January 17, 2008

Geographic Differences in Substance Abuse Treatment Admissions for Methamphetamine/Amphetamine and Marijuana: 2005

As recent findings from the National Survey on Drug Use and Health (NSDUH) show, substance abuse varies across States.¹ Admissions to substance abuse treatment also demonstrate geographic differences, and admissions for various substances of abuse show specific geographic concentrations and patterns. These patterns also change over time.

Admissions to substance abuse treatment by State can be monitored with the Treatment Episode Data Set (TEDS), an annual compilation of data on the demographic characteristics and substance abuse problems of those admitted to substance abuse treatment, primarily at facilities that receive some public funding.^2,3 TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once during a single year.

Among the six primary substances of abuse⁴ that dominate TEDS admissions, the rates of substance abuse treatment admissions in the Nation as a whole increased for three (marijuana, methamphetamine/amphetamine, and opiates other than heroin) and decreased for three (alcohol, cocaine, and heroin). This report focuses on trends in admission rates^5,6 for methamphetamine/amphetamine and marijuana, which have the largest number of admissions among the substances with increased admission rates and, therefore, have the greatest impact on the treatment system.

The methamphetamine/amphetamine treatment admission rate for the United States as a whole increased between 1995 and 2005, from 30 per 100,000 persons aged 12 or older to 68 per 100,000. Admission rates increased in 43 of the 44 States reporting in both years.⁷ Four of the 10 States with the highest rates of admission in 1995 (i.e., those States with admission rates greater than 50 per 100,000) more than doubled their rate of admission in 2005 (Hawaii, Washington, Montana, and Arkansas) (Table 1).

In 1995 and 2005, methamphetamine/amphetamine admission rates were generally highest in the Pacific and Mountain States⁸ (Figure 1). In 1995, one State had a methamphetamine/amphetamine admission rate equal to or greater than 220 per 100,000 persons aged 12 or older; by 2005, four States had rates that high or higher. States east of the Mississippi River generally exhibited higher rates of admissions in 2005 than in 1995.

Table 1. Percentage Increase in Rates from 1995 to 2005 for States with Highest Rates of Methamphetamine/Amphetamine Admissions in 1995

State	Rate per 100,000 Persons Aged 12 or Older		Percentage Increase in Rate of Admissions 1995 to 2005
	1995	2005
Oregon	281	314	12
Iowa	151	229	52
Nevada	112	174	55
California	111	218	96
Utah	110	208	89
Hawaii	107	244	128
Montana	89	185	108
Oklahoma	83	138	66
Washington	82	226	176
Arkansas	51	137	169

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

Figure 1. Methamphetamine/Amphetamine Admission Rates per 100,000 Persons Aged 12 or Older: 1995 and 2005

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

Figure 1 Table A. Methamphetamine/Amphetamine Admission Rates per 100,000 Persons Aged 12 or Older in 1995

State	Rate per 100,000	Percentile Based on 1995 Admission Rates
Alabama	5-46	50th-74th
Alaska	5-46	50th-74th
Arizona	Incomplete Data	Incomplete Data
Arkansas	47-107	75th-89th
California	108-219	90th-98th
Colorado	5-46	50th-74th
Connecticut	Less than 5	Below The Median
Delaware	Less than 5	Below The Median
District of Columbia	Less than 5	Below The Median
Florida	Less than 5	Below The Median
Georgia	5-46	50th-74th
Hawaii	47-107	75th-89th
Idaho	47-107	75th-89th
Illinois	Less than 5	Below The Median
Indiana	5-46	50th-74th
Iowa	108-219	90th-98th
Kansas	47-107	75th-89th
Kentucky	Incomplete Data	Incomplete Data
Louisiana	Less than 5	Below The Median
Maine	Less than 5	Below The Median
Maryland	Less than 5	Below The Median
Massachusetts	Less than 5	Below The Median
Michigan	Less than 5	Below The Median
Minnesota	5-46	50th-74th
Mississippi	Less than 5	Below The Median
Missouri	5-46	50th-74th
Montana	47-107	75th-89th
Nebraska	5-46	50th-74th
Nevada	108-219	90th-98th
New Hampshire	Less than 5	Below The Median
New Jersey	Less than 5	Below The Median
New Mexico	5-46	50th-74th
New York	Less than 5	Below The Median
North Carolina	Less than 5	Below The Median
North Dakota	5-46	50th-74th
Ohio	Less than 5	Below The Median
Oklahoma	47-107	75th-89th
Oregon	220 or more	99th
Pennsylvania	Less than 5	Below The Median
Rhode Island	Less than 5	Below The Median
South Carolina	Less than 5	Below The Median
South Dakota	5-46	50th-74th
Tennessee	Less than 5	Below The Median
Texas	5-46	50th-74th
Utah	108-219	90th-98th
Vermont	Less than 5	Below The Median
Virginia	Less than 5	Below The Median
Washington	47-107	75th-89th
West Virginia	Less than 5	Below The Median
Wisconsin	Less than 5	Below The Median
Wyoming	Incomplete Data	Incomplete Data

