The CBHSQ Report header
National Survey on Drug Use and Health
Short Report
September 29, 2016
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In Brief
  • The 2015 National Survey on Drug Use and Health (NSDUH) data indicate that 8.1 percent or 21.7 million people aged 12 or older needed substance use treatment in the past year.

  • In 2015, an estimated 2.3 million people aged 12 or older who needed substance use treatment received treatment at a specialty facility in the past year. This number represents 10.8 percent of the 21.7 million people who needed substance use treatment in the past year.

  • Among the estimated 19.3 million people aged 12 or older who were classified as needing but not receiving substance use treatment at a specialty facility, about 18.4 million or 95.4 percent did not think that they needed treatment in the past year for their substance use.

America's Need for and Receipt of Substance Use Treatment in 2015
Authors

Rachel N. Lipari, Ph.D, Eunice Park-Lee, Ph.D., and Struther Van Horn, M.A.

Introduction

Substance use disorders (SUDs) represent clinically significant impairment caused by the recurrent use of alcohol or illicit drugs (or both), including health problems, disability, and failure to meet major responsibilities at work, school, or home.1 The consequences of SUD can be costly to people and the nation as a whole because they are often associated with negative outcomes, such as involvement with the justice system,2,3 occurrence of chronic health conditions,4 and poorer health outcomes.5

People who experience SUDs can take many pathways to recovery. Many individuals may benefit from evidence-based substance use treatment that addresses their specific needs, which may include physical, psychosocial, and environmental issues. Although there are benefits to getting substance use treatment, recent research indicates that many people do not get the treatment they need.1 According to the 2016 National Drug Control Strategy, a leading indicator of unmet substance use treatment need is the number of people who need substance use treatment but do not receive it at a specialty facility.6 The overall health of the nation are improved by the extent to which the population has access to needed substance use treatment. Hence, the Substance Abuse and Mental Health Services Administration (SAMHSA) states that recovery is built on access to evidence-based clinical treatment and recovery support services for all populations.7

The National Survey on Drug Use and Health (NSDUH) is an annual survey of the civilian, noninstitutionalized population of the United States aged 12 years or older. NSDUH gathers information on substance use treatment need and service utilization. NSDUH respondents who used alcohol or illicit drugs8 in their lifetime are asked whether they ever received substance use treatment. Those who received substance use treatment in their lifetime are asked whether they received treatment in the 12 months before the survey interview (i.e., the past year). Substance use treatment refers to treatment or counseling that was received for illicit drug or alcohol use, or for medical issues associated with illicit drug or alcohol use. NSDUH also collects information on the receipt of substance use treatment at a specialty facility (i.e., substance use treatment at a hospital [only as an inpatient], a drug or alcohol rehabilitation facility [as an inpatient or outpatient], or a mental health center).9 

This issue of The CBHSQ Report also examines respondents' perception of their need for substance use treatment. This report uses 2015 NSDUH data to examine the need for and receipt of substance use treatment at a specialty facility among people aged 12 or older. Comparisons are made between adolescents aged 12 to 17, young adults aged 18 to 25, and adults aged 26 or older. All differences between age groups discussed in this report are statistically significant at the .05 level.

Need for Substance Use Treatment

NSDUH classifies people as needing substance use treatment if they met the criteria for having SUD10 in the past year (based on symptoms they report) or if they received substance use treatment at a specialty facility in the past year.11 In 2015, an estimated 21.7 million people aged 12 or older needed substance use treatment in the past year (Figure 1). Stated another way, about 8.1 percent of the population aged 12 or older needed substance use treatment in the past year. SUD is defined as meeting criteria for illicit drug or alcohol dependence or abuse based on definitions found in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).10 

The percentage of people identified as needing substance use treatment was highest among young adults aged 18 to 25 and was lowest among adolescents aged 12 to 17. In 2015, approximately 1.3 million adolescents (5.1 percent of this age group), 5.4 million young adults (15.5 percent of this age group), and 15.0 million adults aged 26 or older (7.2 percent of this age group) needed substance use treatment in the past year (Figure 1). Stated another way, about 1 in 20 adolescents, 1 in 6 young adults, and 1 in 14 adults aged 26 or older were classified to be in need of substance use treatment in the past year.

