Chapter 3

Topics of Special Interest

Adolescent Admissions to Substance Abuse Treatment
Trends in Heroin Admissions and Medication-Assisted Opioid Therapy
Polydrug Abuse
Racial/Ethnic Subgroups

This chapter highlights topics that are of current or special interest:

TEDS data indicate that admissions to substance abuse treatment aged 12 to 17 increased by 13 percent between 1998 and 2002, but declined by 10 percent between 2002 and 2008. Almost 80 percent of adolescent treatment admissions involved marijuana as a primary or secondary substance, and about 40 percent were referred to treatment through the criminal justice system.

The number of TEDS admissions for primary heroin abuse increased by 8 percent between 1998 and 2008. However, while the number of admissions aged 35 and older remained stable, the number younger than age 35 increased by 16 percent. Among non-Hispanic Whites under age 35, the number of admissions for primary heroin abuse increased by 65 percent; the number of admissions among non-Hispanic Blacks declined by by a similar percentage.

The proportion of heroin admissions receiving medication-assisted opioid therapy (opioid therapy using methadone or buprenorphine) declined from 40 percent in 1998 to 26 percent in 2008.

Polydrug abuse (the use of more than one substance) was more common among TEDS admissions than was abuse of a single substance.

TEDS data indicate that substance abuse patterns differed widely among racial/ethnic subgroups; however, alcohol was the predominant substance for all racial/ethnic groups except persons of Puerto Rican origin, where the predominant substance was heroin.

 

Adolescent Admissions to Substance Abuse Treatment

Table 3.1 and Figure 19. The number of adolescent admissions aged 12 to 17 increased by 13 percent from 1998 to 2002, then declined by 10 percent from 2002 to 2008


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

 

Table 3.2. Overall, 70 percent of adolescent admissions were male, a proportion heavily influenced by the 76 percent of marijuana admissions that were male. The proportion of female admissions was greater than 40 percent for most other substances. There were more female than male adolescent admissions for methamphetamine/amphetamine (56 percent) and heroin (51 percent).

Half (50 percent) of adolescent admissions were non-Hispanic White, 21 percent were Hispanic, 19 percent were non-Hispanic Black, and 9 percent were of other racial/ethnic groups.

Table 3.3. The number of adolescent admissions increased with age; 1 percent were 12 years old, increasing to 32 percent who were age 17. Among admissions for inhalants, 20 percent were aged 12 or 13. Among admissions for heroin and for opiates other than heroin, 62 percent and 50 percent, respectively, were age 17.

In 2008, almost half (48 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.

Figure 19
Adolescent admissions by primary substance: TEDS 1998-2008

Line chart comparing Adolescent admissions by primary substance: TEDS 1998-2008

Table 3.4 and Figure 20. An admission was considered marijuana-involved if marijuana was reported as a primary, secondary, or tertiary substance. In 1998, similar proportions (38 percent each) of marijuana-involved adolescent admissions were referred to treatment by the criminal justice system and by other sources. Between 1998 and 2002, the proportion referred by the criminal justice system increased to 42 percent while the proportion referred by other sources decreased to 34 percent. In 2007 and 2008, the proportions began to converge.

Adolescent admissions not involving marijuana and referred by the criminal justice system fell from 11 percent in 1998 to 8 percent in 2008. Admissions not involving marijuana referred from other sources were fairly stable, at between 12 and 14 percent of adolescent admissions.

Figure 20
Adolescent admissions by marijuana involvement and criminal justice referral: TEDS 1998-2008

Line chart comparing Adolescent admissions by marijuana involvement and criminal justice referral: TEDS 1998-2008

 

Trends in Heroin Admissions and Medication-Assisted Opioid Therapy

General measures of heroin abuse among treatment admissions were relatively consistent from 1998 through 2008. Primary heroin abuse accounted for 14 to 16 percent of TEDS admissions in every year from 1998 through 2008. Injection was the preferred route of administration for 60 to 65 percent of heroin admissions, inhalation by 30 to 34 percent, and smoking or other route by 4 to 5 percent. The majority of heroin admissions were 35 years of age or older (54 to 55 percent from 1998 through 2007 and 52 percent in 2008).

