April 26, 2007 |
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Annual admissions to substance abuse treatment for primary heroin abuse increased from 228,000 in 1995 to 254,000 in 2005; however, the proportion of primary heroin admissions remained steady at about 14 to 15 percent of all admissions. Between 1995 and 2005, inhalation and injection accounted for at least 94 percent of annual primary heroin admissions.
In every year from 1995 to 2005, most TEDS admissions for primary heroin addiction injected the drug. However, the proportion of primary heroin admissions who injected the drug declined from 69 percent in 1995 to 63 percent in 2005 (despite an 8 percent increase in the number of such admissions over this time period). Although inhalation has remained the second most frequent route of administration, the proportion of primary heroin admissions who inhaled the drug increased from 27 percent in 1995 to 33 percent in 2005.
The racial/ethnic composition of primary heroin injection and inhalation admissions to substance abuse treatment changed between 1995 and 2005. During this time, the general increase in the proportion of White primary heroin admissions was observed for both heroin inhalation admissions (from 25 to 30 percent) and heroin injection admissions (from 50 to 61 percent) (Figure 1). Over the same time period, the proportion of admissions who were Black declined for both heroin inhalation admissions (from 47 to 44 percent) and heroin injection admissions (from 20 to 12 percent).
Inhalation | Injection | |||
---|---|---|---|---|
1995 | 2005 | 1995 | 2005 | |
White | 25% | 30% | 50% | 61% |
Black | 47% | 44% | 20% | 12% |
Hispanic | 26% | 24% | 27% | 24% |
Other | 2% | 2% | 3% | 2% |
Source: 2005 SAMHSA Treatment Episode Data Set (TEDS). |
There was also a shift in the age at admission of primary heroin injection versus inhalation admissions. In 1995, 37 percent of primary heroin inhalation admissions were younger than 30 years of age at admission; by 2005, this proportion decreased to 22 percent (Figure 2). In contrast, 18 percent of primary heroin injection admissions were younger than 30 years of age at admission in 1995; by 2005, this proportion increased to 36 percent.
Inhalation | Injection | |||
---|---|---|---|---|
1995 | 2000 | 1995 | 2000 | |
Younger than 30 | 37% | 22% | 18% | 36% |
30-44 | 55% | 52% | 64% | 40% |
45 or Older | 8% | 26% | 18% | 24% |
Source: 2005 SAMHSA Treatment Episode Data Set (TEDS). |
From 1995 to 2005, the proportion of primary heroin admissions—whether inhalation or injection admissions—receiving ambulatory treatment decreased, while the proportions admitted to other service settings increased.5 Specifically, from 1995 to 2005, the proportion of primary heroin admissions receiving ambulatory treatment decreased by 23 percentage points (from 71 to 48 percent) for injection admissions and by 5 percentage points (from 59 to 54 percent) for inhalation admissions (Figure 3). Necessarily, the proportion of primary heroin admissions using other service settings—residential/rehabilitation or detoxification—rose sharply for injection admissions, and less dramatically for inhalation admissions.
Inhalation | Injection | |||
---|---|---|---|---|
1995 | 2005 | 1995 | 2005 | |
Ambulatory | 59% | 54% | 71% | 48% |
Residential/Rehabilitation | 12% | 14% | 9% | 15% |
Detoxification | 29% | 32% | 20% | 37% |
Source: 2005 SAMHSA Treatment Episode Data Set (TEDS). |
The proportion of primary heroin injection admissions entering substance abuse treatment for the first time was relatively steady from 1995 to 2004, varying between 18 and 20 percent before increasing to 23 percent in 2005. However, the proportion of primary heroin inhalation admissions entering treatment for the first time decreased from 33 percent in 1995 to 29 percent in 2005.
Admissions with five or more prior admissions showed a different trend than admissions entering treatment for the first time. From 1995 to 2005, the proportion of admissions with five or more prior admissions decreased slightly among primary heroin injection admissions (from 32 to 30 percent), while that proportion increased among primary heroin inhalation admissions (from 10 to 14 percent).
The proportion of primary heroin injection admissions planning medication-assisted opioid therapy—using methadone, levo-alpha acetyl methadol (LAAM), or buprenorphine—as part of substance abuse treatment declined from 1995 to 2005. In contrast, the proportion planning such therapy remained relatively stable among inhalation admissions (Figure 4).6 While heroin inhalation admissions were consistently less likely than heroin injection admissions to have methadone or buprenorphine included as part of their treatment plan, this difference narrowed in recent years. The proportion of admissions for which medication-assisted opioid therapy was planned fell from 55 percent of primary heroin injection admissions in 1995 to 31 percent in 2005, but remained stable at around 30 percent of primary heroin inhalation admissions.
Inhalation | Injection | |
---|---|---|
1995 | 29% | 55% |
1996 | 23% | 52% |
1997 | 23% | 46% |
1998 | 32% | 46% |
1999 | 29% | 45% |
2000 | 29% | 43% |
2001 | 31% | 41% |
2002 | 32% | 39% |
2003 | 30% | 35% |
2004 | 28% | 33% |
2005 | 29% | 31% |
Source: 2005 SAMHSA Treatment Episode Data Set (TEDS). |
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. TEDS records represent admissions rather than individuals, as a person may be admitted to treatment more than once. State admission data are reported to TEDS by the Single State Agencies (SSAs) for substance abuse treatment. There are significant differences among State data collection systems. Sources of State variation include completeness of reporting, facilities reporting TEDS data, clients included, and treatment resources available. See the annual TEDS reports for details. Approximately 1.8 million records are included in TEDS each year. The DASIS Report is prepared by the Office of Applied Studies, SAMHSA; Synectics for Management Decisions, Inc., Arlington, Virginia; and by RTI International in Research Triangle Park, North Carolina (RTI International is a trade name of Research Triangle Institute). Information and data for this issue are based on data reported to TEDS through February 1, 2006. Access the latest TEDS reports at: |
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. For questions about this report please e-mail: shortreports@samhsa.hhs.gov. |
This page was last updated on July 11, 2008. |
SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.
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