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CHAPTER 2

OVERVIEW AND TRENDS: 1992-1996 1

Trend data are invaluable in monitoring changing patterns in substance abuse treatment admissions. These patterns reflect underlying changes in substance use in the population, and have important implications for resource allocation and program planning.

Long-Term Trends in Drug Abuse Admissions

Long-term trends at the national level indicate the importance of trend data in substance use surveillance (Figure 1 and Table 2.1). A significant change in drug use, and consequently in treatment needs, occurred during the 1980s, when national-level treatment admissions data were not collected.

Figure 1. Long-Term Trends in Drug Abuse Admissions2
CODAP 1979-1981 and TEDS 1992-1996

Cocaine (primarily smoked cocaine) emerged as the dominant substance among TEDS admissions for drug use. Comparison of the TEDS (1992-1996) and CODAP (1979-1981) data sets clearly indicates the increase in cocaine-related admissions during the 1980s. Treatment for abuse of prescription-type drugs (sedatives and tranquilizers), which in 1981 represented 9 percent of CODAP drug admissions, represented 1 percent of TEDS drug admissions in 1996. Stimulants (which include both licit and illicit drugs) represented 8 percent of drug admissions in 1981, and had fallen to 4 percent in 1992. However, stimulant admissions had increased to 8 percent of drug admissions by 1996.

Trends in the Co-Abuse of Alcohol and Drugs

The concurrent abuse of alcohol and other drugs is a significant problem. Primary alcohol abuse represented between 50 and 60 percent of TEDS admissions from 1992-1996 (Table 2.2). However, some 40 percent of these admissions reported secondary drug use. Similarly, nearly half of all primary drug admissions report problems with alcohol as well.

Figure 2. Trends in the Co-Abuse of Alcohol and Drugs
TEDS 1992-1996

In 1996, over 40 percent of TEDS admissions reported abuse of both alcohol and drugs (Figure2). The proportion of admissions for alcohol use alone declined from 1992-1996. However, this may reflect changing priorities in the treatment system rather than a change in substance use patterns. Limited resources and targeted programs may influence States to selectively fund treatment for drug abusers.

Trends in Primary Substance of Abuse

Treatment admissions are dominated by four substances that together account for over 90 percent of all TEDS admissions. These are alcohol, cocaine, opiates (primarily heroin), and marijuana/hashish (Figure 3 and Table 2.3).

Figure 3. Trends in Primary Substance of Abuse
TEDS 1992-1996

Trends in Demographic Characteristics

Figure 4. Trends in Age at Admission
TEDS 1992-1996 and U.S. Population 1996

Figure 5. Trends in Race/Ethnicity
TEDS 1992-1996 and U.S. Population 1996

The racial/ethnic composition of TEDS admissions has remained fairly constant since 1992, at about 60 percent non-Hispanic white, 25 percent non-Hispanic black, 11 percent Hispanic, and 4 percent other groups.

Trends in Socio-Economic Status

TEDS admissions are socio-economically disadvantaged compared to the U.S. population. This is evident in the unadjusted distributions of employment status and education (Table 2.5). Because TEDS admissions are different demographically from the U.S. population, the distributions have been statistically adjusted to provide a more valid comparison to the U.S. population.3 The adjusted distributions indicate an even greater disparity than do the unadjusted.

Figure 6. Trends in Employment Status
TEDS4 1992-1996 and U.S. Population 1996