Substance Abuse Epidemiology Profile Report - Executive Summary
Consequences of Substance Abuse
IntroductionEight of the ten leading causes of death in New Mexico are at least partially caused by the abuse of alcohol, tobacco, or other drugs. In 2009, the ten leading causes of death in New Mexico were diseases of the heart, malignant neoplasms, unintentional injuries, chronic lower respiratory disease, cerebrovascular disease, diabetes, suicide, Alzheimer's disease, chronic liver disease, and influenza and pneumonia. Of these, chronic liver disease, unintentional injuries, and suicide are associated with alcohol use; chronic lower respiratory disease and influenza and pneumonia are associated with tobacco use; heart disease, malignant neoplasms, and cerebrovascular disease are associated with both alcohol and tobacco use; and unintentional injuries and suicide are associated with the use of other drugs.
Alcohol-related DeathOver the past 30 years, New Mexico has consistently had among the highest alcohol-related death rates in the United States and it has had the highest alcohol-related death rate since 1997. The negative consequences of excessive alcohol use in New Mexico are not limited to death, but also include domestic violence, crime, poverty, and unemployment, as well as chronic liver disease, motor vehicle crash and other injuries, mental illness, and a variety of other medical problems. In 2006, the economic cost of alcohol abuse in New Mexico was more than $2.5 billion, or $1,250 per person. Death rates from alcohol-related causes increase with age. Male rates are substantially higher than female rates. American Indians have higher alcohol-related death rates than other race/ethnicities. McKinley and Rio Arriba counties have extremely high alcohol-related death rates, driven by high rates in the American Indian and Hispanic male populations, respectively. The counties with the most deaths for the five-year period 2005-2009 are Bernalillo, San Juan, Santa Fe, McKinley, and Doņa Ana. New Mexico has extremely high death rates due to both alcohol-related chronic diseases and alcohol-related injuries.
- Alcohol-Related Chronic Disease Death.
New Mexico's rate of death due to alcohol-related chronic diseases is 1.9 times
the national rate. Death rates increase with age. American Indians, both male and
female, and Hispanic males have extremely high rates. As with total alcohol
related death, McKinley and Rio Arriba counties have the highest rates in
Alcohol-related chronic liver disease (AR-CLD) is the disease that accounts for the most deaths due to alcohol-related chronic disease. AR-CLD death rates are extremely high among American Indians, both male and female, and Hispanic males. The high rates among American Indians and Hispanic males between the ages of 35 and 64 represent a tremendous burden in terms of years of potential life lost. While Bernalillo County has the highest number of deaths due to AR-CLD (458 for the years 2005-2009), three counties that stand out for their very high rates are Rio Arriba, McKinley, and Cibola counties, which have rates 3.5 to almost 6 times the national rate.
- Alcohol-Related Injury Death.
New Mexico's rate of alcohol-related injury death is 1.8 times the national rate.
In the current reporting period (2005-2009) falls injuries surpassed alcohol-
related motor vehicle traffic crashes as the leading cause of alcohol-related injury death; and
numerous other types of injury death are also associated with excessive alcohol use
(particularly binge drinking, see below). Deaths from drug overdose, a sizeable
portion of which are partially attributable to alcohol, have also increased
substantially in recent years. Males are more at risk for alcohol-related injury death than
females, with American Indian males at particularly elevated risk.
New Mexico's alcohol-related motor vehicle traffic crash (AR-MVTC) death rate has decreased dramatically over the past 30 years. After substantial declines during the 1980's and 1990's, New Mexico's rate stagnated for almost ten years. However, a comprehensive program to prevent driving while intoxicated (DWI), initiated in 2004, resulted in substantial rate declines during the period 2005-2008. Nonetheless, rate disparities remain: both male and female American Indians have elevated rates, especially among younger males (age 15-44). McKinley and Rio Arriba counties had rates almost five times the national rate for the period covered by this report (2005-2009). The McKinley County rate was driven by the high American Indian rate, while the Rio Arriba County rate was driven by the high Hispanic and American Indian rates.
Smoking-related DeathHistorically, New Mexico has had one of the lowest smoking-related death rates in the nation. Nonetheless, New Mexico's burden of death associated with smoking is considerably greater than the burden associated with alcohol and other drugs. Among all race/ethnic groups, males have higher smoking-related death rates than females. Among both males and females, Whites have the highest rates, followed by Blacks. The counties with the highest rates and relatively heavy burdens of smoking-related death (i.e., 20 or more deaths a year) are Torrance, Sierra, Quay, Valencia, and Socorro counties. The high rates in most of these counties and in the state overall are driven by high rates among Whites.
