| Back to

Housing First

Recovering Substance Abusers

Who Uses Illegal Drugs in America? Who Uses Illegal Drugs in America?

Other Resources Other Resources

Prior Month's Drug Use

View enlargement.

For recovering drug addicts and alcoholics, it's not just what's in a home that matters, but what isn't.

"Straight housing," as it's sometimes called, is critical for anyone trying to stay clean and sober. That means a place to live where any alcohol or drugs are strictly forbidden and, usually, where the other residents are also recovering substance abusers -- people who understand the trials of staying straight and support each other in the effort.

Such housing is at the end of a recovery chain that begins with detox and treatment centers, then, customarily, moves on to halfway houses. At each step along the way, facilities are in short supply. Millions of Americans in need of treatment aren't in the system or are stuck on waiting lists. But even for those who manage to get help, the trip is often from "treatment to halfway house to nothing," says Cathy Polin, executive director of Oxford House, Inc.

Oxford Houses are an attempt to fill that "nothing." The first one was organized in 1975 by residents of a halfway house in suburban Washington, D.C. Today, about 860 Oxford Houses operate on the same basic model: Recovering substance abusers run and finance the group homes, and can live there as long as they wish -- if they stay clean.

Within a year, Oxford House hopes to have chartered 1,000 houses. However, "there would need to be 70,000 Oxford Houses to meet the needs of all the people in this country," says Polin.

Two years ago, an estimated 14 million Americans were illicit drug users, according to the 2000 National Household Survey on Drug Abuse, the latest edition of the government's annual tally. (Current users are those who report using illicit drugs within the previous month.) About 4.5 million Americans were estimated to be drug "abusers" or "dependent users" -- more seriously in need of help. But only about 800,000 people received drug treatment last year, according to the Office of National Drug Control Policy.

The cost to society of illegal drug use -- from increased health-care costs to lost productivity -- was $160 billion in 2000, the Office of National Drug Control Policy estimates. But the cost cannot be measured only in dollars. The Centers for Disease Control says 19,102 people -- an average of about 52 a day -- died in 1999 from drug-related causes.

The 2000 household survey, conducted by the Substance Abuse and Mental Health Administration, also found that alcohol abuse remains a more prevalent problem than drug abuse. Based on its survey of 70,000 Americans, the government estimated that in the previous month, approximately 46 million Americans -- one fifth of the population 12 and over -- had five or more drinks in a single sitting (what the government defines as binge use). About 12.6 million drank at that binge level on at least five different days in that one-month period.

A disproportionate share of people with alcohol or drug problems end up homeless or incarcerated. One survey of homeless youths in Los Angeles found that 71 percent had an alcohol- or drug-abuse problem. The Office of National Drug Control Policy has estimated that 70 to 85 percent of inmates in state prisons need treatment for addiction. The National Council on Alcoholism and Drug Dependence advocates alternatives to incarcerating those with alcohol or drug dependencies -- but, says Council president Stacia Murphy, the reality of addiction is that "rich people go to the Betty Ford clinic and poor people go to jail."

Most treatment facilities and halfway houses are intended as short-term shelter, with 30- or 90-day limits. Straight housing has proven effective, however, if recovering abusers are allowed to stay long enough. An independent study has found that an individual who stays in an Oxford House for 15 months or more has an 80 percent chance of staying clean and sober. "There's nothing magical about it," says Polin. "The key to get somebody to stop using drugs and alcohol is very simple. It's called time. People just need enough time in the right setting."

By Reed Karaim

Who Uses Illegal Drugs in America?

The federal government's annual National Household Survey on Drug Abuse, based on information from about 70,000 Americans, aims to answer that question.

Conventional wisdom says that drug use is heavier among urban and minority populations -- but the survey statistics refute that. Whites and blacks use illegal drugs at the same rate, 6.4 percent of each population. The rates are lower for Hispanics (5.3 percent) and Asians (2.7 percent). The one minority population in the United States that uses illegal drugs at a substantially higher rate than average is Native Americans (12.6 percent), who also have the highest rates of severe poverty.

Illegal drug use is slightly higher in small metropolitan areas than in large metropolitan areas. Among youth, the drug-use rates are highest in "metropolitan, non-urban counties" -- in other words, the suburbs.

(A separate study, by the National Center on Addiction and Substance Abuse at Columbia University in New York, found that eighth graders in rural America were more likely to have used marijuana, crack cocaine and methamphetamines than their counterparts in urban centers.)

Drug use is tied to employment. Roughly 15 percent of unemployed adults used illegal drugs in 2000, according to the survey -- more than twice the rate among those with jobs.

Education also seems to make a difference. Among people 18 and older in 2000, college graduates had the lowest rate of use, 4.2 percent. The rate was 6.3 percent among adults who hadn't finished high school -- despite the fact that college graduates were more likely to have tried illegal drugs at least once than adults who dropped out of high school.

Despite the attention given to newer drugs such as ecstasy, marijuana remains, by far, the most popular illegal drug. Almost 60 percent of current illegal drug users consumed only marijuana. Alcohol is the substance, legal or otherwise, most likely to be abused by far.

Overall, the statistics indicate that America's war on drugs has been fought to a draw in the last year on record. As the Survey's authors conclude: "There were no statistically significant changes between 1999 and 2000 in the overall rates of current use of any of the major illicit drug categories tracked."

Other Resources

The Substance Abuse and Mental Health Administration has information on drug addiction, alcohol and tobacco use, including the 2000 National Household Survey on Drug Abuse.

The study No Place to Hide: Substance Abuse in Mid-Size Cities and Rural America can be found at the National Center on Addiction and Substance Abuse's Web site.

A national directory of Oxford Houses, along with the story of the movement, can be found at the Oxford House Web site.

The National Council on Alcoholism and Drug Dependence provides educational material and resources.

The Office of National Drug Control Policy maintains an extensive site with information on drugs and federal policy.

On the public radio program Magnificent Obsession, each 30-minute episode is the story of one person's battle with -- and recovery from -- alcohol or drug addiction, told in his or her own words. The show was created by Jim Nayder, known to NPR listeners in his lighter guise as host of The Annoying Music Show.

Listen Hear Weekend Edition host Scott Simon interview Nayder about Magnificent Obsession, June 22, 2002.

Listen "B.T." tells his story: "If I stopped taking drugs, I would drink . . . my goal was to always find something to get high on."

Listen "Darlene" tells of finding herself homeless and consumed by drug addictions: "I turned into someone I really wasn't."
Related NPR coverage
ListenWelfare and Drugs
Commentator Joe Davidson says that, in the midst of welfare reform, existing laws unfairly punish convicted drug addicts and ultimately deny them the kind of support they need to recover.
March 5, 2002

ListenDrug Addiction in D.C.
About 60,000 residents of the nation's capital are addicted either to illegal drugs or alcohol -- a rate of addiction more than twice the national average.
September 21, 2001

Lonnie Shavelson's book Hooked follows five drug addicts through their struggles to get clean. Shavelson says their experiences spotlight flaws in the U.S. drug treatment system.
June 18, 2001

ListenDrug Treatment Programs for Inmates
NPR's Scott Simon visits two drug treatment programs for prison inmates in California, run by the non-profit organization Phoenix House. NOTE: This report contains several instances of profanity.
April 15, 2000