
Issue 24	2006

Substance Use Treatment Need among Adolescents: 2003-2004

In Brief
In 2003-2004, 6.1 percent of youths aged 12 to 17 were classified as needing treatment for alcohol use and 5.4 percent as needing treatment for illicit drug use Of the youths who were classified as needing treatment for alcohol use, 7.2 percent received specialty alcohol use treatment; 9.1 percent of the youths who were classified as needing treatment for illicit drug use received specialty illicit drug use treatment Among the youths who were classified as needing treatment, very few of the youths who had not received treatment perceived an unmet need for treatment (2.2 percent for alcohol use treatment and 3.5 percent for illicit drug use treatment)

Research suggests that many people who have a substance use problem do not receive treatment.¹ The National Survey on Drug Use and Health (NSDUH) asks persons aged 12 or older to report on their symptoms of dependence on or abuse of alcohol or illicit drugs. NSDUH defines substance dependence or abuse using criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV),² 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. Any illicit drug refers to marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically.

Respondents also are asked about the treatment they received for a substance use problem. For these analyses, an individual is defined as having received treatment only if he or she reported receiving specialty treatment for alcohol use or illicit drug use in the past year.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 received at an emergency room, private doctor's office, self-help group, prison or jail, or hospital as an outpatient. Persons are classified as needing treatment for a substance problem if they met the criteria for dependence on or abuse of a substance or if they received specialty substance use treatment in the past year.⁴ Respondents were also asked whether there was any time during this period when they felt they needed treatment or counseling for their alcohol or illicit drug use (these persons were classified as having a perceived unmet need).

This report presents estimates of treatment, treatment need, and perceived unmet need among youths aged 12 to 17. Estimates are presented separately for alcohol use treatment and illicit drug use treatment. Because some youths have a problem with both alcohol and illicit drugs, there is overlap in these estimates.⁵ For simplicity, this report does not provide separate estimates for this population with both problems. All findings presented in this report are annual averages based on combined 2003 and 2004 NSDUH data.

Alcohol Use Treatment Need

In 2003-2004, there were 1.5 million youths aged 12 to 17 (6.1 percent of youths) who were classified as needing treatment for alcohol use. The need for alcohol use treatment increased with increasing age (Table 1). Among racial/ethnic groups, American Indian or Alaska Native youths had the highest rate of alcohol use treatment need (14.1 percent). There were no differences in the need for alcohol use treatment by gender or family income.

Table 1. Percentages of Youths Aged 12 to 17 Who Were Classified as Needing Substance Use Treatment in the Past Year, by Demographic Characteristics: 2003 and 2004
Demographic Characteristics	Alcohol Use Treatment Need (Percent)	Illicit Drug Use Treatment Need (Percent)
Gender
Male	6.0	5.5
Female	6.3	5.3
Age Group
12 or 13	1.2	1.4
14 or 15	5.3	5.4
16 or 17	12.0	9.5
Race/Ethnicity*
White, non-Hispanic	6.9	5.8
Black or African American, non-Hispanic	2.8	3.8
American Indian or Alaska Native, non-Hispanic	14.1	11.8
Native Hawaiian or Other Pacific Islander, non-Hispanic	5.4	**
Asian, non-Hispanic	2.9	2.3
Two or More Races, non-Hispanic	9.7	9.5
Hispanic or Latino	6.1	5.6
Family Income
Less Than $20,000	6.0	6.2
$20,000-$49,999	6.0	5.8
$50,000-$74,999	6.3	5.2
$75,000 or Higher	6.2	4.7

Source: SAMHSA, 2003 and 2004 NSDUHs.

Of the youths who were classified as needing alcohol use treatment, 7.2 percent (about 111,000 youths) received specialty treatment for alcohol use in the past year. Males who were classified as needing alcohol use treatment were more likely to have received specialty treatment than females (Table 2). Of the youths who were classified as needing alcohol use treatment, 90.6 percent did not receive treatment and did not perceive the need for treatment (Figure 1). Only 2.2 percent did not receive treatment but did perceive an unmet treatment need.

Table 2. Percentages of Youths Aged 12 to 17 Receiving Substance Use Treatment⁺ in the Past Year among Those Who Were Classified as Needing Substance Treatment in the Past Year, by Demographic Characteristics: 2003 and 2004
Demographic Characteristics	Received Alcohol Use Treatment (Percent)	Received Illicit Drug Use Treatment (Percent)
Gender
Male	8.8	10.2
Female	5.7	7.9
Age Group
12 or 13	4.0	3.5
14 or 15	6.5	8.3
16 or 17	7.9	10.4
Race/Ethnicity*
White, non-Hispanic	8.0	10.5
Black or African American, non-Hispanic	7.8	7.2
American Indian or Alaska Native, non-Hispanic	**	**
Native Hawaiian or Other Pacific Islander, non-Hispanic	**	**
Asian, non-Hispanic	**	**
Two or More Races, non-Hispanic	**	**
Hispanic or Latino	4.0	6.1
Family Income
Less Than $20,000	9.7	9.6
$20,000-$49,999	8.2	11.0
$50,000-$74,999	5.4	6.2
$75,000 or Higher	5.7	7.9

Source: SAMHSA, 2003 and 2004 NSDUHs.