Drug-induced DeathNew Mexico has the highest drug-induced death rate in the nation, and the consequences of drug use continue to burden New Mexico communities. Drug-induced death rates remained higher for males than for females. The highest drug-induced death rate was among Hispanic males, followed by White males. Rio Arriba County had the highest drug-induced death rate in the state, followed by Eddy, Torrance, Chaves, and Bernalillo counties. Bernalillo County continued to bear the highest burden of drug-induced death in terms of total numbers of deaths. Unintentional drug overdoses account for more than 80% of drug-induced deaths. The most common drugs causing unintentional overdose death for the period covered in this report were prescription opioids (i.e., methadone, oxycodone, morphine; 49%), heroin (36%), cocaine (31%), tranquilizers/muscle relaxants (29%) and antidepressants (16%). In New Mexico and nationally, overdose death from prescription opioids has become an issue of enormous concern as these potent drugs are widely available.
Suicide and Mental HealthSuicide is a serious and persistent public health problem in New Mexico. Over the period 1981 through 2007 New Mexico's suicide rate has consistently been among the highest in the nation -- 1.5 to 1.9 times the U.S rate. Male suicide rates are more than three times female rates across the age range, and among all race/ethnic groups. Six counties (Taos, Sierra, Grant, Rio Arriba, Torrance, and Otero) had suicide rates in 2005 -2009 that were more than twice the most recent available U.S. rates. New indicators in this report also document the prevalence of frequent mental distress and current depression among New Mexico adults; persistent sadness or hopelessness, suicidal ideation, and suicide attempt among New Mexico youth; and the association between risk and resiliency factors and substance abuse and mental health indicators, among New Mexico youth.
Alcohol, Tobacco, and Other Drug Consumption BehaviorSubstance use behaviors are important to examine not only because substance abuse can lead to very negative consequences in the short term, but because substance abuse can also have long-term negative consequences. For example, while drinking by youth is a behavior that can lead directly to alcohol-related injury or death, it can also lead to very serious consequences in adulthood, ranging from alcohol abuse or dependence to a variety of diseases associated with chronic heavy drinking.
The following is a list of the substance use indicators included in this report, along with a brief description of key findings related to each indicator:
Adult Binge DrinkingBinge drinking (defined as drinking 5+ drinks on a single occasion, for men, or 4+ drinks on a single occasion, for women) is associated with numerous types of injury death, including motor vehicle traffic crash fatalities, drug overdose, falls, suicide, and homicide. Among adults (age 18 or over) of all ethnicities, binge drinking was more commonly reported by males than females, mirroring higher rates of alcohol-related injury death among males. Among males, American Indians were more likely to report binge drinking than other ethnicities. Young adults (age 18-24) were more likely than other age groups to report binge drinking.
Youth Binge DrinkingIn 2009, New Mexico public high school students were slightly more likely to report binge drinking than U.S. high school students. Among New Mexico high school students, binge drinking was more commonly reported by upper grade students than lower grade students. There was no significant difference in the binge drinking rate between male and female high school students. Hispanic students were more likely to report binge drinking than high school students of other race/ethnicities.
Adult Heavy DrinkingIn 2009, adult heavy drinking (defined as drinking more than two drinks per day, on average, for men, or more than one drink per day, on average, for women) was less commonly reported in New Mexico (4.2%) than in the rest of the nation (5.1%). Heavy drinking was more prevalent among younger (aged 18-24) and middle-aged (aged 25-64) adults, with 4.3% and 4.4% of these age groups, respectively, reporting past-month heavy drinking. New Mexico men were 1.2 times more likely to report chronic drinking than women (4.5% vs. 3.9%).
Adult Drinking and DrivingIn 2008, adult past-30-day drinking and driving was reported in New Mexico by 1.2% of adults aged 18 and over. Past-30-day drinking and driving was more prevalent among young adults (aged 18-24) than among older age groups. New Mexico men were more than three times as likely to report drinking and driving than women (1.9% vs 0.6%). Hispanic males (2.5%) were more likely to report drinking and driving than American Indian (2.0%) and White (1.6%) males.
Youth Drinking and DrivingIn 2009, New Mexico high school students were as likely to report driving after drinking alcohol as other U.S. students. Driving after drinking was more slightly common among boys than girls, and was less common among White youth than among other race/ethnic groups. Eleventh and 12th grade students were more likely to report drinking and driving than 9th and 10th grade students.
Youth Drug UseIn 2009, marijuana and cocaine use were more prevalent among New Mexico students than among U.S. students. The use of marijuana, cocaine, other illicit drugs (heroin, methamphetamine, inhalants, or ecstasy), and pain-killers was less commonly reported by White students than by students in other race/ethnic groups.
Adult Tobacco UseIn 2009, the prevalence of adult smoking was the same in New Mexico as in the nation overall (17.9%). Smoking was most prevalent among younger age groups, and was more common among men than women for the age categories 18-24 and 25-64.
Youth Tobacco UseIn 2009, smoking was more prevalent among New Mexico high school students (24.0%) than in the rest of the nation (19.5%). New Mexico boys were slightly more likely than girls to report current smoking (24.6% vs. 23.2%). American Indian high school students (28.1%) were more likely to report current cigarette smoking than White (23.1%) and Hispanic (23.2%) students.
