuse is the cause of more deaths, illnesses and disabilities than any other preventable health condition, and seriously undermines America's family life, economy and public safety, according to Substance Abuse: The Nation's Number One Health Problem, a report by the Robert Wood Johnson Foundation.

The 128-page document presents the latest information on substance abuse trends, offering "data for action" for practitioners, researchers, policy-makers and others.

Though many of the report's statistics show how far the nation has to go to control substance abuse, not all of the news is bad:

  • Overall rates of illicit drug and alcohol use are down from peak levels in the late 1970s and early 1980s, respectively. Tobacco use has declined since the 1960s.

  • Public awareness about the dangers of substance abuse has increased in the last few decades.

  • Prevention and treatment are working to reduce substance abuse.

But, says the report, illicit drugs are still widely available, underage drinkers still have easy access to alcohol, crime and domestic violence are strongly linked to substance abuse, and more children are experimenting with drugs, particularly marijuana.

The report also notes that Americans have insufficient access to substance abuse prevention and treatment programs, and when they are available, they are underused.

Several trends offer hope for the future, the report says. They include the growth of programs to curb youth access to alcohol and tobacco products, raising excise taxes and the expansion of managed-care programs for substance abuse treatment. Perhaps offering the greatest hope is an increased understanding of the neurological bases of addiction, which is expected to lead the way to better treatment and prevention.


NOTE: Heavy alcohol use is having five or more drinks on the same occasion on each of five or more days in the past 30 days.
SOURCE: U.S. Substance Abuse and Mental Health Services Administration, Office of Applied Studies.
Summary of Findings from the 1998 National Household Survey on Drug Abuse, Rockville, MD, 1999. Table 32-37, pp.95-100.


Further Reading

For more information, visit the Robert Wood Johnson Foundation Web site at