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The author(s) shown below used Federal funds provided by the U.S.Department of Justice and prepared the following final report:

Document Title: Monitoring the Marijuana Upsurge With

DUF/ADAM Arrestees, Final Report

Author(s): Andrew Golub ; Bruce D. Johnson

Document No.: 188867

Date Received: 07/20/2001

Award Number: 99-IJ-CX-0020

This report has not been published by the U.S. Department of Justice.To provide better customer service, NCJRS has made this Federally-funded grant final report available electronically in addition to

traditional paper copies.Opinions or points of view expressed are thoseof the author(s) and do not necessarily reflect

ff f S

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FINAL REPORT4 ,MON ITORING THE MARIJUANA U PSURGE W ITHDUF/ADAM ARRESTEES

(99-IJ-CXOO20)to the National Institute of Justice

Andrew Golub, Principal InvestigatorBruce D . Johnson, C onsultantNational Development and Research Institutes, Inc.

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ABSTRACTMarijuana use nationwide had continually dropped from a peak around 197 9 until the early1990s. Starting in 1991, most of 23 A DAM locations experienced a rapid increase in use amongyouthful (age 18-20) arrestees from an average low of 25% in 1991 up to 57% in 1996. Twonational surveys (MTF and NHSDA) also recorded rapid but more modest increases in youthfulmarijuana use within the mainstream population starting a year later. From 199 6 to 1999, mo stADA M locations as well as the national su rveys recorded stable but relatively high levels ofyouthful marijuana use suggesting that by 1999, the Marijuana E pidemic ha d plateauednationwide. Marijuana itself appears to be the drug-of-choice for a new g enera tion of AD AMarrestees, especially when sm oked as a blunt in an inexpensive cigar. Me mb ers of thisMarijuandB lunts Generation (arrestees born since 1970) have been much less likely to becomeinvolved with crack or heroin injection than their predecessors.

INTRODUCTIONVarious surveys have identified a rapid increase in marijuana use during the 199Os, especiallyamo ng youths. This raises a variety of questions about the future of the Nations drug problems.On the one hand, there is the gatew ay theo ry (Kandel 1975). It has been w idely found thatyouthful substance use tends to progress through a series of stages from non-use, to use ofalcohol andor tobacco leading to potential use ofmarijuana an d then other illicit drugs like crackand heroin. The recent increase in youthful marijuana use has fueled specula tion that a newepidemic of hard drug abuse may be im minent (ON DC P 1997, p. 23) and that the burden ofdrug abuse will be dramatically inc reasing in the nea r future (Gfroer er and Epstein, 1999). O nthe other hand, the start of this new epidemic coincides with the decline in th e popularity o fcrack cocaine, especially among youths. This sugg ests that youthful subcultures m ay have

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[NHSDA] and the Mon itoring the Future [MTF] programs. Th e remainder of this sectiondescribes the theoretical foundation for this work: the epidemiology o f drug use trends, and thenature of the gateway theory.

Structure of a Drug EpidemicMuch research sugg ests that drug epidemics tend to follow a predictable course. This analysisemploys a co nceptual model that d istinguishes the characteristics of four phases: incubation,expansion, plateau and decline. This model was originally operationalized to explain the courseof the Crack Epidemic (Golub and Johnson 1994 ,1997). It has since been used to study theHeroin Injection Epidemic and has been adapted for the study of the recent increase in marijuanause (Golub and Johnson 1999; Johnson and Golub 2001). This study found that the dynamics ofrecent increase in marijuana use followed a similar pattern as the Crack an d Heroin InjectionEpidemics suggesting all three epidemics were the result of a similar phenomen on.This report examines the dynamics of the Ma rijuandB lunts Epidemic over tim e and acrosslocations. Theoretically, the passing of each phase should result in a distinguishable pattern fo rthe prevalence of m arijuana use detected by the ADAM program within the overall population ofadult arrestees (all arrestees age 18 and above) and the population of yo ut hh l arrestees(age 18-20).Much historical evidence suggests that a drug epide mic typically grow s out of a specific socialecontext; the Heroin Injection Epidem ic grew out of the jaz z era (Johnson and G olub 2001) an dthe Crack Epidemic started among inner-city drug dealers (Hamid 1992; Johnson, Golub, andFagan 1995). In both o f these cases, there was an initial incubation pha se during which the newdrug use practice was developed and nurtured am ong a relatively small cohesive grou p of adultusers. Marijuana use has been widespread since the 1960s, however th e prevalence of its use had

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among youthful arrestees and more modest increases overall. The rate of detected marijuana useamong older arrestees would have subsequently increased as 1) the use of m arijuanahlu ntsspread to older users, perhaps former marijuana users; and 2) youthful marijuana users aged intothe older categories. Consequen tly, the rate of detected marijuana use am ong all adult arresteeswas expected to have increased more slowly and for a longer period of time than the rate amo ngyouthful arrestees.By about 1996 (as determined in this study), the MarijuandBlunts Epidemic entered aplateaupha se. During this period, those youths coming of age and getting involved with illegal drugswere primarily using marijuana and not crack or heroin. Indeed, a series of focus groups acrossthe nation found that much of the increased interest in cigars among youths w as for their use a sblunts (DHHS, 1999). Unfortunately, major national surveys such as Mon itoring the Future[MTF], the National Household S urvey on Drug A buse [NH SDA], and ADA M, do notdistinguish among ways of consuming marijuana. Such information would have been ab le tomore accurately identify the extent to wh ich the recent increases in youthfid marijuana use areassociated with the use of blunts. During the plateau phase, the ADAM Program would beexpected to detect stable and high levels of marijuana use amo ng youthful arrestees and s lowlyincreasing rates overall.

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As determined in this study, marijuana was the premier drug of choice a mon g youthful arresteesin the 1990s. This is good news to the extent that the m arijuana use is associated w ith a rejectionof crack and heroin due to the potentially devastating consequences o f their use (Furst, Johnson,Dunlap, and Curtis 19 99; Golub and Johnson 1999). This rejection of other drug s may not be ascharacteristic of the broader population. From 1992 to 1997, the proportion o f high schoo lseniors reporting lifetim e use of LSD increased from 8 .6% up to 13.6% its highest recorded levelsince the start of the MTF program in 1 975 (Johnston, O'Malley, and Bachman 1999). Use o fhallucinogens in England and the U.S. as been frequently associated w ith the rave or danceparty scene typically involving white youths from m iddle and upper-class suburban enclaves