Data SourcesNational/New Mexico population data, 1981-1989: U.S. Census Bureau. Estimates of the Population of States by Age, Sex, Race, and Hispanic Origin: 1981 to 1989. Available from http://www.census.gov/popest/archives/1980s/80s_st_detail.html as of August 16, 2010.
National/New Mexico population data, 1990-1999: U.S. Census Bureau. Estimates of the Population of States by Age, Sex, Race and Hispanic Origin: 1990 to 1999, Internet Release Date August 30, 2000. http://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#july1999 as of September 23, 2010.
National population data, 2000-2008: National Center for Health Statistics. Postcensal estimates of the resident population of the United States for July 1, 2000-July 1, 2008, by year, county, age, bridged race, Hispanic origin, and sex (Vintage 2008). Prepared under a collaborative arrangement with the U.S. Census Bureau; released May 14, 2009. Available from: http://www.cdc.gov/nchs/nvss/bridged_race.htm as of September 2, 2009.
New Mexico population data, 2000-2009: University of New Mexico, Bureau of Business and Economic Research. Annual Estimates of the Population of New Mexico by County, Age, Sex, Race and Hispanic Origin, 2000 to 2009.
National death data: National Center for Health Statistics. Multiple Cause-of-Death files, 1981-2007, machine readable data files and documentation. National Center for Health Statistics, Hyattsville, Maryland. Available from: http://www.cdc.gov/nchs/data_access/VitalStatsOnline.htm#Mortality_Multiple. Death rates were calculated by the New Mexico Department of Health, Epidemiology and Response Division, Injury and Behavioral Epidemiology Bureau, Substance Abuse Epidemiology Program. http://www.cdc.gov/nchs/data_access/VitalStatsOnline.htm#Mortality_Multiple
New Mexico death data: New Mexico Department of Health, Epidemiology and Response Division, Bureau of Vital Records and Health Statistics; and University of New Mexico, Office of the Medical Investigator (for drug overdose death reporting). Death rates were calculated by the New Mexico Department of Health, Epidemiology and Response Division, Injury and Behavioral Epidemiology Bureau, Substance Abuse Epidemiology Program.
National/New Mexico motor vehicle traffic crash fatality data: National Highway Traffic Safety Administration, Fatality Analysis Reporting System.
(1) VMT reporting: Fatalities, Fatalities in Crashes by Driver Alcohol Involvement, Vehicle Miles Traveled (VMT), and Fatality Rate per 100 Million VMT, by State, 1982-2007. Report provided by NHTSA National Center for Statistics and Analysis, Information Services Team. 2008 death rates per 100M VMT calculated by the New Mexico Department of Health, Epidemiology and Response Division, Injury and Behavioral Epidemiology Bureau, Substance Abuse Epidemiology Program.
(2) Per 100,000 population reporting: Persons Killed, by STATE and Highest Driver Blood Alcohol Concentration (BAC) in Crash - State : USA, Year. Available from: http://www-fars.nhtsa.dot.gov/States/StatesAlcohol.aspx. Death rates were calculated by the New Mexico Department of Health, Epidemiology and Response Division, Injury and Behavioral Epidemiology Bureau, Substance Abuse Epidemiology Program. http://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm#july1999
National adult behavioral data: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Adult and Community Health. Behavioral Risk Factor Surveillance System Online Prevalence Data, 1995-2009. Available from: http://apps.nccd.cdc.gov/brfss/ as of April 12, 2011. http://apps.nccd.cdc.gov/brfss/
New Mexico adult behavioral data: New Mexico Department of Health, Epidemiology and Response Division, Injury and Behavioral Epidemiology Bureau, Survey Unit. New Mexico Behavioral Risk Factor Surveillance System (BRFSS). More reporting available from: http://nmhealth.org/ERD/HealthData/health_behaviors.shtml as of April 12, 2011. http://nmhealth.org/ERD/HealthData/health_behaviors.shtml
National youth behavioral data: Centers for Disease Control and Prevention. Surveillance Summaries, June 4, 2010. MMWR. 2010:59(SS-5). More reporting available from: http://www.cdc.gov/HealthyYouth/yrbs/index.htm as of April 12, 2011. http://www.cdc.gov/HealthyYouth/yrbs/index.htm
New Mexico youth behavioral data: New Mexico Department of Health, Epidemiology and Response Division, Injury and Behavioral Epidemiology Bureau, Survey Unit; and the New Mexico Public Education Department, School and Family Support Bureau. New Mexico Youth Risk and Resiliency Survey (YRRS). More reporting available from: http://nmhealth.org/ERD/HealthData/health_behaviors.shtml as of April 12, 2011. http://nmhealth.org/ERD/HealthData/health_behaviors.shtml
New Mexico substance use disorder and mental health data: Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Substate Estimates from the 2006-2008 National Surveys on Drug Use and Health. Available from: http://oas.samhsa.gov/substate2k10/StateFiles/NM.htm. More reporting available from: http://oas.samhsa.gov/statesList.cfm as of April 12, 2011. http://oas.samhsa.gov/statesList.cfm