This report presents national-level data from the Treatment Episode Data Set (TEDS) for admissions in 2008, and trend data for 1998 to 2008. The report provides information on the demographic and substance abuse characteristics of admissions to treatment aged 12 and older for abuse of alcohol and/or 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 substance groups accounted for 96 percent of the 1,893,640 TEDS admissions aged 12 and older in 2008: alcohol (41 percent), opiates (20 percent), marijuana (17 percent), cocaine (11 percent), and methamphetamine/amphetamine (6 percent) [Table 1.1].¹

Alcohol

• Alcohol admissions declined steadily from 49 percent of admissions aged 12 and older in 1998 to 39 percent in 2005, but then increased steadily to 41 percent in 2008. In 2008, 44 percent of primary alcohol admissions aged 12 and older reported secondary drug abuse as well [Table 1.1].
• Admissions for abuse of alcohol alone represented 23 percent of TEDS admissions aged 12 and older in 2008, while admissions for primary alcohol abuse with secondary drug abuse represented 18 percent [Table 1.1].
• Almost three-quarters of admissions for abuse of alcohol alone and for abuse of alcohol with secondary drug abuse were male (73 percent each) [Table 2.1].
• The average age at admission among alcohol-only admissions was 40 years, compared with 36 years among admissions for primary alcohol with secondary drug abuse [Table 2.1].
• More than two-thirds (69 percent) of alcohol-only admissions were non-Hispanic White, followed by Hispanics (13 percent) and non-Hispanic Blacks (12 percent). Among admissions for alcohol with secondary drug abuse, 60 percent were non-Hispanic White, followed by 23 percent who were non-Hispanic Black and 11 percent who were Hispanic [Table 2.2].

Heroin

• Heroin admissions increased from 14 percent of admissions aged 12 and older in 1998 to 16 percent in 2001. They declined to 13 percent in 2007 and 14 percent in 2008 [Table 1.1].
• Heroin represented 93 percent of all opiate admissions in 1998 but declined steadily to 71 percent in 2008 [Table 1.1].
• About two-thirds (68 percent) of primary heroin admissions were male [Table 2.1].
• For primary heroin admissions, the average age at admission was 36 years [Table 2.1].
• More than half (56 percent) of primary heroin admissions were non-Hispanic White, followed by 20 percent each who were of Hispanic origin or were non-Hispanic Black [Table 2.2].
• Sixty-five percent of primary heroin admissions reported injection as the route of administration, and 31 percent reported inhalation [Table 2.4].

Opiates Other than Heroin²

• Opiates other than heroin increased from 1 percent of admissions aged 12 and older in 1998 to 6 percent in 2008.
• Opiates other than heroin represented 7 percent of all opiate admissions in 1998 but rose to 29 percent in 2008 [Table 1.1].
• Just over half (53 percent) of primary non-heroin opiate admissions were male [Table 2.1].
• For primary non-heroin opiate admissions, the average age at admission was 32 years [Table 2.1].
• Most primary non-heroin opiate admissions (89 percent) were non-Hispanic White [Table 2.2].
• More than two-thirds (69 percent) of primary non-heroin opiate admissions reported oral as the route of administration, while 17 percent reported inhalation and 11 percent reported injection [Table 2.4].

Marijuana/Hashish

• Marijuana admissions increased from 13 percent in 1998 to 17 percent in 2008 [Table 1.1].
• Nearly three-quarters (74 percent) of primary marijuana admissions were male [Table 2.1].
• For primary marijuana admissions, the average age at admission was 24 years [Table 2.1].
• Almost half (49 percent) of primary marijuana admissions were non-Hispanic White, 30 percent were non-Hispanic Black, and 15 percent were of Hispanic origin [Table 2.2].

