Chartbook on Behavioral Health Treatment Demand and Provider Capacity in the United States

04/14/2021

Chartbook on Behavioral Health Treatment Demand and Provider Capacity in the United States

Ellen Bouchery

Mathematica

March 2021

Link to Printer Friendly Version in PDF Format (80 PDF pages)


ABSTRACT: This chartbook is a compendium of tables presenting data relevant to behavioral health treatment demand and provider capacity to provide needed treatment. Data is presented from multiple sources: the National Survey of Substance Abuse Treatment Services (N-SSATS), the National Mental Health Services Survey (N-MHSS), the National Survey on Drug Use and Health (NSDUH), the Treatment Episode Data Set (TEDS), the Transformed Medicaid Statistical Information System (T-MSIS) Substance Use Disorder Data Book, and quality measurement data submitted to the Centers for Medicaid & Medicare Services. Taken together, these tables provide a broad overview of issues facing the behavioral health treatment system.

Reports were prepared under contract #HHSP233201600021I between the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Behavioral Health, Disability, and Aging Policy (BHDAP) and Mathematica.  For additional information about this subject, you can visit the BHDAP home page at https://aspe.hhs.gov/bhdap or contact the ASPE Project Officers at HHS/ASPE/BHDAP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201; Judith.Dey@hhs.gov, Laura.Jacobus-Kantor@hhs.gov, Helen.Lamont@hhs.gov.

DISCLAIMER: The opinions and views expressed in this report are those of the authors. They do not reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. This report was completed and submitted on April 22, 2020.


 

TABLE OF CONTENTS

ACRONYMS

A. SUBSTANCE USE DISORDER TREATMENT DEMAND AND CAPACITY

B. MENTAL HEALTH TREATMENT DEMAND AND CAPACITY

C. CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT DEMAND AND CAPACITY

D. DESCRIPTION OF DATA SOURCES

  1. National Survey of Substance Abuse Treatment Services
  2. National Mental Health Services Survey
  3. National Survey on Drug Use and Health
  4. Treatment Episode Data Set
  5. Transformed Medicaid Statistical Information System SUD Data Book

LIST OF TABLES

  • TABLE A.1.a: Number of Persons and Percentage of Population with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older, 2004-2018
  • TABLE A.1.b: Number of Persons and Percentage of Population with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older, 2015-2018
  • TABLE A.2.a: Number of Persons with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older by Age Group, 2015-2018
  • TABLE A.2.b: Percentage of Persons with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older by Age Group, 2015-2018
  • TABLE A.3: Number of Persons and Percentage of Population Who Received Substance Use Treatment at Any Location or a Specialty Facility in the Past Year Among Persons Ages 12 and Older, by Substance and Age Group, 2015-2018
  • TABLE A.4: Number of Persons Receiving Substance Use Treatment in the Past Year Among Persons Ages 12 and Older, by Location of Treatment and Substance, 2015-2018
  • TABLE A.5: Number and Percentage of Substance Use Treatment Admissions to Publicly-Funded Facilities for Persons Ages 12 and Older, by Primary SUD, 2007-2017
  • TABLE A.6: Percentage of Substance Use Treatment Admissions to Publicly-Funded Facilities Originating from Various Treatment Referral Sources, by Type of Care, 2017
  • TABLE A.7: Number of Clients in Specialty Treatment Facilities, by State and Service Setting, 2013, 2015, and 2017
  • TABLE A.8: Number of Clients Receiving Select Opioid Use Disorder Treatment Medications from Specialty Treatment Facilities by State, 2013, 2015, and 2017
  • TABLE A.9: Percentage of Clients Receiving Medications in Specialty Treatment Facilities, by State, 2013, 2015, and 2017
  • TABLE A.10.a: Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Disorder
  • TABLE A.10.b: Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Disorder
  • TABLE A.11.a: Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Type
  • TABLE A.11.b: Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Type
  • TABLE A.11.c: Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Type
  • TABLE A.12: Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Setting
  • TABLE A.13: Days of Service Provided to Medicaid Beneficiaries Who Received Each Service Type in 2017
  • TABLE A.14: Percent of Persons 12 and Older Needing SUD Treatment Who Perceived a Need for Treatment and Made an Effort to get Treatment, 2015-2018
  • TABLE A.15: Percentage of Population Needing but not Receiving SUD Treatment in the Past Year, by Age Group and State, 2017-2018
  • TABLE A.16: Number of Residential and Inpatient Beds Designated for SUD Treatment and Their Utilization Rates, by State, 2013, 2015, and 2017
  • TABLE A.17: Number of DATA-Waived Providers, September 2019
  • TABLE A.18: Mean Rate of IET-AD for Members of Health Plans Participating in NCQA’s State of Health Care Quality Report, 2005-2018
  • TABLE A.19.a: Rate of IET-AD for Medicaid and/or CHIP Beneficiaries, by State FFY 2018
  • TABLE A.19.b: Rate of FUA-AD for Medicaid and/or CHIP Beneficiaries, by State FFY 2018
  • TABLE A.20: Continuity of Care for Medicaid Beneficiaries Treated for a SUD Who Received Services in an Inpatient or a Residential Setting in 2017, by State
  • TABLE B.1: Number of Persons with Any Mental Illness or Serious Mental Illness in the Past Year Among Persons Ages 18 and Older, 2008-2018
  • TABLE B.2: Percentage of Population with Any Mental Illness or Serious Mental Illness in the Past Year Among Persons Ages 18 and Older, by Age Group, 2008-2018
  • TABLE B.3: Number of Persons with Any Mental Illness or Serious Mental Illness in the Past Year Among Persons Ages 18 and Older, by Insurance Status, 2008-2018
  • TABLE B.4.a: Number of Persons with a MDE or Suicidal Thoughts in the Past Age Group, 2008-2018
  • TABLE B.4.b: Percentage of Population with a MDE or Suicidal Thoughts in the Past Year, by Age Group, 2008-2018
  • TABLE B.5: Number of Persons Receiving Any MH Services in the Past Year, by Age and Insurance Status, 2008-2018
  • TABLE B.6: Number of Clients Receiving Specialty MH Treatment in the Past Year, by State and Service Setting, in 2014, 2016, and 2918
  • TABLE B.7: Number of Residential and Inpatient Beds Designated for MH Treatment and Utilization Rates, by State, in 2014, 2016, and 2018
  • TABLE B.8: MH Quality Measures from NCQA’s State of Health Care Quality Report, 2018
  • TABLE B.9.a: Rate of AMM-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018
  • TABLE B.9.b: FUH-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018
  • TABLE B.9.c: SAA-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018
  • TABLE B.9.d: SSD-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018
  • TABLE B.9.e: Percentage of Children Ages 6-20 Hospitalized for Treatment of Mental Illness Who Received a FUH-CH for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018
  • TABLE C.1: Mean Hourly Wage for Occupations Providing Behavioral Health Treatment, 2008-2018
  • TABLE C.2: Total Employment for Occupations Providing Behavioral Health Treatment, 2008-2018
  • TABLE C.3: Number and Percentage of Persons with Both a MDE in the Past Year or Alcohol Use in the Past Month Among Persons Ages 12-17, 2008-2018
  • TABLE C.4: Number and Percentage of Persons with Mental Illness and a SUD in the Past Year Among Persons Age 18 and Older, by Age Group, 2015-2018

 

ACRONYMS

The following acronyms are mentioned in this report.

ADHD Attention Deficit Hyperactivity Disorder
AMM Antidepressant Medication Management
 
CHBSQ SAMHSA Center for Behavioral Health Statistics and Quality
CHIP Children’s Health Insurance Program
 
DQ not reported because of severe data quality issues
DS data suppressed for confidentiality reasons because the group included fewer than 11 beneficiaries
DSM Diagnostic and Statistical Manual of Mental Disorders
 
EAP Employee Assistance Program
ED Emergency Department
 
FFY Federal Fiscal Year
FUA Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence
FUH Follow-Up After Hospitalization for Mental Illness
 
HbA1c Hemoglobin A1c
 
IET Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment
 
LDL Low-Density Lipoprotein
 
MAT Medication-Assisted Treatment
MDE Major Depressive Episode
MH Mental Health
 
N-MHSS National Mental Health Services Survey
N-SSATS National Survey on Substance Abuse Treatment Services
NA Not Available
NCQA National Committee for Quality Assurance
NR Not Reported
NSDUH National Survey on Drug Use and Health
 
OES Occupational Employment Statistics
 
SAA Adherence to Antipsychotic Medications for Individuals with Schizophrenia
SAMHSA Substance Abuse and Mental Health Services Administration
SSD Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications
SUD Substance Use Disorder
 
T-MSIS Transformed Medicaid Statistical Information System
TEDS Treatment Episode Data Set

 

A. SUBSTANCE USE DISORDER TREATMENT DEMAND AND CAPACITY

Table A.1.a. Number of Persons and Percentage of Population with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older, 2004-2018
Substance 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Number of persons (in thousands)
Marijuana 4,469 4,090 4,184 3,941a 4,228 4,322 4,505 4,165 4,304 4,206 4,176 4,007 3,992 4,057 4,421
Cocaine 1,571a 1,549a 1,665a 1,604a 1,412a 1,108 1,012 821 1,119 855 913 896 867 966 977
Heroin 270a 227a 324 214a 283a 369 361 426 467 517 586 591 626 652 526
Alcohol 18,654a 18,658a 18,852a 18,687a 18,478a 18,763a 17,967a 16,672a 17,714a 17,298a 16,994a 15,736 15,057 14,504 14,818
Percentage of population
Marijuana 1.9a 1.7 1.7 1.6 1.7 1.7 1.8 1.6 1.7 1.6 1.6 1.5 1.5 1.5 1.6
Cocaine 0.7a 0.6a 0.7a 0.6a 0.6a 0.4 0.4 0.3 0.4 0.3 0.3 0.3 0.3 0.4 0.4
Heroin 0.1a 0.1a 0.1 0.1a 0.1a 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2
Alcohol 7.8a 7.7a 7.7a 7.5a 7.4a 7.5a 7.1a 6.5a 6.8a 6.6a 6.4a 5.9a 5.6 5.3 5.4
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for number of persons are from Table 7.45A and for percentages are from Table 7.45B. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020.
NOTE: Estimates are derived from the NSDUH, an annual survey of the civilian, noninstitutionalized population of the United States ages 12 years and older. NSDUH collects information from residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories) but excludes homeless people who do not use shelters, military personnel on active duty, and residents of institutional group quarters such as jails and hospitals. Survey respondents were identified as having a SUD if their survey responses indicated that they met symptomatic criteria for substance dependence or abuse based on definitions found in the fourth edition of the DSM. The NSDUH survey was redesigned between 2014 and 2015. Estimates for the disorders related to the substances included in this table are comparable before and after the redesign.
  1. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

Table A.1.b. Number of Persons and Percentage of Population with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older, 2015-2018
Substance Number of Persons (in thousands) Percentage of Population
2015 2016 2017 2018 2015 2016 2017 2018
Illicit drugsa 7,737 7,381e 7,545 8,094 2.9 2.7 2.8 3.0
Marijuanab 4,007 3,992 4,057 4,421 1.5 1.5 1.5 1.6
Illicit drugs other than marijuanab 4,494 4,056 4,308 4,408 1.7 1.5 1.6 1.6
   Cocainec 896 867 966 977 0.3 0.3 0.4 0.4
   Heroinc 591 626 652 526 0.2 0.2 0.2 0.2
   Hallucinogens 267 343 316 273 0.1 0.1 0.1 0.1
   Inhalants 121 110 98 129 0.0 0.0 0.0 0.0
   Methamphetamine 872 684e 964 1,051 0.3 0.3e 0.4 0.4
   Misuse of psychotherapeutics 2,742 2,541 2,530 2,552 1.0 0.9 0.9 0.9
      Pain relievers 2,038 1,753 1,678 1,694 0.88e 0.7 0.6 0.6
      Stimulants 426 540 572 561 0.2 0.2 0.2 0.2
      Tranquilizers or sedatives 789 737 823 751 0.3 0.3 0.3 0.3
         Tranquilizers 688 618 739 673 0.3 0.2 0.3 0.2
         Sedatives 154 205 198 113 0.1 0.1 0.1 0.0
         Benzodiazepines NA NA NA NA NA NA NA NA
Alcoholc 15,736 15,057 14,504 14,818 5.9e 5.6 5.3 5.4
Illicit drugs or alcohol 20,810 20,112 19,700 20,258 7.8 7.5 7.2 7.4
Both illicit drugs and alcohol 2,663 2,326 2,349 2,654 1.0 0.9 0.9 1.0
Illicit drugs only 5,074 5,055 5,196 5,440 1.9 1.9 1.9 2.0
Alcohol only 13,073e 12,731 12,156 12,165 4.9e 4.7 4.5 4.4
Opioids (heroin and/or pain relievers)d 2,375 2,144 2,110 2,028 0.9e 0.8 0.8 0.7
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for number of persons are from Table 7.45A and estimates for percentages are from Table 7.45B. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020.
NOTE: Estimates are derived from the NSDUH, an annual survey of the civilian, noninstitutionalized population of the United States ages 12 years and older. NSDUH collects information from residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories) but excludes homeless people who do not use shelters, military personnel on active duty, and residents of institutional group quarters, such as jails and hospitals. Survey respondents were identified as having a SUD if their survey responses indicated that they met symptomatic criteria for substance dependence or abuse based on definitions found in the DSM-IV.
  1. Illicit drug use disorder is defined as meeting DSM-IV criteria for either dependence or abuse for 1 or more of the following illicit drugs: marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, or prescription psychotherapeutic drugs that were misused (i.e., pain relievers, tranquilizers, stimulants, and sedatives). The total number of individuals with a disorder related to illicit drugs is less than of the sum of individuals with a disorder related to each type of illicit drug because a given individual may have a disorder related to more than 1 illicit substance.
  2. The category Illicit drugs other than marijuanaexcludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs.
  3. The NSDUH survey was redesigned between 2014 and 2015. Estimates for marijuana, cocaine, heroin, and alcohol use disorders are comparable before and after the redesign. Estimates for the other substances are not comparable before and after the redesign.
  4. Respondents were classified as having an opioid use disorder if they met DSM-IV criteria for heroin use disorder, prescription pain reliever use disorder, or both in the past year.
  5. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

Table A.2.a. Number of Persons with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older by Age Group, 2015-2018 (numbers in thousands)
Substance Ages 12-17 Ages 18-25 Ages 26 and Older
2015 2016 2017 2018 2015 2016 2017 2018 2015 2016 2017 2018
Illicit drugsa 855e 789 741 681 2,530 2,428 2,512 2,599 4,352 4,164e 4,292 4,814
Marijuanab 651e 584 557 512 1,796 1,743e 1,799 2,003 1,560e 1,665 1,701 1,907
Illicit drugs other than marijuanab 324e 305 274 245 1,075 927 1,028 914 3,095 2,824 3,006 3,248
   Cocainec 31e 29e 19e 5 229 215 243 212 637 623 703 760
   Heroinc 6 1 4 4 155 152 165e 101 430 473 483 421
   Hallucinogens 66 65 56 38 117 171 130 138 84 107 130 97
   Inhalants 56 54 28 34 15 13e 29 40 51 42 41 55
   Methamphetamine 22 10 24 18 156 135 188 134 694 539e 751 899
   Misuse of psychotherapeutics 216 226 197 183 687e 544 639 551 1,840 1,771 1,693 1,819
      Pain relievers 122 152 99 104 427e 291 339e 248 1,489 1,310 1,240 1,343
      Stimulants 38 56 62 53 159 170 187 185 229 315 323 323
      Tranquilizers or sedatives 99 98 84 68 243 212 288 224 446 427 451 458
         Tranquilizers 77 86 80 61 234 188 278 223 376 343 380 390
         Sedatives 26 32 10 12 22 30e 24 9 106 143 164 91
         Benzodiazepines NA NA NA NA NA NA NA NA NA NA NA NA
Alcoholc 623e 488 443 401 3,821e 3,684 3,444 3,424 11,291 10,885 10,618 10,994
Illicit drugs or alcohol 1,233e 1,064e 992 916 5,327 5,236 5,076 5,118 14,250 13,812 13,632 14,225
Both illicit drugs and alcohol 245e 213 192 166 1,024 876 879 905 1,394 1,237e 1,278 1,582
Illicit drugs only 610 576 549 515 1,506 1,552 1,632 1,694 2,958 2,927 3,014 3,231
Alcohol only 378e 275 251 234 2,797e 2,807e 2,565 2,519 9,897 9,648 9,340 9,411
Opioids (heroin and/or pain relievers)d 127 153 103 108 515e 392 445e 312 1,733 1,599 1,562 1,608
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for ages 12-17 are from Table 7.46A. Estimates for ages 18-25 are from Table 7.48A and estimates for ages 26 and older are from Table 7.49A. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020.
NOTE: Estimates are derived from the NSDUH, an annual survey of the civilian, noninstitutionalized population of the United States ages 12 years and older. NSDUH collects information from residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories) but excludes homeless people who do not use shelters, military personnel on active duty, and residents of institutional group quarters, such as jails and hospitals. Survey respondents were identified as having a SUD if their survey responses indicated that they met symptomatic criteria for substance dependence or abuse based on definitions found in the DSM-IV.
  1. Illicit drug use disorder is defined as meeting DSM-IV criteria for either dependence or abuse for 1 or more of the following illicit drugs: marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, or prescription psychotherapeutic drugs that were misused (i.e., pain relievers, tranquilizers, stimulants, and sedatives). The total number of individuals with a disorder related to illicit drugs is less than of the sum of individuals with a disorder related to each type of illicit drug because a given individual may have a disorder related to more than 1 illicit substance.
  2. The category Illicit drugs other than marijuanaexcludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs.
  3. The NSDUH survey was redesigned between 2014 and 2015. Estimates for marijuana, cocaine, heroin, and alcohol use disorders the redesign.
  4. Respondents were classified as having an opioid use disorder if they met DSM-IV criteria for heroin use disorder, prescription pain reliever use disorder, or both in the past year.
  5. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

Table A.2.b. Percentage of Population with a SUD for Specific Substances in the Past Year Among Persons Ages 12 and Older by Age Group, 2015-2018
Substance Ages 12-17 Ages 18-25 Ages 26 and Older
2015 2016 2017 2018 2015 2016 2017 2018 2015 2016 2017 2018
Illicit drugsa 3.4e 3.2 3.0 2.7 7.2 7.0 7.3 7.6 2.1 2.0 2.0 2.2
Marijuanab 2.6e 2.3 2.2 2.1 5.1e 5.0e 5.2 5.9 0.8 0.8 0.8 0.9
Illicit drugs other than marijuanad 1.3e 1.2 1.1 1.0 3.1 2.7 3.0 2.7 1.5 1.3 1.4 1.5
   Cocained 0.1e 0.1e 0.1e 0.0 0.7 0.6 0.7 0.6 0.3 0.3 0.3 0.4
   Heroinb 0.0 0.0 0.0 0.0 0.4 0.4 0.5e 0.3 0.2 0.2 0.2 0.2
   Hallucinogens 0.3 0.3 0.2 0.2 0.3 0.5 0.4 0.4 0.0 0.1 0.1 0.0
   Inhalants 0.2 0.2 0.1 0.1 0.0e 0.0e 0.1 0.1 0.0 0.0 0.0 0.0
   Methamphetamine 0.1 0.0 0.1 0.1 0.4 0.4 0.5 0.4 0.3 0.3e 0.4 0.4
   Misuse of psychotherapeutics 0.9 0.9 0.8 0.7 2.0 1.6 1.9 1.6 0.9 0.8 0.8 0.8
      Pain relievers 0.5 0.6 0.4 0.4 1.2e 0.8 1.0e 0.7 0.7 0.6 0.6 0.6
      Stimulants 0.2 0.2 0.2 0.2 0.5 0.5 0.5 0.5 0.1 0.1 0.2 0.2
      Tranquilizers or sedatives 0.4 0.4 0.3 0.3 0.7 0.6 0.8 0.7 0.2 0.2 0.2 0.2
         Tranquilizers 0.3 0.3 0.3 0.2 0.7 0.5 0.8 0.7 0.2 0.2 0.2 0.2
         Sedatives 0.1 0.1 0.0 0.0 0.1 0.1e 0.1 0.0 0.1 0.1 0.1 0.0
         Benzodiazepines NA NA NA NA NA NA NA NA NA NA NA NA
Alcoholb 2.5e 2.0 1.8 1.6 10.9e 10.7 10.0 10.1 5.4 5.2 5.0 5.1
Illicit drugs or alcohol 5.0e 4.3e 4.0 3.7 15.3 15.1 14.8 15.0 6.9 6.6 6.4 6.6
Both illicit drugs and alcohol 1.0e 0.9 0.8 0.7 2.9 2.5 2.6 2.7 0.7 0.6 0.6 0.7
Illicit drugs only 2.5 2.3 2.2 2.1 4.3e 4.5 4.8 5.0 1.4 1.4 1.4 1.5
Alcohol only 1.5e 1.1 1.0 0.9 8.0 8.1 7.5 7.4 4.8 4.6 4.4 4.4
Opioids (heroin and/or pain relievers)c 0.5 0.6 0.4 0.4 1.5e 1.1 1.3e 0.9 0.8 0.8 0.7 0.7
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for ages 12-17 are from Table 7.46B. Those for ages 18-25 are from Table 7.48B and those for ages 26 and older are from Table 7.49B. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020.
NOTE: Estimates are derived from the NSDUH, an annual survey of the civilian, noninstitutionalized population of the United States ages 12 and older. NSDUH collects information from residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories) but excludes homeless people who do not use shelters, military personnel on active duty, and residents of institutional group quarters, such as jails and hospitals. Survey respondents were identified as having a SUD if their survey responses indicated that they met symptomatic criteria for substance dependence or abuse based on definitions found in the DSM-IV.
  1. Illicit drug use disorder is defined as meeting DSM-IV criteria for either dependence or abuse for 1 or more of the following illicit drugs: marijuana, cocaine, heroin, hallucinogens, inhalants, methamphetamine, or prescription psychotherapeutic drugs that were misused (i.e., pain relievers, tranquilizers, stimulants, and sedatives). The total number of individuals with a disorder related to illicit drugs is less than of the sum of individuals with a disorder related to each type of illicit drug, because a given individual may have a disorder related to more than 1 illicit substance.
  2. The NSDUH survey was redesigned between 2014 and 2015. Estimates for marijuana, cocaine, heroin, and alcohol use disorders are comparable before and after the redesign. Estimates for the other substances are not comparable before and after the redesign.
  3. Respondents were classified as having an opioid use disorder if they met DSM-IV criteria for heroin use disorder, prescription pain reliever use disorder, or both in the past year.
  4. The category Illicit drugs other than marijuanaexcludes respondents who used only marijuana but includes those who used marijuana in addition to other illicit drugs.
  5. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

TABLE A.3. Number of persons and percentage of population who received substance use treatment at any location or a specialty facility in the past year among persons ages 12 and older, by substance and age group, 2015-2018
Substance for which treatment was received and age group Number of persons (in thousands) Percentage of population
2015 2016 2017 2018 2015 2016 2017 2018
Any treatment
Illicit drugs 2,288 2,181 2,448 2,097 0.9 0.8 0.9 0.8
   12 to 17 141 121 143 130 0.6 0.5 0.6 0.5
   18 to 25 469a 418a 442a 311 1.3a 1.2a 1.3a 0.9
   26 and older 1,678 1,643 1,864 1,656 0.8 0.8 0.9 0.8
Alcohol 2,245 2,301 2,463 2,342 0.8 0.9 0.9 0.9
   12 to 17 94 93 95 73 0.4 0.4 0.4 0.3
   18 to 25 387 347 354 314 1.1 1.0 1.0 0.9
   26 and older 1,764 1,860 2,014 1,955 0.8 0.9 0.9 0.9
Illicit drugs or alcohol 3,679 3,755 4,010 3,723 1.4 1.4 1.5 1.4
   12 to 17 198 180 184 159 0.8 0.7 0.7 0.6
   18 to 25 669a 624 641 547 1.9 1.8 1.9 1.6
   26 and older 2,812 2,950 3,185 3,018 1.4 1.4 1.5 1.4
Specialty treatment
Illicit drugs 1,541 1,406 1,674 1,392 0.6 0.5 0.6 0.5
   12 to 17 63 64 56 80 0.3 0.3 0.2 0.3
   18 to 25 296a 259 319a 201 0.8a 0.7 0.9a 0.6
   26 and older 1,182 1,084 1,299 1,111 0.6 0.5 0.6 0.5
Alcohol 1,352 1,208 1,362 1,387 0.5 0.4 0.5 0.5
   12 to 17 37 48 39 26 0.2 0.2 0.2 0.1
   18 to 25 210 175 214 180 0.6 0.5 0.6 0.5
   26 and older 1,105 985 1,109 1,181 0.5 0.5 0.5 0.5
Illicit drugs or alcohol 2,346 2,229 2,530 2,359 0.9 0.8 0.9 0.9
   12 to 17 80 89 91 83 0.3 0.4 0.4 0.3
   18 to 25 417 383 441a 331 1.2 1.1 1.3a 1.0
   26 and older 1,849 1,756 1,999 1,946 0.9 0.8 0.9 0.9
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Number and percentage receiving treatment from any provider are from Table 7.50A and Table 7.50B, respectively. Number and percentage receiving treatment from a specialty provider are from Table 7.55A and Table 7.55B, respectively. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020.
NOTE: Estimates are derived from the NSDUH, an annual survey of the civilian, noninstitutionalized population of the United States ages 12 years and older. NSDUH collects information from residents of households and noninstitutional group quarters (e.g., shelters, rooming houses, dormitories) but excludes homeless people who do not use shelters, military personnel on active duty, and residents of institutional group quarters, such as jails and hospitals. Specialty treatment facilities include hospitals (inpatient only), drug or alcohol rehabilitation facilities (inpatient or outpatient), and MH centers. Any treatment includes treatment received at specialty facilities and at an emergency room, private doctor�s office, self-help group, or prison/jail. Estimates include persons who received treatment specifically for use of illicit drugs or alcohol, as well as persons who received treatment for use of unspecified substance(s).
  1. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

