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| May 2, 2003 |
American Indian/Alaska Native Treatment Admissions in Rural and Urban Areas: 2000 |
| In Brief |
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American Indians and Alaska Natives made up less than 1 percent of the U.S. population in 2000. During that same period, 2.4 percent of all admissions to publicly funded substance abuse treatment facilities involved American Indians and Alaska Natives.1 Few national surveys collect information on this relatively small population. However, the Treatment Episode Data Set (TEDS) is large enough to permit analysis of substance abuse among American Indians and Alaska Natives. TEDS is an annual compilation of data on the demographic characteristics and substance abuse problems of those admitted for substance abuse treatment. The information comes primarily from facilities that receive some public funding. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once. American Indian/Alaska Native treatment admissions were examined for five urbanization levels, based on the county classification scheme developed by the National Center for Health Statistics2: Large Central Metro-County in a Metropolitan Statistical Area (MSA) of 1 million or more population that contained all or part of the largest central city of the MSA Large Fringe Metro-County in a large MSA (1 million or more population) that did not contain any part of the largest central city of the MSA Small Metro-County in an MSA with less than 1 million population Non-Metro with City-County not in an MSA but with a city of 10,000 or more population Non-Metro without City-County not in an MSA and without a city of 10,000 or more population TEDS records indicate where persons entered treatment and not their area of residence. As not all counties have substance abuse treatment facilities, people may seek treatment in a county whose urbanization level differs from that of their county of residence. Table 1 compares the urbanization distribution of all counties in the United States with that of counties with treatment facilities reporting to TEDS. About 33 percent of American Indian/Alaska Native admissions were in non-metropolitan areas compared with 18 percent of all TEDS admissions (Table 2). Conversely, 67 percent of American Indian/Alaska Native admissions were in metropolitan counties compared with 82 percent of all TEDS admissions.
Primary Substance of Abuse Regardless of level of urbanization, alcohol was the leading substance of abuse, ranging from 47 percent of American Indian/Alaska Native admissions in large central metropolitan areas to 76 percent of such admissions in non-metropolitan areas without cities (Table 3). The second most frequently reported substance of abuse in central and fringe large metropolitan areas was opiates (23 and 19 percent, respectively), while marijuana was second in the small metropolitan areas (16 percent), non-metropolitan areas with cities (19 percent), and non-metropolitan areas without cities (14 percent). Frequency of use of the primary substance of abuse declined in a consistent trend from urban areas to rural areas. American Indian/Alaska Native admissions in large central metropolitan areas were almost three times more likely to report daily use of the primary substance than similar admissions in non-metropolitan areas without cities (55 vs. 20 percent).
Age Large central metropolitan area American Indian/Alaska Native admissions were older at admission than those in non-metropolitan areas without cities, but there was not a consistent trend across rural/urban areas (Figure 1). About 17 percent of American Indian/Alaska Native admissions in large central metropolitan areas were 45 or older, whereas about 12 percent of their counterparts in non-metropolitan areas were 45 or older. Conversely, 6 percent of American Indian/Alaska Native admissions in large central metropolitan areas were younger than age 18, whereas 13 percent of those admissions in non-metropolitan areas without cities were younger than 18. Abuse of drugs started later among American Indian/Alaska Native admissions in large central metropolitan areas (17 years old on average) than among American Indian/Alaska Native admissions in non-metropolitan areas without cities (15 years old on average).
Source of Referral Among American Indian/Alaska Native admissions, referrals through the criminal justice system were most likely in non-metropolitan areas without cities (54 percent) and least likely in large central metropolitan areas (32 percent). Self- or individual referrals among American Indian/Alaska Native admissions were most likely in metropolitan areas (average 32 percent) and least likely in non-metropolitan areas without cities (20 percent). End Notes 1This report is limited to facilities receiving State funds (including Federal Block Grant funds), and Alabama does not collect data on whether clients are American Indians or Alaska Natives. Data on admissions to treatment facilities funded solely by the Federal Indian Health Service or by tribal authorities do not report to TEDS and therefore are not included in this report. 2Eberhardt, M.S., Ingram, D.D., Makuc, D.M., et al. (2001). Urban and Rural Health Chartbook. Health, United States, 2001 (DHHS Publication No. PHS 01-1232-1). Hyattsville, MD: National Center for Health Statistics. Table Note * Approximately 9 percent (4,957) of American Indian/Alaska Native admissions and 9 percent (148,646) of all TEDS admissions did not have an urbanization code.
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This page was last updated on December 30, 2008. |
