Chapter 2
Trends in Substance Abuse Treatment Admissions: 1997-2007

Trends in Primary Substance of Abuse
Trends in the Co-Abuse of Alcohol and Drugs
Trends in Admission Rates by Primary Substance and State
Trends in Demographic Characteristics
Trends in Socioeconomic Status

Trend data are invaluable in monitoring changing patterns in substance abuse treatment admissions. These patterns reflect underlying changes in substance abuse in the population, and have important implications for resource allocation and program planning.

Trends in Primary Substance of Abuse

Tables 2.1a and 2.1b and Figure 1. Between 1997 and 2007, TEDS treatment admissions were dominated by five substances: alcohol, opiates (primarily heroin), marijuana, cocaine, and stimulants (primarily methamphetamine). These substances together consistently accounted for between 95 and 96 percent of all TEDS admissions from 1997 through 2007.

Figure 1
Primary substance of abuse at admission:
TEDS 1997-2007

Line chart comparing primary substance of abuse at admission in teds from 1997 to 2007


1 These drugs include methadone, codeine, hydrocodone, hydromorphone, meperidine, mor­phine, opium, oxycodone, pentazocine, pro­poxyphene, tramadol, and any other drug with morphine-like effects.

Trends in the Co-Abuse of Alcohol and Drugs

Table 2.2 and Figure 2. The concurrent abuse of alcohol and drugs continues to be a significant problem. In 2007, 38 percent of all admissions reported problems with both alcohol and drugs—20 percent reported primary drug abuse with secondary alcohol abuse, and 18 percent reported primary alcohol abuse with secondary drug abuse.

Primary alcohol abuse declined from 50 percent of TEDS admissions in 1997 to 40 percent in 2007. Primary drug abuse in­creased from 48 percent in 1997 to 57 percent in 2007. However, this increase may reflect changing priorities in the treatment/reporting system rather than a change in substance abuse patterns. Limited resources and targeted programs may result in a shift of State funds from treatment of alcohol abusers to treatment of drug abusers.

Figure 2
Co-abuse of alcohol and drugs at admission:
TEDS 1997-2007

Bar chart comparing Co-abuse of alcohol and drugs  at admission in teds from 1997 to 2007

Trends in Admission Rates by Primary Substance and State

Tables 2.3b-2.8b and Figures 3-8 show trends in State admission rates per 100,000 population aged 12 and over for selected substances from 1997 to 2007.

For the maps in Figures 3-8, the median, 75th, 90th, and 99th percentiles of the range of 1997 admission rates for each substance were used to establish the rate categories used in the legend. Therefore, for the 45 States reporting in 1997, each 1997 map generally shows 1 State in dark red (the 99th percentile and above), 4 States in red (the 90th to 98th percentiles), 7 States in orange (the 75th to 89th percentiles), 11 States in gold (the 50th to 74th percentiles), and 22 States in cream (below the median 1997 U.S. rate). Crosshatching indicates States where no data were submitted, or where changes in reporting patterns made inclusion in trend calculations for a given year inappropriate.

Data were not submitted for one or more years in some States or jurisdictions because of changes to their data collection systems. These States were: Alabama (2007), Alaska (2004-2007), Arizona (1997), the District of Columbia (2004-2006), Georgia (2006-2007), Indiana (1997), Mississippi (2007) and West Virginia (1997-1998, 2000 and 2007).

In addition, significant changes in the clients or facilities reported to TEDS by some States and jurisdictions can result in changes in the number of admissions large enough to influence trends for at least one year from 1997 to 2007. For these States, rates are not indicated on the maps for the years affected, although the actual data reported are included in all tables. In this report, only Louisiana (1997) is affected.

Finally, there are some differences in how States have recorded heroin admissions that are reflected in the maps. Nebraska did not collect information on heroin admissions from 2004 to 2006. Tennessee has included heroin admissions among admissions for opiates other than heroin since 1998, therefore, Tennessee is excluded from the Heroin and Opiates other than heroin maps beginning in 1998.


2 The U.S. Census Bureau divides the United States into nine census divisions:

New England—Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
Mid-Atlantic—New Jersey, New York, Pennsylvania
South Atlantic—Delaware, District of Columbia, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia
East North Central—Illinois, Indiana, Michigan, Ohio, Wisconsin
West North Central—Iowa, Kansas. Minnesota, Missouri, Nebraska, North Dakota, South Dakota East
South Central—Alabama, Kentucky, Mississippi, Tennessee
West South Central—Arkansas, Louisiana, Oklahoma, Texas
Mountain—Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming
Pacific—Alaska, California, Hawaii, Oregon, Washington

3 Non-prescription methadone is excluded from Table 2.5 and Figure 5.

US State maps comparing Primary Alcohol admisision rates by State in TEDS from 1997 to 2007 (per 100,000 population aged 12 and over)

US State maps comparing Primary Alcohol admisision rates by State in TEDS from 1997 to 2007 (per 100,000 population aged 12 and over)

US State maps comparing Primary Heroin admisision rates by State in TEDS from 1997 to 2007 (per 100,000 population aged 12 and over)

US State maps comparing Primary heroin admisision rates by State in TEDS from 1997 to 2007 (per 100,000 population aged 12 and over)

US State maps comparing Primary non-heroin opiates/synthetics admisision rates by State in TEDS from 1997 to 2007 (per 100,000 population aged 12 and over)

