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N ational S urvey on D rug Use and H ealth

The NSDUH Report May 3, 2005

Age at First Use of Marijuana


and Past Year Serious Mental
Illness
M
arijuana is the most widely used
In Brief illicit drug, and it is usually the
first drug used by persons who
● Among lifetime marijuana use illicit drugs.1 Recent research points to
users aged 18 or older, 2.1 an association between early marijuana
percent reported that they use and a heightened risk of developing
first used marijuana before schizophrenia or other psychological
age 12, while almost one half disorders.2,3,4 The National Survey on
(45.2 percent) reported that Drug Use and Health (NSDUH) asks
they first used marijuana at persons aged 12 or older to report on their
age 18 or older use of marijuana, including their age at
first use. For persons aged 18 or older,
● Males aged 18 or older were NSDUH also asks questions to assess
more than twice as likely as serious mental illness (SMI) during the 12
females to report that they months prior to the survey. Individuals are
first used marijuana before classified as having SMI if at some time
age 12 during the past 12 months they had a
diagnosable mental, behavioral, or
● Among persons aged 18 or
emotional disorder that met Diagnostic
older, those who first used
and Statistical Manual of Mental
marijuana before age 12 were Disorders (DSM-IV) criteria for a
twice as likely to have serious disorder5 and resulted in a functional
mental illness in the past year impairment that substantially interfered
as those who first used with or limited one or more major life
marijuana at age 18 or older activities. NSDUH measures SMI using
The NSDUH Report (formerly The NHSDA Report) is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health
Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission
from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available online: http://www.oas.samhsa.gov
Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov
NSDUH REPORT: AGE AT FIRST USE OF MARIJUANA AND PAST YEAR SERIOUS MENTAL ILLNESS May 3, 2005

Figure 1. Percentages of Lifetime Marijuana Use Figure 2. Percentages of Lifetime Marijuana Users
among Adults Aged 18 or Older, by Gender and Age Currently Aged 18 or Older by Age at First Marijuana
Group: 2002 and 2003 Use: 2002 and 2003

Males Females
2.1%
70% 16.0%
62.4
60% 56.7 56.1
53.8
51.0
50% 47.1
45.2%
40%
29.9
30%

20% 18.1
36.7%
10%

0% First Use Before Age 12 First Use at Ages 12 to 14


18 to 25 26 to 34 35 to 49 50 or Older First Use at Ages 15 to 17 First Use at or After Age 18

the K-6 distress questions.6,7 This The percentage of lifetime to report that they first used
report focuses on the association marijuana use among persons marijuana before age 12 than
between age at first use of mari- aged 18 or older was higher for lifetime marijuana users aged 35
juana and past year SMI. All of males than for females in each to 49 (1.9 percent) and lifetime
the findings presented in this age group (Figure 1). marijuana users aged 50 or older
report are annual averages based (0.3 percent).
on the combined data from the
2002 and 2003 NSDUH. Age at First Use of
Marijuana Past Year Serious
Mental Illness
Lifetime Marijuana Among persons aged 18 or older
who reported lifetime marijuana In 2002 and 2003, 8.8 percent of
Use use, almost one half (45.2 per- adults aged 18 or older (an esti-
In 2002 and 2003, 42.9 percent cent) reported that they first used mated 18.5 million persons) were
of persons aged 18 or older (an marijuana at age 18 or older. classified as having SMI in the
estimated 90.8 million persons) Almost 53 percent reported that past year. Among adults aged 18
had used marijuana at least once they first used marijuana between or older, past year SMI varied by
in their lifetime. Among adults ages 12 and 17, and about 2 per- gender: 11.0 percent of females
aged 18 or older, lifetime mari- cent reported that they first used had SMI compared with 6.4 per-
juana use varied by gender: 48.4 marijuana before age 12 (Figure 2). cent of males. Adults aged 18 to
percent of males reported lifetime Males aged 18 or older (2.9 per- 25 had the highest prevalence of
use, while 37.9 percent of females cent) were more than twice as past year SMI (13.6 percent),
reported lifetime use. Approx- likely as females (1.1 percent) to while adults aged 50 or older had
imately 58.0 percent of adults report that they first used mari- the lowest prevalence of past year
aged 35 to 49 reported having juana before age 12. Lifetime SMI (5.4 percent). In each age
used marijuana in their lifetime, marijuana users currently aged 18 group, the prevalence of past year
while 22.5 percent of adults aged to 25 and 26 to 34 (3.2 percent SMI was higher among females
50 or older reported having used for each group) were more likely than among males (Figure 3).
marijuana in their lifetime.
May 3, 2005 NSDUH REPORT: AGE AT FIRST USE OF MARIJUANA AND PASTYEAR SERIOUS MENTAL ILLNESS

