Trends in Primary Substance of Abuse: 2000-2010
Trends in the Co-Abuse of Alcohol and Drugs
Trends in Demographic Characteristics
Trends in Employment Status

This report presents national-level data from the Treatment Episode Data Set (TEDS) for admissions in 2010 and trend data for 2000 to 2010. It is a companion to the report Treatment Episode Data Set (TEDS): 2000-2010 State Admissions to Substance Abuse Treatment. These reports provide information on the demographic and substance abuse characteristics of admissions to treatment aged 12 and older for abuse of alcohol and/or drugs in facilities that report to individual State administrative data systems. Data include records for admissions during calendar years 2000 through 2010 that were received and processed through October 10, 2011.¹

TEDS is an admission-based system, and TEDS admissions do not represent individuals. Thus, for example, an individual admitted to treatment twice within a calendar year would be counted as two admissions.

TEDS does not include all admissions to substance abuse treatment. It includes admissions at facilities that are licensed or certified by the State substance abuse agency to provide substance abuse treatment (or are administratively tracked for other reasons). In general, facilities reporting TEDS data are those that receive State alcohol and/or drug agency funds (including Federal Block Grant funds) for the provision of alcohol and/or drug treatment services. Additional information on the history and methodology of TEDS and this report as well as important issues related to State data collection systems are detailed in Appendix A.

This chapter details trends in the annual numbers and rates of admissions aged 12 and older for 2000 to 2010. Trend data are invaluable in monitoring changing patterns in substance abuse treatment admissions. These patterns reflect underlying changes in substance abuse in the population as well as changing priorities in the treatment/reporting system. (For example, limited resources and targeted programs may result in a shift of State funds from treatment of alcohol abusers to treatment to abusers of other drugs.) TEDS data thus have important implications for resource allocation and program planning.

Trends in Primary Substance of Abuse: 2000-2010

Admissions can report up to three substances of abuse. These represent the substances that led to the treatment episode and are not necessarily a complete enumeration of all substances used at the time of admission. Most of the information in this report is based on an admission's primary substance of abuse. (See Appendix A for more details.)

Tables 1.1a-b and Figure 1. The number of admissions aged 12 and older increased by 4 percent from 2000 to 2010, commensurate with a similar increase in the U.S. population aged 12 and older.

• Between 2000 and 2010, five substance groups accounted for 96 percent of the primary substances of abuse reported by TEDS treatment admissions aged 12 and older: alcohol, opiates (primarily heroin), marijuana, cocaine, and methamphetamine/amphetamines. However, the proportions of admissions by primary substance changed considerably over that period:
  • Alcohol admissions declined steadily from 46 percent of admissions aged 12 and older in 2000 to 39 percent in 2005, but then increased steadily to 42 percent in 2009, and then fell slightly to 41 percent in 2010. In 2010, 45 percent of primary alcohol admissions aged 12 and older reported secondary drug abuse as well.
  • Opiate admissions increased from 17 percent of admissions aged 12 and older in 2000 to 23 percent in 2010.
    • Admissions for primary heroin were fairly steady over this time period: they were 15 percent of admissions aged 12 and older in 2000, 16 percent in 2001, 15 percent again from 2002 to 2004, and 14 percent from 2005 to 2010. Heroin represented 91 percent of all opiate admissions in 2000 but declined steadily to 62 percent in 2010.
    • Opiates other than heroin² increased from 2 percent of admissions aged 12 and older in 2000 to 9 percent in 2010. Opiates other than heroin represented 9 percent of all opiate admissions in 2000 but rose steadily to 38 percent in 2010.
  • Cocaine admissions declined from 14 percent of admissions aged 12 and older in 2000 to 8 percent in 2010. Smoked cocaine (crack) represented 71 percent of all primary cocaine admissions in 2010, down from 73 percent in 2000.
  • Marijuana admissions increased from 14 percent of admissions aged 12 and older in 2000 to 18 percent in 2010.
    
  • Stimulant admissions (98 to 99 percent of these admissions were for meth­amphetamine or amphetamine abuse) increased from 5 percent of admissions aged 12 and older in 2000 to 9 percent in 2005, but then decreased to 6 percent in 2010.
  • Tranquilizers, sedatives and hypnotics, hallucinogens, PCP, inhalants, and over-the-counter medications each accounted for 1 percent or less of TEDS admissions between 2000 and 2010.
    

