SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Admissions to Substance Abuse Treatment for the Abuse of Opioid Analgesics: Findings from the Treatment Episode Data Set Deborah Trunzo Office of Applied Studies Substance Abuse and Mental Health Services Administration November 13, 2008

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Treatment Episode Data Set (TEDS) Client-level information on treatment admissions Collected by States and reported to SAMHSA Primarily from facilities receiving public funds Estimated coverage – 80% 1.8 million admissions annually 2

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 TEDS Data Elements Demographic variables Drug use history –top 3 substances of abuse at admission –route of administration –frequency of use –age at first use Treatment variables 3

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Limitations of TEDS Drugs of abuse reported in “generic” categories, not specific brand names or formulations All States report on “opiates other than heroin” as a group Only 16 States report on specific opioid analgesics – 4

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Treatment Admissions by Primary Substance: 2006 * Includes admissions where primary substance was reported as Other opiates/synthetics. Excludes admissions for non- prescription use of methadone. N = 1.8 million 5

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Treatment Admissions Involving Opioid Analgesics Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone. OxyContin introduced 6

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Percent Increase in Admissions for Heroin and Opioid Analgesics 1 : Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone. 7

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Admissions Involving Specific Opioid Analgesics 1 : 2006 Oxycodone15,300 Codeine1,200 Hydrocodone900 Hydromorphone800 Propoxyphene162 Meperidine80 Pentazocine30 Tramadol50 Other opiates or synthetics33,100 1 Data submitted by 16 States: AL, HI, ID, KY, MD, ME, MO, MS, ND, NH, NJ, NM, NV, NY, OH, SD 8

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone. States Reporting Specific Opioid Analgesics:

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Percent Increase in Admissions for Specific Opioid Analgesics 1 : Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone. Analysis restricted to 13 States that reported detailed drug codes for 2000 and

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone. Proportion of Opioid Analgesic 1 Admissions by State: % < 5% 5% No data 6-7%> 16% 11

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Opioid Analgesic 1 Treatment Admission Rates by Urbanization: 2000 and Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone. MSA = Metropolitan Statistical Area 12

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Percent of Primary and Secondary Opioid Analgesic Admissions Using Other Substances:

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Treatment Admissions Involving Opioid Analgesics 1 by Age and Route of Administration: Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone. Age Oral Inhaled Injected Other 14

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Treatment Admissions Involving Oxycodone 1 by Age and Route of Administration: Includes admissions where primary, secondary, or tertiary substance was reported as Oxycodone. Age Oral Injected Inhaled Other 15

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Characteristics of Opioid Analgesic 1 Admissions 1997 and Male56%57% White (non-Hispanic)83%88% Less than 20 years of age 20 to 29 years 30 years or more 5% 16% 79% 11% 37% 52% New users (3 yrs use or less)20%28% Oral Injected Inhaled 78% 14% 3% 74% 10% 13% 1 Includes admissions where primary, secondary, or tertiary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone. 16

SOURCE: Treatment Episode Data Set (TEDS) 2005SOURCE: Treatment Episode Data Set (TEDS) 2005 Admissions for Primary Opioid Analgesics 1 by Age of First Use: and under * Includes admissions where primary substance was reported as Other opiates/synthetics. Excludes admissions for non-prescription use of methadone. 17