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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 age 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, New Jersey has ranked among those states with the lowest rates on the following measures (Table 1).
|Past Year Nonmedical Use of Pain Relievers||12+,12-17|
|Past Month Tobacco Use||12+,26+|
|Past Month Cigarette Use||12+,26+|
|Perception of Great Risk Associated with Smoking One or Two Packs of Cigarettes a Day||12+,26+|
|Past Year Alcohol Abuse or Dependence||12+,26+|
|Past Year Alcohol Dependence||12+|
|Past Year Illicit Drug Dependence||12+|
|Past Year Dependence or Abuse on Illicit Drugs or Alcohol||12+,26+|
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).
Since State estimates were first generated from 2002-2003 data, rates of abuse or dependence on alcohol in New Jersey have generally been at or below the rates for the country as a whole. Rates for abuse or dependence on illicit drugs have also been at or below the national rates for the same time period (Chart 1). On the more global measure of any abuse of or dependence on alcohol or illicit drugs, New Jersey has consistently ranked among the lowest States for the population age 12 and older, as well as for the population age 26 and older.
Substance Abuse Treatment Facilities
According to the 2006 National Survey of Substance Abuse Treatment Services (N-SSATS),3 the number of treatment facilities in New Jersey was 351, the majority of which (206 or 59%) were private nonprofit. An additional 121 facilities were private for-profit, and the remainder were owned or operated by the Federal, State, or local government. The number of New Jersey treatment facilities has increased from 315 in 2002 to 351 in 2006. The majority of this increase is accounted for by an additional 42 private for-profit facilities.
Although facilities may offer more than one modality of care, the majority of facilities in New Jersey in 2006 (302 of 351 or 86%) offered some form of outpatient care. A total of 67 facilities offered some form of residential care, and 37 facilities offered opioid treatment programs. In addition, 365 physicians and 57 treatment programs were certified to provide buprenorphine treatment.
In 2006, 56 percent of all facilities (196) received some form of Federal, State, county, or local government funds, and 137 facilities (39%) had agreements or contracts with managed care organizations for the provision of substance abuse treatment services.
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 The 2006 N-SSATS survey, showed an one-day total of 30,106 clients in treatment, the majority of whom (26,699 or 89%) were in outpatient treatment. Of the total number of clients in treatment on this date, 2,111 (7%) were under the age of 18.
Chart 2 shows the percentage of admissions mentioning particular drugs or alcohol at the time of admission.5 Across the last 15 years, there has been a steady decline in the number of admissions mentioning alcohol or cocaine at treatment admission and increases in the mentions of heroin and marijuana.
Across the years for which TEDS data are available, New Jersey has seen a substantial shift in the constellation of problems present at treatment admission (Chart 3). Alcohol-only admissions have declined from 27 percent of all admissions in 1992 to 18 percent in 2006. Concomitantly, drug only admissions have nearly doubled from 26 percent in 1992 to 51 percent in 2006.
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.
For all age groups and across all survey years, New Jersey has ranked at or below the national rates for unmet treatment need (Chart 4). This is particularly true for unmet need for drug treatment among those 12 and older and unmet need for alcohol treatment for the same age group (Chart 5).