
Psychiatric News August 19, 2005
Volume 40 Number 16
© 2005 American Psychiatric Association
p. 5
Substance-Abuse Admissions Rise for Several Drugs
Aaron Levin
The total number of substance abuse treatment admissions has risen
slightly in 10 years; however, the number of admissions for some substances,
such as methamphetamine, has risen dramatically.
Admissions to substance abuse treatment facilities for disorders related to
the use of methamphetamines and narcotic pain medications rose in 2003, while
those for alcohol, marijuana, and heroin use fell slightly, the Substance
Abuse and Mental Health Services Administration (SAMHSA) reported.
The number of treatment admissions rose in the decade ending in 2003 from
about 1.6 million in 1993 to 1.8 million in 2003, according to the highlights
from Treatment Episode Data Sets, although that total represents a drop from
the peak of 1.9 million admissions logged in 2002. The data cover annual
admissions to drug and alcohol abuse treatment in facilities reporting to
individual state administrative data systems.
Methamphetamine admissions rose about 10 percent, from 105,754 in 2002 to
116,604 in 2003. By comparison, there were only 20,776 methamphetamine
admissions in 1993. Admissions for opiate abuse (including nonprescription
methadone) rose 12 percent in the same period, increasing from 45,927 in 2002
to 51,071 in 2003. There were just 14,143 such admissions in 1993.
"There hasn't been a whole lot of change in 10 years despite
increased research on using medications to treat substance
abuse."
"The alarming growth of methamphetamine use and, in part, its
popularity can be explained by the drug's wide availability, ease of
production, low cost, and highly addictive nature," said SAMHSA
Administrator Charles Curie, M.A., in a statement accompanying release of the
data.
The data are for admissions, not individuals, and cover only facilities
receiving state or federal substance abuse treatment funds.
The general decline in substance abuse admissions from 2002 to 2003
resulted mainly from about 50,000 fewer persons entering treatment for alcohol
abuse. Heroin-related admissions fell by about 17,000, while those for cocaine
and marijuana each rose by about 5,000.
"Any decline [in treatment admissions] is of concern because only a
small percentage of patients who need treatment get it," said Marianne
Guschwan, M.D., a clinical assistant professor of psychiatry at New York
University School of Medicine and past chair of APA's Corresponding Committee
on Treatment Services for Patients With Addictive Disorders.
The number of admissions may well be driven by insurance status, even
though the study data are drawn from government-funded treatment programs, she
said.
SAMHSA's data do not mention payers, but do record that only 29 percent of
patients over age 16 admitted for substance abuse treatment were employed, 31
percent were unemployed, and 40 percent were listed as not in the labor
force.
When viewed as a primary substance of abuse, alcohol accounted for 42
percent of treatment admissions, but 44 percent of those alcohol-abuse
patients reported abusing another drug as well.
Overall, men accounted for 70 percent of substance abuse admissions. About
59 percent of admissions were white, 24 percent black, and 13 percent
Hispanic. Methamphetamine and opiate users were more evenly divided between
men and womenjust over half were male. In addition, 73 percent of
methamphetamine users in treatment were white, and only 2.6 percent were
black.
Nationally, 23.2 percent of admissions (426,720) were due to alcohol abuse
alone, another 18.5 percent (341,278) to alcohol and a secondary drug, 2.8
percent (51,071) to nonheroin opiates, and 6.3 percent (116,604) to
methamphetamine use.
There were, however, noticeable regional differences. For instance, in
California alcohol abuse alone accounted for less than 10 percent of
admissions (half the overall U.S. rate), while methamphetamines accounted for
more than 30 percent (almost five times the national rate). In five other
statesArkansas, Idaho, Nevada, Oklahoma, and Utahalcohol
admissions were close to the national average, but methamphetamine admissions
accounted for over 20 percent of all substance abuse admissionsthree
times the national rate.
About 36 percent of these admissions arrived at treatment as referrals from
the criminal justice system, including more than half of all admissions for
marijuana (57 percent) and methamphetamine/amphetamine (51 percent) abuse.
Sixty-one percent of admissions went to ambulatory care, 22 percent to
detoxification, and 17 percent to residential treatment.
"We have to figure out why there has been such a slow expansion of
care for these patients," said Guschwan. "There hasn't been a
whole lot of change in 10 years despite increased research on using
medications to treat substance abuse."
The "Treatment Episode Data Set Highlights2003"
are posted at
<wwwdasis.samhsa.gov/teds03/2003_teds_highlights.pdf>.
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