Highlights

This report presents results from the 2011 National Survey of Substance Abuse Treatment Services (N-SSATS), an annual census of facilities providing substance abuse treatment. Conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), N-SSATS is designed to collect data on the location, characteristics, and use of alcohol and drug abuse treatment facilities and services throughout the 50 States, the District of Columbia, and other U.S. jurisdictions. Selected findings are given below.

• The N-SSATS facility response rate in 2011 was 94.0 percent. Thirty-two States or jurisdictions had response rates that equaled or surpassed the overall rate [Tables 1.1 and 6.1].
• A total of 14,302 facilities completed the survey. The 13,720 facilities eligible for this report had a one-day census of 1,224,127 clients enrolled in substance abuse treatment on March 31, 2011 [Tables 1.1 and 3.1].
• In the United States, there were 473 clients in treatment per 100,000 population aged 18 and older on March 31, 2011. The rate was highest for persons with both alcohol and drug problems (203 per 100,000 population aged 18 and older), followed by drug problems only (183 per 100,000), and alcohol problems only (87 per 100,000) [Table 6.33].
  

Trends in Facility and Client Characteristics 2007-2011

• Both the total number of substance abuse treatment facilities and the number of clients in treatment increased slightly between 2007 and 2011. The number of facilities responding to the 2011 survey increased by 0.5 percent, from 13,648 facilities in 2007 to 13,720 facilities in 2011 [Table 2.1]. The number of clients in treatment on the survey reference date increased by 7.8 percent, from 1,135,425 in 2007 to 1,224,127 in 2011 [Table 3.1].
• The operational structure of the substance abuse treatment system (i.e., the type of entity responsible for operating the facility: private non-profit, private for-profit, or government—local, State, Federal,¹ or tribal) changed very little between 2007 and 2011 [Table 2.2 and Figure 2].
• The primary focus of activity of facilities (substance abuse treatment services, mental health services, a mix of mental health and substance abuse treatment services, general health care, or other activity) changed very little between 2007 and 2011 [Table 2.2 and Figure 3].
• The major types of care—outpatient, residential (non-hospital), and hospital inpatient—changed very little from 2007 to 2011 in terms of the proportion of facilities offering each type of care or the proportion of clients in treatment in each type of care [Tables 2.3 and 3.2 and Figures 4 and 6].
• Opioid Treatment Programs certified by SAMHSA for the provision of medication-assisted therapy with methadone and/or buprenorphine were provided by 8 to 9 percent of all facilities between 2007 and 2011 [Table 2.3 and Figure 4].
• The proportion of all clients receiving methadone ranged from 22 percent to 25 percent in the period 2007 to 2011 [Table 3.2].
• The proportion of all clients receiving buprenorphine ranged from 1 percent to 3 percent in the period 2008 to 2011 [Table 3.2].
• The proportion of clients in treatment for three broad categories of substance abuse problems—both alcohol and drug abuse, drug abuse only, and alcohol abuse only—changed very little between 2007 and 2011. Clients in treatment for both drug and alcohol abuse made up 42 to 46 percent of all clients. Clients in treatment for drug abuse only made up 35 to 39 percent, and clients in treatment for alcohol abuse only remained fairly steady around 18 percent [Table 3.3].
• Clients under age 18 made up between 7 and 8 percent of all clients in treatment between 2007 and 2011. The type of care (outpatient, residential [non-hospital], or hospital inpatient) received by clients under age 18 differed little from that received by adults, and was stable between 2007 and 2011 [Table 3.4].
  

Facility Operation—March 31, 2011²

• Private non-profit organizations operated 57 percent of all facilities and were treating 53 percent of all clients.
• Private for-profit organizations operated 31 percent of all facilities and were treating 32 percent of all clients.
• Local governments operated 5 percent of all facilities and were treating 6 percent of all clients.
• State governments operated 3 percent of all facilities and were treating 3 percent of all clients.
• The Federal government operated 3 percent of all facilities and was treating 4 percent of all clients.
• Tribal governments operated 2 percent of all facilities and were treating 2 percent of all clients [Tables 4.1 and 5.1].

Primary Focus of Activity—March 31, 2011²

• The provision of substance abuse treatment services was the primary focus of activity of 59 percent of facilities with 65 percent of all clients in treatment.
• A mix of mental health and substance abuse treatment services was the primary focus of 32 percent of facilities with 30 percent of all clients in treatment.
• The provision of mental health services was the primary focus of 6 percent of facilities with 3 percent of all clients in treatment.
• General health care was the primary focus of 1 percent of facilities with 1 percent of all clients in treatment.
• Activities other than those listed above were the primary focus of 1 percent of facilities with 1 percent of all clients in treatment [Tables 4.1 and 5.1].
  

Type of Care—March 31, 2011³

• Outpatient treatment was offered by 81 percent of all facilities and accounted for 90 percent of all clients in treatment.
• Residential (non-hospital) treatment was offered by 26 percent of all facilities and accounted for 9 percent of all clients in treatment.
• Hospital inpatient treatment was offered by 5 percent of all facilities and accounted for 1 percent of all clients in treatment [Tables 4.2b and 5.2b].

Client Substance Abuse Problem and Diagnosed Co-occurring Mental Disorders—March 31, 2011

• Clients in treatment for both alcohol and drug abuse made up 44 percent of all clients.
• Clients in treatment for drug abuse only made up 38 percent of all clients.
• Clients in treatment for abuse of alcohol only made up 18 percent of all clients.
• Forty-five percent of clients in treatment had diagnosed co-occurring substance abuse and mental disorders [Table 5.3].
  

Facility Size and Utilization Rates—March 31, 2011

• The median number of clients at substance abuse treatment facilities was 42—50 at outpatient, 20 at residential (non-hospital), and 10 at hospital inpatient facilities [Table 4.4].
• Ninety-seven percent of all residential (non-hospital) beds and 96 percent of all hospital inpatient beds designated for substance abuse treatment were in use [Tables 4.6 and 4.7].
  

Medication-Assisted Opioid Therapy—March 31, 2011

• Clients receiving methadone or buprenorphine in Opioid Treatment Programs (OTPs) accounted for 26 percent of all clients in treatment, although OTPs were available in only 1,189 (9 percent) of all substance abuse treatment facilities [Tables 2.3 and 4.20].
• Private for-profit organizations operated 54 percent of OTPs compared to 31 percent of all substance abuse treatment facilities [Tables 4.1 and 4.20].
• Of the 313,460 clients receiving medication-assisted opioid therapy in OTPs, 98 percent (306,440) received methadone [Table 4.20].
• Of the 32,676 clients receiving buprenorphine, 79 percent received it in facilities that were not OTPs [Table 4.20].
• More than half (56 percent) of clients receiving methadone were in private for-profit facilities compared to 42 percent of clients receiving buprenorphine. Clients receiving buprenorphine were more likely than those receiving methadone to be in private non-profit facilities (43 percent vs. 35 percent) [Table 4.20].
• Most (93 percent) of the clients receiving methadone were in facilities whose primary focus was the provision of substance abuse treatment services, while these facilities accounted for only 51 percent of buprenorphine clients. Forty-one percent of buprenorphine clients were treated in facilities providing a mix of substance abuse treatment and mental health services [Table 4.20].

Table of Contents