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The Gateway TheoryKandel (1975) identified that most Am erican youths tend to progress through as m any as fou rstages of substanc e use: 1) non-use, 2) alcohol/tobacco, 3) marijuana, and 4) other drugsincluding cocaine and heroin. Individuals who do not use substances associated with one stagerarely use those associated w ith later stages, but not all users at one stage progre ss to the next.This sequencing of substances has been wide ly replicated (Kandel, 2001). Beca use of theirintermediary role, alcohol, tobacco, and marijuana have come to be regarded as GatewayDrugs. Today, much substance use prevention policy seeks to forestall or del ay youthful use ofgateway drugs in order to reduce subsequent abuse of drugs like heroin and crack.This strategy may no longer be so appropriate. Several analyses suggest the gateway sequencemay not be as relevant to the inner-city populations that disproportionately generate youths whoget in trouble with both drug abu se and the law (Go lub and Johnson, 2001b). The gatewaysequence may no longer characterize the experiences of mainstream youths either. Calculationswith NHSDA data suggest that the probability of progression from one stage of substance use tothe next have varied substantially over time (Golub and Johnson, 2001a). Th e probabilitiesincreased steadily after World W ar I1 reaching a peak am ong persons born in 1960. Amongpersons born in the 1970s, so far the risk o f progression to marijuana use increase d but the risk ofprogression to cocaine powder, crack and/or heroin injection has not.These recent studies suggest that youthful substance use progression reflects cultural o rsubcultural norms among youths about which substances are acceptable and that these normsvary over time and across locations. Thu s, it seems essential to m onitor not just whichsubstances youths are using but wh at that substance use represents to them.

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METHODS

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total population of at least 1 million, as well as many smaller cities for geog raphica l diversity. In1997, the program evolved into the Arrestee Drug Abuse Monitoring [ADA M] program. Th eADAM 1998 annual report describes improvemen ts and expansion plans that accompanied thisname chang e (NIJ 1999). The program plans to grow to 75 locations over the next few years.The program collects urine samples (along with self-reported information) from abo ut 300 adultarrestees, each quarter, at each location. Fem ale arrestees are oversa mple d at ma ny locations andcomprise about 30% of the total. Som e locations also recruit samples ofju ve ni le arrestees. Thisstudy examin es trends at the 23 locations operating in 1 997 and is based o n information fromover 300,000 arrestees at these sites from 1987 through 1999 but exclu des sites added in 1998.The 1999 data was obtained late in the study, henc e several tables and figures onl y provideADAM data through 1998.ADAM samp les are typically not representative of the general comm unities where datacollection occurs. Given the drugs-crime nexus, AD AM data prov ide excellent informationabout drug use among man y of the most serious drug abusers at each location. Th is informationis of particular interest to criminal just ice and other agencies. Ana lyses of the ADAM data maybe of even broader interest to the extent that drug use am ong arrestees ten ds to parallel orperhaps even lead trends in the general population.Throughou t the life of the DUF and ADA M programs, the urine testing and m any of the corequestions have remained constant allowing for analysis of trends over time. Urine test resultsprovide a particularly valid indication o f recent marijuana use. Ma rijuana metab olites tend toremain in the body. Marijuana consum ption can be detected by the EM IT urinalysis screen usedby ADA M up to 10 days after last use for infrequent users and 30 d ays or lon ger for chronicusers. In contrast, the drug detection period for opiates (such as heroin) and cocain e is only 2 to3 days. In 1 996, the cutoff level for determ ining recent marijuana use wa s lowered fro m 1 00down to 50 nanograms (NIJ, 1997). Mo re than 34,00 0 samples from 1 995 were tested at bothcutoff levels. Overall the preva lence of detected m arijuana use in creased 5 % to 7% usin g the

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1990-1997. Th e study employs a complex sampling design and oversam ples Hispanics, blacks,and youths ag e 1 2 to 17. Samp le weights were used in all calculations to obtain unbiase destimates.

The Monitoring the Future ProgramEach spring s ince 1975, the University of Michigan's Institute for Social Researc h has conducteda surv ey to estimate the prevalence o f drug use am ong high school seniors in the United Statesand monitor trends over time (Johnston, O'Malley and Bachman, 1999a). Starting in 1991, theprogram also survey ed 81h and lothgraders. The survey tends to undersample many of the mostserious drug users who ar e disproportionately likely to drop out of schoo l or be absent on the da yof the survey. Analyses presented in this report are based on ov er 350,000 r espon ses from high 'school seniors included in public use data files for surveys conducted 1976 -1997 and findingsfrom publish ed reports for 1998-99 when available (Johnston, O'M alley and Bachm an, 1999b).The study employs a complex sampling design. Sample weights were used in all analyses inorder to obtain unbiased estimates of su bstanc e use.

Graphical Trend An alysisThe conceptual mo del for a drug epidemic leads to ve ry explicit predictions about chan ges in theprevalence of marijuana use over time. To exam ine these predictions a nd the timing o f thevarious phases, a graph of detected marijuana use over time was prepared fo r each of the 23locations served by the ADA M program in 1997 . Each chart displays the rate of detectedmarijuana use among all recent adult arrestees age 18+ as well as specific rates fo r acomprehensive series of non-overlapping age categories (1 8-2 0,21 -24 ,25- 29, 3 0-39,40 +). Thisallows for the identification o f when and how much each age group was affected b y the

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determine which age groups were most affected in the early part of the expansio n phase. Lastly,the impact over time of this epidemic on the overall prevalence of detected marijuana wasexamined.Random year-to-year fluc tuations in the rates of marijuana use confounded efforts to identify thedynamics of the Marijua na Epidemic. In general, small variations from one year to the next weredisregarded as potentially attributable to the limited precision of the ADA M estimates. Thegreatest credence was placed on large changes that were confirmed by consistent trends acrossmultiple years. The standard errors for the ADAM estimates provided a gu ide to the potentialmagnitude of random year-to-year variations. Standard errors for the detecte d prevalence o frecent marijuana use within each age category in each year were typically on the order of 3% .Standard errors for all arrestees 18+ com bined were about 1.3%. Thus substantial randomvai-iations from year to year were expected. A year-to-year difference in an y age category needsto be at least 11% to be statistically significant at the w.01 level in a two-tailed z -test. Adifference in the overall rate would need to be at least 5%. Trends smaller than these thresholdvalues might reasonably be attributed to random variation.

Age-Period-Cohort AnalysisDiscerning age, period, and cohort effects is complicated by the multicoline arity of theseparameters-specifically, age = (interview year) - birth year). Henc e, it is not possible toemployed in regression analys is. How ever, all three types of effects result in a distinctive patternof birth cohort participation over time that can b e detected in a tw o-way AN OV A table fordetected marijuana use as a function o f birth year dow n the rows and intervie w year across thecolumns.

