Abstract
The history of the National Survey on Drug Use and Health (NSDUH) regarded as a rock‐solid font of trend information on America's drug use is replete with odd facts. Take the 1992 hurricane in Florida. It apparently caused a 50% drop in drug use in Miami. At least, that's what NSDUH found. Wait…not possible, you say? Mark Weber, then SAMHSA spokesman and now top HHS spokesman, told the Wall Street Journal when the results came out: “Lo and behold, we don't know what happened.” That's not so different from what SAMHSA chief Elinore McCance‐Katz, M.D., Ph.D., told us about the oddly missing heroin treatment data in the 2018 NSDUH (see story, page 1), although with slightly more colorful, if not substantive, language (Weber is a pro's pro and knows more substance than we could ever pry from him). The Robert Wood Johnson Foundation investigated – for SAMHSA‐ what happened and found that the sample interviewed after the hurricane were much different from the sample interviewed before. They were very concerned about privacy, for example, and so they just said they didn't use drugs. An object lesson as threats to 42 CFR Part 2 mean individuals are less likely to seek treatment, as well as less likely to want to talk about drug use due to consequences of disclosure? When trust is gone even in an anonymous survey, it gets hard to fight for funding, not to mention get people into treatment.
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