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 age 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, Alaska has ranked among the 10 States with the highest rates of the following measures (Table 1):

Abuse and Dependance

Questions in NSDUH are used to classify persons as being dependent on or abusing specific substances based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) (American Psychiatric Association, 1994).

Across all survey years, Alaska has been among the 10 States with the highest rates of past year illicit drug dependence for the State population age 12 and older, as well as for adolescents age 12 to 17. For the remaining age groups, rates on this measure have remained above the national rate.

Rates of alcohol abuse and/or dependence in Alaska have been more variable than those for illicit drugs. For example, in 2005–2006 those individuals 12 and older, 12 to 17, and 26 and older showed rates of past year alcohol dependence among the highest in the country. The rate for the 18 to 25 age group was among the 10 lowest in the country.

Substance Abuse Treatment Facilities

According to the National Survey of Substance Abuse Treatment Services (N-SSATS),3 in 2006 there were 70 treatment facilities in Alaska. Of these, 39 (56%) were private nonprofit facilities, and another 5 were private for-profit. In addition to private facilities, in 2006 Alaska had 13 facilities owned/operated by tribal governments, and 10 facilities that offered treatment in American Indian/Alaska Native languages.

The number of treatment facilities in Alaska has decreased from 87 in 2002 to 70 in 2006. This decrease is primarily seen in the number of private nonprofit facilities that declined from 58 in 2002 to 39 in 2006.

Although facilities may offer more than one modality of care, 57 of 70 facilities (81%) in Alaska in 2006 offered some form of outpatient treatment. Twenty-six facilities offered some form of residential care, and three facilities offered methadone treatment. In addition, 21 physicians and 2 treatment programs are certified to provide buprenorphine treatment for opiate addiction.

In 2006, 80 percent of all facilities (56) received some form of Federal, State, county, or local government funds; also, 16 facilities (23%) had agreements or contracts with managed care organizations for the provision of substance abuse treatment services.

Treatment

State treatment data for substance use disorders are derived from two primary sources: an annual one-day census in N-SSATS and annual treatment admissions from the Treatment Episode Data Set (TEDS).4 In the 2006 N-SSATS survey, Alaska showed a one-day census of 2,683 clients in treatment, 2,355 of whom (88%) were in outpatient treatment. Of the total number of clients in treatment on this date, 310 (11%) were under the age of 18.

Chart 2 shows the percentage of admissions mentioning particular drugs or alcohol at the time of admission.

Across the last 12 years, there has been relative stability in the number of substances of abuse mentioned at treatment admission (Chart 3).

Across the years for which TEDS data are available, Alaska has generally maintained similar proportions of admissions for alcohol only, drugs only, and the combination of alcohol and drugs (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.

Rates of unmet need for treatment for drug use have remained among the highest in the country for the Alaska population age 12 and older as well as for the population age 26 and older (Chart 5). Rates on this measure for the remaining age groups have also been at or above the national rates.

Rates of individuals needing and not receiving treatment for alcohol use, however, have been generally at or below the national rates (Chart 6).