Trends in Primary Substance of Abuse: 2002-2012
Trends in the Co-Abuse of Alcohol and Drugs
Trends in Demographic Characteristics
Trends in Employment Status

This report presents national-level data from the Treatment Episode Data Set (TEDS) for admissions in 2012 and trend data for 2002 to 2012. It is a companion to the report Treatment Episode Data Set (TEDS): 2002-2012 State 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 2002 through 2012 that were received and processed through October 17, 2012.¹ It is important to note that percentages in charts, narrative lists, and percentage distributions in tables may not add to 100 percent due to rounding.

TEDS is an admission-based system, and TEDS admissions do not represent individuals. Thus, 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 at facilities that are licensed or certified by a 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 2002 to 2012. 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.

Trends in Primary Substance of Abuse: 2002-2012

Admissions can report up to three substances of abuse. These represent the substances that led to the treatment episode and are not necessarily a complete enumeration of all substances used at the time of admission. Most of the information in this report is based on an admission’s primary
substance of abuse. (See Appendix A for more details.)

Tables 1.1a-b and Figure 1.The number of admissions aged 12 and older decreased by 7 percent from 2002 to 2012. The U.S. population aged 12 and older increased by 9 percent during this time period.

• Between 2002 and 2012, five substance groups accounted for 96 percent of the primary substances of abuse reported by TEDS treatment admissions aged 12 and older: alcohol, opiates (primarily heroin), marijuana, cocaine, and methamphetamine/amphetamines. However, the proportions of admissions by primary substance changed considerably over that period:
  • Alcohol admissions aged 12 and over fluctuated between 2002 and 2012 from a high of 43 percent in 2002 to a low of 39 percent in 2005, 2011, and 2012. In 2012, 45 percent of primary alcohol admissions aged 12 and older reported secondary drug abuse as well.
    
  • Opiate admissions increased from 18 percent of admissions aged 12 and older in 2002 to 26 percent in 2012.
    
    • Admissions for primary heroin were fairly steady over this time period: they were 15 percent of admissions aged 12 and older from 2002 to 2004, 13 percent in 2007, 14 percent from 2008 to 2010, 15 percent in 2011, and 16 percent in 2012. Heroin represented 86 percent of all opiate admissions in 2002 but only 63 percent in 2012.
      
    • Opiates other than heroin² increased from 2 percent of admissions aged 12 and older in 2002 to 10 percent in 2012. Opiates other than heroin represented 14 percent of all opiate admissions in 2002 but 37 percent in 2012.
      
  • Marijuana admissions increased from 15 percent of admissions aged 12 and older in 2002 to 19 percent in 2010, decreasing to 18 percent in 2011, and 17 percent in 2012.
    
  • Cocaine admissions declined from 13 percent of admissions aged 12 and older in 2002 to 7 percent in 2012. Smoked cocaine (crack) represented 69 percent of all primary cocaine admissions in 2012, down from 73 percent in 2002.
    
  • Stimulant admissions (98 to 99 percent of these admissions were for methamphetamine or amphetamine abuse) increased from 7 percent of admissions aged 12 and older in 2002 to 9 percent in 2005, but then decreased to 6 percent in 2008, and in 2012 increased to 7 percent.
    
  • Tranquilizers, sedatives and hypnotics, hallucinogens, PCP, inhalants, and over-the-counter medications each accounted for 1 percent or less of TEDS admissions between 2002 and 2012.

Trends in the Co-Abuse of Alcohol and Drugs

Table 1.2. The concurrent abuse of alcohol and drugs continues to be a significant problem. Because TEDS collects a maximum of three substances of abuse and not all substances abused, alcohol use among polydrug abusers may be underreported.

• The proportion of admissions aged 12 and older reporting abuse of both alcohol and drugs declined from 41 percent in 2002 to 35 percent in 2012.
  