TABLE A.4. Number of Persons Receiving Substance Use Treatment in the Past Year Among Persons Ages 12 and Older, by Location of Treatment and Substance, 2015-2018
Location of Treatment and Substance for which Treatment was Received Number of Persons (in thousands) Percentage of Population
2015 2016 2017 2018 2015 2016 2017 2018
Illicit drugs
Total population 2,288 2,181 2,448 2,097 100.0 100.0 100.0 100.0
Hospital -- inpatient 445 359 519 436 19.5 16.5 21.2 20.8
Rehabilitation facility -- inpatient 637 497 614 513 27.8 22.8 25.1 24.5
Rehabilitation facility -- outpatient 1,097 940 1,226 1,008 48.0 43.1 50.1 48.1
MH center -- outpatient 665 691 747 670 29.1 31.7 30.5 31.9
Emergency room 216 232 304 271 9.4 10.6 12.4 12.9
Private doctor's office 419 501 688 539 18.3b 23.0 28.1 25.7
Self-help group 1,152 929 1,204b 949 50.3 42.6 49.2 45.2
Prison/jaila 192 156 264 178 8.4 7.1 10.8 8.5
Alcohol
Total population 2,245 2,301 2,463 2,342 100.0 100.0 100.0 100.0
Hospital -- inpatient 452 524 557 555 20.1 22.8 22.6 23.7
Rehabilitation facility -- inpatient 631 589 541 636 28.1 25.6 22.0 27.2
Rehabilitation facility -- outpatient 751 744 784 934 33.5 32.3 31.8 39.9
MH center -- outpatient 598 540 584 717 26.6 23.5 23.7 30.6
Emergency room 253 303 331 320 11.3 13.2 13.4 13.7
Private doctor's office 309b 417 433 518 13.8b 18.1 17.6 22.1
Self-help group 1,291 1,211 1,445 1,393 57.5 52.6 58.7 59.5
Prison/jaila 157 150 197 148 7.0 6.5 8.0 6.3
Illicit drugs or alcohol
Total population 3,679 3,755 4,010 3,723 100.0 100.0 100.0 100.0
Hospital -- inpatient 702 732 844 834 19.1 19.5 21.0 22.4
Rehabilitation facility -- inpatient 974 918 911 961 26.5 24.5 22.7 25.8
Rehabilitation facility -- outpatient 1,524 1,446 1,644 1,629 41.4 38.5 41.0 43.8
MH center -- outpatient 1,093 1,054 1,157 1,173 29.7 28.1 28.9 31.5
Emergency room 453 530 573 538 12.3 14.1 14.3 14.4
Private doctor's office 686b 883 961 943 18.7b 23.5 24.0 25.3
Self-help group 1,948 1,808 2,098 1,917 53.0 48.2 52.3 51.5
Prison/jaila 288 252 360 265 7.8 6.7 9.0 7.1
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for number and percentage receiving treatment for illicit drugs are from Table 7.52A and 7.52B, respectively. Estimates for number and percentage receiving treatment for alcohol are from Table 7.53A and 7.53B, respectively. Estimates for number and percentage receiving treatment for illicit drugs or alcohol are from Table 7.54A and 7.54, respectively. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020.
NOTE: Estimates for illicit drugs or alcohol include persons who received treatment specifically for illicit drugs or alcohol as well as persons who received treatment for unspecified substances. Respondents could indicate multiple locations of treatment; thus, these response categories are not mutually exclusive.
  1. The NSDUH surveys only the noninstitutionalized population in the United States. Thus, individuals residing in jails and prisons are not surveyed. This category indicates individuals currently living in the community who received treatment in a jail or prison in the past 12 months.
  2. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

Table A.5. Number and Percentage of Substance Use Treatment Admissions to Publicly-Funded Facilities for Persons Ages 12 and Older, by Primary SUD, 2007-2017a
Substance 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number of admissions (in thousands)
Total 2,162,877 2,265,477 2,223,634 2,089,744 2,086,256 1,988,253 1,917,850 1,806,513 1,840,614 1,916,523 2,005,395
Alcohol 844,544 898,125 891,667 814,827 788,268 739,104 681,781 620,139 590,851 602,480 590,681
Opiates 399,853 448,725 475,839 479,972 523,618 528,039 550,990 554,591 622,212 644,935 682,074
Cocaine 278,430 258,757 207,881 169,707 161,370 134,928 114,589 95,931 90,814 92,004 102,482
Marijuana 346,496 392,278 405,400 388,935 384,426 348,820 320,248 277,616 262,295 261,070 250,786
Stimulants 219,332 190,546 168,511 164,163 158,636 169,667 187,398 193,771 192,063 231,590 239,852
Other drugs 31,503 37,493 42,973 45,689 45,253 42,709 40,316 36,217 40,292 45,299 46,763
None reported 42,719 39,553 31,363 26,451 24,685 24,986 22,528 28,248 42,087 39,145 92,757
Percentage of total admissions
Alcohol 39.0 39.6 40.1 39.0 37.8 37.2 35.5 34.3 32.1 31.4 29.5
Opiates 18.5 19.8 21.4 23.0 25.1 26.6 28.7 30.7 33.8 33.7 34.0
Cocaine 12.9 11.4 9.3 8.1 7.7 6.8 6.0 5.3 4.9 4.8 5.1
Marijuana 16.0 17.3 18.2 18.6 18.4 17.5 16.7 15.4 14.3 13.6 12.5
Stimulants 10.1 8.4 7.6 7.9 7.6 8.5 9.8 10.7 10.4 12.1 12.0
Other drugs 1.5 1.7 1.9 2.2 2.2 2.1 2.1 2.0 2.2 2.4 2.3
None reported 2.0 1.7 1.4 1.3 1.2 1.3 1.2 1.6 2.3 2.0 4.6
SOURCE: Treatment Episode Dataset 2017 Report: Admissions to and discharges from publicly-funded SUD treatment. Number of admissions from Table 1.1a and percentage of admissions from Table 1.1b. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/TEDS-2017.pdf. Accessed on February 22, 2020.
NOTE: Based on administrative data reported to TEDS by all reporting states and jurisdictions.
  1. Significance tests were not conducted for these estimates because TEDS data include the universe of admissions that meet each state's reporting requirements for publicly-funded facilities.

 

Table A.6. Percentage of Substance Use Treatment Admissions to Publicly-Funded Facilities Originating from Various Treatment Referral Sources, by Type of Care, 2017a
Type of Care Self or Individual Court or Criminal Justice System Other Community Referral Substance Use Care Provider Other Health Care Provider School (education) Employer/EAP
Total 42.7 28.3 11.8 10.0 6.1 0.7 0.4
Ambulatory
   Outpatient 26.6 46.6 13.9 4.9 5.8 1.7 0.5
   Intensive outpatient 31.7 36.0 15.7 10.4 5.4 0.4 0.3
Rehabilitation/residential
   Short-term (<30 days) 37.8 18.0 10.3 25.2 8.3 0.1 0.4
   Long-term (30+ days) 36.7 29.5 10.8 17.5 5.0 0.1 0.3
   Hospital (nondetoxification) 56.0 8.7 10.4 15.4 9.4 0.1 0.1
Medication-assisted opioid therapy
   Outpatient 72.8 5.8 9.6 7.6 4.1 * 0.1
   Detoxification 76.5 1.8 3.5 14.6 3.6 * *
   Residential 33.2 12.9 6.9 41.1 5.9 * *
Detoxification
   Freestanding residential 62.6 10.3 8.2 10.1 8.2 0.1 0.7
   Hospital inpatient 74.2 4.4 12.9 3.0 5.0 0.6 0.1
   Ambulatory 51.4 22.5 12.0 5.2 8.6 * 0.3
SOURCE: Treatment Episode Data Set 2017 Report: Admissions to and Discharges from Publicly-Funded SUD Treatment, Table 4.3b. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/TEDS-2017.pdf. Accessed on February 22, 2020.
NOTE: Based on administrative data reported to TEDS by all reporting states and jurisdictions. Types of care categories are mutually exclusive.
* Less than 0.05%.
  1. Significance tests were not conducted for these estimates because TEDS data include the universe of admissions that meet each state's reporting requirements for publicly-funded facilities.

 

Table A.7. Number of Clients in Specialty Treatment Facilities,a by State and Service Setting, 2013, 2015, and 2017b
State Total
(across other columns)
Outpatient
(1-month count)
Residential
(1-day count)
Inpatient
(1-day count)
2013 2015 2017 2013 2015 2017 2013 2013 2017 2013 2015 2017
Total 1,249,629 1,305,647 1,356,015 1,127,235 1,161,456 1,238,654 107,727 119,900 99,881 14,667 24,291 17,480
Alabama 15,089 14,548 13,771 13,632 13,125 12,821 1,205 1,391 920 252 32 30
Alaska 3,900 3,363 3,556 3,531 2,932 3,235 359 431 304 10 0 17
Arizona 31,832 33,978 41,929 29,449 30,671 39,317 2,016 2,845 2,024 367 462 588
Arkansas 5,927 7,154 6,089 5,124 4,704 5,124 715 2,415 869 88 35 96
California 117,159 111,961 118,607 101,899 95,834 104,972 14,300 14,156 13,020 960 1,971 615
Colorado 42,256 34,793 32,213 40,306 33,452 30,867 1,804 1,186 1,224 146 155 122
Connecticut 33,267 37,817 41,873 31,148 35,970 39,513 1,823 1,540 2,024 296 307 336
Delaware 5,278 10,327 7,738 4,969 6,495 7,603 170 3,800 115 139 32 20
District of Columbia 3,833 2,824 2,763 3,324 2,392 2,326 468 431 437 41 1 0
Florida 53,641 63,287 62,427 45,069 51,823 55,212 7,786 8,531 5,656 786 2,933 1,559
Georgia 24,003 25,379 25,466 21,630 22,845 23,162 2,062 1,987 1,826 311 547 478
Hawaii 5,205 5,768 4,922 4,820 5,113 4,490 385 611 432 0 44 0
Idaho 6,619 6,287 7,026 6,467 6,125 6,827 137 148 156 15 14 43
Illinois 42,945 44,616 44,265 39,856 41,234 41,152 2,876 3,176 2,894 213 206 219
Indiana 28,288 25,465 33,301 27,466 23,861 31,808 531 930 978 291 674 515
Iowa 9,731 8,975 11,631 8,946 8,180 10,894 738 747 706 47 48 31
Kansas 10,863 11,471 10,710 9,916 10,603 9,985 935 834 702 12 34 23
Kentucky 24,071 23,565 29,228 21,175 20,697 26,069 2,509 2,347 2,841 387 521 318
Louisiana 9,903 12,011 10,066 8,241 9,930 8,473 1,464 1,765 1,352 198 316 241
Maine 11,373 10,849 11,801 10,865 10,483 11,482 362 289 257 146 77 62
Maryland 42,128 46,913 48,654 39,992 44,659 46,815 1,704 1,989 1,702 432 265 137
Massachusetts 44,133 45,438 58,280 40,227 40,734 53,719 3,171 3,602 3,291 735 1,102 1,270
Michigan 47,749 46,781 54,064 42,045 43,577 51,159 5,241 3,043 2,790 463 161 115
Minnesota 18,034 19,235 25,993 14,223 15,676 17,210 3,753 3,487 8,707 58 72 76
Mississippi 6,726 4,699 4,164 5,360 3,547 3,355 994 841 617 372 311 192
Missouri 23,028 25,015 21,914 21,600 22,590 20,328 1,279 2,223 1,238 149 202 348
Montana 4,429 5,064 5,762 3,809 4,785 5,429 488 187 241 132 92 92
Nebraska 6,374 5,735 6,461 5,690 4,909 5,604 684 824 828 0 2 29
Nevada 7,048 6,930 5,903 6,403 6,179 5,203 492 487 597 153 264 103
New Hampshire 6,702 8,164 8,631 6,326 7,766 8,235 367 394 366 9 4 30
New Jersey 36,605 36,708 35,659 33,068 32,578 32,662 2,813 3,404 2,364 724 726 633
New Mexico 12,868 15,062 18,808 10,949 14,499 18,141 1,808 449 605 111 114 62
New York 114,660 113,713 110,078 103,167 101,982 100,629 9,839 9,986 7,507 1,654 1,745 1,942
North Carolina 40,575 42,026 49,179 37,394 38,374 46,460 2,481 3,196 2,130 700 456 589
North Dakota 1,785 2,404 2,781 1,222 1,949 2,340 510 396 419 53 59 22
Ohio 37,262 45,129 56,197 34,397 42,006 52,395 2,365 2,406 3,081 500 717 721
Oklahoma 16,700 16,783 14,466 15,356 15,512 13,250 1,204 1,171 1,074 140 100 142
Oregon 21,898 30,401 24,027 20,537 29,047 22,579 1,299 1,258 1,400 62 96 48
Pennsylvania 57,715 59,584 64,303 52,011 53,822 57,460 5,245 5,433 6,318 459 329 525
Puerto Rico 15,169 11,358 9,232 12,119 7,817 6,051 2,511 2,971 1,632 539 570 1,549
Rhode Island 10,404 14,269 8,001 10,039 9,005 7,660 323 1,723 269 42 3,541 72
South Carolina 15,824 18,236 16,844 14,906 16,473 16,060 552 614 538 366 1,149 246
South Dakota 3,267 2,964 2,941 2,569 2,308 2,367 623 585 440 75 71 134
Tennessee 14,149 22,445 16,765 11,698 20,187 14,821 2,010 1,994 1,485 441 264 459
Texas 34,704 35,293 35,474 28,843 26,984 30,140 5,065 6,391 4,224 796 1,918 1,110
Utah 12,586 12,496 14,326 11,183 11,070 12,491 1,389 1,379 1,706 14 47 129
Vermont 5,230 7,380 7,015 4,124 6,522 6,796 1,013 164 148 93 694 71
Virginia 22,838 22,305 22,413 21,879 20,807 21,306 712 1,174 908 247 324 199
Washington 42,030 50,633 43,846 39,680 43,724 41,390 2,210 6,762 2,265 140 147 191
West Virginia 10,057 10,099 18,115 9,547 9,500 17,283 492 545 698 18 54 134
Wisconsin 28,657 24,371 22,628 26,314 23,235 20,885 2,068 888 950 275 248 793
Wyoming 2,798 3,261 3,236 2,465 2,916 2,689 326 331 543 7 14 4
U.S. territories 314 315 473 260 248 410 51 43 63 3 24 0
SOURCE: N-SSATS 2013, 2015, and 2017.
NOTE: Inpatient and residential client counts represent the number of clients receiving services on March 31 of the indicated year (see Questions 28a and 29a in N-SSATS 2013 and Questions 29a and 30a in N-SSATS 2015 and 2017). Outpatient client counts represent the number of clients who received outpatient services in March of the indicated year and who were still enrolled in care at the facility where they received those services on March 31 (see Question 30a in N-SSATS 2013 and Question 31a in N-SSATS 2015 and 2017). Totalclients is the sum of inpatient, residential, and outpatient clients. Client counts reflect information reported by all facilities responding to the survey with no adjustment for nonresponse. The survey response rate was 94%, 92%, and 89% in 2013, 2015, and 2017, respectively.
  1. The N-SSATS survey is limited to providers that offer specialized treatment programs for SUDs. Primary care providers who provide SUD treatment services as part of a general health care program are not included in these estimates.
  2. Significance tests were not conducted for these estimates because N-SSATS surveys the universe of specialty SUD treatment facilities.

 

Table A.8. Number of Clients Receiving Select Opioid Use Disorder Treatment Medications from Specialty Treatment Facilities,a by State, 2013, 2015, and 2017b
State Total Receiving Methadone Receiving Buprenorphine Receiving Injectable Naltrexone
2013 2015 2017 2013 2015 2017 2013 2015 2017 2013 2015 2017
Total 383,130 439,602 518,155 331,215 356,843 382,867 48,134 75,724 112,223 3,781 7,035 23,065
Alabama 8,785 8,457 8,511 7,738 7,639 7,441 967 787 969 80 31 101
Alaska 285 444 506 144 331 364 137 91 137 4 22 5
Arizona 7,585 8,291 10,472 6,425 7,107 8,621 1,040 987 1,363 120 197 488
Arkansas 992 1,484 1,305 831 1,095 754 161 389 520 NA NA 31
California 33,301 38,607 45,472 30,899 35,231 39,376 2,154 2,922 3,385 248 454 2,711
Colorado 2,561 2,290 3,526 2,084 1,934 2,468 379 256 734 98 100 324
Connecticut 16,540 14,658 16,332 15,531 14,072 13,793 980 544 2,050 29 42 489
Delaware 2,826 5,834 5,935 2,422 3,266 3,555 380 2,425 1,827 24 143 553
District of Columbia 1,856 1,428 1,803 1,760 1,315 1,736 93 104 67 3 9 0
Florida 16,471 20,978 23,441 14,441 17,670 18,300 1,700 2,922 3,620 330 386 1,521
Georgia 10,542 11,990 12,666 10,194 11,212 11,628 297 659 869 51 119 169
Hawaii 700 745 977 612 623 733 87 121 215 1 1 29
Idaho 147 678 511 NA 312 364 137 353 117 10 13 30
Illinois 13,230 15,053 16,984 11,922 13,559 13,732 1,199 1,303 2,815 109 191 437
Indiana 10,037 8,393 10,249 9,265 7,073 6,673 744 1,178 2,416 28 142 1,160
Iowa 692 889 1,574 623 783 1,200 69 106 325 NA NA 49
Kansas 2,284 2,585 2,606 2,077 2,313 2,292 207 261 261 NA 11 53
Kentucky 4,719 5,136 9,866 1,626 2,955 4,896 3,079 2,158 4,727 14 23 243
Louisiana 2,193 4,731 4,853 1,907 3,502 3,422 271 1,153 1,365 15 76 66
Maine 4,503 5,304 6,474 3,658 3,751 3,928 838 1,529 2,501 7 24 45
Maryland 22,278 26,692 31,149 19,564 22,927 25,026 2,622 3,533 5,443 92 232 680
Massachusetts 19,626 22,146 33,877 15,479 17,633 21,739 3,861 4,113 10,705 286 400 1,433
Michigan 9,116 12,064 12,476 7,851 9,806 10,237 1,187 1,900 1,725 78 358 514
Minnesota 5,048 6,258 7,341 4,533 5,530 6,033 483 667 1,124 32 61 184
Mississippi 257 274 249 183 176 169 70 97 57 4 1 23
Missouri 3,817 4,764 5,578 2,704 3,083 3,699 738 1,155 1,275 375 526 604
Montana 382 773 739 174 489 483 190 284 193 18 NA 63
Nebraska 954 688 615 553 619 427 78 52 154 323 17 34
Nevada 1,572 1,847 1,910 1,493 1,555 1,670 75 261 233 4 31 7
New Hampshire 2,656 4,754 6,966 2,340 2,748 3,377 311 1,991 3,447 5 15 142
New Jersey 12,818 14,506 16,262 11,704 13,103 14,040 1,036 1,166 1,496 78 237 726
New Mexico 2,752 5,029 6,330 2,407 4,088 5,184 332 890 1,064 13 51 82
New York 43,740 41,502 45,739 38,873 34,535 35,540 4,540 6,394 8,232 327 573 1,967
North Carolina 14,930 19,382 22,781 11,499 13,665 14,497 3,369 5,637 7,765 62 80 519
North Dakota 9 109 221 NA NA 67 9 84 144 NA 25 10
Ohio 7,580 14,092 20,635 4,908 6,147 6,909 2,618 7,347 10,991 54 598 2,735
Oklahoma 3,279 3,760 3,656 3,091 3,500 3,197 188 227 349 NA 33 110
Oregon 4,348 5,322 7,006 4,045 4,663 4,657 288 601 2,132 15 58 217
Pennsylvania 23,096 24,262 28,258 20,623 20,408 22,136 2,308 3,530 4,659 165 324 1,463
Puerto Rico 8,761 5,230 4,206 8,348 4,515 3,615 380 702 586 33 13 5
Rhode Island 4,243 7,552 5,094 3,517 6,213 4,155 715 1,078 874 11 261 65
South Carolina 5,020 5,334 6,367 4,323 4,524 5,360 671 799 946 26 11 61
South Dakota 83 10 176 82 5 154 1 5 10 NA NA 12
Tennessee 2,974 5,721 6,561 2,427 4,421 4,776 488 1,179 1,628 59 121 157
Texas 12,497 12,126 12,730 11,662 9,833 10,973 673 2,189 1,402 162 104 355
Utah 3,028 3,489 4,404 2,635 2,459 2,557 345 790 1,417 48 240 430
Vermont 1,435 3,901 3,765 918 1,624 2,151 504 2,275 1,459 13 2 155
Virginia 6,655 7,096 9,542 5,323 5,735 6,650 1,278 1,319 2,601 54 42 291
Washington 8,950 10,953 15,834 7,495 9,191 10,903 1,335 1,534 4,670 120 228 261
West Virginia 5,510 5,330 7,132 4,299 3,120 3,109 1,134 2,072 3,539 77 138 484
Wisconsin 5,279 6,542 6,236 4,003 4,769 4,101 1,206 1,521 1,449 70 252 686
Wyoming 188 92 256 NA NA 0 182 73 171 6 19 85
SOURCE: N-SSATS 2013, 2015, and 2017.
NOTE: The number of clients receiving methadone, buprenorphine, or injectable naltrexone is based on counts of clients receiving these services, as reported in Questions 28c, 29c, and 30c in N-SSATS 2013 and Questions 29c, 30c, and 31c in N-SSATS 2015 and 2017. Counts represent the number of clients who received outpatient services in March of the indicated year and who were still enrolled in care at the facility where they received those services on March 31. Totalclients is the sum of clients receiving methadone, buprenorphine, or injectable naltrexone. In the 2013 and 2015 surveys, responding facilities reported the number of clients who were dispensed methadone, dispensed or prescribed buprenorphine, or administered Vivitrolat the facility. In 2017, the questions for all these medications were edited to limit the clients reported to those receiving the medications for opioid use disorder,and Vivitrolwas replaced with naltrexone.Client counts reflect information reported by all facilities responding to the survey with no adjustment for nonresponse. The survey response rate was 94%, 92%, and 89% in 2013, 2015, and 2017, respectively.
  1. The N-SSATS survey is limited to providers that offer specialized treatment programs for SUDs. Primary care providers who provide SUD treatment services as part of a general health care program are not included in these estimates.
  2. Significance tests were not conducted for these estimates because N-SSATS surveys the universe of specialty SUD treatment facilities.

