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The National Survey on Drug Use and Health (NSDUH) generates state-level estimates for 23 measures of substance use and mental health problems for four age groups: the entire state population over the age of 12 (12+); individuals age 12 to 17; individuals age 18 to 25; and individuals age 26 and older (26+). Since state estimates of substance use and abuse were first generated using the combined 2002-2003 NSDUHs and continuing until the most recent state estimates based on the combined 2005-2006 surveys, Georgia has ranked among the 10 States with the lowest rates on the following measures (Table 1).
Table 1: Georgia is among those States with the lowest rates of the following:
|Past Month Marijuana Use||12-17|
|Most Perception of Risk Associated with Smoking Marijuana Once a Month||12+, 18-25, 26+|
|Past Year Cocaine Use||18-25|
|Past Month Alcohol Use||12-17, 12-20, 18-25|
|Past Month Binge Alcohol Use||12-17, 12-20, 18-25|
Abuse and Dependance
Questions in NSDUH are used to classify persons as being dependent on or abusing specific substances based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (American Psychiatric Association, 1994).
Georgia's rates of past year alcohol dependence or abuse have typically been at or below the national rates. This is particularly true for two age groups; those age 12 to 17 and those age 18 to 25 (Chart1).
Rates of past year drug dependence or abuse have been more variable both across time and among age groups. Generally, for the population as a whole (those age 12 and older) and for individuals age 12 to 17 and 18 to 25, the rates have been at or below the national rates. For the population age 26 and older, however, the rates of past year drug dependence have generally been above national rates.
Substance Abuse Treatment Facilities
According to the National Survey of Substance Abuse Treatment Services (N-SSATS)3 annual surveys, the number of treatment facilities in Georgia has remained relatively constant. In 2006, there were 277 facilities; of these, 84 (30%) were private nonprofit and 76 (27%) were private for-profit. An additional 78 facilities were owned/operated by the State government.
Although facilities may offer more than one modality of care, the majority of facilities (222 of 277, or 80%) offered some form of outpatient treatment in 2006; 76 facilities (27%) offered some form of residential care; and 32 programs offered opioid treatment. In addition, 240 physicians and 30 treatment programs offered buprenorphine treatment for opiate addiction.
In 2006, 54 percent of all facilities (149) received some form of Federal, State, county, or local government funds, and 118 facilities (43%) had agreements or contracts with managed care organizations for the provision of substance abuse treatment services.
State treatment data for substance use disorders are derived from two primary sources'an annual one-day census in N-SSATS and annual treatment admissions from the Treatment Episode Data Set (TEDS).4 In the 2006 N-SSATS survey, Georgia showed an one-day total of 17,848 clients in treatment, the majority of whom (14,963 or 84%) were in outpatient treatment. Of the total number of clients in treatment on this date, 1,183 (7%) were under the age of 18.
Since 1992, there has been a steady increase in the annual number of admissions to treatment in Georgia'from approximately 30,000 in 1992, to nearly 45,000 in 2005 (the most recent year for which data are available). Chart 3 shows the percent of admissions mentioning particular drugs or alcohol at the time of admission.5 Across the last 14 years, there has been a steady decline in the number of admissions mentioning alcohol and an increase in the percent of those mentioning either marijuana or methamphetamine.
Across the years for which TEDS data are available, Georgia has seen a substantial shift in the constellation of problems present at treatment admission. Alcohol-only admissions have declined from over 45 percent of all admissions in 1992, to just over 21 percent in 2005. Concomitantly, drug-only admissions have increased from 25 percent in 1998, to 46 percent in 2005 (Chart 4).
Unmet Need For Treatment
NSDUH defines unmet treatment need as an individual who meets the criteria for abuse of or dependence on illicit drugs or alcohol according to the DSM-IV, but who has not received specialty treatment for that problem in the past year.
Across all survey years and among all age groups, the rates of unmet need for alcohol treatment in Georgia have been at or below the national rates (Chart 5). Consistently, the rates of unmet treatment need for individuals age 12 to 17 have been among the lowest in the country.
To some extent, rates of unmet need for drug treatment mirror those of past year drug dependence or abuse. Rates for three population groups (12+, 12-17, and 18-25) have consistently been at or below the national rates, while rates for those individuals 26 and older have been above the national rate (Chart 6).