Download - Deborah Trunzo Office of Applied Studies Substance Abuse and Mental Health Services Administration
Admissions to Substance Abuse Treatment for the Admissions to Substance Abuse Treatment for the Abuse of Opioid Analgesics:Abuse of Opioid Analgesics:
Findings from theFindings from the Treatment Episode Data SetTreatment Episode Data Set
Deborah TrunzoOffice of Applied Studies
Substance Abuse and Mental Health Services Administration
May 5, 2008
Treatment Episode Data Set (TEDS)
• Client-level information on treatment admissions
• Collected by States and reported to SAMHSA
• Primarily from facilities receiving public funds
• Estimated coverage – 80%
• 1.8 million admissions annually
TEDS Data Elements
• Demographic variables
• Drug use history – top 3 substances of abuse at admission– route of administration– frequency of use– age at first use
• Treatment variables
Limitations of TEDS
• Drugs of abuse reported in “generic” categories, not specific brand names or formulations
• All States report on “opiates other than heroin” as a group
• Only 16 States report on specific opioid analgesics
–
Treatment Admissions by Primary Substance: 2006
Alcohol39%
Marijuana16%
Cocaine14%
Heroin14%
Stimulants9%
Opioid analgesics*
4%
Other4%
* Includes admissions where primary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone.
N = 1.8 million
Treatment Admissions Involving Opioid Analgesics1
1992-2006
0
20
40
60
80
100
120
140
1992 1994 1996 1998 2000 2002 2004 2006
No
. o
f ad
mis
sio
ns (
000s)
1 Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone.
OxyContin introduced
Percent Increase in Admissions for Heroin and Opioid Analgesics1: 1997-2006
12% 4%
367%
295%
0
50
100
150
200
250
300
350
400
Totaladmissions
Heroin (primary) Opioidanalgesics
(primary)
Opioidanalgesics
(any)
% i
ncre
ase
1 Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone.
Admissions Involving Specific Opioid Analgesics1: 2006
Oxycodone 15,300
Codeine 1,200
Hydrocodone 900
Hydromorphone 900
Propoxyphene 162
Meperidine 80
Pentazocine 30
Tramadol 50
Other opiates or synthetics 33,100
1Data submitted by 16 States: AL, HI, ID, KY, MD, ME, MO, MS, ND, NH, NJ, NM, NV, NY, OH, SD
States Reporting Specific Opioid Analgesics: 2006
Percent Increase in Admissions for Specific Opioid Analgesics1:2000-2006
137% 121%19%
1,513%
67%
-60%
168%
-200
0
200
400
600
800
1,000
1,200
1,400
1,600
All op
ioid
anal
gesic
s
Codeine
Hydro
morp
hone
Mep
erid
ine
Oxyco
done
Penta
zoci
ne
Propoxy
phene
% i
nc
rea
se
1 Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone. Analysis restricted to 13 States that reported detailed drug codes for 2000 and 2006.
1 Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone.
Opioid Analgesic1 Admission Rates by State: 2006
129 - 288
< 51
51 - 77 Incomplete data
78 - 128 289 or more
Admissions per 100,000 population aged 12 and over
Opioid Analgesic1 Treatment Admission Rates by Urbanization: 2000 and 2006
23
1623
30 28 26
55
31
58
68
7671
0
10
20
30
40
50
60
70
80
90
Total US LargeMSA, inCentral
City
LargeMSA, Notin Central
City
Small MSA Non-MSA,Small City
Non-MSA,No City
Pe
r 1
00
,00
0 a
ge
12
& o
ve
r
2000 2006
1 Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone.
MSA = Metropolitan Statistical Area
Percent of Primary and Secondary Opioid Analgesic Admissions Using Other Substances: 2006
37
2220
17
107
59
29
13 15
3
29
6 5
0
0
40
NoneAlcohol
Marijuana
Cocaine
Tranquillizers
Heroin
Stimulants
Other/unknown
Perc
ent
Opiate Analgesics Primary Opiate Analgesics Secondary
Treatment Admissions Involving Opioid Analgesics1 by Age and Route of Administration: 2006
0
1000
2000
3000
4000
10 15 20 25 30 35 40 45 50 55 60
No
. o
f a
dm
iss
ion
s
1 Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone.
Age
Oral
Inhaled
InjectedOther
Treatment Admissions Involving Oxycodone1 by Age and Route of Administration: 2006
0
50
100
150
200
250
300
350
400
450
10 15 20 25 30 35 40 45 50 55 60
No
. o
f ad
mis
sio
ns
1 Includes admissions where primary, secondary, or tertiary substance was reported as Oxycodone.
Age
Oral
Injected
Inhaled
Other
Characteristics of Opioid Analgesic1 Admissions1997 and 2006
1997 2006
Male 56% 57%
White (non-Hispanic) 83% 88%
Less than 20 years of age
20 to 29 years
30 years or more
5%
16%
79%
11%
37%
52%
New users (3 yrs use or less) 20% 28%
Oral
Injected
Inhaled
78%
14%
3%
74%
10%
13%
1 Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone.
Admissions for Primary Opioid Analgesics1 by Age of First Use: 1997-2006
0%
25%
50%
75%
100%
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
% o
f adm
issi
ons
17 and under
18 - 24
25 - 34
35 - 44
55+
45 - 54
* Includes admissions where primary substance was reported as Other
opiates/synthetics. Excludes admissions for non-prescription use of methadone.