IMPORTANCE:
Current
information on the prevalence and sociodemographic and clinical profiles of
individuals in the general population with DSM-5 drug use disorder (DUD) is
limited. Given the present societal and economic context in the United States
and the new diagnostic system, up-to-date national information is needed from a
single uniform data source.
OBJECTIVE:
To
present nationally representative findings on the prevalence, correlates,
psychiatric comorbidity, disability, and treatment of DSM-5 DUD diagnoses
overall and by severity level.
DESIGN, SETTING, AND PARTICIPANTS:
In-person
interviews were conducted with 36 309 adults in the 2012-2013 National
Epidemiologic Survey on Alcohol and Related Conditions-III, a cross-sectional
representative survey of the United States. The household response rate was
72%; person-level response rate, 84%; and overall response rate, 60.1%. Data
were collected April 2012 through June 2013 and analyzed from February through
March 2015.
MAIN OUTCOMES AND MEASURES:
Twelve-month
and lifetime DUD, based on amphetamine, cannabis, club drug, cocaine,
hallucinogen, heroin, nonheroin opioid, sedative/tranquilizer, and/or
solvent/inhalant use disorders.
RESULTS:
Prevalences
of 12-month and lifetime DUD were 3.9% and 9.9%, respectively. Drug use
disorder was generally greater among men, white and Native American
individuals, younger and previously or never married adults, those with lower
education and income, and those residing in the West. Significant associations
were found between 12-month and lifetime DUD and other substance use disorders.
Significant associations were also found between any 12-month DUD and major
depressive disorder, dysthymia, bipolar I, posttraumatic
stress disorder, and antisocial, borderline, and schizotypal personality disorders. Similar associations were found for
any lifetime DUD with the exception that lifetime DUD was also associated with
generalized anxiety disorder, panic disorder, and social phobia.
Twelve-month DUD was associated with significant disability, increasing with
DUD severity. Among respondents with 12-month and lifetime DUD, only 13.5% and
24.6% received treatment, respectively.
CONCLUSIONS AND RELEVANCE:
DSM-5
DUD is a common, highly comorbid, and disabling disorder that largely goes
untreated in the United States. These findings indicate the need for additional
studies to understand the broad relationships in more detail; estimate
present-day economic costs of DUDs; investigate hypotheses regarding etiology,
chronicity, and treatment use; and provide information to policy makers about
allocation of resources for service delivery and research. Findings also
indicate an urgent need to destigmatize DUD and educate the public, clinicians,
and policy makers about its treatment to encourage affected individuals to
obtain help.
By: Grant BF1, Saha TD1, Ruan WJ1, Goldstein RB1, Chou SP1, Jung J1, Zhang H1, Smith SM1, Pickering RP1, Huang B1, Hasin DS2.
- 1Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland.
- 2Department of Psychiatry, College of Physicians and Surgeons and Mailman School of Public Health, Columbia University, New York, New York3New York State Psychiatric Institute, New York.