 

Table A.9. Percentage of Clients Receiving Medications in Specialty Treatment Facilitiesa, by State, 2013, 2015, and 2017b
  Total Receiving Methadone Receiving Buprenorphine Receiving Injectable Naltrexone
2013 2015 2017 2013 2015 2017 2013 2015 2017 2013 2015 2017
Total 31 34 38 27 27 28 4 6 8 0 1 2
Alabama 58 58 62 51 53 54 6 5 7 1 0 1
Alaska 7 13 14 4 10 10 4 3 4 0 1 0
Arizona 24 24 25 20 21 21 3 3 3 0 1 1
Arkansas 17 21 21 14 15 12 3 5 9 NA NA 1
California 28 34 38 26 31 33 2 3 3 0 0 2
Colorado 6 7 11 5 6 8 1 1 2 0 0 1
Connecticut 50 39 39 47 37 33 3 1 5 0 0 1
Delaware 54 56 77 46 32 46 7 23 24 0 1 7
District of Columbia 48 51 65 46 47 63 2 4 2 0 0 NA
Florida 31 33 38 27 28 29 3 5 6 1 1 2
Georgia 44 47 50 42 44 46 1 3 3 0 0 1
Hawaii 13 13 20 12 11 15 2 2 4 0 0 1
Idaho 2 11 7 NA 5 5 2 6 2 0 0 0
Illinois 31 34 38 28 30 31 3 3 6 0 0 1
Indiana 35 33 31 33 28 20 3 5 7 0 1 3
Iowa 7 10 14 6 9 10 1 1 3 NA NA 0
Kansas 21 23 24 19 20 21 2 2 2 NA 0 0
Kentucky 20 22 34 7 13 17 13 9 16 0 0 1
Louisiana 22 39 48 19 29 34 3 10 14 0 1 1
Maine 40 49 55 32 35 33 7 14 21 0 0 0
Maryland 53 57 64 46 49 51 6 8 11 0 0 1
Massachusetts 44 49 58 35 39 37 9 9 18 1 1 2
Michigan 19 26 23 16 21 19 2 4 3 0 1 1
Minnesota 28 33 28 25 29 23 3 3 4 0 0 1
Mississippi 4 6 6 3 4 4 1 2 1 0 0 1
Missouri 17 19 25 12 12 17 3 5 6 2 2 3
Montana 9 15 13 4 10 8 4 6 3 0 NA 1
Nebraska 15 12 10 9 11 7 1 1 2 5 0 1
Nevada 22 27 32 21 22 28 1 4 4 0 0 0
New Hampshire 40 58 81 35 34 39 5 24 40 0 0 2
New Jersey 35 40 46 32 36 39 3 3 4 0 1 2
New Mexico 21 33 34 19 27 28 3 6 6 0 0 0
New York 38 36 42 34 30 32 4 6 7 0 1 2
North Carolina 37 46 46 28 33 29 8 13 16 0 0 1
North Dakota 1 5 8 NA NA 2 1 3 5 NA 1 0
Ohio 20 31 37 13 14 12 7 16 20 0 1 5
Oklahoma 20 22 25 19 21 22 1 1 2 NA 0 1
Oregon 20 18 29 18 15 19 1 2 9 0 0 1
Pennsylvania 40 41 44 36 34 34 4 6 7 0 1 2
Puerto Rico 58 46 46 55 40 39 3 6 6 0 0 0
Rhode Island 41 53 64 34 44 52 7 8 11 0 2 1
South Carolina 32 29 38 27 25 32 4 4 6 0 0 0
South Dakota 3 0 6 3 0 5 0 0 0 NA NA 0
Tennessee 21 25 39 17 20 28 3 5 10 0 1 1
Texas 36 34 36 34 28 31 2 6 4 0 0 1
Utah 24 28 31 21 20 18 3 6 10 0 2 3
Vermont 27 53 54 18 22 31 10 31 21 0 0 2
Virginia 29 32 43 23 26 30 6 6 12 0 0 1
Washington 21 22 36 18 18 25 3 3 11 0 0 1
West Virginia 55 53 39 43 31 17 11 21 20 1 1 3
Wisconsin 18 27 28 14 20 18 4 6 6 0 1 3
Wyoming 7 3 8 NA NA NA 7 2 5 0 1 3
SOURCE: N-SSATS 2013, 2015, and 2017.
NOTE: The percentages of clients receiving methadone, buprenorphine, and injectable naltrexone are based on counts of clients receiving these services (as reported in TABLE B.2) relative to the total number of clients (indicated in TABLE B.4.a). Client counts reflect information reported by all facilities responding to the survey. The survey response rate was 94%, 92%, and 89% in 2013, 2015, and 2017, respectively.
  1. The N-SSATS survey is limited to providers that offer specialized treatment programs for SUDs. Primary care providers who provide SUD treatment services as part of a general health care program are not included in these estimates.
  2. Significance tests were not conducted for these estimates because N-SSATS surveys the universe of specialty SUD treatment facilities.

 

Table A.10.a. Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Disordera
State Total Number of Medicaid Beneficiaries Any SUD Alcohol Cannabis Opioids
Number Percentage Number Percentage Number Percentage Number Percentage
Total 53,462,361 4,084,089 7.6 858,776 1.6 532,392 1.0 1,164,950 2.2
Alabama 512,074 51,300 10.0 6,311 1.2 5,395 1.1 10,516 2.1
Alaska 158,199 18,048 11.4 6,690 4.2 2,522 1.6 4,471 2.8
Arizona 1,512,837 108,967 7.2 26,748 1.8 15,907 1.1 28,644 1.9
Arkansas 460,867 12,265 2.7 1,957 0.4 1,986 0.4 1,289 0.3
California 10,050,069 422,080 4.2 85,881 0.9 47,477 0.5 84,719 0.8
Colorado 1,052,116 67,997 6.5 16,624 1.6 5,758 0.5 15,818 1.5
Connecticut 713,934 87,004 12.2 21,759 3.0 13,951 2.0 34,393 4.8
Delaware 179,030 18,528 10.3 3,911 2.2 2,562 1.4 9,956 5.6
District of Columbia 200,116 15,642 7.8 3,558 1.8 2,021 1.0 3,569 1.8
Florida 2,410,115 136,441 5.7 22,415 0.9 17,729 0.7 27,281 1.1
Georgia 1,110,320 63,803 5.7 9,648 0.9 7,562 0.7 11,099 1.0
Hawaii 307,278 18,200 5.9 3,145 1.0 1,943 0.6 3,736 1.2
Idaho 161,110 10,416 6.5 1,433 0.9 675 0.4 2,393 1.5
Illinois 311,088 15,377 4.9 4,233 1.4 2,867 0.9 2,833 0.9
Indiana 1,097,727 94,721 8.6 18,063 1.6 11,985 1.1 28,386 2.6
Iowa 627,465 51,123 8.1 11,815 1.9 9,178 1.5 5,459 0.9
Kansas 249,801 20,250 8.1 3,330 1.3 3,531 1.4 2,745 1.1
Kentucky 1,115,633 137,127 12.3 15,667 1.4 11,357 1.0 47,530 4.3
Louisiana 594,525 39,945 6.7 5,791 1.0 5,798 1.0 7,067 1.2
Maine 169,150 20,830 12.3 3,178 1.9 1,176 0.7 9,328 5.5
Maryland 980,899 117,863 12.0 58,880 6.0 2,343 0.2 65,868 6.7
Massachusetts 1,429,779 180,056 12.6 44,726 3.1 18,337 1.3 79,511 5.6
Michigan 2,050,490 190,471 9.3 40,457 2.0 23,032 1.1 43,138 2.1
Minnesota 905,247 100,405 11.1 27,790 3.1 14,319 1.6 21,377 2.4
Mississippi DQ DQ DQ DQ DQ DQ DQ DQ DQ
Missouri DQ DQ DQ DQ DQ DQ DQ DQ DQ
Montana DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nebraska DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nevada 528,501 41,400 7.8 9,136 1.7 5,204 1.0 10,581 2.0
New Hampshire 165,862 13,430 8.1 2,462 1.5 933 0.6 7,214 4.3
New Jersey 1,358,106 81,928 6.0 18,591 1.4 9,824 0.7 28,208 2.1
New Mexico 255,223 19,153 7.5 4,896 1.9 2,816 1.1 6,269 2.5
New York 4,814,854 412,492 8.6 104,428 2.2 79,048 1.6 117,969 2.5
North Carolina 1,106,940 109,346 9.9 16,011 1.4 12,398 1.1 26,252 2.4
North Dakota 35,353 3,072 8.7 651 1.8 522 1.5 317 0.9
Ohio 2,459,666 362,088 14.7 63,859 2.6 57,873 2.4 102,734 4.2
Oklahoma 438,682 42,095 9.6 4,921 1.1 4,062 0.9 8,737 2.0
Oregon 844,280 90,062 10.7 22,781 2.7 13,307 1.6 22,106 2.6
Pennsylvania 2,336,316 278,008 11.9 52,061 2.2 36,626 1.6 108,875 4.7
Puerto Rico 2,548,531 15,227 0.6 2,668 0.1 1,803 0.1 5,620 0.2
Rhode Island 267,077 17,881 6.7 5,245 2.0 1,677 0.6 9,826 3.7
South Carolina 620,945 42,561 6.9 6,903 1.1 6,502 1.0 6,457 1.0
South Dakota 71,413 5,875 8.2 1,600 2.2 1,106 1.5 505 0.7
Tennessee 1,066,003 89,695 8.4 11,994 1.1 11,794 1.1 18,377 1.7
Texas 2,500,164 113,195 4.5 17,682 0.7 17,425 0.7 17,085 0.7
Utah 198,617 11,367 5.7 1,725 0.9 970 0.5 3,910 2.0
Vermont 143,771 19,100 13.3 4,096 2.8 2,206 1.5 9,906 6.9
Virginia 671,301 50,330 7.5 6,698 1.0 4,106 0.6 15,142 2.3
Washington 1,442,574 137,886 9.6 31,221 2.2 20,585 1.4 44,119 3.1
West Virginia 459,782 45,593 9.9 6,109 1.3 3,142 0.7 20,453 4.4
Wisconsin 724,820 79,303 10.9 18,077 2.5 8,530 1.2 22,546 3.1
Wyoming 43,711 4,143 9.5 951 2.2 522 1.2 616 1.4
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table A.1.i. (Produced based on the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020.
NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims.
  1. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

 

Table A.10.b. Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Disordera
State

Total Number of Medicaid Beneficiaries

Polysubstance Stimulants Tobacco Other
Number Percentage Number Percentage Number Percentage Number Percentage
Total 53,462,361 1,104,594 2.1 464,803 0.9 2,314,143 4.3 394,095 0.7
Alabama 512,074 12,529 2.4 4,345 0.8 39,328 7.7 4,855 0.9
Alaska 158,199 5,426 3.4 2,161 1.4 8,393 5.3 1,772 1.1
Arizona 1,512,837 30,458 2.0 22,226 1.5 51,908 3.4 10,554 0.7
Arkansas 460,867 2,206 0.5 1,200 0.3 7,568 1.6 1,264 0.3
California 10,050,069 98,180 1.0 62,398 0.6 214,656 2.1 35,026 0.3
Colorado 1,052,116 15,429 1.5 6,458 0.6 40,654 3.9 4,607 0.4
Connecticut 713,934 26,859 3.8 9,671 1.4 39,438 5.5 8,133 1.1
Delaware 179,030 6,685 3.7 2,425 1.4 8,161 4.6 1,841 1.0
District of Columbia 200,116 5,036 2.5 1,763 0.9 10,463 5.2 2,270 1.1
Florida 2,410,115 35,198 1.5 11,592 0.5 93,714 3.9 17,269 0.7
Georgia 1,110,320 14,641 1.3 6,855 0.6 43,458 3.9 6,709 0.6
Hawaii 307,278 4,581 1.5 4,158 1.4 10,150 3.3 1,675 0.5
Idaho 161,110 1,992 1.2 774 0.5 7,384 4.6 666 0.4
Illinois 311,088 4,587 1.5 1,795 0.6 9,310 3.0 1,538 0.5
Indiana 1,097,727 25,029 2.3 10,269 0.9 54,645 5.0 10,317 0.9
Iowa 627,465 14,109 2.2 9,249 1.5 32,420 5.2 3,739 0.6
Kansas 249,801 4,989 2.0 3,369 1.3 12,778 5.1 1,710 0.7
Kentucky 1,115,633 34,312 3.1 13,336 1.2 84,338 7.6 15,084 1.4
Louisiana 594,525 9,933 1.7 4,823 0.8 26,972 4.5 4,755 0.8
Maine 169,150 4,054 2.4 539 0.3 9,966 5.9 1,633 1.0
Maryland 980,899 27,394 2.8 2,024 0.2 19,692 2.0 3,759 0.4
Massachusetts 1,429,779 59,950 4.2 18,388 1.3 98,221 6.9 22,861 1.6
Michigan 2,050,490 43,800 2.1 13,363 0.7 117,272 5.7 12,278 0.6
Minnesota 905,247 28,475 3.1 16,568 1.8 54,734 6.0 9,158 1.0
Mississippi DQ DQ DQ DQ DQ DQ DQ DQ DQ
Missouri DQ DQ DQ DQ DQ DQ DQ DQ DQ
Montana DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nebraska DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nevada 528,501 11,719 2.2 7,666 1.5 21,871 4.1 4,507 0.9
New Hampshire 165,862 3,229 1.9 764 0.5 5,232 3.2 1,277 0.8
New Jersey 1,358,106 22,680 1.7 5,271 0.4 45,213 3.3 9,714 0.7
New Mexico 255,223 4,945 1.9 2,426 1.0 7,081 2.8 2,082 0.8
New York 4,814,854 134,717 2.8 52,139 1.1 247,821 5.1 45,698 0.9
North Carolina 1,106,940 25,575 2.3 9,204 0.8 72,237 6.5 9,846 0.9
North Dakota 35,353 837 2.4 409 1.2 2,028 5.7 302 0.9
Ohio 2,459,666 109,703 4.5 34,773 1.4 241,912 9.8 34,569 1.4
Oklahoma 438,682 9,076 2.1 4,392 1.0 28,603 6.5 4,199 1.0
Oregon 844,280 26,834 3.2 17,247 2.0 45,455 5.4 5,285 0.6
Pennsylvania 2,336,316 80,338 3.4 29,990 1.3 141,967 6.1 30,536 1.3
Puerto Rico 2,548,531 2,569 0.1 1,802 0.1 4,328 0.2 1,786 0.1
Rhode Island 267,077 3,141 1.2 1,235 0.5 3,167 1.2 917 0.3
South Carolina 620,945 10,389 1.7 4,215 0.7 29,003 4.7 3,543 0.6
South Dakota 71,413 1,444 2.0 405 0.6 3,806 5.3 417 0.6
Tennessee 1,066,003 22,424 2.1 8,804 0.8 62,450 5.9 11,421 1.1
Texas 2,500,164 25,757 1.0 12,940 0.5 73,004 2.9 13,726 0.5
Utah 198,617 2,579 1.3 1,256 0.6 6,150 3.1 1,127 0.6
Vermont 143,771 5,392 3.8 1,226 0.9 8,154 5.7 1,265 0.9
Virginia 671,301 10,287 1.5 2,842 0.4 32,882 4.9 3,716 0.6
Washington 1,442,574 43,704 3.0 25,360 1.8 64,398 4.5 12,778 0.9
West Virginia 459,782 11,005 2.4 3,120 0.7 23,479 5.1 5,061 1.1
Wisconsin 724,820 19,569 2.7 7,214 1.0 45,824 6.3 6,607 0.9
Wyoming 43,711 829 1.9 354 0.8 2,455 5.6 243 0.6
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table A.1.ii. (Produced based on the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020.
NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. A polysubstance use disorder involves a diagnosis in which there are 2 or more SUDs or a polysubstance diagnosis code. The Othercategory includes treatment for caffeine; hallucinogens; sedatives, hypnotics, and anxiolytics; inhalants; and unspecified or unknown SUD.
  1. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

 

Table A.11.a. Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Typea
State Total Number of Medicaid Beneficiaries Case Management Community Support Consultation Counseling Detoxification
Number Percent Number Percent Number Percent Number Percent Number Percent
Total 4,084,089 185,050 4.5 70,447 1.7 246,794 6.0 990,714 24.3 148,643 3.6
Alabama 51,300 0 0.0 251 0.5 4,320 8.4 5,448 10.6 1,379 2.7
Alaska 18,048 1,489 8.3 3,648 20.2 426 2.4 2,501 13.9 682 3.8
Arizona 108,967 40,963 37.6 2,611 2.4 8,418 7.7 31,451 28.9 3,508 3.2
Arkansas 12,265 67 0.5 600 4.9 750 6.1 1,775 14.5 104 0.8
California 422,080 10,458 2.5 3,862 0.9 36,070 8.5 81,550 19.3 5,947 1.4
Colorado 67,997 1,021 1.5 506 0.7 68 0.1 6,754 9.9 643 0.9
Connecticut 87,004 351 0.4 277 0.3 18,192 20.9 25,076 28.8 2,424 2.8
Delaware 18,528 0 0.0 87 0.5 146 0.8 6,891 37.2 984 5.3
District of Columbia 15,642 313 2.0 48 0.3 1,800 11.5 2,492 15.9 432 2.8
Florida 136,441 865 0.6 10,395 7.6 11,692 8.6 10,832 7.9 2,249 1.6
Georgia 63,803 878 1.4 2,033 3.2 1,477 2.3 7,239 11.3 1,314 2.1
Hawaii 18,200 65 0.4 107 0.6 433 2.4 3,564 19.6 35 0.2
Idaho 10,416 0 0.0 DS DS 1,167 11.2 118 1.1 83 0.8
Illinois 15,377 130 0.8 110 0.7 2,515 16.4 1,199 7.8 666 4.3
Indiana 94,721 4,325 4.6 47 0.0 960 1.0 22,958 24.2 5,567 5.9
Iowa 51,123 270 0.5 781 1.5 4,792 9.4 13,074 25.6 1,107 2.2
Kansas 20,250 560 2.8 343 1.7 DS DS 4,274 21.1 184 0.9
Kentucky 137,127 7,206 5.3 715 0.5 4,388 3.2 37,000 27.0 2,418 1.8
Louisiana 39,945 0 0.0 660 1.7 1,954 4.9 4,478 11.2 813 2.0
Maine 20,830 166 0.8 335 1.6 2,741 13.2 6,486 31.1 202 1.0
Maryland 117,863 DS DS 57 0.0 5,282 4.5 48,499 41.1 3,405 2.9
Massachusetts 180,056 35 0.0 7,807 4.3 11,183 6.2 46,294 25.7 13,425 7.5
Michigan 190,471 10,684 5.6 6,767 3.6 5,596 2.9 56,102 29.5 11,019 5.8
Minnesota 100,405 1,717 1.7 1,615 1.6 3,523 3.5 14,459 14.4 2,061 2.1
Mississippi DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Missouri DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Montana DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nebraska DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nevada 41,400 690 1.7 162 0.4 966 2.3 4,746 11.5 1,736 4.2
New Hampshire 13,430 859 6.4 516 3.8 1,828 13.6 3,274 24.4 609 4.5
New Jersey 81,928 1,152 1.4 602 0.7 3,385 4.1 23,594 28.8 5,596 6.8
New Mexico 19,153 86 0.4 569 3.0 773 4.0 4,901 25.6 194 1.0
New York 412,492 34 0.0 271 0.1 4,534 1.1 110,895 26.9 19,712 4.8
North Carolina 109,346 14 0.0 927 0.8 7,242 6.6 21,822 20.0 929 0.8
North Dakota 3,072 193 6.3 15 0.5 0 0.0 605 19.7 17 0.6
Ohio 362,088 60,818 16.8 620 0.2 36,856 10.2 122,959 34.0 12,734 3.5
Oklahoma 42,095 2,541 6.0 2,563 6.1 1,247 3.0 7,107 16.9 318 0.8
Oregon 90,062 9,602 10.7 582 0.6 56 0.1 39,068 43.4 5,630 6.3
Pennsylvania 278,008 6,660 2.4 5,678 2.0 34,780 12.5 76,364 27.5 20,576 7.4
Puerto Rico 15,227 0 0.0 209 1.4 1,026 6.7 4,557 29.9 0 0.0
Rhode Island 17,881 1,410 7.9 79 0.4 470 2.6 7,782 43.5 525 2.9
South Carolina 42,561 663 1.6 866 2.0 1,506 3.5 8,151 19.2 874 2.1
South Dakota 5,875 0 0.0 109 1.9 72 1.2 712 12.1 16 0.3
Tennessee 89,695 1,524 1.7 261 0.3 1,332 1.5 15,046 16.8 3,000 3.3
Texas 113,195 3,111 2.7 2,275 2.0 4,358 3.8 12,711 11.2 2,222 2.0
Utah 11,367 148 1.3 703 6.2 105 0.9 1,319 11.6 311 2.7
Vermont 19,100 1,487 7.8 876 4.6 308 1.6 5,564 29.1 1,153 6.0
Virginia 50,330 355 0.7 136 0.3 197 0.4 6,005 11.9 786 1.6
Washington 137,886 9,769 7.1 6,595 4.8 9,579 6.9 40,732 29.5 6,547 4.7
West Virginia 45,593 1,494 3.3 82 0.2 3,676 8.1 16,884 37.0 561 1.2
Wisconsin 79,303 507 0.6 1,323 1.7 4,234 5.3 14,748 18.6 3,930 5.0
Wyoming 4,143 370 8.9 766 18.5 371 9.0 654 15.8 16 0.4
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table C.1.i. (Based on analysis of the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020.
NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. Service types were determined based on National Drug Codes, procedure codes, and revenue codes. The sum of the percentages across service categories (Table A.11.a, Table A.11.b and Table A.11.c) within each state is not 100 because many Medicaid beneficiaries treated for a SUD received more than 1 treatment. See Report to Congress: T-MSIS SUD Data Book, page 39, for a description of the service categories.
  1. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

 

Table A.11.b. Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Typea
State Total Number of Medicaid Beneficiaries Emergency Services Inpatient Care Intervention MAT Medication Management Observation Care Other
Number Percent Number Percent Number Percent Number Percent Number Percent Number Percent Number Percent
Total 4,084,089 1,914,223 46.9 1,688,293 41.3 164,150 4.0 951,891 23.3 30,584 0.7 200,889 4.9 215,824 5.3
Alabama 51,300 34,798 67.8 25,970 50.6 325 0.6 6,483 12.6 1,276 2.5 1,535 3.0 2,448 4.8
Alaska 18,048 7,469 41.4 7,107 39.4 856 4.7 4,091 22.7 426 2.4 798 4.4 4,694 26.0
Arizona 108,967 49,461 45.4 48,745 44.7 13,254 12.2 19,388 17.8 6,763 6.2 9,074 8.3 23,663 21.7
Arkansas 12,265 5,444 44.4 6,876 56.1 162 1.3 956 7.8 DS DS 494 4.0 181 1.5
California 422,080 217,364 51.5 182,171 43.2 5,533 1.3 94,906 22.5 2,739 0.6 9,421 2.2 4,221 1.0
Colorado 67,997 41,442 60.9 28,498 41.9 2,125 3.1 14,470 21.3 DS DS 6,671 9.8 904 1.3
Connecticut 87,004 30,513 35.1 26,037 29.9 1,512 1.7 33,107 38.1 21 0.0 3,561 4.1 2,882 3.3
Delaware 18,528 7,731 41.7 7,877 42.5 379 2.0 7,083 38.2 20 0.1 737 4.0 679 3.7
District of Columbia 15,642 10,222 65.3 8,155 52.1 493 3.2 2,810 18.0 52 0.3 847 5.4 516 3.3
Florida 136,441 82,423 60.4 83,088 60.9 1,836 1.3 19,576 14.3 1,578 1.2 13,325 9.8 9,977 7.3
Georgia 63,803 32,762 51.3 38,574 60.5 563 0.9 4,896 7.7 160 0.3 3,764 5.9 4,265 6.7
Hawaii 18,200 9,972 54.8 8,078 44.4 233 1.3 2,704 14.9 DS DS 1,313 7.2 61 0.3
Idaho 10,416 3,166 30.4 4,789 46.0 48 0.5 1,523 14.6 12 0.1 147 1.4 96 0.9
Illinois 15,377 4,289 27.9 9,447 61.4 260 1.7 1,626 10.6 53 0.3 686 4.5 248 1.6
Indiana 94,721 28,799 30.4 48,045 50.7 1,847 1.9 26,916 28.4 1,508 1.6 4,575 4.8 3,955 4.2
Iowa 51,123 21,780 42.6 24,217 47.4 322 0.6 5,866 11.5 14 0.0 2,364 4.6 818 1.6
Kansas 20,250 4,469 22.1 8,699 43.0 595 2.9 2,534 12.5 DS DS 614 3.0 434 2.1
Kentucky 137,127 53,435 39.0 52,662 38.4 3,971 2.9 42,430 30.9 41 0.0 3,118 2.3 5,157 3.8
Louisiana 39,945 22,686 56.8 19,683 49.3 231 0.6 5,369 13.4 29 0.1 1,751 4.4 458 1.1
Maine 20,830 6,359 30.5 3,763 18.1 793 3.8 8,721 41.9 1,784 8.6 470 2.3 226 1.1
Maryland 117,863 50,437 42.8 38,605 32.8 1,103 0.9 50,865 43.2 0 0.0 9,515 8.1 9,142 7.8
Massachusetts 180,056 79,799 44.3 66,069 36.7 15,508 8.6 69,402 38.5 391 0.2 11,773 6.5 3,547 2.0
Michigan 190,471 91,519 48.0 68,033 35.7 10,167 5.3 40,499 21.3 468 0.2 7,872 4.1 7,273 3.8
Minnesota 100,405 43,878 43.7 36,251 36.1 2,387 2.4 21,748 21.7 99 0.1 5,021 5.0 6,183 6.2
Mississippi DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Missouri DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Montana DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nebraska DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nevada 41,400 10,065 24.3 12,756 30.8 745 1.8 5,262 12.7 564 1.4 996 2.4 2,295 5.5
New Hampshire 13,430 4,577 34.1 3,761 28.0 661 4.9 5,963 44.4 90 0.7 547 4.1 89 0.7
New Jersey 81,928 40,327 49.2 32,860 40.1 1,289 1.6 20,087 24.5 204 0.2 5,233 6.4 1,656 2.0
New Mexico 19,153 7,368 38.5 7,600 39.7 246 1.3 4,661 24.3 227 1.2 749 3.9 2,490 13.0
New York 412,492 184,903 44.8 172,159 41.7 16,430 4.0 84,147 20.4 3,344 0.8 13,409 3.3 3,121 0.8
North Carolina 109,346 56,780 51.9 55,364 50.6 3,169 2.9 14,974 13.7 DS DS 7,231 6.6 2,452 2.2
North Dakota 3,072 1,093 35.6 1,896 61.7 24 0.8 172 5.6 DS DS 189 6.2 87 2.8
Ohio 362,088 209,279 57.8 126,578 35.0 14,552 4.0 87,496 24.2 71 0.0 25,614 7.1 45,238 12.5
Oklahoma 42,095 15,364 36.5 22,148 52.6 353 0.8 4,830 11.5 107 0.3 1,102 2.6 3,205 7.6
Oregon 90,062 37,907 42.1 24,612 27.3 3,121 3.5 22,000 24.4 553 0.6 2,546 2.8 6,935 7.7
Pennsylvania 278,008 120,552 43.4 106,937 38.5 5,216 1.9 76,827 27.6 5,764 2.1 12,236 4.4 8,485 3.1
Puerto Rico 15,227 1,297 8.5 4,427 29.1 974 6.4 3,343 22.0 0 0.0 500 3.3 52 0.3
Rhode Island 17,881 5,733 32.1 3,782 21.2 855 4.8 9,866 55.2 DS DS 350 2.0 1,457 8.1
South Carolina 42,561 22,972 54.0 20,967 49.3 689 1.6 4,975 11.7 29 0.1 2,060 4.8 6,670 15.7
South Dakota 5,875 2,479 42.2 3,899 66.4 30 0.5 368 6.3 DS DS 246 4.2 100 1.7
Tennessee 89,695 37,854 42.2 43,803 48.8 2,787 3.1 11,775 13.1 452 0.5 3,988 4.4 825 0.9
Texas 113,195 60,325 53.3 66,473 58.7 1,435 1.3 13,830 12.2 1,461 1.3 9,994 8.8 5,794 5.1
Utah 11,367 3,326 29.3 3,152 27.7 DS DS 2,424 21.3 DS DS 81 0.7 403 3.5
Vermont 19,100 6,458 33.8 5,653 29.6 829 4.3 9,007 47.2 18 0.1 456 2.4 292 1.5
Virginia 50,330 24,110 47.9 24,176 48.0 111 0.2 8,761 17.4 17 0.0 1,828 3.6 471 0.9
Washington 137,886 63,605 46.1 43,279 31.4 31,585 22.9 33,952 24.6 171 0.1 4,506 3.3 27,023 19.6
West Virginia 45,593 18,327 40.2 17,606 38.6 1,299 2.8 15,485 34.0 DS DS 2,458 5.4 2,057 4.5
Wisconsin 79,303 37,573 47.4 31,016 39.1 13,224 16.7 23,245 29.3 11 0.0 4,936 6.2 2,134 2.7
Wyoming 4,143 1,732 41.8 1,950 47.1 23 0.6 472 11.4 67 1.6 188 4.5 465 11.2
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table C.1.ii. (Based on analysis of the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020.
NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. Service types were determined based on National Drug Codes, procedure codes, and revenue codes. The sum of the percentages across service categories (Table A.11.a, Table A.11.b and Table A.11.c) within each state is not 100 because many Medicaid beneficiaries treated for a SUD received more than 1 treatment. See Report to Congress: T-MSIS SUD Data Book, page 39, for a description of the service categories.
  1. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

 

Table A.11.c. Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Typea
State Total Number of Medicaid Beneficiaries Partial Hospitalization Peer Support Physician Services Pharmacotherapy Screening/Assessment Treatment Program
Number Percent Number Percent Number Percent Number Percent Number Percent Number Percent
Total 4,084,089 9,768 0.2 32,264 0.8 1,254,769 30.7 185,480 4.5 733,495 18.0 258,427 6.3
Alabama 51,300 29 0.1 0 0.0 13,683 26.7 3,323 6.5 4,239 8.3 145 0.3
Alaska 18,048 0 0.0 83 0.5 8,623 47.8 1,616 9.0 4,670 25.9 88 0.5
Arizona 108,967 DS DS 12,020 11.0 28,244 25.9 4,980 4.6 35,925 33.0 6,640 6.1
Arkansas 12,265 DS DS 0 0.0 2,189 17.8 292 2.4 979 8.0 61 0.5
California 422,080 DS DS 0 0.0 93,501 22.2 20,217 4.8 20,074 4.8 11,334 2.7
Colorado 67,997 0 0.0 DS DS 23,405 34.4 4,264 6.3 6,057 8.9 59 0.1
Connecticut 87,004 905 1.0 0 0.0 21,159 24.3 1,269 1.5 20,347 23.4 9,177 10.5
Delaware 18,528 715 3.9 659 3.6 8,663 46.8 585 3.2 2,943 15.9 1,072 5.8
District of Columbia 15,642 0 0.0 DS DS 4,701 30.1 445 2.8 2,087 13.3 17 0.1
Florida 136,441 DS DS 14 0.0 22,075 16.2 4,842 3.5 13,028 9.5 57 0.0
Georgia 63,803 248 0.4 229 0.4 17,222 27 852 1.3 7,608 11.9 272 0.4
Hawaii 18,200 38 0.2 DS DS 6,651 36.5 966 5.3 2,758 15.2 411 2.3
Idaho 10,416 0 0.0 0 0.0 2,756 26.5 91 0.9 584 5.6 0 0.0
Illinois 15,377 0 0.0 0 0.0 3,007 19.6 53 0.3 1,634 10.6 0 0.0
Indiana 94,721 371 0.4 102 0.1 28,037 29.6 2,239 2.4 17,794 18.8 1,310 1.4
Iowa 51,123 669 1.3 51 0.1 17,376 34 3,617 7.1 14,395 28.2 4,109 8.0
Kansas 20,250 0 0.0 904 4.5 5,154 25.5 246 1.2 3,904 19.3 1,856 9.2
Kentucky 137,127 110 0.1 3,505 2.6 56,415 41.1 10,446 7.6 23,962 17.5 8,122 5.9
Louisiana 39,945 0 0.0 DS DS 10,028 25.1 2,738 6.9 5,357 13.4 3,419 8.6
Maine 20,830 0 0.0 0 0.0 10,736 51.5 765 3.7 8,381 40.2 1,254 6.0
Maryland 117,863 22 0.0 0 0.0 43,502 36.9 1,066 0.9 41,185 34.9 15,407 13.1
Massachusetts 180,056 1,174 0.7 37 0.0 81,430 45.2 7,652 4.2 31,890 17.7 17,511 9.7
Michigan 190,471 22 0.0 6,486 3.4 70,065 36.8 16,269 8.5 48,833 25.6 17,905 9.4
Minnesota 100,405 129 0.1 54 0.1 38,716 38.6 6,056 6.0 32,433 32.3 27,619 27.5
Mississippi DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Missouri DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Montana DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nebraska DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nevada 41,400 DS DS 249 0.6 5,000 12.1 1,573 3.8 4,009 9.7 574 1.4
New Hampshire 13,430 0 0.0 50 0.4 5,480 40.8 480 3.6 2,626 19.6 1,309 9.7
New Jersey 81,928 1,700 2.1 0 0.0 23,804 29.1 3,354 4.1 18,512 22.6 4,223 5.2
New Mexico 19,153 80 0.4 0 0.0 6,264 32.7 1,206 6.3 4,454 23.3 643 3.4
New York 412,492 612 0.1 DS DS 116,914 28.3 2,723 0.7 30,080 7.3 6,597 1.6
North Carolina 109,346 18 0.0 958 0.9 34,144 31.2 6,819 6.2 14,455 13.2 7,875 7.2
North Dakota 3,072 35 1.1 0 0.0 872 28.4 64 2.1 512 16.7 315 10.3
Ohio 362,088 569 0.2 DS DS 125,547 34.7 45,023 12.4 111,994 30.9 25,535 7.1
Oklahoma 42,095 DS DS 0 0.0 10,917 25.9 2,455 5.8 3,324 7.9 14 0.0
Oregon 90,062 0 0.0 4,078 4.5 33,788 37.5 5,839 6.5 28,220 31.3 5,777 6.4
Pennsylvania 278,008 251 0.1 224 0.1 78,262 28.2 1,996 0.7 53,943 19.4 53,131 19.1
Puerto Rico 15,227 67 0.4 0 0.0 7,438 48.8 41 0.3 3,395 22.3 17 0.1
Rhode Island 17,881 317 1.8 445 2.5 5,690 31.8 211 1.2 4,594 25.7 1,075 6.0
South Carolina 42,561 0 0.0 108 0.3 9,179 21.6 338 0.8 7,972 18.7 1,791 4.2
South Dakota 5,875 0 0.0 0 0.0 991 16.9 190 3.2 577 9.8 438 7.5
Tennessee 89,695 935 1.0 23 0.0 30,756 34.3 3,021 3.4 10,635 11.9 6,351 7.1
Texas 113,195 713 0.6 DS DS 26,390 23.3 2,144 1.9 9,184 8.1 2,844 2.5
Utah 11,367 DS DS 46 0.4 1,109 9.8 225 2.0 1,023 9.0 88 0.8
Vermont 19,100 0 0.0 0 0.0 5,308 27.8 109 0.6 3,619 18.9 1,708 8.9
Virginia 50,330 20 0.0 0 0.0 10,463 20.8 1,627 3.2 2,848 5.7 291 0.6
Washington 137,886 0 0.0 1,886 1.4 46,446 33.7 7,523 5.5 39,356 28.5 8,139 5.9
West Virginia 45,593 19 0.0 0 0.0 22,237 48.8 2,111 4.6 10,007 21.9 637 1.4
Wisconsin 79,303 DS DS 0 0.0 29,228 36.9 1,323 1.7 16,371 20.6 1,210 1.5
Wyoming 4,143 0 0.0 53 1.3 1,204 29.1 196 4.7 718 17.3 DS DS
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table C.1.iii. (Based on analysis of the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020.
NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. Service types were determined based on National Drug Codes, procedure codes, and revenue codes. The sum of the percentages across service categories (Table A.11.a, Table A.11.b and Table A.11.c) within each state is not 100 because many Medicaid beneficiaries treated for a SUD received more than 1 treatment. See Report to Congress: T-MSIS SUD Data Book, page 39, for a description of the service categories.
  1. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

 

Table A.12. Number and Percentage of Medicaid Beneficiaries Treated for a SUD in 2017, by Service Settinga
State Total Number of Medicaid Beneficiaries Treated in an Inpatient Setting Treated in an Outpatient Setting Treated in a Residential Setting Treated in a Home-Based Setting Treated in a Community-Based Setting Treated in an Unknown Setting
Number Percent Number Percent Number Percent Number Percent Number Percent Number Percent
Total 4,084,089 1,774,756 43.5 3,074,191 75.3 166,070 4.1 75,535 1.8 46,838 1.1 457,639 11.2
Alabama 51,300 26,352 51.4 39,787 77.6 1,234 2.4 509 1.0 228 0.4 69 0.1
Alaska 18,048 7,135 39.5 14,209 78.7 1,589 8.8 260 1.4 3,565 19.8 435 2.4
Arizona 108,967 49,905 45.8 83,584 76.7 4,433 4.1 6,891 6.3 873 0.8 27,930 25.6
Arkansas 12,265 6,594 53.8 4,121 33.6 780 6.4 61 0.5 89 0.7 5,674 46.3
California 422,080 183,473 43.5 298,264 70.7 35,686 8.5 2,801 0.7 2,637 0.6 59,149 14.0
Colorado 67,997 28,633 42.1 46,856 68.9 253 0.4 293 0.4 309 0.5 35,078 51.6
Connecticut 87,004 28,102 32.3 75,531 86.8 1,739 2.0 2,032 2.3 118 0.1 2,978 3.4
Delaware 18,528 6,699 36.2 15,365 82.9 2,836 15.3 142 0.8 44 0.2 184 1.0
District of Columbia 15,642 8,082 51.7 11,618 74.3 922 5.9 90 0.6 15 0.1 94 0.6
Florida 136,441 87,887 64.4 80,391 58.9 2,301 1.7 2,443 1.8 9,332 6.8 523 0.4
Georgia 63,803 39,493 61.9 39,091 61.3 970 1.5 992 1.6 1,639 2.6 1,178 1.8
Hawaii 18,200 8,557 47.0 13,475 74.0 324 1.8 43 0.2 102 0.6 99 0.5
Idaho 10,416 5,464 52.5 7,164 68.8 275 2.6 57 0.5 DS DS 491 4.7
Illinois 15,377 9,972 64.9 7,287 47.4 457 3.0 68 0.4 106 0.7 2,898 18.8
Indiana 94,721 49,449 52.2 64,859 68.5 1,538 1.6 808 0.9 45 0.0 1,288 1.4
Iowa 51,123 24,889 48.7 38,593 75.5 2,268 4.4 419 0.8 485 0.9 588 1.2
Kansas 20,250 11,669 57.6 12,193 60.2 1,864 9.2 505 2.5 191 0.9 619 3.1
Kentucky 137,127 54,447 39.7 111,752 81.5 7,327 5.3 888 0.6 701 0.5 1,213 0.9
Louisiana 39,945 18,890 47.3 28,037 70.2 6,348 15.9 351 0.9 50 0.1 2,686 6.7
Maine 20,830 4,006 19.2 19,220 92.3 236 1.1 187 0.9 252 1.2 603 2.9
Maryland 117,863 39,882 33.8 101,915 86.5 6,019 5.1 965 0.8 46 0.0 8,461 7.2
Massachusetts 180,056 79,983 44.4 152,372 84.6 10,570 5.9 4,140 2.3 7,191 4.0 16,056 8.9
Michigan 190,471 68,048 35.7 100,150 52.6 1,981 1.0 578 0.3 160 0.1 129,437 68.0
Minnesota 100,405 36,641 36.5 85,110 84.8 2,357 2.3 7,496 7.5 673 0.7 6,156 6.1
Mississippi DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Missouri DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Montana DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nebraska DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nevada 41,400 21,461 51.8 30,331 73.3 1,256 3.0 751 1.8 78 0.2 932 2.3
New Hampshire 13,430 3,921 29.2 11,281 84.0 1,148 8.5 434 3.2 183 1.4 1,253 9.3
New Jersey 81,928 36,444 44.5 62,820 76.7 1,505 1.8 2,439 3.0 562 0.7 635 0.8
New Mexico 19,153 7,409 38.7 15,472 80.8 897 4.7 259 1.4 517 2.7 118 0.6
New York 412,492 184,041 44.6 331,943 80.5 7,472 1.8 2,272 0.6 202 0.0 9,173 2.2
North Carolina 109,346 57,504 52.6 76,404 69.9 3,301 3.0 2,674 2.4 566 0.5 2,312 2.1
North Dakota 3,072 1,810 58.9 1,784 58.1 302 9.8 59 1.9 DS DS 588 19.1
Ohio 362,088 131,318 36.3 308,936 85.3 12,812 3.5 10,028 2.8 574 0.2 42,670 11.8
Oklahoma 42,095 22,524 53.5 27,756 65.9 1,132 2.7 969 2.3 2,322 5.5 781 1.9
Oregon 90,062 25,180 28.0 78,084 86.7 8,256 9.2 1,219 1.4 509 0.6 2,963 3.3
Pennsylvania 278,008 112,866 40.6 208,307 74.9 3,873 1.4 11,784 4.2 629 0.2 73,539 26.5
Puerto Rico 15,227 5,105 33.5 12,053 79.2 25 0.2 70 0.5 207 1.4 DS DS
Rhode Island 17,881 3,884 21.7 16,235 90.8 389 2.2 163 0.9 75 0.4 776 4.3
South Carolina 42,561 21,840 51.3 28,936 68.0 971 2.3 282 0.7 822 1.9 2,588 6.1
South Dakota 5,875 3,894 66.3 3,369 57.3 348 5.9 DS DS 108 1.8 162 2.8
Tennessee 89,695 47,511 53.0 65,613 73.2 990 1.1 1,472 1.6 172 0.2 1,219 1.4
Texas 113,195 66,021 58.3 70,922 62.7 6,598 5.8 3,458 3.1 1,748 1.5 1,687 1.5
Utah 11,367 6,818 60.0 5,762 50.7 2,124 18.7 46 0.4 422 3.7 406 3.6
Vermont 19,100 5,746 30.1 16,351 85.6 124 0.6 172 0.9 136 0.7 3,815 20.0
Virginia 50,330 27,750 55.1 32,635 64.8 762 1.5 240 0.5 75 0.1 202 0.4
Washington 137,886 43,652 31.7 115,581 83.8 14,951 10.8 1,794 1.3 6,232 4.5 5,127 3.7
West Virginia 45,593 19,746 43.3 34,199 75.0 1,266 2.8 943 2.1 19 0.0 453 1.0
Wisconsin 79,303 32,116 40.5 65,710 82.9 985 1.2 952 1.2 1,200 1.5 1,990 2.5
Wyoming 4,143 1,943 46.9 2,763 66.7 276 6.7 36 0.9 629 15.2 363 8.8
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table C.2. (Based on analysis of the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020.
NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims. Service types were determined based on National Drug Codes, procedure codes, and revenue codes. Setting was defined as unknownwhen there was not enough information on the claim to categorize the service by setting.
  1. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

 

Table A.13. Days of Service Provided to Medicaid Beneficiaries Who Received Each Service Type in 2017a
State Inpatient Care MAT Observation Care Partial Hospitalization
Number of Beneficiaries Receiving Service Total Number of Days Average Number of Days Per Beneficiary Number of Beneficiaries Receiving Service Total Number of Days Average Number of Days Per Beneficiary Number of Beneficiaries Receiving Service Total Number of Days Average Number of Days Per Beneficiary Number of Beneficiaries Receiving Service Total Number of Days Average Number of Days Per Beneficiary
Total 1,688,293 15,309,087 9.1 951,891 12,309,275 129.3 200,889 684,463 3.4 9,768 163,769 16.8
Alabama 25,970 325,139 12.5 6,483 1,210,702 186.8 1,535 5,719 3.7 29 617 21.3
Alaska 7,107 62,559 8.8 4,091 436,878 106.8 798 3,169 4.0 0 0 0.0
Arizona 48,745 437,937 9.0 19,388 1,615,477 83.3 9,074 38,240 4.2 DS DS DS
Arkansas 6,876 50,346 7.3 956 49,370 51.6 494 1,551 3.1 DS DS DS
California 182,171 1,444,319 7.9 94,906 15,553,357 163.9 9,421 30,330 3.2 DS DS DS
Colorado 28,498 210,822 7.4 14,470 1,206,850 83.4 6,671 26,282 3.9 0 0 0.0
Connecticut 26,037 324,848 12.5 33,107 2,948,667 89.1 3,561 8,422 2.4 905 7,913 8.7
Delaware 7,877 93,441 11.9 7,083 1,102,713 155.7 737 2,870 3.9 715 11,745 16.4
District of Columbia 8,155 90,449 11.1 2,810 480,725 171.1 847 3,393 4.0 0 0 0.0
Florida 83,088 694,301 8.4 19,576 1,451,475 74.1 13,325 60,370 4.5 DS DS DS
Georgia 38,574 368,400 9.6 4,896 572,117 116.9 3,764 14,596 3.9 248 2,216 8.9
Hawaii 8,078 57,746 7.1 2,704 413,147 152.8 1,313 4,732 3.6 38 379 10.0
Idaho 4,789 19,233 4.0 1,523 192,132 126.2 147 184 1.3 0 0 0.0
Illinois 9,447 63,228 6.7 1,626 97,922 60.2 686 1,827 2.7 0 0 0.0
Indiana 48,045 398,821 8.3 26,916 2,707,429 100.6 4,575 16,486 3.6 371 5,654 15.2
Iowa 24,217 173,578 7.2 5,866 509,422 86.8 2,364 7,420 3.1 669 12,502 18.7
Kansas 8,699 94,629 10.9 2,534 196,963 77.7 614 1,851 3.0 0 0 0.0
Kentucky 52,662 401,796 7.6 42,430 5,927,602 139.7 3,118 8,018 2.6 110 2,338 21.3
Louisiana 19,683 167,708 8.5 5,369 694,161 129.3 1,751 7,313 4.2 0 0 0.0
Maine 3,763 27,851 7.4 8,721 1,829,467 209.8 470 840 1.8 0 0 0.0
Maryland 38,605 340,179 8.8 50,865 4,839,198 95.1 9,515 36,795 3.9 22 195 8.9
Massachusetts 66,069 755,227 11.4 69,402 12,545,064 180.8 11,773 26,932 2.3 1,174 9,423 8.0
Michigan 68,033 478,647 7.0 40,499 4,837,859 119.5 7,872 24,732 3.1 22 153 7.0
Minnesota 36,251 428,021 11.8 21,748 2,813,253 129.4 5,021 19,608 3.9 129 1,217 9.4
Mississippi DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Missouri DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Montana DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nebraska DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ DQ
Nevada 12,756 132,583 10.4 5,262 473,295 89.9 996 3,086 3.1 DS DS DS
New Hampshire 3,761 26,833 7.1 5,963 821,284 137.7 547 980 1.8 0 0 0.0
New Jersey 32,860 322,164 9.8 20,087 2,080,304 103.6 5,233 20,167 3.9 1,700 58,002 34.1
New Mexico 7,600 51,613 6.8 4,661 922,417 197.9 749 953 1.3 80 302 3.8
New York 172,159 2,185,283 12.7 84,147 10,224,380 121.5 13,409 52,603 3.9 612 10,958 17.9
North Carolina 55,364 442,362 8.0 14,974 1,355,091 90.5 7,231 29,731 4.1 18 189 10.5
North Dakota 1,896 17,278 9.1 172 15,218 88.5 189 361 1.9 35 455 13.0
Ohio 126,578 809,181 6.4 87,496 11,230,010 128.3 25,614 53,960 2.1 569 12,486 21.9
Oklahoma 22,148 220,120 9.9 4,830 514,156 106.5 1,102 3,837 3.5 DS DS DS
Oregon 24,612 199,177 8.1 22,000 2,836,702 128.9 2,546 10,177 4.0 0 0 0.0
Pennsylvania 106,937 1,039,712 9.7 76,827 10,818,977 140.8 12,236 36,637 3.0 251 3,718 14.8
Puerto Rico 4,427 37,549 8.5 3,343 445,514 133.3 500 1,197 2.4 67 299 4.5
Rhode Island 3,782 33,115 8.8 9,866 1,433,020 145.2 350 909 2.6 317 2,535 8.0
South Carolina 20,967 165,161 7.9 4,975 567,963 114.2 2,060 9,541 4.6 0 0 0.0
South Dakota 3,899 53,522 13.7 368 35,488 96.4 246 926 3.8 0 0 0.0
Tennessee 43,803 374,649 8.6 11,775 862,624 73.3 3,988 13,002 3.3 935 13,327 14.3
Texas 66,473 590,800 8.9 13,830 1,439,370 104.1 9,994 42,888 4.3 713 6,771 9.5
Utah 3,152 22,995 7.3 2,424 339,351 140.0 81 181 2.2 DS DS DS
Vermont 5,653 55,881 9.9 9,007 1,965,471 218.2 456 1,967 4.3 0 0 0.0
Virginia 24,176 216,313 8.9 8,761 1,164,446 132.9 1,828 6,100 3.3 20 275 13.8
Washington 43,279 412,010 9.5 33,952 4,201,106 123.7 4,506 19,143 4.2 0 0 0.0
West Virginia 17,606 121,508 6.9 15,485 2,281,120 147.3 2,458 7,761 3.2 19 100 5.3
Wisconsin 31,016 252,663 8.1 23,245 2,798,161 120.4 4,936 16,438 3.3 DS DS DS
Wyoming 1,950 17,390 8.9 472 35,339 74.9 188 238 1.3 0 0 0.0
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table D.1.ii. (Based on analysis of the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020.
NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims.
  1. Significance tests were not conducted for these estimates because the universe of Medicaid claims reported to T-MSIS was used to develop these estimates.

