Chapter 5

Topics of Special Interest

 

Adolescent Substance Abuse (Ages 12-17)

Heroin Admissions by Route of Administration and Planned Use of Methadone

Polydrug Abuse

Population Racial/Ethnic Subgroups

[Main Table of Contents]


This chapter highlights topics that are of current or special interest:

Adolescent Substance Abuse (Ages 12-17)

TEDS data indicate an overall increase in adolescent admissions aged 12-17 for substance abuse treatment between 1992 and 2000, attributable primarily to increased admissions involving marijuana and increased referral to treatment through the criminal justice system. However, the total number of adolescent admissions peaked in 1998.

Tables 5.1a and 5.1b and Figure 27. The number of adolescents aged 12-17 admitted to substance abuse treatment showed a net increase of 38 percent between 1992 and 2000. Admissions for marijuana abuse grew steadily from 23 percent of adolescent admissions in 1992 to 62 percent in 2000, and accounted for the overall increase in adolescent admissions from 1992 to 2000.

Table 5.2a. Overall, 71 percent of adolescent admissions were male. However, this proportion was heavily influenced by marijuana admissions, where 76 percent were male. The male:female ratio was much closer for most other substances. For heroin and cocaine, male adolescent admissions outnumbered female only slightly.

Figure 27
Adolescent admissions by primary substance: TEDS 1992-2000

Figure 27, Adolescent admissions by primary substance: TEDS 1992-2000

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.

Table 5.2a. In 2000, more than half (51 percent) of adolescent admissions were referred to treatment through the criminal justice system. Seventeen percent were self- or individual referrals, and 11 percent were referred through schools. These referral sources together accounted for 79 percent of all youth admissions.

Figure 28. The number of admissions from the criminal justice system increased every year from 1992 to 1999, but demonstrated a slight decrease in 2000. Admissions resulting from self- or individual referrals, schools, and other referral sources have been stable or declined slightly since 1995.

Figure 28
Adolescent admissions by referral source: TEDS 1992-2000

Figure 28, Adolescent admissions by referral source: TEDS 1992-2000

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.

Table 5.3a. In 2000, 53 percent of all adolescent admissions involved the use of both alcohol and marijuana. Admissions involving both alcohol and marijuana increased by 74 percent between 1992 and 2000. Admissions involving primary marijuana and no alcohol increased more than fivefold, by 443 percent. Over the same period, admissions involving primary alcohol and no marijuana declined by 62 percent. For admissions involving both marijuana and alcohol, or marijuana and no alcohol, the majority of increase was from criminal justice referrals.

Figure 29 summarizes the data in Table 5.3a according to whether marijuana was involved in the admission. Adolescent admissions increased between 1992 and 2000 only for marijuana-involved admissions. The number of marijuana-involved admissions originating in the criminal justice system increased every year through 1999. However, marijuana-involved admissions from other referral sources increased only through 1995, then stabilized and declined slightly. In 1999 and 2000, marijuana-involved adolescent admissions referred through the criminal justice system outnumbered those entering treatment through other referral sources. Adolescent admissions not involving marijuana declined between 1992 and 2000, regardless of referral source.

Figure 29
Adolescent admissions by marijuana involvement and criminal justice referral:
TEDS 1992-2000

Figure 29, Adolescent admissions by marijuana involvement and criminal justice referral: TEDS 1992 - 2000

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.

Heroin Admissions by Route of Administration and Planned Use of Methadone

TEDS data indicate that heroin inhalation and, to a lesser extent, heroin smoking were growing problems among young adults in the 1990s. Despite increases in the numbers of admissions for heroin abuse, the number where methadone use was planned as a part of treatment declined.

Tables 5.4a and 5.4b. Heroin admissions increased by 45 percent between 1992 and 2000. Increases of 115 percent in admissions for heroin inhalation and 194 percent in admissions for heroin smoking were responsible. The number of admissions for heroin injection increased 18 percent. The proportion of heroin admissions represented by injection declined from 77 percent in 1992 to 65 percent in 2000. Heroin inhalation made up 30 percent of all heroin admissions in 2000, an increase from 20 percent in 1992.