Figure 1. Need for substance use treatment in the past year among people aged 12 or older, by age group: 2015

If you would like someone from our staff to read the numbers on this graph or table image to you, please call 240-276-1250.
Receipt of Substance Use Treatment at a Specialty Facility among People Who Needed Substance Use Treatment

The extent of the unmet substance use treatment need in the United States is measured by calculating the number of people aged 12 or older who were classified as needing substance use treatment but who did not receive substance use treatment at a specialty facility in the past year. This section focuses on the receipt (or lack of receipt) of treatment at a specialty facility among people who needed substance use treatment in the past year.

In 2015, an estimated 2.3 million people aged 12 or older who needed substance use treatment received treatment at a specialty facility in the past year (Figure 2). This number represents 0.9 percent of all people aged 12 or older and 10.8 percent of the 21.7 million people who needed substance use treatment. Conversely, there were about 19.3 million people aged 12 or older who needed substance use treatment but did not receive substance use treatment at a specialty facility; this represents 89.2 percent of people who needed substance use treatment in the past year.12

Figure 2. Receipt of substance use treatment at a specialty facility in the past year among people aged 12 or older who needed substance use treatment in the past year: 2015

If you would like someone from our staff to read the numbers on this graph or table image to you, please call 240-276-1250.

As shown earlier, in 2015, an estimated 1.3 million adolescents aged 12 to 17, 5.4 million young adults aged 18 to 25, and 15.0 million adults aged 26 or older needed substance use treatment in the past year. Of those who needed substance use treatment, about 80,000 adolescents (or 6.3 percent of this age group), 417,000 young adults (or 7.7 percent of this age group), and 1.8 million adults aged 26 or older (12.3 percent of this age group) received substance use treatment at a specialty facility in the past year. Among people who needed substance use treatment, adults aged 26 or older were more likely to have received treatment at a specialty facility in the past year than adolescents or young adults (12.3 vs. 6.3 and 7.7 percent, respectively). Conversely, among people in specific age groups who needed substance use treatment, 93.7 percent of adolescents, 92.3 percent of young adults, and 87.7 percent of adults aged 26 or older did not receive treatment at a specialty facility in the past year (Figure 3). 

Figure 3. Receipt of substance use treatment at a specialty facility in the past year among people aged 12 or older who needed substance use treatment in the past year, by age group: 2015

If you would like someone from our staff to read the numbers on this graph or table image to you, please call 240-276-1250.
Perceived Need for Substance Use Treatment among People Who Needed but Did Not Receive Substance Use Treatment at a Specialty Facility

In 2015, among the estimated 19.3 million people aged 12 or older who were classified as needing substance use treatment but who did not receive substance use treatment at a specialty facility in the past year, about 880,000 (or 4.6 percent of this population) perceived a need for substance use treatment. The vast majority (95.4 percent), on the other hand, did not think that they needed treatment in the past year for their substance use (Figure 4). 

Among those who needed but did not receive substance use treatment at a specialty facility in 2015, adolescents were less likely to have felt a need for treatment than young adults or adults aged 26 or older (data not shown). Of the estimated 1.2 million adolescents aged 12 to 17 who needed but did not receive substance use treatment at a specialty facility in the past year, 17,000 (1.4 percent) perceived a need for substance use treatment. Among the estimated 5.0 million young adults aged 18 to 25 who needed but did not receive substance use treatment at a specialty facility in the past year, about 138,000 (2.7 percent) perceived a need for substance use treatment. Of the estimated 13.1 million adults aged 26 or older who needed but did not receive substance use treatment at a specialty facility in the past year, approximately 725,000 (5.5 percent) perceived a need for substance use treatment.

Figure 4. Perceived need for substance use treatment among people aged 12 or older who needed but did not receive substance use treatment in the past year: 2015

If you would like someone from our staff to read the numbers on this graph or table image to you, please call 240-276-1250.
Discussion

As previously stated, many people in need of substance use treatment may benefit from evidence-based substance use treatment that addresses their specific needs; however, the research suggests that few Americans receive any or adequate substance use treatment.1 The 2015 NSDUH data presented in this report suggest that the majority of people aged 12 or older who needed substance use treatment in the United States do not receive treatment at a specialty facility. The report finds that about 21.7 million or 8.1 percent of people aged 12 or older needed substance use treatment in the past year. ​In addition, among the 19.3 million people aged 12 or older who were classified as needing substance use treatment because they either met the criteria for having a substance use disorder or they have been in substance use treatment at a specialty facility in the past year, a large proportion of this population indicated they did not perceive that they had a need for substance use treatment. In addition, receipt of substance use treatment at a specialty facility and perceived need for substance use treatment among those who needed substance use treatment varied by age group. For example, compared with adults aged 26 or older, lower percentages of adolescents and young adults who needed substance use treatment received treatment at a specialty facility. Similarly, lower percentages of adolescents and young adults who were classified as needing substance use treatment felt that they needed treatment for their substance use than adults aged 26 or older.