0, naively include all three factors as independent variables in an algebraic e quation such as

Each row traces the marijuana use hi story of persons born in a given year, known as a birth

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The use o f marijuana can be affected by various period effects,historical changes in itspopularity, its availability, and the risk of sanctions. Period effects result in decreased (orincreased) levels of use am ong persons o f all ages as indicated as a variation across colum ns inthe age-period-cohort analysis. To facilitate detection of period effects, the ag e-period-cohorttables in this report provide column av erages at the bottom of each table that su mm arizemarijuana use am ong persons age 18 and above, and among persons age 18-20. Persons underage 18 were excluded from these averages as still at risk for initiating marijuana use.Som e historical events permanently affect individuals at an impressionable age. Users o f somedrugs like crack and heroin often persist in their habits throughout m uch of their lives. In thismanner, the Heroin Injection and Crack Epidemics heav ily influenced thos e individuals whocame of age at the time and u se of these drugs became associated with mem bers of a particularbirth cohort, a cohort egect. Marijuana use ma y have a similar effect on this new generation ofdrug users. Cohort effects can be identified in an age-period-cohort analy sis as variation downthe rows. This variation is summarized by the row averages for detected marijuana prevalenceamong arrestees age 18 and ab ove at the right of each table.An age-period-cohort analysis can examine a wider range o f possible variations than th egraphical trend analysis. Indeed, the primary data included in the graph (prevalence overall andamong youthful arrestees) are provided on the bottom o f the table. Visual inspection o f thesetables was employed to determin e whether the timing of various historical changes affected each

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0 birth cohort similarly.The flexibility of the age-period-cohort analysis comes at a price. Th e individual estimates ofeach birth cohort's m arijuana use in each year are of limited accuracy. Estimates based on fewerthan 25 respondents w ere excluded from the tables in this report in ord er to guarantee amaximum standard error of 10%. Older arrestees were grouped into multi-year birth cohorts:those born before 1940, 1940-44, 1945-49, 1950-54, and 1955-59.

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Th e results of the three-generations graph can be am biguous. Variations o f substance use acros sbirth years can be caused by age, period or cohort effects. Golub and Johnson (1999) confirmedthat the heroin injection, crack smoking, and marijuana use amon g ADA M-M anhattan arresteeswere the result of period effects in three separa te age-period-cohort an alyses for detected use o fopiates, cocaine, and marijuana. This report presents age-period-cohort an alyses for detected useof marijuana at each location. Golub, Hakeem and Johnson (1 996) presented age-period-co hortanalyses that sugge st the Crack Epidemic resulted in a cohort effect at most of the A DA Mlocations.

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For each ADA M location, a graph of drug use as a function of birth year was created. Theprecision o f the estimate for each birth year was enhanced by use o f multiple years o f data.Three substances were plotted corresp onding to each of the three drug generations: heroininjection, crack, and marijuana. The proportion o f heroin injectors (former or current) wasestimated from their self-reports of lifetime heroin use and lifetime injection of illicit drugs.Individuals had to report both. This calculation was necessary becau se the AD AM q uestionnairedid not ask explicitly about heroin injection in all years of the survey. At som e location s manyindividuals reported injection drug use but not heroin u se (they may ha ve been ihjecting cocaineor amphetam ines) and others reported heroin use but no injection drug use ( man y of these werepresumab ly sniffers). Individual self-reports of lifetime crack use were used to ind icate formeror current involvemen t with this drug. Detected marijuana use was used to indicate currentmarijuana use. Presumably many of these current marijuana users were smo king blunts. Thi susage could not be determined however sinc e the ADAM questionnaire does not explicitly askabout use of blunts.

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RESULTSThis section presents results of graphical trend analyse s for each AD AM location and for the

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more modestly to 17%. Relatively stable rates were subsequently recorded through 1999 forhigh school seniors and 1998 for household members, which suggests that the epidemic in thegeneral population may have reached a plateau around 1996.The table below summ arizes the status of the Marijuana Epidemic at each location across thenation. By 1 999 , the Epidemic had reached the plateau phase in most locations. Th e similarityin findings acro ss most o f 'the 23 ADAM locations suggests that the M ar ij u an al u n ts Epidemicwas national in scope. Based on this finding, an ADAM Program A verage was calculated tofacilitate presentation ofdh e general characteristics of the phenomena b y s imply averag ing theprevalence of detected marijuana use at each age in each year across locations. Thi s ADA Mprogram average does not nece ssarily represent the average across arrestees nationwide.Furthermore, it is not necessarily a good idea to focus on this type of an average for use o f otherdrugs like coc aine krac k, amphetamines, and heroin for which use varies widely across locations.Indeed, even for marijuana use there were impo rtant local differences. Th e remainder of thissection presents the general trends in marijuana use detected by the AD AM Program Average,NHSDA, and M TF data.

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average. From 1996 to 1999, both the overall rate and rate a mong youth ful arrestees heldrelatively stead y at around 60% and 37% , respectively. Thus, the plateau phase am ong arresteesappears to have set in by 1996 and lasted at least through 1999, on average.All three major national surveys (NHSDA, MTF and ADAM) recorded a simi lar overall patternin youthful marijuana use : a decline in the 1980s followed by a rise and stabilization in the1990s. These findings along with the ethnographic information cited previously strongly suggestthat a new nationwide epidemic in m arijuana use passed through its expansion phase by 1996and was in its plateau phase through 1999.There were several important differences across survey findings. Th e incre ase in marijuana usestarted among yo uth hl arrestees (ADAM) a year or two before it started within the generalpopulation (NHSDA and MTF). Additionally, the peak rate of reported past m onth use am onghigh school seniors occurring during the plateau phase (abo ut 22%) was far below the previouspeak (37%) recorded back in the late 1970s. It was also far below the peak rate of detectedmarijuana use among yo ut hh l arrestees in the same period (about 57%) as well as their rate ofreported past-mon th use (about 60%).2 This suggests that the Marijua ndB lunts Epidemic startedamon g those individuals who tend to get in trouble with the law an d sprea d more wid ely withinthis group than among youths in the general population. Conce ivably, the prevalence ofmarijuana use in the general population could undergo another expansio n if use sprea d to otheryouthful subpopulations. Further research is clearly needed to identify which groups ofmainstream youth have been most affected so far. The following sections examine geographicvariation among arrestees across ADAM locations according to the following regions: Northeast,Midwest, Southeast, Southwest, and West Coast.

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eThe Marijuana/Blunts Epidemic Among Arrestees in the NortheastManhattan-plateau since 1996. Marijuana use in Manhattan had dropped from 27 percent

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Philadelphia- plateau since 1995. Marijuana use among all adult arrestees in Philadelphiadropped precipitously fiom 30 percent in 1 988 to16 percent in 1990. From 1990 to 1993,marijuana use among youthful arrestees expanded rapidly and the rate among all adult arresteesreturned to its former level. In 199 3, the rate am ong youthful arrestees appeared t o have entereda plateau at abou t 52 percent, but it subsequently inched up t o 59 percent in 1995. Th e rateamon g youthful arrestees remained around 6 0 percent from 1995 through 1999, and th e overallrate held stead y around 35 percent.Washington, DC -plateau since 1996. In 1990, only 7 percent of all Washin gton, D.C.,dultarrestees were detected as recent marijuana users.' Th e rate increased rapidly a mo ng youthfularrestees and then am ong older arrestees. By 1996, about 60 percent o f youthful arrestees an d 35percent of all arrestees were detected as recent m arijuang users. These rates rema ined relativelystable from 1996 through 1998. (This location did not collect a full sample in 1999.)