Tables 5.4a and 5.4b and Figure 30. The planned use of methadone as part of treatment did not keep pace with the increase in heroin admissions. While heroin admissions increased by 45 percent between 1992 and 2000, the planned use of methadone decreased by 2 percent. Methadone use was more likely to be planned for heroin injectors and smokers than inhalers. Among admissions for heroin injection (the majority of heroin admissions), planned use of methadone fell by 16 percent between 1992 and 2000. The proportion of admissions for heroin inhalation that included planned use of methadone rose from a low of 24 percent in 1996 to 34 percent in 2000, a level below the 47 percent reported in 1992.

Figure 30
Planned use of methadone by route of heroin administration: TEDS 1992-2000

Figure 30, Planned use of methadone by route of heroin administration: TEDS 1992-2000

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.

Table 5.5b and Figure 31. People who inhaled or smoked heroin and sought treatment tended to be younger than those who reported injecting heroin at the time of admission. While the proportion of admissions under age 30 decreased among heroin inhalers, it increased among heroin injectors. In 1992, 45 percent of admissions for inhalation were under 30 years of age, compared to 21 percent of those injecting heroin. By 2000, however, the proportion of those admitted for inhaling heroin who were under age 30 had fallen to 27 percent. The proportion admitted for injecting heroin who were under age 30 had increased to 26 percent. Among heroin smokers, the proportion under age 30 fluctuated between about 35 and 40 percent.

Table 5.5a. Among heroin abusers experiencing a first treatment episode in 2000, the average duration of use was shorter for heroin smokers and heroin inhalers (11 years) than for admissions where the route of heroin administration was injection (13 years).

Figure 31
Heroin admissions under age 30 by route of administration: TEDS 1992-2000

Figure 31, Heroin admissions under age 30 by route of administration: TEDS 1992-2000

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.

Polydrug Abuse

Polydrug abuse (the use of more than one substance) was more common among TEDS admissions than was the abuse of a single substance.

Table 5.6 and Figure 32. Polydrug abuse was reported by 53 percent of all TEDS admissions in 2000. Alcohol, marijuana/hashish, and cocaine were the most common secondary substances reported.

Abuse of alcohol as either a primary or secondary substance was characteristic of most treatment admissions. Nearly half (45 percent) of all treatment admissions were for primary alcohol abuse, and 22 percent of persons admitted for other drugs reported that they also had an alcohol problem. Overall, 67 percent of all persons admitted to treatment abused alcohol.

Alcohol and opiates were reported more often as primary substances than as secondary substances. Twenty-one percent of all admissions involved opiate use with 17 percent reporting primary use and 4 percent reporting secondary use.

For marijuana/hashish and cocaine, more admissions reported these drugs as secondary substances than as primary substances. Marijuana/hashish was reported as a primary substance by 15 percent of all admissions, but was a secondary substance for another 21 percent, so that 36 percent of all treatment admissions used marijuana. Cocaine was a primary substance for 14 percent of admissions, but was a secondary substance for an additional 17 percent. Thus nearly one-third of all treatment
admissions involved cocaine abuse.

Table 5.7. This table details the most common substance combinations for selected primary substances. For example, for primary alcohol admissions, 57 percent reported using only alcohol, 15 percent reported using only alcohol and marijuana, and 7 percent reported using the combination of primary alcohol with secondary cocaine and marijuana.

Figure 32
Primary and secondary substance abuse: TEDS 2000

Figure 32, Primary and secondary substance abuse: TEDS 2000

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.

Population Racial/Ethnic Subgroups

TEDS permits analysis of racial/ethnic subgroups that are generally poorly represented in sample surveys.

Tables 3.1a, 3.1b, 3.2a, and 3.2b and Figures 33-38. Substance abuse patterns differed widely among racial/ethnic subgroups in 2000. However, alcohol was the predominant substance for all racial/ethnic groups except persons of Puerto Rican origin. The proportion of admissions with alcohol as the primary substance ranged from 23 percent for persons of Puerto Rican origin to 65 percent for American Indians/Alaska Natives [Table 3.1b].

