Scientists and nonscientists alike have long recognized a two-way association between alcohol consumption and violent or aggressive behavior. Not only may alcohol consumption promote aggressiveness, but victimization may lead to excessive alcohol consumption. Violence may be defined as behavior that intentionally inflicts, or attempts to inflict, physical harm. Violence falls within the broader category of aggression, which also includes behaviors that are threatening, hostile, or damaging in a nonphysical way

Extent of the Alcohol-Violence Association

Based on published studies, Roizen (3) summarized the percentages of violent offenders who were drinking at the time of the offense as follows: up to 86 percent of homicide offenders, 37 percent of assault offenders, 60 percent of sexual offenders, up to 57 percent of men and 27 percent of women involved in marital violence, and 13 percent of child abusers. These figures are the upper limits of a wide range of estimates. In a community-based study, Pernanen (4) found that 42 percent of violent crimes reported to the police involved alcohol, although 51 percent of the victims interviewed believed that their assailants had been drinking.

Alcohol-Violence Relationships

Several models have been proposed to explain the complex relationships between violence or aggression and alcohol consumption. To avoid exposing human or animal subjects to potentially serious injury, research results discussed below are largely based on experiments on nonphysical aggression. Other studies involving humans are based on epidemiological surveys or data obtained from archival or official sources. In 1998, an estimated 13.6 million Americans overall (6.2 percent of the U.S. population age 12 and older) were current users of illicit drugs.  That is not a statistically significant change from 1997 when the estimate was 13.9 million.  The number of current illicit drug users is about half its peak in 1979, when there were 25 million current users.
 
Marijuana continues to be the most frequently used illicit drug; about 60 percent of all illicit drug users reported using marijuana only, and another 21 percent reported marijuana use and some other illicit drug use.

The survey also showed that among youths age 12-17, the perceived risk of smoking marijuana once or twice a week remained unchanged between 1997 and 1998.  This may indicate a leveling off after years of decline in perceived risk of marijuana use, including “once a month” use, that has occurred since 1990.  The trend in perceived risk mirrors the trend in the use of marijuana among youth.  As the perceived risk decreased, use increased, and vice versa.  This measure provides an important correlate of drug use that can help explain the patterns and trends in substance use, particularly among youths.

The decline in teenagers' use of illicit drugs confirms the leveling off noted in the last two years of the Monitoring the Future Studies of 8th, 10th and 12th graders, released each December.  In particular, use of marijuana, the drug most widely used by teens, appears to be leveling off.

Dr. Nelba Chavez, administrator of HHS' Substance Abuse and Mental Health Services Administration (SAMHSA), which conducts the annual survey, said, "Our efforts in forging stronger partnerships with states, cities, and communities and focusing on more comprehensive drug prevention efforts -- which identify and address family, school, and mental health problems before they lead to substance abuse and other destructive behaviors -- appear to be paying off. "

Among youth age 12-17, the rate of current alcohol use was about 50 percent in 1979, fell to about 21 percent in 1992, and has remained relatively stable since then.  In 1998, the rate was 19.1 percent.  In 1998, the rates of binge drinking (31.7 percent) and heavy alcohol (13.8 percent) use among young adults age 18-25 were significantly higher than in 1997 (28.0 percent and 11.1 percent, respectively), but similar in 1998 to the rates observed in 1996 (32.0 percent and 12.9 percent, respectively).

The NHSDA provides annual estimates of the prevalence of illicit drug, alcohol, and tobacco use in the U.S. and monitors the trends in use over time.  It is based on a representative sample of the U.S. population age 12 and older, including persons living in households and in some group quarters such as dormitories and homeless shelters.  In 1998, a sample of 25,500 persons was interviewed for the survey. Additional 1998 survey highlights include:

Marijuana

In 1998, 8.3 percent of youths age 12-17 were current users of marijuana.  Youth marijuana use reached a peak of 14.2 percent in 1979, declined to 3.4 percent in 1992, more than doubled from 1992 to 1995 (8.2 percent), and has fluctuated since then (7.1 percent in 1996, 9.4 percent in 1997, and 8.3 percent in 1998).

