Chapter 2
Trends in Substance Abuse Treatment Admissions: 1994-2004

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

Table 2.1b and Figure 1. Between 1994 and 2004, TEDS treatment admissions were dominated by five substances: alcohol, opiates (primarily heroin), cocaine, marijuana, and stimulants (primarily methamphetamine). These substances together consistently accounted for between 95 and 96 percent of all TEDS admissions from 1994 to 2004.

Figure 1
Primary substance of abuse at admission:
TEDS 1994-2004

Line chart comparing Primary substance of abuse at admission in TEDS 1994 to 2004

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.06.


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 2004, approximately 40 percent of all admissions reported problems with both alcohol and drugs—22 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 53 percent of TEDS admissions in 1994 to 40 percent in 2004. Primary drug abuse increased from 44 percent in 1994 to 57 percent in 2004. However, this 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 1994-2004

Stacked bar chart comparing Co-abuse of alcohol and drugs 
at admission in TEDS 1994 to 2004

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.06.

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 1994 to 2004.

For the maps in Figures 3 to 8, the median, 75th, 90th, and 99th percentiles of the range of 1994 admission rates for each substance were used to establish the rate categories used in the legend. Therefore, for the 46 States reporting in 1994, each 1994 map generally shows 1 State in purple (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 23 States in cream (below the median 1994 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: Alaska (2004), Arizona (1994-1997), the District of Columbia (2004), Indiana (1997), Kentucky (1994-1996), Mississippi (1994), West Virginia (1994, 1997-1998, 2000, and 2003), and Wyoming (1995-1996).

In five States and jurisdictions, significant changes in the clients or facilities reported to TEDS from 1994 to 2004 resulted in changes in the number of admissions large enough to influence trends. For these States, rates are not indicated on the maps for the years affected: the District of Columbia (1994-1996), Louisiana (1997), New Mexico (2002), Texas (1996), and Virginia (1997-1998). The actual data reported, however, are included in all tables.


2These drugs include codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, propoxyphene, tramadol, and any other drug with morphine-like effects. Non-prescription use of methadone is not included.

3Tennessee included Heroin admissions among admissions for Opiates other than heroin beginning in 1998. Therefore Tennessee is excluded from the tabulations of the number of States reporting in both 1994 and 2004.

Figure 3
Primary alcohol admission rates by State: TEDS 1994-2004
(per 100,000 population aged 12 and over)

Maps comparing Primary alcohol admission rates by State in TEDS 1994 to 2004 (per 100,000 population aged 12 and over)

 

Figure 4
Primary heroin admission rates by State: TEDS 1994-2004
(per 100,000 population aged 12 and over)

Maps comparing Primary heroin admission rates by State in TEDS 1994 to 2004 (per 100,000 population aged 12 and over)

 

Figure 5
Primary non-heroin opiates/synthetics admission rates by State: TEDS 1994-2004
(per 100,000 population aged 12 and over)

Maps comparing Primary non-heroin opiates/synthetics admission rates by State in TEDS 1994 to 2004 (per 100,000 population aged 12 and over)

 

Figure 6
Primary cocaine admission rates by State: TEDS 1994-2004
(per 100,000 population aged 12 and over)

Maps comparing Primary cocaine admission rates by State in TEDS 1994 to 2004 (per 100,000 population aged 12 and over)

 

Figure 7
Primary marijuana admission rates by State: TEDS 1994-2004
(per 100,000 population aged 12 and over)

Maps comparing Primary marijuana admission rates by State in TEDS 1994 to 2004 (per 100,000 population aged 12 and over)

 

Figure 8
Primary methamphetamine/amphetamine admission rates by State: TEDS 1994-2004
(per 100,000 population aged 12 and over)

Maps comparing Primary methamphetamine/amphetamine admission rates by State in TEDS 1994 to 2004 (per 100,000 population aged 12 and over)

Trends in Demographic Characteristics

Table 2.9b. Males represented 68 percent of TEDS admissions in 2004, a proportion that declined slightly from 71 percent in 1994. The distribution of TEDS admissions by sex was different from that of the U.S. population, where approximately half (49 percent) of the population was male.

Table 2.9b and Figure 9. The age distribution of TEDS admissions changed between 1994 and 2004. The proportion of TEDS admissions aged 25 to 34 years declined from 38 percent in 1994 to 25 percent in 2004. 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 12 percent in 1994 to 20 percent in 2004. The proportion of younger admissions (less than 25 years of age) increased from 21 percent in 1994 to 27 percent in 2004. (The population of TEDS admissions aged 35 to 44 years remained relatively stable, at between 29 and 33 percent, from 1994 through 2004.)

Figure 9
Age at admission: TEDS 1994-2004

Line chart comparing Age at admission in TEDS 1994 to 2004

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.06.

The age distribution of TEDS treatment admissions was different from that of the U.S. population. In 2004, some 88 percent of TEDS admissions were between the ages of 18 and 54, compared to 52 percent of the U.S. population.

Table 2.9b and Figure 10. The racial/ethnic composition of TEDS admissions changed very little between 1994 and 2004. Non-Hispanic Whites made up 58 to 60 percent of admissions throughout the time period. The proportion of non-Hispanic Blacks declined slightly, from 27 percent of admissions in 1994 to 23 percent in 2004. This was offset by an increase in the proportion of admissions for Hispanics (from 11 percent in 1994 to 13 percent in 2004) and for other racial/ethnic groups (from 4 percent in 1994 to 5 percent in 2004).

Figure 10
Race/ethnicity of admissions: TEDS 1994-2004

Line chart comparing Race/ethnicity of admissions in TEDS 1994 to 2004

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.06

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 represented 60 percent of TEDS admissions in 2004, compared to 70 percent of the U.S. population. Non-Hispanic Blacks represented 23 percent of TEDS admissions in 2004 and 12 percent of the U.S. population. However, the proportion of Hispanic TEDS admissions (13 percent) was similar to the proportion of Hispanics in the U.S. population (12 percent). Other racial/ethnic groups made up 5 percent of TEDS admissions and 5 percent of the U.S. population.

Trends in Socioeconomic Status

Tables 2.10a, 2.10b, and Figures 11 and 12. TEDS admissions aged 16 and over were socioeconomically 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 2004 TEDS admissions aged 16 and over were unemployed or not in the labor force, compared to 38 percent of the U.S. population aged 16 and over. Only 22 percent (18 percent adjusted) were employed full time, compared to 51 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 1994 to 22 percent in 2004.

The proportion of TEDS admissions that were unemployed declined from 28 percent in 1994 to a low of 24 percent in 1999 and 2000, but increased to 31 percent by 2004.


4The distributions have been adjusted for age, sex, 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, sex, and racial/ethnic characteristics.

Figure 11
Employment status at admission, aged 16 and over: TEDS 1994-2004

Line chart comparing Employment status at admission, aged 16 and over in TEDS 1994 to 2004

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.06.

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 2004, some 34 percent (30 percent adjusted) of TEDS admissions aged 18 and over had not completed high school, compared to 16 percent of the U.S. population aged 18 and over. TEDS admissions were also less likely to have received education beyond high school—22 percent (27 percent adjusted) of TEDS admissions aged 18 and over, compared to 52 percent of the U.S. population aged 18 and over. These proportions were relatively stable from 1994 to 2004.

Figure 12
Education at admission, aged 18 and over: TEDS 1994-2004

Line chart comparing Education at admission, aged 18 and over in TEDS 1994 to 2004

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 2.1.06.

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