Treatment rates low for substance use disorders in US

Findings in a SAMHSA report indicated approximately 4% of individuals with an alcohol use disorder received specialty treatment for the disorder in 2015; similarly, 11% of individuals with an illicit drug use disorder received treatment.

“Currently, behavioral health problems such as the prescription opioid and heroin epidemic and deaths by suicide, continue to impact communities and families across the country,” study researcher Beth Han, MD, PhD, MPH, of SAMHSA, told Healio/Psychiatry. “The recently released fourth edition of the ‘Behavioral Health Barometer: United States’ shows the behavioral health status of our nation by providing the prevalence of substance use, serious mental illness, serious thoughts of suicide, and related treatment. The Barometer also provides findings by age, gender, racial and ethnic categories, poverty status, and health insurance status.”

To provide a snapshot of behavioral health in the United States, researchers analyzed data from the National Survey on Drug Use and Health and the National Survey of Substance Abuse Treatment Services for 2015.

Youth mental health , substance use

The percentage of adolescents aged 12 to 17 years who used marijuana in the past month decreased from 7.9% in 2011 to 7% in 2015.

In 2015, 8.8% of adolescents used illicit drugs in the past month. Marijuana and prescription drugs were the most common types of illicit drug use among adolescents.

The percentage of adolescents who initiated alcohol use, marijuana use and cigarette use in the past year were lower in 2015 than in 2011. In 2015, approximately 9.5% or adolescents used alcohol for the first time.

Most adolescents did not perceive great risk for harm from monthly or weekly marijuana use or having five or more drinks once or twice a week.

An estimated 3 million (12.5%) adolescents had at least one major depressive episode in the past year in 2015. The percentage of major depressive episodes among females was three times higher than that of males (19.5% vs. 5.8%).

Further, the percentage of adolescent females who experienced a major depressive episode was higher in 2015 than in any year from 2011 to 2014.

Adult mental health

In 2015, 4% of adults aged 18 years and older had serious thoughts about suicide in the past year, indicating a significant increase from 2011 (3.7%) but not 2012, 2013 or 2014.

Serious thoughts of suicide were more common among adults without health insurance (5.3%) and those living in households with income less than 100% of the poverty level (6.4%).

Serious mental illness was reported among 4% of adults in 2015, comparable to the percentage in 2011 (3.9%).

The percentage of serious mental illness was significantly higher among females than males in 2015 (5% vs. 3%).

Past-year serious mental illness was more common among adults living in households with income less than 100% of the poverty level (6.8%) and living in nonmetropolitan areas (4.7%)

Substance use, disorders

In 2015, 4.7% of individuals aged 12 years and older misused prescription pain relievers in the past year.

The most common reasons for last misuse were to relieve physical pain (62.6%), to feel good or get high (12.1%) and to relax or relieve tension (10.8%).

The most commonly reported source for misused prescription pain relievers was from a friend or relative (53.7%), with 40.5% getting them from a friend or relative for free.

In 2015, 5.9% of individuals aged 12 years and older reported past-year alcohol use disorder and 2.9% reported illicit drug use disorder.

Treatment

In 2015, 39.3% of adolescents with past-year major depressive episode received treatment for depression in the past year. This was comparable to the percentage in 2011 (38.4%).

In 2015, 65.3% of adults with serious mental illness received mental health services in the past year, which was not significantly different than percentages in any year from 2011 to 2014.

Overall, 4.4% of individuals with an alcohol use disorder received specialty treatment for the disorder in the past year and 92.9% of individuals did not receive treatment or perceive a need for treatment.

From 2011 to 2015, the number of individuals who received methadone in opioid treatment programs increased by approximately 16% and receipt of buprenorphine more than doubled.

Approximately 11% of individuals with an illicit drug use disorder received specialty treatment in the past year and 82.3% did not receive treatment and did not perceive a need for treatment.

“The findings of the Barometer have significant implications for clinical practice for psychiatrists and other mental health and addiction care providers,” Han said. “These results can help them understand the current status of our nation’s behavioral health. Moreover, the Barometer shows the importance of screening for and treating behavioral health problems. These findings will help clinicians identify and treat people with substance use problems, people with serious thoughts of suicide, and people with serious mental illness.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.

Reference:

Substance Abuse and Mental Health Services Administration. Behavioral Health Barometer: United States, 2016. HHS Publication No. SMA–17–BaroUS–16. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2017.