Substance Dependence, Abuse and Treatment

3. Treatment for a Substance Use Problem

Estimates described in this chapter refer to treatment received to reduce or stop drug or alcohol use, or for medical problems associated with the use of drugs or alcohol. For the purposes of this chapter, "treatment" is defined as any treatment received in the past year at any location, such as in a hospital, at a rehabilitation facility (outpatient or inpatient), mental health center, emergency room, private doctor's office, self-help group, or prison/jail. Some estimates only include treatment received at the most recent treatment within the past year, such as estimates of people receiving treatment for marijuana at their most recent treatment. The definition of treatment in this chapter is different from the definition of treatment used in measuring the treatment gap and described in the next chapter. The definition of treatment used in measuring the treatment gap does not include treatment at an emergency room, private doctor's office, self-help group, prison or jail, or at a hospital as an outpatient.

3.1 Overview

• An estimated 2.8 million people aged 12 or older (1.3 percent of the population) received some kind of treatment for a problem related to the use of alcohol or illicit drugs in the 12 months prior to being interviewed in 2000. Of these, 0.9 million received treatment for both alcohol and illicit drugs (0.4 percent of the total population). An estimated 0.4 million persons received treatment for illicit drugs but not alcohol (0.2 percent of the total population); an estimated 1.2 million people received treatment for alcohol but not illicit drugs (0.5 percent of the total population) (Figure 9). (Estimates for alcohol only, illicit drug only, and both do not add to the total because the total includes persons who reported receiving treatment but did not report whether the treatment was for alcohol or illicit drugs.)

Figure 9 Past Year Substance Abuse Treatment among Persons Aged 12 or Older and among Youths Aged 12 to 17: 2000

Note: "Illicit drug" refers to marijuana/hashish, cocaine (including crack), inhalants, hallucinogens (including LSD and PCP), heroin, or any prescription-type psychotherapeutic used nonmedically.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000.

3.2 Age

• In 2000, 1.6 percent of youths aged 12 to17 and 2.0 percent of young adults aged 18 to 25 received treatment for an alcohol or illicit drug problem in the past year. In comparison, 1.5 to 1.6 percent of adults aged 30 to 44 received treatment for an alcohol or illicit drug problem.

• An estimated 0.2 million youths aged 12 to 17 received treatment for an illicit drug problem in 2000 (1.1 percent of all youths aged 12 to 17), and 0.3 million adults aged 18 to 25 received treatment for an illicit drug problem (0.9 percent of all adults aged 18 to 25).

• An estimated 0.2 million youths aged 12 to 17 received treatment for an alcohol problem (1.0 percent of all youths aged 12 to 17), and 0.4 million young adults aged 18 to 25 received treatment for an alcohol problem (1.4 percent of all adults aged 18 to 25).

3.3 Gender

• In 2000, males were more likely to receive treatment compared with females among persons aged 12 or older as well as among youths aged 12 to 17. Among persons aged 12 or older, 1.8 percent of males received treatment for an alcohol or illicit drug problem in the past year compared with 0.8 percent of females. Among youths aged 12 to 17, the percentage of males who received treatment for an alcohol or illicit drug problem was 1.8 percent, and the percentage of females who received treatment was 1.3 percent, even though there were comparable rates of abuse and dependence within this age group.

• Among persons aged 12 or older, males were more than twice as likely as females to receive alcohol treatment in 2000 (1.4 vs. 0.5 percent, respectively). However, among youths aged 12 to 17, the percentage of males receiving treatment for an alcohol problem was not significantly higher than the percentage of females receiving treatment for an alcohol problem (1.1 vs. 0.9 percent, respectively).

• Among black youths aged 12 to 17, males were more than 3 times as likely to receive treatment for an illicit drug problem compared with females (1.1 vs. 0.3 percent, respectively).

3.4 Race/Ethnicity

• Among persons aged 12 or older, the rate for alcohol or illicit drug treatment during the 12 months prior to the interview was highest among American Indians/Alaska Natives (4.0 percent). However, this rate was not significantly different from the rate for whites (1.3 percent). The rate for blacks was 1.5 percent, and the rate for Hispanics was 1.1 percent. Only 0.3 percent of Asians had received treatment for substance use problems in the past 12 months.