Figure 1. Receipt of and Perceived Need for Alcohol Treatment⁺ in the Past Year among Youths Aged 12 to 17 Who Were Classified as in Need of Alcohol Treatment: 2003 and 2004

Figure 1 Table. Receipt of and Perceived Need for Alcohol Treatment⁺ in the Past Year among Youths Aged 12 to 17 Who Were Classified as in Need of Alcohol Treatment: 2003 and 2004
	Percent
Received Alcohol Treatment	7.2
Did Not Receive Alcohol Treatment, But Perceived a Need for Treatment	2.2
Did Not Receive Alcohol Treatment and Did Not Perceive a Need for Treatment	90.6

Source: SAMHSA, 2003 and 2004 NSDUHs.

Illicit Drug Use Treatment Need

In 2003-2004, there were 1.4 million youths aged 12 to 17 (5.4 percent of youths) who were classified as needing treatment for illicit drug use. More youths aged 16 or 17 were classified as needing treatment for illicit drug use compared with youths aged 14 or 15 and those aged 12 or 13. Among racial/ethnic groups, American Indian or Alaska Native youths had the highest rate of illicit drug use treatment need (11.8 percent) (Table 1). Youth in families with an income of less than $20,000 per year and $20,000 to $49,999 per year were more likely to have been classified as being in need of illicit drug treatment than youth from families with incomes of $75,000 or more. There was no difference in the need for illicit drug use treatment by gender.

Of the youths who were classified as needing illicit drug use treatment, 9.1 percent (about 124,000 youths) had received specialty treatment for illicit drug use in the past year. Youths aged 12 or 13 who were classified as needing illicit drug use treatment were less likely to have received specialty treatment than youths aged 14 or 15 or those aged 16 or 17 (Table 2). Of the youths who were classified as needing illicit drug use treatment, 87.4 percent did not receive treatment and did not perceive the need for treatment (Figure 2). Only 3.5 percent did not receive treatment but did perceive an unmet treatment need.

Figure 2. Receipt of and Perceived Need for Illicit Drug Treatment⁺ in the Past Year among Youths Aged 12 to 17 Who Were Classified as in Need of Illicit Drug Treatment: 2003 and 2004

Figure 2 Table. Receipt of and Perceived Need for Illicit Drug Treatment⁺ in the Past Year among Youths Aged 12 to 17 Who Were Classified as in Need of Illicit Drug Treatment: 2003 and 2004
	Percent
Received Illicit Drug Treatment	9.1
Did Not Receive Illicit Drug Treatment, But Perceived a Need for Treatment	3.5
Did Not Receive Illicit Drug Treatment and Did Not Perceive a Need for Treatment	87.4

Source: SAMHSA, 2003 and 2004 NSDUHs.

End Notes

¹ Office of Applied Studies. (2005). Overview of findings from the 2004 National Survey on Drug Use and Health (DHHS Publication No. SMA 05-4061, NSDUH Series H-27). Rockville, MD: Substance Abuse and Mental Health Services Administration.
² American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
³ An individual who was dependent on or had abused illicit drugs was counted as receiving treatment only if he or she received specialty treatment in the past year for illicit drugs. An individual who was dependent on or had abused alcohol was counted as receiving treatment only if he or she received specialty treatment in the past year for alcohol. Individuals who reported receiving specialty substance use treatment but were missing specific information (i.e., alcohol vs. illicit drugs) were not counted in the estimates for either specialty illicit drug use treatment or specialty alcohol use treatment.
⁴ An estimated 45,000 persons who were not classified with dependence or abuse of illicit drugs received specialty treatment for an illicit drug problem in the past year, and an estimated 42,000 persons who were not classified with dependence or abuse of alcohol received specialty treatment for an alcohol problem in the past year.
⁵ An estimated 631,000 persons were classified with dependence on or abuse of both illicit drugs and alcohol.

Table/Figure Notes

^* Race/ethnicity categories are determined by combining the responses from two separate questions. For this report, respondents identifying themselves as Hispanic were assigned to the Hispanic group regardless of their racial identification. Respondents identifying themselves as non-Hispanic were grouped according to their racial identification. Thus, "white" refers to those identifying themselves as non-Hispanic and white.
^** Data are suppressed due to small sample size.
⁺ An individual is defined as having received treatment only if he or she reported receiving specialty treatment in the past year. Specialty substance use treatment is defined as treatment received at drug or alcohol rehabilitation facilites (inpatient or outpatient), hospitals (inpatient only), and mental health centers.

The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). Prior to 2002, this survey was called the National Household Survey on Drug Abuse (NHSDA). The 2003 and 2004 data are based on information obtained from 44,966 persons aged 12 to 17, of whom 2,857 were classified as needing treatment for alcohol use and 2,506 were classified as needing treatment for illicit drug use. 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 NSDUH used in compiling data for this issue is available in the following publications:

Office of Applied Studies. (2005). Results from the 2004 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 05-4062, NSDUH Series H-28). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Office of Applied Studies. (2004). Results from the 2003 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 04-3964, NSDUH Series H-25). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Also available online: http://www.oas.samhsa.gov.

Because of improvements and modifications to the 2002 NSDUH, estimates from the 2002, 2003, and 2004 surveys should not be compared with estimates from the 2001 or earlier versions of the survey to examine changes over time.

The NSDUH Report (formerly The NHSDA 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://www.oas.samhsa.gov. Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov.

This page was last updated on December 30, 2008.