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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 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, Virginias rates on all major prevalence measures have remained at or below the rates for the country as a whole.
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). As with the prevalence rates above, rates of past year abuse or dependence on illicit drugs or alcohol have remained consistently at or below the rates for the country as a whole for all population groups (Chart 1).
Substance Abuse Treatment Facilities
According to the National Survey of Substance Abuse Treatment Services (N-SSATS),2 in 2006, there were 196 treatment facilities in Virginia. Of these, 55 (28%) were private nonprofit and 43 (22%) were private for-profit. The State government operated an additional 70 facilities. The number of treatment facilities in Virginia has declined from 228 in 2002 to 196 in 2006. The decrease is primarily attributable to a loss of 13 private for-profit facilities and 26 facilities owned/operated by the State government.
Although facilities may offer more than one modality of care, in 2006 the majority of Virginia facilities (167 of 196, or 85%) offered some form of outpatient care. Another 42 facilities offered residential care, and 20 facilities had opioid treatment programs. In addition, 133 physicians and 35 treatment programs were certified to provide buprenorphine 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).3 In the 2006 N-SSATS survey, Virginia showed a total of 22,847 clients in treatment, the majority of whom (21,311 or 93%) were in outpatient treatment. Of the total number of clients in treatment on this date, 2,879 (12%) were under the age of 18.
Chart 2 shows the percentage of admissions mentioning particular drugs or alcohol at the time of admission.4 Across the last 14 years, there has been a modest decline in the number of admissions mentioning alcohol as a substance of abuse and modest increases in admissions mentioning marijuana and heroin.
Across the years for which TEDS data are available, Virginia has seen a modest shift in the constellation of problems present at treatment admission. Alcohol-only admissions have declined from over 26 percent of all admissions in 1992 to just over 14 percent in 2005. Concomitantly, drug-only admissions have increased from 15 percent in 1992 to 23 percent in 2005 (Chart 3).
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 rates of individuals needing and not receiving drug or alcohol treatment have generally remained at or below the national rates, those age 18 to 25 exhibit unmet treatment need higher than other population groups both in Virginia and in the country as a whole (Charts 4 and 5).