Chapter 2
Trends in Substance Abuse Treatment Admissions: 1996-2006

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 1996 and 2006, 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 1996 through 2006.

Figure 1
Primary substance of abuse at admission:
TEDS 1996-2006

Line chart comparing Primary substance of abuse at admission in 
TEDS 1996 to 2006

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.9.07.


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 2006, 39 percent of all admissions reported problems with both alcohol and drugs—21 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 51 percent of TEDS admissions in 1996 to 40 percent in 2006. Primary drug abuse increased from 47 percent in 1996 to 58 percent in 2005 and 2006. 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 1996-2006

Stacked bar chart comparing Co-abuse of alcohol and drugs 
at admission in TEDS 1996 to 2006

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.9.07

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 1996 to 2006.

For the maps in Figures 3-8, the median, 75th, 90th, and 99th percentiles of the range of 1996 admission rates for each substance were used to establish the rate categories used in the legend. Therefore, for the 45 States reporting in 1996, each 1996 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 1996 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 (2004-2006), Arizona (1996-1997), the District of Columbia (2004-2006), Georgia (2006), Indiana (1997), Kentucky (1996), Vermont (2006), West Virginia (1997-1998 and 2000), and Wyoming (1996).

In addition, significant changes in the clients or facilities reported to TEDS by some States and jurisdictions resulted in changes in the number of admissions large enough to influence trends for at least one year from 1996 to 2006. For these States, rates are not indicated on the maps for the years affected: the District of Columbia (1996), Idaho (2005), Louisiana (1997), Texas (1996), Virginia (1997-1998), and West Virginia (1996). The actual data reported, however, are included in all tables.

Finally, Tennessee included heroin admissions among admissions for opiates other than heroin2 beginning in 1998. Therefore Tennessee is excluded from the Heroin and Opiates other than heroin2 maps beginning in 1998.


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.

3The U.S. Census Bureau divides the United States into nine census divisions:
New England—Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont
Middle 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

US Maps comparing primary alcohol admission rates by State in TEDS 1996 to 2006

 

Us maps comparing Primary heroin admission rates by State in TEDS 1996 to 2006

 

Us maps comparing Primary non-heroin opiates/synthetics admission rates by State in TEDS 1996 to 2006

 

US maps comparing Primary cocaine admission rates by State in TEDS 1996 to 2006

 

US maps comparing Primary marijuana admission rates by State in TEDS 1996 to 2006

 

US maps comparing Primary methamphetamine/amphetamine admission rates by State in TEDS 1996 to 2006

 

Trends in Demographic Characteristics

Table 2.9b. Males represented 68 percent of TEDS admissions in 2006, a proportion that declined slightly from 71 percent in 1996. 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 1996 and 2006. The proportion of TEDS admissions aged 25 to 34 years declined from 34 percent in 1996 to 25 percent in 2006. 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 13 percent in 1996 to 22 percent in 2006. The proportion of younger admissions (less than 25 years of age) increased from 22 percent in 1996 to 26 percent in 2006. (The population of TEDS admissions aged 35 to 44 years increased from 31 percent in 1996 to between 32 and 33 percent from 1997 through 2001. The proportion began a small, but steady decline from 31 percent in 2002 to 27 percent in 2006.)

The age distribution of TEDS treatment admissions was different from that of the U.S. population. In 2006, 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 1996-2006

Line chart comparing Age at admission in TEDS 1996 to 2006

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.9.07.

Table 2.9b and Figure 10. The racial/ethnic composition of TEDS admissions changed very little between 1996 and 2006. Non-Hispanic Whites made up 58 to 60 percent of admissions throughout the time period. The proportion of nonHispanic Blacks declined slightly, from 26 percent of admissions in 1996 to 21 percent in 2006. This was offset by increases in the proportions of admissions of Hispanic origin (from 10 percent in 1996 to 14 percent in 2006) and for other racial/ethnic groups combined (from 4 percent in 1996 to 5 percent in 2006).

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 59 percent of TEDS admissions in 2006 compared to 66 percent of the U.S. population. Non-Hispanic Blacks represented 21 percent of TEDS admissions in 2006 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 (14 percent). Other racial/ethnic groups made up 5 percent of TEDS admissions and 6 percent of the U.S. population.

Figure 10
Race/ethnicity of admissions: TEDS 1996-2006

Line chart comparing Race/ethnicity of admissions in TEDS 1996 to 2006

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.9.07.

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 70 percent (74 percent adjusted) of 2006 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 22 percent (18 percent adjusted) were employed full time compared to 53 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 1996 to 22 percent in 2006.

The proportion of TEDS admissions that were unemployed declined from 26 percent in 1996 to a low of 24 percent in 1999 and 2000, but increased to 32 percent by 2006.


4 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.

Figure 11
Employment status at admission, aged 16 and over: TEDS 1996-2006

Line chart comparing Employment status at admission, aged 16 and over in TEDS 1996 to 2006

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.9.07.

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 2006, some 33 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—23 percent (27 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 1996 to 2006.

Figure 12
Education at admission, aged 18 and over: TEDS 1996-2006

Line chart comparing Education at admission, aged 18 and over in TEDS 1996 to 2006

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.9.07.

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