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The M arijuana/Blunts Epidemic Am ong Arrestees in the Midw est ,Chicago-plateau since 1996. Marijuana use among all adult arrestees in Chicago dropped from48 percent in 1988 to 23 percent in 1991. In 1993, however, the overall rate bounced u p to about40 percent, w here it approximately remained through 1999. The rate of recent m arijuana usedetected amo ng youthful arrestees rose dramatically from 27 percent in 1992 to 75 percent 1996,where it approximately remained through 1999.Cleveland- plateau since 1998. Marijuana u se among all adult arrestees in Cleveland droppedfiom 2 6 percent in1988 to 11 percent in 1991 . Subsequently, the rate am ong youthful arresteesbegan a steady rise from 14 percent in 1991 to 72 percent by 1998. The overall rate reached justbelow 40 percent in 1997, where it remained through 1999. The rate of marijuana use detectedam ong youthful arrestees in 1999 dipped slightly, suggesting that the ep idemic i n Cleveland hadentered a plateau in 1998.

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Omaha- plateau since 1996. Marijuana use among all adult arrestees in Omaha dropped from45 percent in 1988 to 21 percent in 19 90. Subsequently, that rate rose steadi ly to 39 percent in1992 and to 49 percent by 1996. The rate among youthful arrestees rose from 25 percent in 1990and then held steady around 55 percent from 1993 through 1995. In 1996, the rate of marijuanause detected among youthful arrestees jumped to 71 percent, where it approximately remainedthrough 1999. This change was probably not attributable to a change in the A DA M cu toffstandard for determinin g recent marijuana use. (The prevalence of marijuana use am ongOmahas you thful arrestees in 1995 increased on ly slightly from 53 percent under the previous100 nanogram c utoff to 56 percent under the new 50 nanogram standard.)

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St. Louis-plateau since 1996. Marijuana use am ong youthful arrestees in S t. Louis rose steadilyfrom a low of 15 percent in 1990 to 72 percent in 1996,,where t approximately remaine d Ithrough 1998. Th e rate of overall use increased from a low of 14 percent in 1991 to a steady 45percent by 1996, where it remained through 1998. (This ADA M location d id not collect a sam plein 1999.)The Ma rijuana Blun ts Epidemic Am ong Arrestees in the SoutheastAtlanta-plateau/possibly expansion. In 1990, the prevalence of recent marijuana use detec tedamong youthful (6 percent) and all adult (3 percent) arrestees in Atlanta was the lowest of anyADA M location. The rate am ong all adult arrestees increased to 3 3 percent by 1996.Theepidem ic did not appear centered on youthful arrestees only; rather, the rate o f recent m arijuanause detected increased among all adult arrestees as early as 1991. The rate among youthfularrestees, however, did increase the most, reaching 69 percent in 1996. Fro m 1996 to 1998, therate amo ng youthful arrestees drifted slightly dow nward to 62 percent. Th e rate of use among alladult arrestees also decreased, from 33 percent in 1997 to 25 percent in 1998 . Both rates bouncedback to new peaks in 1999, suggesting the New Marijuana Epidemic in Atlanta could still have

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Fort L auderdale -plateau/possible expansion. Marijuana use amo ng all adult arrestees in FortLauderdale dropped from 42 percent in 1988 to 20 percent in 1990. Th e rate of detectedmarijuana use am ong youthful arrestees started a very slow but steady increase from a low of 28percent in 1990 to 63 percent in 1998. The overall rate increased even mo re slowly, from 20percent in 1990 to 38 percent in 1998. The mod est dip in the rate in 1 999 suggests that theepidemic might have reached a plateau in 1998. On the other hand, the relatively slow expansionand a history of 2 previous years in which the expans ion appeared to have h alted (1 992-93 and1996-97) suggest that the expansion may not have plateaued by 1 999.Miami- no epidemic. From 1988 through 1999, marijuana use amon g all adult arrestees inMiami fluctuated around 3 0 percent. Th e rate among youthful arrestees fluctuated within a w iderrange-between 31 and 66 percent. The dramatic 1-year jum p in marijuana use am ong y ou thh larrestees, from 45 percent in 1998 to 66 percent in 1999, may have been caused b y changes tothe ADAM sampling procedures. The data suggest no sustained trend in marijuana use hasoccurred amon g arrestees. Miami experienced neither a sustained dec line in marijuana useamong arrestees nor the epidem ic-like growth in use am ong youthful arrestees observed at otherADAM locations.

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The Marijuana/Blunts Epidemic Among Arrestees in the SouthwestDallas- plateau since 1996. Marijuana use amon g all adult arrestees in Dallas had dropp edsteadily from 32 percent in 1988 to 17 percent in 1991. Th e rate of detected marijuana useamong youthful arrestees subsequently increased from 22 percent in 19 91 to 57 percent in 1996.The overall rate increased to 3 8 percent. Both rates remained stable from 1996 through 1999.Denver- plateau since 1994. In Denver, the rate of detected marijuana use among youthfularrestees rose rapidly from 26 percent in 1991 to 60 percent in 199 4, dropp ed mod estly to 54percent in 1995, and inched up to 6 2 percent by 1999. The overall rate rose m ore slowly, from 23

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New 'Orleans- plateau since 1995. Marijuana use am ong all adult arrestees in Ne w Orleansdropped precipitously from 46 percent in 1 987 to 14 percent by 1991. Marijuana use am ongyouthful arrestees subsequently increased from 17 percent (1991 ) to 5 4 percent (199 5) and thenfluctuated in the 50 percent to 60 percent range. Th e overall rate of detected m arijuana useinched up to 35 percent by 1999, still well below the rate observed in the late 1980s.Phoenix- plateau since 1998. The rate of detected marijuana use amo ng all adult arrestees inPhoen ix dropped steadily from 42 percent in 1987 to 19 percent in 1991. Subsequ ently, the rateamong youthful arrestees entered a slow but steady expansion, increasing from 2 2 percent in1991 to 40 percent in 1995. At that time, th e marijuana epidem ic appeared to ha ve entered aplateau. However, youthful marijuana use jum ped to 54 percent in 1998, where it remained in1999. This increase suggests that the marijuana epidem ic may have sp read in the 1997-98period to another portion of youths who tend to get arrested. This chang e could have also beencaused by changes in police priorities or AD AM sampling procedures.San Antonio- plateau since 1996. Marijuana use am ong all adult arrestees in San Antoniodecreased from 34 percent in 1988 to 18 percent by 1991. The rate am ong yo uthful arrestees thenslowly increased from 20 percent in 1991 to 45 percent in 1996, where it remained through 1999.Overall marijuana use had increased to 32 percent by 1996 and fluctuated around this ratethrough 1999.The Mariju anaB lunts Epidemic Am ong Arrestees on the West CoastLos Angeles- plateau/possible expansion. It is difficult to determine the timin g of a NewMarijuana Epidemic in Los Angeles because th e rate of increase in detected m arijuana useamong youthful arrestees was very slow in the early 1990s and becau se it took a dip in 1994,which sugg ests the rate had plateaued. How ever, the increase in detected marijuana use a mo ngyouthful arrestees from 22 percent in 199 1 to 4 9 percent in 1996 strongly suggests that a

