Highlights

This report presents results from the Treatment Episode Data Set (TEDS) for 2004, and trend data for 1994 to 2004. The report provides information on the demographic and substance abuse characteristics of the 1.9 million annual admissions to treatment for abuse of alcohol and drugs in facilities that report to individual State administrative data systems.

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 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.

Major Substances of Abuse

• Five substances accounted for 95 percent of the 1,875,026 TEDS admissions in 2004: alcohol (40 percent), opiates (18 percent, primarily heroin), marijuana (16 percent), cocaine (14 percent), and stimulants (8 percent, primarily methamphetamine) [Table 2.1b].

Alcohol

• Alcohol as a primary substance accounted for two in five (40 percent) of all TEDS admissions in 2004, down from more than half (53 percent) in 1994. However, 45 percent of primary alcohol admissions reported secondary drug abuse as well [Table 2.1b].
• Alcohol admission rates generally were highest in the New England, Pacific, and West North Central States. For the United States as a whole, the alcohol admission rate declined by 28 percent between 1994 and 2004, from 430 per 100,000 population aged 12 and over to 308 per 100,000. Rates declined in 36 of the 45 States reporting in both years and increased in 9 States [Table 2.3b and Figure 3].
• About three-quarters of admissions for abuse of alcohol alone and for abuse of alcohol with secondary drug abuse were male (75 percent and 74 percent, respectively) [Table 3.1a].
• Almost three-quarters (70 percent) of alcohol-only admissions were non-Hispanic White, followed by non-Hispanic Blacks and Hispanics (12 percent each). Among admissions for alcohol with secondary drug abuse, 60 percent were non-Hispanic White, followed by 25 percent who were non-Hispanic Black and 10 percent who were Hispanic [Table 3.1a].
• For alcohol-only admissions, the average age at admission was 39 years, compared with 35 years among admissions for primary alcohol with secondary drug abuse [Table 3.2a].

Heroin

• TEDS admissions for primary heroin abuse increased from 13 percent of all admissions in 1994 to a peak of 16 percent in 2001, then declined to 14 percent in 2004. TEDS admissions for primary heroin abuse have exceeded admissions for primary cocaine abuse for 6 years, since 1999 [Table 2.1b].
• Heroin admission rates were highest in the New England States and Middle Atlantic States. For the United States as a whole, the heroin admission rate increased by 2 percent between 1994 and 2004, from 106 per 100,000 population aged 12 and over to 108 per 100,000. Heroin admission rates increased in 28 of the 44 States reporting in both years, declined in 13 States, and were unchanged in 3 States [Table 2.4b and Figure 4].
• About two-thirds (68 percent) of primary heroin admissions were male [Table 3.1a].
• Half (50 percent) of primary heroin admissions were non-Hispanic White, followed by 24 percent who were non-Hispanic Black and 23 percent who were Hispanic [Table 3.1a].
• For primary heroin admissions, the average age at admission was 36 years [Table 3.2a].
• Sixty-three percent of primary heroin admissions reported injection as the route of administration, 32 percent reported inhalation, and 2 percent reported smoking [Table 3.4].

Other Opiates

• TEDS admissions for primary abuse of opiates other than heroin increased from 1 percent of all admissions in 1994 to 3 percent in 2004 [Table 2.1b]. These drugs include methadone, codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, propoxyphene, tramadol, and any other drug with morphine-like effects.
• Admission rates for opiates other than heroin were generally highest in the New England and East South Central States. For the United States as a whole, the admission rate for opiates other than heroin increased by 257 percent between 1994 and 2004, from 7 per 100,000 population aged 12 and over to 25 per 100,000. Admission rates for opiates other than heroin increased in 43 of the 44 States reporting in both years [Table 2.5b and Figure 5].
• Just over half (53 percent) of primary non-heroin opiate admissions were male [Table 3.1a].
• Most primary non-heroin opiate admissions (89 percent) were non-Hispanic White [Table 3.1a].
• For primary non-heroin opiate admissions, the average age at admission was 34 years [Table 3.2a].
• About three-quarters (73 percent) of primary non-heroin opiate admissions reported oral as the route of administration, while 12 percent each reported inhalation and injection [Table 3.4].

Cocaine/Crack

• The proportion of admissions for primary cocaine abuse declined from 18 percent in 1994 to 14 percent in 2004 [Table 2.1b].
• Cocaine admission rates were generally highest in the Middle Atlantic and South Atlantic States. For the United States as a whole, the cocaine admission rate declined by 28 percent between 1994 and 2004, from 145 per 100,000 population aged 12 and over to 105 per 100,000. Cocaine admission rates declined in 33 of the 45 States reporting in both years, but increased in 11 States, and were unchanged in 1 State [Table 2.6b and Figure 6].
• Smoked cocaine (crack) represented 72 percent of all primary cocaine admissions in 2004 [Table 2.1a].
• Fifty-nine percent of primary smoked cocaine admissions were male, compared with 66 percent of primary non-smoked cocaine admissions [Table 3.1a].
• Among primary smoked cocaine admissions, 53 percent were non-Hispanic Black, 38 percent were non-Hispanic White, and 7 percent were Hispanic. Among primary non-smoked cocaine admissions, 51 percent were non-Hispanic White, followed by non-Hispanic Blacks (29 percent) and Hispanics (16 percent) [Table 3.1a].
• For primary smoked cocaine admissions, the average age at admission was 38 years, compared with 34 years for non-smoked cocaine admissions [Table 3.2a].
• Among primary non-smoked cocaine admissions, 78 percent reported inhalation as the route of administration, 13 percent reported injection, and 7 percent reported oral [Table 3.4].

