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The National Survey on Drug Use and Health (NSDUH) generates state-level estimates for 23 measures of substance use and mental health problems for four age groups: the entire state population over the age of 12 (12+); individuals age 12 to 17; individuals age 18 to 25; and, individuals age 26 and older (26+). Since state estimates of substance use and abuse were first generated using the combined 2002-2003 NSDUHs and continuing until the most recent state estimates based on the combined 2005-2006 surveys, Indianas rates on all major measures of the use of alcohol and illicit drugs have remained at or below the national rates. The most notable exceptions to this have been the rates of past year nonmedical use of pain relievers, where the rates in Indiana have been consistently above the national rates and, in 2005-2006, were among the highest in the country for all age groups except those age 12 to 17.
Abuse and Dependance
Questions in NSDUH are used to classify persons as being dependent on or abusing specific substances based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (American Psychiatric Association, 1994).
As with the prevalence rates noted above, rates of abuse of or dependence on illicit drugs or alcohol have generally been close to the national rates. In 2005-2006, however, the rate for adolescents age 12 to 17 was among the 10 lowest in the country (Chart 1).
Substance Abuse Treatment Facilities
According to the 2006 National Survey of Substance Abuse Treatment Services (N-SSATS),3 the majority of Indiana facilities (227 of 338, or 67%) were private nonprofit; 94 facilities were private for-profit; and the remainder were owned or operated by Federal, State, or local governments.
The number of treatment facilities in Indiana has increased from 288 in 2002, to 338 in 2006 (the last year for which data are available). The difference is accounted for principally by an increase of 34 private nonprofit facilities and 21 private for-profit facilities.
Although facilities may offer more than one modality of care, the majority of facilities in Indiana in 2006 (313 of 338, facilities or 93%) offered some form of outpatient care, and an additional 48 facilities (14%) offered some form of residential care. In addition, 15 facilities offered an opioid treatment program, and 112 physicians and 55 programs are certified to offer buprenorphine care.
In 2006, 64 percent of all facilities (217 of 338) received some form of Federal, State, county, or local government funds, and 203 facilities (60%) had agreements or contracts with managed care organizations for the provision of substance abuse treatment services.
State treatment data for substance use disorders are derived from two primary sources'an annual 1-day census in N-SSATS and annual treatment admissions from the Treatment Episode Data Set (TEDS).4 In the 2006 N-SSATS survey, Indiana showed a 1-day total of 28,045 clients in treatment, the majority of whom (26,698 or 95%) were in outpatient treatment. Of the total number of clients in treatment on this date, 1,690 (6%) were under the age of 18.
Since 1992, there has been a steady increase in the annual number of admissions to treatment; from over 17,000 in 1992, to over 34,000 in 2006 (the most recent year for which data are available). Chart 2 shows the percent of admissions mentioning particular drugs or alcohol at the time of admission.5 Across the last 15 years, there has been a steady decline in the number of admissions mentioning alcohol and increases in the mentions of marijuana and methamphetamine. Across the years for which TEDS data are available, Indiana has seen a substantial shift in the constellation of problems present at treatment admission. Alcohol-only admissions have declined from over 40 percent of all admissions in 1992, to just over 23 percent in 2006. Concomitantly, drug-only admissions have increased from 9 percent in 1992, to 29 percent in 2006 (Chart 3).
Unmet Need For Treatment
NSDUH defines unmet treatment need as an individual who meets the criteria for abuse of or dependence on illicit drugs or alcohol according to the DSM-IV, but who has not received specialty treatment for that problem in the past year.
Rates of unmet treatment need for either alcohol or illicit drugs have generally remained at or below the national rates except for individuals age 18 to 25, where the rates in 2005-2006 were above the national rates (Charts 4 and 5).