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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 age 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, Ohios rates on most drug and alcohol prevalence measures have been at or below the national rates for all age groups. These include past month and past year marijuana use, past month use of a drug other than marijuana and past month alcohol and binge alcohol use.
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).
Rates of past year dependence on or abuse of illicit drugs have been quite variable across survey years and among age groups. For example, in 2005-2006, the rate for individuals between 12 and 17 was among the lowest2 in the country, while the rate for individuals 12 and older was among the 10 highest in the country (Chart 1).
Rates of past year alcohol dependence, however have been less variable and have remained at or below the national rates across all survey years. In 2005-2006, the rates on this measure for both individuals age 12 to 17 and those 26 and older were among the lowest in the country.
Substance Abuse Treatment Facilities
According to the National Survey of Substance Abuse Treatment Services (N-SSATS),3 the number of treatment facilities has declined from 515 facilities in 2002 to 424 facilities in 2006. A decrease of 85 private nonprofit facilities accounts for the majority of this difference. In 2006, 349 of 424 of all Ohio treatment facilities (82%) were private nonprofit, and only 34 facilities (8%) were private for-profit. The remaining facilities were owned or operated by Federal, State, or local government.
Although facilities may offer more than one modality of care, 363 facilities (86%) offered some form of outpatient treatment in 2006. An additional 115 facilities offered some form of residential care, and 19 facilities offered an opioid treatment program. Buprenorphine treatment for opiate addiction is available through 201 physicians and 48 treatment programs.
In 2006, 303 facilities (71%) received some form of Federal, State, county, or local government funds, and 199 facilities 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 one-day census in N-SSATS and annual treatment admissions from the Treatment Episode Data Set (TEDS).4 In the 2006 N-SSATS survey, Ohio showed a total of 34,988 clients in treatment, 32,001 (91%) of whom were in outpatient treatment. Of the total number of clients in treatment on this date, 4,551 (13%) were under the age of 18.
Chart 2 shows the percentage 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 percentage of admissions mentioning either marijuana or heroin.
Across the years for which TEDS data are available, Ohio has seen a substantial shift in the constellation of problems present at treatment admission (Chart 3). Alcohol-only admissions have declined from 42 percent of all admissions in 1992 to 19 percent in 2006. Concomitantly, drug-only admissions have increased from 12 percent in 1992 to 30 percent in 2006.
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.
In Ohio, rates of unmet treatment need for both alcohol use and drug use have been at or below the national rates (Charts 4 and 5).