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 15 percent between 1999 and 2002, but declined by 5 percent between 2002 and 2009. In 2009, 86 percent of adolescent treatment admissions involved marijuana as a primary or secondary substance, and 43 percent were referred to treatment through the criminal justice system.

The number of TEDS admissions for primary heroin abuse increased by 10 percent between 1999 and 2009.

The proportion of heroin admissions whose treatment plans included medication-assisted opioid therapy (opioid therapy using methadone or buprenorphine) declined from 38 percent in 1999 to 28 percent in 2009.

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

Tables 3.1a and 3.1b and Figure 19. The number of adolescent admissions aged 12 to 17 increased by 15 percent from 1999 to 2002, then declined by 5 percent from 2002 to 2009.

Table 3.2. In 2009, overall 71 percent of adolescent admissions were male, a proportion heavily influenced by the 77 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/amphetamines (57 percent).

Almost half (48 percent) of adolescent admissions were non-Hispanic White, 23 percent were of Hispanic origin, 20 percent were non-Hispanic Black, and 9 percent were of other racial/ethnic groups.


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

Figure 19. Adolescent admissions, by primary substance: 1999-2009

Figure 19. Line chart comparing Adolescent admissions, by primary substance: 1999-2009

Table 3.3. The number of adolescent admissions increased with age; 1 percent were 12 years old, increasing to 33 percent who were age 17. Among admissions for inhalants, 21 percent were aged 12 or 13. Among admissions for heroin and for opiates other than heroin, 63 percent and 46 percent, respectively, were age 17.

In 2009, almost half (49 percent) of adolescent admissions were referred to treatment through the criminal justice system. Sixteen percent were self- or individual referrals, and 12 percent were referred through schools.

Table 3.4 and Figure 20. An admission was considered marijuana-involved if marijuana was reported as a primary, secondary, or tertiary substance. In 1999, 43 percent of all adolescent admissions were marijuana-involved admissions referred to treatment by the criminal justice system, and 39 percent were marijuana involved but referred by other sources. Between 1999 and 2002, the proportion referred by the criminal justice system increased to 45 percent while the proportion referred by other sources decreased to 37 percent. The proportions started to converge in 2007.

Adolescent admissions not involving marijuana that were referred by the criminal justice system fell from 8 percent in 1999 to 5 percent in 2009. Admissions not involving marijuana that were referred from other sources were fairly stable, at between 9 and 11 percent of adolescent admissions.

Figure 20. Adolescent admissions, by marijuana involvement and criminal justice referral: 1999-2009

Figure 20. Line chart comparing Adolescent admissions, by marijuana involvement and criminal justice referral: 1999-2009

Trends in Heroin Admissions and Medication-Assisted Opioid Therapy

General measures of heroin abuse among treatment admissions were relatively consistent from 1999 through 2009. Primary heroin abuse accounted for 14 to 16 percent of TEDS admissions in every year from 1999 through 2009. Injection was the preferred route of administration for 60 to 67 percent of primary heroin admissions, inhalation for 29 to 34 percent, and smoking or other route for 4 to 5 percent. The majority of primary heroin admissions were 35 years of age or older (54 to 56 percent from 1999 through 2007 and 48 percent in 2009).

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

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 aged 12 and older, by age group and race/ethnicity: 1999-2009

Figure 21. Line chart comparing Heroin admissions aged 12 and older, by age group and race/ethnicity: 1999-2009

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 those 45 and older.

Figure 22. Heroin admissions aged 12 and older, by route of administration and age group: 1999-2009

Figure 22. Line chart comparing  Heroin admissions aged 12 and older, by route of administration and age group: 1999-2009

Table 3.7 and Figures 23 and 24. Planned use of medication-assisted opioid therapy (opioid therapy using methadone or buprenorphine) declined among TEDS admissions for heroin abuse between 1999 and 2009.

Figure 23. Heroin admissions aged 12 and older receiving medication-assisted opioid therapy, by route of heroin administration: 1999-2009

Figure 23. Line chart comparing Heroin admissions aged 12 and older receiving medication-assisted opioid therapy, by route of heroin administration: 1999-2009

Figure 24. Heroin admissions aged 12 and older receiving medication-assisted opioid therapy, by age group: 1999-2009

Figure 24. Line chart comparing Heroin admissions aged 12 and older receiving medication-assisted opioid therapy, by age group: 1999-2009

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 54 percent of TEDS admissions aged 12 or older in 2009. Marijuana, alcohol, and cocaine were the most commonly reported secondary and tertiary substances.

Abuse of alcohol as a primary, secondary, or tertiary substance was characteristic of most treatment admissions. Forty-two percent of all treatment admissions were for primary alcohol abuse, and 19 percent of admissions for primary drug abuse reported that they also had an alcohol problem. Overall, 61 percent of all treatment admissions reported alcohol as a substance of abuse.

Figure 25. Primary and secondary/tertiary substance of abuse: 2009

Figure 25. Stacked bar chart comparing Primary and secondary/tertiary substance of abuse: 2009

Racial/Ethnic Subgroups

Table 2.3b and Figures 26-31. TEDS data indicate that substance abuse patterns differed widely among racial/ethnic subgroups. Among admissions of Hispanic origin, 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: 2009

Figure 26. Line chart comparing White (non-Hispanic) admissions, by gender, primary substance, and age: 2009

Figure 27. Black (non-Hispanic) admissions, by gender, primary substance, and age: 2009

Figure 27. Line chart comparing Black (non-Hispanic) admissions, by gender, primary substance, and age: 2009

Figure 28. Mexican origin admissions, by gender, primary substance, and age: 2009

Figure 28. Line chart comparing Mexican origin admissions, by gender, primary substance, and age: 2009

Figure 29. Puerto Rican origin admissions, by gender, primary substance, and age: 2009

Figure 29. Line chart comparing Puerto Rican origin admissions, by gender, primary substance, and age: 2009

Figure 30. American Indian/Alaska Native admissions, by gender, primary substance, and age: 2009

Figure 30. Line chart comparing American Indian/Alaska Native admissions, by gender, primary substance, and age: 2009

Figure 31. Asian/Pacific Islander admissions, by gender, primary substance, and age: 2009

Figure 31. Line chart comparing Asian/Pacific Islander admissions, by gender, primary substance, and age: 2009

TO TABLES

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