The number of people affected by drug and alcohol addiction throughout the United States is growing at an alarming annual rate. It is currently estimated that a total of 21.5 million American citizens meet the criteria for a substance use disorder – meaning roughly one in every 10 Americans over the age of 12 struggle with problematic alcohol or drug use. Despite these unsettling numbers, less than 11% of individuals battling a life-threatening addiction are currently receiving the care and support they need to recover.
Approximately 80 million Americans are considered at-risk users, while 43,982 U.S. citizens died at the hands of substance dependency in 2013 (more fatalities than attributed to homicides, suicides, and motor vehicle accidents combined). As overdose deaths (particularly from opioids) continue to rise, the demand for adequate treatment remains far from being met. Here, we’ll shed some light on the disturbing and devastating undertreatment of addiction throughout the United States.
First, let’s look at the estimated percent of total substance abusers treated. While there are large communities that could potentially benefit from recovery services and treatment in both Florida and California, only 3.9% of those who need substance abuse treatment in each state actually receive such treatment. Connecticut and New York are providing between about 15% and 17% of local citizens with adequate treatment – the highest percentages aside from that of South Dakota, which exceeds all other states significantly with a whopping 28.3%. Most states ring in well below 5%, meaning that at least 95% of all individuals with substance abuse problems statewide are not receiving the treatment they so desperately need.
Taking a look at statewide treatment admissions based on abused substance type, we can see that alcohol reigns supreme throughout the majority of Middle America and many Western states. Opiates and heroin dominate much of the Northeast and some Southern states, while amphetamines prove to be a major source of addiction in California, Nevada, Hawaii, and Oklahoma.
What is most shocking: the exceedingly widespread amount of treatment sought primarily for marijuana addiction. Marijuana is the primary reason behind treatment admissions in a total of 12 states, spread across the nation. Still, alcohol remains the primary cause for the majority of treatment admissions nationwide, with a total of 16 states experiencing a preponderance of admittances for alcohol alone. Heroin and other opiates are the principal reason for admissions in 13 states, mainly small states along the East Coast and some Southern states. Alcohol and marijuana admissions combined comprise a much larger portion of the country geographically than heroin and opiates. The rates of treatment for marijuana dependency are second only to rates for alcohol abuse alone.
Is marijuana truly a bigger national issue than heroin? Or are treatment options for opiate dependency simply severely lacking?
Many states with large numbers of admissions for marijuana also saw high (and typically similar) percentages of alcoholism admissions. Out of all 50 states, only 11 didn’t include alcohol in the top two reasons for admission. Interestingly enough, several of these “non-alcoholic” states seem to struggle predominantly with marijuana and amphetamines – Idaho, California, Hawaii, and Oklahoma specifically. In most cases, the degree of separation between first and second top treatments by state is less than 5%. States with widespread opiate abuse similarly grapple with a high prevalence of alcohol abuse, while several states – Delaware, Illinois, Maryland, Florida, and Tennessee – secondarily suffer from prevalent marijuana abuse. Alcohol reigns across the board, with marijuana trailing close behind. The majority of treatment admissions throughout Louisiana remain unknown, though opiates make up roughly 16% of total admissions.
Looking at the percentage of admissions for differing substances, we can see, on a national level, the overwhelming majority of treatment type being sought is for alcohol use alone. Meanwhile, rates of treatment for marijuana, heroin, and opiate dependency vary significantly by state.
States with higher percentages of alcohol treatment tended to experience lower percentages of opiate and amphetamine treatment. States with more treatment sought for illicit substances (specifically heroin) saw less treatment for alcohol and marijuana. Overall, treatment for alcohol and marijuana seems to be sought more often than treatment for any other illicit substance. Is treatment for these substances simply more accessible?/p>
As far as treatment focus per region, alcohol treatment dominates the Mountain region and the Midwest; treatment for amphetamine abuse rules the West Coast. Treatment admissions for heroin addiction are especially prevalent throughout the upper East Coast, and marijuana is a major factor throughout the lower East Coast and the Bible Belt. Clearly, drug trends vary greatly by region.
Regardless of the type of substance being abused, America as a whole experiences an astounding amount of substance dependency cases annually. Roughly 20.2 million American citizens currently report needing but not receiving treatment for drug or alcohol abuse. 31.4% of these individuals perceived this lack of treatment as a direct result of cost or need for adequate health coverage. As the demand for treatment grows, the numbers remain somewhat stagnant – indicating that no matter the type of substance being abused, adequate assistance in overcoming addiction falls woefully short.
