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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, Tennessee has ranked among those States with the lowest rates of the following measures (Table 1):
|Past Month Marijuana Use||12-17|
|Past Month Alcohol Use||All Age Groups|
|Past Month Binge Alcohol Use||All Age Groups|
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). Tennesseeā''s rates of past year alcohol dependence have consistently been among the 10 lowest in the country for all age groups and across all survey years (Chart 1).Rates of past year drug dependence have been more variable across all survey years (Chart 2).
Substance Abuse Treatment Facilities
According to the 2006 National Survey of Substance Abuse Treatment Services (N SSATS),3 there were 195 treatment facilities in Tennessee. Of these, 147 (75%) were private nonprofit, and 35 (18%) were private for-profit. Although facilities may offer more than one modality of care, in 2006 the 171 facilities (88%) offered some form of outpatient treatment, and an additional 54 facilities (28%) offered some form of residential care. Seven facilities offered an opioid treatment program, and 124 physicians and 24 treatment programs offered buprenorphine treatment for opiate addiction.In 2006, 113 facilities (58%) received some form of Federal, State, county, or local government funds, and 116 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 sourcesā''an annual one-day census in N-SSATS and annual treatment admissions from the Treatment Episode Data Set (TEDS).4 In the N-SSATS 2006 survey, Tennessee showed a total of 15,053 clients in treatment, 13,348 of whom (89%) were in outpatient treatment. Of the total number of clients in treatment on this date, 1,003 (7%) were under the age of 18.Chart 3 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 (from 82% in 1992, to 59% in 2006), and a concomitant increase in the percentage of admissions mentioning opiates other than heroin (from 6% in 1992, to 29% in 2006).Across the years for which TEDS data are available, Tennessee has seen a substantial shift in the constellation of problems present at treatment admission. Drug-only admissions have increased, from 18 percent of all admissions in 1992, to 41 percent in 2006. Concomitantly, admissions for both drugs and alcohol have decreased, from 45 percent in 1992 to 28 percent in 2006 (Chart 4).
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 for unmet drug treatment need have varied considerably across time and among age groups. In 2005-2006, the rates for all age groups were above the national average and, for those individuals age 18 to 25, they were among the 10 highest in the country (Chart 5).On the other hand, rates of unmet need for alcohol treatment have consistently been below the national rates, and for three age groups (12+, 12-17, and 26+) in 2005-2006 they were among the 10 lowest in the country (Chart 6).