Treatment admission rates involving abuse of narcotic painkillers1
increased in publicly funded substance abuse treatment facilities across the
nation between 1992 and 2000. In 1992, the treatment admission rate for narcotic
painkiller abuse in the United States was 13 admissions per 100,000 persons
aged 12 or older. By 1997, the admission rate had increased by 15 percent,
to 15 per 100,000, and by 2000, it had increased by another 74 percent, to
27 per 100,000.
This report examines narcotic painkiller treatment admission rates per 100,000 persons aged 12 or older at five urbanization levels for 1992, 1997, and 2000. Data are from the Treatment Episode Data Set (TEDS), an annual compilation of data on the 1.6 million annual admissions to publicly-funded substance abuse treatment.
U.S. counties and county equivalents were assigned to one of five urbanization
levels according to the classification scheme developed by the National Center
for Health Statistics (NCHS):2
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, not their area of residence. As not all counties have substance abuse treatment facilities, people may seek treatment at an urbanization level different from where they live. Table 1 compares the levels of urbanization of all counties in the U.S. with that of counties with treatment facilities reporting narcotic painkiller admissions to TEDS.
| Table 1. County
Urbanization in the U.S. and in Counties Reporting Narcotic
Painkiller Admissions to TEDS |
| |
United States |
TEDS |
|
|
No. of Counties |
3,000 |
1,600 |
|
|
Percent |
|
|
Large Central Metro |
2% |
4% |
|
Large Fringe Metro |
8% |
12% |
|
Small Metro |
17% |
25% |
|
Non-Metro with City |
15% |
23% |
|
Non-Metro without City |
58% |
36% | |
| Source: 2000 SAMHSA Treatment Episode
Data Set (TEDS). |
Treatment Admission Rates for Narcotic Painkillers
Treatment admission rates for narcotic painkillers increased between 1992 and 2000 in the United States as a whole and at most levels of urbanization (Figure 1). Large central metropolitan areas had the highest rate of narcotic painkiller admissions in 1992, but they exhibited little change over the period 1992-2000 (Figure 2). By 2000, treatment admission rates for narcotic painkillers were lowest in large central metropolitan areas. The largest increase, 135 percent, occurred in non-metropolitan areas without cities.
| Figure 1. Treatment Admissions Involving Narcotic Painkillers per 100,000 Persons Aged 12 or Older, by Urbanization: 1992, 1997, and 2000 |
|
| Source: 2000 SAMHSA Treatment Episode Data Set (TEDS). |
| Figure 2. Increase in Rates of Treatment Admissions Involving Narcotic Painkillers, by Urbanization: 1992-2000 |
|
| Source: 2000 SAMHSA Treatment Episode Data Set (TEDS). |
Route of Administration
The route of administration among narcotic
painkiller abusers entering treatment changed between 1992 and 2000. In 1992,
66 percent of admissions for narcotic painkiller abuse took the drugs orally,
and 25 percent injected them (Table 2). By 2000, however, the proportion taking
the drugs orally had increased to 80 percent, and the proportion injecting
had fallen to 12 percent.
The route of administration changed most in metropolitan areas (central, fringe,
and small), where the proportion of narcotic painkiller treatment admissions
taking the drugs orally increased by between 13 and 18 percentage points,
and the proportion injecting decreased similarly. Non-metropolitan areas with
cities exhibited a similar pattern, but with changes of only about 5 percentage
points.
In the most rural areas (non-metropolitan areas without cities), the proportions
of narcotic painkiller treatment admissions who took the drugs orally or injected them
decreased slightly, by 2 to 3 percentage points. In these areas only, an increase
was seen in the proportion who inhaled the drugs, from 3 percent in 1992 to
9 percent in 2000.
| Table 2. Route of Administration of Narcotic Painkillers, by Urbanization: 1992 and 2000 |
| |
|
Total
U.S |
Large
Central Metro |
Large
Fringe Metro |
Small
Metro |
Non-Metro
with City |
Non-Metro
without City |
| |
|
|
Percent |
|
|
1992 |
|
|
|
|
|
|
| Oral |
66 |
60 |
74 |
64 |
71 |
75 |
| Injection |
25 |
25 |
19 |
29 |
21 |
17 |
| Inhalation |
3 |
4 |
3 |
2 |
3 |
3 |
| Other |
6 |
11 |
4 |
5 |
5 |
5 |
| Total |
100 |
100 |
100 |
100 |
100 |
100 |
|
|
| 2000 |
|
|
|
|
|
|
| Oral |
80 |
78 |
87 |
79 |
77 |
72 |
| Injection |
12 |
9 |
7 |
14 |
16 |
15 |
| Inhalation |
4 |
5 |
3 |
4 |
3 |
9 |
| Other |
4 |
8 |
3 |
3 |
4 |
4 |
| Total |
100 |
100 |
100 |
100 |
100 |
100 |
|
| Source: 2000 SAMHSA Treatment Episode Data
Set (TEDS). |
End Notes
1 Narcotic painkiller admissions include all admissions reporting primary, secondary, or tertiary abuse of narcotic painkillers such as oxycodone, codeine, Dilaudid, morphine, Demerol, and any other drug with morphine-like effects. Admissions involving abuse of heroin and/or methadone are excluded from this report.
2 Eberhardt, M.S., Ingram, D.D., Makuc, D.M., et al. (2001). Urban and Rural Health Chartbook. Health, United States, 2001. Hyattsville, MD: National Center for Health Statistics.
The Drug and Alcohol Services Information System (DASIS) is an integrated data system maintained by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). One component of DASIS is the Treatment Episode Data Set (TEDS). TEDS is a 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. Information on treatment admissions is routinely collected by State administrative systems and then submitted to SAMHSA in a standard format. Approximately 1.6 million records are included in TEDS each year. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once.
The DASIS Report is prepared by the Office of Applied Studies, SAMHSA; Synectics for Management Decisions, Inc., Arlington, Virginia; and RTI, Research Triangle Park, North Carolina.
Information and data for this issue are based on data reported to TEDS through May 31, 2003.
Access the latest TEDS reports at:
http://www.oas.samhsa.gov/dasis.htm
Access the latest TEDS public use files at:
http://www.oas.samhsa.gov/SAMHDA.htm
Other substance abuse reports are available at:
http://www.oas.samhsa.gov
|
| The DASIS Report is published
periodically by the Office of Applied Studies, Substance Abuse and Mental
Health Services Administration (SAMHSA).
All material appearing in this report is in the public domain and may be
reproduced or copied without permission from SAMHSA.
Additional copies of this report or other reports from the Office of Applied
Studies are available on-line: http://www.oas.samhsa.gov.
Citation of the source is appreciated. |
|
