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, Connecticut has been among the 10 States with the highest rates on the following measures (Table 1).

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).

On the global measure of any abuse of or dependence on illicit drugs or alcohol, Connecticut’s rates have generally been at or above the national rates. In 2004–2005 and again in 2005–2006, the rates for those individuals age 18 to 25 were among the highest in the country. It is also worth noting that over the same time period, the rates of alcohol dependence or abuse and illicit drug dependence or abuse were among the highest in the country for this age group (Charts 1 and 2).

Substance Abuse Treatment Facilities

According to the National Survey of Substance Abuse Treatment Services (N-SSATS)3 annual surveys, the number of treatment facilities in Connecticut has declined from 247 in 2002, to 209 facilities in 2006. In 2006, the majority of facilities (179 of 209, or 86%) were private nonprofit. An additional 12 facilities were private for-profit. One facility in Connecticut is owned/operated by a Tribal government. The decrease in facilities between 2002 and 2006 is primarily accounted for by the loss of 32 private for-profit facilities and 10 private nonprofit facilities.

Although facilities may offer more than one modality of care, 152 facilities (73%) offer some form of outpatient care. An additional 66 facilities offer some form of residential care, and 41 facilities offer an opioid treatment program. In addition,171 physicians and 46 treatment programs are certified to provide buprenorphine treatment. In 2006, 73 percent of all facilities (153) received some form of Federal, State, county, or local government funds, and 142 facilities had agreements or contracts with managed care organizations for the provision of substance abuse treatment services.

Treatment

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 In the 2006 N-SSATS survey, Connecticut showed a one-day total of 22,809 clients in treatment, the majority of whom (20,896 or 92 %) were in outpatient treatment. Of the total number of clients in treatment on this date, 645 (3%) were under the age of 18.

Since 1992, there has been a steady increase in the annual number of admissions to treatment; from 39,000 in 1992, to 46,000 in 2006 (the most recent year for which data are available). Chart 3 shows the percent 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 as a substance of abuse; from 78 percent of all admissions in 1992, to 50 percent in 2006. At the same time, the number of admissions mentioning heroin has nearly doubled; from 22 percent in 1992, to 41 percent in 2006.

Across the years for which TEDS data are available, Connecticut has seen a substantial shift in the constellation of problems present at treatment admission. Alcohol-only admissions have declined from over 36 percent of all admissions in 1992, to just over 16 percent in 2006. Concomitantly, drugonly admissions have increased from 22 percent in 1992, to 45 percent in 2006 (Chart 4).

Unmet Need For Treatment

NSDUH defines unmet treatment 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. Connecticut’s rates of unmet need for drug treatment have generally remained at or above the national average. In 2005–2006, the rates of this unmet need for individuals age 12 to 17 and for those age 18 to 25 were among the highest in the Nation (Chart 5).

Similarly, rates of unmet treatment need for alcohol use have generally remained at or above the national rates for all age groups, but especially for those individuals age 18 to 25 (Chart 6).