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The National Survey on Drug Use and Health (NSDUH) generates state-level estimates for 23 measures of substance use and mental health problems for four age groups: the entire state population over the age of 12 (12+); individuals age 12 to 17; individuals age 18 to 25; and individuals age 26 and older (26+). Since state estimates of substance use and abuse were first generated using the combined 2002-2003 NSDUHs and continuing until the most recent state estimates based on the combined 2005-2006 surveys, rates of past month use of any illicit drug and past month alcohol use have fluctuated.
Abuse and Dependance
Questions in NSDUH are used to classify persons as being dependent on or abusing specific substances based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (American Psychiatric Association, 1994).
Rates of past year alcohol abuse or dependence have generally exceeded the national rates and have been among the highest in the country for both the State population as a whole and for adolescents age 12 to 17 (Chart 1).
Conversely, rates of past year abuse of or dependence on illicit drugs have generally remained at or below national rates (Chart 2).
Substance Abuse Treatment Facilities
According to the annual National Survey of Substance Abuse Treatment Services (N SSATS),3 the number of treatment facilities in Wyoming has changed little between 2002 and 2006. Of the 57 facilities responding to the 2006 survey, 33 (58%) were private nonprofit, and an additional 11 facilities were private for-profit. Although facilities may offer more than one modality of care, in the most recent survey the majority of facilities (44 of 57, or 77%) offered some form of outpatient care. A total of 16 facilities (28%) offered residential care. Two programs and 13 physicians are certified to provide buprenorphine treatment for opiate addiction. A total of 44 of all facilities (77%) receive some form of Federal, State, county, or local government funds, and 23 facilities (40%) have agreements or contracts with managed care organizations for the provision of substance abuse treatment services.
State treatment data for substance use disorders are derived from two primary sources�''an annual one-day census in N-SSATS and annual treatment admissions from the Treatment Episode Data Set (TEDS).4 With all facilities responding to the 2006 N-SSATS survey, Wyoming showed a total of 3,246 clients in treatment, the majority of whom 2,894 (89%) were in outpatient treatment. Of the total number of clients in treatment on this date, 676 (21%) were under the age of 18. Chart 3 shows the percentage of admissions mentioning particular drugs or alcohol at the time of admission.5 Across the last 15 years, there has been a decline in the number of admissions mentioning alcohol and a concomitant increase in the number of admissions mentioning marijuana and methamphetamine.
Across the years for which TEDS data are available, Wyoming has seen a modest shift in the constellation of problems present at treatment admission. Alcohol-only admissions have declined from over 58 percent of all admissions in 1992 to just over 37 percent in 2005. Concomitantly, drug-only admissions have increased from 4 percent in 1998 to 39 percent in 2005 (Chart 4)
Unmet Need For Treatment
NSDUH defines unmet treatment need as an individual who meets the criteria for abuse of or dependence on illicit drugs or alcohol according to the DSM-IV, but who has not received specialty treatment for that problem in the past year. While the rates of unmet need for treatment for drug use have generally been at or below the national rates for all age groups in Wyoming (Chart 5), the rates of unmet need for treatment of alcohol use have consistently been above the national average (Chart 6). This is particularly true for adolescents age 12 to 17 where the rates of unmet need for alcohol treatment have consistently been among the highest in the country.