Executive Summary

The Kentucky Needs Assessment 2004 Adult Household Survey Report includes estimates of nicotine, alcohol, and illicit drug use by adult Kentuckians 18 years and older as well as estimates of substance use treatment need. These estimates were developed from data collected during confidential and anonymous telephone interviews with 4,210 adults randomly sampled from households across Kentucky . Interviews were conducted by the University of Kentucky Survey Research Center from May to September 2004. Summaries of survey findings for different drugs and treatment need are described below.

Nicotine

An estimated 716,741 adult Kentuckians (23%) smoked cigarettes daily. Three-fourths of males and two-thirds of females had their first cigarette before the legal age of 18. Daily cigarette smoking was negatively correlated to education and income such that those with more education or with more annual income were less likely to smoke daily. Hispanics (18.3%) were less likely to smoke cigarettes daily than Whites (22.9%) or African-Americans (24.4%).

Alcohol

An estimated 1,112,156 adult Kentuckians (35.6%) drank alcohol within the past 30 days, and an estimated 197,880 (6.3%) drink alcohol everyday. Almost 88% of males and 80% of females have their first drink of alcohol before the legal age of 21. African-Americans start drinking later (18.1 years old) than Whites (17.1 years old) or Hispanics (16.4 years old) but are more likely to use alcohol in combination with other drugs. An estimated 268,197 adult Kentuckians (8.6%) believe that alcohol was a problem for them at some point in their life, with males three times more likely than females to believe this.

Marijuana

An estimated 979,568 adult Kentuckians (31%) used marijuana in their lifetime and 133,968 (4.2%) used in the past year. Of the estimated 92,959 adult Kentuckians (2.9%) who used marijuana in the past 30 days, 19.6% of males and 17.1% of females reported using marijuana every day. The average age of first use of marijuana was 18 years old. An estimated 106,773 adult Kentuckians believe that marijuana has been a problem for them at some point in their life.

Cocaine

An estimated 229,231 adult Kentuckians (7.3%) used cocaine in their lifetime. Males were estimated to be twice as likely as females to have used cocaine (150,663 vs. 78,568). Most people who used cocaine were less than fifty years of age, and only 1 in 4 of these users believed that cocaine was a problem for them at some point in their life. An estimated 31,895 adult Kentuckians (1%) have used cocaine in the past year. Cocaine users in the past year were slightly more likely to be male (17,812) than female (14,083).

Methamphetamine

An estimated 81,603 adult Kentuckians (2.6%) illicitly used methamphetamine in their lifetime. Males were estimated to be three times more likely than females to have used this stimulant (60,859 vs. 20,744). Among those who used methamphetamine, more than half of male users (56.6%) and 25% of female users believed the drug was a problem in their life. Younger aged adults were more likely to report lifetime use of methamphetamine than older aged adults. Only 10% of people who have used methamphetamine report using it in the past year, but the ratio of male users to female users remained at 3 to 1 (6,680 vs. 2233).

MDMA (ecstasy)

An estimated 69,713 adult Kentuckians (2.2%) used MDMA in their lifetime, 57% of which were males. The majority of those who used MDMA were less than 30 years of age. An estimated 8,904 adult Kentuckians (< 1%) used MDMA in the past year. Similar to methamphetamine, approximately three-fourths of those who reported using MDMA in the past year were male.

Other Stimulants

An estimated 221,819 adult Kentuckians (7.1%) used other stimulants (e.g., methylphenidate or other specific drug if known) in their lifetime, 68% of which were males. The largest proportion of lifetime users of other stimulants was adult Kentuckians between 40 and 49 years of age. Approximately 20% of males and 10% of females believe the use of stimulants other than cocaine, methamphetamine, and MDMA was a problem in their life. Of the estimated 25,977 adults in Kentucky (< 1%) who used other stimulants in the past year, most of them were male (80%).

Inhalants

An estimated 62,320 adult Kentuckians (2%) used inhalants in their lifetime. Approximately 2.5 times as many males (44,531) than females (17,789) have used inhalants. Nineteen percent of males and 12.5% of females who used inhalants ever considered it a problem in their life. Consistent with previous needs assessment studies, inhalant use tends to cease after adolescence and very few adult Kentuckians (< 1%) report using inhalants in the past year.

Hallucinogens

An estimated 207,810 adult Kentuckians (6.7%) used hallucinogens in their lifetime. Nearly three of every four persons reporting hallucinogen use were male. Younger aged adults were more likely to report lifetime use of hallucinogens than older adults. Less than 10% of those who used hallucinogens ever considered them to be a problem in their life. An estimated 10,388 adult Kentuckians (< 1%) have used hallucinogens in the past year and use is predominantly by males (8,906).

Sedatives

An estimated 139,453 adult Kentuckians (4.5%) illicitly used sedatives in their lifetime. Persons between the ages of 18 and 29 most frequently reported sedative use. Although more males were estimated to have used sedatives, the estimated number of sedative users was more evenly distributed across gender than most other drugs (80,898 males vs. 58,555 females). A higher percentage of females (16.3%) than males (12.4%) reported that sedatives had been a problem in their life. An estimated 57,860 adult Kentuckians used sedatives during the past year, and these again were more evenly distributed across gender than most other drugs (34,883 males vs. 22,977 females).