Marijuana/Hashish

• The proportion of admissions for primary marijuana abuse increased from 9 percent in 1994 to 16 percent in 2004 [Table 2.1b].
• Marijuana treatment admission rates were generally highest in the West North Central and Pacific States. For the United States as a whole, the marijuana admission rate increased by 74 percent between 1994 and 2004, from 70 per 100,000 population aged 12 and over to 122 per 100,000. Marijuana admission rates increased in 39 of the 45 States reporting in both years and declined in 6 States [Table 2.7b and Figure 7].
• Three-quarters (74 percent) of primary marijuana admissions were male [Table 3.1a].
• Over half (54 percent) of primary marijuana admissions were non-Hispanic White, followed by 29 percent who were non-Hispanic Black and 12 percent who were Hispanic [Table 3.1a].
• For primary marijuana admissions, the average age at admission was 24 years [Table 3.2a].

Methamphetamine/Amphetamine and Other Stimulants

• The proportion of admissions for primary abuse of methamphetamine/amphetamine and other stimulants increased from 3 percent to 8 percent between 1994 and 2004 [Table 2.1b].
• Methamphetamine/amphetamine treatment admission rates were generally highest in the Pacific and Mountain States. For the United States as a whole, the methamphetamine/amphetamine admission rate increased by 182 percent between 1994 and 2004, from 22 per 100,000 population aged 12 and over to 62 per 100,000. Methamphetamine/amphetamine admission rates increased in 44 of the 45 States reporting in both years and were unchanged in 1 State [Table 2.8b and Figure 8].
• Over half (55 percent) of primary methamphetamine/amphetamine admissions were male [Table 3.1a].
• Almost three-quarters (73 percent) of primary methamphetamine/amphetamine admissions were non-Hispanic White, followed by 16 percent who were Hispanic and 3 percent each who were Asian/Pacific Islander and non-Hispanic Black [Table 3.1a].
• For primary methamphetamine/amphetamine admissions, the average age at admission was 30 years [Table 3.2a].
• Fifty-nine percent of primary methamphetamine/amphetamine admissions reported smoking as the route of administration, 21 percent reported injection, and 14 percent reported inhalation [Table 3.4].

Race/Ethnicity

Among all racial/ethnic groups except Hispanics of Puerto Rican origin, alcohol (alone or in combination with other drugs) was the most frequently reported primary substance at treatment admission. However, the proportion reporting primary use of the other four most common substances varied considerably by racial/ethnic group.

• Among non-Hispanic Whites, alcohol (44 percent) was followed by opiates (17 percent), marijuana (14 percent), and stimulants and cocaine (10 percent each) [Table 3.1b].
• Among non-Hispanic Blacks, alcohol (32 percent) was followed by cocaine (28 percent), marijuana (20 percent), opiates (16 percent), and stimulants (1 percent) [Table 3.1b].
• Among persons of Mexican origin, alcohol (38 percent) was followed by stimulants (19 percent), marijuana (17 percent), opiates (16 percent), and cocaine (8 percent) [Table 3.1b].
• Among persons of Puerto Rican origin, opiates (47 percent) were followed by alcohol (27 percent), marijuana (12 percent), cocaine (11 percent), and stimulants (1 percent) [Table 3.1b].
• Among persons of Cuban origin, alcohol (31 percent) was followed by cocaine (25 percent), marijuana (18 percent), opiates (17 percent), and stimulants (5 percent) [Table 3.1b].
• Among Alaska Natives, alcohol (41 percent) was followed by opiates (27 percent), marijuana (12 percent), cocaine (10 percent), and stimulants (8 percent). [Table 3.1b].
• Among American Indians, alcohol (59 percent) was followed by marijuana (13 percent), stimulants (9 percent), opiates (7 percent), and cocaine (6 percent) [Table 3.1b].
• Among Asians/Pacific Islanders, alcohol (33 percent) was followed by stimulants (28 percent), marijuana (19 percent), opiates (9 percent), cocaine (8 percent) [Table 3.1b].

Adolescent Substance Abuse

• The number of adolescents aged 12 to 17 admitted to substance abuse treatment increased 43 percent between 1994 and 2004 [Table 5.1a].
• The increase in adolescent substance abuse treatment admissions was largely accounted for by the increase in the number of adolescent primary marijuana admissions (115 percent between 1994 and 2004). The proportion of adolescent primary marijuana admissions grew from 43 percent of adolescent admissions in 1994 to 64 percent in 2004 [Tables 5.1a and 5.1b].
• In 2004, more than half (51 percent) of adolescent admissions were referred to treatment through the criminal justice system. Seventeen percent were self- or individual referrals, and 11 percent were referred through schools [Table 5.3a].
• The number of adolescent substance abuse treatment admissions referred through the criminal justice system increased by 81 percent between 1994 and 2004, while admissions referred through other sources increased by 15 percent between 1994 and 2004 [Table 5.5a].

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