• The proportion reporting abuse of drugs only increased from 32 percent in 2002 to 42 percent in 2012, while the proportion reporting abuse of alcohol only fell slightly, from 24 percent in 2002 to 21 percent in 2012.
  
  

Trends in Demographic Characteristics

Table 1.3b. Males represented 67 percent of TEDS admissions aged 12 and older in 2012, a proportion that declined steadily, if slightly, from 70 percent in 2002.

• The distribution of TEDS admissions aged 12 and older differed markedly by gender from that of the U.S. population, where 49 percent of the population was male.
  

Table 1.3b and Figure 2. The age distribution of TEDS admissions aged 12 and older changed between 2002 and 2012.

• The proportion of admissions aged 18 to 29 years increased from 28 percent in 2002 to 34 percent in 2012. The proportion of admissions aged 12 to 17 decreased slightly from 8 percent in 2002 to 7 percent in 2012.
  
• Admissions aged 30 to 44 years made up 45 percent of TEDS admissions in 2002 but only 34 percent in 2012.
  
• The proportion of admissions aged 45 and older increased from 18 percent in 2002 to 25 percent in 2012.
  
• The age distribution of TEDS treatment admissions aged 12 and older differed considerably from that of the U.S. population. In 2012, some 68 percent of TEDS admissions were aged 18 to 44 years compared with 44 percent of the U.S. population. Adolescents aged 12 to 17 years made up 7 percent of TEDS admissions but 9 percent of the U.S. population. Admissions aged 45 and older made up 25 percent of TEDS admissions but 47 percent of the U.S. population.
  
  

Table 1.4 and Figure 3. The racial/ethnic composition of TEDS admissions aged 12 and older changed very little between 2002 and 2012.

• Non-Hispanic Whites increased from 58 to 61 percent of admissions over the time period.
  
• The proportion of non-Hispanic Blacks declined, from 24 percent of admissions in 2002 to 20 percent in 2012.
  
• The proportion of admissions of Hispanic origin remained steady at 13 percent from 2002 to 2012 except in 2005 when it increased to 14 percent.
  
• Other racial/ethnic groups combined made up 4 to 6 percent of admissions throughout the time period.
  
• The racial/ethnic composition of TEDS admissions differed from that of the U.S. population. Non-Hispanic Whites were the majority in both groups, but they represented 61 percent of TEDS admissions in 2012 compared with 70 percent of the U.S. population. Non-Hispanic Blacks represented 20 percent of TEDS admissions in 2012 and 11 percent of the U.S. population. However, the proportion of TEDS admissions of Hispanic origin was the same as the proportion of Hispanics in the U.S. population (13 percent each). Other racial/ethnic groups made up 6 percent of TEDS admissions and 6 percent of the U.S. population.
  

Trends in Employment Status

Table 1.5 and Figure 4. TEDS admissions aged 16 and older were less likely to be employed than the U.S. population aged 16 and older. This is evident in the unadjusted distributions of admissions by employment status (employed, unemployed, and not in labor force) shown in Table 1.5. Because TEDS admissions differ demographically from the U.S. population, Table 1.5 also shows distributions that have been statistically adjusted to provide a more valid comparison to the U.S. population.³ The adjusted distributions indicate an even greater disparity in socioeconomic status than do the unadjusted.

• Between 2002 and 2012, unemployment grew from the least common employment status reported (28 percent) by treatment admissions aged 16 and older to the most common treatment admission status (39 percent).
  
• The most common employment status reported by TEDS admissions aged 16 and older between 2002 and 2007 was “not in labor force.” However, this proportion declined from a peak of 42 percent in 2002 to 38 percent in 2012.
  
• Among the U.S. population aged 16 and older in 2012, 36 percent were not in the labor force.

³ The distributions have been adjusted for age, gender, and race/ethnicity to the U.S. population. In essence, this technique compares the distributions under the assumption that the TEDS population and the U.S. population had the same age, gender, and racial/ethnic characteristics.

TO TABLES

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