Cocaine
 
An estimated 1.8 million (0.8 percent) Americans age 12 and older were current users of cocaine in 1998.  The estimate was 1.5 million (0.7 percent) in 1997 but the difference is not statistically significant.  Cocaine use reached a peak of 5.7 million (3.0 percent) in 1985.

Alcohol
 

113 million Americans (52 percent of the population) age 12 and older reported current use of alcohol in 1998.  Of these, about 33 million (29.2 percent) were engaged in binge drinking and 12 million (10.6 percent) were heavy drinkers.  The percentages of the population falling into these different groups have not changed since 1988.

In 1998, 10.4 million (9.2 percent) current drinkers were age 12-20.  Of this group, 5.1 million (48.5 percent) engaged in binge drinking and 2.3 million (21.9 percent) were also classified as heavy drinkers.  There have been no statistically significant changes in the rates of underage drinking since 1994.

The survey also found that drug use among youths was higher among those who were currently using cigarettes and alcohol, compared with youths not using these substances.

An estimated 5.6 percent of youths age 12-17 were current cigar smokers in 1998.  This compares to 5.0 percent in 1997, not a statistically significant difference.

Perceived Risk
 
Between 1997 and 1998, there was no change in the percentages of youths age 12-17 reporting great risk from using cigarettes, marijuana, cocaine, or alcohol.

Trends in New Use of Substances (Incidence)

Because information on when people first used a substance is collected on a retrospective basis, information on first-time use or incidence is always one year behind information on current use.
 

In 1997, an estimated 2.1 million persons first used marijuana, approximately 5,800 new marijuana users per day.  The rate of first use of marijuana among youths age 12-17 declined significantly from 79.3 per one thousand potential new users in 1996 to 64.4 per one thousand potential new users in 1997.  This is after years of rising incidence during the 1990s when the rate of new use among youth age 12-17 rose from 37 per one thousand potential users in 1991 to about 79.3 per one thousand potential users in 1996.

An estimated 81,000 persons used heroin for the first time in 1997.  The rate of initiation for youths age 12–17 increased from below 1.0 per one thousand potential new users during the 1980s to 2.7 in 1996 and, while not statistically significant, dropped to 1.1 in 1997.

There were an estimated 730,000 new cocaine users in 1997.   The rate of new use among youths age 12-17 increased from 4.1 per one thousand potential users in 1991 to 10.8 per one  thousand potential users in 1997.

In 1997, there were an estimated 1.1 million new hallucinogen users.  The rate of first-time hallucinogen users among youths age 12-17 increased from 11.1 per one thousand potential new users in 1991 to 23.9 per one thousand potential users in 1997.

HHS’ efforts to reduce tobacco, alcohol and illicit drug use in the U.S. include SAMHSA’s State Incentive Grants for Community-Based Action, awarded in 20 states and the District of Columbia to support planning for coordinated substance abuse prevention services, and Starting Early-Starting Smart Grants which examine the effectiveness of integrating substance abuse and mental health services into primary care settings and into early childhood service settings.  SAMHSA’s new Targeted Capacity Expansion Grants also assist local governments and Indian Tribal Governments to address serious, emerging drug problems at the earliest possible stage.

Additionally, HHS’ efforts to reduce marijuana use among America’s youth continue through its comprehensive Marijuana Initiative begun in 1995.  As part of this initiative, HHS has funded new research on the effects of marijuana, and launched major prevention-oriented campaigns -- such as the anti-marijuana campaign "Reality Check" -- to help parents educate children about the dangers of drugs.  Free materials, such as "Marijuana: What Parents Need to Know,”  "Tips for Teens," and “Keeping Youth Drug Free” can be obtained by calling 1-800-729-6686 or by accessing SAMHSA’s National Clearinghouse for Drug and Alcohol Information web site http://www.health.org.

SAMHSA will expand its National Household Survey on Drug Abuse (NHSDA) to provide information on substance abuse at the state level in August/September 2000.   The expanded survey will report on 70,000 interviews each year, up from 18,000-25,000 in previous years.
 
Note: Summary Findings from the 1998 National Household Survey on Drug Abuse is available on the World Wide Web at http://www.samhsa.gov.
 

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