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, Idaho has consistently ranked among the 10 states with the lowest rates of the following measures (Table 1).

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).

Rates of past year alcohol abuse or dependence in Idaho have varied considerably among the four age groups and across survey years; however, the rates for individuals age 12 to 17 have consistently ranked among the highest in the country (Chart 1).

Rates of past year illicit drug abuse or dependence in have also varied considerably but rates for past year drug dependence in the group age 26 and older have remained consistently among the lowest in the country (Chart 2).

Substance Abuse Treatment Facilities

According to the 2006 National Survey of Substance Abuse Treatment Services (N-SSATS),3 the number of treatment facilities in Idaho was 57. Of these, 21 were private nonprofit and 28 private for-profit. Four facilities were owned/operated by tribal governments.

The number of facilities in Idaho has decreased from a high of 73 facilities in 2004 to 57 facilities in 2006. The decrease is principally attributable to the loss of nine private not-for-profit facilities and four private for-profit facilities.

Although facilities may offer more than one modality of care, the majority of facilities (50 of 67) in Idaho in 2006 offered some form of outpatient care, and 13 facilities offered some form of residential care. A total of 18 physicians and 3 treatment programs are certified to provide buprenorphine treatment for opiate addiction.

In 2006, 70 percent of all Idaho treatment facilities (40 of 57) received some form of Federal, State, county, or local government funds, and 29 (51%) facilities had agreements or contracts with managed care organizations for the provision of substance abuse treatment services.

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).4 In the 2006 N-SSATS survey, Idaho showed a one-day census of 3,824 clients in treatment, the majority of whom (3,546 or 93%) were in outpatient treatment. Of the total number of clients in treatment on this date, 395 (10%) were under the age of 18.

Chart 3 shows the percentage of admissions mentioning particular drugs or alcohol at the time of admission.5 Across the last 14 years, there has been a steady decline in the number of admissions mentioning alcohol and cocaine as substances of abuse and a sharp increase (from 8% in 1992 to 53% in 2005) of admissions for methamphetamine use.

Similarly, across the available years of TEDS data, there has been a marked change in the combinations of drugs and alcohol at treatment admission with drug-only admissions increasing from 10 percent in 1992 to 35 percent in 2005 (Chart 4).

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 Idaho, rates of individuals needing and not receiving treatment for drug use have varied considerably over time; however, the rate for unmet treatment need among individuals age 12 to 17 has remained consistently at or above the rate of the country as a whole (Chart 5).