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The number of annual benzodiazepine and narcotic pain reliever combination admissions increased 569.7 percent from 5,032 admissions in 2000 to 33,701 admissions in 2010 (Figure 1). By contrast, the annual number of other admissions decreased by 9.6 percent during the same period (from 1,675,736 to 1,514,940 admissions from 2000 to 2010).
2000 | 2001 | 2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 |
---|---|---|---|---|---|---|---|---|---|---|
5,032 | 6,715 | 8,130 | 9,287 | 10,370 | 11,883 | 13,935 | 16,413 | 21,390 | 27,028 | 33,701 |
Source: SAMHSA Treatment Episode Data Set (TEDS), 2000 to 2010. |
In 2010, 43.1 percent of benzodiazepine and narcotic pain reliever combination admissions occurred in the South, while only 5.3 percent occurred in the West.
The 2010 demographic profile of benzodiazepine and narcotic pain reliever combination admissions shows that most of these admissions were non-Hispanic White (91.4 percent; Table 1). Benzodiazepine and narcotic pain reliever combination admissions were almost evenly divided between females and males (49.2 and 50.8 percent, respectively). The average age of benzodiazepine and narcotic pain reliever combination admissions was 31.2 years; 66.9 percent were aged 18 to 34 (Figure 2).
Demographic Characteristic | Benzodiazepine and Narcotic Pain Reliever Combination Admissions (%) |
Other Admissions (%) |
---|---|---|
Race/Ethnicity | ||
Non-Hispanic White | 91.4% | 55.8% |
Hispanic | 3.6% | 14.5% |
Non-Hispanic Black | 2.5% | 23.2% |
American Indian/Alaska Native | 0.7% | 2.5% |
Asian/Pacific Islander | 0.3% | 1.1% |
Other | 1.5% | 2.8% |
Gender | ||
Female | 49.2% | 30.2% |
Male | 50.8% | 69.8% |
Education | ||
8 Years or Fewer | 8.4% | 8.7% |
9 to 11 Years | 20.0% | 24.4% |
High School/GED | 41.0% | 42.5% |
Some College | 30.7% | 24.4% |
Employment | ||
Unemployed | 46.4% | 38.8% |
Not in Labor Force | 37.0% | 37.7% |
Full-Time Employment | 10.7% | 15.7% |
Part-Time Employment | 5.9% | 7.8% |
Health Insurance Status | ||
Not Insured | 58.7% | 60.0% |
* "Other admissions" refer to admissions who did not report benzodiazepine or narcotic pain reliever abuse at treatment admission. Source: SAMHSA Treatment Episode Data Set (TEDS), 2010. |
Age Group | Benzodiazepine and Narcotic Pain Reliever Combination Admissions |
Other Admissions |
---|---|---|
Aged 12 to 17 | 3.3% | 7.9% |
Aged 18 to 24 | 26.4% | 17.8% |
Aged 25 to 34 | 40.5% | 25.9% |
Aged 35 to 44 | 16.4% | 22.2% |
Aged 45 to 54 | 10.5% | 20.0% |
Aged 55 to 64 | 2.6% | 5.5% |
Aged 65 or Older | 0.3% | 0.8% |
* "Other admissions" refer to admissions who did not report benzodiazepine or narcotic pain reliever abuse at treatment admission. Source: SAMHSA Treatment Episode Data Set (TEDS), 2010. |
In comparison with benzodiazepine and narcotic pain reliever combination admissions, the other admissions group (that did not report either drug) had higher percentages of Hispanics (14.5 vs. 3.6 percent) and non-Hispanic Blacks (23.2 vs. 2.5 percent; Table 1). Other admissions were also more likely than benzodiazepine and narcotic pain reliever combination admissions to be male (69.8 vs. 50.8 percent). The age distribution of other admissions was more evenly distributed across the age groups between the ages of 18 to 54, ranging from 17.8 percent among those aged 18 to 24 to 25.9 percent among those aged 25 to 34 (Figure 2).
Of the benzodiazepine and narcotic pain reliever combination admissions in 2010, 48.2 percent reported primary narcotic pain reliever abuse and secondary benzodiazepine abuse, while 9.9 percent reported primary benzodiazepine abuse and secondary narcotic pain reliever abuse. The remaining 41.7 percent of these admissions reported some other primary substance of abuse, with benzodiazepines or narcotic pain relievers as secondary or tertiary drugs of abuse.
TEDS allows for the identification of the order of drug initiation. More than one third of benzodiazepine and narcotic pain reliever combination admissions reported initiating narcotic pain relievers first (34.1 percent); more than one quarter reported initiating benzodiazepines first (27.1 percent). For the remainder of admissions (38.7 percent), the two drugs were initiated during the same year.
In the month prior to treatment admission, 61.2 percent of benzodiazepine and narcotic pain reliever combination admissions reported daily use of any substance compared with 34.6 percent of other admissions (Figure 3). Among these admissions, 57.1 percent reported daily use of narcotic pain relievers and 45.5 percent reported daily use of benzodiazepines.
Daily Use | Percent |
---|---|
Benzodiazepine and Narcotic Pain Reliever Combination Admissions | |
Daily Use of Any Substance | 61.2% |
Daily Use of Narcotic Pain Relievers | 57.1% |
Daily Use of Benzodiazepines | 45.5% |
Other Admissions | |
Daily Use of Any Substance | 34.6% |
* "Other admissions" refer to admissions who did not report benzodiazepine or narcotic pain reliever abuse at treatment admission. Source: SAMHSA Treatment Episode Data Set (TEDS), 2010. |
The two admissions groups also showed distinctions by mental health status, treatment characteristics, and treatment history. Specifically, almost half (45.7 percent) of benzodiazepine and narcotic pain reliever combination admissions reported having a co-occurring psychiatric disorder.7 Benzodiazepine and narcotic pain reliever combination admissions were most commonly self-referred to treatment (46.2 percent) (Figure 4). More than one third of benzodiazepine and narcotic pain reliever combination admissions received regular outpatient treatment (35.7 percent), more than one quarter received detoxification (29.0 percent), and 15.8 percent received short-term residential treatment (Figure 5).