The substance use recovery process is highly personal and occurs via many pathways. For many Americans, this recovery process includes access to and use of substance use treatment at specialty facilities, such as a hospital (only as an inpatient), a drug or alcohol rehabilitation facility (as an inpatient or an outpatient), or a mental health center. Having access to substance use treatment and supportive services to address various needs associated with substance use disorders is critical for those who are in need of treatment. In order to aid individuals in need of treatment, SAMHSA provides information about where to find substance use and mental health treatment at https://findtreatment.samhsa.gov

Endnotes
  1. Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51). Retrieved from http://samhsa.gov/data/
  2. Glasheen, C., Hedden, S. L., Kroutil, L. A., Pemberton, M. R., & Goldstrom, I. (2012, November). CBHSQ Data Review: Past year arrest among adults in the United States: Characteristics of and association with mental illness and substance use. Retrieved from http://samhsa.gov/data/
  3. Feucht, T. E., & Gfroerer, J. (2011, May). SAMHSA Data Review: Mental and substance use disorders among adult men on probation or parole: Some success against a persistent challenge (NCJ 235637). Retrieved from http://samhsa.gov/data/
  4. Clarke, D. M., & Currie, K. C. (2009). Depression, anxiety and their relationship with chronic diseases: A review of the epidemiology, risk and treatment evidence. Medical Journal of Australia, 190(7 Suppl.), S54–S60.
  5. McCusker, J., Cole, M., Ciampi, A., Latimer, E., Windholz, S., & Belzile, E. (2007). Major depression in older medical inpatients predicts poor physical and mental health status over 12 months. General Hospital Psychiatry, 29(4), 340–348. doi:10.1016/j.genhosppsych.2007.03.007
  6. Office of National Drug Control Policy. 2015. 2015 National Drug Control Strategy. Retrieved from https://www.whitehouse.gov/sites/default/files/ondcp/policy-and-research/2015_national_drug_control_strategy_0.pdf
  7. Substance Abuse and Mental Health Services Administration. (2015). Recovery and recovery support [Web page]. Retrieved from http://samhsa.gov/recovery
  8. NSDUH estimates of "illicit drug use" include the data from 10 drug categories: the use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine; or the misuse of prescription pain relievers, tranquilizers, stimulants, or sedatives. 
  9. Information on the receipt of substance use treatment at nonspecialty treatment facilities such as emergency rooms, private doctors' offices, prisons or jails, and self-help groups is reported elsewhere. For more information, see Park-Lee, E., Lipari, R. N., Hedden, S. L., Copello, E. A. P., & Kroutil, L. A. (2016, September). Receipt of services for substance use and mental health issues among adults: Results from the 2015 National Survey on Drug Use and Health. NSDUH Data Review. Retrieved from http://www.samhsa. gov/data/
  10. NSDUH includes a series of questions about past year SUDs among respondents who used alcohol or illicit drugs in the past 12 months. These questions are used to classify people as having an SUD in the past 12 months based on criteria specified in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. The criteria include symptoms such as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference with major obligations at work, school, or home during the past 12 months.
  11. In 2015, about 96.0 percent of the adults who needed treatment for a substance use issue were defined as such because they had an SUD in the past year, regardless of whether they received substance use treatment at a specialty facility.
  12. People who are classified as needing substance use treatment may receive treatment at a nonspecialty facility for their substance use issues; however, the majority of people who needed treatment do not receive any substance use treatment. For example, about 679,000 people aged 12 or older in 2015 who needed substance use treatment received nonspecialty treatment, whereas 18.6 million people did not receive any treatment.
Suggested Citation

Lipari, R. N., Park-Lee, E., and Van Horn, S. America’s need for and receipt of substance use treatment in 2015. The CBHSQ Report: September 29, 2016. Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD.