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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, Oklahoma has remained among the 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).
Rates of alcohol dependence or abuse in Oklahoma have typically remained at or below national rates for all age groups and across all survey years. Rates of dependence on illicit drugs, however, have generally remained at or above national levels. Of particular note is the rate of dependence on illicit drugs among those age 26 and older (Chart 1).
Substance Abuse Treatment Facilities
According to the 2006 National Survey of Substance Abuse Treatment Services (N-SSATS),3 there were 176 treatment facilities in Oklahoma. Of these, the majority (109 or 62%) were private nonprofit, an additional 29 (16%) were private for-profit, and 15 facilities were owned or operated by a Tribal government.
The number of treatment facilities in Oklahoma has increased from a total of 146 facilities in 2002 to 176 facilities in 2006. The increase is primarily accounted for by the addition of 10 private nonprofit facilities and 14 for-profit facilities.
Although facilities may offer more than one modality of care, in 2006 the majority of Oklahoma facilities (152 of 176, or 86%) offered some form of outpatient treatment, and an additional 47 facilities offered some form of residential care. Eight facilities offered opioid treatment, and 45 physicians were certified to provide buprenorphine treatment. In 2006, 65 percent of all facilities (115) received some form of Federal, State, county, or local government funds, and 36 facilities (20%) 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 In the 2006 N-SSATS survey, Oklahoma showed an one-day census of 2,301 clients in treatment, the majority of whom (1,837 or 80%) were in outpatient treatment. Of the total number of clients in treatment on this date, 270 (12%) were under the age of 18.
Chart 2 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, and increases in the mentions of both marijuana and methamphetamine.
Across the years for which TEDS data are available, Oklahoma has seen a substantial shift in the constellation of problems present at treatment admission (Chart 3). Alcohol-only admissions have declined from 57 percent of all admissions in 1992, to just over 31 percent in 2006. Concomitantly, drug-only admissions have increased from 1.6 percent in 1992 to 20 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.
While rates of individuals needing and not receiving treatment for drug use have generally remained at or above national rates (Chart 4), rates of unmet need for alcohol use have generally remained at or below national rates (Chart 5). This is particularly true for the Oklahoma population age 26 and older.