Surveys need to distinguish between tobacco and alcohol use and use of drugs that are illicit

I’ve spent some time recently looking at studies of psychoactive drug use, mainly in the Western Hemisphere. Most of the reports include detailed information about alcohol and tobacco use, as indeed they should, since these are the psychoactive substances that are responsible overall for the highest burden of disease, health care costs and mortality. Study after study show much higher prevalences of alcohol and tobacco use than of illicit drugs, and generally speaking, alcohol and tobacco are the drugs that young people use first (however, CICAD did some striking studies in the Caribbean recently that seem to indicate marijuana as the drug of first use). My quibble with some of these studies is that when they summarize the data—in an Executive Summary, for example—a number of important pieces of information about illicit drug use get lost in the larger figures about alcohol and tobacco use. The actual dimensions of the use of marijuana, heroin, cocaine, crack and synthetic drugs are submerged into an overall figure of “psychoactive drug use”. This kind of reporting may be accurate, but may convey the impression to policy-makers and the general public that the “illicit drug problem” is worse than it actually is. A number of surveys have shown that people think that the number of drug users is higher than it is in fact. I’m not a statistician or epidemiologist, as you all know, but this type of reporting worries me. Should I be concerned? If so, what do we do about it?