Over the course of the past several decades, Medicaid has taken over as the predominant source of treatment funding. However, the vast majority of treatment centers across the United States do not accept Medicaid, relying solely on out-of-pocket payment and private insurers. The lack of adequate care for individuals without private insurance or financial stability contributes greatly to the alarming number of individuals with drug and alcohol abuse problems who remain untreated.
From 1986 to 2009, national spending on substance abuse treatment has increased by a total of $15 billion. Still, America as a whole remains devastatingly undertreated. State and federal funding for treatment currently contribute about 38% to the total expenditures. For more individuals to receive the help they need, this percentage will need to increase (rather than decrease, as projected for 2020).
Heroin is inexpensive and highly addictive. It is estimated that 23% of individuals who try heroin will eventually become dependent. From 2001 to 2013, heroin-related overdose fatalities have increased fivefold, with 28 total states seeing an overall increase in heroin overdose deaths from 2010 to 2012. Treatment admissions for heroin addiction are relatively high throughout the East Coast – but considering that opiate addiction is quickly becoming a leading national issue, treatment for heroin dependency still severely lacks across the remainder of the country.
While marijuana use potentially can lead to patterns of substance dependency when used in large quantities over a prolonged period of time, it is estimated that only 9% of marijuana users will become dependent. And marijuana-related overdose deaths still ring in at zero. However, treatment admissions for marijuana dependency made up about 17.5% of all admission in 2012.
Why are the rates of admission for marijuana dependency so high, considering the risk of dependency and overdose-related fatality concerning heroin and other opiates is so much greater? It stands to reason that those who struggle with drugs such as heroin, meth, and crack cocaine lack private insurance or the means to pay for treatment out-of-pocket. The devastation of these highly addictive and lethal drugs is rapid and severe and often leaves users with little to no financial stability.
Whatever the case, it is clear that those suffering from addiction to opiates are severely undertreated and existing facilities are unable to meet the rapidly escalating demand. It is also clear that the primary reasons for gaps in treatment are: lack of insurance, inadequate insurance coverage, and insufficient public funds.
As it stands, only one out of every 10 individuals with a substance use disorder is currently receiving the treatment they need. While treatment admissions are clearly lacking across the country, rates of national drug use continue to skyrocket. Drug users in New England and throughout the Mid-Atlantic are turning to heroin in unprecedented numbers, and though they are being treated at rates 2–3 times higher than their counterparts in most other regions, adequate treatment still lacks. The only other region providing a comparable level of treatment is a fragment of the North West, which is saddled predominantly with the issue of alcohol abuse. North Dakota is the most treated state, with 28.3% of users statewide receiving treatment – and it’s the only state exceeding 20%.
The United States as a whole remains significantly undertreated – though it’s not a problem without a solution. The majority of alcohol and drug abusing men and women who are not receiving adequate care either lack the financial means or health insurance coverage to enroll in a professionally facilitated program. Increasing the availability of state-funded treatment may make a significant impact on accessibility, and improving national health insurance coverage could make treatment far more available to those who need it. Additionally, simply increasing awareness of pre-existing treatment options could lead to higher levels of treatment received.
Marijuana abuse is the largest admission cause behind alcohol, which comes as somewhat of a shock seeing as the threat of marijuana-related mortality is exceedingly small compared to that of any other chemical substance (zero marijuana-related deaths contrasted with the 43,982 other chemical dependency-related deaths in 2013 alone). This fact further leads to the conclusion that suitable treatment is inaccessible to the majority of those who need it. Without an increase in public care, more accessible health insurance policies, and a continuously improved circulation of knowledge regarding addiction treatment, the gap between those struggling with substance abuse and treatment received will only continue to widen.
Many men and women who need substance abuse treatment do not have the means or information necessary to receive the help they deserve. If you have been unsuccessful in seeking treatment from a state-funded facility, or simply are unaware of treatment options available to you, give us a call at 1-888-851-2649 – treatment support advisors can help you explore a wide array of addiction rehabilitation options. Browse our site at DrugTreatment.com, or fill out our treatment inquiry form to receive more information about recovery programs.
For the Estimated % of Addicted Users Treated map we took 2013 SAMSHA estimates of drug users and compared it to TEDS admissions data for 2012 (the most recent available for many states). For Pennsylvania and West Virginia we used 2010 TEDS data.
For the rest of the analysis we used this 2012 TEDS data to look at admissions more deeply, analyzing percentages of admissions. In some cases such as the interactive chart, we grouped drugs with small footprints into the Other/Unknown category.
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