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, rates of several measures of illicit drug use have
remained at or above the national average for most age groups.
This includes past month illicit drug use for the population
age 12 and older; past month and past year marijuana use; and
past month use of an illicit drug other than marijuana.
Rates of the non-medical use of pain relievers, however, have
remained at or below the national rates for all population
groups, except those age 26 and older for whom the rates are
higher than the national rates.Rates of past month alcohol use and past month binge
alcohol use have also consistently remained below the national
average; in the 2005-2006 rate on the perception of risk
associated with having five or more drinks of an alcoholic
beverage once or twice a week, California ranked among the
10 highest 2 States in the country.
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 (American Psychiatric Association, 1994).
Until the 2005-2006 surveys, rates of alcohol abuse or dependence in California were at or below the national average for all age groups. In 2005-2006, however, the rate for the population age 26 and older ranked among the 10 highest states in the country (Chart 1).
Since 2003-2004, rates of past year illicit drug dependence or abuse have remained higher than the national rates; however, these rates were not among the highest tier of states.
Substance Abuse Treatment Facilities
According to the annual National Survey of Substance Abuse Treatment Services (N-SSATS)3, the number of treatment facilities in California recognized or certified by the Single State Agency has increased from 1,772 in 2002, to 1,820 in 2006. The major contribution for this increase was the addition of 43 private for-profit facilities (from 363 to 406 in 2002 and 2006, respectively), an increase of 7 federally operated facilities, and a decrease of 2 facilities operated or owned by Tribal Governments.
Although facilities may offer more than one modality of care, the majority of California facilities in 2006 (1,285 of 1,820, or 71%) offered some form of outpatient treatment; 41 percent of facilities offered some form of residential care; 132 facilities offered methadone treatment; and there were 921 physicians certified to provide buprenorphine therapy.
There were 1,140 facilities (63%) that received some form of Federal, state, county, or local government funds to provide treatment, and 476 facilities (26%) had agreements or contracts with managed care organizations for the provision of treatment services.
Treatment
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. With 96 percent of all California facilities responding to the 2006 N-SSATS survey, California showed a one-day census total of 138,342 clients in treatment, the majority of whom (118,840 or 86%) were in outpatient treatment. Of the total number of clients in treatment on this date, 12,174 (9%) were under the age of 18.
Since 2002, there has been a steady increase in the annual number of admissions to treatment in California, from approximately 154,000 in 2002 to more than 183,000 in 2005 (the most recent year for which data are available). Chart 2 shows the percentage of admissions mentioning particular drugs or alcohol at the time of admission5. Across the last 13 years, there has been a decline in the number of admissions mentioning alcohol, cocaine, or heroin as a substance of abuse, and concomitant increases in the mentions of marijuana. The sharpest increase, however, has been the number of admissions attributable to methamphetamine abuse.
Unmet Need For Treatment
California has consistently ranked at or above the national average in the rate of individuals needing and not receiving treatment for alcohol abuse for all age groups, as well as for individuals needing and not receiving treatment for drug use. Mirroring the rates of alcohol dependence for individuals 26 and older, as indicated above, the rate of individuals in this age group needing and not receiving treatment for alcohol abuse in 2005-2006 was among the highest in the country.