However, these measures conceal substantial changes in the age, race/ethnicity, and route of administration of heroin-using sub-populations.

Table 3.5 and Figure 21. TEDS data indicate that heroin abuse has been increasing among young non-Hispanic White adults. Among non-Hispanic Blacks, however, admissions have declined except among older admissions.

Figure 21
Heroin admissions by age group and race/ethnicity: TEDS 1998-2008

Line chart comparing Heroin admissions by age group and race/ethnicity: TEDS 1998-2008

Table 3.6 and Figure 22. Route of administration of heroin was closely linked to age and race/ ethnicity. Injection increased among young adults; inhalation increased among the those 45 and older.

Figure 22
Heroin admissions by route of administration and age group: TEDS 1998-2008

Line chart comparing Heroin admissions by route of administration and age group: TEDS 1998-2008

Table 3.7 and Figures 23 and 24. Medication-assisted opioid therapy (opioid therapy using methadone or buprenorphine) declined among TEDS admissions for heroin abuse between 1998 and 2008.

Figure 23
Medication-assisted opioid therapy by route of heroin administration: TEDS 1998-2008

Line chart comparing Medication-assisted opioid therapy by route of heroin administration: TEDS 1998-2008

Figure 24
Medication-assisted opioid therapy by age group: TEDS 1998-2008

Line chart comparing Medication-assisted opioid therapy by age group: TEDS 1998-2008

 

Polydrug Abuse

Polydrug abuse (the use of more than one substance) was more common among TEDS admissions than was abuse of a single substance.

Table 3.8 and Figure 25. Polydrug abuse was reported by 55 percent of all TEDS admissions in 2008. Alcohol, marijuana, and cocaine were the most commonly reported secondary and tertiary substances.

Table 3.9. This table details the most common substance combinations for selected primary substances. For example, for primary alcohol admissions, 56 percent reported abuse of alcohol alone, 15 percent reported abuse of alcohol and marijuana but no other drugs, and 6 percent reported primary abuse of alcohol with abuse of cocaine and marijuana as secondary and tertiary substances.

Figure 25
Primary and secondary/tertiary substance abuse: TEDS 2008

Stacked bar chart comparing Primary and secondary/tertiary substance abuse: TEDS 2008

 

Racial/Ethnic Subgroups

Table 2.3b and Figures 26-31. TEDS data indicate that substance abuse patterns differed widely among racial/ethnic subgroups. Among Hispanics, substance abuse patterns differed according to country of origin. Patterns also differed between men and women within subgroups.

Figure 26
White (non-Hispanic)
Admissions by gender, primary substance, and age: TEDS 2008

Line chart comparing White (non-Hispanic) Admissions by gender, primary substance, and age: TEDS 2008

Figure 27
Black (non-Hispanic)
Admissions by gender, primary substance, and age: TEDS 2008

Line chart comparing Black (non-Hispanic) Admissions by gender, primary substance, and age: TEDS 2008

Figure 28
Mexican origin
Admissions by gender, primary substance, and age: TEDS 2008

Line chart comparing Mexican origin Admissions by gender, primary substance, and age: TEDS 2008

Figure 29
Puerto Rican origin
Admissions by gender, primary substance, and age: TEDS 2008

Line chart comparing Puerto Rican origin Admissions by gender, primary substance, and age: TEDS 2008

Figure 30
American Indian/Alaska Native
Admissions by primary substance, gender, and age: TEDS 2008

Line chart comparing American Indian/Alaska Native
Admissions by primary substance, gender, and age: TEDS 2008

Figure 31
Asian/Pacific Islander
Admissions by gender, primary substance, and age: TEDS 2008

Line chart comparing Asian/Pacific Islander
Admissions by gender, primary substance, and age: TEDS 2008

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