Trends in the Co-Abuse of Alcohol and Drugs

Table 1.2. The concurrent abuse of alcohol and drugs continues to be a significant problem. Because TEDS collects a maximum of three substances of abuse and not all substances abused, alcohol use among polydrug abusers may be underreported.

• The proportion of admissions aged 12 and older reporting abuse of both alcohol and drugs declined from 42 percent in 2000 to 37 percent in 2010.
• The proportion reporting abuse of drugs only increased from 30 percent in 2000 to 39 percent in 2010, while the proportion reporting abuse of alcohol only fell slightly, from 26 percent in 2000 to 23 percent in 2010.
  

Trends in Demographic Characteristics

Table 1.3b. Males represented 68 percent of TEDS admissions aged 12 and older in 2010, a proportion that declined steadily, if slightly, from 70 percent in 2000.

• The distribution of TEDS admissions aged 12 and older differed markedly by gender from that of the U.S. population, where 48 percent of the population was male.
  

Table 1.3b and Figure 2. The age distribution of TEDS admissions aged 12 and older changed between 2000 and 2010.

• The proportion of admissions aged 18 to 29 years increased from 28 percent in 2000 to 35 percent in 2010. The proportion of admissions aged 12 to 17 was stable at about 7 percent.
• Admissions aged 30 to 44 years made up 48 percent of TEDS admissions in 2000 but only 34 percent in 2010.
• The proportion of admissions aged 45 and older increased from 17 percent in 2000 to 24 percent in 2010.
• The age distribution of TEDS treatment admis­sions aged 12 and older differed considerably from that of the U.S. population. In 2010, some 69 percent of TEDS admissions were aged 18 to 44 years compared to 43 percent of the U.S. population. Adolescents aged 12 to 17 years made up 7 percent of TEDS admissions but 10 percent of the U.S. population. Admissions aged 45 and older made up 24 percent of TEDS admissions but 47 percent of the U.S. population.
  
  

Table 1.4 and Figure 3. The racial/ethnic composition of TEDS admissions aged 12 and older changed very little between 2000 and 2010.

• Non-Hispanic Whites made up 58 to 61 percent of admissions throughout the time period.
• The proportion of non­Hispanic Blacks declined, from 25 percent of admissions in 2000 to 20 percent in 2010.
• This was offset by increases in the proportions of admissions of Hispanic origin (from 12 percent in 2000 to 13 percent in 2010) and for other racial/ethnic groups combined (from 5 percent in 2000 to 6 percent in 2010).
• The racial/ethnic composition of TEDS admis­sions differed from that of the U.S. population. Non-Hispanic Whites were the majority in both groups, but they represented 61 percent of TEDS admissions in 2010 compared to 70 percent of the U.S. population. Non-Hispanic Blacks represented 20 percent of TEDS admissions in 2010 and 11 percent of the U.S. population. However, the proportion of TEDS admissions of Hispanic origin (13 percent) was the same as the proportion of Hispanics in the U.S. population (13 percent). Other racial/ethnic groups made up 6 percent of TEDS admissions and 6 percent of the U.S. population.
  

Trends in Employment Status

Table 1.5 and Figure 4. TEDS admissions aged 16 and older were less likely to be employed than the U.S. population aged 16 and older. This is evident in the unadjusted distributions of admissions by employment status (employed, unemployed, and not in labor force) shown in Table 1.5. Because TEDS admissions differ demographically from the U.S. population, Table 1.5 also shows distributions that have been statistically adjusted to provide a more valid comparison to the U.S. population.³ The adjusted distributions indicate an even greater disparity in socioeconomic status than do the unadjusted.

• Unemployment as a proportion of TEDS admissions aged 16 and older rose sharply from a low of 24 percent in 2000 to 40 percent in 2010. Between 2000 and 2010, unemployment grew from the least common employment status reported by treatment admissions aged 16 and older to the most common status.
• The most common employment status reported by TEDS admissions aged 16 and older between 2000 and 2008 was "not in the labor force." However, this proportion declined from a peak of 43 percent in 2000 and 2001 to 38 percent in 2010.

³ The distributions have been adjusted for age, gender, and race/ethnicity to the U.S. population. In essence, this technique compares the distributions under the assumption that the TEDS population and the U.S. population had the same age, gender, and racial/ethnic characteristics.

TO TABLES

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