Young Adults' Need for and Receipt of Alcohol and Illicit Drug Use Treatment: 2007
In Brief
About one fifth of young adults aged 18 to 25 (21.1 percent) were classified as needing treatment for alcohol or illicit drug use; 17.2 percent were in need of alcohol use treatment, 8.4 percent were in need of illicit drug use treatment, and 4.4 percent were in need of both alcohol and illicit drug use treatment
Less than one tenth (7.0 percent) of the young adults who were in need of alcohol or illicit drug use treatment in the past year received it at a specialty facility in the past year
Of the young adults who needed but did not receive alcohol or illicit drug use treatment in a specialty facility in the past year, 96.0 percent did not perceive the need
Less than one third of the young adults who did not receive treatment in a specialty facility but thought they needed it made an attempt to obtain it
Young adults compose the majority of the college and university populations and are the backbone of the entry-level workforce. Also, young adults traditionally have had higher rates of alcohol and illicit drug use compared with other age groups.1 Ensuring that the behavioral health needs of this age group are met is an important priority with long-term consequences for the country.
This issue of The NSDUH Report focuses on the alcohol and illicit drug use treatment needs of young adults (i.e., persons aged 18 to 25) and on the difference between the number who need treatment and those who actually receive it. The National Survey on Drug Use and Health (NSDUH) classifies persons as needing treatment for alcohol or illicit drug use if they met the criteria for dependence or abuse or if they received specialty treatment in the past year.2,3,4, Respondents who had not received treatment in the past 12 months were asked whether there was any time during this period when they felt they needed substance use treatment. Respondents who reported that they needed treatment were asked if they had made an attempt to obtain treatment. All data are from the 2007 NSDUH.
Treatment Need
In 2007, 21.1 percent of young adults (an estimated 6.9 million persons) needed treatment for alcohol or illicit drug use in the past year (Figure 1). Nearly one fifth (17.2 percent) were in need of alcohol use treatment, 8.4 percent were in need of illicit drug use treatment, and 4.4 percent were in need of both alcohol and illicit drug use treatment.
Figure 1. Past Year Need for Substance Use Treatment among Young Adults, by Substances for Which Treatment Was Needed: 2007
Figure 1 Table. Past Year Need for Substance Use Treatment among Young Adults, by Substances for Which Treatment Was Needed: 2007
Substance
Percent
Alcohol or Illicit Drugs
21.1%
Alcohol
17.2%
Illicit Drugs
8.4%
Alcohol and Illicit Drugs
4.4%
Source: 2007 SAMHSA National Survey on Drug Use and Health (NSDUH).
Need for alcohol or illicit drug treatment varied by demographic and socioeconomic characteristics. Young adult males were more likely than their female counterparts to have needed treatment (26.3 vs. 15.9 percent). Young adults with family incomes of less than $20,000 per year and those with family incomes of more than $75,000 per year were more likely to be in need of treatment than those with family incomes of $20,000 to $49,999 per year and $50,000 to $74,999 per year (Figure 2). The rate of need for treatment was higher among young adults with no health insurance coverage than among those with private insurance, Medicaid/CHIP, or other health insurance.
Figure 2. Past Year Need for Alcohol or Illicit Drug Use Treatment among Young Adults, by Family Income and Health Insurance Coverage: 2007
Figure 2 Table. Past Year Need for Alcohol or Illicit Drug Use Treatment among Young Adults, by Family Income and Health Insurance Coverage: 2007
* Respondents could indicate multiple types of health insurance; thus, categories are not mutually exclusive.
** CHIP is the Children's Health Insurance Program.
*** Other health insurance is defined as having Medicare, CHAMPUS, TRICARE, CHAMPVA, the VA, military health care, or any other type of health insurance.
Source: 2007 SAMHSA National Survey on Drug Use and Health (NSDUH).
Receipt of Treatment
Of the 6.9 million young adults who needed alcohol or illicit drug use treatment in the past year, 7.0 percent (482,000 persons) received treatment at a specialty facility in the past year. Among those who needed treatment for alcohol or illicit drug use, those who had private insurance were less likely to have received treatment at a specialty facility than those who had Medicaid/CHIP, other health insurance, or no health insurance (Figure 3). There was little difference in the percentage receiving specialty treatment by gender or family income.
