Substance Dependence, Abuse and Treatment

Appendix D: Other Sources of Data

A variety of other surveys and data systems collect data on substance abuse and dependence and/or treatment for a substance use problem. It is useful to consider the results of these other studies when discussing the National Household Survey on Drug Abuse (NHSDA) data. In doing this, it is important to understand the methodological differences between the different surveys and the impact that these differences could have on estimates of substance abuse, dependence, or treatment. This appendix briefly describes several of these other data systems, including results from them.

National Comorbidity Survey (NCS). This survey was sponsored by the National Institute of Mental Health (NIMH), NIDA, and the W.T. Grant Foundation. It was designed to measure the prevalence of the illnesses in the Diagnostic Statistical Manual of Mental Disorders (DSM-III-R) (APA, 1987). The NCS was a household survey consisting of more than 8,000 respondents aged 15 to 54, and the interviews took place between 1990 and 1992. The NCS used a modified version of the Composite International Diagnostic Interview (the UM-CIDI) for its diagnoses. The results show that 3.6 percent of the population abused or were dependent on some type of drug in the past 12 months (Kessler et al., 1994). The corresponding NHSDA rate for these age groups in 2000 was 2.6 percent. Alcohol, however, showed a much higher prevalence in the NCS, with 9.7 percent of the population abusing or dependent on the drug in the past year. The 2000 NHSDA estimate was 7.4 percent. When comparing these two studies, one should keep in mind that they were conducted in two different time periods and each used a different set of diagnostic questions. The 2000 NHSDA estimates for abuse and dependence are based on the 4^th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (APA, 1994). The NCS results also indicated that 13.3 percent of the population aged 15 to 54 received outpatient mental health or substance abuse treatment in the past year. This estimate is not comparable with the NHSDA estimate of treatment for a substance use problem because it includes treatment for substance abuse as well as mental health.

National Longitudinal Alcohol Epidemiologic Survey (NLAES). This survey was conducted by the U.S. Bureau of the Census for the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in 1992. Face-to-face interviews were conducted with 42,862 respondents aged 18 or older in the contiguous United States. It was designed to study the drinking practices, behaviors, and related problems in the general public. The survey included an extensive set of questions designed to assess the presence of symptoms of alcohol and drug abuse and dependence during the prior 12 months, based on the criteria from the DSM-IV. (This study also based its diagnoses on the updated DSM-IV.) The survey found that 7.4 percent of adults were abusing or dependent on alcohol (Grant, 1995). In 2000, the NHSDA found that 6.7 percent of adults were abusing or dependent on alcohol. NLAES also found that 1.5 percent of adults were abusing or dependent on some type of illicit drug in the past year. In comparison, the 2000 NHSDA found that 1.7 percent of adults were abusing or dependent on some illicit drug. Past year prevalence of abuse and dependence was below 1 percent for sedatives, tranquilizers, and hallucinogens in the NLAES. This was consistent in the 2000 NHSDA. Marijuana, however, showed a past year abuse and dependence prevalence of 1.2 percent in the NLAES. The marijuana dependence and abuse rate in the 2000 NHSDA was 1.3 percent. Although the estimates from these two surveys are relatively close, one should note that they were conducted in different time periods.

The National Survey of Substance Abuse Treatment Services (N-SSATS). (Prior to 2000, NSSATS was known as the Uniform Facility Data Set [UFDS]). N-SSATS is a survey of facilities providing substance abuse treatment and is conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA). It is designed to collect data on the location, characteristics, and utilization of alcohol and drug abuse treatment facilities and services throughout the 50 States, the District of Columbia, and other U.S. jurisdictions. It includes all facilities in the United States providing substance abuse treatment (both public and private). The number of persons in substance abuse treatment (illicit drugs or alcohol) on October 1, 1998, reported by UFDS was 1,038,378 (SAMHSA, 2000). The 2000 NHSDA estimated that 781,000 persons were enrolled in substance abuse treatment at a hospital, mental health center, or drug rehabilitation center on October 1, 1999.

Treatment Episode Data Set (TEDS). The TEDS system is an admission-based system where admissions do not represent individuals. Thus, for example, an individual admitted to treatment twice within a calendar year would be counted as two admissions in TEDS. In the NHSDA, this individual would be counted as having received treatment in the past year. TEDS includes facilities that are licensed or certified by the State substance abuse agencies to provide substance abuse treatment (or are administratively tracked for other reasons). In general, facilities reporting TEDS data are those that receive State alcohol and/or drug agency funds (including Federal Block Grant funds) for the provision of alcohol and/or drug treatment services. In 1999, there were 1.6 million treatment admissions for illicit drugs or alcohol from TEDS (SAMHSA, 2001b). Because the NHSDA is not an admission-based system, estimates of treatment from the NHSDA are smaller and not comparable with estimates from TEDS.

This page was last updated on June 16, 2008.

SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.