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San D iego- no epidemic. Marijuana use a mong San Diegos youthful arrestees remained steadyand relatively high from 1987 through 1999, ranging from 3 7 to 55 percent. Marijuana useamo ng all adult arrestees exhibited a modest dr op from 44 percent in 1988 to 29 percent in 1991.The rate then fluctuated around 34 percent through 1999. The rate of detected m a r ij u a a useamong youthful arrestees exhibited a modes t 1 year increase from 37 percent in 199 1 to 47percent in 1992. Th e rate amon g youthful arrestees subsequ ently fluctuated in the mid-40-percent range. The modestldip and recovery in youthful marijuana use from 1989 to 1992 seemmuch too sm all to constitute a new drug epide mic, although their timin g is consistent with that ofthe New M arijuana Epidemic at other ADA M locations. Another steady but sh ort increase inyouthful marijuana use okcurred from 1997 to 1 999, when the rate among yo uthful arresteesinched up from 44 to 55 percent. Again, the short period and rather mod est increase sug gest thatthis change was not part of a longer, sustained epidem ic.San Jose- plateau. Since 1995, overall marijuana use amon g San Jose arrestees was relatively ,stable at about 24 percent from 1989 through 1998. Th e rate among yo uthful arrestees increasedfrom 21 percent in 1992 to 43 percent in 1995, where it roughly remained throu gh 1998. Th esharp increase to 56 percent in 19 99 may b e an anom alous 1-year fluctuation.

Age-Period-Co hort AnalysisAn age-period-cohort analysis of the NH SD A data indicates that recent increases in m arijuanause w ithin the general population have b een largely restricted to youths. Th is contrasts with theCrack Epidemic which first spread amo ng older users and only afterwards spread to youths firstcoming of age (Golub and Johnson 1994, 1997). The rate of past-month marijuana use am ong18year-olds increased from 9% in 1992 (for the 1974 birth cohort) up to 16% in 1997 (for the1979 birth cohort). This table also indicates that in the general population marijuana usegenerally declines with age. For example, the 1967 birth cohort reached ag e 18 in 1985. At thattime, 25% reported past month use of marijuana. By age 25 (in 1992) only 12% reported pastmonth use, and by age 30 (in 1 997) the rate had decreased to 6%. Th is maturation from age 25

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,.-.,, 17I

18. Desistance of use in adulthood was much less evident than am ong the NHSDA respondents.This could be a selection effect associated w ith analyzing rates amo ng arrestees; those drug-using criminal offenders who desist from drug use might tend to simultaneously desist fromcriminal offending.Am ong arrestees from each birth cohort, it appears that marijuana use b ecam e less popular from1988 to 1990 and then returned to its former level of popularity from 199 0 to 1993. This appearsto be a period effect perhaps caused by increased drug law enforcement, greater hvo lve me ntwith other drugs such as crack, or decreased availability of marijuana. Th e rate of overalldetected marijuana use dropped from 35% (1988 ) to 19% (1990) and then returned to 28%(1993). This dip in usage was reflected in each birth cohort's marijuana use experiences duringthis period. For exam ple, the marijuana use am ong arrestees born in 196 0 declined fio m 39%(1 988) to 17% (1 990) and then returned to 2 4% (1993) where it approximately remained through1998. The nature of this decline suggests that for this birth cohort the period effect had animmediate effect of reducing marijuana use by 22% (from 39% down to 17%) and a som ewhatsmaller long-term effect of reducing marijuana use by 15%. All of the older birth cohortsexperienced sharp short-term declines and more m odest long-term declines from 1988 to 1993except for the oldest arrestees. Arrestees born 1901-1939 had a relatively low level of marijuanause in 1988 of 9% that declined to 5% (1990) but then returned to a slighter higher level of 11%in 1993.The 1972 birth cohort reached ag e 18 in 1990, right at the lull in marijuana use a mo ng arrestees.Their rate of marijuana use dropped from 30% at age 17 (in 1989) to 2 1% at age 18 (1990) butthen continued to increase up to 47% by 1996. For this birth cohort, the period of lowermarijuana use led them to postpone but did not forestall their involvement w ith marijuana.Unlike in previous birth co horts, which had established their peak level o f marijuana use by age18, arrestees from the 1972- 1976 birth cohorts exhibited a rise in their m arijuana use in theirearly twenties. It would appear that more and more of them became invo lved with marijuana

0 '

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. I**< 18I

To quantify this observation, the percent growth in detected marijuana use from 199 1 to 1998among arrestees from older birth cohorts (those born before 196 7) was calculated. Th e overallprevalence in 1991 was calculated as the average of the prevalence within each birth coho rt (asprovided in the age-p eriod-cohort tables) weighted accord ing to each birth cohort'srepresentation a mon g arrestees in 1991. Similarly, the overall prevalence o f detected marijuanause in 1998 was calculated as the prevalence in 1998 weighted according to each birth cohort'srepresentation in 1991. he formula for this calculation is presented below. Standardizing to the1991 distribution of arrestees by birth cohort controlled for any changes c aused b y demo graphicshifts in the composition of the arrestee samp le over time.

:Percentage of 1998 arresteesborn before 1967 detecteda s recent marijuana usersweighted according to the1991 distribution of arresteesby birth cohort

= ci 2 index ofbirth cohorts

Percentage of 1998arrestees from birthcohort i detected asrecent marijuana users

1Number of 1991arrestees born inyear i 1umber of 1991arrestees bornbefore 1967Th e table below presents the change from 1991 to 1998 in prevalence of recent marijuana usedetected am ong older birth cohorts and y outhful arrestees for each A D A M location. At a fewlocations on the West Coast, the rate among older birth cohorts actually declined. At o therlocations the increase ranged as high as 14%. In contrast, many AD AM locations experiencedan increase among youthfu l arrestees as high as 30-50%. Th e increase am ong youthful arresteesfar exceeded the increase am ong older birth cohorts at every location iden tified as experiencing aMarijuandB lunts Epidemic (this excludes Miami and San Diego).

