Monday, June 30, 2008

United States has highest level of illegal cocaine and cannabis use... and more

Public Library of Science

United States has highest level of illegal cocaine and cannabis use... and

United States has highest level of illegal cocaine and cannabis use

A survey of 17 countries has found that despite its punitive drug policies
the United States has the highest levels of illegal cocaine and cannabis
use. The study, by Louisa Degenhardt (University of New South Wales, Sydney,
Australia) and colleagues, is based on the World Health Organization's
Composite International Diagnostic Interview (CIDI) and is published in this
week's PLoS Medicine.

The authors found that 16.2% of people in the United States had used cocaine
in their lifetime, a level much higher than any other country surveyed (the
second highest level of cocaine use was in New Zealand, where 4.3% of people
reported having used cocaine). Cannabis use was highest in the US (42.4%),
followed by New Zealand (41.9%).

In the Americas, Europe, Japan, and New Zealand, alcohol had been used by
the vast majority of survey participants, compared to smaller proportions in
the Middle East, Africa, and China.

The survey found differences in both legal and illegal drug use among
different socioeconomic groups. For example, males were more likely than
females to have used all drug types; younger adults were more likely than
older adults to have used all drugs examined; and higher income was related
to drug use of all kinds. Marital status was found to be related to tobacco,
cannabis, and cocaine use, but not alcohol use (the never married and
previously married having higher odds of lifetime cocaine and cannabis use
than the currently married; tobacco use is more likely in people who have
been previously married while less likely among the never married).

Drug use "does not appear to be simply related to drug policy," say the
authors, "since countries with more stringent policies towards illegal drug
use did not have lower levels of such drug use than countries with more
liberal policies." In the Netherlands, for example, which has more liberal
policies than the US, 1.9% of people reported cocaine use and 19.8% reported
cannabis use.

Data on drug use were available from 54,068 survey participants in 17
countries. The 17 countries were determined by the availability of research
collaborators and on funding for the survey. Trained lay interviewers
carried out face-to-face interviews (except in France where the interviews
were done over the telephone) using a standardized, structured diagnostic
interview for psychiatric conditions and drug use. Participants were asked
if they had ever used alcohol, tobacco, cannabis, or cocaine.

The study's main limitations are that only 17 countries were surveyed,
within these countries there were different rates of participation, and it
is unclear whether people accurately report their drug use when interviewed.
Nevertheless, the findings present comprehensive data on the patterns of
drug use from national samples representing all regions of the world.

Citation: Degenhardt L, Chiu W-T, Sampson N, Kessler RC, Anthony JC, et al.
(2008) Toward a global view of alcohol, tobacco, cannabis, and cocaine use:
Findings from the WHO World Mental Health Surveys. PLoS Med 5(7): e141.



Louisa Degenhardt
National Drug and Alcohol Research Centre
University of New South Wales
Sydney, New South Wales 2052
+61 2 9385 0230
+61 2 9385 0222 (fax)

David Cameron
Associate Director of Public Affairs
Harvard Medical School
Boston, MA 02115
United States of America
+1 671 432 0441

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