Chapter 1

Trends in Substance Abuse Treatment Admissions
Aged 12 and Older: TEDS 1999-2009

All Admissions

Selcted Primary Substance

This report presents data from the Treatment Episode Data Set (TEDS) by Census division and State or jurisdiction for admissions in 2009 and trend data for 1999 to 2009. It is a companion to the report, Treatment Episode Data Set (TEDS): 1999-2009 National Admissions to Substance Abuse Treatment. These reports provide 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. Data include records for admissions during calendar years 1999 through 2009 that were received and processed through November 3, 2010.1

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 admissions to 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. Additional information on the history and methodology of TEDS and this report as well as important issues related to State data collection systems are detailed in Appendix A.

This chapter details trends in the annual numbers and rates of admissions aged 12 and older for 1999 to 2009. Trend data are invaluable in monitoring changing patterns in substance abuse treatment admissions. These patterns reflect underlying changes in substance abuse in the population as well as changing priorities in the treatment/reporting system. (For example, limited resources and targeted programs may result in a shift of State funds from treatment of alcohol abusers to treatment of drug abusers.) TEDS data thus have important implications for resource allocation and program planning.

While the tables in this report present data by Census division (Figure 1) and by State or jurisdiction, it is important to note that comparisons between and across divisions and States should be made with caution. There are many factors (e.g., facilities included, clients included, ability to track multi-service episodes, services offered, and completeness and timeliness of reporting) that can affect comparability. See Appendix A for a full discussion.

Figure 1. U.S. Census divisions

Map depicting the nine U.S. Census divisions

All Admissions

Table 1.1 presents the total number of treatment admissions aged 12 and older by Census division and State or jurisdiction for 1999 through 2009.2

Table 1.2 presents the treatment admissions rates per 100,000 population aged 12 and older by Census division and State or jurisdiction for 1999 through 2009.

Table 1.3 presents the treatment admission rate adjusted for age, gender, and race/ethnicity to the U.S. 2000 population by Census division and State or jurisdiction for 1999 through 2009. Adjustment is a way to make fairer comparisons when there are different admission rates among population subgroups and different proportions of the subgroups in each division, State, or jurisdiction. The adjusted rates are the rates that would have been seen if each division, State, or jurisdiction had the same distribution of subgroups as the U.S. 2000 population.

For example, the 2009 unadjusted rates (Table 1.2) for Delaware and Ohio were 1,043 and 1,020 per 100,000 population aged 12 and older, respectively—these two States had similar rates. However, the adjusted rates (1,078 per 100,000 for Delaware and only 525 per 100,000 for Ohio; Table 1.3) indicate that, if the population distribution in the two States were similar, Ohio's admission rate would be 50 percent lower than Delaware's. This is because Ohio had high admission rates in subgroups that were a large proportion of the State's population but represented relatively small proportions of the U.S. population. In contrast, Delaware's population distribution very closely resembles the U.S. population. This example clearly demonstrates that if Ohio's 2009 population distribution were similar to that of the United States in 2000, then one would expect the admission rate to be about half of what it actually was in 2009.

Selected Primary Substance

Six substance groups (alcohol, marijuana, heroin, cocaine, methamphetamine/amphetamines, and opiates other than heroin)3 accounted for 96 percent of all TEDS admissions aged 12 and older in 2009.4

Tables 1.4a–1.9a present the numbers of admissions aged 12 and older by Census division and by State and jurisdiction from 1999 through 2009 for each of the selected primary substances.

Tables 1.4b–1.9b present the admission rate per 100,000 aged 12 and older by Census division and by State and jurisdiction from 1999 through 2009 for each of the selected primary substances.

The admission rates are mapped in Figures 2–7. The map categories are based on the median, 75th, 90th, and 99th percentiles of the range of 1999 admission rates for each substance. Therefore, for the 51 States and jurisdictions reporting in 1999, each 1999 map generally shows 1 State in dark red (the 99th percentile and above), about 5 States in red (the 90th to 98th percentiles), about 8 States in orange (the 75th to 89th percentiles), 12 States in gold (the 50th to 74th percentiles), and 25 States in cream (below the median 1999 U.S. rate). Cross hatching indicates States or jurisdictions where data were not submitted or were incomplete.

Alcohol

Marijuana

Heroin

Cocaine

Methamphetamine/amphetamine

Opiates other than heroin

United States maps comparing Primary alcohol addmission rates, by state or jurisdiction: 1999-2009 (per 100,000 population aged 12 and over)



United States maps comparing Primary marijuana addmission rates, by state or jurisdiction: 1999-2009 (per 100,000 population aged 12 and over)


United States maps comparing Primary heroin addmission rates, by state or jurisdiction: 1999-2009 (per 100,000 population aged 12 and over)


United States maps comparing Primary cocaine addmission rates, by state or jurisdiction: 1999-2009 (per 100,000 population aged 12 and over)


United States maps comparing Primary methamphetamine/amphetamine addmission rates, by state or jurisdiction: 1999-2009 (per 100,000 population aged 12 and over)


United States maps comparing Primary non-heroin opiates addmission rates, by state or jurisdiction: 1999-2009 (per 100,000 population aged 12 and over)

[To Chapter 1 Tables]


1For researchers interested in more detailed analysis, TEDS public use files are available for online data analysis or download at the Substance Abuse and Mental Health Data Archive, which can be accessed at http://www.datafiles.samhsa.gov.
Summary 2009 data for individual States that have submitted the full year of data are available online through the TEDS Quick Statistics website at http://wwwdasis.samhsa.gov/webt/NewMapv1.htm.

2 Data were not submitted or were incomplete for one or more years in some States or jurisdictions because of changes to their data collection systems: Alabama (2007-2008), Alaska (2004-2007), Arkansas (2004), the District of Columbia (2004-2007, 2009), Georgia (2006-2009), Puerto Rico (1999-2002), West Virginia (2000-2002). The populations of these States were excluded from calculations of admission rate by Census division.
3 Opiates other than heroin include methadone, codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, propoxyphene, tramadol, and any other drug with morphine-like effects.
4 See: Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). 1999 - 2009. National Admissions to Substance Abuse Treatment Services, DASIS Series: S-56, HHS Publication No. (SMA) 11-4646, Rockville, MD; Substance Abuse and Mental Health Services Administration, 2011, Table 1.1b.
5 Tennessee reported all heroin admissions as Opiates other than heroin for 1999 through June 2009. Tennessee began disaggregating heroin admissions from other opiates in July 2009. In this report, all Tennessee's heroin admissions are included in the other opiates category since there is less than a full year of disaggregated heroin data. Therefore, Tennessee's admissions are not included in this comparison and not included in the associated map (Figure 4).

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