Among non-Hispanic Whites [Figure 33 and Table 3.2b], alcohol as the primary substance accounted for 56 percent of admissions among males and 43 percent of female admissions. Marijuana was the primary illicit substance for non-Hispanic White men (15 percent), followed by opiates (13 percent) and cocaine (7 percent). For non-Hispanic White women, opiates were the primary illicit drug (18 percent), followed by marijuana (12 percent), cocaine (11 percent), and stimulants (10 percent).

Among non-Hispanic Blacks [Figure 34 and Table 3.2b], 34 percent of male admissions and 26 percent of female admissions involved alcohol as the primary substance. Cocaine was the primary illicit substance for both men and women (27 percent and 39 percent, respectively). This was followed by marijuana (20 percent) and opiates (15 percent) for men and opiates (19 percent) and marijuana (11 percent) for women.

Among Hispanics, substance abuse patterns differed according to country of origin. Among persons of Mexican origin [Figure 35 and Table 3.2b], alcohol was the primary substance involved in 46 percent of male admissions, but only 26 percent of female admissions. Opiates were the primary illicit substance for both men and women (26 percent and 30 percent, respectively). For men, this was followed by marijuana (14 percent), cocaine (7 percent), and stimulants (6 percent). For women, it was followed by stimulants (17 percent), marijuana (13 percent), and cocaine (12 percent). Stimulant abuse was higher among persons of Mexican origin than among other Hispanic groups.

Among persons of Puerto Rican origin [Figure 36 and Table 3.2b], opiates were the main substance at treatment admission for both men and women (52 percent and 48 percent, respectively). This was followed by alcohol (24 percent), marijuana (14 percent), and cocaine (9 percent) for men. For women, alcohol (21 percent), cocaine (15 percent), and marijuana (11 percent) were the next most common primary substances.

American Indians and Alaska Natives together accounted for 2 percent of all TEDS admissions [Table 3.1a]. Among American Indian/Alaska Native admissions, 69 percent of men and 58 percent of women entered treatment because of primary alcohol abuse [Figure 37 and Table 3.2b]. Marijuana was the primary illicit substance, responsible for 14 percent of male and 12 percent of female admissions. This was followed by opiates (6 percent), cocaine, and stimulants (4 percent each) for men. For women, opiates and stimulants accounted for 10 percent and 9 percent of admissions, respectively, while cocaine accounted for 7 percent.

Asians and Pacific Islanders accounted for approximately 1 percent of all TEDS admissions [Table 3.1a]. Among this group [Figure 38 and Table 3.2b], 38 percent of male admissions and 27 percent of female admissions involved alcohol as the primary substance. Marijuana was the primary illicit drug for men (22 percent), followed by stimulants (17 percent). The reverse was true for women, with 30 percent of admissions for stimulants and 16 percent for marijuana. For both men and women, opiates (12 percent and 13 percent, respectively) and cocaine (9 percent and 11 percent, respectively) followed.

Figure 33
White (non-Hispanic)
Admissions by primary substance, sex, and age: TEDS 2000

Figure 33, White (non-Hispanic) Admissions by primary substance, sex, and age: TEDS 2000

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.

Figure 34
Black (non-Hispanic)
Admissions by primary substance, sex, and age: TEDS 2000

Figure 34, Black (non-Hispanic) Admissions by primary substance, sex, and age: TEDS 2000

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.

Figure 35
Mexican origin
Admissions by primary substance, sex, and age: TEDS 2000

Figure 35, Mexican origin Admissions by primary substance, sex, and age: TEDS 2000

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.

Figure 36
Puerto Rican origin
Admissions by primary substance, sex, and age: TEDS 2000

Figure 36, Puerto Rican origin Admissions by primary substance, sex, and age: TEDS 2000

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.

Figure 37
American Indian/Alaska Native
Admissions by primary substance, sex, and age: TEDS 2000

Figure 37, American Indian/Alaska Native Admissions by primary substance, sex, and age: TEDS 2000

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.

Figure 38
Asian/Pacific Islander
Admissions by primary substance, sex, and age: TEDS 2000

Figure 38, Asian/Pacific Islander Admissions by primary substance, sex, and age: TEDS 2000

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS) - 4.1.02.

[Back to Top]