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

Figure 1 Table B. Methamphetamine/Amphetamine Admission Rates per 100,000 Persons Aged 12 or Older: 2005

State	Rate per 100,000	Percentile Based on 1995 Admission Rates
Alabama	5-46	50th-74th
Alaska	Incomplete Data	Incomplete Data
Arizona	47-107	75th-89th
Arkansas	108-219	90th-98th
California	108-219	90th-98th
Colorado	108-219	90th-98th
Connecticut	Less than 5	Below The Median
Delaware	5-46	50th-74th
District of Columbia	Incomplete Data	Incomplete Data
Florida	5-46	50th-74th
Georgia	47-107	75th-89th
Hawaii	220 or more	99th
Idaho	Incomplete Data	Incomplete Data
Illinois	5-46	50th-74th
Indiana	5-46	50th-74th
Iowa	220 or more	99th
Kansas	47-107	75th-89th
Kentucky	5-46	50th-74th
Louisiana	5-46	50th-74th
Maine	5-46	50th-74th
Maryland	Less than 5	Below The Median
Massachusetts	Less than 5	Below The Median
Michigan	5-46	50th-74th
Minnesota	108-219	90th-98th
Mississippi	5-46	50th-74th
Missouri	108-219	90th-98th
Montana	108-219	90th-98th
Nebraska	108-219	90th-98th
Nevada	108-219	90th-98th
New Hampshire	5-46	50th-74th
New Jersey	Less than 5	Below The Median
New Mexico	Incomplete Data	Incomplete Data
New York	Less than 5	Below The Median
North Carolina	5-46	50th-74th
North Dakota	47-107	75th-89th
Ohio	5-46	50th-74th
Oklahoma	108-219	90th-98th
Oregon	220 or more	99th
Pennsylvania	Less than 5	Below The Median
Rhode Island	Less than 5	Below The Median
South Carolina	5-46	50th-74th
South Dakota	108-219	90th-98th
Tennessee	5-46	50th-74th
Texas	5-46	50th-74th
Utah	108-219	90th-98th
Vermont	5-46	50th-74th
Virginia	5-46	50th-74th
Washington	220 or more	99th
West Virginia	5-46	50th-74th
Wisconsin	5-46	50th-74th
Wyoming	Incomplete Data	Incomplete Data

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

The marijuana admission rate for the United States as a whole increased from 81 per 100,000 persons aged 12 or older in 1995 to over 118 per 100,000 in 2005. Rates increased in 36 of the 44 States reporting in both years, and declined in 8 States.⁹ Three of the 10 States with the highest rates of admission in 1995 (i.e., those States with at least 130 admissions per 100,000) increased their rates of admission in 2005 by at least 20 percent (Iowa, Montana, and Maryland) (Table 2).

Although admission rates for marijuana were generally higher in 2005 than in 1995, the geographic pattern was similar in 1995 and 2005 (Figure 2). Marijuana treatment admission rates were generally highest in the West North Central and Pacific States.

