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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 to 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, Kentucky has been among the 10 States with the highest rates of the following measures :

MeasureAge Groups
Past Month Use of an Illicit Drug Other than Marijuana 12-17
Nonmedical Use of Prescription Pain Relievers 12-17
Past Month Tobacco Use All Age Groups
Past Month Cigarette Use All Age Groups

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 [APA], 1994). In Kentucky, rates of past year dependence on or abuse of alcohol havegenerally been at or below the national rates. This is particularly true for individuals age 18 to 25 and those age 26 and older where the rates of alcohol dependence or abuse have consistently been among the lowest in the country (Chart 1).

By contrast, rates of past year illicit drug have been more variable but generally at or above the national rate (Chart 2).

Substance Abuse Treatment Facilities

According to the National Survey of 1.702003-20042004-20052005-20062006-2007Substance Abuse Treatment Services (N-SSATS)3, the number of treatment facilities in Kentucky has remained relatively stable and certified to provide bupenorphine care for opiate in the 2006 survey, there were 312 treatment facilities. addiction.Of these facilities, 185 (58%) were private non-profit In Kentucky, 48% of all facilities (149) received and another 118 (38%) were private for-profit. some form of federal, State, county or local Although facilities may offer more than one modality government funds in 2006, and 129 facilities of care, the majority of facilities in Kentucky (270 (41%) had agreements or contracts with or 86%) offer some form of outpatient treatment. managed care organizations for the provision of Residential care was available at 53 facilities, and substance abuse treatment services.12 facilities had an opioid treatment program. In addition, 93 physicians and 23 treatment programs are.

Treatment

State treatment data for substance use disorders are derived from two primary sources ' an annual one-day census in N-SSATS and annual treatmentadmissions from the Treatment Episode Data Set (TEDS)4. With all facilities responding to the 2006 N-SSATS survey, showed a total of 19,510 clients in treatment, the majority of whom(17,995 or 92%) were in outpatient treatment. Of the total number of clients in treatment on thisdate, 1,298 (7%) were under the age of 18.Chart 3 shows details the number of substances which were reported at treatment admission, regardless of whether the substance was reported as primary, secondary or tertiary. Since 1997, there has been a stead decline in the percent of admissions with no primary substance (from 46% in 1997 to 23% in 2006) and increases in the percent of admissions with one or more reported substances. In chart 4 we see the percent of admissions mentioning particular drugs or alcohol at the time of admission. Across the last 10 years, there have been steady increases in the number of admissions mentioning alcohol, cocaine, marijuana, and opiates other than heroin.Across the years for which TEDS data are available, Kentucky has seen a substantial shift in the constellation of problems present at treatment admission. Alcohol-only admissions have remained relatively steady, while drug-only admissions have tripled from 9 percent in 1997 to 28 percent in 2006 (Chart 5).

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 (Chart 6).

Generally, the rate of unmet need for alcohol treatment for the State population age 12 and older has been at or below the national rate; for the population age 18 to 25, this rate has consistently been among the lowest in the country (Chart 7).

Rates of unmet need for drug treatment have also generally been at or below the national level for the population as a whole.