@ ',

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Those individuals w ho cam e of age during the early part of the M ar i ju anf l lu nts Epidemic

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Three-Generations AnalysisThe three generations analysis reproduced the key findings from Go lub an d Johnson (1 999) at

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,-*< 21

0

Tw o ADA M locations experienced slightly different trend. In Phoenix, persons born since 1 970reported rates of lifetime crack use around 30% which were com parable to the rates of 40%reported by persons born 1954 to 1969. It would appear that the Crack Epid emic had not endedin Phoenix by 1998. This was consistent with a previously published observation that as of 1996the crack epidemic was in decline in most of the country except in Phoen ix where it wa s stillexperiencing its plateau phase (Golub and Johnson 1997). The other modest excep tion occurredin San Antonio where the rate of lifetime crack use barely ever reached 15% . By he 1979 birthcohort, the rate was still close to 10%. This is consistent with the previously publishedobservation that San Antonio had not experienced a significant Crack Epidem ic as of 1996.

I8 I

SUMMARYThis study identified that the increase in marijuana use in the 1990s generally conformed to atheoretical model for a drug epidemic. This model provided a powerful fram ewo rk forinterpreting the recent trends in marijuana use am ong arrestees using data fro m the ADAMprogram and within the general population. This section presents the major findings about theMarijuandB lunts Epidemic organized to correspond to the four phases o f the conceptual model.Incubation Phase

0 The MarijuanaBlunts Epidemic followed a long-term decline in youthful, marijuana use. The NH SDA and MT F programs reported substantial and continuousdeclines in marijuana use starting back in 1979. Th e ADAM pro gram w as started in1987, but not at all 23 locations. From 1988 to 1990, the rate amon g arrestees declinedsubstantially at most locations in the program. Conceivab ly, the start of these declines inmarijuana use among arrestees may da te back to earlier in the 1980s.

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4 22

0 Local differences are important. The M arijuana/Blunts Epidemic followed atypical pattern at most ADA M locations. However, there were exc eption s at a fewlocations to every one of the major regularities observed: So me locations did not observean epidemic, some epidemics were not limited to younger arrestees, som e epidemicsstarted later, and some epidemics exp ande d more slowly.0

who tend to get in trouble with the law. The rate of increase among arrestees.18-20and 21-24 exhibited parallel increases in the early 1990s. Ho wev er, increases amongolder arrestees typically did not occur until later years. This delay ed increase am ongolder arrestees suggests that among those w ho tend to get in trouble with the la w that themarijuana (epidemic) was centered primarily amo ng persons age 18-24. In a few Ilocations the Mariju andB lunts Epide mic affected arrestees of all ages including Omaha,Saint Louis, and Atlanta.

Th e Marijuanamlunts Epidemic was initially centered am on g persons age 18-24

0 Th e Marijuanamlunts Epidemic started am ong youths who tend to get introuble with the law and then spread to the broader population. The increase inyouthful marijuana use within the general population did not start until 1993. Th eincreases were modes t and restricted primarily to persons 18-20. Th e NHSDA recorded amodest increase among 1 8-20 year-olds from 1992 to 1996. Th e M TF recorded a steadyincrease among high school seniors from 1992 to 1997. These elevated rates in thegeneral population were still substantially lower than peak levels prevailing around 1979.

Plateau Phase0 The epidemic entered a p lateau around 1996 at most ADAM locations-withsome notable exceptions scattered around th e country. The MTF and NHSDA

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-*i 23

e T he Mar i juan aBlu nts Epidemic resul ted in massive increases in m ari jua na useam ong y ou thfu l arrestees. At locations experiencing an epidemic, marijuana useamong youthful arrestees (age 18-20) typically rose from 1530% in 1990 up to 50-80%by 1996. Th e program average across all ADAM locations mo re than doubled in sixyears, increasing from 24% in 1990 to 57% in 1996. Several locations recorded m uchsmaller increases including Fort Lauderdale, Dallas, Houston, Phoenix, SanAntonio, LosAngeles, Portland, and San Jose.0

of youths th at tend to get in trou ble with d rug s and th e law. Youthful arrestees in the1990s (especially those born 1974-79) were using marijuana more than their predecessorshad. Unlike their predecessors, howev er, few (generally under 10%) reported an ylifetime crack use or heroin injection. This suggests that viewing m arijuana as a gatewaydrug may be inappropriate for this new generation. Indeed, their use o f marijuana m ay bean act of resilience and the direct result of cultural and su bcultural norms against the useof crack and heroin.

By the mid 199Os, ma rijuan a i tself was the dr u g of choice of the new generation

0

the new generation of mar ijuan a u sers comes to comprise a la rge r por t ion of thearrestee population.

Modest increases in the overall rates of detected m arij ua na use may continue as

, Decline Phasee By 1999, the M arijuana/Blu nts Ep idemic had shown l i t t le evidence of abating.The rates of detected marijuana use am ong youthful arrestees at most A DA M locationand nationwide seemed relatively stable. Members of the M arijuand Blun ts G enerationappear to be persisting in their m arijuana use, at least well into the ir twenties.

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may help create a more productive labor force and assure further declines in drug abuse and itsattendant criminality. If inner-city youths born in the 1970s who get in trouble wi th the lawcould be transformed into fully employab le workers, then their marijuana u se migh t also declineas they assume conventional adult roles ju st as it tends to among mem bers of th e generalpopulation (Bachman et al. 1997).

0.

SELECTED REFERENCESBachman, Jerald G., Katherine N. Wadsworth, Patrick M. 'Malley, Lloyd D. Johnston., andJohn E. Schulenberg. 1997. Smoking, Drinking, and Drug Use in Young Adu lthood: The Impactsof New Freedoms and New Responsibilities. Mahwah, NJ: Erlbaum.Department of Health and Human Services [DHHS]. 1999. Youth Use of Cigars: Patterns of Useand Perceptions of Risk. Publication NO . OEI-060 98-00030.Furst, R. Terry, Bruce D. Johnson, Eloise Dunlap, and Richard Curtis. 1999. The Stigma tizedImage of the Crack Head: A Sociocultural Exploration of a Barrier to C ocaine S mo king Am onga Cohort of Youth in New York City. Deviant Behavior 20: 153-181.Gfroerer, J. C. and J. F. Epstein. 1999 . Marijuana initiates and their impac t on future dru g abusetreatment need. Drug and Alcohol Dependence 54: 229-237.Golub, Andrew, Farrukh H akeem, and Bruce D. Johnson. 1996. Monitoring the d eclin e in theCrack Epidemic with data from the Drug U se Forecasting Program. Final report to the Nationa lInstitute of Justice.Golub, Andrew, and Bruce D. Johnso n. 1994. A recent decline in coca ine use a mo ng youthfularrestees in Manhattan (1987-1 993). American Journal of Public Health, 84(8): 1250-1254.