Table 2. Percentage Difference in Rates from 1995 to 2005 for States with Highest Rates of Marijuana Admissions in 1995

State	Rate per 100,000 Persons Aged 12 or Older		Percentage Difference in Rate of Admissions 1995 to 2005
	1995	2005
Iowa	204	268	31
Kansas	194	162	-16
Oregon	189	216	14
Montana	162	195	20
Maryland	157	195	24
Minnesota	153	179	17
Colorado	138	149	8
Michigan	135	117	-13
Utah	134	110	-18
Ohio	130	151	16

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

Figure 2. Marijuana Admission Rates per 100,000 Persons Aged 12 or Older: 1995 and 2005

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

Figure 2 Table A. Marijuana Admission Rates per 100,000 Persons Aged 12 or Older in 1995

State	Rate per 100,000	Percentile Based on 1995 Admission Rates
Alabama	Less than 79	Below The Median
Alaska	125-153	75th-89th
Arizona	Incomplete Data	Incomplete Data
Arkansas	79-124	50th-74th
California	Less than 79	Below The Median
Colorado	125-153	75th-89th
Connecticut	79-124	50th-74th
Delaware	Less than 79	Below The Median
District of Columbia	Less than 79	Below The Median
Florida	79-124	50th-74th
Georgia	Less than 79	Below The Median
Hawaii	Less than 79	Below The Median
Idaho	125-153	75th-89th
Illinois	Less than 79	Below The Median
Indiana	Less than 79	Below The Median
Iowa	199 or more	99th
Kansas	154-198	90th-98th
Kentucky	Incomplete Data	Incomplete Data
Louisiana	Less than 79	Below The Median
Maine	79-124	50th-74th
Maryland	154-198	90th-98th
Massachusetts	Less than 79	Below The Median
Michigan	125-153	75th-89th
Minnesota	125-153	75th-89th
Mississippi	Less than 79	Below The Median
Missouri	79-124	50th-74th
Montana	154-198	90th-98th
Nebraska	Less than 79	Below The Median
Nevada	Less than 79	Below The Median
New Hampshire	Less than 79	Below The Median
New Jersey	Less than 79	Below The Median
New Mexico	Less than 79	Below The Median
New York	79-124	50th-74th
North Carolina	Less than 79	Below The Median
North Dakota	Less than 79	Below The Median
Ohio	125-153	75th-89th
Oklahoma	79-124	50th-74th
Oregon	154-198	90th-98th
Pennsylvania	Less than 79	Below The Median
Rhode Island	79-124	50th-74th
South Carolina	79-124	50th-74th
South Dakota	79-124	50th-74th
Tennessee	Less than 79	Below The Median
Texas	Less than 79	Below The Median
Utah	125-153	75th-89th
Vermont	79-124	50th-74th
Virginia	Less than 79	Below The Median
Washington	79-124	50th-74th
West Virginia	Less than 79	Below The Median
Wisconsin	Less than 79	Below The Median
Wyoming	Incomplete Data	Incomplete Data

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

Figure 2 Table B. Marijuana Admission Rates per 100,000 Persons Aged 12 or Older: 2005

State	Rate per 100,000	Percentile Based on 1995 Admission Rates
Alabama	79-124	50th-74th
Alaska	Incomplete Data	Incomplete Data
Arizona	79-124	50th-74th
Arkansas	79-124	50th-74th
California	79-124	50th-74th
Colorado	125-153	75th-89th
Connecticut	79-124	50th-74th
Delaware	199 or more	99th
District of Columbia	Incomplete Data	Incomplete Data
Florida	Less than 79	Below The Median
Georgia	79-124	50th-74th
Hawaii	125-153	75th-89th
Idaho	Incomplete Data	Incomplete Data
Illinois	154-198	90th-98th
Indiana	154-198	90th-98th
Iowa	199 or more	99th
Kansas	154-198	90th-98th
Kentucky	79-124	50th-74th
Louisiana	125-153	75th-89th
Maine	125-153	75th-89th
Maryland	154-198	90th-98th
Massachusetts	Less than 79	Below The Median
Michigan	79-124	50th-74th
Minnesota	154-198	90th-98th
Mississippi	Less than 79	Below The Median
Missouri	199 or more	99th
Montana	154-198	90th-98th
Nebraska	Less than 79	Below The Median
Nevada	79-124	50th-74th
New Hampshire	Less than 79	Below The Median
New Jersey	79-124	50th-74th
New Mexico	Incomplete Data	Incomplete Data
New York	199 or more	99th
North Carolina	Less than 79	Below The Median
North Dakota	79-124	50th-74th
Ohio	125-153	75th-89th
Oklahoma	79-124	50th-74th
Oregon	199 or more	99th
Pennsylvania	79-124	50th-74th
Rhode Island	154-198	90th-98th
South Carolina	125-153	75th-89th
South Dakota	199 or more	99th
Tennessee	Less than 79	Below The Median
Texas	Less than 79	Below The Median
Utah	79-124	50th-74th
Vermont	199 or more	99th
Virginia	79-124	50th-74th
Washington	154-198	90th-98th
West Virginia	Less than 79	Below The Median
Wisconsin	Less than 79	Below The Median
Wyoming	Incomplete Data	Incomplete Data

Source: 2005 SAMHSA Treatment Episode Data Set (TEDS).