US State maps comparing Primary non-heroin opiates/synthetics admisision rates by State in TEDS from 1997 to 2007 (per 100,000 population aged 12 and over)

US State maps comparing Primary cocaine admisision rates by State in TEDS from 1997 to 2007 (per 100,000 population aged 12 and over)

US State maps comparing Primary cocaine admisision rates by State in TEDS from 1997 to 2007 (per 100,000 population aged 12 and over)

US State maps comparing Primary marijuana admisision rates by State in TEDS from 1997 to 2007 (per 100,000 population aged 12 and over)

US State maps comparing Primary cocaine admisision rates by State in TEDS from 1997 to 2007 (per 100,000 population aged 12 and over)

US State maps comparing Primary methamphetamine/amphetamine admisision rates by State in TEDS from 1997 to 2007 (per 100,000 population aged 12 and over)


US State maps comparing Primary methamphetamine/amphetamine admisision rates by State in TEDS from 1997 to 2007 (per 100,000 population aged 12 and over)

Trends in Demographic Characteristics

Table 2.9b. Males represented 68 percent of TEDS admissions in 2007, a proportion that declined slightly from 70 percent in 1997. The distribu­tion of TEDS admissions by gender was different from that of the U.S. population, where over half (51 percent) of the population was female.

Table 2.9b and Figure 9. The age distribution of TEDS admissions changed between 1997 and 2007. The proportion of TEDS admissions aged 25 to 34 years declined from 32 percent in 1997 to 26 percent in 2007. This decline was offset by overall increases in the proportions of both older and younger admissions. The proportion of older admissions (aged 45 and older) increased from 14 percent in 1997 to 23 percent in 2007. The proportion of younger admissions (less than 25 years of age) increased from 22 percent in 1997 to 26 percent in 2007. (The population of TEDS admissions aged 35 to 44 years increased from 32 percent in 1997 to between 32 and 33 percent from 1997 through 2001. The proportion began a small, but steady decline from 31 percent in 2002 to 26 percent in 2007.)

The age distribution of TEDS treatment admissions was different from that of the U.S. population. In 2007, some 88 percent of TEDS admissions were between the ages of 18 and 54 compared to 52 percent of the U.S. population.

Figure 9
Age at admission:
TEDS 1997-2007

Line chart comparing age at admission in TEDS from 1997 to 2007


Table 2.9b and Figure 10. The racial/ethnic composition of TEDS admissions changed very little between 1997 and 2007. Non-Hispanic Whites made up 58 to 60 percent of admissions throughout the time period. The proportion of non-Hispanic Blacks declined slightly, from 25 percent of admissions in 1997 to 21 percent in 2007. This was offset by increases in the proportions of admissions of Hispanic origin (from 11 percent in 1997 to 14 percent in 2007) and for other racial/ethnic groups combined (from 4 percent in 1997 to 5 percent in 2007).

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 60 percent of TEDS admissions in 2007 compared to 66 percent of the U.S. population. Non-Hispanic Blacks represented 21 percent of TEDS admissions in 2007 and 12 percent of the U.S. population. However, the proportion of TEDS admissions of Hispanic origin (14 percent) was similar to the proportion of Hispanics in the U.S. population (15 percent). Other racial/ethnic groups made up 6 percent of TEDS admissions and 6 percent of the U.S. population.

Figure 10
Race/ethnicity at admission:
TEDS 1997-2007

Line chart comparing Race/ethnicity at admission in TEDS from 1997 to 2007

Trends in Socioeconomic Status

Tables 2.10a, 2.10b, and Figures 11 and 12. TEDS admissions aged 16 and over were socio-economically disadvantaged compared to the U.S. population aged 16 and over. This is evident in the unadjusted distributions of admissions by employment status and education shown in Table 2.10a. Because TEDS admissions differ demographically from the U.S. population, Table 2.10b shows distributions that have been statistically adjusted to provide a more valid comparison to the U.S. population.4 The adjusted distributions indicate an even greater disparity in socioeconomic status than do the unadjusted.

TEDS admissions aged 16 and over were less likely to be employed than the U.S. population aged 16 and over. Some 71 percent (75 percent adjusted) of 2007 TEDS admissions aged 16 and over were unemployed or not in the labor force compared to 37 percent of the U.S. population aged 16 and over. Only 21 percent (18 percent adjusted) were employed full time compared to 52 percent of the U.S. population aged 16 and over.

The proportion of TEDS admissions that were employed full time declined from 26 percent in 1997 to 21 percent in 2007.

The proportion of TEDS admissions that were unemployed declined from 25 percent in 1997 to a low of 24 percent in 1999 and 2000, but increased to 34 percent by 2007.

Figure 11
Employment status at admission:
TEDS 1997-2007

Line chart comparing Employment status at admission in TEDS from 1997 to 2007

Tables 2.10a, 2.10b, and Figure 12. TEDS admissions aged 18 and over had less education than the U.S. population aged 18 and over. In 2007, some 32 percent (29 percent adjusted) of TEDS admissions aged 18 and over had not completed high school compared to 15 percent of the U.S. pop­ulation aged 18 and over. TEDS admissions were also less likely to have received education beyond high school—24 percent (30 percent adjusted) of TEDS admissions aged 18 and over compared to 53 percent of the U.S. population aged 18 and over. These pro­portions were relatively stable from 1997 to 2007.

Figure 12
Education at admission:
TEDS 1997-2007

Line chart comparing Education at admission in TEDS from 1997 to 2007

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