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The Dasis Report (Drug and Alcohol Information System)
December 5, 2003

Treatment Admissions for Injection of Multiple Drugs: 2000

In Brief
  • About 19 percent of admissions reporting injection of drugs reported injection of two or more drugs
    •
  • Injection of both heroin and cocaine was reported by 75 percent of admissions who reported injection of more than one drug

  • Types of drugs injected by admissions injecting more than one drug differed by race/ethnicity

In addition to the harmful effects of drug use, injecting drugs may cause additional medical problems by introducing contaminants into the body via shared needles and a lack of sterile techniques. These problems include blood-borne infections such as HIV and hepatitis1. Injected drugs may also include additives, placing those who inject one or more drugs at additional risk.

TEDS records up to three substances of abuse and the route of administration of each substance. In 2000, there were 215,000 admissions reported to TEDS that involved injection of one or more of the three drugs reported.2 Most of these admissions (81 percent) reported injection of one drug only. However, some 42,000 (19 percent) reported injection of two or more drugs.3
Injected Drugs
The most common drugs among admissions injecting multiple drugs were heroin and cocaine. These drugs were reported by 75 percent of admissions with multiple injected drugs. Heroin and methamphetamine were reported by 7 percent of admissions injecting multiple drugs; cocaine and methamphetamine were reported by 6 percent; and other combinations were reported by 12 percent.

Table 1 shows the types of injected drugs abused by admissions injecting both primary and secondary drugs.4 Among admissions reporting injection of both primary and secondary drugs, 89 percent of those reporting heroin as the primary drug injected cocaine as the secondary drug. Among those reporting cocaine as the primary drug, 63 percent injected heroin as the secondary drug.
Table 1. Admissions Reporting Multiple Injected Drugs, by Primary and Secondary Injected Drug: 2000
 
Primary Injected Drug*
 
 

Heroin
(n=28,500)

Cocaine
(n=2,000)

Methamphet-
amine
(n=2,000)

Other Amphetamine
(n=500)

Non-heroin
Opiates
(n=28,500)

 
Secondary Injected Drug
Percent
 Heroin
 63
 40
 29
 43
 Cocaine
 89
 54
 60
 40
 Methamphetamine
 6
 23
 1
 6
Other Amphetamine
1
9
1
4
Non-heroin Opiates
2
2
2
4
Other
2
3
3
6
7
Total
100
100
100
100
100
Source: 2000 SAMHSA Treatment Episode Data Set (TEDS).


Demographics
Admissions that reported injecting more than one drug were similar demographically to those who reported injecting only one drug. Two-thirds of both groups (about 66 percent) were male, and age distributions were similar among those reporting the injection of one drug and those reporting the injection of more than one drug.

Admissions injecting one drug and those injecting multiple drugs had similar racial distributions (Figure 1). However, types of drugs injected by admissions injecting more than one drug differed by race/ethnicity. Two thirds (65 percent) of White admissions, 94 percent of Black admissions, 90 percent of Hispanic admissions, 54 percent of American Indian/Alaska Native admissions, and 82 percent of Asian admissions injecting more than one drug reported heroin and cocaine (Figure 2). Among all racial/ethnic groups, the other drugs most frequently reported were cocaine and stimulants as well as heroin and stimulants.
Figure 1. Number of Drugs Injected, by Race/Ethnicity: 2000
Figure 1. Number of Drugs Injected, by Race/Ethnicity: 2000
Source: 2000 SAMHSA Treatment Episode Data Set (TEDS).


Figure 2. Race/Ethnicity by Types of Drugs Injected: 2000
Figure 2. Race/Ethnicity by Types of Drugs Injected: 2000
Source: 2000 SAMHSA Treatment Episode Data Set (TEDS).


Referral Source
 The sources of referral to substance abuse treatment were similar regardless of the number of drugs injected. About 56 percent of multiple injectors and of single-drug injectors entered treatment through self-referral, about 17 percent of each group were referred by the criminal justice system, and 12 percent of each group were referred by substance abuse providers.

 
Previous Treatment
Regardless of the number of drugs injected, most admissions had been in treatment prior to the current treatment episode (77 percent of multiple injectors, and 75 percent of single-drug injectors, respectively).

 
Type of Service
Admissions who reported injection of more than one drug were somewhat less likely to enter detoxification than were admissions who reported injection of one drug only (34 percent and 41 percent, respectively). Conversely, admissions who reported injection of more than one drug were more likely to enter outpatient treatment (45 percent vs. 42 percent) or residential treatment (20 percent vs. 17 percent) than those who injected only one drug.

 
Methadone Use in Treatment
Admissions reporting the injection of heroin and cocaine were more likely to have their treatment plan include methadone (40 percent) than those who reported the injection of heroin and methamphetamine (26 percent).

End Notes
1Centers for Disease Control, U.S. Department of Health & Human Services. (2001, May 18). Public health and injection drug use [Electronic version]. Morbidity and Mortality Weekly Report, 50 (19), 377.

2 For a previous report on injecting drugs, see Substance Abuse and Mental Health Services Administration, Office of Applied Studies. The DASIS report: Treatment admissions for injection drug abuse. Rockville, MD. June 21, 2002.

3TEDS records only the information that a particular drug was abused by injection. It does not record whether two injected drugs were abused simultaneously or on separate occasions.

4 The primary substance of abuse is the main substance abused at the time of admission.

Table Note
*This table contains the 80 percent of the 42,000 multiple injected drug admissions who reported their injected drugs as "primary" and "secondary."

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 April 1, 2002.

Access the latest TEDS reports at:
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.

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