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, 26

Golub, Andrew, and Bruce D. Johnson. 2001b. Substance use progression and hard dru g abuse ininner-city New Y ork. In K andel, Denise B. (ed.) Stages and Pathway s of Involvement in DrugUse: Examining the Gate way Hypothe sis. New York: Cambridge, forthcom ing.Grinspoon, Lester, and Jame s B. Bakalar. 1997. Marihuana. In J. H. Lowinson, P. Ruiz, R. B.Millman, and J. G. Langrod (eds.), Substance Abuse: A Comprehensive Textbook, third edition.Baltimore: Williams and wilk ins . pp. 199-206.

0

Hamid, Ansley. 1992. The developmental cycle of a drug epidemic: The cocaine sm okingepidemic of 1981-1991. journal of Psychoactive Drug s 24:( 337-348. , IHunt, Dana. 1997 . Rise of Hallucinogen U se. National Institute of Justice Research in Brief NCJ166607.John son, Bruce D., and Andrew Golub. 2001. Generational trends in heroin use a nd injectionamong a rrestees in New York City. In Musto, David. One Hundred Years of Heroin. Westport,C T Greenwood, forthcoming.Johnson, Bruce D., Andrew G olub, and Jeffrey Fagan. 1995. Careers i n cra ck, d p g use, drugdistribution an d nondru g criminality. Crim e and Delinquency 41 (3): 275-2 95.Johnson, Bruce. D., Andrew Golub, and Eloise Dun lap. 2000. The R ise and Decline of Hard

I

Drugs, Drug Ma rkets, and Violence in Inner-City Ne w York. In Blum stein, Alfred (ed.) TheDecline in Kolent Crime. forthcoming.Johnston, Lloyd D., Patrick M. OMalley, and Jerald G. Bachman. 1999a. National SurveyResults on Drug Use rom the Monitoring the Future Study, 1975-1998, Vol. 1. Nat ional Instituteon Drug Abuse. NIH Publication No. 99-4660.Johnston, Lloyd D., Patrick M. OMalley, and Jerald G. Bachman. 1999b. Dru g trends in 1999are mixed. Press release. Ann Arbor, MI: Univer sity of Michigan News and InformationServices. Available on line www.monitoringthefuture.org.

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3 -*< 27I

Parker, Howard, Judith Aldridge, and Fiona M easham. 1998. Illegal Leisure: The Normalizationof Adolescent Recreational Drug U se. London : Routledge.Rogers, Everett M. 1995. Diffusion of Innovations, 4th ed. New York: Fre e Press.Sifaneck, Stephen J., and Charles D. Kaplan. 1996. "New Rituals of Cannabis Preparation andSelf-Regulation in Two Cultural Settings an d Their Implications for Second ary Prevention."New York: National Development and Research Institutes, Inc. W orking M anuscript ,Sifaneck, Stephen J., and C. Sm all. 1997. "Blunts and Forties: The Drug s of Ch oice for the NewGeneration." New York: National Developm ent and Research Institutes, Inc. Wo rkingManuscript.Sbbstance Abu se and Mental Health Services Administration [SA MH SA]. 1999. NationalHousehold Survey on Drug Abuse Series: H-IO. Summary of Findings fro m the 1998 NationalHousehold Survey on Drug Abuse. Office of Applied studies. DH HS Publication No.(SMA) 99-3295.

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Appendix A: Marijuana Use by Location , 28

a U.S. General Population, NHSDA

79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97.98Interview Year

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Appendix A: Marijuana Use by Location

100%

80%

60%

40%

20%

0%

, 29

U.S. Secondary School Students, MTF

I , I

76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99Interview Yea r

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Appendix A: Marijuana Use by Location 30

U.S. Arrestee Population,ADAM Program Average

60%

40%

20%

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100%

80%

60%

40%

20%

0%

Manhattan

, 31

87 88 89 90 91 92 93 94 95 96 97 98 99

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60%

40%

20%

, 32, I

-- - -

- - - -

-- - -

Philadelphia

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100%

80%

60%

40%

20%

Washington, D.C.

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100%

80%I . ,

60%

40%

20%

. -

Chicago

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Cleveland

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Detroit

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&ppendix A: Marijuana Use by Location 37

Indianapolis


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100%

80%

60%

40%

20%

Omaha

/ X

b Appendix A: Marijuana Use by Location 39

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'

St. Louis100%

80%I,, ,

60%

40%

. Aljpendix A: Marijuana Use by Location 40

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1UU%

80%

60%

40%

20%

Atlanta

Appendix A: Ma rijuana Use by Location , 41

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100%

80%

60%

40%

20% .

Birmingham. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _

, I

I

- - - - - - - - -- - - - - - - - - - - --

Appendix A: Ma rijuana Use by Location

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100%

80 %

60%

40%

20%

Fort Lauderdale

I


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looo/o

800/0

Miami- - - - - - - - - - - -- - - - - - - - - - - - ---I------------

-I - - - - I - - - - - - - - - - - - - - - - _ _ - - - _ _ _ _ _ _ _ _ _ _ _

.. - m X. m


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4

I ,

Dallas


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100%

80%

60%

40%

20%

Denver

Appendix A: Marijuana Use by Location.. 46

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Houston

60%

40 %

20%


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100%

80%

60%

40%

20%

New Orleans

' - . x 'm -

Appen dix A: Marijuana Use by Location 48

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,

Phoenix

60%

40%

20%


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100%

80%

60%

40%

2 0 % .

San Antonio

. _ _ _ _ _ _ _ _ _ - - - - - - I - _ - - - - - - - - - - - - - - - - - - - - - -

Q

50ppendix A: Marijuana Use by Location

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Los Angeles

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100%

80%

60%

40%

20%

San D'iego

I

- rn'

4 ' p e n d i x A: Marijuana Use by Location 53

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100%

80%I., ,

60%

40%

20%

San Jose

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ARpendix B: Age-Period-Cohort Analyses of Marijuana Use 55

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Percent Detected as Mariiuana UsersBirth Year 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 Tot 18+

Appendix B: Age-Period-Cohort Analyses ofMarijuana Use,

56

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ADAM-Man hattan

Appendix B: Age-Period-Cohort Analyses of Marijuana U se 57

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,

Appendix B: Age-Period-Cohort Analyses of Marijuana Use 58

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59ppendix B: Age-Period-Cohort Analyses of Marijuana Use

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Appendix B: Age-Period-Cohort Analyses of Marijuana Use , 60

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ADAM -Cleveland

Appendix B: Age-Period-Cohort Analyses of Marijuana Use

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ADAM -Detroit

I62ppendix B: Age-Period-Cohort Analyses of Marijuana Use

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ADAM-Omaha


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ADAM-St. Louis

Appendix B: Age-Period-Cohort Analyses of Marijuana Use 65I

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Appendix B: Age-Period-Cohort Analyses of M arijuana Use 66

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;hading indicates age at interview: m,25, 0 .

