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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, rates on measures of past month and past year use of illicit drugs have been quite variable across all age groups. Generally, the rates of past month use of any illicit substance have been at or below the national rates, including rates for marijuana use. Rates of cocaine use in 2002-2003 were above the national levels, but generally below the national levels by 2005-2006. Rates of past month alcohol use were similar generally at or below the national rates; however, rates of binge alcohol use were generally at or above the national rates.
Abuse and DependanceQuestions 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 alcohol dependence have generally been at or above the national rates for all age groups and across survey years (Chart 1).Rates of past year drug dependence have generally been at or below the national rates and in 2005-2006 were among the 10 lowest2 in the country (Chart 2).
Substance Abuse Treatment Facilities
According to the National Survey of Substance Abuse Treatment Services (N-SSATS),3 the number of treatment facilities in Missouri has remained relatively stable since 2002. In 2006, there were a total of 257 facilities, of which 196 (76%) were private nonprofit facilities and another 48 (19%) were private for-profit.Although facilities may offer more than one In 2006, 73 percent of all facilities (188) received modality of care, in 2006 the majority of facilities some form of Federal, State, county, or local in Missouri (240 of 257, or 93%) offered some government funds, and 126 facilities had agreements form of outpatient treatment. An additional 67 or contracts with managed care organizations for the facilities offered some form of residential care. Ten provision of substance abuse treatment services.facilities offered opioid treatment programs, and 70 physicians and 14 treatment programs were certified to provide buprenorphine treatment for opiate addiction.
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 According to the 2006 N-SSATS survey, Missouri showed an one-day total of 20,163 clients in treatment, the majority of whom (18,221 or 90%) were in outpatient treatment. Of the total number of clients in treatment on this date, 2,134 (11%) were under the age of 18.Chart 3 shows the percent 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 as a substance of abuse, and marked increases in the percentage of admissions mentioning marijuana and methamphetamine.Across the years for which TEDS data are available, Missouri has seen a substantial shift in the constellation of problems present at treatment admission (Chart 4). Alcohol-only admissions have declined from 46 percent of all admissions in 1992, to 21 percent in 2005. Concomitantly, drug-only admissions have tripled from 15 percent in 1992 to 45 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.Rates of unmet treatment need for alcohol use have generally been at or above the national average, and in 2005-2006 the rate for individuals age 18 to 25 was among the highest in the country (17.03 for the U.S. vs. 20.97 for Missouri) (Chart 5).Rates of unmet need for drug treatment have been more variable across time and among age groups (Chart 6).