Cocaine/Crack

• Cocaine admissions declined from 15 percent in 1998 to 11 percent in 2008. Smoked cocaine (crack) represented 71 percent of all primary cocaine admissions in 2008, down from 74 percent in 1998 [Table 1.1].
• Fifty-seven percent of primary smoked cocaine admissions were male compared with 65 percent of primary non-smoked cocaine admissions [Table 2.1].
• The average age at admission among smoked cocaine admissions was 40 years, compared with 34 years among non-smoked cocaine admissions [Table 2.1].
• Among primary smoked cocaine admissions, 50 percent were non-Hispanic Black, 39 percent were non-Hispanic White, and 8 percent were of Hispanic origin. Among primary non-smoked cocaine admissions, 52 percent were non-Hispanic White, followed by non-Hispanic Blacks (24 percent) and admissions of Hispanic origin (20 percent) [Table 2.2].
• Eighty-two percent of primary non-smoked cocaine admissions reported inhalation as their route of administration and 10 percent reported injection [Table 2.4].

Methamphetamine/Amphetamine

• Methamphetamine/amphetamine admissions (about 95 percent of these admissions were for methamphetamine in States that reported both) increased from 4 percent of all admissions in 1998 to 9 percent in 2005, but then decreased to 6 percent in 2008 [Table 1.1].
• For primary methamphetamine/amphetamine admissions, the average age at admission was 33 years [Table 2.1].
• Fifty-five percent of primary methamphetamine/amphetamine admissions were male [Table 2.1].
• Almost two-thirds (65 percent) of primary methamphetamine/amphetamine admissions were non-Hispanic White, followed by 21 percent who were of Hispanic origin [Table 2.2].
• Sixty-six percent of primary methamphetamine/amphetamine admissions reported smoking as the route of administration, 19 percent reported injection, and 9 percent reported inhalation [Table 2.4].

Adolescent Admissions to Substance Abuse Treatment

• 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 [Table 3.1].
• Almost half (48 percent) of adolescent treatment admissions were referred to treatment through the criminal justice system [Table 3.3].
• About four in five (79 percent) of adolescent treatment admissions involved marijuana as a primary or secondary substance [Table 3.4].

Trends in Heroin Admissions and Medication-Assisted Opioid Therapy

• The proportion of non-Hispanic Whites aged 20 to 34 among heroin admissions increased from just over 1 in 5 (22 percent) in 1998 to more than 1 in 3 (35 percent) in 2008 [Table 3.5].
• The proportion of injectors aged 20 to 34 among heroin admissions increased from about 1 in 4 (24 percent) in 1998 to more than 1 in 3 (34 percent) in 2008. During that period, the proportion of injectors aged 35 to 44 fell from 25 percent to 14 percent [Table 3.6].
• The proportion of heroin admissions receiving medication-assisted opioid therapy fell from 40 percent in 1998 to 30 percent in 2008 [Table 3.7].

Polydrug Abuse

• Polydrug abuse was reported by 55 percent of all TEDS admissions in 2008 [Table 3.8].
  • Alcohol, opiates, and methamphetamine/amphetamines were reported more often as primary substances than as secondary or tertiary substances.
  • Marijuana and cocaine were reported more often as secondary or tertiary substances than as primary substances.

Race/Ethnicity

Alcohol was the most frequently reported primary substance at treatment admission among all racial/ethnic groups except admissions of Puerto Rican origin. However, the proportions reporting primary use of the other four most common substances varied considerably by racial/ethnic group [Table 2.2].

• Among non-Hispanic Whites, alcohol (45 percent) was followed by opiates (22 percent), marijuana (14 percent), cocaine (8 percent), and methamphetamine/amphetamines (7 percent).
• Among non-Hispanic Blacks, alcohol (32 percent) was followed by marijuana (24 percent), cocaine (23 percent), opiates (15 percent), and methamphetamine/amphetamines (1 percent).
• Among persons of Mexican origin, alcohol (38 percent) was followed by marijuana (21 percent), methamphetamine/amphetamines (18 percent), opiates (13 percent), and cocaine (8 percent).
• Among persons of Puerto Rican origin, opiates (43 percent) were followed by alcohol (29 percent), marijuana (15 percent), cocaine (11 percent), and methamphetamine/amphetamines (1 percent).
• Among American Indians/Alaska Natives, alcohol (65 percent) was followed by marijuana (13 percent), opiates (8 percent), methamphetamine/amphetamines (7 percent), and cocaine (4 percent).
• Among Asians/Pacific Islanders, alcohol (38 percent) was followed by methamphetamine/amphetamines (21 percent), marijuana (20 percent), opiates (10 percent), and cocaine (7 percent).

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