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, Oregon has consistently ranked among the highest 10 States for several measures of use and abuse of alcohol and other substances in two age groupingsthe population of the State age 12 and older and the population of the State age 26.

Abuse and Dependance

Questions in NSDUH are used to classify persons as 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). Prevalence rates for alcohol and illicit drug abuse and/or dependence have fluctuated across the 4 years for which data are available. Prevalence rates for all four age groups (12+, 12-17, 18-25, and 26+) have remained at or near the national average. Comparing prevalence rates for the population age 26 and older, however, shows a marked decline between 2002–2003 and 2005–2006 where the rates are among the lowest in the country (Chart 1).

Substance Abuse Treatment Facilities

According to the National Survey of Substance Abuse Treatment Services (N-SSATS),3 the number of treatment facilities has declined slightly between 2002 and 2006, from a high of 232 facilities to the current 224 facilities. In 2006, 124 facilities (55%) were private nonprofit. Another 55 facilities (25%) were private for-profit, and 35 facilities (16%) were operated by local governments. Notably, Oregon has nine facilities (4% of all facilities) that are owned/operated by tribal government(s), and two facilities that offer treatment programs in American Indian/Alaska Native languages.

Although facilities may offer more than one modality of care, 200 out of 232 facilities offer some form of outpatient treatment; 50 facilities offer some form of residential care; 12 facilities statewide offer opioid treatment programs; and 68 physicians are certified to provide buprenorphine care.

In 2006, 132 of 232 facilities received some form of Federal, State, county, or local government funds, and 167 facilities had agreements or contracts with managed care organizations for the provision of substance abuse 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 In the N-SSATS: 2006 survey, Oregon showed a one-day census on March 31, 2006, of 22,353 clients in treatment. Of these, 2,273 (approximately 10%) were under the age of 18. The majority of clients (89%) were in outpatient treatment.

Chart 2 shows that the percentage of admissions mentioning two or more drugs at admission5 has risen substantially over time.

TEDS also collects information on the mention of particular drugs or alcohol at the time of admission. Across the last 13 years, there has been a steady decline in the number of admissions mentioning alcohol or cocaine as an abused substance and concomitant increases in the mentions of marijuana and heroin (Chart 3).

The decline in alcohol mentions at admissions is mirrored by the change in admissions composition where alcohol-only admissions declined from 54 percent in 1992 to 30 percent in 2005 and drug-only admissions increased from 8 percent to 26 percent across the same time period (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.

While the rates of unmet need for treatment for alcohol and illicit drug abuse in Oregon are at or below the national rates, the individuals in the age group 18 to 25 show the largest gaps in treatment need (Charts 5 and 6).