Tranquilizers

An estimated 205,507 adult Kentuckians (6.6%) illicitly used tranquilizers in their lifetime. Similar to hallucinogen use, nearly three of every four persons reporting tranquilizer use were male. Only 13.7% of those who used tranquilizers ever believed they were a problem in their life. An estimated 48,240 adult Kentuckians (1.5%) used tranquilizers in the past year with the estimated number of male users (34,157) being about 2.5 times as many as the estimated number of female tranquilizer users (14,083).

Heroin

An estimated 30,425 adult Kentuckians (1%) used heroin in their lifetime. Although a low number of male heroin users (15.9%) reported ever believing heroin was a problem in their life, almost half of the females (48.3%) believed it was a problem. Very few respondents to the survey reported heroin use in the past year; therefore, estimates of recent heroin users could not be calculated.

Oxycodone

An estimated 60,829 adult Kentuckians (1.9%) used oxycodone for non-medical use in their lifetime. Persons between the ages of 18 and 29 most frequently reported oxycodone use. Approximately 1 in 5 oxycodone users reported thinking the drug was a problem in their life. An estimated 20,028 adult Kentuckians (< 1%) used oxycodone in the past year. Males accounted for 59.3% of these recent users while females accounted for 40.7%.

Other Non-OTC Pain Medication

An estimated 207,684 adult Kentuckians (6.7%) used illicitly other non-over-the-counter pain medications. Fifteen percent of those who reported illicit non-OTC pain medication use believed it was ever a problem. Persons between the ages of 18 and 29 most frequently reported the illicit use of other non-OTC pain medications. An estimated 53,411 adult Kentuckians (1.7%) used other non-OTC pain medications for non-medical use in the past year. Males accounted for 62.5% of these recent users while females accounted for 37.5%.

Any Illicit Drug

An estimated 1,052,348 adult Kentuckians (33.7%) used at least one illicit drug in their lifetime. Persons 50 years of age and older were less likely to have used an illicit drug in their lifetime than younger persons (16% vs. 44%). An estimated 179,858 adult Kentuckians (5.8%) have considered illicit drug use to ever be a problem in their life. An estimated 213,560 adult Kentuckians (6.8%) used at least one illicit drug in the past year. Males accounted for 63.9% of recent users while females accounted for 36.1%.

Alcohol Abuse and Dependence

An estimated 342,162 adult Kentuckians (11%) met DSM-IV-TR criteria for alcohol abuse and/or dependence in their lifetime. An estimated 136,559 adult Kentuckians (4.4%) met DSM-IV-TR criteria for alcohol abuse and/or dependence in the past year.

Drug Abuse and Dependence

An estimated 65,291 adult Kentuckians (2.1%) met DSM-IV-TR criteria for drug abuse and/or dependence in their lifetime. An estimated 50,446 (1.6%) met DSM-IV-TR criteria for drug abuse and/or dependence in the past year.

Substance Abuse Treatment Utilization

An estimated 116,399 adult Kentuckians (3.7%) received treatment or counseling for their use of alcohol and/or drugs in their lifetime.

Substance Abuse Treatment Need

An estimated 374,884 adult Kentuckians (12%) need substance abuse treatment but are not receiving it.

Comparison to the 1999 Kentucky Adult Household Survey

When comparing to the 1999 Kentucky Adult Household Survey, notable declines in past year use of cigarettes (32.4% vs. 28.9%) and marijuana (5.9% vs. 4.3%) were found. Cocaine use, however, increased (0.6% vs. 1.0%), as did the overall prevalence of illicit drug in the past year from 6.1% (1999) to 6.8% (2004). Although the overall treatment need stayed roughly the same (12.6% in 1999 and 12.0% in 2004), the need for substance abuse treatment changed by gender. The estimated percentage of males who need substance abuse treatment declined from 21.3% to 17.5%, whereas the estimated percentage of females who need substance abuse treatment increased from 4.7% to 6.9%.

Regional Comparison

Variability in substance use and treatment need was found across Kentucky 's 14 MHMR regions. The regions with the highest percentage of adults who used illicit drugs in their lifetime were in Seven Counties (37.1%), Communicare (37.1%), and Bluegrass (36.6%). The regions with the lowest percentage of adults who used illicit drugs in their lifetime included Mountain (24.9%), Adanta (28.1%), and River Valley (29.0%). The percentage of adults with current substance abuse treatment needs was highest in Seven Counties (17.2%), North Key (13.5%) and Bluegrass (12.0%) and was lowest in River Valley (6.8%), Mountain (7.1%) and Pathways (9.0%).

Jefferson and Fayette Counties

A larger percentage of adults who live in Jefferson (40.6%) and Fayette (39.9%) used illicit drugs in their lifetime than adults in the remaining 118 counties (30.9%). Despite this large discrepancy in illicit drug use between the two most populous counties and the rest of state, the rates of lifetime use of certain drugs such as methamphetamine and non-OTC pain medication are higher in the less populated areas. The current need for substance abuse treatment for Jefferson and Fayette Counties was estimated at 18.1% and 11.3%, respectively, whereas the current treatment need for the rest of the state was estimated at 10.6%.