Figure 3. Received Treatment for Alcohol or Illicit Drug Use in a Specialty Facility in the Past Year among Young Adults in Need of Treatment, by Health Insurance Coverage: 2007
Figure 3 Table. Received Treatment for Alcohol or Illicit Drug Use in a Specialty Facility in the Past Year among Young Adults in Need of Treatment, by Health Insurance Coverage: 2007
* CHIP is the Children's Health Insurance Program.
** Other health insurance is defined as having Medicare, CHAMPUS, TRICARE, CHAMPVA, the VA, military health care, or any other type of health insurance.
*** Respondents could indicate multiple types of health insurance; thus, categories are not mutually exclusive.
Source: 2007 SAMHSA National Survey on Drug Use and Health (NSDUH).
Needing but Not Receiving Treatment
NSDUH provides information on the difference between the number of people in need of treatment and the number of people who received it in a specialty facility. Among young adults in need of substance use treatment in the past year, 93.0 percent did not receive it.
Although the gap between treatment need and treatment receipt appears large, it is important to point out that a couple of factors contribute to this gap. First, the capacity of the treatment system is constrained by available fiscal and personnel resources and, in some instances, by legislation. Secondly, the treatment gap may be exacerbated by the fact that many persons who need treatment may not perceive that they need it and hence not seek the services that are available.5 Of the young adults who needed but did not receive substance use treatment in a specialty facility in the past year, 96.0 percent did not perceive a need for treatment. Among the 4.0 percent of young adults who did not receive treatment in a specialty facility but perceived a need for it, less than one third (32.2 percent) made an attempt to get treatment.
Discussion
This analysis on young adults provides important insights into opportunities in both prevention and treatment. Illicit drug and alcohol dependence and abuse are preventable disorders, and increased prevention efforts targeted at young adults could reduce the prevalence of these disorders among this age group. Similarly, outreach efforts to help individuals with substance use disorders to recognize the disorder and access the help available could increase the percentage who seek and use available treatment services.
End Notes1 Office of Applied Studies. (2008). Results from the 2007 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 08-4343, NSDUH Series H-34). Rockville, MD: Substance Abuse and Mental Health Services Administration. 2 NSDUH defines substance dependence or abuse using criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), including symptoms such as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference in major obligations at work, school, or home during the past year. For details, see the following resource: American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. 3 Specialty substance use treatment is defined as treatment received at drug or alcohol rehabilitation facilities (inpatient or outpatient), hospitals (inpatient only), and mental health centers. Specialty substance use treatment excludes treatment in an emergency room, private doctor's office, self-help group, prison or jail, or hospital as an outpatient. 4 NSDUH defines illicit drugs to include marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically. Nonmedical use is defined as use not prescribed for the respondent by a physician or used only for the experience or feeling the drug(s) caused. Nonmedical use of any prescription-type pain reliever, sedative, stimulant, or tranquilizer does not include over-the-counter drugs; nonmedical use of stimulants includes methamphetamines. 5 The gap between substance treatment need and utilization is also affected by court-ordered treatment through diversionary programs, such as mandatory driving under the influence (DUI) or driving while impaired or intoxicated (DWI) programs and drug courts. However, this issue is complex and cannot be addressed within the context of this report.
Suggested CitationSubstance Abuse and Mental Health Services Administration, Office of Applied Studies. (June 25, 2009). The NSDUH Report: Young Adults' Need for and Receipt of Alcohol and Illicit Drug Use Treatment: 2007. Rockville, MD.
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The 2007 data used in this report are based on information obtained from 22,187 persons aged 18 to 25. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.
The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)
Information on the most recent NSDUH is available in the following publication:
Office of Applied Studies. (2008). Results from the 2007 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 08-4343, NSDUH Series H-34). Rockville, MD: Substance Abuse and Mental Health Services Administration. Also available online: http://oas.samhsa.gov.
The NSDUH Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available online: http://oas.samhsa.gov. Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov.
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