Figure 3. Prevalence of Past Year SMI among Adults Figure 4. Prevalence of Past Year SMI among
Aged 18 or Older, by Gender and Age Group: 2002 Lifetime Marijuana Users Aged 18 or Older, by Age at
and 2003 First Marijuana Use: 2002 and 2003

Males Females
20% 25%

16.8 21.0
20%
15% 17.4
13.5
12.7
15%
10.3 12.2
10% 10.5
10%
7.2
6.7 6.6

5% 4.0 5%

0%
First Use First Use First Use First Use
0% Before at Ages at Ages at or After
18 to 25 26 to 34 35 to 49 50 or Older Age 12 12 to 14 15 to 17 Age 18

6. Kessler, R. C., Barker, P. R., Colpe, L. J.,


End Notes
Age at First Use of Epstein, J. F., Gfroerer, J. C., Hiripi, E., Howes,
M. J., Normand, S. L., Manderscheid, R. W.,
1. Gfroerer, J. C., Wu, L.-T., & Penne, M. A.
Marijuana and Past (2002). Initiation of marijuana use: Trends,
Walters, E. E., & Zaslavsky, A. M. (2003).
Screening for serious mental illness in the
Year Serious Mental patterns, and implications (DHHS Publication
No. SMA 02-3711, Analytic Series A-17).
general population. Archives of General
Psychiatry, 60, 184-189.
Illness Rockville, MD: Substance Abuse and Mental
7. For a discussion of the methodology used to
Health Services Administration, Office of
Applied Studies. Available at generate SMI estimates see Appendix B,
In 2002 and 2003, 12.5 percent http://www.oas.samhsa.gov/analytic.htm Section B.6 of the following document: Office
of persons aged 18 or older who 2. Green, B.E., & Ritter, C. (2000). Marijuana use
of Applied Studies. (2003). Results from the
2002 National Survey on Drug Use and Health:
reported lifetime marijuana use and depression. Journal of Health and Social
National findings (DHHS Publication No. SMA
Behavior, 41, 40-49.
were classified as having past year 03-3836, NSDUH Series H-22). Rockville, MD:
3. Rey, J. M., Martin, A., & Krabman, P. (2004). Is Substance Abuse and Mental Health Services
SMI. Adults who first used mari- the party over? Cannabis and juvenile Administration. Available at
juana before age 12 (21.0 percent) psychiatric disorder: The past 10 years. http://www.oas.samhsa.gov/NHSDA/
Journal of the American Academy of Child and 2k3NSDUH/appb.htm
were twice as likely as adults who Adolescent Psychiatry, 43, 1194-1205.
first used marijuana at age 18 or 4. Smit, F., Bolier, L., & Cuijpers, P. (2004).
older (10.5 percent) to be class- Cannabis use and the risk of later schizophre- Figure Note
nia: A review. Addiction, 99, 425-430.
ified as having SMI in the past 5. American Psychiatric Association. (1994).
Source: SAMHSA, 2002 and 2003 NSDUH.

year (Figure 4). Diagnostic and statistical manual of mental


disorders (4th ed.). Washington, DC: Author.

The National Survey on Drug Use and Health International in Research Triangle Park, North National findings (DHHS Publication No. SMA 03-
(NSDUH) is an annual survey sponsored by the Carolina. (RTI International is a trade name of 3836, NSDUH Series H-22). Rockville, MD:
Substance Abuse and Mental Health Services Research Triangle Institute.) Substance Abuse and Mental Health Services
Administration (SAMHSA). Prior to 2002, this Administration.
Information and data for this issue are based on
survey was called the National Household
the following publications and statistics: Also available online: http://www.oas.samhsa.gov
Survey on Drug Abuse (NHSDA). The 2002 and
2003 data used in this report are based on Office of Applied Studies. (2004). Results from the Because of improvements and modifications to
information obtained from 89,600 persons aged 2003 National Survey on Drug Use and Health: the 2002 NSDUH, estimates from the 2002 and
18 or older. The survey collects data by National findings (DHHS Publication No. SMA 04- 2003 surveys should not be compared with
administering questionnaires to a representative 3964, NSDUH Series H-25). Rockville, MD: estimates from the 2001 or earlier versions of the
sample of the population through face-to-face Substance Abuse and Mental Health Services survey to examine changes over time.
interviews at their place of residence. Administration. U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
Substance Abuse & Mental Health Services Administration
The NSDUH Report is prepared by the Office of Office of Applied Studies. (2003). Results from the Office of Applied Studies
Applied Studies (OAS), SAMHSA, and by RTI 2002 National Survey on Drug Use and Health: www.samhsa.gov

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