Sources of Referral | Benzodiazepine and Narcotic Pain Reliever Combination Admissions |
Other Admissions |
---|---|---|
Individual/Self | 46.2% | 30.5% |
Criminal Justice System | 20.3% | 39.8% |
Alcohol/Drug Abuse Care Provider | 14.2% | 9.2% |
Other Community Referral | 9.4% | 12.6% |
Other Health Care Provider | 9.3% | 6.1% |
School Referral | 0.2% | 1.3% |
Employer/EAP | 0.4% | 0.5% |
* "Other admissions" refer to admissions who did not report benzodiazepine or narcotic pain reliever abuse at treatment admission. Source: SAMHSA Treatment Episode Data Set (TEDS), 2010. |
Treatment Type | Benzodiazepine and Narcotic Pain Reliever Combination Admissions |
Other Admissions |
---|---|---|
Hospital Treatment | 0.8% | 0.3% |
Long-Term Residential Treatment | 8.4% | 7.5% |
Intensive Outpatient Treatment | 10.4% | 12.1% |
Short-Term Residential Treatment | 15.8% | 8.5% |
Detoxification | 29.0% | 20.3% |
Regular Outpatient Treatment | 35.7% | 51.3% |
* "Other admissions" refer to admissions who did not report benzodiazepine or narcotic pain reliever abuse at treatment admission. Source: SAMHSA Treatment Episode Data Set (TEDS), 2010. |
In contrast to benzodiazepine and narcotic pain reliever combination admissions, other admissions were less likely to report a co-occurring disorder (27.8 vs. 45.7 percent). Other admissions were also twice as likely as benzodiazepine and narcotic pain reliever combination admissions to be referred to treatment through the criminal justice system (39.8 vs. 20.3 percent) and less likely to be self- or individually referred to treatment (30.5 vs. 46.2 percent) (Figure 4). Other admissions had a higher likelihood of receiving regular outpatient services compared with benzodiazepine and narcotic pain reliever combination admissions (51.3 vs. 35.7 percent) but were also less likely to receive detoxification (20.3 vs. 29.0 percent) (Figure 5).
While the volume of benzodiazepine and narcotic pain reliever combination admissions is comparatively small relative to the annual number of treatment admissions, substance abuse treatment programs are treating an increasing number of patients who co-abuse these drugs. This report shows that benzodiazepine and narcotic pain reliever admissions differed from other treatment admissions in many respects. By magnitude, the most striking differences are related to race/ethnicity and gender, daily use prior to admission, referral sources, and co-occurring disorders (Table 2). All of these differences have treatment implications.
Benzodiazepine and narcotic pain reliever combination
admissions are MORE likely than other treatment admissions
to be or report:
|
* "Other admissions" refer to admissions who did not report benzodiazepine or narcotic pain reliever abuse at treatment admission. Source: SAMHSA Treatment Episode Data Set (TEDS), 2010. |
The high proportion of benzodiazepine and narcotic pain reliever combination admissions reporting daily use suggests behavioral patterns that may be difficult to change. These admissions need to be prepared for the severe withdrawal effects from both drugs, particularly since benzodiazepines compound the withdrawal effects of narcotic pain relievers.6 Providing medical and supportive services to mitigate the severe withdrawal effects may be critical to avoid treatment attrition and relapse.6
The high rate of co-occurring mental health disorders among the benzodiazepine and narcotic pain reliever combination admissions may reflect in part that benzodiazepines are used to treat some mental health problems, such as anxiety. Substance abuse treatment may provide a unique opportunity to facilitate access to both substance abuse treatment and mental health services for people who co-abuse these drugs.
The Treatment Episode Data Set (TEDS) is an administrative data system providing descriptive information about the national flow of admissions aged 12 or older to providers of substance abuse treatment. TEDS intends to collect data on all treatment admissions to substance abuse treatment programs in the United States receiving public funds. Treatment programs receiving any public funds are requested to provide TEDS data on publicly and privately funded clients. TEDS is one component of the Behavioral Health Services Information System (BHSIS), maintained by the Center for Behavioral Health Statistics and Quality (CBHSQ), Substance Abuse and Mental Health Services Administration (SAMHSA). TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once. Information on treatment admissions is routinely collected by State administrative systems and then submitted to SAMHSA in a standard format. There are significant differences among State data collection systems. Sources of State variation include the amount of public funding available and the constraints placed on the use of funds, facilities reporting TEDS data, clients included, services offered, and completeness and timeliness of reporting. See the annual TEDS reports for details. TEDS received approximately 1.8 million treatment admission records from 48 States and Puerto Rico for 2010. Definitions of demographic, substance use, and other measures mentioned in this report are available in Appendix B of the annual TEDS report on national admissions (see latest report at https://www.samhsa.gov/data/2k12/TEDS2010N/TEDS2010NAppB.htm). The TEDS Report is prepared by the Center for Behavioral Health Statistics and Quality, SAMHSA; Synectics for Management Decisions, Inc., Arlington, VA; and RTI International, Research Triangle Park, NC. Information and data for this issue are based on data reported to TEDS through October 10, 2011. Latest TEDS reports: |
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