 

Table A.14. Percent of Persons 12 and Older Needing SUD Treatment Who Perceived a Need for Treatment and Made an Effort to get Treatment, 2015-2018a
  2015 2016 2017 2018
Illicit drug use disorder
   Perceived need for treatment 7.5 6.4 8.2 6.4
   Made effort to get treatment 2.9 3.3 3.3 3.0
   Made no effort to get treatment 4.7 3.0 4.9 3.4
   Did not perceive need for treatment 92.5 93.6 91.8 93.6
Alcohol use disorder
   Perceived need for treatment 2.9 3.2 4.4 3.9
   Made effort to get treatment 0.9 1.4 2.2 1.6
   Made no effort to get treatment 2.0 1.8 2.2 2.3
   Did not perceive need for treatment 97.1 96.8 95.6 96.1
Drugs or alcohol use disorder
   Perceived need for treatment 4.6 4.5 5.7 5.1
   Made effort to get treatment 1.6 1.9 2.7 2.1
   Made no effort to get treatment 2.9 2.5 3.0 3.0
   Did not perceive need for treatment 95.4 95.5 94.3 94.9
SOURCE: Estimates from 2018 NSDUH: Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for illicit drug use disorder are from Table 7.62B. Estimates for alcohol are from Table 7.63B. Estimates for illicit drugs and alcohol are from Table 7.64B. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect7pe2018.htm. Accessed on February 22, 2020.
NOTE: The population in this table is survey respondents classified as needing substance use treatment based on meeting the criteria in the DSM-IV for an illicit drug or alcohol use disorder or received treatment for illicit drug or alcohol use at a specialty facility (i.e., drug and alcohol rehabilitation facility [inpatient or outpatient], hospital [inpatient only], or MH center). Respondents were classified as not perceiving a need for treatment if they responded to the survey that, at the time of their disorder, they did not think they needed treatment. Respondents were classified as making an effort to get treatment if they responded affirmatively to the survey question, "During the past 12 months, did you make an effort to get treatment or counseling for your use of [substance for which individual had associated SUD]?"
  1. For each row in this table the difference between the 2018 estimate and the estimates for each of the other years was tested for statistical significance at the 0.05 level. None of these differences is statistically significant at the 0.05 level.

 

Table A.15. Percentage of Population Needing but not Receiving SUD Treatment in the Past Year, by Age Group and State, 2017-2018a
State Illicit Drug Use Disorder Alcohol Use Disorder Drug or Alcohol Use Disorder
12-17 18-25 26 and Older 12-17 18-25 26 and Older 12-17 18-25 26 and Older
Total 2.7 6.9 1.8 1.7 9.7 4.8 3.6 14.1 6.0
Alabama 2.5 7.7 1.8 1.6 7.7 4.4 3.4 13.1 5.8
Alaska 3.2 7.7 2.2 1.9 11.6 6.0 4.3 15.6 7.7
Arizona 2.7 6.6 1.6 1.8 9.8 4.7 3.8 13.5 5.9
Arkansas 2.7 7.0 1.8 2.0 9.1 4.7 3.7 13.8 6.0
California 3.1 7.0 2.0 1.8 9.9 5.5 3.9 14.1 6.8
Colorado 3.7 12.3 3.0 2.1 14.3 7.5 4.7 22.2 9.5
Connecticut 2.6 8.7 2.1 1.8 11.3 5.0 3.5 18.3 6.2
Delaware 3.1 7.6 2.1 1.5 10.2 5.7 3.7 14.7 6.8
District of Columbia 3.7 8.7 3.4 1.7 13.0 8.8 5.4 17.5 10.2
Florida 3.2 7.0 1.8 1.6 8.1 4.2 4.1 12.9 5.4
Georgia 2.4 7.2 1.7 1.4 7.5 4.1 3.0 12.3 5.4
Hawaii 2.8 5.8 1.7 2.1 11.4 4.7 4.0 14.6 5.6
Idaho 2.6 4.9 1.4 1.7 9.6 5.0 3.8 12.1 6.1
Illinois 2.7 7.1 1.8 1.9 10.9 5.4 3.8 15.0 6.4
Indiana 2.5 7.3 1.9 1.5 9.6 4.2 3.2 14.1 5.5
Iowa 2.4 6.4 1.8 2.1 14.0 5.7 4.0 17.2 6.7
Kansas 2.3 5.4 1.5 1.9 10.6 4.7 3.6 13.4 5.6
Kentucky 2.7 6.0 1.8 1.6 8.2 4.4 3.6 12.0 5.6
Louisiana 2.1 6.4 1.9 1.7 9.8 5.8 3.2 14.5 6.8
Maine 3.0 9.4 2.2 2.3 11.4 5.5 4.4 18.3 7.3
Maryland 2.5 7.2 1.7 1.3 8.6 4.3 3.2 12.9 5.3
Massachusetts 2.6 7.3 2.4 1.9 12.8 5.3 3.7 17.7 6.7
Michigan 2.5 6.9 1.7 1.6 9.1 4.7 3.4 13.5 5.8
Minnesota 2.9 6.6 2.0 1.5 10.5 4.5 3.8 13.7 5.7
Mississippi 2.3 5.8 1.7 1.3 6.9 4.0 3.1 10.9 5.2
Missouri 2.5 6.3 1.8 1.6 8.3 4.6 3.5 12.7 5.9
Montana 3.3 8.3 2.0 2.9 13.0 6.7 4.8 17.0 7.5
Nebraska 2.4 7.0 1.7 1.8 12.3 5.0 3.6 16.4 5.8
Nevada 3.5 10.8 2.4 1.7 9.8 4.9 4.4 17.1 7.0
New Hampshire 2.9 7.0 1.8 2.0 14.3 5.7 4.2 18.3 7.1
New Jersey 2.5 6.3 1.7 1.5 10.2 4.3 3.4 14.3 5.7
New Mexico 3.7 7.4 1.8 1.7 9.1 4.5 4.5 14.3 5.6
New York 2.4 7.2 1.9 1.5 8.7 4.9 3.3 13.7 5.9
North Carolina 2.8 7.1 1.8 1.6 8.0 4.3 3.5 12.5 5.5
North Dakota 2.5 6.4 1.7 2.1 13.0 5.6 4.1 16.3 6.5
Ohio 2.9 7.5 2.0 1.6 9.5 4.4 3.7 13.9 5.8
Oklahoma 2.9 7.0 1.6 1.7 10.0 5.3 3.9 14.6 6.5
Oregon 3.2 8.4 2.2 2.3 12.5 6.8 4.3 17.6 8.0
Pennsylvania 2.3 5.8 1.8 1.6 10.7 4.3 3.2 14.1 5.3
Rhode Island 2.9 7.9 2.0 1.8 11.8 5.4 3.8 16.6 6.5
South Carolina 2.7 6.5 1.6 1.6 10.5 4.8 3.6 15.4 5.7
South Dakota 2.8 7.4 1.8 2.3 13.8 5.8 4.6 18.0 6.6
Tennessee 2.7 6.1 1.8 1.7 8.2 4.2 3.6 12.2 5.4
Texas 2.2 5.6 1.3 1.3 8.2 4.0 3.0 11.9 5.0
Utah 2.2 5.2 1.5 1.5 8.1 3.9 3.0 10.8 4.8
Vermont 3.8 9.4 2.4 2.7 13.8 6.1 4.9 19.9 7.6
Virginia 2.4 6.6 1.5 1.6 10.3 4.7 3.4 14.3 5.8
Washington 3.5 8.4 2.3 2.3 11.0 5.1 4.7 15.7 6.7
West Virginia 2.7 6.1 1.7 1.6 8.3 3.8 3.9 12.4 5.2
Wisconsin 2.6 6.2 1.8 2.0 13.8 5.8 3.9 16.9 6.4
Wyoming 2.8 5.8 1.4 2.3 10.3 4.9 4.2 12.6 5.5
SOURCE: Estimates from 2017-2018 NSDUH: Model-Based Prevalence Estimates, Center for Behavioral Health Statistics and Quality, 2019. Estimates for illicit drugs, alcohol, and illicit drugs or alcohol are from Tables 24, 25, and 26, respectively. Available at https://www.samhsa.gov/data/sites/default/files/reports/rpt23235/2k18SAEExcelTabs/NSDUHsaeExcelTabs2018.xlsx. Accessed December 16, 2019.
NOTE: Survey respondents were classified as needing substance use treatment if they met the criteria for an illicit drug or alcohol use disorder as defined in the DSM-IV or received treatment for illicit drug or alcohol use at a specialty facility (i.e., drug and alcohol rehabilitation facility [inpatient or outpatient], hospital [inpatient only], or MH center). Needing but not receiving SUD treatment refers to respondents who are classified as needing illicit drug or alcohol treatment, but who did not receive such treatment at a specialty facility. Illicit drug use includes the misuse of prescription psychotherapeutics or the use of marijuana, cocaine (including crack), heroin, hallucinogens, inhalants, or methamphetamine. Misuse of prescription psychotherapeutics is defined as use in any way not directed by a doctor, including use without a prescription of one's own; use in greater amounts, more often, or longer than prescribed; or use in any other way not directed by a doctor. Prescription psychotherapeutics do not include over-the-counter drugs. Differences among estimates reported here may not be statistically significant.
  1. Significance tests were not conducted for this table. Confidence intervals for the estimates reported here are included in the source document.

 

Table A.16. Number of Residential and Inpatient Beds Designated for SUD Treatment and Their Utilization Rates, by State, 2013, 2015, and 2017a
  Number of Designated Beds Utilization Rate
Residential Inpatient Hospital Residential Inpatient Hospital
2013 2015 2017 2013 2015 2017 2013 2015 2017 2013 2015 2017
Total 100,417 104,012 91,601 12,213 15,415 12,707 97.0 105.5 93.9 96.6 108.6 98.3
Alabama 1,212 1,031 1,073 252 52 64 92.1 95.2 85.7 95.6 53.8 45.3
Alaska 383 347 382 NA 0 32 89.0 109.2 74.6 NA 0.0 41.0
Arizona 1,853 2,235 1,562 210 297 416 97.4 120.0 101.2 129.0 116.8 108.2
Arkansas 798 686 563 83 46 96 85.8 350.0 128.8 94.0 63.0 65.6
California 13,688 13,390 13,180 750 477 594 94.2 95.5 93.6 102.0 95.0 95.1
Colorado 1,446 1,162 1,265 172 184 111 97.9 92.5 79.7 80.2 72.8 64.0
Connecticut 1,766 1,491 1,333 290 219 226 100.2 100.5 123.1 98.3 111.4 108.8
Delaware 184 262 78 NA 30 35 92.4 1450.4 147.4 NA 106.7 57.1
District of Columbia 428 396 482 NA 12 0 97.9 108.8 90.7 NA 8.3 0.0
Florida 6,020 6,363 6,110 641 843 1,040 120.2 100.5 86.1 93.9 127.9 131.6
Georgia 1,934 1,933 1,612 284 413 350 98.0 83.2 94.5 90.5 110.4 114.6
Hawaii 456 466 409 0 48 0 84.4 94.6 93.4 0.0 91.7 0.0
Idaho 162 144 191 NA 15 68 69.8 97.2 81.7 NA 93.3 63.2
Illinois 3,099 2,885 2,785 328 253 356 87.1 100.2 99.8 59.5 64.8 53.1
Indiana 541 618 737 237 552 424 81.5 129.9 105.4 74.7 92.4 76.2
Iowa 815 935 737 NA 30 34 80.0 72.9 88.3 NA 80.0 44.1
Kansas 765 720 725 NA 29 20 85.5 95.7 74.8 NA 79.3 90.0
Kentucky 1,798 2,264 2,228 291 329 427 102.4 94.3 121.6 79.7 126.1 70.0
Louisiana 1,615 1,785 1,551 199 270 374 83.0 91.5 83.8 80.9 74.1 51.3
Maine 296 257 216 112 118 52 106.8 90.7 98.6 108.0 39.0 75.0
Maryland 2,074 2,063 1,660 709 344 189 70.2 85.6 78.5 56.7 74.7 69.3
Massachusetts 3,211 3,292 3,348 595 811 1,037 94.9 104.9 96.6 106.2 120.8 103.1
Michigan 2,985 2,996 3,111 180 173 109 163.4 88.0 78.9 185.6 44.5 54.1
Minnesota 3,862 3,593 3,482 63 95 63 96.3 92.8 105.1 92.1 75.8 88.9
Mississippi 1,133 968 791 259 148 162 71.5 69.1 63.0 129.0 128.4 113.6
Missouri 1,107 1,215 1,222 55 73 116 88.0 174.8 99.2 194.5 76.7 168.1
Montana 258 222 231 24 78 114 177.1 84.2 104.3 529.2 117.9 77.2
Nebraska 812 748 816 0 0 29 82.0 98.4 97.4 0.0 0.0 7.0
Nevada 455 543 615 113 143 184 93.4 89.7 80.8 131.0 132.9 56.0
New Hampshire 368 390 278 NA 15 15 89.7 89.7 99.6 NA 26.7 66.7
New Jersey 2,541 2,837 2,324 365 307 494 105.0 117.7 87.4 95.3 130.6 90.1
New Mexico 481 483 602 137 125 34 353.4 83.0 93.5 72.3 90.4 82.4
New York 10,531 10,125 8,003 2,067 1,741 1,779 91.2 97.4 92.3 79.1 95.0 106.5
North Carolina 2,655 2,591 2,042 429 368 461 92.5 112.3 97.5 128.7 72.6 87.2
North Dakota 378 440 259 94 83 118 111.4 84.1 146.7 56.4 71.1 18.6
Ohio 1,758 1,955 1,992 586 561 355 99.2 102.3 93.5 84.5 87.7 96.9
Oklahoma 1,570 1,206 1,258 131 113 75 75.9 96.5 81.8 85.5 68.1 58.7
Oregon 1,260 1,268 970 83 52 17 84.9 97.5 133.7 74.7 184.6 82.4
Pennsylvania 5,756 5,570 6,591 529 392 351 91.0 95.0 94.5 82.6 61.7 92.6
Puerto Rico 3,027 2,553 1,303 178 198 170 75.3 108.7 119.8 250.6 177.8 232.4
Rhode Island 348 1,721 284 NA 3,543 58 92.8 100.1 94.7 NA 99.9 108.6
South Carolina 471 692 546 301 209 182 117.2 88.7 95.4 115.6 536.8 130.2
South Dakota 543 623 285 87 98 169 114.7 92.9 109.5 86.2 69.4 79.3
Tennessee 1,848 1,913 1,738 142 129 156 86.0 92.7 81.4 279.6 95.3 211.5
Texas 5,448 4,809 4,460 375 404 711 87.1 122.1 91.4 88.5 138.4 121.8
Utah 896 928 1,287 NA 49 51 109.4 90.5 87.1 NA 71.4 102.0
Vermont 245 213 123 112 116 120 403.7 77.0 106.5 82.1 587.1 48.3
Virginia 801 1,060 728 109 277 152 71.8 94.6 90.5 152.3 112.6 105.9
Washington 2,417 5,729 2,464 189 192 242 86.5 116.9 90.3 72.5 76.6 72.3
West Virginia 433 552 437 NA 74 69 91.2 92.6 91.3 NA 55.4 136.2
Wisconsin 1,114 904 840 130 261 188 73.7 86.0 95.6 101.5 68.2 88.8
Wyoming 316 388 224 0 16 18 103.2 83.0 87.1 0.0 31.3 16.7
US territories 56 52 68 0 10 NA 89.3 82.7 92.6 0.0 240.0 0.0
SOURCE: N-SSATS 2013, Questions 28d and 29d, and N-SSATS 2015 and 2017, Questions 29d and 30d, indicate hospital- and residential-designated beds.
NOTE: The utilization rate is calculated by dividing the number of clients in care on the single day covered by the survey by the total number of designated beds.
  1. Significance tests were not conducted for these estimates because N-SSATS surveys the universe of specialty SUD treatment facilities.

 

Table A.17. Number of DATA-Waived Providers, September 2019a
State Total Waivered to Treat up to 30 Patients Waivered to Treat up to 100 Patients Waivered to Treat up to 275 Patients
Physicians Other Practitionersb Physicians Other Practitionersb Physicians Other Practitionersb Physicians Other Practitionersb
Total 88,061 23,098 65,517 18,287 17,008 4,312 5,536 497
Alabama 1,324 91 812 73 348 15 164 3
Alaska 385 178 327 154 47 22 11 2
Arizona 1,655 1006 1,345 846 235 147 75 13
Arkansas 372 120 266 95 82 23 24 2
California 8,903 1471 7,325 1,273 1307 192 271 6
Colorado 1,485 707 1,190 605 229 98 66 4
Connecticut 1,610 543 1,203 420 324 111 83 12
Delaware 296 97 207 70 62 22 27 5
District of Columbia 308 111 256 101 46 10 6 0
Florida 4,504 770 3,162 620 1,033 138 309 12
Georgia 1,556 216 1,115 186 342 29 99 1
Hawaii 271 65 234 59 31 6 6 0
Idaho 330 168 266 139 48 27 16 2
Illinois 2,077 456 1,676 388 319 64 82 4
Indiana 1,437 628 943 433 349 168 145 27
Iowa 261 105 219 92 35 13 7 0
Kansas 358 72 291 61 53 10 14 1
Kentucky 1,825 658 1,064 425 526 197 235 36
Louisiana 1,113 254 695 188 300 59 118 7
Maine 1,098 411 786 316 256 80 56 15
Maryland 2,389 1097 1,750 836 499 220 140 41
Massachusetts 5,225 1283 4,005 1,002 929 247 291 34
Michigan 2,500 455 1,801 355 555 88 144 12
Minnesota 1,121 369 880 297 192 65 49 7
Mississippi 499 94 304 73 139 20 56 1
Missouri 1,198 198 911 146 209 48 78 4
Montana 201 130 161 102 33 23 7 5
Nebraska 176 60 139 53 27 7 10 0
Nevada 531 191 394 154 111 36 26 1
New Hampshire 699 326 504 254 144 69 51 3
New Jersey 2,705 558 2,016 453 522 99 167 6
New Mexico 936 326 736 264 165 61 35 1
New York 7,973 1,854 6,357 1,534 1,264 289 352 31
North Carolina 2,305 920 1668 698 454 201 183 21
North Dakota 97 87 67 62 21 22 9 3
Ohio 4,237 1,583 2,890 1,175 938 358 409 50
Oklahoma 803 190 589 156 151 33 63 1
Oregon 1,404 489 1,124 405 221 73 59 11
Pennsylvania 5,409 1,080 3,701 799 1,195 229 513 52
Puerto Rico 726 0 598 0 117 0 11 0
Rhode Island 773 166 575 135 142 29 56 2
South Carolina 995 314 723 231 198 77 74 6
South Dakota 101 49 91 44 7 5 3 0
Tennessee 2,046 6 1,181 6 590 0 275 0
Texas 3,027 545 2,237 472 614 71 176 2
Utah 1,025 331 788 266 192 63 45 2
Vermont 573 143 444 116 100 24 29 3
Virginia 1,643 403 1,155 320 366 74 122 9
Washington 3,255 1,078 2,726 844 425 214 104 20
West Virginia 837 314 494 229 233 73 110 12
Wisconsin 1,371 268 1,044 208 258 55 69 5
Wyoming 102 63 72 53 24 10 6 0
US territories 11 1 10 1 1 0 0 0
SOURCE: SAMHSA. Number of DATA-waived Practitioners: Waiver Totals by State. Available at https://www.samhsa.gov/medication-assisted-treatment/practitioner-resources/DATA-program-data. Accessed February 22, 2020.
NOTE: On October 17, 2000, Congress passed the Drug Addiction Treatment Act (DATA), which permitted qualified physicians to apply for a waiver to treat narcotic dependence with schedules III, IV, and V controlled narcotic substances that have been approved by the Food and Drug Administration for that use. On July 22, 2016, the Comprehensive Addiction and Recovery Act (CARA) of 2016 became law, expanding the individuals permitted to apply for these waivers to nurse practitioners, physician assistants, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives. Waivers limit practitioners to treating 30, 100, or 275 patients, depending on the practitioner's request and qualifications.
  1. Significance tests were not conducted because the data used to develop this table includes all DATA-waivered practitioners.
  2. Other practitioners encompasses all nonphysician practitioners eligible for DATA waivers (that is, nurse practitioners, physician assistants, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives).

 

Table A.18. Mean Rate of IET-AD for Members of Health Plans Participating in NCQA's State of Health Care Quality Report, 2005-2018a
Calendar Year Initiation of Alcohol and Other Drug Treatment (%) Engagement in Alcohol or Other Drug Treatment (%)
Commercial Medicaid Medicare Commercial Medicaid Medicare
HMO PPO HMO HMO PPO HMO PPO HMO HMO PPO
2018 35.4 36.2 42.8 33.5 33.9 12.2 13.8 14.0 4.5 3.9
2017 36.6 36.7 42.3 33.9 36.1 12.5 14.3 13.5 4.4 3.6
2016 33.5 33.9 40.8 32.7 36.5 11.3 12.9 12.5 3.6 3.4
2015 33.3 34.5 38.2 32.7 35.2 11.8 13.5 10.2 3.2 2.9
2014 34.7 36.1 38.3 32.5 35.1 12.8 14.2 11.3 3.3 3.5
2013 37.6 40.3 38.2 33.7 37.8 13.7 14.8 10.6 3.2 3.5
2012 39.1 41.2 39.4 38.8 43.3 13.6 14.6 10.8 3.1 3.0
2011 40.2 40.6 39.2 41.0 47.6 15.2 16.0 11.9 3.7 3.8
2010 42.7 40.8 42.9 44.6 57.4 15.6 16.0 14.2 3.7 3.8
2009 42.7 46.0 45.6 46.2 57.4 16.1 15.7 12.3 4.6 4.2
2008 42.4 42.6 44.5 45.9 49.1 16.2 16.2 12.4 4.3 9.4
2007 44.5 46.0 45.6 50.3 56.5 15.2 15.2 14.4 4.5 6.3
2006 43.2 49.0 43.3 50.3 50.0 13.8 16.0 11.7 4.5 7.0
2005 44.5 45.8 40.7 50.9 52.3 14.1 15.3 9.7 4.7 3.2
SOURCE: NCQA. State of Health Care Quality Report. Available at https://www.ncqa.org/hedis/measures/initiation-and-engagement-of-alcohol-and-other-drug-abuse-or-dependence-treatment/. Accessed on February 22, 2020.
NOTE: Initiation of Alcohol or Other Drug Abuse or Dependence Treatment measures the percentage of adolescents and adults who within 14 days of a SUD diagnosis initiated treatment in any of the following types of care: inpatient stay, outpatient visit, intensive outpatient or partial hospitalization service, telehealth, or MAT. Engagement in Alcohol or Other Drug Abuse or Dependence Treatment measures the percentage of adolescents and adults who within 34 days of initiating treatment received 2 or more additional alcohol or other drug abuse or dependence treatment services. Specifications for these measures are updated annually. These updates may affect the comparability of estimates across years. Estimates represent the average rate for the reporting health plans. More than 1,000 health plans that voluntarily submitted data are represented in these estimates.
  1. Significance testing was not conducted for these estimates.