68ppendix B: Age-Period-Cohort Analyses of Marijuana UseI..,

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Appendix B : Age-Period-Cohort Analyses of Marijuana Use 69

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Appendix B: Age-Period-Cohort Analyses of M arijuana Use , 70

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Appendix B: Age-Period-Cohort Analyses of Marijuana Use8

71

ADAM-Houston

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Appendix B: Age-Period-Cohort Analyses of Marijuana Use 72,ADAM-New Orleans

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Appendix B: Age-Period-Cohort Analyses of Marijuana Use , 73ADAM-Phoenix

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Appendix B: Age-Period-Cohort Analyses of Marijuana Use I 74ADAM -San Antonio

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Appendix 6: Age-Period-Cohort Analyses of Marijuana Use , 75

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Appendix B : Age-Period-Cohort Analyses of Marijuana Use 76

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Appendix B: Age-Period-Cohort Analyses of Marijuana Use 1 77

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Appendix B: Age-Period-Cohort Analyses of Marijuana Use 78ADAM-San Jose

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Appendix C: Three G enerations of Drug Use

U.S. General Population, NHSDA

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U.S. High School Seniors, MTF

0% I I I I v \ / /\ v v1944 1949 1954 1959 1964 - 1969 1974 1979I940

Birth Year (approximate)

This document is a research report submitted to the U.S. Department of Justice. This report hasnot been published by the Department. Opinions or points of view expressed are those of theauthor(s) and do not necessarily reflect the official position or policies of the U.S. Department ofJustice.

Appendix C: Three Generations of Drug Use 81

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50%

40%

30%

20%

10%0%4940 1944 1949 1954 1959 1964 1969 1974 1979

Birth Year


Appendix C: Three Generations of Drug Use

Phi adelph a

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l ooo / o -.-- ^ I __. _ - - - - - -I I I - - I I I - - I - - - -. .- -- - - -I - - - --- - - - - - .- -- X - Heroin injection (self-report of lifetime use) ---ll-l-------.III- --+ rack (self-report of lifetime use)

- - - _ - - - - - - - - _ - - I - _ I I I _ I - - - - - . - - - _-43- Marijuana (current use as detected by urinalysis)80% _- .-I4940 1944 19 49 1954 1959 1964 1969 1974 1979

Birth Year



Washington, D.C

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I

- __ I I - - -I - - - I -- -- -- - ^I_" I -- -I*Marijuana (current use as detected by urinalysis)

e1940 1944 1949 1954 1959 1964 1969 1974 1979Birth Year -



Chicago

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100%

90%8070o60%50%40%30%20%10%0%

- - - I -- - - - - -II- - - - - - -~- -_ .- - .- - -I --Marijuana (current use as detec ted by urinalysis)

4 94 0 I 9 4 4 1949 1954 1959 1964Birth Year

1969 1974 1979



C eveiand85

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1000/ "_ _ _ I _ _ _ _ _ _ I . I I _ _ I _ _ I _ _ _ _ _ I I _ I - I I _ _ _ - _ _ _ _ _ I _ _ _ - -- %- Heroin injection (self-report of lifetime use) - - - - I I - - - . - -- - -Crack (self-report of lifetime use)

O I80 %70%60O50%40 %30o20%10 %0%< I 940 1944 A 949 1954 1959 1964 1969 1974 1979

Birth Year



Detroit0 6

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- .#- Heroin injection (self-report of lifetime use) -. - - I _ -I -I I - _ - - I - _ - - .-I- -. -_-+Crack (self-report of lifetime use) --I_II - -I------I- I I -I . ._..Marijuana (current use as detected by urinalysis)70 %60 %50 %40 %

20 %10 %0%

4 9 4 0 1 9 4 4 1949 1954 1959 1964Birth Year

1969 1974 1979



Indianapolis

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100%

90%

80%70 %60%50%40%

30%20%10%0%

- --e rack (self-report of lifetime use)

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90/105

40%30%20%10 %0%

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100%90%

80%

70%60%

50%

40 %30%

20%10 %

0Yo

- a

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70%

60%

50%40%30%20%10 %0%

< I94 0 1944 1949 1954 1959 1964Birth Year

1969 1974 1979


Appendix C: Three Generations of Drug Use 91fBirmingham

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1954 1959 1964 1969 1974 1979I94 0 1944 1949 Birth Year



Ft. Lauderdale

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100%90%

80 %70o60%

50%40%30%

20%10 %0%

-I - - - _I - -~ - -I - -I I I -I-- *Marijuana (current use as detected by urinalysis)

< I 940 1944 1949 1954 1959 1964Birth Year

1969 1974 1979



Miami93

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- -1954 1959 1964 1969 1974 1979I40 1944 1949 Birth Year



Dallas

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100%90%80%

70%

60%50%

40 %30%

20%10%0% r . ..,.I I 1 I I I

< I 9 4 0 1944 1949 1954 1959 1964Birth Year

1969 1974 1979


100%

Appendix C: Three G enerations of Drug Us e

Denveri."I - -- - - - I -- --I.I _ -I _ I _-- - I -.---I- - I -I - - - I - -.-I-I -- -

95

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90 %80 %70%60 %50 %40%30%20%10% (

\z0% -

- X- Hero in injection (self-report of lifetime use)+Crack (self-report of lifetime use) - - - - - -"I-------I---

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100%

90 %80%

70%60%50 %40%

30%20%10 %0%4940 1944 1949 1954 1959 1964

Birth Year1969 1974 1979 -



New Orleans

- 97

.- -. _. - _ - - _- - _- _ _. _ _- I _- - _. - - - I _- - - - - - - -- -_. - - - - - - - - _- -- - - - - --- - - -'Oooh 1

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- X - Heroin injection (self-report of lifetime use)

40%30%20%10 %0% 1944 1949 1954 1959 1964 1969 1974 19794 9 4 0

Birth Year


e p e n d i x C: Three Generations of Drug Use

Phoenix100%

98

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90%80 %70%

60%50%40%

30%20%10 % ~0%c1940 1944 1949 1954 1959 1964

Birth Year1969 1974 1979 . -


Appendix C: Three Generations of Drug Use a 99San Antonio

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e1940 1944 1949 1954 1959 1964Birth Year

1969 1974 1979


100

100%

Los Angeles

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90 %80%

70%

60%50%

40%30%20%10%0%

- -- +Crack (self-repo rt of lifetime use)

4 9 4 0 1944 1949 1954 1959 1964Birth Year

1969-

1974 1979


Appendix C: Three G enerations of Drug Use 101

100%

Portland (OR)

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