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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, Minnesota has ranked among the 10 States with the highest rates of the following measures (Table 1):
|Past Month Alcohol Use||12+, 18-25, 26+|
|Past Month Binge Alcohol Use||12+, 26+|
|Least Perception of Risk Associated with Monthly Use of Marijuana||12+, 26+|
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).
On the global measure of any past year dependence on or abuse of illicit drugs or alcohol, Minnesota's rates for three age groups (12+, 12-17, 26+) were among the 10 highest in the country (Chart 1).
When viewed separately, however, rates of past year illicit drug dependence have tended to be at or below the national rates, while rates of past year alcohol dependence have generally been at or above the national rates.
Substance Abuse Treatment Facilities
According to the National Survey of Substance Abuse Treatment Services (N-SSATS),3 the majority of Minnesota facilities in 2006 (140 of 263, or 53%) were private nonprofit. Another 98 facilities (37%) were private for-profit, and the remainder were owned or operated by Federal, State, or local government. Since 2002, the number of treatment facilities in Minnesota has remained relatively stable.
Although facilities may offer more than one modality of care, in 2006 the majority of facilities (204 of 263, or 78%) offered some form of outpatient treatment, and 112 facilities (43%) offered some form of residential care. Additionally, 9 facilities offered an opioid treatment program, and 57 physicians and 31 programs were certified to provide buprenorphine treatment for opiate addiction.
In 2006, 54 percent of all facilities (143) received some form of Federal, State, county, or local government funds, and 185 facilities (70%) 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 sources'an annual one-day census in N-SSATS and annual treatment admissions from the Treatment Episode Data Set (TEDS).4 In the 2006 N-SSATS survey, Minnesota showed an one-day total of 10,078 clients in treatment, the majority of whom (7,246 or 72%) were in outpatient treatment. Of the total number of clients in treatment on this date, 832 (8%) were under the age of 18.
Chart 2 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 small decline in the number of admissions mentioning alcohol and a marked increase in the percent of admissions mentioning methamphetamine (from 1.9% in 1992, to more than 18% in 2006).
Across the years for which TEDS data are available, Minnesota has seen a shift in the constellation of problems present at treatment admission (Chart 3). Alcohol-only admissions have declined from 44 percent of all admissions in 1992, to just over 28 percent in 2006. Concomitantly, drug-only admissions have tripled from 7 percent in 1992, to 23 percent in 2005.
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.
In Minnesota, the rates of individuals needing and not receiving drug treatment have generally been below the national rates; however, the rates of individuals needing and not receiving alcohol treatment have generally been above the national rates. In 2005-2006, Minnesota was among the 10 States with the highest rates of unmet alcohol treatment need for the State population as a whole (12+), and for those individuals age 26 and older (Chart 4).