 

Table A.19.a. Rate of IET-AD for Medicaid and/or CHIP Beneficiaries, by state, FFY 2018a
State Population Number of Beneficiaries with SUD Diagnoses Initiation (%) Engagement (%)
States reporting ages 18 to 64
   Alabama Medicaid 3,505 39.9 3.8
   Arizona Medicaid, dual eligibles 6,173 57.2 21.0
   California Medicaid 81,814 28.2 5.3
   Delaware Medicaid, dual eligibles 1,137 42.1 15.0
   Illinois Medicaid, CHIP 35,457 32.4 8.9
   Iowa Medicaid 11,388 34.9 20.2
   Louisiana Medicaid, CHIP 12,053 38.6 10.6
   Maryland Medicaid, CHIP 22,834 29.4 18.8
   Massachusetts Medicaid, dual eligibles 15,816 40.9 14.2
   Mississippi Medicaid 1,967 44.0 4.3
   Missouri Medicaid, CHIP 6,014 40.1 11.4
   Nevada Medicaid 4,532 39.2 9.3
   New Hampshire Medicaid 797 38.9 13.8
   New York Medicaid 59,308 41.7 15.8
   North Carolina Medicaid 12,146 38.3 11.7
   Oklahoma Medicaid, dual eligibles 3,219 35.6 5.5
   Oregon Medicaid, dual eligibles 4,358 39.0 14.8
   Pennsylvania Medicaid 20,146 30.8 22.3
   South Carolina Medicaid, CHIP 3,919 35.4 9.4
   South Dakota Medicaid, CHIP, dual eligibles 1,074 38.6 4.4
   Vermont Medicaid, CHIP 2,408 38.3 16.6
   Washington Medicaid, dual eligibles 20,137 27.9 6.4
   West Virginia Medicaid, dual eligibles 7,560 36.9 15.6
   Wisconsin Medicaid 7,084 39.9 14.4
States reporting other age groups
   Connecticut Medicaid, CHIP 13,859 44.7 26.1
   Florida Medicaid 13,262 44.7 4.8
   Kansas Medicaid, dual eligibles 2,258 37.9 8.8
   Kentucky Medicaid, dual eligibles 11,580 37.7 10.3
   New Mexico Medicaid 11,517 37.9 12.3
   Ohio Medicaid, CHIP 31,177 47.4 13.1
   Tennessee Medicaid 8,780 45.3 11.1
   Texas Medicaid 12,062 41.2 6.5
SOURCE: Centers for Medicare & Medicaid Services. Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement/performance-on-the-adult-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020.
NOTE: Initiation of Alcohol and Other Drug Abuse or Dependence Treatment indicates the percentage of adults who within 14 days of a SUD diagnosis initiated treatment in any of the following types of care: inpatient stay, outpatient visit, intensive outpatient or partial hospitalization service, telehealth, or MAT. Engagement in Alcohol or Other Drug Abuse or Dependence Treatment indicates the percentage of adults who within 34 days of initiating treatment received 2 or more additional alcohol or other drug abuse or dependence treatment services. Dual eligibles are individuals enrolled in both the Medicaid and Medicare programs.
  1. Significance testing was not conducted for these estimates.

 

Table A.19.b. Rate of FUA-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018a
State Population Number of Beneficiaries with SUD ED Visit 7-day Follow-up (%) 30-day Follow-up (%)
States reporting ages 21 to 64
   Alabama Medicaid 1,570 9.7 11.4
   Arizona Medicaid 1,912 24.3 31.5
   Arkansas Medicaid, CHIP, dual eligibles 948 3.9 5.2
   California Medicaid 59,217 6.4 10.7
   Delaware Medicaid, dual eligibles 680 10.1 17.4
   Iowa Medicaid 4,448 40.7 44.7
   Louisiana Medicaid, CHIP 8,267 7.4 12.2
   Massachusetts Medicaid 12,943 24.3 33.9
   Minnesota Medicaid, CHIP, dual eligibles 10,728 17.5 28.4
   Mississippi Medicaid 920 5.5 8.2
   Missouri Medicaid, CHIP 4,295 4.7 5.0
   Nebraska Medicaid, CHIP, dual eligibles 664 5.4 9.8
   Nevada Medicaid 4,238 9.2 13.0
   New Hampshire Medicaid 638 22.7 34.6
   New York Medicaid 41,168 21.0 27.5
   Oklahoma Medicaid, dual eligibles 1,901 35.5 43.9
   Pennsylvania Medicaid 17,993 15.3 23.2
   South Carolina Medicaid, CHIP 2,422 8.4 13.3
   Tennessee Medicaid 4,060 3.9 6.1
   Vermont Medicaid, CHIP 1,024 17.9 27.1
   West Virginia Medicaid, dual eligibles 4,057 8.1 15.9
States reporting other age groups
   Connecticut Medicaid 12,049 21.4 31.5
   District of Columbia Medicaid, CHIP, dual eligibles 439 13.7 15.9
   Florida Medicaid 7,797 6.0 8.7
   Hawaii Medicaid, dual eligibles 2,367 13.8 21.7
   Kentucky Medicaid, dual eligibles 10,841 13.2 19.8
   New Mexico Medicaid 9,166 9.4 16.7
   Ohio Medicaid, CHIP 18,235 16.9 24.3
   Rhode Island Medicaid, CHIP 3,228 14.1 21.7
   Texas Medicaid 6,246 3.7 5.9
SOURCE: Centers for Medicare & Medicaid Services. Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement/performance-on-the-adult-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020.
NOTE: The 7-day and 30-day follow-up rates measure the percentage of adults who had an ED visit for an alcohol or other drug use diagnosis with a follow-up visit with a principal diagnosis of alcohol or other drug abuse or dependence within the stated number of days. Dual eligibles are individuals enrolled in both the Medicaid and Medicare programs.
  1. Significance testing was not conducted for these estimates.

 

Table A.20. Continuity of Care for Medicaid Beneficiaries Treated for a SUD Who Received Services in an Inpatient or a Residential Setting in 2017, by Statea
State Number of Beneficiaries with a SUD Who Received Services in an Inpatient or a Residential Setting Received at Least 1 Outpatient or Home or Community-Based SUD Service within 30 Days of Discharge Received More than 1 Outpatient or Home or Community-Based Service within 30 days of Discharge
Number Percentage Number Percentage
Total 1,750,767 424,875 24.3 280,369 16.0
Alabama 25,161 6,063 24.1 2,957 11.8
Alaska 7,696 2,293 29.8 1,537 20.0
Arizona 49,236 14,191 28.8 10,374 21.1
Arkansas 6,582 307 4.7 70 1.1
California 191,981 35,218 18.3 22,458 11.7
Colorado 26,685 3,605 13.5 1,546 5.8
Connecticut 26,811 9,777 36.5 7,251 27.0
Delaware 8,060 3,049 37.8 2,198 27.3
District of Columbia 7,993 1,815 22.7 1,076 13.5
Florida 83,424 12,854 15.4 6,483 7.8
Georgia 37,545 5,211 13.9 2,537 6.8
Hawaii 8,152 1,830 22.4 964 11.8
Idaho 5,357 916 17.1 424 7.9
Illinois 9,069 1,436 15.8 647 7.1
Indiana 46,628 8,840 19.0 5,679 12.2
Iowa 24,171 6,045 25.0 3,856 16.0
Kansas 12,058 2,011 16.7 1,096 9.1
Kentucky 54,497 12,852 23.6 7,337 13.5
Louisiana 20,618 3,482 16.9 2,236 10.8
Maine 3,872 1,376 35.5 1,040 26.9
Maryland 40,681 13,704 33.7 10,500 25.8
Massachusetts 78,810 34,298 43.5 27,076 34.4
Michigan 64,680 5,771 8.9 1,942 3.0
Minnesota 34,987 11,572 33.1 8,099 23.1
Mississippi DQ DQ DQ DQ DQ
Missouri DQ DQ DQ DQ DQ
Montana DQ DQ DQ DQ DQ
Nebraska DQ DQ DQ DQ DQ
Nevada 20,712 5,140 24.8 3,055 14.7
New Hampshire 4,482 1,451 32.4 966 21.6
New Jersey 34,966 8,604 24.6 6,582 18.8
New Mexico 7,479 2,015 26.9 1,197 16.0
New York 176,942 59,995 33.9 45,281 25.6
North Carolina 55,508 9,363 16.9 4,827 8.7
North Dakota 1,800 258 14.3 128 7.1
Ohio 129,417 41,369 32.0 27,988 21.6
Oklahoma 21,632 2,913 13.5 1,309 6.1
Oregon 29,492 10,542 35.7 7,555 25.6
Pennsylvania 108,026 23,154 21.4 14,498 13.4
Puerto Rico 4,714 897 19.0 481 10.2
Rhode Island 3,853 1,593 41.3 1,280 33.2
South Carolina 21,028 3,208 15.3 1,838 8.7
South Dakota 3,895 650 16.7 322 8.3
Tennessee 44,953 9,765 21.7 5,140 11.4
Texas 65,920 10,187 15.5 5,347 8.1
Utah 7,520 1,253 16.7 668 8.9
Vermont 5,424 1,667 30.7 1,070 19.7
Virginia 26,752 3,235 12.1 1,664 6.2
Washington 50,514 16,507 32.7 11,800 23.4
West Virginia 18,614 3,276 17.6 1,927 10.4
Wisconsin 30,363 8,990 29.6 5,888 19.4
Wyoming 2,007 327 16.3 175 8.7
SOURCE: Report to Congress: T-MSIS SUD Data Book, Treatment of SUD in Medicaid 2017, Table F.1.(Based on analysis of the 2017 TAF version 2, Medicaid beneficiaries ages 12 and older who have full or comprehensive benefits.) Available at https://www.medicaid.gov/medicaid/data-and-systems/downloads/macbis/sud-data-book.pdf. Accessed on February 22, 2020.
NOTE: Beneficiaries with a SUD were identified by using National Drug Codes; diagnosis codes; and select procedure, place of service, type of bill, and revenue center codes on Medicaid claims.
  1. Significance testing was not conducted for these estimates.

 

B. MENTAL HEALTH TREATMENT DEMAND AND CAPACITY

Table B.1. Number of Persons with Any Mental Illness or Serious Mental Illness in the Past Year Among Persons Ages 18 and Older, 2008-2018 (in thousands)
  2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Any mental illness
   18 and older 39,826a 41,195a 41,417a 41,381a 43,714a 43,846a 43,553a 43,421a 44,652a 46,632 47,635
      18 to 25 6,099a 6,043a 6,151a 6,356a 6,774a 6,754a 7,014a 7,574a 7,635a 8,849 8,944
      26 to 49 20,697a 21,455a 20,648a 19,936a 20,777a 21,061a 20,007a 20,589a 20,903a 22,256 22,721
      50 and older 13,030a 13,698a 14,618 15,089 16,163 16,031 16,531 15,257 16,114 15,527 15,969
Serious mental illness
   18 and older 8,331a 8,383a 9,334a 9,011a 9,570a 10,018a 9,822a 9,765a 10,360a 11,190 11,373
      18 to 25 1,236a 1,124a 1,334a 1,296a 1,423a 1,468a 1,681a 1,756a 2,035a 2,566 2,619
      26 to 49 4,763a 4,858a 5,132a 4,951a 5,065a 5,193a 4,807a 4,896a 5,279a 5,580 5,907
      50 and older 2,332 2,401 2,868 2,764 3,082 3,356 3,335 3,113 3,047 3,044 2,848
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Numbers for any mental illness are from Table 10.1A, and numbers for any serious mental illness are from Table 10.3A. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020.
NOTE: Any mental illness and serious mental illness align with the criteria in the DSM-IV and were defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental disorder or SUD. Estimates of serious mental illness are a subset of estimates of any mental illness because serious mental illness is limited to persons with any mental illness that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are therefore not direct measures of diagnostic status. NSDUH does not produce estimates of any mental illness or serious mental illness for persons younger than age 18.
  1. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

Table B.2. Percentage of Population with Any Mental Illness or Serious Mental Illness in the Past Year Among Persons Ages 18 and Older, by Age Group, 2008-2018
  2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Any mental illness
   18 and older 17.7a 18.1a 18.1a 17.8a 18.6 18.5 18.1a 17.9a 18.3a 18.9 19.1
      18 to 25 18.5a 18.0a 18.1a 18.5a 19.6a 19.4a 20.1a 21.7a 22.1a 25.8 26.3
      26 to 49 20.7a 21.6 20.9a 20.3a 21.2a 21.5 20.4a 20.9a 21.1a 22.2 22.5
      50 and older 14.1 14.5 15.1 15.0 15.8a 15.3 15.4a 14.0 14.5 13.8 14.0
Serious mental illness
   18 and older 3.7a 3.7a 4.1a 3.9a 4.1a 4.2 4.1a 4.0a 4.2a 4.5 4.6
      18 to 25 3.8a 3.3a 3.9a 3.8a 4.1a 4.2a 4.8a 5.0a 5.9a 7.5 7.7
      26 to 49 4.8a 4.9a 5.2a 5.0a 5.2a 5.3 4.9a 5.0a 5.3a 5.6 5.9
      50 and older 2.5 2.5 3.0 2.8 3.0 3.2a 3.1a 2.8 2.7 2.7 2.5
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Numbers for any mental illness are from Table 10.1B, and numbers for any serious mental illness are from Table 10.3B. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020.
NOTE: Any mental illness and serious mental illness align with the criteria in the DSM-IV and were defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental disorder or SUD. Estimates of serious mental illness are a subset of estimates of any mental illness because serious mental illness is limited to persons with any mental illness that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are therefore not direct measures of diagnostic status. NSDUH does not produce estimates of any mental illness or serious mental illness for persons younger than age 18.
  1. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

Table B.3. Number of Persons with Any Mental Illness or Serious Mental Illness in the Past Year Among Persons Ages 18 and Older, by Insurance Status, 2008-2018 (in thousands)
  2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Any mental illness
   Private 23,775a 24,949a 23,693a 22,565a 23,589a 25,011a 24,456a 24,972a 26,307a 27,933 28,245
   Medicaid/CHIP 5,287a 5,767a 6,084a 6,664a 7,085a 7,282a 8,776a 9,147a 9,845 10,090 10,410
   Medicare or other 8,227a 8,587a 9,815a 9,727a 11,458 10,796 11,620 10,971 10,990 10,845 11,142
   No coverage 7,751a 7,446a 7,863a 8,095a 8,423a 7,725a 6,206a 5,235 4,636a 4,901 5,371
Serious mental illness
   Private 4,502a 4,099a 4,765a 3,967a 4,106a 4,767a 4,656a 5,093a 5,334a 5,813 5,977
   Medicaid/CHIP 1,438a 1,680a 1,694a 2,033a 1,965a 1,988a 2,434a 2,436a 2,831 2,978 2,978
   Medicare or other 1,706a 1,799a 2,204 1,941 2,569 2,499 2,572 2,622 2,226 2,533 2,338
   No coverage 1,678 1,710 1,909a 1,972a 2,290a 2,208a 1,556 1,202a 1,298 1,369 1,524
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for any mental illness are from Table 10.2A, and estimates for serious mental illness are from Table 10.4A. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020.
NOTE: Any mental illness and serious mental illness align with the criteria in the DSM-IV were defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental disorder or SUD. Estimates of serious mental illness are a subset of estimates of any mental illness because serious mental illness is limited to persons with any mental illness that resulted in serious functional impairment. These mental illness estimates are based on a predictive model and are not direct measures of diagnostic status. Insurance status was self-reported. Individuals could report more than 1 type of insurance.
  1. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

Table B.4.a. Number of Persons with a MDE or Suicidal Thoughts in the Past Year, by Age Group, 2008-2018 (in thousands)
  2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Major depressive episode
   12 to 17 2,027a 1,954a 1,911a 2,011a 2,213a 2,587a 2,751a 3,031a 3,089a 3,214a 3,482
   18 and older 14,462a 14,836a 15,556a 15,153a 16,026a 15,670a 15,655a 16,079a 16,225a 17,297 17,720
      18 to 25 2,742a 2,677a 2,796a 2,826a 3,051a 3,007a 3,200a 3,554a 3,705a 4,416 4,609
      26 to 49 7,377 7,546 7,361 7,536 7,370 7,336 6,970a 7,329a 7,236a 7,635 7,990
      50 and older 4,343 4,613 5,400 4,790 5,606 5,327 5,485 5,196 5,284 5,245 5,121
Suicidal thoughts
   12 to 17 NA NA NA NA NA NA NA NA NA NA NA
   18 and older 8,335a 8,467a 8,724a 8,540a 9,031a 9,292a 9,436a 9,767a 9,829a 10,642 10,744
      18 to 25 2,227a 2,027a 2,257a 2,329a 2,489a 2,568a 2,586a 2,878a 3,022a 3,555 3,709
      26 to 49 3,951a 4,290 4,006a 3,587a 4,064a 3,875a 3,953a 4,072a 4,173a 4,292 4,657
      50 and older 2,157 2,150 2,461 2,624 2,478 2,849 2,897 2,817 2,634 2,795 2,379
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for adult MDEs are from Table 10.32A, and estimates for adult suicidal thoughts are from Table 10.36A. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020. Estimates for adolescent MDEs are from Table 11.2A. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect11pe2018.htm. Accessed on February 22, 2020.
NOTE: The definition used for MDE is consistent with the DSM-V. Individuals were defined as having a past-year MDE if in the past 12 months they reported at least 5 or more of the following 9 symptoms nearly every day (except where noted) in the same 2-week period, and at least 1 of the symptoms was a depressed mood or loss of interest or pleasure in daily activities: (1) depressed mood most of the day; (2) markedly diminished interest or pleasure in all or almost all activities most of the day; (3) significant weight loss when not dieting, or weight gain, or decrease or increase in appetite; (4) insomnia or hypersomnia; (5) psychomotor agitation or retardation; (6) fatigue or loss of energy; (7) feelings of worthlessness; (8) diminished ability to think or concentrate, or indecisiveness; and (9) recurrent thoughts of death or recurrent suicide ideation. Recurrent thoughts of death or suicidal ideation did not need to occur nearly every day. Consistent with the DSM-V criteria, the NSDUH does not exclude MDEs that occurred exclusively in the context of bereavement. Respondents were classified as having suicidal thoughts based on self-reporting of suicidal thoughts in the past 12 months.
  1. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

Table B.4.b. Percentage of Population with a MDE or Suicidal Thoughts in the Past Year, by Age Group, 2008-2018
  2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Major depressive episode
   12 to 17 8.3a 8.1a 8.0a 8.2a 9.1a 10.7a 11.4a 12.5a 12.8a 13.3a 14.4
   18 and older 6.5a 6.6a 6.8 6.6a 6.9 6.7a 6.6a 6.7a 6.7a 7.1 7.2
      18 to 25 8.4a 8.0a 8.3a 8.3a 8.9a 8.7a 9.3a 10.3a 10.9a 13.1 13.8
      26 to 49 7.4 7.6 7.5 7.7 7.6 7.6 7.2a 7.5 7.4a 7.7 8.0
      50 and older 4.8 4.9 5.6a 4.8 5.5a 5.1 5.2 4.8 4.8 4.7 4.5
Suicidal thoughts
   12 to 17 NA NA NA NA NA NA NA NA NA NA NA
   18 and older 3.7a 3.7a 3.8a 3.7a 3.9a 3.9a 3.9a 4.0 4.0 4.3 4.3
      18 to 25 6.8a 6.1a 6.7a 6.8a 7.2a 7.4a 7.5a 8.3a 8.8a 10.5 11.0
      26 to 49 4.0a 4.3 4.1a 3.7a 4.2 4.0a 4.0a 4.1a 4.2 4.3 4.7
      50 and older 2.3 2.3 2.6 2.6 2.4 2.7a 2.7a 2.6 2.4 2.5 2.1
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for adult MDEs are from Table 10.32B. Estimates for adult suicidal thoughts are from Table 10.36B. Both are available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020. Estimates for adolescent MDEs are from Table 11.2B. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect11pe2018.htm. Accessed on February 22, 2020.
NOTE: The definition used for MDE is consistent with the DSM-V. Individuals were defined as having had a past-year MDE if in the past 12 months they reported at least 5 or more of the following 9 symptoms nearly every day (except where noted) in the same 2-week period, and at least 1 of the symptoms was a depressed mood or loss of interest or pleasure in daily activities: (1) depressed mood most of the day; (2) markedly diminished interest or pleasure in all or almost all activities most of the day; (3) significant weight loss when not dieting, or weight gain, or decrease or increase in appetite; (4) insomnia or hypersomnia; (5) psychomotor agitation or retardation; (6) fatigue or loss of energy; (7) feelings of worthlessness; (8) diminished ability to think or concentrate, or indecisiveness; and (9) recurrent thoughts of death or recurrent suicide ideation. Recurrent thoughts of death or suicidal ideation did not need to occur nearly every day. Consistent with the DSM-V criteria, the NSDUH does not exclude MDEs that occurred exclusively in the context of bereavement. Respondents were classified as having suicidal thoughts based on self-reporting of these thoughts in the past 12 months.
  1. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

Table B.5. Number of Persons Receiving Any MH Services in the Past Year, by Age and Insurance Status, 2008-2018 (in thousands)
  2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Adults 18 and older
Age group
   18 and older 30,201a 30,341a 31,490a 31,642a 34,122a 34,644a 35,498a 34,243a 34,982a 36,416 37,101
      18 to 25 3,612a 3,740a 3,717a 3,899a 4,120a 4,221a 4,135a 4,044a 4,423a 5,073 5,120
      26 to 49 14,030a 14,481a 14,627a 14,543a 14,811a 15,101a 14,930a 15,057a 15,154a 15,695 16,113
      50 and older 12,559a 12,120a 13,146a 13,200a 15,191 15,322 16,432 15,142 15,404 15,647 15,868
Insurance status
   Private 20,564a 19,691a 20,324a 19,879a 21,618a 22,294a 22,033a 22,805a 22,660a 23,813 24,849
   Medicaid/CHIP 4,036a 4,520a 4,567a 5,133a 4,936a 5,510a 6,717 6,288 7,295 7,597a 6,834
   Medicare or other 7,811a 7,384a 8,079a 8,128a 9,604 9,452 11,296 10,186 9,866 10,027 10,363
   No coverage 3,102a 3,307a 3,540a 3,334a 3,906a 3,747a 2,842a 1,787 1,816 1,916 1,985
Adolescents 12 to 17
   Specialty services 3,129a 2,925a 2,920a 3,101a 3,118a 3,341a 3,369a 3,253a 3,598a 3,646a 3,901
   Nonspecialty services NA 3,430a 3,465a 3,463a 3,649a 3,634a 3,736 3,691a 3,732a 3,810 3,977
SOURCE: NSDUH, 2008-2018. Estimates for adult MH services by age group are from Table 10.7A. Estimates for adult MH services by insurance status are from Table 10.8A. Both are available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020. Estimates for adolescent MDEs are from Table 11.1A. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect11pe2018.htm. Accessed on February 22, 2020.
NOTE: Specialty MH settings include outpatient, inpatient, or residential MH settings. The outpatient settings include: (1) private therapists, psychologists, psychiatrists, social workers, or counselors; (2) MH clinics or centers; (3) partial day hospitals or day treatment programs; and (4) In-home therapists, counselors, or family preservation workers. The inpatient settings include: (1) hospitals; and (2) residential treatment centers. Adolescents were defined as having received specialty MH services if they reported receiving treatment or counseling in any of these settings for emotional or behavioral problems. Nonspecialty settings include the education, general medical, juvenile justice, and child welfare settings.
  1. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