• Although among youths aged 12 to 17 the percentage receiving treatment for alcohol or illicit drugs was highest among American Indians/Alaska Natives (5.0 percent), this rate was not significantly different from the rate among whites (1.7 percent). Hispanics were twice as likely as blacks to receive treatment for alcohol or illicit drugs during the 12 months prior to the interview (2.0 vs. 1.0 percent, respectively).

3.5 Education

• As in the case for dependence on or abuse of illicit drugs or alcohol, treatment rates for a problem with illicit drugs or alcohol were correlated with educational status. Among persons aged 18 or older in 2000, college graduates had the lowest rates of treatment (0.5 percent). Adults with less than a high school education had the highest rate (1.9 percent). The rates among high school graduates and those with some college were 1.4 and 1.2 percent, respectively.

3.6 Employment

• Treatment rates for illicit drugs or alcohol were also correlated with employment. The rate of treatment for both illicit drugs and alcohol was highest among unemployed persons (1.5 percent). The rate among persons employed part time was 0.5 percent, and the rate among persons employed full time was 0.3 percent.

3.7 Geographic Area

• Treatment rates for a problem with illicit drugs or alcohol did not vary greatly by county type in 2000. The rate was lowest in completely rural counties (0.9 percent) and highest for counties in small metropolitan areas with populations fewer than 250,000 and urbanized counties outside metropolitan areas (1.4 percent).

• Treatment rates for a problem with illicit drugs or alcohol varied by geographic region and division in 2000. Rates were highest in the Midwest (1.6 percent) and lowest in the South (0.9 percent). The highest rate by division was observed for the West North Central division (1.8 percent), and the lowest rate was observed for the East South Central division (0.6 percent).

3.8 Location of Treatment
       Note: The estimates and figure for this section include persons reporting more than one location.

• Among the 2.1 million persons aged 12 or older who received alcohol treatment in the past year, more people received treatment at a self-help group than any other location (0.5 million people). An estimated 0.3 million people received alcohol treatment at each of the following three locations: (a) an inpatient rehabilitation facility, (b) an outpatient rehabilitation facility, and (c) an outpatient mental health center.

• The estimated number of people receiving treatment for alcohol in the past year at a hospital as an inpatient was essentially equal to the estimated number of people receiving treatment at a private doctor's office (0.2 million people). The number of people who received treatment at a prison or jail was essentially equal to the number of people who received treatment at an emergency room (0.1 million people).

• In 2000, the pattern in rates of treatment at different locations for a problem with illicit drugs was similar to the pattern in rates of treatment at different locations for a problem with alcohol. Among the 1.3 million people who received treatment for an illicit drug problem in the past year, most people received treatment at a self-help group (0.4 million persons). Treatment at an outpatient rehabilitation facility was the next largest group of people (0.3 million persons).

• The number of people receiving treatment at an inpatient rehabilitation center for a problem with illicit drugs was essentially equal to the number of people receiving treatment at an outpatient mental health center (0.2 million people). There were 0.1 million people who received treatment for illicit drugs at a prison or jail (5.7 percent of the people receiving treatment for illicit drugs in the past year). Estimates for an emergency room or a private doctor's office were not precise enough to report.

• Slightly more than half of the people receiving any illicit drug or alcohol treatment in the past year received treatment at a self-help group (52.8 percent). Over a third of the people who received any illicit drug or alcohol treatment received treatment at an outpatient rehabilitation center (37.3 percent), and over one quarter received outpatient treatment at a mental health center (27.5 percent) (Figure 10).

• Among persons receiving treatment for alcohol or illicit drugs in the past year, the percentage receiving treatment was about the same at each of the following three locations: (a) an inpatient rehabilitation center, (b) a private doctor's office, and (c) a hospital as an inpatient (20.3, 19.6, and 18.7 percent, respectively). There were 0.3 million persons receiving treatment at an emergency room (10.2 percent of the people who received treatment for alcohol or drugs) and 0.1 million persons receiving treatment at a prison or jail (5.1 percent of the people receiving treatment for alcohol or drugs).

