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 18-25; 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, Louisiana has ranked among the 10 states with the lowest rates on the following measures (Table 1):

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).

On the measures of past year dependence on or abuse of alcohol, Louisiana has consistently ranked at or below the national rates for all age groups and across all survey years (Chart 1).

Rates of past year dependence on or abuse of illicit drugs, however, have been more variable; with the 26 and older age group ranking among the highest in the country across all survey years (Chart 2).

Substance Abuse Treatment Facilities

According to the 2006 National Survey of Substance Abuse Treatment Services (N-SSATS),3 Louisiana had a total of 145 treatment facilities. Of these, 53 were private nonprofit, 38 were private for-profit, and 2 facilities were owned/operated by a offered an opioid treatment program. In addition, Tribal authority.141 physicians and 14 treatment programs were certified to provide buprenorphine therapy for The number of treatment facilities in Louisiana has opiate addiction.decreased from 167 in 2002, to 145 in 2006—the most recent year for which data are available. The In 2006, 63 percent of all facilities (91) received decrease is primarily accounted for by the loss of 11 some form of Federal, State, county, or local private nonprofit facilities and 12 facilities owned/government funds, and 37 facilities had agreements operated by Federal, State, or local government(s).or contracts with managed care organizations for the provision of substance abuse treatment services.Although facilities may offer more than one modality of care, in 2006 the majority of Louisiana facilities (104 or 72%) offered some form of outpatient treatment. Another 47 facilities offered some form of residential care, and 10 facilities.

Treatment

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, Louisiana showed a one-day total of 9,280 clients in treatment, the majority of whom (7,667 or 83%) were in outpatient treatment. Of the total number of clients in treatment on this date, 601 (6%) were under the age of 18.Chart 3 shows the percent of admissions mentioning particular drugs or alcohol at the time of admission.

Across the last 15 years, there has been a small decline in the number of admissions mentioning alcohol and increases in the number of mentions of opiates other than heroin and methamphetamine.Across the years for which TEDS data are available, Louisiana has seen a substantial shift in the constellation of problems present at treatment admission. Alcohol-only admissions have declined from 20 percent of all admissions in 1992, to 12 percent in 2006. Concomitantly, drug-only admissions have doubled from 22 percent in 1992, to 44 percent in 2006 (Chart 6).

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.While rates of unmet drug treatment need have been quite variable across time and among age groups, the rate of unmet treatment need for individuals age 26 and older has consistently been among the 10 highest in the country (Chart 5).Rates of unmet need for alcohol treatment have also been higher than the national rates across time (Chart 4).