Table B.6. Number of Clients Receiving Specialty MH Treatment in the Past Year, by State and Service Setting, in 2014, 2016, and 2018a
State Total
(across other columns)
Outpatient
(1-month count)
Residential
(1-day count)
Inpatient
(1-day count)
2014 2016 2018 2014 2016 2018 2014 2016 2018 2014 2016 2018
Total 3,971,758 4,332,881 4,125,284 3,801,558 4,161,697 3,937,407 68,849 65,324 58,762 101,351 105,860 129,115
Alabama 59,743 60,595 59,887 57,014 57,607 57,167 1,613 1,166 1,070 1,116 1,822 1,650
Alaska 11,991 16,556 11,132 11,214 15,128 10,359 534 451 487 243 977 286
Arizona 122,249 135,147 145,182 119,373 131,688 135,673 1,478 1,646 1,468 1,398 1,813 8,041
Arkansas 67,449 61,641 65,279 65,034 59,852 62,516 1,249 599 1,307 1,166 1,190 1,456
California 248,474 270,009 246,757 230,332 256,013 228,138 4,824 6,407 5,462 13,318 7,589 13,157
Colorado 68,144 72,927 91,810 65,914 68,328 84,241 1,008 1,170 987 1,222 3,429 6,582
Connecticut 76,959 68,673 66,870 74,167 66,111 61,865 1,099 1,296 2,898 1,693 1,266 2,107
Delaware 8,028 10,056 8,597 7,511 5,285 8,149 124 120 71 393 4,651 377
District of Columbia 17,158 15,558 14,564 16,408 15,118 14,202 300 0 12 450 440 350
Florida 160,192 183,368 228,525 150,254 175,463 210,619 3,988 2,681 2,914 5,950 5,224 14,992
Georgia 69,620 178,142 77,784 67,016 174,875 74,591 1,197 1,215 1,187 1,407 2,052 2,006
Hawaii 11,333 7,187 5,374 10,626 6,739 4,938 386 223 92 321 225 344
Idaho 38,651 188,084 24,382 37,938 187,521 23,923 251 150 107 462 413 352
Illinois 130,408 113,605 111,463 123,905 106,952 105,732 2,538 2,338 1,769 3,965 4,315 3,962
Indiana 81,509 106,911 119,948 76,191 102,546 116,067 1,933 2,238 1,801 3,385 2,127 2,080
Iowa 55,307 46,729 52,721 53,613 45,367 51,371 1,023 740 587 671 622 763
Kansas 44,581 48,217 52,601 41,953 43,720 50,654 1,635 1,364 825 993 3,133 1,122
Kentucky 66,968 53,638 68,818 64,725 50,941 66,124 1,127 1,135 1,371 1,116 1,562 1,323
Louisiana 38,762 40,483 42,046 36,666 38,163 35,892 125 241 265 1,971 2,079 5,889
Maine 40,966 39,407 27,922 39,991 37,899 27,104 564 1,095 396 411 413 422
Maryland 94,155 94,620 73,089 90,264 91,489 70,528 1,831 1,326 953 2,060 1,805 1,608
Massachusetts 145,551 144,486 144,052 140,889 138,531 139,916 2,257 2,344 1,888 2,405 3,611 2,248
Michigan 158,326 198,900 162,966 154,441 193,776 158,692 1,444 2,344 1,295 2,441 2,780 2,979
Minnesota 80,624 82,006 62,254 77,978 79,692 59,307 1,201 1,207 1,637 1,445 1,107 1,310
Mississippi 44,301 53,726 56,225 41,810 51,153 53,980 1,139 1,226 1,093 1,352 1,347 1,152
Missouri 72,812 80,934 86,374 68,087 76,601 79,834 1,663 1,410 1,477 3,062 2,923 5,063
Montana 17,155 18,386 14,584 15,482 16,676 13,564 787 736 444 886 974 576
Nebraska 22,742 32,058 28,557 21,540 31,050 27,424 570 522 534 632 486 599
Nevada 15,536 16,928 21,695 14,746 16,094 20,945 64 159 191 726 675 559
New Hampshire 23,410 22,262 19,692 22,609 21,531 19,091 493 416 324 308 315 277
New Jersey 92,646 82,110 76,697 87,564 77,149 71,774 1,585 1,258 1,172 3,497 3,703 3,751
New Mexico 19,005 20,422 24,107 17,942 19,297 23,151 472 660 286 591 465 670
New York 352,232 334,794 319,034 336,171 323,683 306,696 6,517 3,815 4,032 9,544 7,296 8,306
North Carolina 56,141 63,149 71,346 52,427 59,019 67,732 1,312 1,108 987 2,402 3,022 2,627
North Dakota 8,239 12,664 12,902 7,936 11,798 12,440 187 368 169 116 498 293
Ohio 245,426 260,754 288,731 240,595 255,945 283,238 2,384 1,805 2,123 2,447 3,004 3,370
Oklahoma 36,974 46,692 46,404 34,826 45,273 45,226 694 564 334 1,454 855 844
Oregon 42,396 47,397 59,703 39,895 44,969 57,700 1,613 1,395 937 888 1,033 1,066
Pennsylvania 228,208 206,337 225,921 220,380 198,249 218,826 2,852 2,666 2,517 4,976 5,422 4,578
Puerto Rico 0 22,498 39,987 0 21,551 38,930 0 523 327 0 424 730
Rhode Island 25,893 20,097 20,348 25,040 19,397 19,606 368 291 304 485 409 438
South Carolina 61,011 50,321 65,799 59,015 48,358 63,938 722 798 510 1,274 1,165 1,351
South Dakota 13,538 10,053 15,813 12,900 9,545 15,272 533 398 372 105 110 169
Tennessee 120,380 121,734 126,870 116,958 117,993 123,392 1,649 1,877 1,585 1,773 1,864 1,893
Texas 122,741 128,313 126,091 114,300 118,795 116,659 2,750 2,578 2,281 5,691 6,940 7,151
Utah 28,931 33,523 45,479 27,239 30,796 43,583 1,112 1,125 984 580 1,602 912
Vermont 16,696 20,918 16,231 15,997 20,302 15,732 545 346 306 154 270 193
Virginia 82,156 89,970 82,561 78,748 84,494 77,988 1,327 2,447 1,792 2,081 3,029 2,781
Washington 101,368 112,603 112,867 98,253 110,465 109,864 1,272 1,173 1,120 1,843 965 1,883
West Virginia 41,278 26,573 31,440 40,100 24,964 29,985 360 751 633 818 858 822
Wisconsin 121,558 144,136 113,697 118,974 141,715 111,454 1,071 1,159 825 1,513 1,262 1,418
Wyoming 11,907 14,804 10,151 11,444 14,342 9,685 276 230 254 187 232 212
U.S. territories 49,930 1,780 1,955 47,163 1,689 1,930 803 24 0 1,964 67 25
SOURCE: N-MHSS, 2014, 2016, and 2018.
NOTE: Counts include clients who received services at the MH treatment facilities that responded to the survey. Surveyed facilities included the following types of facilities: (1) psychiatric hospitals; (2) general hospitals with a separate inpatient psychiatric unit; (3) Veterans Affairs medical centers; (4) partial hospitalization or day treatment MH facilities; (5) outpatient MH facilities; (6) residential treatment centers for children; (7) residential treatment centers for adults; (8) multi-setting MH facilities; (9) community MH centers; and (10) other types of outpatient, residential, and inpatient treatment facilities that provide programs focused on the treatment of mental illness. Estimates were not adjusted for survey nonresponse. The survey response rates were 88%, 91%, and 90% in 2014, 2016, and 2018, respectively.
  1. Significance tests were not conducted for these estimates because N-MHSS surveys the universe of specialty MH facilities.

 

Table B.7. Number of Residential and Inpatient Beds Designated for MH Treatment and Utilization Rates, by State, in 2014, 2016, and 2018a
  Number of Designated Beds Utilization Rate
Residential Inpatient Hospital Residential Inpatient Hospital
2014 2016 2018 2014 2016 2018 2014 2016 2018 2014 2016 2018
Total 76,280 67,560 62,253 106,236 106,486 109,241 90.3 96.7 94.4 95.4 99.4 118.2
Alabama 1,781 1,097 1,344 1,442 1,716 1,429 90.6 106.3 79.6 77.4 106.2 115.5
Alaska 583 496 569 278 310 342 91.6 90.9 85.6 87.4 315.2 83.6
Arizona 1,627 1,667 1,625 1,651 1,817 1,958 90.8 98.7 90.3 84.7 99.8 410.7
Arkansas 1,292 646 1,481 1,344 1,543 1,746 96.7 92.7 88.3 86.8 77.1 83.4
California 5,467 6,275 6,331 9,086 8,516 10,993 88.2 102.1 86.3 146.6 89.1 119.7
Colorado 1,075 1,072 901 1,217 1,149 1,447 93.8 109.1 109.5 100.4 298.4 454.9
Connecticut 1,127 1,145 1,005 1,530 1,330 1,462 97.5 113.2 288.4 110.7 95.2 144.1
Delaware 130 124 37 430 469 421 95.4 96.8 191.9 91.4 991.7 89.5
District of Columbia 249 0 12 490 518 391 120.5 0.0 100.0 91.8 84.9 89.5
Florida 4,176 2,935 3,255 6,745 6,238 6,227 95.5 91.3 89.5 88.2 83.7 240.8
Georgia 1,231 1,208 1,282 1,918 2,492 2,076 97.2 100.6 92.6 73.4 82.3 96.6
Hawaii 749 403 113 381 361 386 51.5 55.3 81.4 84.3 62.3 89.1
Idaho 375 312 226 580 560 451 66.9 48.1 47.3 79.7 73.8 78.0
Illinois 2,215 2,045 2,044 4,361 4,743 4,467 114.6 114.3 86.5 90.9 91.0 88.7
Indiana 2,156 2,243 1,803 2,818 2,818 2,680 89.7 99.8 99.9 120.1 75.5 77.6
Iowa 1,217 902 772 814 657 817 84.1 82.0 76.0 82.4 94.7 93.4
Kansas 2,721 1,617 946 1,156 1,409 1,228 60.1 84.4 87.2 85.9 222.4 91.4
Kentucky 1,160 1,524 1,304 1,665 2,040 1,832 97.2 74.5 105.1 67.0 76.6 72.2
Louisiana 126 243 282 2,204 2,380 2,862 99.2 99.2 94.0 89.4 87.4 205.8
Maine 681 537 431 537 475 486 82.8 203.9 91.9 76.5 86.9 86.8
Maryland 1,717 1,614 1,117 2,293 2,065 2,087 106.6 82.2 85.3 89.8 87.4 77.0
Massachusetts 2,424 2,364 2,049 2,463 3,147 2,271 93.1 99.2 92.1 97.6 114.7 99.0
Michigan 1,500 1,754 1,357 2,652 2,650 2,734 96.3 133.6 95.4 92.0 104.9 109.0
Minnesota 1,570 1,338 1,779 1,347 1,198 1,017 76.5 90.2 92.0 107.3 92.4 128.8
Mississippi 1,136 1,303 680 1,651 1,624 1,555 100.3 94.1 160.7 81.9 82.9 74.1
Missouri 1,783 1,601 1,623 3,606 3,508 5,254 93.3 88.1 91.0 84.9 83.3 96.4
Montana 667 713 638 390 501 738 118.0 103.2 69.6 227.2 194.4 78.0
Nebraska 613 523 668 797 532 771 93.0 99.8 79.9 79.3 91.4 77.7
Nevada 76 234 246 663 866 760 84.2 67.9 77.6 109.5 77.9 73.6
New Hampshire 624 497 354 398 369 315 79.0 83.7 91.5 77.4 85.4 87.9
New Jersey 1,556 1,367 1,239 3,856 3,942 3,599 101.9 92.0 94.6 90.7 93.9 104.2
New Mexico 525 584 402 787 668 728 89.9 113.0 71.1 75.1 69.6 92.0
New York 7,002 4,321 3,784 10,906 8,399 7,909 93.1 88.3 106.6 87.5 86.9 105.0
North Carolina 1,544 1,276 1,127 2,651 2,715 3,015 85.0 86.8 87.6 90.6 111.3 87.1
North Dakota 154 410 173 199 547 334 121.4 89.8 97.7 58.3 91.0 87.7
Ohio 2,402 2,102 1,843 2,938 3,484 3,108 99.3 85.9 115.2 83.3 86.2 108.4
Oklahoma 811 619 416 1,747 1,187 1,060 85.6 91.1 80.3 83.2 72.0 79.6
Oregon 1,753 1,279 1,087 964 1,080 1,136 92.0 109.1 86.2 92.1 95.6 93.8
Pennsylvania 3,290 2,930 2,950 5,650 5,680 5,111 86.7 91.0 85.3 88.1 95.5 89.6
Puerto Rico NA 608 372 NA 561 756 NA 86.0 87.9 NA 75.6 96.6
Rhode Island 350 334 328 545 483 352 105.1 87.1 92.7 89.0 84.7 124.4
South Carolina 916 806 548 1,440 1,348 1,578 78.8 99.0 93.1 88.5 86.4 85.6
South Dakota 548 349 375 136 136 192 97.3 114.0 99.2 77.2 80.9 88.0
Tennessee 1,873 2,150 1,917 2,239 2,393 2,400 88.0 87.3 82.7 79.2 77.9 78.9
Texas 3,077 2,816 2,822 6,310 7,148 7,868 89.4 91.5 80.8 90.2 97.1 90.9
Utah 1,559 1,394 1,286 750 1,127 880 71.3 80.7 76.5 77.3 142.1 103.6
Vermont 568 405 358 169 161 221 96.0 85.4 85.5 91.1 167.7 87.3
Virginia 1,650 2,077 1,923 2,570 3,299 2,749 80.4 117.8 93.2 81.0 91.8 101.2
Washington 1,192 1,061 1,160 1,922 989 2,072 106.7 110.6 96.6 95.9 97.6 90.9
West Virginia 593 680 640 931 1,040 1,095 60.7 110.4 98.9 87.9 82.5 75.1
Wisconsin 1,594 1,237 824 1,218 1,679 1,491 67.2 93.7 100.1 124.2 75.2 95.1
Wyoming 309 299 405 214 323 336 89.3 76.9 62.7 87.4 71.8 63.1

U.S. territories

766 24 0 1,187 96 48 104.8 100.0 0.0 165.5 69.8 52.1
SOURCE: N-MHSS 2014, 2016, and 2018.
NOTE: The utilization rate was calculated by dividing the number of clients in care on a particular day, as assessed by the survey, by the total number of designated beds. Estimates were not adjusted for survey nonresponse. The survey response rates were 88%, 91%, and 90% in 2014, 2016, and 2018, respectively.
  1. Significance tests were not conducted for these estimates because N-MHSS surveys the universe of specialty MH facilities.

 

Table B.8. MH Quality MeasureS from NCQA's State of Health Care Quality Report, 2018
(average percentage of applicable health plan beneficiaries)a
  Commercial Medicaid Medicare
HMO PPO HMO HMO PPO
Diabetes monitoring for people with both schizophrenia and diabetesb NA NA 70.5 NA NA
Cardiovascular disease monitoring for people with both schizophrenia and cardiovascular diseasec NA NA 76.9 NA NA
AMM-ADd
   Effective acute phase treatment 69.2 69.2 53.5 72.3 74.6
   Effective continuation phase treatment 52.9 53.7 37.9 56.3 60.1
Follow-Up After Hospitalization for Mental Illnesse
   Follow-up within 7-days post-discharge 45.6 43.0 35.8 27.7 27.3
   Follow-up within 30-days post-discharge 66.6 64.9 56.8 48.1 49.2
SAA-ADf NA NA 59.8 NA NA
Follow-up after ED visit for mental illnessg
   Follow-up within 7-days post-ED visit 45.6 44.6 40.3 32.2 29.3
   Follow-up within 30-days post-ED visit 60.1 59.5 54.8 48.5 44.5
Follow-up care for children prescribed medication for ADHDh
   Follow-up care after initiation of treatment 40.6 39.6 44.2 NA NA
   Follow-up care during continuation and maintenance of treatment 49.7 46.8 54.6 NA NA
Metabolic monitoring of children and adolescents on antipsychoticsi 37.2 33.1 35.3 NA NA
Use of first-line psychosocial care for children and adolescents on antipsychoticsj 55.4 54.9 57.6 NA NA
SOURCE: NCQA�s State of Health Care Quality Report. Available at https://www.ncqa.org/report-cards/health-plans/state-of-health-care-quality-report/. Accessed January 2, 2020.
  1. Significance testing was not conducted for these estimates.
  2. Percentage with both an LDL-C test and an HbA1c test during the measurement year.
  3. Percentage with LDL-C test during the measurement year.
  4. Effective acute phase treatment indicates the percentage of adults on antidepressant medication who remained on the medication for at least 12 weeks. Effective continuation phase treatment indicates the percentage of adults on antidepressant medications who remained on the medications for at least 6 months.
  5. Percentage of adults and children ages 6 and older who were hospitalized for treatment of mental illness or intentional self-harm who had a follow-up outpatient or intensive outpatient treatment service visit with a MH practitioner within the specified number of days following discharge.
  6. Percentage of adults ages 19-64 with a schizophrenia diagnosis who were dispensed and remained on an antipsychotic medication for at least 80% of their treatment period.
  7. Percentage of ED visits for adults and children ages 6 and older with a mental illness diagnosis who had a follow-up visit for mental illness within the specified number of days following discharge.
  8. For the initiation phase, the percentage of children between ages 6 and 12 who were diagnosed with ADHD and who had a follow-up visit with a practitioner who can prescribe within 30 days of their first prescription for ADHD medication. For the continuation and maintenance phase, the percentage of children between ages 6 and 12 who had a prescription for ADHD medication, remained on the medication for at least 210 days, and had at least 2 follow-up visits with the practitioner in the 9 months after the initial prescription.
  9. Percentage of children and adolescents taking antipsychotic medication on an ongoing basis for whom metabolic testing was conducted during the year.
  10. Percentage of children and adolescents with an initial prescription for antipsychotic medication for whom documentation indicated psychosocial care was provided as the first line of treatment.

 

Table B.9.a. Rate of AMM-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018a
State Population Denominator Acute Phase Treatment Continuation Phase Treatment
States reporting ages 18 to 64
Alabama Medicaid 4,135 45.4 31.0
California Medicaid 1,693 46.7 26.1
Delaware Medicaid, dual eligibles 26 47.9 33.4
Illinois Medicaid, CHIP 618 41.7 23.1
Iowa Medicaid 2 29.6 21.4
Louisiana Medicaid, CHIP 128 52.3 38.4
Massachusetts Medicaid, dual eligibles 1,060 50.3 35.6
Michigan Medicaid 14 47.0 27.0
Minnesota Medicaid, dual eligibles 26,872 53.0 38.7
Mississippi Medicaid 4,686 37.3 21.5
Missouri Medicaid, CHIP 89 43.7 26.7
New Hampshire Medicaid 1,270 57.1 41.0
New York Medicaid 1,267 52.0 37.6
North Carolina Medicaid 22,854 46.5 31.2
South Carolina Medicaid, CHIP 8,448 40.6 25.5
Vermont Medicaid, CHIP 3,472 73.5 59.3
Washington Medicaid 24,766 51.6 35.9
West Virginia Medicaid, dual eligibles 19 57.3 39.9
Wisconsin Medicaid 10,523 62.0 45.9
States reporting ages 18 and older
Connecticut Medicaid, CHIP 13,524 61.3 44.6
District of Columbia Medicaid, CHIP, dual eligibles 1,489 52.7 36.3
Florida Medicaid 22,671 52.6 37.2
Hawaii Medicaid, dual eligibles 3,734 50.3 34.5
Kansas Medicaid, dual eligibles 5,023 50.7 33.8
Kentucky Medicaid, dual eligibles 29,102 52.9 38.6
New Mexico Medicaid 12,307 48.7 33.2
Ohio Medicaid, CHIP 52,508 49.7 34.0
Pennsylvania Medicaid 42,840 51.4 37.1
Rhode Island Medicaid, CHIP 6,047 50.8 36.2
Tennessee Medicaid 25,351 47.1 30.6
Texas Medicaid 25,711 49.6 34.8
Utah Medicaid, dual eligibles 472 47.2 29.2
Virginia Medicaid, CHIP NR 50.2 35.2
SOURCE: Centers for Medicare & Medicaid Services, Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement/performance-on-the-adult-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020.
NOTES: This measure identifies the percentage of adults age 18 and older diagnosed with major depression who were treated with antidepressant medication and remained on antidepressant medication treatment for the 12-week acute phase and the 6-month continuation phase. Dual eligibles are individuals enrolled in both the Medicaid and Medicare programs.
  1. Significance testing was not conducted for these estimates.

 

Table B.9.b. FUH-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018a
  Population Denominator 7-day Follow-up 30-day Follow-up
States reporting ages 21 to 64
Alabama Medicaid 4,361 38.5 55.3
Arizona Medicaid 8,352 41.4 61.7
Arkansas Medicaid, CHIP, dual eligibles 2,474 31.7 53.3
California Medicaid 27,690 54.4 67.0
Delaware Medicaid, dual eligibles 1,206 30.5 47.3
District of Columbia Medicaid, CHIP, dual eligibles 3,005 57.6 73.3
Georgia Medicaid 8,131 31.9 51.5
Illinois Medicaid, CHIP 24,055 26.4 42.5
Iowa Medicaid 4,676 32.8 59.8
Louisiana Medicaid, CHIP 13,879 17.3 39.3
Maryland Medicaid, CHIP 4,898 38.4 60.3
Massachusetts Medicaid, dual eligibles 8,975 52.7 74.0
Michigan Medicaid 13,590 43.8 65.6
Minnesota Medicaid, CHIP, dual eligibles 9,937 35.0 62.9
Mississippi Medicaid 5,795 33.6 59.4
Missouri Medicaid, CHIP 9,228 22.7 37.9
Nebraska Medicaid, CHIP, dual eligibles 2,336 47.4 72.5
New Hampshire Medicaid 1,633 53.6 71.7
New York Medicaid 31,105 44.7 61.4
North Carolina Medicaid 12,886 25.4 46.1
Oklahoma Medicaid, dual eligibles 3,521 18.9 39.5
Oregon Medicaid, dual eligibles 2,583 85.3 NR
Pennsylvania Medicaid 30,453 34.9 56.0
South Carolina Medicaid, CHIP 1,880 29.0 52.4
South Dakota Medicaid, CHIP, dual eligibles 614 32.6 56.8
Vermont Medicaid, CHIP, dual eligibles 1,305 51.0 69.8
Washington Medicaid, dual eligibles 6,238 66.5 82.1
West Virginia Medicaid, dual eligibles 3,847 10.0 33.7
Wisconsin Medicaid 6,225 42.7 66.2
Wyoming Medicaid, dual eligibles 128 39.8 57.8
States reporting other ages
Connecticut Medicaid 8,049 51.0 70.4
Florida Medicaid 39,041 30.5 51.1
Hawaii Medicaid, dual eligibles 1,371 38.4 55.4
Kansas Medicaid 5,031 59.0 76.5
Kentucky Medicaid, dual eligibles 10,509 34.3 56.6
Nevada Medicaid 4,896 32.7 49.8
New Jersey Medicaid, CHIP 695 15.5 32.4
New Mexico Medicaid 5,981 38.0 61.6
Ohio Medicaid, CHIP 26,635 44.0 65.3
Rhode Island Medicaid, CHIP 3,690 55.4 74.9
Tennessee Medicaid 13,261 35.1 57.2
Texas Medicaid 15,457 20.7 38.9
Utah Medicaid, dual eligibles 1,416 61.3 75.9
SOURCE: Centers for Medicare & Medicaid Services, Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement/performance-on-the-adult-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020.
NOTES: Percentage of discharges for adults ages 21 and older who were hospitalized for treatment of selected mental illness diagnoses who received a follow-up visit with a MH practitioner within 7 days and 30 days after discharge. Dual eligibles are individuals enrolled in both the Medicaid and Medicare programs.
  1. Significance testing was not conducted for these estimates.

 

Table B.9.c. SAA-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018a
State Population Denominator Rate
Alabama Medicaid 1,606 53.9
Arkansas Medicaid, CHIP, dual eligibles 2,485 57.2
California Medicaid 56,934 56.7
Connecticut Medicaid, CHIP 4,446 68.1
Delaware Medicaid, CHIP 463 52.7
District of Columbia Medicaid, CHIP, dual eligibles 304 40.1
Florida Medicaid 15,711 62.7
Hawaii Medicaid 1,118 65.9
Illinois Medicaid, CHIP 9,772 54.7
Iowa Medicaid 929 37.5
Kentucky Medicaid, dual eligibles 4,386 58.2
Louisiana Medicaid, CHIP 9,533 47.4
Massachusetts Medicaid 6,010 68.5
Michigan Medicaid 14,307 59.1
Mississippi Medicaid 3,288 57.4
Missouri Medicaid, CHIP 7,532 64.9
Nebraska Medicaid, CHIP, dual eligibles 981 54.4
Nevada Medicaid 1,614 40.1
New Hampshire Medicaid 428 79.7
New Mexico Medicaid 2,912 54.3
New York Medicaid 38,429 63.1
North Carolina Medicaid 10,212 57.7
Ohio Medicaid, CHIP 11,617 54.4
Pennsylvania Medicaid 15,369 69.0
Rhode Island Medicaid 1,333 66.2
South Carolina Medicaid, CHIP 3,186 58.0
Tennessee Medicaid 8,205 59.6
Texas Medicaid 21,366 55.8
Utah Medicaid 121 57.0
Vermont Medicaid, CHIP 284 79.2
Virginia Medicaid, CHIP NR 67.0
Washington Medicaid 3,677 64.2
West Virginia Medicaid, dual eligibles 1,965 47.1
SOURCE: Centers for Medicare & Medicaid Services, Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement-performance-on-the-adult-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020.
NOTE: This measure identifies the percentage of adults ages 19-64 with schizophrenia who were dispensed and remained on an antipsychotic medication for at least 80% of their treatment period during the measurement year. Dual eligibles are individuals enrolled in both the Medicaid and Medicare programs.
  1. Significance testing was not conducted for these estimates.