¹ Wright, D., Sathe, N., & Spagnola, K. (2007). State estimates of substance use from the 2004-2005 National Surveys on Drug Use and Health (DHHS Publication No. SMA 07-4235, NSDUH Series H-31). Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies.
² State-to-State comparisons using TEDS data should be made with caution. TEDS aggregates data collected through the data collection systems of the Single State Agencies (SSAs) for substance abuse treatment. Data from States vary on a number of methodological issues, such as completeness of reporting, whether all or only certain types of facilities within a State report, whether only clients whose treatment is paid for with State/public funds are included, how successfully States can identify and report client admissions, and whether States include or exclude reporting by certain sectors of the treatment population (e.g., treatment programs based in the criminal justice system). Therefore, differences in rates of admission between States may be, in part, owing to the methodological differences of the data collected. Although State-to-State comparisons must be made with caution, maps can show important information about differences in the nature and the scope of substance abuse and its treatment. For more information on State reporting, see chapter 4 of Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (2007). Treatment Episode Data Set (TEDS): 1995-2005. National admissions to substance abuse treatment services (DASIS Series: S-37, DHHS Publication No. (SMA) 07-4234). Rockville, MD.
³ In 1995, TEDS collected data on almost 1.7 million admissions to substance abuse treatment facilities. Three States (AZ, KY, and WY) did not submit data in 1995. In 2005, TEDS collected data on 1.8 million admissions to substance abuse treatment facilities. Four States and jurisdictions (AK, DC, NM, and WY) did not submit data in 2005. Data for Idaho were incomplete in 2005.
⁴ The primary substance of abuse is the main substance reported at the time of admission.
⁵ Admission rates were calculated using the U.S. Census Bureau projections for 1995 and 2005 for the population aged 12 years or older as the denominator and TEDS admissions aged 12 years or older as the numerator.
⁶ The same percentile categories are used for mapping both 1995 and 2005 admissions rates. The maps therefore show how a State’s admission rate in 2005 compares with that same State in 1995, using 1995 admission rates as the baseline for establishing the categories for admission rates. For the maps, the median, 75th, 90th, and 99th percentiles of the range of 1995 admission rates were used to establish the rate categories used in the legend. Each 1995 map generally shows 1 State in dark green (the 99th percentile and above), 4 States in dark blue (the 90th to 98th percentiles), 7 States in light green (the 75th to 89th percentiles, 12 States in light blue (the 50th to 74th percentiles), and 23 States in white (below the median 1995 U.S. rate). Crosshatching indicates States where no data were submitted or where changes in reporting patterns made inclusion inappropriate.
⁷ Substance Abuse and Mental Health Services Administration, Office of Applied Studies, op cit., table 2.8b.
⁸ The U. S. Census Bureau divides the country into nine census divisions: New England (CT, MA, ME, NH, RI, and VT), Middle Atlantic (NJ, NY, and PA), East North Central (IL, IN, MI, OH, and WI), West North Central (IA, KS, MN, MO, ND, NE, and SD), South Atlantic (DC, DE, FL, GA, MD, NC, SC, VA, and WV), East South Central (AL, KY, MS, and TN), West South Central (AR, LA, OK, and TX), Mountain (AZ, CO, ID, MT, NM, NV, UT, and WY), and Pacific (AK, CA, HI, OR, and WA).
⁹ Substance Abuse and Mental Health Services Administration, Office of Applied Studies, op cit., table 2.7b.

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (January 17, 2008). The DASIS Report - - Geographic Differences in Substance Abuse Treatment Admissions for Methamphetamine/Amphetamine and Marijuana: 2005. Rockville, MD.