Figure 10 Past Year Treatment Received at Specific Locations among Persons Aged 12 or Older Who Received Any Illicit Drug or Alcohol Treatment in the Past Year: 2000

Note: Respondents could indicate multiple locations of treatment; thus, these response categories are not mutually exclusive. "Illicit drug" refers to marijuana/hashish, cocaine (including crack), inhalants, hallucinogens (including LSD and PCP), heroin, or any prescription-type psychotherapeutic used nonmedically.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000.

3.9 Treatment for Specific Substances at Most Recent Treatment
       Note: The estimates and figure for this section include persons reporting more than one substance.

• In 2000, among persons aged 12 or older, more people received treatment for alcohol at their most recent treatment in the past year than any other substance (1.9 million persons). This represents 68.0 percent of all people receiving treatment for a substance use problem in the past year. The substance with the next highest rate was marijuana. There were 0.7 million people who received treatment for marijuana (25.2 percent of all people receiving treatment for a substance use problem). The next highest rate was for cocaine (17.5 percent of all persons receiving treatment for a substance use problem). For hallucinogens, the rate was 9.9 percent, for stimulants it was 8.6 percent, and for inhalants it was 5.8 percent (Figure 11).

• Almost half of all youths aged 12 to 17 receiving treatment in the past year received treatment for marijuana at their most recent treatment (49.2 percent). Among youths aged 12 to 17 receiving treatment in the past year, 9.2 percent received treatment for hallucinogens, 8.2 percent for pain relievers, 7.9 percent for cocaine, 7.3 percent for inhalants, 4.5 percent for tranquilizers, 4.2 percent for stimulants, 2.0 percent for sedatives, and 1.6 percent for heroin.

Figure 11 Past Year Treatment for Specific Substances at Most Recent Treatment among Persons Aged 12 or Older and among Youths Aged 12 to 17 Who Received Treatment in the Past Year: 2000

Note: Respondents could indicate multiple substances for which they received their most recent treatment; thus, these response categories are not mutually exclusive. "Illicit drug" refers to marijuana/hashish, cocaine (including crack), inhalants, hallucinogens (including LSD and PCP), heroin, or any prescription-type psychotherapeutic used nonmedically.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000.

3.10 Source of Payments for Most Recent Treatment
       Note: The estimates and figure for this section include persons reporting more than one source.

• Among the 2.8 million persons aged 12 or older who received any alcohol or illicit drug treatment in the past year, more paid for all or part of their most recent treatment with their own savings or earnings than any other source (47.4 percent); for 27.8 percent of the persons aged 12 or older who received any alcohol or illicit drug treatment in the past year, private health insurance paid for all or part of the most recent treatment; for 18.0 percent, public assistance other than Medicaid paid for all or part of their most recent treatment; for 14.8 percent, Medicare paid; for 16.4 percent, family members paid; for 13.6 percent, Medicaid paid; for 8.3 percent, their employer paid; for 9.1 percent, the courts paid; and for 5.6 percent, CHAMPUS, TRICARE, CHAMPVA, the VA, or some other military health care paid (Figure 12).

• The pattern in rates for source of payment for all or part of the most recent treatment among persons receiving only illicit drug treatment and among persons receiving only alcohol treatment is similar to the pattern among persons receiving any illicit drug or alcohol treatment.

• Among the 0.2 million youths aged 12 to 17 who received any illicit drug or alcohol treatment in the past year, more paid for all or part of their most recent treatment with private health insurance (29.2 percent); for 26.4 percent, all or part of their most recent treatment was paid for by family members; for 16.8 percent, Medicaid paid; for 14.6 percent, Medicare paid; for 12.4 percent, the courts paid; for 2.1 percent, CHAMPUS, TRICARE, CHAMPVA, the VA, or some other military health care paid; and for 1.4 percent, their employer paid.

Figure 12 Source of Payment for Most Recent Treatment for Any Illicit Drug or Alcohol Use among Persons Receiving Treatment in the Past Year: 2000

Note: Respondents could indicate multiple sources of payment for their most recent treatment; thus, these response categories are not mutually exclusive. "Illicit drug" refers to marijuana/hashish, cocaine (including crack), inhalants, hallucinogens (including LSD and PCP), heroin, or any prescription-type psychotherapeutic used nonmedically.

Source: SAMHSA, Office of Applied Studies, National Household Survey on Drug Abuse, 2000.

This page was last updated on June 16, 2008.

SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.