 

Table B.9.d. SSD-AD for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018a
State Population Denominator Rate
Alabama Medicaid 7,103 77.1
Arkansas Medicaid, CHIP, dual eligibles 4,618 76.9
California Medicaid 89,764 75.3
Connecticut Medicaid, CHIP 10,263 79.0
Delaware Medicaid, CHIP 1,543 71.4
District of Columbia Medicaid, CHIP, dual eligibles 859 69.0
Florida Medicaid 23,697 80.8
Hawaii Medicaid 3,320 72.1
Illinois Medicaid, CHIP 17,664 91.5
Iowa Medicaid 2,075 80.8
Kentucky Medicaid, dual eligibles 12,013 83.1
Louisiana Medicaid, CHIP 18,462 82.5
Massachusetts Medicaid 14,552 80.6
Michigan Medicaid 31,164 79.9
Mississippi Medicaid 4,374 70.8
Missouri Medicaid, CHIP 14,294 84.3
Nevada Medicaid 3,781 79.4
New Hampshire Medicaid 905 81.9
New Mexico Medicaid 6,369 76.9
New York Medicaid 60,518 79.6
North Carolina Medicaid 19,177 76.3
Ohio Medicaid, CHIP 29,641 80.2
Pennsylvania Medicaid 15,568 88.1
Rhode Island Medicaid, CHIP 3,118 79.6
South Carolina Medicaid, CHIP 4,834 72.5
Tennessee Medicaid 17,344 83.5
Texas Medicaid 31,941 80.9
Utah Medicaid 203 90.1
Vermont Medicaid, CHIP 882 77.8
Virginia Medicaid, CHIP NR 82.2
Washington Medicaid 8,724 85.2
West Virginia Medicaid, dual eligibles 6,605 81.5
SOURCE: Centers for Medicare & Medicaid Services, Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement/performance-on-the-adult-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020.
NOTES: This measure identifies the percentage of adults ages 18-64 with schizophrenia or bipolar disorder who were dispensed an antipsychotic medication and who were screened for diabetes during the measurement year. Dual eligibles are individuals enrolled in both the Medicaid and Medicare programs.
  1. Significance testing was not conducted for these estimates.

 

Table B.9.e. Percentage of Children Ages 6-20 Hospitalized for Treatment of Mental Illness Who Received a FUH-CH for Medicaid and/or CHIP Beneficiaries, by State, FFY 2018a
State Population Denominator 7-day Follow-up 30-day Follow-up
Alabama Medicaid 4,054 45.9 68.6
Alabama CHIP 285 34.7 56.8
Alaska Medicaid, CHIP 410 10.0 31.2
Arizona Medicaid 4,358 61.2 77.7
Arkansas Medicaid, CHIP 6,109 45.5 69.0
California Medicaid, CHIP 13,826 67.8 80.4
Connecticut Medicaid, CHIP 2,721 62.7 79.6
Delaware Medicaid, CHIP 104 36.5 48.1
District of Columbia Medicaid, CHIP 570 48.8 74.2
Florida Medicaid, CHIP 40,165 30.6 51.2
Georgia Medicaid, CHIP 6,585 38.3 64.7
Hawaii Medicaid, CHIP 1,371 38.4 55.4
Illinois Medicaid, CHIP 12,138 48.4 68.0
Indiana Medicaid, CHIP 3,989 50.7 73.8
Iowa Medicaid 3,763 40.6 67.5
Iowa CHIP 384 50.5 82.6
Kansas Medicaid, CHIP 5,031 59.0 76.5
Kentucky Medicaid, CHIP 10,509 34.3 56.6
Louisiana Medicaid, CHIP 6,076 40.3 63.0
Maine Medicaid, CHIP 1,153 50.1 76.7
Massachusetts Medicaid, CHIP 2,219 57.0 78.5
Michigan Medicaid 4,202 55.0 74.5
Minnesota Medicaid, CHIP 4,330 44.7 70.3
Mississippi CHIP 268 37.7 66.0
Missouri Medicaid, CHIP 4,203 34.5 56.4
Montana CHIP 137 57.7 77.4
Nebraska Medicaid, CHIP 1,506 29.7 63.9
Nevada Medicaid 4,896 32.7 49.8
Nevada CHIP 73 58.9 72.6
New Hampshire Medicaid, CHIP 764 61.1 78.0
New Jersey Medicaid, CHIP 695 15.5 32.4
New Mexico Medicaid, CHIP 5,981 38.0 61.6
New York Medicaid, CHIP 6,620 70.4 85.1
North Carolina CHIP 425 39.3 63.5
Ohio Medicaid, CHIP 26,635 44.0 65.3
Oklahoma Medicaid, CHIP 6,058 27.2 51.2
Oregon Medicaid, CHIP 474 81.4 NR
Pennsylvania Medicaid, CHIP 11,944 51.3 74.2
Rhode Island Medicaid, CHIP 3,690 55.4 74.9
South Carolina Medicaid, CHIP 1,297 42.2 62.3
South Dakota Medicaid, CHIP 1,071 23.3 42.7
Tennessee Medicaid 13,261 35.1 57.2
Tennessee CHIP 277 49.1 71.8
Texas Medicaid 23,239 33.6 56.5
Texas CHIP 1,379 34.7 55.6
Utah Medicaid 1,416 61.3 75.9
Utah CHIP 58 32.8 46.6
Vermont Medicaid, CHIP 299 59.2 79.6
Virginia Medicaid NR 52.9 66.7
West Virginia Medicaid 2,211 9.7 39.6
West Virginia CHIP 93 21.5 55.9
Wyoming Medicaid 398 53.3 76.4
Wyoming CHIP 18 * *
SOURCE: Centers for Medicare & Medicaid Services, Performance on the Adult Core Set Measures, as reported by the states. Available at https://www.medicaid.gov/medicaid/quality-of-care/downloads/performance-measurement/performance-on-the-child-core-set-measures-ffy-2018.zip. Accessed on February 22, 2020.
NOTES: This measure identifies the percentage of children ages 6 to 20 hospitalized for treatment of selected mental illness diagnoses who received a follow-up visit with a MH practitioner within 7 days and 30 days after discharge. Dual eligibles = individuals enrolled in both the Medicaid and Medicare programs.
  1. Significance testing was not conducted for these estimates.

* Rate not reported because denominator is less than 30.

 

C. CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT DEMAND AND CAPACITY

Table C.1. Mean Hourly Wage for Occupations Providing Behavioral Health Treatment, 2008-2018 (in dollars)a
Occupation 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
All occupations 20.32 20.90 21.35 21.74 22.01 22.33 22.71 23.23 23.86 24.34 24.98
Substance abuse and behavioral disorder counselora 19.07 19.43 19.62 19.73 19.67 19.75 20.13 20.64 21.23 22.38b 23.04b
MH counselora 19.36 20.05 19.88 20.48 20.81 21.01 21.15 21.67 22.14
MH and substance abuse social worker 19.05 19.88 20.13 20.50 20.84 21.36 22.03 22.69 23.02 22.99 23.86
Marriage and family therapist 22.56 23.57 22.85 23.42 23.69 24.85 24.87 25.73 26.00 25.89 26.03
Psychiatrist 74.06 78.68 80.58 83.73 85.35 87.82 87.84 93.12 93.63 103.89 105.95
Psychiatric technician 15.48 14.77 15.15 15.08 15.93 16.09 16.91 17.44 14.89 17.34 18.15
Psychiatric aide 13.10 13.19 12.84 13.11 12.83 12.98 13.67 13.55 12.85 14.10 14.95
Clinical, counseling, and school psychologist 33.74 34.77 34.87 35.14 34.72 34.96 35.59 36.56 37.83 39.10 41.03
Industrial-organizational psychologist 41.57 49.31 54.82 59.69 47.50 42.29 43.30 44.38 39.79 49.29 52.42
Psychologist, all other 43.49 40.49 41.59 41.27 41.53 42.50 43.18 44.73 46.02 44.92 45.97
SOURCE: Bureau of Labor Statistics, Occupational Employment Statistics for May 2008-2018. Available at https://www.bls.gov/oes/tables.htm. Accessed on February 22, 2020.
NOTE: The OES is a semiannual survey that assesses occupational employment and wage rates for wage and salary workers in nonfarm establishments in the United States. The OES survey draws its sample from state unemployment insurance files.
  1. Significance testing was not conducted for these estimates.
  2. The occupations for substance abuse and behavioral disorder counselor versus MH counselor were reported separately from 2008 to 2016 but together in 2017 and 2018.

 

Table C.2. Total Employment for Occupations Providing Behavioral Health Treatment, 2008-2018a
Occupation 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Substance abuse and behavioral disorder counselora 79,180 78,470 77,940 76,600 80,130 83,120 85,180 87,090 91,040 241,930b 267,730b
MH counselora 104,650 106,920 110,300 114,180 115,080 115,580 120,010 128,200 139,820
MH and substance abuse social worker 131,010 127,140 119,960 115,390 109,920 110,010 109,460 110,070 114,040 112,040 116,750
Marriage and family therapist 24,520 26,450 33,050 33,990 34,270 29,060 30,150 32,070 36,960 42,880 48,520
Psychiatrist 22,140 22,210 22,690 23,140 24,210 25,040 25,080 24,060 24,820 25,250 25,630
Psychiatric technician 54,800 70,730 72,650 69,840 67,760 66,760 64,540 58,450 61,720 66,930 71,360
Psychiatric aide 59,050 62,610 64,730 71,570 77,880 75,340 72,860 69,550 67,410 65,770 56,910
Clinical, counseling, and school psychologist 97,880 98,330 100,700 100,850 103,590 104,480 104,730 105,600 107,980 108,060 110,490
Industrial-organizational psychologist 1,460 1,710 1,420 1,230 1,030 1,040 1,110 990 1,020 920 780
Psychologist, all other 9,870 10,260 10,690 10,580 10,350 10,870 11,980 12,400 13,310 12,880 13,480
SOURCE: Bureau of Labor Statistics, Occupational Employment Statistics for May 2008-2018. Available at https://www.bls.gov/oes/tables.htm. Accessed on February 22, 2020.
NOTE: The OES is a semiannual survey that measures occupational employment and wage rates for wage and salary workers in nonfarm establishments in the United States. The OES survey draws its sample from state unemployment insurance files. The estimated total employment was rounded to the nearest 10 and excluded self-employed workers.
  1. Significance testing was not conducted for these estimates.
  2. The occupations for substance abuse and behavioral disorder counselor versus MH counselor were reported separately from 2008 to 2016 but together in 2017 and 2018.

 

Table C.3. Number and Percentage of Persons with Both a MDE in the Past Year and Either Marijuana Use in the Past Year or Alcohol Use in the Past Month Among Persons Ages 12-17, 2008-2018
  2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018
Number (in thousands)
MDE in past year 2,027a 1,954a 1,911a 2,011a 2,213a 2,587a 2,751a 3,031a 3,089a 3,214a 3,482
MDE and marijuana use 485a 472a 481a 523a 547a 664a 664a 675a 751a 724a 878
MDE and alcohol use 509 473 460a 482 503 490 556 524 508 524 558
MDE and binge alcohol use NA NA NA NA NA NA NA 288 268 293 295
Percentage of persons age 12 to 17 with an MDE
MDE and marijuana use 23.9 24.2 25.2 26.0 24.7 25.7 24.1 22.3 24.3 22.5 25.2
MDE and alcohol use 25.1 24.2 24.1 24.0 22.7 18.9 20.2 17.3 16.4 16.3 16.0
MDE and binge alcohol use NA NA NA NA NA NA NA 9.5 8.7 9.1 8.5
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for the number of persons ages 12-17 with an MDE are from Table 11.2A. Estimates for number of persons age 12-17 with MDE and marijuana, alcohol, or binge alcohol use are from Table 11.6A. Percentages for each year and substance use category were calculated by dividing the number of persons with MDE and the use of each substance by the total number with MDE in the past year. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect11pe2018.htm. Accessed February 21, 2020.
NOTE: The definition used for MDE is consistent with the DSM-V. Individuals were defined as having had a past-year MDE if in the past 12 months they reported at least 5 or more of the following 9 symptoms nearly every day (except where noted) in the same 2-week period, and at least 1 of the symptoms was a depressed mood or loss of interest or pleasure in daily activities: (1) depressed mood most of the day; (2) markedly diminished interest or pleasure in all or almost all activities most of the day; (3) significant weight loss when not dieting, or weight gain, or decrease or increase in appetite; (4) insomnia or hypersomnia; (5) psychomotor agitation or retardation; (6) fatigue or loss of energy; (7) feelings of worthlessness; (8) diminished ability to think or concentrate, or indecisiveness; and (9) recurrent thoughts of death or recurrent suicide ideation. Recurrent thoughts of death or suicidal ideation did not need to occur nearly every day. Consistent with the DSM-V criteria, the NSDUH does not exclude MDEs that occurred exclusively in the context of bereavement. Binge use of alcohol was defined for females as drinking 4 or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) and for males as drinking 5 or more drinks on the same occasion.
  1. The difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

Table C.4. Number and Percentage of Persons with Mental Illness and a SUD in the Past Year Among Persons Age 18 and Older, by Age Group, 2015-2018
Category Any Mental Illness Serious Mental Illness
2015 2016 2017 2018 2015 2016 2017 2018
Mental illness (number in thousands)
Total 43,421a 44,652a 46,632 47,635 9,765a 10,360a 11,190 11,373
   18 to 25 7,574a 7,635a 8,849 8,944 1,756a 2,035a 2,566 2,619
   26 to 49 20,589a 20,903a 22,256 22,721 4,896a 5,279a 5,580 5,907
   50 and older 15,257 16,114 15,527 15,969 3,113 3,047 3,044 2,848
SUD and mental illness (number in thousands)
Total 8,069a 8,249a 8,526 9,187 2,323a 2,627a 3,092 3,166
   18 to 25 2,060a 2,123a 2,376 2,447 593a 711a 947 879
   26 to 49 4,285a 4,462a 4,369a 5,020 1,307a 1,421a 1,584 1,726
   50 and older 1,725 1,663 1,782 1,720 422 496 562 560
Percentage of those with mental illness who have a SUD
Total 18.6 18.5 18.3 19.3 23.8 25.4 27.6 27.8
   18 to 25 27.2 27.8 26.9 27.4 33.8 34.9 36.9 33.6
   26 to 49 20.8 21.3 19.6 22.1 26.7 26.9 28.4 29.2
   50 and older 11.3 10.3 11.5 10.8 13.6 16.3 18.5 19.7
SOURCE: Estimates from 2018 NSDUH Detailed Tables, Center for Behavioral Health Statistics and Quality, 2019. Estimates for any mental illness are from Table 10.1A and for serious mental illness are from Table 10.3A. Estimates for any mental illness and a SUD and for serious mental illness and a SUD are from Table 10.6A. Percentages were calculated by dividing the number with a SUD and mental illness by the total number with mental illness for each year and age group. Available at https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetTabsSect10pe2018.htm. Accessed on February 22, 2020.
NOTE: Any mental illness and serious mental illness aligned with the criteria of the DSM-IV were defined as having a diagnosable mental, behavioral, or emotional disorder, other than a developmental disorder or SUD. Estimates of serious mental illness are a subset of estimates of any mental illness because serious mental illness is limited to persons with any mental illness that resulted in serious functional impairment. These mental illness estimates were based on a predictive model and thus were not direct measures of diagnostic status.
  1. For the number with mental illness and the number with a SUD and mental illness, the difference between this estimate and the 2018 estimate is statistically significant at the 0.05 level.

 

D. DESCRIPTION OF DATA SOURCES

This appendix briefly describes the five data sources that we used to develop the analyses in this report.

1. National Survey of Substance Abuse Treatment Services (N-SSATS)

The N-SSATS is an important source for analyzing trends in clients who are receiving specialty substance use disorder (SUD) treatment as well as trends in SUD treatment facility characteristics. It is an annual survey of the universe of specialty SUD treatment facilities. Counts of clients in care (on the last working day in March of each survey year) were collected annually through 2013 and biannually thereafter. Key strengths of the survey include its comprehensiveness in terms of the inclusion of facilities and the types of information collected. The N-SSATS, which includes all known specialty SUD treatment facilities in the United States, consistently achieves response rates greater than 90 percent and there is no adjustment for the roughly 10 percent of facilities that do not respond. This allows for detailed analysis of small states or subgroups.

However, N-SSATS data are limited in several ways. Specifically, the N-SSATS excludes nonspecialty providers, solo practitioners, and facilities that serve only criminal justice populations. The exclusion of solo practitioners might be particularly important to analysis of programs such as those implementing hub-and-spoke models, which seek to increase treatment access at nonspecialty providers. The exclusion of facilities that serve only criminal justice populations might limit the potential for analyzing programs for people exiting criminal justice institutions; however, many of these people might be served by facilities included in the N-SSATS. The N-SSATS does include information on whether facilities have programs that focus on criminal justice clients (excluding programs for those convicted of driving under the influence or driving while intoxicated).

The N-SSATS estimates presented in this report were directly extracted from N-SSATS reports and special tabulations.

2. National Mental Health Services Survey (N-MHSS)

The N-MHSS is an annual census of facilities that provide mental health services. This survey collects information on the characteristics of the facilities in the U.S. mental health treatment delivery system and is an important source of data, as it is the only national and state-level survey of public and private facilities that provide mental health services. The data collected by the N-MHSS covers several topics including: what services facilities are providing, the characteristics of the facilities providing services, and the types of clients receiving services. These data allow for comparisons in service availability and utilization across states, facility characteristics, and client characteristics.

The major limitation of the N-MHSS is that it is a survey for a certain point in time, instead of representing annual totals. The survey is for a reference date and provides information based on the mental health treatment delivery system around that time. Additionally, the survey typically achieves responses rates around 90% and there is no adjustment for the roughly 10% of facilities that do not respond.

3. National Survey on Drug Use and Health (NSDUH)

The NSDUH is designed to track the prevalence of SUDs in the United States by type of substance. The NSDUH is an annual survey of the civilian, noninstitutionalized population ages 12 and older in the United States. As a population survey, it provides the most comprehensive information about the number of people who met the diagnostic criteria for a SUD, who misused prescription opioids, and who accessed any SUD treatment service in the past year. The NSDUH includes a sufficient sample of respondents to develop state-level estimates when two years of survey data are combined; however, standard errors for estimates are often quite large for smaller states--which makes it impossible to identify small changes in a disorder's prevalence or treatment use.

There are a number of limitations to the NSDUH survey data. The NSDUH provides limited information on the type of substance use treatment services that respondents received and no information on the intensity of services received. The survey excludes people who are homeless and not in a shelter as well as those who are institutionalized, such as those residing in hospitals, residential treatment settings, jails, or prisons. However, the NSDUH includes individuals who have been released from prison or institutional care. Overall, estimates of the prevalence of alcohol and illicit drug use disorders based on the NSDUH reflect the household population only. Thus, the NSDUH is likely to understate national prevalence because groups with high prevalence are excluded. In addition to the exclusion of subpopulations that have a higher prevalence of SUDs (Office of Applied Studies 2002), the self-reported nature of the data collection likely results in some underreporting (Harrell 1997).

Substance Abuse and Mental Health Services Administration (SAMHSA) redesigned the NSDUH between the 2014 and 2015 surveys. Due to methodological changes associated with the redesign, estimates from 2015 and later years are not comparable to earlier years. Updates to the prescription drug questions were a key component of the redesign (CHBSQ 2015):

  • Beginning in 2015, questions about prescription drugs were restructured to collect more information on the use and misuse of specific prescription drugs. The definition of misuse was also changed, with respondents being given more specific examples of misuse. In particular, before 2015, the definition of misuse did not include overuse of prescribed medication.

  • Methamphetamine was included as a prescription stimulant before 2015. However, most methamphetamine that is used in the United States is manufactured illegally, not prescribed. Therefore, beginning in 2015, a new methamphetamine module was added to address both prescription and nonprescription use.

  • To help respondents categorize substances, the term "Molly" was added to questions about Ecstasy use in the hallucinogens module and the use of felt tip pens and computer keyboard cleaner were added to the inhalants' module.

The redesign also affected the abuse and dependence modules in the following key ways:

  • The logic for routing individuals to the substance abuse and dependence modules was updated.

  • Sedative withdrawal was updated to require two or more symptoms of withdrawal instead of one or more.

  • Dependence and abuse questions were added for methamphetamine.

The NSDUH estimates presented in this report were directly extracted from NSDUH reports prepared by SAMHSA or from summarized data presented in those reports.

4. Treatment Episode Data Set (TEDS)

Relative to the N-SSATS and the NSDUH, the TEDS provides more detailed information on treatment services and the characteristics of clients at admission and discharge. The TEDS aggregates admissions data collected in individual state administrative data systems. States collect these data to monitor their SUD treatment systems. Reporting requirements can vary substantially by state. Generally, facilities that receive public funds or that are licensed or certified by a state substance abuse agency are included in state administrative systems. The universe of their admissions is reported to the TEDS. The scope of facilities that report to the TEDS in each state may change over time.

5. Transformed Medicaid Statistical Information System (T-MSIS) SUD Data Book

The SUD Data Book is a report to Congress that provides useful information related to the prevalence and treatment of SUDs in state Medicaid populations. The SUD Data Book focuses on Medicaid and Children�s Health Insurance Program (CHIP) enrollees age 12 or older who have been diagnosed with a SUD. It includes information on enrollment categories; the types of SUD treatment services received; the setting where services were received; the payment models for services received; the utilization of services; and whether treatments in inpatient or residential settings were followed up in an outpatient, home-based, or community-based setting within 30 days of discharge.

The data in the SUD Data Book comes from the T-MSIS Analytic Files (TAF), which are constructed from monthly data reported by state Medicaid programs to the Centers for Medicare & Medicaid Services on Medicaid and CHIP enrollments, service utilization, payments, providers, and other information. The TAF, and therefore the SUD Data Book, have limitations due to the newness of the T-MSIS reporting system and data quality issues. The quality of the SUD Data Book is expected to improve over time as the T-MSIS reporting improves.

 


Analyses of Disability, Aging and Long-Term Care Policy and Data

These reports summarize results from BHDAP work examining recent trends in mental health (MH) and substance use disorder (SUD) treatment needs, unmet needs, and system capacity to provide treatment. The reports synthesize data from a variety of existing sources including the National Mental Health Services Survey (N-MHSS), the National Survey of Substance Abuse Treatment Services (N-SSATS), the Treatment Episode Data Set (TEDS), and quality measurement data submitted to the Centers for Medicaid & Medicare Services. Overall, results indicate increasing numbers of individuals with unmet need for MH treatment, very high utilization rates for inpatient and residential MH treatment, and low rates of follow-up for individuals after hospitalization for mental illness. Taken together, these findings suggest that the MH treatment system may not have sufficient capacity to treat current rates of treatment need. The reports also highlight recent increases in the delivery of SUD treatment provided in private doctor’s offices and specialty outpatient settings, and the delivery of medication assisted treatment. Analyses also suggest that SUD prevalence rates have declined among adolescents and young adults, while rates have remained constant, or increased, among adults aged 26 or older. However, rates of unmet need for SUD treatment also remain very high.

Reports were prepared under contract #HHSP233201600021I between the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Behavioral Health, Disability, and Aging Policy (BHDAP) and Mathematica.  For additional information about this subject, you can visit the BHDAP home page at https://aspe.hhs.gov/bhdap or contact the ASPE Project Officers at HHS/ASPE/BHDAP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201; Judith.Dey@hhs.gov, Laura.Jacobus-Kantor@hhs.gov, Helen.Lamont@hhs.gov.

Reports Available

Has Treatment for Substance Use Disorders Increased? Issue Brief

Chartbook on Behavioral Health Treatment Demand and Provider Capacity in the United States

Mental Health Treatment Need and Treatment System Capacity Issue Brief

Age Group Differences in Progress toward Reducing Substance Use Disorders, 2015-2018 Issue Brief


To obtain a printed copy of these reports, send the full report title and your mailing information to:

U.S. Department of Health and Human Services
Office of Behavioral Health, Disability, and Aging Policy
Room 424E, H.H. Humphrey Building
200 Independence Avenue, S.W.
Washington, D.C. 20201
FAX:  202-401-7733