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,
the rates of past month use of any illicit substance
have been at or below the national rates, including
rates for marijuana use. Rates of cocaine use in
2002-2003 were above the national levels, but generally
below the national levels by 2005-2006. Rates of
past month alcohol use were similar—generally
at or below the national rates; however, rates of
binge alcohol use were generally at or above the
national rates.
Abuse and Dependency in Missouri
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 dependence have generally
been at or above the national rates for all age
groups and across survey years.
Rates of past year drug dependence have generally
been at or below the national rates and in 2005-2006
were among the 10 lowest2 in the country.
Missouri's Past Year Dependence on or
Abuse of Illicit Drugs or Alcohol 2005-2006
Substance Abuse Treatment
Facilities in Missouri
According to the National Survey of Substance
Abuse Treatment Services (N-SSATS),3 the number
of treatment facilities in Missouri has remained
relatively stable since 2002. In 2006, there were
a total of 257 facilities, of which 196 (76%)
were private nonprofit facilities and another
48 (19%) were private for-profit.
Although facilities may offer more than one modality
of care, in 2006 the majority of facilities in
Missouri (240 of 257, or 93%) offered some form
of outpatient treatment. An additional 67 facilities
offered some form of residential care. Ten facilities
offered opioid treatment programs, and 70 physicians
and 14 treatment programs were certified to provide
buprenorphine treatment for opiate addiction.
In 2006, 73 percent of all facilities (188) received
some form of Federal, State, county, or local
government funds, and 126 facilities had agreements
or contracts with managed care organizations for
the provision of substance abuse treatment services.
Addiction Treatment in Missouri
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). According to the 2006 N-SSATS survey,
Missouri showed a one-day total of 20,163 clients
in treatment, the majority of whom (18,221 or
90%) were in outpatient treatment. Of the total
number of clients in treatment on this date, 2,134
(11%) were under the age of 18.
The percent of admissions mentioning particular
drugs or alcohol at the time of admission.5 Across
the last 15 years, there has been a steady decline
in the number of admissions mentioning alcohol
as a substance of abuse, and marked increases
in the percentage of admissions mentioning marijuana
and methamphetamine.
Across the years for which TEDS data are available,
Missouri has seen a substantial shift in the constellation
of problems present at treatment admission. Alcohol-only
admissions have declined from 46 percent of all
admissions in 1992, to 21 percent in 2005. Concomitantly,
drug-only admissions have tripled from 15 percent
in 1992 to 45 percent in 2006.
Unmet Need for Addiction Treatment
in Missouri
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 treatment need for alcohol use
have generally been at or above the national average,
and in 2005-2006 the rate for individuals age
18 to 25 was among the highest in the country
(17.03 for the U.S. vs. 20.97 for Missouri).
Rates of unmet need for drug treatment have been
more variable across time and among age groups.
Sources: Facility Data: National
Survey of Substance Abuse Treatment Services (N-SSATS)–2006
is available at: http://www.dasis.samhsa.gov.
Center for Mental Health Services
Uniform Reporting System Output Tables 2006 is
available at: http://mentalhealth.samhsa. gov/cmhs/MentalHealthStatistics/URS2006.asp
Substance Abuse Treatment Data:
Treatment Episode Data Set–Concatenated
File–is available from the Substance Abuse
and Mental Health Data Archive: http://www. icpsr.umich.edu/SDA/SAMHDA.
Mental Health Treatment Data: Center
for Mental Health Services Uniform Reporting System
Output Tables 2006 is available at: http://mentalhealth.samhsa.gov/cmhs/
MentalHealthStatistics/URS2006.asp.
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