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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, Colorado has ranked among the 10 States with the highest rates on the following measures (Tabe 1).
|Past Month Illicit Drug Use||12+, 26+|
|Past Year Marijuana Use||12-17|
|Least Perception of Risk Associated with Using Marijuana Once or Twice a Month||12+, 26+|
|Past Month Use of an Illicit Drug Other than Marijuana||18-25|
|Past Year Cocaine Use||12+, 18-25, 26+|
|Past Year Nonmedical Use of Pain Relievers||26+|
|Past Month Alcohol Use||12+,26+|
|Least Perception of Risk Associated with Having Five or More Drinks of an Alcoholic Beverage Once or Twice a Week||12-17|
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, rates in Colorado have generally been higher than the national rate. In 2005'2006, the rates were among the 10 highest in the country for all age groups. Viewed separately, however, there are differences between age groups for alcohol and illicit drugs.
Substance Abuse Treatment Facilities
According to the 2006 National Survey of Substance Abuse Treatment Services (N-SSATS) annual survey,3 the number of treatment facilities in Colorado was 443. The majority of these facilities (245 of 443, or 55%) were private forprofit, and 165 (37%) were private nonprofit. Since 2002, the number of treatment facilities in Colorado has increased from 389 to 443. The majority of this increase is accounted for by an additional 45 private for-profit facilities.
Although facilities may offer more than one modality of care, 417 facilities (94%) in 2006 offered some form of outpatient treatment. An additional 68 facilities offered some form of residential care, and 11 facilities offered an opioid treatment program. Additionally, 104 physicians and 18 treatment programs offered buprenorphine treatment for opium addiction
In 2006, 39 percent of all facilities (172) received some form of Federal, State, county, or local government funds, and 72 facilities 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 1-day census in N-SSATS and annual treatment admissions from the Treatment Episode Data Set (TEDS).4 In the 2006 N-SSATS survey, Colorado showed a 1-day total of 33,264 clients in treatment, the majority of whom (31,591 or 95%) were in outpatient treatment. Of the total number of clients in treatment on this date, 2,717 (8%) were under the age of 18.
Chart 3 shows the percent of admissions mentioning particular drugs or alcohol at the time of admission.5 Across the last 15 years, the percent of admissions mentioning alcohol, cocaine, or marijuana has remained relatively constant. Methamphetamine admissions, however, have increased from 2 percent in 1992, to 11 percent in 2006.
Across the years for which TEDS data are available, Colorado has seen little change in the constellation of problems present at treatment admission. Alcohol-only admissions have declined from 69 percent of all admissions in 1992, to 63 percent in 2006. Concomitantly, drug-only admissions have increased from 7 percent in 1992, to 16 percent in 2006 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. Rates of unmet need for alcohol treatment have generally been above the national rates for all age groups and across all survey years. This is particularly true for individuals age 26 and older (Chart 5).
Similarly, rates of unmet need for drug treatment have generally been above the national average, particularly for those age 18 to 25 (Chart 6).