Reducing Substance Abuse in America: Building the Nation's Demand Reduction Infrastructure A Framework for Discussion

The Vision: A Life in the Community for Everyone
The Challenge: Stopping Drug use Before It Starts…Healing America’s Drug Users
The Commitment: Meeting the Challenges Through National Leadership
The Charge: Building the Nation’s Demand Reduction Infrastructure
The Programs: Building Resilience
The Programs: Facilitating Recovery
The Programs: Building Treatment Capacity
Cross-Cutting Infrastructure and Services
Making It Count: Ensuring Accountability Through Data-Driven Decision-making
Making It Count: Ensuring Accountability Through Data-Driven Decision-making

To ensure that prevention and treatment funding has the greatest possible impact, SAMHSA's Office of Applied Studies (OAS) collects important national, state, and regional data. SAMHSA provides this valuable data to the public through its many publications and internet resources. The data that SAMHSA collects and analyzes helps SAMHSA intervene early and prevent the further spread of substance abuse among our children, our families, and our communities. The following data collection and analysis efforts represent only a portion of the data that is collected by SAMHSA and SAMHSA funded grants.

Streamlining Reporting Requirements

SAMHSA has responded to the public’s demand that government agencies demonstrate accountability to the taxpayer by wisely investing resources into treatments and services that produce positive outcomes. To enhance the effectiveness of SAMHSA funded programs and to streamline reporting requirements, SAMHSA and the States have created a simple, performance-based, outcome-driven measurement system for SAMHSA's two Block Grant programs. These National Outcome Measures (NOMs) represent meaningful, real life outcomes for people who are striving to attain and sustain recovery, build resilience, and work, learn, live, and participate fully in their communities.

National Outcome Measures

In alignment with SAMHSA's three strategic goals, NOMs also reduce State reporting burdens and provides uniform, consistent reporting of information focusing on 10 domains:

  • Abstinence from drug use and alcohol abuse
  • Resilience and sustaining recovery,
    __Getting and keeping a job or enrolling and staying in school
    __Decreasing involvement with the criminal justice system
  • Finding safe and stable housing
  • Improving social connectedness to others in the community
  • Increased access to services
  • Retention in substance abuse treatment or decreased inpatient hospitalizations for mental health treatment
  • Quality of services provided
  • Client perception of care
  • Cost-effectiveness
  • Use of evidence-based treatment practices.

After receiving data from each state, SAMHSA and state officials collaborate on data analysis and performance management to improve services. SAMHSA is realigning its entire grant and contract data collection programs—both internal and external— using these National Outcome Measures, while expanding and focusing its technical assistance resources to help states and providers develop NOMs reporting capacity.

The Annual National Household Survey on Drug Use and Health

The National Survey on Drug Use and Health (NSDUH) is the nation’s most comprehensive source of substance abuse related data. The NSDUH is a SAMHSA-sponsored annual survey of the U.S. civilian population ages 12 and older, excluding people residing in institutions. Formerly known as the National Household Survey on Drug Abuse, NSDUH is the primary source of statistical information on the use of illegal drugs by the U.S. population. The survey presents national and State-level estimates on rates of use, numbers of users, and other measures related to illegal drugs, alcohol, and tobacco products, as well as measures related to mental health problems.

Because it is an annual survey, NSDUH reveals important trends in substance use that can be used to plan effective, science-based treatment and services and to judge the success of current activities. For example, results of the 2004 NSDUH show a 11 percent decline from 2002 to 2004 in use of illegal drugs among youth between the ages of 12 and 17. Youth who reported talking to at least one of their parents about the dangers of drugs, tobacco, or alcohol use reported less current, past year, and lifetime use of these substances. Unfortunately, the survey also indicates that many people who need substance abuse treatment do not receive it. SAMHSA, is committed to supporting evidence-based prevention programs and to expanding the capacity of the treatment system to meet the needs of youth and adults with substance use and mental disorders.

The Drug Abuse Warning Network: A Public Health Surveillance System

SAMHSA's Drug Abuse Warning Network (DAWN) is a public health surveillance system designed to track the impact of drug use, misuse, and abuse in the U.S. by monitoring drug-related visits to hospital emergency departments and drug-related deaths investigated by medical examiners and coroners. Redesigned in 2003, DAWN helps communities and member facilities identify emerging problems, improve patient care, and manage resources.

DAWN tracks three categories of hospital emergency department visits related to drug misuse and abuse: Use of illegal drugs; use of alcohol, alone and in combination with other drugs; and non-medical use ("misuse") of pharmaceuticals, including prescription and over-the-counter medication. DAWN data helps SAMHSA to direct its resources toward unmet needs in communities with serious, emerging substance abuse problems.

The Drug and Alcohol Services Information System

When people who are in need of substance abuse treatment and services reach out for help, quick and easy access to information about local treatment providers, programs and other resources can make all the difference in gaining back that "life in the community for everyone." The Drug and Alcohol Services Information System (DASIS) is the primary source of national information on the services available for substance abuse treatment and the characteristics of individuals admitted to treatment. DASIS contains three data sets that are maintained by SAMHSA with the cooperation and support of the States:

  • The Inventory of Substance Abuse Treatment Services (I-SATS) is a master list of organized substance abuse treatment programs known to SAMHSA.

  • The National Survey of Substance Abuse Treatment Services (NSSATS) is an annual census of all facilities listed on the I-SATS that includes information on the location, characteristics, and use of services at public and private substance abuse treatment facilities.

  • The Treatment Episode Data Set (TEDS) is a minimum data set of demographic and drug history information about individuals admitted to treatment, submitted primarily by providers receiving public funding.